oD Drug Policy Forum: Front Line Report - Week of February 20th 2010

We lead this week with news of the impending meeting between UN High Commissioner for Human Rights, Navi Pillay, and Russian President Medvedev. We hope that recent positive emphasis at the UNODC on harm reduction, substitution therapy and human rights translates here into meaningful dialogue based on an evidence led public health perspective; particularly pressing in view of Russia's dramatically unfolding intravenous drug user led HIV/AIDS epidemic.
Mark Weiss Charles Shaw
20 February 2011

The UN High Commissioner for Human Rights sheds the light on the crucial role of harm reduction in Russia

A Russian coalition, supported by international colleagues — representing affected communities, activists, practitioners and NGOs working in the field of HIV/AIDS and harm reduction — has been urging Judge Navanethem (Navi) Pillay, UN High Commissioner for Human Rights, to carry forward an important message: Harm reduction in Russia is needed now to curb the concentrated HIV epidemic among people who use drugs. 

According to the WHO, Russia has more than three million people regularly using heroin, yet routinely refuses to finance basic harm reduction services, including needle exchange or substitution therapies, fuelling one of the world’s fastest-growing HIV/AIDS epidemics. WHO research concludes OST remains the clearest means of curbing this deadly trend.

“The overt lack of concern for the human rights of those who use drugs is directly contributing to the proliferation of HIV in Russia” says Mikhail Golichenko, Senior Policy Analyst of the Canadian HIV/AIDS Legal Network. In turn, activist Irina Teplinskaya, meeting with Pillay said “tens of thousands die every year because Russian law forbids OST, recommended by the UN and successfully used in all the world’s developed countries. OST stabilises the lives, improves health, and reduces HIV infection and crime rates.”

To learn more please follow see the IDPC press release here, the Open Society’s press release here and read Irina Teplinskaya's speech.

Source: IDPC and Open Society

The first step is denial 

Russia blames NATO policies for its heroin crisis. But is Afghanistan just a scapegoat for a broader problem?

Since taking office 2½ years ago, Russian drug Czar Viktor Ivanov has been shuttling between Moscow, the US and Europe, to make the case NATO’s counter-narcotics approach in Afghanistan is “misguided” and causing of a 40-fold increase in opium production threatening to turn Russia into a nation of heroin addicts.

However, Anya Sarang, president of the Andrey Rylkov Foundation for Health and Social Justice, which advocates harm-reduction policies, says most of the addicts her organization sees throughout the country have switched from heroin to homemade substances synthesized from opium-based pharmaceuticals like codeine tablets, behind the rise of thrombosis, a condition in which a clot develops in blood vessels, and osteonecrosis, a disease that leads to the breakdown of bones.

There’s no question that Russia has a heroin problem. In fact, the UN estimates that around 1.5 million Russians are addicted to the drug. But the emergence of another serious narcotics epidemic unrelated to Afghanistan challenges the notion that all the reasons for Russia’s addiction problem lie abroad. To learn more, please follow this link

Source: Macleans

Russia and Methadone: Breaking the Ice

As the articles above show, little has changed since international pressure on Russia to introduce opiate substitution treatment for heroin users was raised in this excellent HCLU short film, despite Russian Drug Czar Ivanov announcing that methadone is not prohibited in Russia. Learn more and take action here:



Source: HCLU

DrugScope Respond to NTA pooled treatment allocation details

The National Treatment Agency (NTA) has published details of central government funding for drug treatment for 2011/12.

The NTA confirms government plans to introduce an additional element to the PTB allocation formula for 2012/13 to 'incentivise local systems to become more recovery focused'. Partnerships will be rewarded for the number of individuals 'successfully completing treatment'. The new element applied in 2012/13 will be based on outcomes delivered in 2011/12.

While DrugScope welcomes the emphasis in the strategy on improving treatment outcomes, the charity has urged caution based on the numbers counted as completing treatment. Careful thought needs to be given to avoiding ‘perverse incentives’, such as clients being pressured to leave treatment too early or people with more ‘entrenched’ of multiple needs being disadvantaged when seeking to access treatment. To learn more, and read Chief Executive Martin Barnes’ view, please follow this link

Source: DrugScope

IHRA joins International Coalition Intervening to save Vancouver Safe-Injection Site 

An international coalition of harm reduction experts — comprised of the International Harm Reduction Association (IHRA), the Canadian HIV/AIDS Legal Network, and CACTUS Montréal — has today been granted intervener status to appear before the Supreme Court of Canada to support Insite, Vancouver’s supervised injection site, against the Canadian government’s attempts to shutter it.

