Used needles being returned to a needle exchange point in St. Petersburg, Russia.

© 2007 Lorena Ros

In many countries around the world, drug control efforts result in serious human rights abuses - torture and ill-treatment by police, extrajudicial killings, arbitrary detention, and denial of essential medicines and basic health services. UN drug control agencies have paid little attention to whether international drug control efforts are consistent with human rights protections, or to the effect of drug control policies on fundamental human rights.

Human Rights Watch has been documenting human rights abuses linked to drug enforcement laws, policies and practices for more than a decade. In our investigations, we have found that some governments have justified a wide range of serious human rights abuses in the name of fighting a "war on drugs."

1. Deadly Drug Penalties

2. Locked Up for Treatment

3. Violent Abuse by Police

4. Deprived of Treatment

5. Incarceration and Treatment in Prison

6. Access to Controlled Medicines

7. Human Rights Watch Reports

8. Drug Policy and Human Rights - International Perspectives

1. Deadly Drug Penalties

Governments have routinely killed people to implement drug enforcement policies.

This was most dramatically illustrated in Thailand in 2003, when the Thai government's efforts to make the country "drug free" led to the extrajudicial killing of some 2800 people.

The death penalty for drug offenses is a violation of international human rights law. But more than 30 UN member states retain the death penalty for drug law offenses, including some that require the death penalty as a mandatory sentence. Each year since 1990, China has marked the UN's International Day against Drug Abuse and Illicit Trafficking with show trials in which drug users are sentenced to death and publicly executed.

2. Locked Up for Treatment

In many countries, people who are identified as drug users are consigned for extended periods of time to locked "treatment facilities," where they are detained without trial; held in prison conditions that put them at risk of HIV, Hepatitis C, and TB, and forced to do unpaid labor; and subjected to experimental techniques, solitary confinement, mandatory HIV testing, and in some cases, physical and psychological abuse in the name of "drug treatment."

Human Rights Watch has documented:

  • In China: Forced expulsion of injection drug users and people living with HIV and AIDS from home towns, and arrest and forced treatment of suspected drug users without due process. Those arrested for drug possession and use can be consigned to forced detoxification centers without trial. Once inside, detainees are required to perform unpaid, forced labor and are subject to mandatory HIV testing without access to treatment, and to militarized psychological and moral education.
  • In Thailand: Detention of suspected drug offenders without trial, extractions of false or forced confessions, and incarceration of injection drug users with no access to HIV prevention services and limited access to HIV treatment.
  • In Russia: Detention of suspected drug offenders without trial, and incarceration of drug users in prison environments posing high HIV risk.

3. Violent Abuse by Police

People who use drugs are routinely subjected to violence during arrest and detention, in some cases to extract confessions.

Law enforcement in many countries has relied on tactics amounting to inhuman treatment or in some cases to torture, including forcing suspects to suffer withdrawal to extract confessions and extorting money from them. Human Rights Watch has documented:

  • In Kazakhstan: Physical violence by police, including beatings with fists and with wooden clubs, to coerce confessions from drug users; psychological pressure on drug users' relatives to prevent drug users' future arrest; and breach of fair trial standards (including false or forced confessions) during trials of suspected drug offenders.
  • In Canada: Physical violence by police, including beatings of drug users in handcuffs and illegal search and seizure of suspected drug offenders.
  • In Ukraine: Physical and psychological abuse by police against suspected drug users, including coercion of testimony from drug users in withdrawal; severe beatings, electroshock, partial suffocation with gas masks, and threats of rape.
  • In Thailand: Violence, including beatings, against suspected drug users by police.
  • In Bangladesh: Violence and extortion against suspected drug users by police and thugs.
  • In Russia: Denial of medical assistance to drug users in withdrawal and use of withdrawal symptoms as a tool to coerce testimony or extort money from drug users.

4. Deprived of Treatment

Drug control efforts undermine lifesaving health services, including HIV prevention and treatment and drug dependence treatment.

Laws proscribing syringe possession and associated policing practices targeting drug users increase the risk of HIV and other adverse health consequences. In some countries, many people who inject drugs do not carry sterile syringes or other injecting equipment, even though it is legal to do so, because possession of such equipment can mark an individual as a drug user and expose him or her to punishment on other grounds. Police presence at or near government sanctioned harm reduction programs (such as legal needle exchange sites) drives drug users away from these services out of fear of arrest or other punishment. Methadone or buprenophine - the most effective treatment for opioid dependence - is barred by law or policy in many jurisdictions. Many prisons combine the failure to treat drug dependence with harsh disciplinary measures for drug use and possession.

Human Rights Watch has documented:

  • In Russia: Russia is suffering an explosive HIV epidemic, largely among injection drug users. Yet methadone and buprenorphine are illegal, despite their proven effectiveness as critical to HIV prevention and treatment for injection drug users. Drug users also face restrictions on general health information and services, including a lack of access to anti-retroviral treatment for HIV and prison health services.
  • In the United States: Drug dependent prisoners in New York State with repeated disciplinary charges for drug use can be - and are - sentenced to solitary confinement for years without treatment.
  • In Russia: Restrictions on general health information and services, including access to ARV treatment and prison health services, for injection drug users.
  • Arbitrary restrictions on needle exchange programs, including banning needle exchange and/or allowing police to interfere with legal needle exchange, in Thailand, Russia, Ukraine, US, Bangladesh, Kazakhstan and Canada.
  • In Ukraine, Russia, and Thailand: Restrictions on access to substitution therapy, to ARV treatment and prison health services, for injection drug users.

