The world is suffering from an invisible epidemic, an epidemic of pain.

As many as 60 million people are reckoned to suffer avoidable agony every year.

It is a situation that a visionary Indian doctor, Dr MR Rajagopal, has been campaigning to change for decades.

It isn't that the patients themselves are silent, he explains. Indeed, it was hearing the screams of agony of a neighbour in the last stages of cancer almost four decades ago that first set him on the path that would earn him his nickname: India's "father of palliative care".

"His family asked if I could help", he says, "and I couldn't, I was just a medical student."

It was his sense of helplessness in the face of that suffering that led him to specialise first as an anaesthetist, then in palliative care - the prevention and treatment of serious health-related suffering.

Why are so many people denied the painkillers they need?

Sweden is accustomed to being praised for its forward-thinking approach, but there's one area where many feel it lies behind the curve. The country's "zero tolerance" policy towards drugs is an increasingly isolated one compared to its neighbours, and has even been subject to criticism from the UN. The Local's Sweden In Focus series looks at why Sweden takes such a hard-line stance on drugs, what the consequences are, and if it will ever change.

Sweden's long-standing zero-tolerance drugs policy is based on the fundamental vision of a "drug-free society", and was shaped by lobbying group The Association for a Drug-Free Society (RNS). The group, founded by psychiatrist and "father of Swedish drugs policy" Nils Bejerot in 1969, pushes for the prevention of drug use through penalties rather than treatment of drug addiction. This has led to tough policing with a focus on small crimes of possession.

As the Swedish government's website explains, the zero-tolerance policy makes no distinction between "hard" and "soft" drugs. Police can detain and give a compulsory urine test to anyone they suspect of being high – followed by a criminal charge if proven to be true.

Is Sweden's zero-tolerance approach to drugs a failing model?

Today, Public Safety Minister Ralph Goodale and Correctional Services Canada (CSC) Interim Commissioner Anne Kelly quietly announced a prison needle exchange program (PNSP) to be implemented in two federal prisons. Many prisoners, public health experts and advocates, including the Canadian HIV/AIDS Legal Network, have fought for more than 20 years for prisoners to have access to these types of vital health programs in Canada’s prisons. In fact, in September 2012, Steven Simons, a former prisoner, the Legal Network, Prisoners with HIV/AIDS Support Action Network (PASAN), CATIE and the Canadian Aboriginal AIDS Network (CAAN) launched a constitutional challenge against the Government of Canada over its failure to make sterile injection equipment available to federal prisoners and prevent the spread of HIV and hepatitis C (HCV) in federal prisons. This litigation is ongoing and continues to be necessary to ensure meaningful protection of the health and wellbeing of all federal prisoners, many of whom are from vulnerable and marginalized populations, including Indigenous populations. Today’s announcement by the Government of Canada reflects a significant concession by the federal government on the importance of PNSPs. As knowledgeable public health experts and advocates have maintained for years and the government now finally accepts, PNSPs are safe, effective and crucial to protect prisoners’ health. Moving forward, litigation is still necessary to ensure that the government completes the task as soon as possible and implements PNSPs in all federal prisons, in accordance with the evidence and public health principles. Every day without access to PNSPs violates prisoners’ fundamental Charter rights. It is clear that the Government of Canada now recognizes the solid and mounting international evidence about the effectiveness of PNSPs in preventing needless HIV and HCV infections behind bars. It is also clear that the federal government understands that PNSPs “are not associated with increased attacks on prison staff or other inmates, contribute to workplace safety, facilitate referral to available drugdependence treatment programs, and can coexist with other drug prevention and drug dependence treatment programs.” These are welcome developments, but will require determined follow-through, including the engagement of prisoners and the applicants in this lawsuit, to ensure that this important program is actually implemented, and that PNSPs are accessible and effective. Further information on our ongoing lawsuit against the Government of Canada can be found at http://www.prisonhealthnow.ca/.

Advocates welcome major change concessions in government of Canada's prison needle exchange announcement

 published an article by Ammar Shahbazi with the title “Bangladesh drugs gangs exploit Rohingya refugees.” The article made a number of conclusions based on little evidence, then linked them together to produce a sensationalist report that risks provoking an alarmist drug policy response and exposing Rohingya refugees to backlash.