In a landmark 2010 decision, the British Columbia Court of Appeal ruled that Insite fell within the jurisdictional authority of the provincial government, since the supervision of injections of illicit drugs within a health-care setting constituted a matter of public health, and as such did not violate federal health or drug laws — a decision the federal government lost little time in appealing. This appeal is now before the Supreme Court of Canada.

“Insite abides by international law, by our own Canadian Charter of Rights and Freedoms, and by the law of the province of British Columbia,” says Richard Elliott, Executive Director of the Canadian HIV/AIDS Legal Network. “Insite is also an international success story. Yet the federal government continues to ignore not only scientific evidence, but legal precedent as well.” To learn more please follow this link 

Source: IHRA 

UNODC and the United Arab Emirates Step up Cooperation on Crime and Drugs Threats

Yury Fedotov has opened the UNODC Sub-Regional Office for the Gulf States. The Office, which was set up in partnership with the United Arab Emirates Ministry of Interior, will strengthen the intra-regional response to the threats of drugs, crime and terrorism.

Accompanied by Dr. Hamad Abdullah Al-Ghaferi, Director General of the National Rehabilitation Centre (NRC), Mr. Fedotov visited the Centre, which is collaborating with UNODC for universal access to evidence-based drug dependence treatment services in the context of a joint programme with the World Health Organization (WHO) on drug dependence treatment and care. The NRC and UNODC are also involved in building the NRC laboratory capacity and the Centre is thus becoming a regional hub for efforts against drug addiction.

To learn more please follow this link

Source: UNODC

A Heroin User in Stockholm 

An HCLU film on why there is still no needle exchange program in the city of Stockholm, the capital of Sweden, while according to a recent study, the prevalence of Hepatitis C among injecting users is 85%? The film is made in cooperation with the Swedish Drug Users Union, and highlights the need to ensure human rights of Sweden’s drug users and sex workers.

Source: HCLU 

UNODC assists Pakistan in drug control work along Khyber pass

On 15 February, the first inter-agency border liaison office was opened at the border between Pakistan and Afghanistan in a move aimed at curbing the flow of illicit drugs in that region. Supported by UNODC, the border liaison office is situated at one of the busiest ports of entry for people and goods moving between Pakistan and Afghanistan - the historic Khyber Pass.

"As the destination and transit country for over 40 per cent of the opiates produced in Afghanistan as well as a key transit country for precursors, Pakistan's borders are particularly vulnerable, and we hope the border liaison office at Torkham will make a contribution to countering some of the trafficking and linked transnational organized crime", said Jeremy Douglas, UNODC Representative in Pakistan.

The border liaison office at Torkham is being established within the framework of the Triangular Initiative, a UNODC-led group whose membership comprises the drug control ministers of Afghanistan, the Islamic Republic of Iran and Pakistan and the objective of which is to strengthen cooperation in law enforcement between those three countries. To learn more, please follow this link

Source: UNODC

Harm reduction boost for Middle East and North Africa

Iran, Pakistan, Libya, Lebanon, Syria, Jordan, Bahrain, Morocco, Egypt, Afghanistan, Oman and West Bank and Gaza will receive needle and syringe exchange programmes and opioid substitution therapy following a first round of funding in July.

The Middle Eastern and North African (MENA) region forms part of the major drug trafficking routes from Afghanistan to Europe and North America and is the only area apart from Eastern Europe experiencing an increase in new injecting drug use-driven HIV infections. There are an estimated 1m injecting drug users in the region, with the number of new infections doubling from 36,000 in 2001 to 75,000 last year.

The funding follows a successful bid by the Beirut-based Middle East and North Africa Harm Reduction Association. ‘The Global Fund announcement is timely and will save lives,’ said MENAHRA director Dr Elie Aaraj. ‘With few exceptions, all MENA and North Africa, countries are marked by a weak response to HIV and IDU. The Global Fund’s financing will help to fill that void.’

Source: Drink and Drug News 

Mexico's B-movie boom: 'Narco cinema' inspired by real-life crime is on a high 

The notorious drug-related violence in northern Mexico continues to make headlines around the world. Less well-known, and rather more surprising, is that the long-running battles between police and drug dealers are fuelling a popular film movement: 'narco cinema'.

