A/HRC/39/39 standard of physical and mental health has urged national authorities to consider scaling up available opioid replacement therapies for people who use drugs (see A/HRC/20/15/Add.2). D. Access to treatment in prisons and other custodial settings 23. The outcome document of the thirtieth special session calls for the implementation of treatment-related initiatives in prisons and other custodial settings, 42 and also for access to health care, social services and treatment for those in prison or pretrial detention. 43 24. The Committee against Torture has expressed concerns regarding insufficient health services for prisoners with substance addiction. The Committee recommended that the provision of medical services to prisoners, particularly those who are addicted to drugs, should be ensured, and that all measures necessary to implement the United Nations Standard Minimum Rules for the Treatment of Prisoners should be taken. 44 The Committee on the Elimination of Discrimination against Women recommended “gender-sensitive and evidence-based drug treatment services to reduce harmful effects for women who use drugs, including harm reduction programmes for women in detention”. 45 The Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment recommended the introduction of effective drug-replacement therapy in detention centres. 46 25. Furthermore, various human rights treaty bodies have observed that detention settings are high-risk environments for HIV, hepatitis C and tuberculosis transmission and have recommended that States ensure access to harm reduction services in prison. 47 At the end of 2016, in prison or places of detention, opioid substitution therapy was only available in 52 countries, while only 8 countries provided needle and syringe programmes. 48 The International Association for Hospice and Palliative Care noted in its submission that access to controlled medicines for palliative care should also be available in custodial settings. III. Joint commitments on effective law enforcement and human rights 26. In the outcome document of the thirtieth special session, all States committed themselves to effective drug-related crime prevention and law enforcement measures. 49 27. In recent years there have been some alarming tendencies towards a deeper militarization of the responses by States to counter drug-related crimes. In some instances, this is associated with the progressive militarization of civilian police forces. Several institutional reforms and new laws have come into force in Latin American countries which have facilitated militarization processes in the context of drug operations. Submissions indicated that excessive use of force is more likely to occur when military or special security forces are involved in drug operations. Such approaches have disproportionately affected vulnerable groups and has repeatedly resulted in serious human rights violations. 50 28. The Special Rapporteur on extrajudicial, summary or arbitrary executions stated that various threats, which included drug dealing, challenged the adequacy of traditional law 42 43 44 45 46 47 48 49 50 6 Recommendation 1 (k) and (o). Recommendation 4 (b) and (m). See CAT/C/CPV/CO/1. See CEDAW/C/GEO/CO/4-5, para. 31 (e). See www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=23193&LangID=E. See CERD/C/CAN/CO/21-23, CEDAW/C/CAN/CO/8-9, A/HRC/23/41/Add.1, CAT/OP/PRY/2, E/C.12/POL/CO/6, E/C.12/SWE/CO/6, E/C.12/LTU/CO/2, CEDAW/C/GEO/CO/4-5 and A/HRC/13/39/Add.3. Submission from Harm Reduction International. Recommendation 3. Submissions from the Centre for Legal and Social Studies and the Mexican Commission for the Defence and Promotion of Human Rights.