CapeTalk/702's Eusebius Mackaiser spoke to Shaun Shelly of Addiction Division, Department of Psychiatry and Mental Health at University of Cape Town, about the possibilities of decriminalising the use of recreational drugs.

Recreational drugs are mind-altering chemical substances that are used for non-medicinal, leisure purposes. Among them are methamphetamine, cocaine, crack cocaine, heroin, phencyclidine (PCP), MDMA or Ecstasy, and cannabis.

When asked how dangerous different kinds of drugs are, Shelly said that everything has inherent risk that can either be reduced or increased.

In the field of drugs, it is inherently policy that has made the use of drugs particularly dangerous.

— Shaun Shelly, Department of Psychiatry and Mental Health at UCT

He says the problem comes when there is criminalisation of drugs, adding that he believes we've had centuries of non-problematic use of cannabis in Africa until the colonials decided to burn it.

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Should drugs be decriminalised?

Faced with stark numbers of brain trauma and psychological distress cases among combat veterans, the nation’s largest active veteran’s organization has thrown its weight behind the growing movement to push for relaxing federal restrictions on marijuana.

The American Legion, the nation’s largest wartime veterans organization, took a position on medical marijuana for the first time last week. At its national convention, it passed a resolution calling on Congress to amend its laws to “at a minimum ... recognize cannabis as a drug with potential medical value”.

Marijuana is currently classified by the Drug Enforcement Administration (DEA) as a Schedule 1 drug, putting it alongside drugs such as heroin and cocaine. The designation, which the DEA reaffirmed last month, means that the federal government officially believes there is no “accepted medical use” for the drug.

“It’s a tool in a toolbox,” said William Detweiler, who serves as the chairman of the American Legion’s traumatic brain injuries (TBI) and post-traumatic stress disorder (PTSD) committee and who is a past national commander of the organization. “We’re not advocating the use of marijuana or any other drugs,” but he said veterans “have a right to anything that may help them”.

Darrin Harris Frisby/Drug Policy Alliance

Veterans group pushes to ease marijuana restictions to treat PTSD

Crystal meth is a popular drug in Indonesia. Recent years have seen an increase in the number of meth users, locally known under the street name shabu. However, so far, harm reduction services don’t target meth users. Mainline and local partner Karisma started an innovative pilot in Indonesia to change this.

The reason why Mainline finds it important to develop interventions that target this group of people who use drugs (PWUD) is that the research conducted by the Atma Jaya University in Jakarta shows that Shabu users are at increased risk of HIV infection and other STIs. This is true whether people snort, smoke or inject their drugs. The research also showed that Crystal meth users avoid existing HIV intervention programmes in Indonesia. They associate these services with heroin users and don’t identify with them.

The aim of the new harm reduction pilot is to reach this hidden population and address their health needs. A special peer-driven outreach team will experiment with different outreach strategies to reach the often hidden subgroups of crystal meth users. One can think of Men who have Sex with Men (MSM), sex workers and their clients, people who work night shifts or even students. Experimenting with new ways of outreach work will help to develop best practices on how to provide harm reduction to meth users. By documenting the lessons learned and strong data collection, we hope to develop a set of specific harm reductions interventions that can be replicated in other regions in Indonesia.

Crystal meth: piloting harm reduction for shabu users in Indonesia

By Jeerawat Na Thalang And Paritta Wangkiat

Thirteen years ago Saksiri Vanichanon was one of tens of thousands of addicts caught up in Thaksin Shinawatra's "war on drugs".

Then aged in his mid-twenties, he had first tried heroin when he was 15. He turned toya ba in 1996 after the government shifted methamphetamine on its drug schedule from Category 2 -- which allows medical use -- to Category 1, which carries the most severe penalties, including the death sentence.

Thaksin's crackdown on the drug trade had led to stricter police surveillance and the price of ya ba shot up from 30 baht a pill to more than 200 baht.

Mr Saksiri, now aged 39, said he had to steal money from family and friends to buy ya ba. The Thaksin government's extreme measures made him afraid, but he needed to feed his habit.

"Fear and needs are different matters," he recalled, saying the threat of imprisonment never stopped him from seeking out dealers.

Meth in the madness

In a major shift promoted by the Obama administration, the United States federal government is poised to end its use of private prisons, concluding that they are less secure and not cost effective. What does this shift mean for Latin America, where in recent years governments have been increasingly interested in prison privatization?