These low-budget B-movies tell formulaic, violent, action-filled tales of the drug wars, and while not distributed legally in Mexico, the straight-to-DVD titles are eagerly snapped up on the black market.

The photographer Fabio Cuttica visited various narco-cinema film sets to capture this cinematic subculture on camera for himself. Tijuana, Cuttica's hometown, is a production hub for these movies. Several small companies, often family-run, have concentrated their efforts on the burgeoning narco movie market – more than 30 films are shot in Tijuana alone each year. To learn more, please follow this link

Source: The Independent

National Treatment Agency’s Paul Hayes’ Speech – ‘Seize the Day!’ 

Service users and people in recovery have a key role to play in leading the development of local recovery-oriented drug treatment systems, Paul Hayes told Seize the day! DDN's 4th service user conference held in Birmingham last Thursday.

Delegates who, talked about the need to come together to challenge stigma and shape the next generation of recovery orientated services. Mr Hayes said the government had set a clear direction of travel in the new Drug Strategy, but delivery of recovery-orientated services in a locally-owned landscape was uncharted territory.

He said bringing drugs and alcohol together under Public Health England (PHE) brought new opportunities ending historic criticism of this split. He also pointed out that proposals to locate directors of public health in Local Authorities are both an opportunity (to improve joint working) and a risk (for disinvestment in drugs and alcohol services). To learn more please follow this link

Source: National Treatment Agency

Treatment utilization and barriers to treatment: Results of a survey of dependent methamphetamine users 

Australia has one of the highest rates of methamphetamine use in the world; however, treatment access for methamphetamine is comparatively low. This descriptive study aimed to identify patterns of treatment utilization and perceived barriers to accessing treatment among dependent methamphetamine users in the hope that such information will enable services to more appropriately respond to this group. 


Source: INEF

Buprenorphine treatment in pregnancy: less distress to babies 

In this comparative effectiveness trial, buprenorphine was found to be superior to methadone in reducing withdrawal symptoms in the newborns, according to a recent study funded by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health. 

Methadone is currently the recommended treatment for opioid-addicted pregnant women, and when properly used is considered relatively safe for the fetus. However, it is associated with neonatal abstinence syndrome (NAS)—a cluster of symptoms stemming from opioid withdrawal in the newborn—often requiring medical treatment and extended hospital stays.

This study found that, compared to methadone, buprenorphine resulted in similar maternal and fetal outcomes, yet had lower severity of NAS symptoms, thus requiring less medication and less time in the hospital for babies. To learn more, please follow this link, and you can find the study here

Source: NIDA

Action needed to reduce health impact of harmful alcohol use 

Wider implementation of policies is needed to save lives and reduce the health impact of harmful alcohol drinking, says a new report launched today by WHO. Harmful use of alcohol results in the death of 2.5 million people annually, causes illness and injury to many more, and increasingly affects younger generations and drinkers in developing countries. 

The Global status report on alcohol and health analyses available evidence on alcohol consumption, consequences and policy interventions at global, regional and national level reveals the following statistics: 

  • Nearly 4% of all deaths are related to alcohol. Most alcohol-related deaths are caused by alcohol result from injuries, cancer, cardiovascular diseases and liver cirrhosis.
  • Globally, 6.2% of all male deaths are related to alcohol, compared to 1.1% of female deaths. One-in-five men in the Russian Federation and neighbouring countries die due to alcohol-related causes.
  • Globally, 320 000 young people aged 15-29 years die annually, from alcohol-related causes, resulting in 9% of all deaths in that age group.

Too few countries use effective policy options to prevent death, disease and injury from alcohol use. To learn more please follow this link

Source: WHO

Statement and position paper on capital punishment for drug offences for INPUD

INPUD’s opposition to the death penalty is based on both moral and practical grounds. Capital punishment is a violation of the Declaration for Human Rights, especially its fundamental tenets on the right to life and that no one be subject to cruel, inhuman, or degrading punishment. There is no proof the death penalty is a deterrent, or reduces crime. Judicial systems are subject to human error: and reports of mistaken identity, false or misleading evidence and forced confessions are not uncommon from retentionist countries.

Drug crimes are generally economic, non-violent and victimless offences; as such, they should never result in capital punishment. Even the International Narcotics Control Board has, in highlighting “proportionality”, acknowledged that some countries are getting “carried away” with drug crime punishments, the most unconscionable of which is execution. Excessive punishments have also been shown to restrict development of and access to more effective responses to drug related harm, including drug treatment programs. 