First, the contributing writer Shahbazi claims that the influx of Rohingya refugees into Bangladesh has resulted in the increased availability of methamphetamine pills (commonly known as ‘yaba’). Shahbazi asserts that this alleged increase is based on the “dramatic fall of more than 50% in the price,” which is established only by the estimation of a person named Kashif Khan identified as a “Yaba addict” in the article.

Second, Shahbazi claims that Rohingya refugees “have brought problems” as “[s]ome drug traffickers have taken advantage of the desperate refugees, using them as couriers of their products.” There is no supporting evidence for this claim in the article, only a statement from the head of Bangladesh’s Department of Narcotics Control, who claimed that working as a “drug mule” was a “major option for a refugee to get to Bangladesh.”

The deportation of Rohingya from Myanmar has particularly affected Bangladesh. Since October 2016, the Myanmar authorities forced more than 715,000 Rohingya into Bangladesh, causing a humanitarian crisis. The issue of drugs in Rohingya refugee camps in Bangladesh should be treated as a protection issue and the Government of Bangladesh should ensure their protection.

My colleagues and I at the International Drug Policy Consortium, a global network of civil society organisations advocating for evidence-based drug policies that achieve improved outcomes for health, human rights, and development, appreciate ethical journalism and reports that are supported by evidence. Mr. Shahbazi’s article was neither. Sensationalist and inflammatory reporting such as this can cause serious harm. Similar reports of this nature have fuelled horrific human rights violations against people suspected of using or having other involvement with drugs, around the world but notably in Asia, including extra-judicial killings, use of the death penalty, torture, arbitrary detention, and denial of medical care. We trust the 

 will engage in responsible and rigorous reporting of these sensitive issues in the future.

IDPC letter to the editor of the Nikkei Asian Review regarding a recent article on the illicit drugs market in Bangladesh and the Rohingya

In 2006, Mexico adopted a national security policy firmly focused on the “war on drugs”. Under the justification of combating crime, the Armed Forces were called on to perform the role of the police and, twelve years later, hundreds of people have been killed in conflicts and thousands of others are missing.

The Mexican case bears similarities with what is being done in Brazil with the operations to Guarantee Law and Order (GLOs) and, more recently, the federal military intervention in public security in Rio de Janeiro. Both in Mexico and in Brazil, soldiers have taken on functions they are not equipped to perform and if they kill civilians, they are judged by military courts.

Data from the Rio de Janeiro Public Security Institute reveal that, in the first month of the military intervention in the state, the main indices that measure violence worsened and there was also a significant reduction in police activities, such as the seizure of weapons and drugs.

What Brazil can learn from the militarization of Mexico

It is a great pleasure to be here in Vienna for the first time as Secretary-General.

I thank the United Nations staff based here, the representatives of Member States, civil society and all our partners, for your work on some of the most challenging problems the international community faces today: transnational crime, human trafficking, corruption, drug policy, cybercrime.

My overriding priorities since taking office are preventing conflicts and crises, and mobilizing efforts to implement the 2030 Agenda for Sustainable Development. The UN Office on Drugs and Crime, and this Commission, have a crucial role to play.

I would like to say a few words about your work, in the context of our global efforts.

I welcome the three resolutions on human trafficking tabled at this Commission. This heinous crime is flourishing, as a result of protracted conflicts, growing inequality and the absence of an organized international response to migration.

The results are all around us: appalling deaths on the high seas and across deserts; forced labour and sexual servitude; the recruitment of child soldiers and many other forms of exploitation and abuse.

But these are just the visible signs of vast, cross-border criminal networks. We need to tackle these networks in their entirety, from recruiters to ship captains and brothel owners, all the way to the gang bosses who make fortunes from human misery.

This will require much stronger cooperation among Member States, based on the UN Convention Against Transnational Organized Crime and its Protocol on human trafficking.

The UN Security Council is targeting the financing of human traffickers.

The Global Compact on Safe, Orderly and Regular Migration that will be adopted later this year should be another milestone.

When we discuss crime prevention and criminal justice, we should always remember that laws work by compliance rather than coercion. It is the public’s perception of what is fair and just that best guarantees the effectiveness of law and its enforcement efforts.

