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"Those of us who manage public policies know that confinement and prison alone do not solve the problem, and it is necessary to work on social inclusion and rehabilitation"

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Published on 03/10/19

Diego M. Olivera Couto has a degree in Social Work from the University of the Republic. By resolution of the President of the Republic, Dr. Tabaré Vázquez was appointed Secretary-General of the National Board of Drugs, a position he has held since July 1, 2016. He has a professional development associated with the elaboration, planning, and management of public policies. In this field, he has managed to harmonize his vocation for social and public service with the development of specific competencies in the academic, institutional and political fields. Between 2012 and 2016, he was General Coordinator of the MIDES Youth on the Net Program, where he participated in the inter-institutional development program dedicated to serving young people who do not study, do not work and concentrate on other vulnerability indicators. He was Coordinator of the Youth and Social Vulnerability Area of the National Youth Institute, where he implemented public policies aimed at young people in situations of social vulnerability. Between 2002 and 2012, he participated in different programs focusing on the individual, family and community approach at the socio-educational level to change the harsh living conditions. He has developed teaching work at the academic level, in the Department of Social Work of UDELAR.

  • Uruguay has a National Drug Observatory working for more than 20 years. How do you think COPOLAD has helped its development?

Our Observatory has a very important amount of research production, not only from the most traditional measurements of the different prevalences, from the offer of treatment or from studies on specific population surveys such as the student population in secondary education, but it has adopted in the last ten years a series of new methodologies, beyond the statistical, incorporating an anthropological and cultural vision on the phenomenon of consumption, aiming to investigate hidden populations, such as the prison population or those in street situations and users of smokable cocaine. In this process of diversification, we have tried to keep pace with the dynamics of the phenomenon of drug consumption, which is very changing and has acquired particular characteristics in the 21st century, and this has been an important challenge. COPOLAD has allowed us to integrate with the rest of the Observatories in the region, and perhaps because of our differential development, it has offered us the possibility of leading working groups within the scope of the Drug Observatories, in some activities, which is a source of pride and also a great responsibility, and gives us the opportunity to strengthen our methods, our work and the way of communicating it, in order to work with countries in the region that were one step behind in this matter. We have come a long way together with these countries in meetings in different parts of the region, which have been very fruitful.

  • Specifically, how do you see from Uruguay the development of Early Warning Systems in the region and how has your country helped others in this area, within the framework of COPOLAD?

The Early Warning System (EWS) was an excellent opportunity that Uruguay developed early on, perhaps because it had well resolved a package of research and operating methods that were already consolidated. Through the innovative spirit of the Observatory team, we set out to be at the forefront of these systems. Uruguay perhaps did not have a great impact on New Psychoactive Substances (NSP); although they existed, they only did in very specific communities and environments where these types of substances were used. Today, when these substances have a greater impact, we are better prepared, because the EWS was developed when the phenomenon was very incipient in the country, and it has allowed us to provide a lot of information to health services, and to compile and systematize information on NPS produced not only in the region, but also in Europe, where this reality is much more consolidated or has had a more important development over the years, and to generate a network of actors, including laboratories, not only in the academic field, but also in the forensic and police fields. This laboratory work joins the reports of the health systems on emerging cases at the clinical level of situations, mainly associated with intoxications at night parties. We have a working environment that is very fluid and that is accepted by the state as a reference when working on this phenomenon. Through COPOLAD we have had the opportunity to consult other countries such as Argentina or Colombia, with whom we speak continuously and who have taken steps forward in this regard. In the case of Argentina, in addition to cultural and geographical ties, we have millions of tourists crossing the border, especially in the summer, and the binational work is constant and very positive, with continuous alerts that we cross between the two countries.

  • What is the importance for Uruguay of the process of supporting the validation of quality and evidence-based criteria that is being developed within the framework of the programme and in which your country actively participates?

