By Алексей Курманаевский,

Drugreporter’s partner, the DUNews filming crew visited Balti, a city of the Republic of Moldova to learn by experience about the harm reduction services. Watch their video!

Five cities of the EECA region are Almaty, Balti, Odessa, Sofia, and Tbilisi. United by the regional project of the Alliance of Public Health and Partners, with the support of the Global Fund, they undertook to stop AIDS and tuberculosis in their territories. We carefully examined this process and observed what will become the starting point for them: how strong the cities are right now, and how the project will change the services for the risk groups over, say, three years.

We present to you the point of view of DUNews on these five very different cities. They already have something to teach us, and the format we offer – research using video – gives us an excellent opportunity to see the city’s situation in its entirety and in detail.

Please enjoy and do not forget to use the interesting and useful solutions you can see in this film, in your work.

Meet the city of Balti, Republic of Moldova.

(Turn on English subtitles by clicking on the CC button at the right bottom of the video.)

Easy access: Harm reduction in Balti, Republic of Moldova

President Donald Trump has said he supports states deciding whether to legalise marijuana or not.

White House Press Secretary Sarah Huckabee Sanders said the president supports states’ rights on the matter despite a threat made just three months ago by US Attorney General Jeff Sessions.

Republican Senator Cory Gardner from Colorado, one of the states that has already benefited from legalising and regulating the sale and distribution of the drug, said Mr Trump made the pledge to him in a conversation between the two earlier this week.

Mr Gardner has been pushing to reverse a decision made by Mr Sessions in January that allowed federal prosecutors to pursue cases against people who were following marijuana laws in states that have legalised it.

The drug has been fully legalised in eight states, and 24 states allow some form of marijuana use.

Donald Trump says individual states can decide whether to legalise marijuana

Richard Di Natale’s policy would also allow sales in licensed shops and up to six marijuana plants at home for personal use.

The Greens have proposed full legalisation of cannabis – including for recreational use – with a new government agency to act as the single wholesaler of plain-packaged cannabis.

People would also be allowed to grow up to six marijuana plants at home for their personal use under the new policy, which was announced by Richard Di Natale on Monday.

The policy is the first time a party with significant federal representation has backed full legalisation, providing a point of difference with the Coalition and Labor, which both support a scheme initiated in 2016 to legalise cannabis for medicinal use only.

Under the plan cannabis would be taxed and regulated in much the same way as alcohol and tobacco. It would be sold to adults by licensed shops and attract GST as well as federal excise tax.

In a statement, Di Natale characterised the policy as a harm minimisation approach that treats “drug use as a health issue, not a criminal issue” and a rational response to the “failed” policy of prohibition.

 Greens propose full legalisation of cannabis in Australia

Bangladeshi authorities have proposed an overhaul of the country’s drug laws, which includes provisions for people to be executed for selling methamphetamine.

The country's Department of Narcotic Control (DNC) has drafted new overarching drug legislation for the country, the Narcotics Control Act 2018, which would replace the existing Narcotics Control Act 1990. If this new Act is introduced, someone found producing or selling over 200 grams of methamphetamine – colloquially referred to as “yaba” – could face the death penalty. The current maximum penalty for such offences is 15 years imprisonment.

Speaking in early April, the DNC’s head Jamaluddin Ahmed said "we'll raise the punishment for yaba trafficking. In the new law the maximum punishment will be [the] death sentence", according to Agence France-Presse. He justified the draconian measure by referring to “a huge inflow of yaba from Myanmar” that authorities have been unable to contain, and which has resulted – he claims – in increased use.

Currently, the law allows for the death penalty to be imposed for other drug offences, including heroin trafficking, but it is very rare in practice. Bangladesh has not executed someone for a drug offence since 2009. A movement towards implementing capital punishment for certain drug offences began to grow in 2017, following an apparent rise in methamphetamine use and increasingly heated political discussions on the subject.

"Drug addiction ... is turning in to a grave situation … The nation as a whole is in panic with the consequence of [the] increasing trend of using diversified additive [sic] items," a spokesperson for the DNC said in March 2017, "we need to do something drastic without any delay to come out from this evil situation. Otherwise, the whole nation may immediately start suffering so much [that it] will go beyond recovery and repair".

Bangladesh plans death penalty for selling meth

How many years have we known that abstinence-based programs like D.A.R.E. fail to truly educate young people about drugs, and that we need a replacement?

The answer: too many. But happily, now there’s an alternative: DPA’s 

Safety First: Real Drug Education for Teens

 started out as a resource for parents to talk to their teens about drugs and has now evolved into a curriculum designed to be implemented in 9th and 10th grade high school health classes. It is based in the principles of harm reduction and consists of 14 interactive lessons covering how we define a ‘drug,’ how drugs work in the body, their effects, risks and benefits of five major drug classes, and the impact of drug policy on personal and community health.

 is the culmination of almost 20 years of work in youth drug issues by DPA’s Dr. Marsha Rosenbaum, as well as many other DPA staffers. I am proud to have joined that group by guiding 

 in its first real-world pilot and evaluation last month at Bard High School Early College Manhattan. For the first time ever in a U.S. public school, students are receiving a science and harm reduction-based education about drugs.

