The number of patients admitted to hospital for overdosing on powerful and potentially addictive opioid painkillers has more than doubled in a decade, with doctors saying it is the “very worrying” consequence of the drugs being prescribed too readily.

Data from NHS Digital shows an increase in people attending hospital with poisoning from prescription opioids such as codeine, morphine, oxycodone and fentanyl rising from 4,891 in 2005-06 to 11,660 last year in England.

Dr Jane Quinlan, a consultant in anaesthesia and pain management at Oxford University Hospitals NHS foundation trust, described the increase as “very worrying”.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

Overdoses on opioid painkillers more than double in a decade

U.S. President Donald Trump is threatening that he may decertify Colombia as a partner in the war against drugs unless the South American nation reverses a record surge in cocaine production.

The shock rebuke for Washington’s staunchest ally in Latin America came Wednesday in the White House’s annual designation of nations it deems major drug-producing or drug-transit zones.

Colombia, the source of 90 percent of the cocaine consumed in the U.S., has long been a fixture on the list, which was unchanged from last year. But not since the late 1990s, when contributions from the Cali cartel funded the campaign of Colombia’s then-President Ernesto Samper, has the country’s commitment to fighting narcotics trafficking been called into question by Washington.

Twenty-two countries were designated by the U.S. as major drug transit zones Wednesday, and only Venezuela and Bolivia were deemed once again not to be fulfilling their international obligations to combat drug production and trafficking. The leftist governments of both those nations are hostile to the U.S.

Trump delivers shock rebuke to Colombia over cocaine surge

ASEAN countries continue to mete out extreme punishments against people suspected of using or selling drugs. Human rights advocates are concerned that President Rodrigo Duterte’s brutal drug suppression tactics, which have led to an estimated 12,000 people killed in the Philippines since June 2016, have emboldened other countries in the region to take similarly harsh measures. Amnesty International recently highlighted its concern in Indonesia, having documented at least 60 killings of drug suspects there this year. The rise in killings of alleged drug suspects follows the rhetorical sanction of such behavior by political leaders: in Indonesia’s case, both the head of the Narcotics Division and President Joko Widodo vocalized support for being “merciless” toward drug dealers.

In Cambodia, the arrest of people who use drugs continues to escalate since the initiation of a campaign against drug trafficking and use. By July, 9400 alleged drug users were arrested. While the impact of arrests on curbing drug use and trafficking has been questionable, the rising number of people arrested has strained the detention centers in that country. Cambodia’s detention centers have long been criticized by rights advocates for their lack of appropriate living conditions and access to health services, and for physical abuse, among other rights violations. With swelling arrests and long periods of pre-trial detention, conditions at the centers have worsened. The UN Special Rapporteur for Cambodia conveyed evidence of such conditions at her meeting with the Ministry of Social Affairs following her visit to Prey Speu, a detention center that the country’s Prime Minister had recommended in 2016 be improved or shut down.

People who use drugs are a UNAIDS “key population” requiring more attention and evidence-based support in order to reach global targets to end HIV/AIDS. This worsening environment further undermines, rather than protects, their legal status and human rights.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

Thumbnail Flickr CC Office of Public Affairs

Across Southeast Asia, people who use drugs continue to suffer arbitrary arrest and detention

The Ontario government announced Friday that it will create a cannabis control board and open up to 60 storefronts in the first year to manage the sale and distribution of marijuana in the province.

Ontario ministers announced the measures at morning press conference.

The plans include restricting marijuana sales to those 19 and older, a year above the minimum age recommended by the federal government's cannabis task force report in December.

The stores selling marijuana to the public will not be housed inside existing LCBO stores as Ontario Premier Kathleen Wynne had previously suggested.

Illegal pot shops in Ontario would be shut down over the next 12 months.

Ontario to create cannabis control board, open up storefronts

An international conference bringing together hepatitis C experts from around the world is today calling for strategies to prioritise people who use drugs, saying hepatitis C elimination is impossible without them.

"The number of people around the world dying from hepatitis C is increasing. We have the tools to reverse this trend, to eliminate this disease and save millions of lives. But it will not happen until people who use drugs become a focus of our efforts," said Associate Professor Jason Grebely, President of the International Network of Hepatitis C in Substance Users(INHSU), the convenors of the conference.