We come from a process of reaffirmation of the health services that address the problem of mental health, and in particular, within this field, addictions. We have recently passed a law that reforms the framework, not only legal, but conceptual, in the approach to mental health and addictions, and we are in the process of implementing that new legal framework. We have developed a national network of drug care and treatment that offers services throughout the country, at the neighborhood and community level, but also residential treatment. We have had to, and decided to, develop an evaluation and monitoring component based on the quality criteria summarized by COPOLAD in its publication on this subject, which is for us the guide we are applying and which has allowed us to provide guidance to the professionals who manage these services. In addition to keeping them motivated, in a task that is hard and requires a lot of professional and human commitment, it also allows them to have a goal in terms of quality management that is extremely important for professionals; they have taken it with a lot of commitment and motivation, and for us it is a way of rendering accounts, and that the public resources that we are applying in the system of care and treatment are translated into professional services and quality, which has not been the historical tonic of this type of services for drug users, which in the past, have been based on criteria little validated scientifically, without a clear methodological framework. The fact that we have a unified framework, validated and discussed internationally with the rest of the countries in the region and the EU, serves as a roadmap, which we are applying.

  • Currently, the SND is leading the elaboration of a pioneering regional study on gender and drugs, sponsored by COPOLAD. How do you assess the importance of mainstreaming gender issues in public drug policies and the outstanding participation of Uruguay in the production of this document?

Gender-related transformations are part of the great political and cultural milestones of the 21st century. There is a great demand that we impose on ourselves as a government, but society also demands that the policies, all of them, have a coherent gender perspective. In the SND we have assumed leadership in this sense; for example, in the area of treatment, we are seeing what are the access barriers that affect when Uruguayan women have adequate space, opportunities, and receptivity to express their problems and concerns related to drug use. Our studies on the prevalence of drug use indicate that many of the barriers to drug use have been removed. Where before there were some consumptions that had a very masculinized profile, today these barriers have been eliminated, and although there is a certain cultural inertia to consider the problems of addictions and drug consumption as problems, mostly, with a male face, when there is evidence that this is not the case. We have to generate opportunities for family care so that women who need specialized treatment do not have to make a sacrifice in terms of family life, or if they have to, that there are accompanying by proper policies, and that is why Uruguay has developed a system of care that incorporates protection and complementary services to early childhood. This generates more availability of hours, of real-time, so that women not only try to fulfill their labor and professional objectives but also so that they can dedicate more care to their health and not only appear in the services as people who accompany, whether as daughters, sisters or couples, at the time of access to a service.

In the other component affected, which is criminal justice, we try to see what is happening with the role of women in the circuits of illegal drug trafficking. What conditions and dynamics are happening in it, which have pushed women to fulfill tasks, especially in the drug-dealing; in our country, there is a dynamic of commercialization of drugs fundamentally in family houses. In general, it is the women who are present when there is a raid or when the police arrive to seize, and this has generated an increase in the number of women imprisoned for drugs; all this requires a strong commitment when developing policies.

This investment made by COPOLAD, which has required us to co-lead the Mechanism for research on gender and drug policies throughout Latin America and the Caribbean, will provide us with a very good basis for common information and analysis on the state of the art and the future challenges we face in this area.

  • In a first assessment of the road traveled by Uruguay in the process of regularization of the legal use of marijuana, what first lessons learned and challenges could you share with the rest of the countries?

This process has had great milestones. The approval of the law in 2013 called for a great social and political debate on how to efficiently control drug markets in order to displace the activity of organized crime groups, but also to protect the health of the population. It implied a very important sincerity around the fact that the model centered on provisioning is an exhausted model and that it has not been able to respond effectively to the great challenges that we have in terms of well-being and public health around psychoactive substances. What we have had in recent years has been the challenge of implementation: first, of the commercialization to the public of psychoactive cannabis. Our concept is not so much that of legalization, but that of legal regulation; it is a small but important nuance: it implies that there is a strong state control of the mechanisms of production and access, either through commercialization or self-sufficiency, which are the two paths that can be traveled in our country. We have prohibited commercial promotion, marketing, and we have forced, on the other hand, a series of public institutions to redouble their efforts in terms of warnings, work on prevention and health promotion, and access to public health services for people who use drugs and have problems with consumption.