On August 18, the U.S. Department of Justice (DOJ) released alandmark memo instructing federal personnel to phase out their reliance on private prisons. The announcement was based on a report comparing 14 prisons operated by private companies and 14 prison facilities operated by the Federal Bureau of Prisons (BOP). The findings are staggering. Researchers found that private prisons had significantly higher incidents of violence than their government-operated counterparts. According to the report, private prisons saw nine times as many lockdowns due to emergency security situations, roughly 30 percent more incidents of inmates assaulting each other, and over 50 percent more incidents of assaults on prison staff. Private prisons also seized larger numbers of contraband like drugs, weapons, and cell phones. The report also identified major pitfalls in overseeing healthcare provision at private prisons, corroborating multiple press reports in recent years.

At the same time, these private prisons were found to be no more cost efficient than those run by the BOP. This element of the report is crucial, as it undermines a principal tenet of the drive to privatize prisons in the first place. Beginning in the 1980s, the private prison industry expanded rapidly with the promise that it could provide authorities with the same level of service as government-operated facilities, but at less cost. But the DOJ has concluded otherwise. In the August 18 memo, Deputy Attorney General Sally Yates asserted that private prisons “simply do not provide the same level of correctional services, programs, and resources; they do not save substantially on costs.”

In fact, the cost efficiency of private prisons in the United States has been put into question a number of times in recent years. Other studies have had similar findings. A 2011 study by the Arizona Department of Corrections found that public prisons were not significantly more expensive, and in some cases were as much as $1,600 cheaper per inmate per year than private facilities. A University of Utah analysis conducted in 2007 found that savings from private prisons were “not guaranteed and appear minimal.”

Private prisons: a questionable model across the Americas

Global health experts are today are calling for the removal of restrictions preventing people who use drugs from accessing new hepatitis C cures. So long as these restrictions exist, the goal of disease elimination will remain out of reach, they say.

They are gathered in Oslo for the 5th International Symposium on Hepatitis Care in Substance Users, where new research continues to highlight not just the pivotal role treatment for people who use drugs plays in reducing hepatitis C transmission, but also how it can be rolled out to achieve best results.

"The science is clear. We now need to focus on overcoming barriers to access, and harness latest research to implement programs that work," said President of the International Network of Hepatitis C in Substance Users (INHSU), Associate Professor Jason Grebely, the Kirby Institute, UNSW Australia.

"To delay further is unethical and undermines public health," he added.

New research supports hep C treatment for people who use drugs

VANCOUVER — Health Canada has amended regulations allowing doctors to prescribe heroin to people who are severely addicted to opioids.

The government says the country is facing an opioid overdose crisis and health-care providers need help in treating patients suffering from chronic dependency.

The change to the former Conservative government’s legislation means pharmaceutical-grade heroin can be prescribed under a special-access program in cases where traditional treatment has failed.

However, Health Canada says that while there is scientific evidence to support emergency access to the drug, the treatment is not an option for most people.

Health Minister Jane Philpott has said the government will hold a summit this fall to address the issue of opioid addiction leading to hundreds of overdose deaths across Canada.

Supervised heroin therapy is used in several countries, including Switzerland, Germany and the Netherlands, and a clinical trial in Canada has concluded injectable heroin was more effective than standard methadone treatment.

Canada allows heroin to be prescribed in severe opioid addiction cases

London's biggest nightclub Fabric doesn’t have a drug problem. The whole of the U.K. does. In the wake of north London borough Islington Council’s decision to permanently revoke the venue’s license on September 6, it might seem the local government are under the impression that the club is the only place in the country where people take ecstasy while they dance. But in fact, drug-related deaths in the U.K. are at an all-time high since records began in 1993. Drug use is rising, particularly MDMA, which 3.5% of young British people reported taking in the last year.

The fact is, pills and powders are a part of many ravers’ weekends up and down the U.K., and too many new users are dying due to a lack of education about what they’re swallowing. Two young men tragically died at Fabric this summer after taking MDMA. Outside of Fabric, though — to take just three recent examples — a 17-year-old girl died after taking ecstasy at Red Bull Culture Clash in June, a boy of the same age also died at Leeds festival in August, and a northern teenager overdosed at a friend’s house earlier in the summer. These young people lost their lives because of a society that refuses to talk about drugs, and instead takes a hardline criminalization approach.

Why closing nightclubs like Fabric does not save lives 

The Philippines has scaled up its war on drugs with devastating consequences. President Rodrigo Duterte’s tough talk and anti-drug platform has led to a staggering number of vigilante killings and the mass incarceration of people associated with drug use and its trade. But we’ve seen this before. 12 years ago, Thailand launched a bloody and ultimately futile war on drugs.