Hepatitis C is a blood borne virus that if left untreated can result in cirrhosis, liver cancer, and liver failure. Globally, there is an estimated 71.1 million people with chronic hepatitis C, resulting in over 700 000 deaths each year and the numbers are increasing. Eight per cent of those living with the disease and almost a quarter of new infections are in people who use drugs.

New, highly effective curative treatments have sparked hope of a world free of hepatitis C. Countries like Australia are currently on track to eliminate the disease as a public health concern by 2026 thanks to a public health strategy that offers treatment to all without restriction, and the prioritisation of people who use drugs. However in the US and many countries globally, hepatitis C testing, linkage to care, and treatment for people who use drugs remain low.

People who use drugs require prioritisation, not exclusion, in HCV elimination

The drug-users union known as VANDU marks its twentieth anniversary at a time when B.C. struggles with an unprecedented epidemic of overdose deaths.

In the late summer of 1997, a poster with a message aimed at drug users appeared on electrical poles around the Downtown Eastside.

“Meeting in the park,” one read. “Discussion items: police conduct, violence and safety, ‘Is this your home?,’ washroom facilities, neighbourhood relations....Let’s talk about a community approach.”

It was a revolutionary idea, that people who use drugs should gather and organize around shared challenges and interests.

On September 9, 1997, a few dozen people took note and met at the east end of Oppenheimer Park.

Donald MacPherson was there that day. He was working at the Carnegie Community Centre at the time and the plight of drug users who congregated on the corner of Main Street and East Hastings had caught his attention.

The Vancouver Area Network of Drug Users looks back on 20 years fighting for human rights

After the office was raided and computers were seized, the members of the staff and the Steering Committee announced their resignation from EHRN. Is this the end of the network? No, it is only the end of EHRN as an organisation but the network is alive and well. Another NGO has been registered to provide a new organisational framework. This is the story from the former co-chair’s perspective!

I received many questions after I resigned as the co-chair of EHRN. I know it must be frustrating for many members and allies to receive news that contain limited, sometimes conflicting information and don’t let them to see the whole picture. I am not a staff member and I was not involved in the day-to-day management of the network so I don't know all the details - but I feel it is my duty to tell you the story from my perspective.

When I was elected as the co-chair of the Eurasian Harm Reduction Network in 2014, I did not expect that the network will undergo the most serious organisational crisis during my term. It was a challenging period, with changing drug markets, new outbreaks of HIV, rising political populism, budget cuts, and retreating international donors all over the region. But the network itself was fit for purpose, and it seemed we had everything needed to face the problems: committed and capable staff members, stable financial resources, a vibrant and colourful membership. I thought the main challenge we had to focus on would be how to mobilise membership more effectively to implement our two main strategic goals, that is, to push national governments to reform repressive drug laws, and to provide resources for harm reduction programs.

What happened with the Eurasian Harm Reduction Network (EHRN)?

The apparent extrajudicial executions by Philippine police of two children over a three-day period underscores the need for a United Nations inquiry into President Rodrigo Duterte’s abusive “war on drugs,” Human Rights Watch said today. While several dozen children under 18 have died in drug war-related killings since June 2016, circumstances suggest that the Philippine National Police (PNP) deliberately targeted the two children.

“The apparent willingness of Philippine police to deliberately target children for execution marks an appalling new level of depravity in this so-called drug war,” said Phelim Kine, deputy Asia director. “These killings demonstrate that Duterte’s rejection of the rule of law has made all Filipinos potential ‘drug-war’ victims, no matter how young.”

On September 6, 2017, a passerby spotted the body of Reynaldo de Guzman, a 14-year-old Grade 5 student from Pasig City, floating in a creek, 20 days after he was reported missing. A pathologist report indicates that de Guzman died from at least 30 stab wounds after his assailants wrapped his head in packing tape. Packing tape has been a gruesome hallmark of many drug-war killings under Duterte. De Guzman had last been seen alive on August 18 in the company of his friend Carl Angelo Arnaiz, 19, who the police shot to death later that day after they accused him of robbing a taxi driver in Manila’s Caloocan City.

Philippines: abusive drug war targets children

Michelle Thiessen of the Canadian Students for Sensible Drug Policy and Nazlee Maghsoudi of the International Centre for Science in Drug Policy react to the Ontario's pot policy.

Is government control of marijuana sales the right way to approach legalized pot?

The Global Fund recently announced a list of priorities for multi-country funding for the 2017-2019 cycle. Of the $260 million available, some is ear-marked for pre-identified applicants and some will be open to competitive applications, though the eligible regions and objectives of the grants are prescribed by the Global Fund (see GFO article).