What Uruguay has experienced is a process that has to move forward and needs further evaluation, but the first conclusion indicates that it is an efficient mechanism on both sides. On the side of the displacement of the illicit activity linked to marijuana, we have prevented more than 25 million dollars from being captured by drug trafficking organizations, this being the economic value of the marijuana produced by the three legally authorized routes. On the other hand, there are more than 50,000 cannabis users who have safe access to a substance that has no additional contamination, which is the dried cannabis flowers, with an intermediate level of psychoactivity, but also dispensed with a very careful mechanism, where each package has its warnings printed on it. There is a system of traceability between producers and those who market, which implies that we know the origin of each of these packages, we know who sold it, and eventually, if this is necessary in the framework of a court action, we can know who acquired it, beyond that we have devoted a great effort to protect sensitive data and private information of people who consume cannabis through these legal access channels. It has been a great challenge in terms of public policy, so it involves innovation and getting rid of a mechanism that we felt was not having good results. We know that a good part of the world looks to Uruguay to analyze the results of this policy because many communities feel that provisioning is showing evident signs of exhaustion.

  • Three regional programmes of the European Union (COPOLAD, El PAcCTO and EUROsociAL +) promote an unprecedented activity on alternative measures to the deprivation of liberty these days in Montevideo. What is the relevance of holding the Conference in Uruguay at this time?

In Uruguay, the issue of alternatives to prison comes at a very opportune time because we are reforming the criminal justice system and in the last two years we are witnessing the implementation of a new code of criminal procedure. This has meant that both the police, the national prosecutor's office, and the courts have had to adapt to new possibilities, but also to new challenges. Unfortunately, in Uruguay, there is an increase in violent crime and this challenges all of us who work in public policies, not only in security and justice policies but also in social policies, coexistence, and access to public services. There is a great challenge in that sense; Uruguay comes from a historical process of reducing poverty and improving equity in access to income, very substantial, because it has been driven by economic growth, but there are expressions in terms of social fracture, not only in the territorial but in shared values and particularly in the phenomenon of violence, whether gender-based or associated with criminal groups, which requires a great deal from us. One of the aspects that we need to improve is the application of criminal sanctions. On the one hand, we live in societies, as is happening throughout the region, and as Europe has even said, which are calling for tougher sanctions so that people who have committed crimes are locked up in prisons, regardless of the seriousness of these crimes. On the one hand, it is understandable that there is great social sensitivity towards the demand for greater sanctions, but those of us who manage public policies in the field of security know that confinement and prison alone do not solve the problem, and it is necessary to work on social inclusion and rehabilitation as a broad concept, and to validate, from the point of view of results, but also from the cultural point of view, alternative measures as effective measures. Measures that are in accordance with human rights and that can reward society in a better impact on coexistence, through restorative justice in the treatment of problematic drug use, as a complement to deprivation of liberty or alternative to conditional suspension of sentences. This is a day of much learning and reaffirmation of the things we think and want to carry forward and of very fruitful dialogue, with only other countries but with the cooperation agencies, which by their magnitude have organized a very important event.

  • What is the added value of European Union cooperation for Uruguay and how do you assess the impact of the action of the three programmes on your country's public policy?

On the one hand, we await with great expectation the realization of a new round of programs linked to COPOLAD. We have made our proposals, we believe that the result of what has been achieved so far is very positive; the countries of the region have incorporated it as part of our agendas and work strategies, so we are interested in strengthening COPOLAD and its future projection. We know from the public security counterpart that the PAcCTO has followed a very similar path, which has allowed us to receive technical assistance and cooperation in areas that are very sensitive and on the agenda for our agencies. EUROsociAL + is a programme with great diversity, it is only necessary to see the range of interventions that they carry out, ranging from approaches to childhood and adolescence, to educational issues... I believe that what we have to do and what this conference in some way allows us to do, is that we have to think about transversal and integrated interventions between the three programme frameworks. I think that the decision that agencies should work together is very welcome, this is a milestone for cooperation agencies as well. We usually say that problems are complex and require intelligent, articulated and comprehensive solutions. It would not be consistent for agencies to act in a disjointed way, so I think it is a challenge that is being met very well. For us as a counterpart of the agencies, it has also brought a good level of coordination to the institutions in the field of security, drug policy agencies and the social inclusion and cohesion component. I think this is the right way to tackle these problems: collective intelligence, dialogue, and a holistic approach.

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