On Tuesday, the municipal government sent excavators to start demolishing two full blocks, under the authority of an eminent domain decree. Police gave store owners a few hours to vacate the buildings. Three residents were injured when part of the building collapsed after an excavator hit a wall nearby.

Hundreds of people who used drugs continue to loiter and sleep in the streets around cracolândia. Municipal services, such as shelters, were not prepared to respond. City authorities admitted they had not even warned those services of the operation.

In response, public defenders obtained an injunction that forbids evicting people without providing them with other lodging, and have launched a joint investigation with the prosecutor’s office into the possible misuse of municipal civil guards during the operation.

Meanwhile, the municipal government has requested that a judge authorize it to use police to force people who use drugs to undergo medical examinations and compulsory drug treatment.

If given the new powers, the city hall’s doctors and psychologists would have the power to order involuntary drug treatment at their own discretion. Currently, only judges can do that.

The callousness exhibited by authorities in São Paulo is shocking. No one should be imprisoned solely because of drug use or possession for personal use. Moreover, medical treatment should be based on free and informed consent.

The effort by the São Paulo government is a classic example of the “war on drugs” approach that for decades has failed to reduce drug use, driven people who use drugs away from essential health services, and given rise to widespread human rights violations.

Drugs should be viewed as a health issue, not a police problem. The best way to address it is by offering harm reduction services and community-based voluntary treatment programs.

That was the rationale behind “With Open Arms,” a program created by the previous mayor. It provided crack users with housing, food, and jobs, without requiring drug abstinence, on the premise that people can reduce problematic drug use on their own if helped to improve their overall quality of life.

This week, the new conservative mayor closed that program down and inaugurated its replacement, called “Redemption,” with the show of police force. It has started badly.

César Muñoz is a senior researcher at Brazil’s Human Rights Watch. He used to be EFE’s Bureau Chief in Brazil, Ecuador, and Paraguay.

From 2015 to 2016, using both qualitative and quantitative methods (from interviews to data analysis), we undertook an evaluation of Programa Atitude, the state’s five-year-old social outreach program. The study was led by José Luis Ratton, of the Federal University of Pernambuco.

Our study found that the program has both increased health and well-being among Pernambuco’s most vulnerable drug users and reduced violence within this at-risk population — and thus in the state as a whole.

In our opinion, these results support the government’s controversial strategy — which the political right has several times threatened to repeal – to go beyond just arresting people who use drugs to actually help them.

As one drug user in the program said, “We don’t need more prisons. We need aid.”

The results also provide lessons for other cities, both in Brazil and elsewhere, that are struggling to deal effectively with open drug-use scenes.

In Brazil, as across the Americas, people who use drugs openly on the street are often among the poorest, most marginalized in society. This profile holds true in Pernambuco, where our research found that stimulant users are largely poor (84%), black or mixed-race (78.5%) and male (80%), with a little education. They are often homeless, and nearly always unemployed (90%).

This population also faces serious health risks. Among Atitude beneficiaries, HIV is 17 times higher than the Brazilian average (6.7%, versus 0.4%), and 12.8% have syphilis.

Beyond the health harms posed by homelessness and drug use, this population is also highly exposed to violence. Around 96% of Atitude beneficiaries have suffered some kind of violence and 65% had their lives threatened in the last six months. Women were five times more likely to have been abused emotionally or physically.

The program emerged late in the first decade of the 2000s, as Brazil was seeing a sharp uptick in crack consumption – particularly among poor black men.

Other cities, such as São Paulo, responded with New York City-style violent police crackdowns in communities where drugs were openly consumed.

Many cities here still respond to any narcotics activity with intense law enforcement. For example, Rio de Janeiro’s SWAT-style Police Pacification program has heavily armed officers essentially occupying favelas and arresting, sometimes killing, people they identify as “traffickers”.

Pernambuco was not a total exception. One Atitude beneficiary told us that the police “would grab us in the river bed and beat us for no reason, only because we were drug users.”

But in Pernambuco, a pioneer in mental health reforms, policymakers also understood that given the nature of illicit markets and the profile of crack users, arrests alone could not solve the problem.

By 2007, Pernambuco’s murder rate was double the Brazilian average, at 54 per 100,000, and Recife had become Brazil’s third-most dangerous capital.

So in 2007 the state launched the Pact for Life, a violence-prevention initiative, that incorporated elements of Boston’s successful Operation Ceasefire. That helped homicides decrease 40% from 2007 to 2013, back to 1980s levels.

Pernambuco next recognized that a considerable portion of its murder victims were also drug users, killed by dealers to whom they owed money or victims of generalized gang-related street violence in poor neighborhoods.

In other words, drug users were part of the state’s homicide epidemic. So in 2010 the government added US$ 1.5 million to Pact for Life for a one-year pilot program to protect this vulnerable community.

According to our evaluation, 77.2% of beneficiaries spoke about feeling safer in the program, which can provide them with temporary housing safely removed from their own risky neighborhoods if necessary.

This finding, while not conclusive, suggests that some crime in violent communities can be prevented not by aggressive policing — a strategy that’s caused resentment in both New York and Brazil — but with social services.

Another useful finding is that after completing Programa Atitude, people tended to smoke less crack. The number of people who smoked 15 or more rocks at a time decreased from 57% to 24.8%. Daily consumption dropped from 82.1% to 22.1%. And 35.6% claimed to have stopped using drugs entirely.

