Table 2: Harm Reduction and Freedom from Torture and Cruel, Inhuman, and Degrading Treatment, including in prisons

Examples of Human Rights Violations

  • Police of security officers beat and injure people suspected of using drugs. Investigators force drug suspects into withdrawal from heroin in order to extract confessions.
  • A government imposes lengthy mandatory prison sentences for minor drug-related offenses.
  • Persons convicted of drug offenses are detained and committed to treatment in overcrowded and unsanitary facilities, without access to medical services.
  • Interruption of medical treatment in pretrial detention—e.g., opioid substitution treatment.
  • Drug users are denied mental health treatment while in prison, jail, or drug treatment.
Human Rights Standards Treaty Body Interpretation
ICCPR 7: No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation. HRC: Expressing concern about high rates of HIV and TB in Ukraine, and recommended that Ukraine provide hygienic facilities, assure access to health care and adequate food, and reduce the prison population, including by using alternative sanctions. CCPR/C/UKR/CO (2006).
Human Rights Standards Case Law
ECHR 3: No one shall be subjected to torture or to inhuman or degrading treatment or punishment. ECtHR: Holding that refusal of medical treatment to an HIV-positive detainee held on drug charges violated Article 3. Khudobin v. Russia, 59696/00 (Oct. 26, 2007).

ECtHR: Holding that forcing a drug suspect to regurgitate to retrieve a balloon of heroin violated Article 3. Jalloh v. Germany, 54810/00 (July 11, 2006).

ECtHR: Holding that the UK government breached Article 3 by failing to provide necessary medical care to a heroin dependent woman who died in a UK prison while serving a four-month sentence for theft. McGlinchey and others v. UK, 50390/99 (Apr. 29, 2003).

Other Interpretations 

SR Torture: “From a human rights perspective, drug dependence should be treated like any other health-care condition. … denial of medical treatment and/or absence of access to medical care in custodial situations may constitute cruel, inhuman or degrading treatment or punishment and is therefore prohibited under international human rights law. … Given that lack of access to pain treatment and opioid analgesics for patients in need might amount to cruel, inhuman and degrading treatment, all measures should be taken to ensure full access and to overcome current regulatory, educational and attitudinal obstacles to ensure full access to palliative care.” Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment for the 10th session of the Human Rights Council (2009).

SR Torture: Recommending that Kazakhstan “initiate harm-reduction programmes for drug users deprived of their liberty, including by providing substitution medication to persons and allowing needle exchange programmes in detention.” A/HRC/13/39/Add.3 (SR Torture, 2009)

SR Torture: Noting of Indonesia that in police stations, “in particular in urban areas, torture and ill-treatment is used routinely to extract confessions or in the context of drug charges to reveal dealers/suppliers.” A/HRC/7/3/Add.7 (SR Torture, 2008)

Declaration on the Protection of All Persons from Being Subjected to Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Art. 5: “The training of law enforcement personnel and of other public officials who may be responsible for persons deprived of their liberty shall ensure that full account is taken of the prohibition against torture and other cruel, inhuman or degrading treatment or punishment.”

Standard Minimum Rules for Non-custodial Measures (1990) (“Tokyo Rules”), Art. 1.1: “provide a set of basic principles to promote the use of non-custodial measures, as well as minimum safeguards for persons subject to alternatives to imprisonment.”

ECOSOC, United Nations Rules for the Treatment of Women Prisoners and Non-Custodial Measures for Women Offenders (“Bangkok Rules”). www.un.org/en/ecosoc/docs/2010/res%202010-16.pdf. 

Code of Conduct for Law Enforcement Officials, Art. 2: “In the performance of their duty, law enforcement officials shall respect and protect human dignity and maintain and uphold the human rights of all persons.”

Body of Principles for the Protection of All Persons Under Any Form of Detention or Imprisonment, Principles of Medical Ethics Relevant to the Role of Health Personnel, Particularly Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.