This brings me to the top of the list of contemporary criminal justice issues: the fight against corruption.

I attach great importance to your work against this crime, which denies people opportunities, undermines economic growth and the rule of law, and damages people’s faith in governments.

Thanks to 24-hour news and social media, corruption is increasingly visible. It is rejected and repudiated by ordinary people all over the world, who want leaders and institutions that demonstrate transparency and accountability.

Combating corruption requires a culture of integrity, led from the top.

The UN Convention against Corruption, agreed fifteen years ago and adopted by 184 parties, is delivering real change. Legal institutions around the world are taking action.

I commend UNODC’s work in this area – but much more needs to be done. I urge you to strengthen the UN’s support to Member States in tackling corruption, strengthening good governance and the rule of law.

The United Nations Office on Drugs and Crime also has a key role to play in addressing the global menace of drug abuse and trafficking.

When I was Prime Minister of Portugal, I used the flexibility afforded by the three international drug-control conventions to introduce non-criminal, health-based responses to the possession of drugs for personal use.

We increased the resources allocated to prevention, treatment and social reintegration programmes, and we retained a very strict policy on the criminalization of drug trafficking. The policy was hailed as a major success. HIV rates among injecting drug users fell dramatically; drug use rates also fell by almost fifty per cent. Portugal now has one of the lowest death rates for drug use in Europe.

So I strongly endorse a balanced, comprehensive approach to drug policy, giving full weight to prevention and treatment, in line with progress made at the United Nations General Assembly Special Session on the World Drug Problem in 2016. I hope the next Ministerial meeting will build on these agreements.

UN Secretary-General's remarks to the 27th session of the Commission on Crime Prevention and Criminal Justice

In 2015, something strange happened in Japan – something which made the country, for a moment, think differently about its past. Akie Abe, the wife of the Prime Minister, was photographed standing in a field of very large cannabis plants. This was not an accident. She was arguing for the revival of a cannabis culture that had prevailed in Japan for at least 2000 years – until it was stamped out by foreigners, in living memory.[1]

Japan today has some of the harshest drug laws of any advanced democracy. If you are found in possession of cannabis in Japan for personal use you could receive a maximum prison sentence of five years, and if you are caught growing it, you can be sent to prison for up to seven years. Each year, the laws are enforced against 2000 people, who are brutally publicly shamed before, during and after their prison sentence.[2] For example, when the actress Saya Takagi was caught with cannabis, all reruns of the dramas she appeared on – like the popular detective series Aibo - were scrubbed from the TV schedules.[3] She had written the theme song for another TV show: it was immediately ditched. Or to give another example, when a rugby player for Japan’s national team was caught with the drug, he was banned from ever playing again, and the electronics giant Toshiba suspended all sponsorship of his regional team.[4] To be associated with cannabis in Japan is to be destroyed.

So at first glance, Akie Abe’s call to restore Japan’s earlier culture – even saying she had considered growing hemp herself – seemed baffling to many Japanese people. What was she talking about? “Most Japanese people see cannabis as a subculture of Japan but they’re wrong. For thousands of years, cannabis has been at the very heart of Japanese culture,” Japan’s leading expert on cannabis, Takayasu Junichi, told the Asia Pacific Journal in an interview.

Japan, the place with the strangest drug debate in the world

BANGKOK, 13th May 2018 (NNT) – The new draft narcotics law to be proposed to the Cabinet this month will allow the manufacturing, import, distribution, and possession of cannabis for research purpose and medical use, says official.

The Narcotics Control Board (NCB) Secretary-General, Sirinya Sitdhichai, said the development of the move to allow cannabis research and usage for medical purposes in Thailand was a result from years of joint working between the NCB and the Ministry of Public Health (MOPH). This had led to the drafting of a new narcotic code.

The new narcotic code will give the authority to the Minister of Public Health, under the suggestion of the NCB, to authorize the production, import, distribution, and possession of cannabis for research and for medical use. The law will also give the authority to the NCB to announce areas for cannabis farming for research and for medical use.

The new narcotic law is expected to be purposed to Cabinet meeting for approval within this month.