Our findings support a growing body of research from cities across the Americas that have sought to deal with violence and drug use in more humane ways, which shows that stability, health and connectivity can make people feel less need to get high.

By supporting people to get a job, rebuild family ties, stick with therapy, and update legal documents, social-inclusion programs help drug users do the basic things necessary for a satisfying, sustainable life.

“I was very skinny,” one participant told us. “I began to gain weight. I ate. [I began] to sleep well.”

This outcome demonstrates why policymakers must move beyond the binary of seeing drugs as either a criminal problem or a health issue. Drug use is a complex phenomenon that requires complex responses.

Considering the social determinants of health (income, employment, race and gender, among other things), and not insisting on abstinence as a prerequisite for getting help is the foundation of other harm-reduction initiatives.

New York’s Pathways Housing First, for example, provides housing to homeless drug users on the basis that stability — a mailing address, a bed — is a necessary first step for people to make other positive changes, such as finding employment.

More recently, under its previous mayor, São Paulo implemented the Programa de Braços Abertos – “Open Arms” — which provides housing, employment, food, and social services to homeless drug users in the city’s so-called “Crackland”.

Brazil’s Conservative Backlash

But harm-reduction programs, among other social policies, are endangered by Brazil’s rightward tilt and economic crisis.

Conservatives in power seek to replace the harm-reduction initiatives now operating in Brazil with outdated models that have been proven ineffective.

Drug treatment in Brazil — and indeed in many Latin American countries — often consists of compulsory hospitalization or lengthy interments in faith-based “therapeutic communities”.

Evidence shows that coerced, abstinence-based rehab rarely helps addiction, and may actually violate users’ human rights.

As one person who’d been through religious “treatment” asserted, “I don’t want to become evangelical, I want to get rid of the addiction.”

However, this approach to addiction continues to be pushed in Brazil.

The Atitude program is not perfect. Our study found insufficient follow-up with program graduates, uneven coordination among the government entities that operate it and chronic under-funding. Some of these problems are locally rooted, and others are endemic to Brazilian government programs. Many are fixable.

And even in a challenging place like Brazil today — with its economic and political crises — human-centered programs are a relatively affordable and proven effective way to help society’s most vulnerable people, keep them safe and, as a result, improve overall community well-being.

Will Brazilian leaders pay attention to the evidence?

Rafael West is a researcher at Universidade Federal de Pernambuco. West works with the National Secretary of Drugs in Brazil and also with the Fundação Oswaldo Cruz.

Arturo Escobar is a research scholar for the Study Group on Alcohol and Other Drugs, Universidade Federal de Pernambuco. Escobar works for the Executive Secretary on Drug Policy of the State of Pernambuco. He is also affiliated with Antiprohibitionist Collective of Pernambuco.

The research cited here was funded by the Open Society Foundations.

This article was originally published on The Conversation. Read the original article here: https://theconversation.com/why-cities-should-stop-arresting-crack-users-and-help-them-instead-67828

“We are talking about a whole crack geography,” said Paulo Ziulskoski, president of the CNM, National Confederation of Municipalities).

For the CNM, the promise to alter this reality was not fulfilled  by  the PT (Workers Party). This was one of the top priority issues promised to be dealt with by the Workers Party –  President Lula’s party, whose popularity helped to elect Mrs. Dilma Roussef his successor.

Estimates are that crack consumption will lead to the death of 300,000 Brazilians in the next six years.
 
The  research  has also revealed that only 3,39% of the cities  had submitted any sort of  proposal to the federal government related to any effective anti-drug program  and for drug treatment. 

In the state of São Paulo this number was even lower with less than 2,50% of the cities showing any concrete concern for the problem. The CNM has also reported  that the federal government is in large part responsible  for the increased growth of crack consumption. 

The São Paulo government  has purposely  placed several obstacles for  municipalities to have access to the  necessary funds for combating the widespread use of drugs and for treatment facilities.

In 2010 alone  62% of the municipalities had to rely on their own budget to combat the proliferation of drug use and to provide medical treatment for users.
 
The SENAD (National Politics Secretariat Against Drugs) has rebuffed the criticism alleging that this year they will provide  410 million reais (US$ 239 million) for projects related to drug prevention.

According to the SENAD, 73 million reais (US$ 43 million) should be used to create medical centers for drug treatment and NASFs (Center for Families Support).
 
Back in 2008, in Rio de Janeiro for example,  between 80 and 90% of the homeless population were addicted to crack. The reason is simple, a pebble of crack which is a potent and highly addictive form of cocaine can be bought at a very low price.

For as little as 5 reais (US$ 2.9) anyone can have access to this drug, especially in the poorest areas of the city, where they are commercialized in broad daylight and are very profitable for drug dealers. 

The homeless population is more vulnerable as this type of drugs easily takes away the appetite. In many parts of the country, there are entire blocks of crack users who congregate in certain areas forming the so-called Cracolândia or Crackland.
 
Edison Bernardo DeSouza is a journalist, having graduated in Social Communication Studies at Pontifical Catholic University in São Paulo, Brazil . He lived in the US and Canada for close to 12 years and participated in volunteering activities in social works agencies. DeSouza currently lives in São Paulo where he teaches English as a Second Language for both private English Language Institute and Private High-School. He is  currently  participating  as an actor in two  English Musicals  in Sao Paulo – Brazil and is pursuing further advancements in his career. He is particularly interested in economics, history, politics and human rights articles.