To learn more please follow this link and read INPUD’s rationale for ending capital punishment, particularly as applied to drug related offenses here

Source: INPUD 

Colombian President Would Consider Legalizing Drugs to Reduce Violence and Crime in His Country 

The conservative Colombian president's pronouncement comes on the heels of several other prominent Latin American leaders – including former presidents Fernando Henrique Cardosa of Brazil, Ceasar Gaviria of Colombia, and former Mexican presidents Ernesto Zedillo and Vicente Fox – who have expressed willingness to consider legalizing drugs as a way to address drug-related violence. 

Ethan Nadelmann, executive director for the Drug Policy Alliance, the nation's leading organization promoting alternatives to the war on drugs, released the following statement about President Santos's announcement: 

"President Santos's cautious but clear support for seriously debating the option of legalization as a solution to prohibition-related violence and crime sends an important message to other presidents and prime ministers.  Taken together with President Obama's recent acknowledgement that legalization is a legitimate topic for debate, it suggests that the debate is opening up globally in ways that are both unprecedented and essential to meaningful drug policy reform.” 

Source: Drug Policy Alliance 

Ecstasy 'does not damage brain power' 

Taking the drug Ecstasy does not impair mental function, according to a new study, which criticises previous research that showed cognitive difference between users and non-users. 

Tests comparing 52 Ecstasy users in the US with 59 non-users show that consumption does not lead to loss of mental ability, according to findings reported in the journal Addiction. Earlier studies that found impairment of brain power were flawed, it says. 

However lead author John Halpern, of McLean hospital in Massachussetts, warned that the drug is still risky. "Illegally-made pills can contain harmful contaminants, there are no warning labels, there is no medical supervision, and in rare cases people are physically harmed or even die from overdosing," he said. 

Source: The Guardian

Warning to heroin users after four drug deaths 

Drug workers have issued warnings to heroin users after four addicts died from overdoses in Kilkenny and Carlow in the last week. Experts said high purity heroin is now back on the streets following the end of one of the longest heroin droughts to hit the country. Three heroin users are reported to have died from overdoses in Kilkenny in the past six days, with a further death in Carlow. 

We are receiving reports that there are of batches of heroin that are better quality and can elevate the risk of overdose. Unfortunately, recently there have been three fatal overdoses in the Kilkenny region,” said Tim Bingham of the Irish Needle Exchange Forum. 

Pat Connaughton, a drugs outreach worker with the South East Drugs Task Force and employed by St Vincent de Paul, said the problem was now an epidemic, noting that the drug had been off the streets because of a supply problem but that a new batch is so pure it is killing users not used to the strength. To learn more, please follow this link

Source: INEF

Canadians back tougher sentences for drug dealers

Northumberland-Quinte West MP Rick Norlock said he's confident a majority of Canadians support his government's efforts to get tough on drug traffickers by making minimum sentences mandatory.

Bill S-10 amends the Controlled Drugs and Substances Act to include a minimum sentence of one year if the drug-related offence is committed for a criminal organization, or involves violence or its threatened use. The minimum becomes two years if the offence takes place in or near a school, or any public place frequented by young people under the age of 18.

The bill's most controversial amendment is to set a minimum sentence of six months for growing more than five marijuana plants for the purpose of trafficking. To learn more please follow this link

Source: Northumberland News 

EMCDDA Launch Hepatitis and Drug use Page

In Europe, injecting drug use is a major transmission route for hepatitis C virus (HCV) infections. Estimates suggest that around 1 million people who have injected drugs may be living with HCV in the EU today.

Typically between 40 % and 90 % of injecting drug users are infected, and many contract the disease soon after their first injection. This is due to unsafe injecting practices which include sharing of needles/syringes and other injection materials. 

The high prevalence of HCV infection among drug injectors represents a serious public health problem for the EU, made worse by the fact that many of those who have contracted the virus are unaware of their infection status. HCV infection may lead to severe chronic liver disease and premature death. This can occur after many years of asymptomatic infection. To learn more follow this link 

Source: EMCDDA

Bolivia energises campaign to legalise coca leaf 

The US is expected to push this week for a continued international ban on coca leaf chewing in its latest clash with Bolivia. US diplomats are due to file a formal objection to Bolivia's attempt to amend a half-century-old UN ban, claiming it would promote the raw ingredient for cocaine and undermine the "war on drugs". 