The opposite of D.A.R.E – DPA launches new high school drug education curriculum in a NYC School

Amnesty International has expressed concern that the death penalty continues to be applied in some Middle Eastern countries, as it reported a worldwide decline in executions and death sentences in 2017. In its annual report published on Thursday, the international rights group documented at least 993 executions in 23 countries last year - a four percent decline from 2016, when 1,032 executions were recorded. From a record high of 3,117 in 2016, since Amnesty began documentation, 2,591 death sentences were imposed worldwide - a 17 percent decline. But for the second year in a row, the Middle Eastern countries of Iran, Saudi Arabia and Iraq were the top three for the number of executions in the world - along with Pakistan, they account for 84 percent of executions recorded worldwide.

At 264, the Middle East and North Africa region also recorded the highest number of drug-related executions last year, the report said. In Saudi Arabia, beheadings of drug offenders accounted for 40 percent of total executions - an increase from 16 percent in 2016.

Since 1977, Amnesty has been advocating the abolition of the death penalty, which Popoola said is "the ultimate denial of human rights" and "serves the society no good". "Despite strides towards abolishing this abhorrent punishment, there are still a few leaders who would resort to the death penalty as a 'quick-fix' rather than tackling problems at their roots with humane, effective and evidence-based policies," said Salil Shetty, Amnesty International's secretary-general, in a statement.

Amnesty: Almost 1,000 prisoners executed worldwide in 2017

ATLANTA — Dr. Nora Volkow has heard a frightening scenario play out around the country. People are administering naloxone to synthetic opioid drug users who have overdosed. But the antidote doesn’t work well. So they give another dose. And it’s only after multiple doses — four, five, even six times — that drug users finally come to their senses.

Naloxone is the only widely available drug to reverse opioid overdoses. But anecdotal reports of its limitations against synthetic opioids are on the rise. Spurred by that public health threat — as well as a booming commercial market for the antidote — drug companies, researchers, and health officials are eagerly eyeing the development of new treatments to augment the use of naloxone or, in some cases, potentially replace it.

“The strategies we’ve done in the past for reversing overdoses may not be sufficient,” Volkow, director of the National Institute for Drug Abuse, said in a recent speech at the 2018 National Rx Drug Abuse and Heroin Summit. “We need to develop alternatives solutions to reversing overdoses.”

Those alternatives are taking a variety of forms. One biotech company is studying a drug with similar mode of action as naloxone — an opioid antagonist — but one that lasts roughly four times longer. Some addiction medicine specialists are hopeful that a different drug, buprenorphine, presently used to treat opioid addiction, could also be tweaked to reverse an overdose. Meanwhile, the National Institutes of Health hopes to pursue research into drugs that wouldn’t counteract the opioids directly but rather keep the patient breathing — the thing that causes so many overdoses to be fatal.

The next naloxone? Companies, academics search for better overdose-reversal drugs

On-site testing of 'party drug' pills could reduce the harms caused by drug use and potentially save lives, according to an independent review of Australia's National Drug Strategy, published in the open access 

Dr Andrew Groves at Deakin University, Australia, examines evidence in support of pill testing to reduce fatalities caused by 'party drugs' such as ecstasy and methamphetamines, at festivals, clubs and raves. Pill testing involves party-goers having a sample of their drugs tested on-site by scientists and drug experts. They then receive information about what is in their drug, with the option of keeping the drug or anonymously handing it over.

Dr Andrew Groves, corresponding author, said: "The most surprising finding of our research is that the evidence has clearly identified the inadequacy of existing punitive, zero tolerance strategies across several countries, and yet such policies often remain embedded in government legislative action. While we still need further evaluation of how best to implement pill testing and other harm reduction initiatives, the evidence suggests that they are useful and there is widespread support from the community and practitioners in the field. The debate must be about harm, rather than criminality."

In the review, the author evaluated examples of drug policies around the world, including Portugal, where the government has implemented pill testing, as part of much broader policy reforms including the decriminalisation of the possession of drugs. This led to drug use being viewed as a public health concern, rather than a criminal issue and reduced problematic drug use and its related harms.

Review by researcher calls for pill testing to be part of Australia's drug strategy

The United States surgeon general issued a rare national advisory on Thursday urging more Americans to carry naloxone, a drug used to revive people overdosing on opioids.

The last time a surgeon general issued such an urgent warning to the country was in 2005, when Richard H. Carmona advised women not to drink alcohol when pregnant.

Naloxone is a medication designed to immediately reverse an opioid overdose. It blocks the brain’s opioid receptors and restores normal breathing in people who have overdosed on fentanyl, heroin or prescription painkillers. Its effects last for 30 to 90 minutes, which ideally buys enough time to get medical attention.

