After years of denial and hesitation, Punjab has at last taken the first step towards addressing the opioid crisis currently confronting the state. The decision taken last month by the Government of Punjab to open “Outpatient Opioid Assisted Treatment” (OOAT) centres constitutes an evidence-based, compassionate approach for people struggling with dependence — and shows what a health-oriented approach to drug use may look like on a national scale.

OOAT centres are being set up in the three districts of Amritsar, Taran Taran and Moga, and will be expanded to other areas in the state. They will provide a range of services to heroin/opioid-dependent persons, including counselling, peer support, referral, follow-up and, most importantly, pharmacological therapy using Buprenorphine, which is an internationally accepted Opioid Substitution Therapy (OST) for treating dependence, recommended by the World Health Organization, the UN Office on Drugs and Crime, and scientific bodies.

A template to fight addiction in Punjab

Intravenous drug users who inject in a secret U.S. facility where staff provide clean needles and guard against overdoses say they appreciate the site for letting them in off the streets and for its history-shaping role.

“It’s history in the making,” one of the users of the underground supervised-injection facility told a researcher in a new International Journal of Drug Policy report. “It’s the first of its kind.”

The clandestine site, operating in an undisclosed urban area hard hit by the opioid epidemic, is the first known safe-injection site in the U.S.

Thumbnail: CC Flickr Living-Learning Programs

Drug users find safety, community in underground injection facility

An estimated 4,000 prisoners currently on death row in Iran for drug-related crimes could have their death sentences revoked according to a just-issued judicial order based on the country’s newly amended drug trafficking law.

“Iran has taken a positive first step toward reducing the country’s high execution rate,” said Hadi Ghaemi, the executive director of the Center for Human Rights in Iran (CHRI).

“The amendment to Iran’s Law Against Drug Trafficking is the result of the international community banding together to engage Iran on improving its human rights record as well as the determined efforts by activists inside Iran and members of Parliament to push the amendment past hardliners,” he added.

Iran suspends thousands of drug-related death sentences after years of domestic and international campaigning

Europe remains an important market for illicit drugs, both in terms of those supplied within the continent and shipped in from other regions worldwide. During the past two decades, new drug trends have emerged across Europe and the market has continued to evolve. These are largely due to innovations in drug production and trafficking methods, the establishment of new trafficking routes and online markets.

The EU Drugs Strategy has attempted to respond to these global challenges through adopting an international approach to drug trafficking and sales and being reactive to new patterns in drug consumption. However, this does not seem to have curbed the rise in drug-use or drug-related deaths across Europe.

Is the EU drugs strategy helping to curb the harm caused by drugs?

As of 1 January, Denmark now allows the use of medical cannabis for patients suffering from various illnesses. The four year-trial was authorised on 18 December by the parliament in Copenhagen, in a move which also licensed some companies to grow and produce the drug in the Scandinavian country.

Cannabis is increasingly recognised as a valid tool to fight pain by the international medical and scientific community. In the EU, only Austria, the Czech Republic, Finland, Germany, Italy, Portugal, Poland and Spain currently authorise marijuana's use as a medicine - while a few other states are planning legislation on the issue.

Medical cannabis makes small steps in EU

If a single date marks the beginning of the end for the legal prohibition of marijuana, there’s a very good case for January 1, 2018.

On this day, California began allowing the legal sales of marijuana for recreational use. According to state estimates, more than 400 businesses were licensed. With that, the most populous state — and the world’s sixth-largest economy — officially launched an entirely new legal industry within its borders.

This all goes back to California’s successful 2016 ballot initiative, in which 57 percent of the state’s voters elected to fully legalize marijuana.

California’s new legal marijuana market marks the beginning of the end for prohibition

The Elton John AIDS Foundation today announced new funding initiatives to increase advocacy and service delivery for people living with and at-risk for HIV and hepatitis C.

In Eastern Europe, we will launch the Key Populations Fund for Eastern Europe and Central Asia (EECA KP Fund), focused on prevention and treatment of HIV for individuals most vulnerable to the HIV epidemic in the region: people who use drugs, sex workers, and gay and bisexual men in the region.

EJAF announces bold new funding initiatives to combat HIV epidemics in Eastern Europe/Central Asia and in the U.S.

KnowYourStuffNZ director Wendy Allison said they had seen a particularly high number of cathinones, often called bath salts, this summer.

The New Zealand Drug Foundation said cathinones are a group of drugs which are much more harmful than the drugs they mimic, and very little is known about the risks from short or long term use.

Drugs tested at festivals found to be 'much more potent'

The Japanese government decided Friday to consider promoting drug offenders’ rehabilitation through the utilization of withdrawal services offered by medical and other institutions, instead of consigning them to prison.

The plan is part of the government’s five-year program for the prevention of repeat offenses starting in fiscal 2018, which was adopted at the day’s cabinet meeting.

“What’s important is to steadily implement enduring measures,” Prime Minister Abe Shinzō told the meeting. He said the government should work on crime control in cooperation with the private sector.

Japan to promote drug offenders’ rehabilitation outside prison

О том, как культурные различия, политическая обстановка и ожидания доноров формируют политику снижения вреда – и о том, как они могут помешать этому движению достигать изначально поставленных целей.