President Evo Morales, an Aymara Indian and former coca grower, called the prohibition, enshrined in the 1961 Single Convention on Narcotic Drugs, absurd and an affront to Andean culture. The leaf, a mild stimulant, has for centuries been chewed and brewed in tea to combat hunger, fatigue and altitude sickness. The Aymara and other indigenous groups use it in religious and cultural ceremonies. "How can it be possible that the coca leaf, which represents our identity, which is ancestral, be penalised," Morales said last week. 

Both sides have clashed repeatedly over the leaf since Morales became Bolivia's first indigenous president in 2005 on the promise of championing a culture long oppressed by European settlers and US-led "imperialism".

Morales expelled DEA agents, accusing them of spying, and asked the UN to decriminalise the leaf and bring the narcotics convention in line with the 2007 UN Declaration on the Rights of Indigenous Peoples. To learn more please follow this link 

Source: The Guardian

Mexico, chief casualty of America's 'war on drugs'

The central problem with the military strategy underlying the “war on drugs” is that it does not distinguish between violent and non-violent criminals, or serious and less harmful crimes. As Kerlikowske has pointed out, Mexican cartels are not "insurgents" or "terrorists", but "multivalent criminal organisations", which have diversified into a wide variety of activities including kidnapping, extortion, piracy, human trafficking, money-laundering and government corruption, as well as the transportation and sale of illegal drugs.

Of all of these crimes, by far the least harmful for social and economic development is the transportation of drugs. Although drug consumption is clearly damaging, simply transporting illegal substances does not, in itself, create violence, economic crisis or human suffering. And even the harm of drug consumption pales in comparison to the effects of kidnappings, beheadings and human trafficking, especially when the consumption involves marijuana, sales of which make up two thirds of the profits of the Mexican cartels.

Nevertheless, due to pressure from the US government, Mexican authorities have been forced to concentrate their scarce law enforcement resources on pursuing the least harmful crimes. This strategy has had the obvious consequence of pushing the criminals towards more dangerous and violent activities. The result: a stratospheric increase in violence, with over 35,000 assassinations in the past four years, 15,000 during 2010 alone. The problem in Mexico is, therefore, not a lack of firepower or support for the "war on drugs", but the very strategy of "war" itself.  To learn more please follow this link 

Source: The Guardian 

Drinking habits

THE world drank the equivalent of 6.1 litres of pure alcohol per person in 2005, according to a report from the World Health Organisation published on February 11th. The biggest boozers are mostly found in Europe and in the former Soviet states.

Moldovans are the most bibulous, getting through 18.2 litres each, nearly 2 litres more than the Czechs in second place. Over 10 litres of a Moldovan's annual intake is reckoned to be 'unrecorded' home-brewed liquor, making it particularly harmful to health. Such moonshine accounts for almost 30% of the world's drinking. The WHO estimates that alcohol results in 2.5m deaths a year, more than AIDS or tuberculosis. In Russia and its former satellite states one in five male deaths is caused by drink.

Source: The Economist

Swiss drug policy should serve as model

Countries whose drug policy remains focused on punishing offenders, including Russia and much of Eastern Europe and Central Asia, should learn from a Swiss strategy based on "harm reduction" that protects both users and communities, they said. 

"We had to change perspective and introduce the notion of public health. We extended a friendly hand to drug addicts and brought them out of the shadows," Ruth Dreifuss, a former Swiss president and interior minister (1993-2002), told a briefing.

Swiss authorities authorized experiments such as syringe exchange programs and safe injection rooms offering a shower, bed and hygienic conditions under medical supervision, said Dreifuss, who led the campaign to reform narcotic drug policy.

Some 70 percent of the 20,000-30,000 opiate or cocaine users in Switzerland now receive treatment, one of the highest rates globally, said Dr. Ambros Uchtenhagen. "The number of drug injectors with HIV has been reduced by over 50 percent in 10 years. Overdose mortality among injectors has been reduced by over 50 percent in the decade," he said. "Delinquency related to drugs has been reduced enormously."

To learn more please follow this link

Source: Reuters

Abuse in the Name of Treatment - Drug Detention Centers in Asia

We end this weeks report with a short film from the Hungarian Civil Liberties Union about forced drug detention centers in Asia.

Source: Drug Reporter



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