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

Abstract

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.

WHO’s first scientific review of medicinal Cannabis: from global struggle to patient implications

“…Beyond Cannabis , this paper points at normative deficits that have curtailed WHO’s assessments (lack of a robust science-based framework for the work of the ECDD experts) and the important democratic deficit that the Cannabis scheduling process faced during subsequent CND discussions (Lohman and Barrett, 2020). The latter calls for an articulation of political voluntarism with efficient diplomacy.…”

“…On top of that, the treaties’ criteria for substance scheduling, under which the ECDD has to frame its reviews, are anything but scientifically sound: they base the addition of new drugs to the Schedules on their similarity to CCDs (Danenberg et al , 2013; Hallam et al , 2014; Lohman and Barrett, 2020; Riboulet-Zemouli, 2018, pp. 18–19).…”

Incorporating Child Rights into Scheduling Decisions at the UN Commission on Narcotic Drugs

“…While states may limit rights in certain circumstances, such limitations must be justified with respect to the goal being pursued, necessity, and proportionality. These factors are currently missing from un cnd decision-making (Lohman and Barrett, 2020). Incorporating child rights into the process may help to fill this gap, at least with regard to the child rights obligations directly engaged by the process.…”

“…This could be done in isolation, or as part of a wider human rights impact assessment of such decisions (e.g. based on the right to health; see Lohman and Barrett, 2020). Such a system could be set up via a resolution of the un cnd, requesting child rights assessments from its secretariat, the UN Office on Drugs and Crime (unodc).…”

A social science perspective on literature relating to medically prescribed stimulants: a systematic review.

“…Substances are organised into different schedules (categories) based on their risk and abuse potential from Schedule I to Schedule V; this allows for the control of these substances through prescriptions and importing/exporting processes (Lohman & Barrett, 2020). Schedule I medications have the highest abuse potential, and Schedule V have the least potential for abuse (Lohman & Barrett, 2020). MPS are considered to have a high potential for misuse and thus are categorised as a Schedule II medication.…”