Child-centred harm reduction.

Harm reduction has become increasingly influential in drug policy and practice, but has developed primarily around adult drug use. Theoretical, practical, ethical and legal issues pertaining to children and adolescents under the age of majority - both relating to their own use and the effects of drug use among parents or within the family - are less clear. This commentary proposes a sub-field of drug policy at the intersection of harm reduction and childhood which we refer to as 'child-centred harm reduction'. We provide a definition and conceptual model, as well as illustrative questions that emerge through a child-centred harm reduction lens. Many people in different countries are already working on these kinds of issues, whose work needs greater recognition, analysis and support. In beginning to name and define this sub-field we hope to improve this situation, and inspire further international debate, collaboration, and innovation.

Best interests and low thresholds: legal and ethical issues relating to needle and syringe services for under 18s in Sweden.

Access for legal minors to needle and syringe programmes raises a number of practical, legal and ethical challenges that traverse clinical practice, child protection and child rights. This article addresses the current legal age restriction on access to needle and syringe programmes (NSPs) in Sweden. Based on legislation and legislative preparatory works, it traces the rationale for retaining an age restriction in the context of a policy priority to improve access for people who inject drugs. Building on threshold theory and child rights literature, the article unpacks the apparent tension between protecting the low threshold nature of service provision, child protection duties of healthcare staff, and the best interests of the child. It explores whether this tension could be alleviated through replacing a legal age restriction for all with best interests assessments for each individual, and discusses the potential ethical and practical challenges involved in such a change.

Scheduling medicines as controlled substances: addressing normative and democratic gaps through human rights-based analysis.

Recent years have seen contentious debate about efforts to schedule medicines such as ketamine and tramadol under the international drug control conventions. Proponents argue that misuse poses a significant risk to public health and that scheduling would help address these problems. However, scheduling of medicines can negatively affect their availability, accessibility and affordability for medical purposes, with serious health consequences for patients, especially in low and middle-income countries. The current process for scheduling medicines under the international drug control conventions does not provide sufficient normative standards through which balanced decisions may be reached. It is undemocratic in its structure and opaque in its reasoning. In this article, we argue that such decisions represent de facto limitations on the right to health and may engage the principle of non-retrogression. Using the examples of ketamine and tramadol, we propose that standard legal tests in international human rights law can help to address the normative and democratic deficits in the system and produce more rigorous, fairer and more transparent decisions.

Canada, cannabis and the relationship between UN child rights and drug control treaties.

Article 33 of the UN Convention on the Rights of the Child requires States to take appropriate measures to protect children from illicit drugs 'as defined in the relevant international treaties'. Those treaties are the UN drugs conventions. Following cannabis legalisation, then, can Canada remain in compliance with the CRC while breaching treaties to which Article 33 expressly refers? This article investigates this question with reference to the drafting of the CRC and the drugs conventions, how the relationship between the two systems has been approached, and the practice of the UN Committee on the Rights of the Child from 1993-2015. While the CRC could offer an alternative framework through which to critically assess drug laws and policies, by and large it has operated so as to reinforce the drug control system. An interpretation of Article 33 in the light of Canada's cannabis reforms is proposed. Based on the text of the provision, the pacta tertiis rule, and the object and purpose of the provision, it decouples the CRC from the normative requirements of the drugs conventions.

Security, development and human rights: normative, legal and policy challenges for the international drug control system.

This commentary addresses some of the challenges posed by the broader normative, legal and policy framework of the United Nations for the international drug control system. The 'purposes and principles' of the United Nations are presented and set against the threat based rhetoric of the drug control system and the negative consequences of that system. Some of the challenges posed by human rights law and norms to the international drug control system are also described, and the need for an impact assessment of the current system alongside alternative policy options is highlighted as a necessary consequence of these analyses.