P4M: Poppy for Medicine
As the raw material for essential painkilling medicines such as morphine, if carefully controlled, the opium poppy can be a positive resource, both for economic development, and to bring illegal drug production under control. This Poppy for Medicine Technical Dossier comprises a blueprint for the implementation of integrated grassroots-level counter-narcotics and counter-insurgency projects. These projects are village-based Poppy for Medicine schemes; through which small Afghan village-based organizations are licensed to locally produce simple poppy-based medicines, for sale by the Afghan government to meet the growing global need for affordable painkilling medicines.

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The licensed cultivation of poppy for the production of medicines has important precedents as a counter-narcotics strategy, and indeed, Afghanistan’s current Counter Narcotics Law provides for the implementation of poppy licensing schemes. Based on this law, on international precedents, and on extensive field research, a Poppy for Medicine project model has been developed which is tailored to the complexities of Afghanistan.

Community control the key condition for Poppy for Medicine Project licence

The initiative would not provide a blanket license for all Afghan farming communities to grow poppy and produce opium. Rather, specific farming communities would be licensed by a central government agency to implement Poppy for Medicine projects to locally produce morphine medicines under tightly controlled and highly monitored conditions. Receipt of these licences would carry three conditions: the unavailability of sustainable livelihoods other than to poppy cultivation in a potential project village; a community-wide commitment to the elimination of drug trafficking in the areas under community control; and an undertaking to implement economic diversification activities.

Morphine: a simple poppy-derived pain medicine remains the world’s most effective painkiller

The benchmark to which all new painkilling medicines are measured, morphine is the gold standard in pain management, and forms the basis of treatment for pain around the world.

A nineteenth century medicine, morphine was discovered in 1805. The extraction of morphine from raw poppy materials is relatively simple, requiring inexpensive chemicals and simple chemical processes, and ten kilograms of raw poppy materials yields approximately one kilogram of morphine medicines.

While in the past morphine was used to treat everything from insomnia to alcohol abuse, today morphine forms the bedrock of pain management for patients suffering from all moderate to severe pain, including pain associated with HIV/AIDS and cancer. On the World Health Organisation’s Model List of Essential Medicines, morphine is considered the world’s most effective painkiller.

Poppy for Medicine project model compliant with international law

Providing for the production and export of finished poppy-based medicines, the Poppy for Medicine project model would not unbalance the international system of raw poppy materials supply, and would therefore comply with the regulations of the 1961 Single Convention on Narcotic Drugs, the international legal instrument which governs the production and export of raw poppy materials from supply countries to manufacturing countries. Further, the finished morphine medicines exported from Afghanistan would only be sold to those countries currently lacking access to affordable pain medicines. As such, Afghan-made medicines would not compete with current international medicine suppliers.

International precedent for poppy licensing as an alternative to forced eradication

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In 1970 the US offered financial compensation in return for the eradication of poppy in Turkey. The Turkish government refused, emphasising the political weight of the 70,000 poppy farming families, with Prime Minister Demirel saying “eradication would create a clash between the government forces and the people, and would make the problem worse, since it would create public support for plantings.” Turkey insisted that eradication would “bring down the government,” and US memos from this period indicate that the Nixon administration was fully aware that “further pressure to eradicate could ‘topple’ the Demirel government.”

In 1970 the Turkish government decided to pursue the implementation of a poppy licensing system for the production of medicines. Acknowledging that licensed Turkish opium would help resolve the global shortage of poppy-based painkillers, the United States began to support the Turkish poppy licensing programme, extending ‘special protected market status’ to Turkey under a Drug Enforcement Agency Regulation, commonly known as the ‘80-20’ Rule.