Noticeably absent from the list is any funding for multi-country approaches for HIV in Sub-Saharan Africa – the region hardest hit by the disease. The Global Fund has indicated that the decision was based on technical partners’ guidance and information. Activists have called it “frustrating” and “irresponsible.”

(Aidspan invited Seth Faison, the Global Fund’s Head of Communications to comment on a draft of this article. He provided a statement which we have included at the end of this article.)

Currently, the Global Fund is investing $59.3 million in eight multi-country HIV grants in Africa (see table), the majority of which end in 2018 without possibility of renewal.

Activists stunned by Global Fund decision to end funding for regional HIV programming in Africa

Heroin Assisted Treatment involves supervising prescribed pharmaceutical heroin self-administration with intensive psycho-social help to a minority of people with severe heroin dependence who have not benefitted from multiple other treatments.

The signatories of this letter include senior clinicians and researchers, major health organisations, peer based organisations and people with long standing experience and expertise in the fields of law enforcement, drug policy and drug treatment.

We support the urgent introduction of Heroin Assisted Treatment in Australia.

Twenty years ago this month in August 1997, the then Federal Cabinet decided against notifying the UN Commission on Narcotic Drugs of an intention to conduct an Australian trial of Heroin Assisted Treatment. Consequently, the proposed trial had to be abandoned.

Since then, trials of supervised heroin assisted treatment in seven countries with a combined total of more than 1,500 people using street heroin have found that this treatment was more effective than high quality methadone treatment for people with severe heroin dependence who had not benefitted from multiple other treatments.

Heroin Assisted Treatment, as well as more recently treatment with other injectable opioids, has been demonstrated to improve physical and mental health, reduce the use of street heroin, reduce criminal activity and improve social functioning. This treatment also saves a lot more money than it costs to provide or the current cost to the community of not treating people with severe heroin dependence.

Heroin Assisted Treatment is only needed for a small minority of the heroin using population. However, research in Switzerland, the Netherlands, Spain, Germany, Canada, Belgium and the UK has shown its benefit for individuals, families and communities is often quite profound.

Australia should start providing heroin assisted treatment

A commentary on a draft bill recently proposed at Parliament

Myanmar is better known for its serious drug problems - including large-scale illicit drugs production and trafficking and high rates of heroin use - than for implementing progressive drug policies that prioritise the health of its population. However, this could change in the near future.

Myanmar is better known for its serious drug problems - including large-scale illicit drugs production and trafficking and high rates of heroin use - than for implementing progressive drug policies that prioritise the health of its population. However, this could change in the near future. Last year, Police Colonel Myint Aung, head of the International Department of the Central Committee for Drug Abuse Control (CCDAC), commented in an interview that legislative changes were being considered to “make [drug use] a health issue, rather than a criminal one”. More recently, Major General Aung Soe, the military-appointed deputy Minister for Home Affairs, declared to a Member of the Parliament that “prevention and judicial strategies are not enough to solve drug problems,” and that “the economy, social affairs, health and development must [also] be taken into consideration”.

This changing approach to tackling drug issues is reflected in a draft bill that was approved by the upper house of the Parliament (“Amyothar Hluttaw”) on the 16th of August. The text proposes to introduce several amendments to 1993 Narcotic Drugs and Psychotropic Substances Law and, most notably, to eliminate prison penalties for drug use. In a country where failing to register as a drug user can lead to 3 to 5 years imprisonment, and where up to 74% of all inmates are in prison for – mostly minor – drug-related offences, the step is significant. However, if Myanmar policy makers really want drug users to be seen as people who need help and support, rather than as merely criminals, it is fundamental that they also extend the exemption from prison penalties to include the possession of small amounts of drugs for personal use.

The decriminalisation of drug use has long been advocated for by numerous organisations, including several local and international NGOs and UN Agencies. In February this year, the Drug Policy Advocacy Group – Myanmar (DPAG), a civil society platform, also released a briefing that recommended ending the criminalisation of drug use and increasing access to health, harm reduction and voluntary treatment for drug users, among other interventions. Indeed, extensive evidence from around the world shows that, while the fear of prison penalties is not an effective deterrent against drug use, it does have a substantial negative impact on the health of drug users and the community at large.

Thumbnail Flickr CC United Nations Photo

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