Both Thailand and the Philippines have prohibitive drug policies that demand severe punishment, with little provision for evidence-based public health interventions. Thailand, the Philippines and Singapore are the only three Southeast Asian countries that have rejected harm reduction policies.

Former Thai prime minister and former police officer Thaksin Shinawatra spearheaded Thailand’s 2003 war on drugs using inflammatory phrases such as ‘shoot to kill’ and ‘eye for an eye’ to legitimise and incite violence. In three months police killed more than 2,275 people with impunity and 320,000 people surrendered themselves to the police. There were reports of human rights abuses ranging from harassment and sexual violence to torture. And throughout the campaign, public opinion polls showed widespread support — up to 90 per cent — for Thaksin’s efforts.

Duterte’s drug policy following in Thailand’s footsteps

For decades, public health experts have known that syringe exchange programs reduce the spread of certain viral infections — like H.I.V.,hepatitis B and hepatitis C — by removing contaminated syringes from circulation.

They have known that programs using sterile injection equipment are both safe and save money.

And yet they are rarely seen in the United States.

Evidence abounds that they work. A study of the first American program — started in the Tacoma, Wash., area in 1988 — found that use of the exchange was associated with a greater than 60 percent reduction in the risk of contracting hepatitis B or C. Another study of over 1,600 injection drug users in New York found that those who didn’t use a syringe exchange in the early 1990s were more than three times as likely to contract H.I.V.

Syringe exchange programs do more than improve health. Because they are so effective and far cheaper than the lifetime cost of treating H.I.V., hepatitis B or hepatitis C, they save taxpayers money. A cost-effectiveness analysis published in 2014 replicated the findings of others that came before it: A dollar invested in syringe exchange programs saves at least six dollars in avoided costs associated with H.I.V. alone.

Politics are tricky but science is clear: Needle exchanges work

This movie features the Global Ibogaine Conference that was held in Mexico in March, filmed by a member of Drugreporter's new global video network and an alumni of our video advocacy training, Brun Balanced and his peers, Karina Muscarina and Gabriel Amezcua.

The Global Ibogaine Conference has emerged as one of the most important events in the world for discussing ibogaine therapy, the overall climate of drug policy, its relationship with plant-based medicines - as well as the sustainability and traditional use of this African plant with psychedelic and medicinal properties, tabernanthe iboga, which has shown amazing beneficial effects, as yet unknown in other plants or substances.

Organised by the Global Ibogaine Therapy Alliance (GITA), this year's conference was held in the magical colonial village of Tepoztlan, Mexico, between March 14-16th, and brought together more than 500 people from around the world. This mini-documentary allows us to appreciate the reasons why this conference marks a historic moment in the research of tabernanthe iboga. Never before has an ibogaine conference attracted so many people, and generated such a multidisciplinary and diverse atmosphere in terms of the profiles of speakers and contributors.

A global conference on ibogaine

The resurgence of interest in the medical and spiritual uses of psychedelic and entheogenic substances is occurring in many parts of the world. However, restrictive drug policies that criminalize people and create obstacles for research are a major impediment to realizing the potential of these substances to catalyze healing and learning.

This presentation is based on interviews conducted with 30 informants working in psychedelic research or drug policy reform, along with supplementary internet research, to explore perceptions of cross-fertilization between movements. Our findings suggest that by fostering cross-sectoral capacity building, each of these movements can be strengthened and contribute to shared goals of shaping global drug policies that minimize harms and maximize benefits of psychedelic and entheogenic substances.

Andrea Langlois holds a Master’s in Media Studies from Concordia University (Montreal, Canada) and lives and works in Victoria, British Columbia. She is a community-based research facilitator, working to create links between community and university researchers and to build capacity for involvement in engaged geared at catalyzing social change. Andrea’s current research focuses on the areas of HIV/AIDS, housing, drug policy, stigma, and social movements and psychedelics. She has also written and edited books and articles on autonomous media and pirate radio in the Canadian context.

Kenneth W. Tupper is an Adjunct Professor in the School of Population and Public Health at the University of British Columbia, where his research interests include: psychedelic studies; the cross-cultural and historical uses of psychoactive substances; public, professional and school-based drug education; and creating healthy public policy to maximize benefits and minimize harms from currently illegal drugs. Kenneth’s Ph.D. dissertation (and earlier M.A. thesis) in Education developed the concept of “entheogenic education,” a potential theoretical frame for understanding how psychedelic plants and substances—in particular the Amazonian brew ayahuasca—can function as cognitive tools for learning.

Thumbnail: GFDL wikimedia Frank Vincentz

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