However, he said, this new narcotic law will not allow any manufacturing or use of cannabis for recreational purposes, making the manufacturing of cannabis by unauthorized person remains illegal and punishable. All procedures of cannabis research and medical use will be performed under strict control of the NCB and the MOPH.

New law in Thailand to allow cannabis research, medical use

The world’s first clinical trials exploring the use of MDMA assisted therapy for treating alcohol dependency have begun in the UK.

The study is being led by researchers from Imperial College London. It consists of multiple therapy sessions, with two of the sessions - in week three and week six - being MDMA assisted. The study’s initial sessions have already begun, with the first MDMA doses set to be administered in the coming weeks. The study could provide valuable insights into alternative therapies for mental health conditions.

TalkingDrugs spoke with Dr Ben Sessa, a consultant child psychiatrist and senior research fellow at Imperial, who is working on the trials. He highlighted how the currently available treatment options are simply not working for a lot of people.

According to the US’ National Institute for Alcohol Abuse and Alcoholism, approximately 90 per cent of people dependent on alcohol are likely to experience at least one relapse over the four-year period following treatment.

“There’s no other part of medicine that would tolerate that”, Sessa told us. “Imagine those kind of outcomes in surgery or immunology or even oncology. Doctors wouldn’t tolerate that. After a 100 years of modern psychiatry, it’s outrageous! If we can do any better than 90 per cent relapse rates then we’re onto something.”

World’s first MDMA trials for treating alcohol dependency begin in United Kingdom

They drink it in alleyways and markets, at bars and in private homes. They take it straight or mix it with Coca-Cola, making their purchases underground or in pharmacies, with a prescription or without.

It's codeine cough syrup, and Nigerian lawmakers estimate that the residents of just two states in the country's north consume more than 3 million bottles of it each day. “There is no family now that is not affected,” said Oluyemisi Ogun, the medical director at a psychiatric hospital in Lagos, at a symposium in Nigeria last year. “Our children are at risk as much as our husbands, wives and other relatives.”

Now the country’s health ministry has banned the import and production of the painkilling medicine-turned-street-drug. This week’s ban came immediately after the BBC released "Sweet Sweet Codeine," a documentary that shows pharmaceutical-company staff selling large amounts of cough syrup to undercover BBC reporters. The government claims the ban is the result of an internal investigation and not related to the BBC’s report.

Nigeria bans codeine cough syrup to stop an addiction epidemic. But something worse could take its place.

The Office of the High Commissioner for Human Rights (OHCHR) is currently seeking contributions for its report on the implementation of the UNGASS Outcome Document.

The mandate for the report derives from the Human Rights Council (HRC) resolution 37/42, adopted on 23 March 2018. The resolution requests the Office of the High Commissioner to prepare a report, in consultation with States, the United Nations Office on Drugs and Crime (UNODC) and other United Nations agencies, civil society and other relevant stakeholders, on the implementation of the joint commitment to effectively addressing and countering the world drug problem with regards to human rights, and to present it to the Human Rights Council at its thirty-ninth session, and also requests the Office of the High Commissioner to share the report with the Commision on Narcotic Drugs (CND), through the appropriate channels, as a contribution to their work in this field and in preparation for the sixty-second session of the Commission, which will include the 2019 Ministerial Segment.

Any relevant information (max. 1,500 words) should be sent

 either electronically to registry@ohchr.org (zmahmood@ohchr.org) or by post to the Office of the High Commissioner for Human Rights, United Nations Office at Geneva (c/o Zaved Mahmood), CH 1211-Geneva 10, Switzerland.

The Office will make all submissions publicly available on its website, unless otherwise advised by the contributor.

Report of the OHCHR on the implementation of the UNGASS Outcome Document with regard to human rights

A second pill-testing trial at an Australian music festival is likely to take place following its success at Canberra's Groovin the Moo, a leading drug expert has said. The president of Harm Reduction Australia, Gino Vumbaca, said it's a matter of when, not if, that a second trial would take place after the first round of testing in the country happened last weekend.

"I think that would be a natural conclusion to draw. I know there's been a lot of discussion with governments, but most governments outside the ACT have taken a position against it, but now they have an understanding of how it operates," he said. "What they should do is reopen political discussion on pill testing, now there's Australian-based evidence."

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