5. Incarceration and Treatment in Prisons

People incarcerated for drug offenses account for a substantial percentage of prisoners in many countries throughout the world.

Those incarcerated are often the most marginalized - small time dealers, low level drug offenders, and overwhelmingly, people who use drugs.

  • In the United States, the "war on drugs" falls disproportionately on African Americans. Although white Americans commit more drug offenses, African Americans are sent to prison at 10 times the rate of whites. HRW has documented racial disparities among drug offenders sent to prison and automatic exclusion from public housing of people with criminal records, including drug users.
  • Many prisons combine the failure to treat drug dependence with harsh disciplinary measures for drug use and possession. In New York, effective drug dependence treatment and harm reduction services are unavailable to many prisoners; and drug dependent prisoners face harsh punishment - including solitary confinement for years - that bars them from treatment as part of the disciplinary sanction.

6. Access to Controlled Medicines

Unnecessarily strict narcotic drug control laws, policies, and practices in many countries also severely restrict access to controlled medicines for therapeutic purposes, thus undermining the right to health and to be free from cruel, inhuman and degrading treatment or punishment for millions of people who need narcotic drugs to treat pain or drug dependence.

Human Rights Watch has documented how the international community's strong focus on cracking down on illicit drug use has led many countries to neglect their obligation to ensure that people can benefit from the crucial medicinal qualities of narcotic drugs.

7. Reports


"Deadly Denial: Barriers to HIV/AIDS Treatment for People Who Use Drugs in Thailand" (November 2007) (Also available in Thai)

"Not Enough Graves: The War on Drugs, HIV/AIDS, and Violations of Human Rights in Thailand" (July 2004) (Also available in Thai)


"Rehabilitation Required: Russia's Human Rights Obligation to Provide Evidence-based Drug Dependence Treatment" (November 2007) (Also available in Russian)

"Lessons Not Learned: Human Rights Abuses and HIV/AIDS in the Russian Federation" (April 2004)


"Rhetoric and Risk: Human Rights Abuses Impeding Ukraine's Fight against HIV/AIDS" (March 2006) (Also available in Ukrainian and Russian)

United States and Canada

"Barred from Treatment: Punishment of Drug Dependent Prisoners in New York State" (March 2009)

"Targeting Blacks: Drug Law Enforcement and Race in the United States" (May 2008)

"No Second Chance: People with Criminal Records Denied Access to Public Housing" (November 2004)

"Injecting Reason: Human Rights and HIV Prevention for Injection Drug Users" (September 2003)

"Abusing the User: Police Misconduct, Harm Reduction and HIV/AIDS in Vancouver" (May 2003)

"Punishment and Prejudice: Racial Disparities in the War on Drugs" (May 2000)

"Cruel and Usual: Disproportionate Sentences for New York Drug Offenders" (March 1997)


"An Unbreakable Cycle: Drug Dependency, Mandatory Confinement and HIV/AIDS in China's Guangxi Province" (December 2008)

"Health and Human Rights Concerns of Drug Users in Detention in Guangxi Province, China" (December 2008), JE Cohen and JJ Amon, PLoS Med. vol. 5, no. 12. (English); (Chinese)

"Locked Doors: The Human Rights of People Living with HIV/AIDS in China" (September 2003) (Summary available in Chinese)


"Ravaging the Vulnerable: Abuses Against Persons at High Risk of HIV in Bangladesh" (August 2003)


"Fanning the Flames: How Human Rights Abuses Are Fueling the AIDS Epidemic in Kazakhstan" (June 2003)

Access to Controlled Medicines

"Please, do not make us suffer any more...': Access to Pain Treatment as a Human Right" (March 2009) (Also available in French, Spanish and Russian)

"Government Should Improve Access to Pain Treatment: Millions Worldwide Suffer Unnecessarily" (October 2008)

8. Drug Policy and Human Rights - International Perspectives

Multilateral Support for Human Rights-based Drug Policy

"Building Consensus: A Reference Guide to Human Rights and Drug Policy." Human Rights Watch and the International Harm Reduction Association prepared this overview to assist country delegations during key debates at the UN High Level Meeting on drugs in March 2009 by showing the extent of support from international agencies and experts for human rights-based approaches to drug policy.

Multilateral Support for Harm Reduction Interventions

"International Support for Harm Reduction: An Overview of Multi-Lateral Endorsement of Harm Reduction Policy and Practice." Human Rights Watch and the International Harm Reduction Association prepared this overview to assist country delegations during key debates in the run up to the UN High Level Meeting on drugs in March 2009 (which stalled on the issue of harm reduction) by showing the extent of the support for harm reduction from international agencies and experts in the HIV, public health, human rights and drug policy fields. (Also available in Russian)

UN Drug Policy Reform

"Recalibrating the Regime: The Need for a Human Rights-Based Approach to International Drug Policy," looks at the growing tensions between the UN drug control system and international human rights law; highlights the lack of engagement on human rights abuses perpetrated in the name of drug control; and presents a series of avenues for reform at the international level to address this imbalance. (co-authored with the International Harm Reduction Association, the Beckley Foundation Drug Policy Programme, and The Canadian HIV/AIDS Legal Network).

Human Rights and Drug Dependence Treatment

"Ethical and Human Rights Imperatives to Ensure Medication-Assisted Treatment for Opioid Dependence in Prisons and Pre-trial Detention," was co-written by Human rights Watch advocate, Rebecca Schleifer, and R. Douglas Bruce from the Yale University AIDS program, and appeared in the January 2008 issue of The International Journal of Drug Policy.