“Active drug users, people who live with or love drug users, and people on methadone or buprenorphine, who are often coming out of treatment and know people at high risk of overdose,” said Robert Childs, executive director of the North Carolina Harm Reduction Coalition in Wilmington, N.C. The surgeon general also listed patients who take high doses of prescribed opioids.

People who are coming out of prison or detox programs should carry the drug, because detox lowers tolerance, Mr. Childs said. Those who work in places where there are public bathrooms or where drug users congregate, such as shopping center parking lots, should consider getting trained to use naloxone and keep it on hand.

Naloxone stops opioid overdoses. How do you use it?

When the wave of adult marijuana legalization in some states started in 2013, the position of the federal authorities regarding the government’s international obligations to prohibit drugs was based on a flexible interpretation of the United Nations drug conventions, commonly known as the Brownfield doctrine. The legality of this interpretation has been questioned by the U.N. convention-control bodies. But as the U.S. administration grows more suspicious of multilateralism, is the United Nations still equipped, technically and politically, to be heard?

At the U.N. Special Session on drugs (UNGASS) held in 2016, almost every country that spoke in the General Assembly hall emphasized how high drugs were on their national agendas. Yet they all agreed that the 2019 review of the decennial U.N. political declaration and the plan of action on drugs would take the form of simple ministerial meeting at a subsidiary U.N. commission based in Vienna, the Commission on Narcotic Drugs (CND). This can be interpreted as proof that drug policy is not taken as seriously, despite how it impacts people’s lives on the ground.

International drug policy is different from other highly covered topics in the multilateral system for one main reason: no global player or P5 member has any apparent interest in opening a reform discussion, unlike for environmental, HIV or migration policies that benefit from large human, financial and communication resources.

The United States, which initiated the global war on drugs over 50 years ago, finds itself in a situation where its states are legalizing cannabis by ballot or legislative votes in contradiction with the U.N. drug conventions, while the country faces an unprecedented opioid overdose crisis that undermines every belief that prohibition results in effective drug control or is able to act as a deterrent for use.

International drug policy: Is the UN becoming irrelevant?

David Lammy MP is one of many who has suggested that a tougher approach to drug law would reduce knife crime..

This morning, during an interview about London's soaring knife crime problem, David Lammy MP told BBC Radio 4's 

 programme that "the police and our country has lost control of [the] drugs market". To some degree, he's right – but arguably, neither the government nor law enforcement ever had control of the drugs market in the first place, something the Home Office acknowledged in a 2017 report evaluating the national drugs strategy.

Lammy rightly said "there is no single cause" for the spike in fatal stabbings, but in denouncing the police's approach also seemed to be arguing that more drug policing would lead to a reduction in violent crime – a sentiment echoed by many on social media. The evidence, however, would suggest otherwise.

If politicians and police really want to tackle the rise in knife crime, drug policy reform is an important part of the solution. We should move away from the same old prohibitionist policies and instead focus on implementing strategies that treat drug use as a health and education issue, rather than a criminal justice matter. In recent weeks we have increasingly heard calls for an intensification of stop-and-search to tackle knife crime. However, these calls fail to properly analyse how this police power is currently used in London and how stop-and-search can contribute to young people losing trust in the police, leading them to take matters into their own hands.

Harsher drug policing will not stop knife crime in the United Kingdom

A new app has been launched to help the thousands of people prosecuted for drug possession every year in England and Wales.

 was developed by lawyers at Release, the UK’s centre of expertise on drugs and drug laws. It provides a step-by-step guide for dealing with a drug possession offence, including informing people of what to say and do in the police station and in court. The aim of the app is to get the best possible result for the individual depending on their personal situation.

As government data shows, a huge number of people continue to face criminal convictions for possessing small quantities of drugs for personal use. In 2016, a staggering 23,000 people in England and Wales were prosecuted for simple drug possession, among which 95 per cent were found guilty.

Due to government cuts to legal aid, most people who are prosecuted for simple drug possession in the UK are required to represent themselves in court – without a lawyer – if they cannot afford to pay for representation. If a person representing themselves fails to put forward relevant mitigation, or fails to accurately demonstrate their financial circumstances, they may face a harsher sentence or financial penalty. Essentially, under current conditions, poorer people may face unfair and disproportionate legal consequences for simple drug possession.

For example, someone found in possession of cannabis for personal use for the first time should receive a cannabis warning. However, someone without legal representation may be unaware of this, and may then accept a caution or conviction for cannabis possession, both of which can have far-reaching consequences - from hindering job applications to disqualifying them from obtaining certain international visas.

These consequences of criminalisation are compounded for people who have other issues besides their drug charge – including people with mental health problems or dependencies on drugs or alcohol – as their ability to represent themselves may be hindered further.

Kirstie Douse, Release’s head of legal services, said that the 

app will help address this inherent inequality in the UK’s legal system.

“It goes beyond providing knowledge of legal process and principles, and helps reduce the harms caused by the criminalisation of drug possession. We hope that this tool empowers people to engage with the law in order to ensure that it is applied accurately and fairly, preventing poor decisions.”