Abstract:
Polar approaches to the issue of drug use endure in Nepal, where Ministry of Home Affairs (MoHA) enforces criminal drug law to create a drug free society, while Ministry of Health and Population (MoHP) advocates and endorses harm reduction policies to reduce drug-related harms and HIV epidemics.This study employs qualitative methods to explore the implications of drug law enforcement on barriers to accessing harm reduction services, human rights violations and risky behavior among PWID. In June 2016, 28 in-depth interviews were conducted with four distinct population categories [Policy level (1), national HIV program level (7), harm reduction service delivery level (5) and community level (15 (Male -11/Female -4))]. A maximum variance sampling technique was applied. Drug law provided ultimate power to law enforcement authorities and concomitant fear to PWID. Abuse of such power resulted in range of human rights violations, including sexual harassment, brutal torture and financial hassle practiced by nexus of some field authorities and drug rehabs, and increased barriers to accessing harm reduction services as well as increased risky behavior practices among PWID. Law enforcement implicated high drug price, which was associated with delinquent activities and risky behavior. Findings suggested most of the law enforcement related impediments were occurring due to lack of awareness and failure in flow of information within government agencies and law enforcement authorities. Knowledge of harm reduction services resulted in changes in law enforcement activities such as referrals and service intake inside custody.Consistent coordination, monitoring mechanisms and education for law enforcement authorities should be initiated as an immediate response to improve the dire situation of PWID. But the long-term health development of PWID cannot be envisaged without favorable policy and law reform around age of consent, police academy curricula and drug control law through the perspective of public health, human rights and evidence-based harm reduction approaches ensuring a participatory process.