Мы снимаем фильмы о наркополитике с 2007 года. С тех пор мы объехали почти весь мир, посетили множество сайтов снижения вреда и взяли интервью у сотен активистов, профессионалов и руководителей в самых разных странах.

О состоянии дел в области снижения вреда в конкретной стране легко сделать поспешные выводы. У меня всегда есть определенная картина в голове, еще до того, как приехал в страну – ведь я прочитал столько статей и отчетов. И, как правило, потом приходится признавать, что действительность намного сложнее сложившихся о ней представлений. Из опыта я знаю, что иногда в тех странах, которые считаются реакционными в вопросах наркополитики и снижения вреда, можно увидеть потрясающие примеры живых и энергичных программ снижения вреда на местах. А страны, которые традиционно хвалят за прогрессивную политику в отношении наркотиков, могут разочаровать жестким и медикализированным подходом к решению проблем.

Иногда самые важные уроки в области снижения вреда и прав человека можно извлечь из опыта именно тех людей, которые живут в странах с самыми неблагоприятными условиями.

 Часто их опыту не уделяется должного внимания, и только успешные примеры работы описываются и восхваляются в отчетах международных организаций. Но ведь для руководителей и профессионалов снижения вреда, работающих в сходных по сложности условиях, полезно не только знакомиться с передовым опытом западных стран, но и делиться своими собственными наработками и знаниями. То, что страна отстает по измеримым показателям в области либерализации наркополитики, не обязательно означает бесплодность усилий в области адвокации за перемены.

Снижение вреда работает во имя людей, для людей и силами людей. Оценивать научные данные по показателям распространения инфекций или доступности служб необходимо, когда мы рассматриваем социальное значение снижения вреда как комплекса мероприятий. Однако статистические данные сами по себе вовсе не дают нам полной картины того, насколько действенно снижение вреда как движение, насколько глубоко укоренилось оно в местном политическом и культурном контексте, каково его влияние на жизнь отдельного человека и общества.

Можно выделить несколько основных факторов, которые определяют суть и форму снижения вреда. Эти структурные факторы не так уж сильно отличаются от тех, что формируют индивидуальный опыт в отношении наркотиков. С 1960-х годов общепринято считать, что опыт в отношении наркотиков основан на трех факторах: отношение (ментальный настрой потребителя наркотиков), окружение (физическая и социальная среда) и доза (используемого вещества). Аналогичным образом, снижение вреда в стране во многом определяется следующими тремя факторами:

Оставайтесьвкурсесобытийнаркополитики, подписавшисьна

Снижение вреда не в цифрах

It was bound to happen. The Polish Ministry of Health has decided to target ‘legal highs’ and it is doing it in the worst imaginable way. If the Ministry’s ideas are implemented in their current form, mere possession of new psychoactive substances may send people to prison for up to three years.

The new draft law on drug use prevention prepared by the Ministry of Health was announced on November 13th . It is 41 pages long and its authors promise that the new regulations will solve the problem of legal highs. I have read the draft proposal and haven’t seen any sensible suggestions.

Everything that’s wrong with Polish war on legal highs

This weekend will mark the 30th anniversary of legislation to support the implementation of one of New Zealand’s most successful public health programmes. The New Zealand Needle Exchange Programme has been leading harm reduction in New Zealand for 30 years.

On 17 December 1987, New Zealand became the first country in the world to introduce a state sponsored needle exchange programme when parliament passed the Health (Needles and Syringes) Regulations. This Sunday will be the 30th anniversary of this important legislation.

The needle exchange programme facilitatesthe supply of needles and syringes to people injecting drugs in order to minimise the risk of the spread of blood borne viruses. Due to the early introduction of needle exchange, the prevalence of HIV amongst people who inject drugs in New Zealand is relatively low (0.2% compared to 13% internationally).

Needle Exchange is as important today as it was in the 1980’s. Whilst there have been significant advances made in relation to HIV infection within the community, hepatitis C is a significant issue. With new drugs and patterns of injecting drug use, the needle exchange remains as relevant as ever and at the forefront of harm reduction in New Zealand.

As we approach our 30th year we acknowledge the work of all those involved in the early development of the programme, members of the injecting drug using community who mobilised, self-organised and advocated for support for people who used and injected drugs. Members of the gay community, and sex workers supported this early activism.

New Zealand and Australia have led the world in the development of peer based and peer led needle syringe programmes. We now distribute over $3million needles and syringes each year through a national network of dedicated outlets stretching from Whangarei through to Invercargill and a comprehensive pharmacy programme. Today we remain peer led, and peer based, committed to a health, and human rights based service approach for people who use drugs.

Needle and syringe programmes are an important harm reduction intervention. Harm reduction is based on empathy and a non-judgemental approach, working with people where they are at and however they understand their drug use. Injecting drug users frequently experience stigma and discrimination; this can often present a barrier to accessing services. As peers mainly staff our exchanges, we have an established credibility and trust within the community. Needle exchanges are therefore a safe space and an important source of information and advice.

“The principle of nothing about us, without us, for us has driven the development of needle exchange in New Zealand. Today is an important milestone and an opportunity to acknowledge the activists and pioneers from both the injecting drug using and health community who advocated for this important legislation. Because of their hard work and hard won battles, New Zealand today has an enviable record internationally in reducing the spread of HIV amongst those who inject drugs.” Kathryn Leafe – Executive Director NZNEP

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