The launch of a new Senegalese drug harm reduction network has solidified the traditionally conservative country’s reputation as a regional leader amid fears that increased exposure to drug trafficking routes could see a rise in national drug use.

The new National Network of Civil Society Drug Organisations (Réseau national des intervenants de la société civile sur les drogues) has been formed by non-governmental organisations hoping to promote cooperation in order to better support people who use drugs problematically.

Civil society groups met 4 October to strategize how the network could identify relevant groups working on issues as diverse as gender-based violence, HIV/AIDS & TB prevention and drug education reports Senegalese newspaper Le Soleil. The network hopes to encourage mutual dialogue and the establishment of common positions on drug issues between these groups.

The Executive Secretary of the National Council to Fight AIDs who presided over the meeting, and with whose organisation the new network will be working closely, told Le Soleil that “we can no longer obscure the issue content with saying that Senegal is merely a transit country for drugs, because our country is also a place of drug consumption”.

Senegal has a relatively low rate of HIV infection in the general population (0.7%) reports the West African Commission on Drugs (WACD), the rate among people who inject drugs is significantly higher (10.2%) and Hepatitis C prevalence is as high as 23 percent among this demographic according the United Nations Office on Drugs and Crime.

Effective action by the Senegalese government such as including drug users as a target group in their 2011-2015 National AIDS programme and the establishment of a community-based needle exchange programmes in 2013 has made Senegal a regional bright spot; the only country where such provision exists report Harm Reduction International (HRI).

These programmes allow educational outreach on safer drug injection practices as well as the distribution of sterile equipment.

UNODC reports that since the 1990s the West African region has become a key trafficking route for heroin, cocaine and amphetamine-type stimulants. Senegal’s increasing consumer purchasing power combined with already established availability of drugs entering through its extensive coastline makes the country vulnerable to an increase in problem drug use.

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New harm reduction network launched in Senegal faces uphill battle

Under investigation was what sort of harm-reduction interventions can be developed with a view to reducing the risk of a GHB-related (Gamma-hydroxybutyrate) overdose and the associated health damage. The study’s conclusion is that the harm reduction measures to be developed are strongly dependent on the subgroup based on the GHB experience, their information needs and their level of knowledge on the topic of overdosing.

Within this study, three distinct groups were identified:

1. People with modest GHB experience
(lifetime use: 1 – 50 times)

are the ones most eager to avoid passing out. This group is interested in hearing stories of other people who use, harm-reduction tips and the long-term effects of GHB.

 befitting this often higher educated audience are informative online / offline articles about sex, drugs and health where experiential stories are supplemented with expert knowledge. This group often cites sexual arousal as a motivation for using GHB. Other possibilities include: strengthening bonds within peer groups, such as appointing someone to keep track of time and dosages, and developing a GHB helpline where people can seek advice anonymously.

2. People with considerable GHB experience
(lifetime use: 50 to 200 times)

say they pass out occasionally due to their frequency of use. They are interested in tools that facilitate safer use. Under the influence you lose your inhibitions, your vision and sense of time.

 is to distribute syringes with which the dosage can be measured more precisely in millilitres. The use of a timer can also be encouraged. These tools can be integrated with a 'G-app': an application on smartphones with information about GHB and passing out. An added value of an app can be a monitoring function that makes your substance use within the time period visible. With the help of self-control tips, periods of non-use can subsequently be strengthened.

Overdose prevention among hard-to-reach people who use GHB at home

Outreach workers armed with sterile needles, condoms, and screw caps patrol the narrow river that marks Malaysia's northern border with Thailand, looking for men from both countries who gather there to take drugs.

Even though punishments for drug use in the Southeast Asian nation are severe, none of the users they meet are likely to be arrested. The police know what's going on but stay away.

The workers are the front line in Malaysia's 10-year-old harm reduction programme that has helped curb a disturbing rise in HIV infections among injecting drug users. Cooperation between health officials, civil society groups, and the police has also eased widespread scepticism about needle exchanges and the provision of methadone treatment for people addicted to drugs.

"We needed this programme, and we needed it to be quick," said Dr Ilias Adam Yee, executive director of the Malaysian AIDS Council. "The epidemic was blowing up."

In Kelantan, the site of the Golok River, the HIV infection rate was running at four times the national average before harm reduction was introduced.

"The reality is that we cannot stop them from getting involved in drugs, so we make sure when they do, they can use a clean syringe and have safe sex," explained Dr Ahmad Razin Ahmad Mahir from the Ministry of Health in Kelantan.

"That is the crux of the programme. Our interest is to control HIV, and we have managed to do that."

Yet, despite growing evidence that the programme reduces the risk of HIV and helps wean users off hard drugs, global funding for such initiatives - already only seven percent of the $2.3bn UNAIDS estimates is needed in 2015 - is under threat as donor priorities shift.

Malaysia: Halting HIV and drug use with compassion

Civil society organisations (CSOs) in West Africa have been urged to effectively strategise and work together and with their respective governments to influence better policies aimed at addressing the drug problem in the region.

Members of the West Africa Drug Policy Network (WADPN) were invited to influence their governments to take a common position to counter the ‘war on drugs’, which is considered to be a failed approach to address the drug problem in the region.

“We have a huge task ahead. As we target UNGASS to get more of our governments to support our agenda and make political commitments at the global level but also come home to domesticate and implement them, we must bear in mind the fact that it will take more than the ordinary to get us what we want and we must be prepared”, said Nana Afadzinu, Executive Director of the West Africa Civil Society Institute (WACSI).

She made this call as national focal points of WADPN convened in Dakar, Senegal from October 13 to 16 to deepen their understanding of the drug problem in the region and brainstorm on a common position towards UNGASS 2016.

This convening created a forum for the capacity of participating organisations to be enhanced on emerging issues related to drug policy, drug prevention and treatment, harm reduction, security and governance and effective advocacy.

CSOs in West Africa promote harm reduction strategies 

A recent ruling in Australia could result in naloxone, the life-saving drug that reverses opioid overdoses, being available without prescription from February 2016.

The interim ruling, made by the Therapeutic Goods Administration (TGA), moves naloxone from Schedule 4 to Schedule 3, removing physical and legal barriers for those most in need of access to the life-saving medication, while also making it possible for families and friends of drug users to obtain naloxone to keep on hand. One of the reasons provided for the decision is the following:

"Benefits of rescheduling naloxone for reversal of opioid overdose to Schedule 3 include that products would be supplied labelled with full and clear instructions for use, understandable by consumers. People who need naloxone would be able to obtain it more easily, which is likely to decrease the proportion of (deliberate or accidental, usually illicitly obtained) opioid overdoses that result in death. Increased accessibility would also potentially reduce morbidity due to opioid overdose, such as hypoxic brain damage."

As it currently stands, those who seek access to naloxone need to visit a doctor and admit to using opioids in order to receive a prescription.

When it comes to opioids, heroin has historically been the most misused in Australia, though there has been concern about an uptick in the rate of overdoses related to prescription painkillers in recent years.

In 2011 the National Drug and Alcohol Research Centre (NDARC) reported 683 opioid-related deaths and the rate of fatal opioid overdose in Australia to be 30.5 deaths per million, highlighting the need for unrestricted access to naloxone. In 2012, the amount of drug overdose deaths outnumbered the amount of deaths from road accidents (1,427 and 1,338 respectively). Opioids are estimated to account for around 650 overdose deaths on an annual basis.

Naloxone to be made available over the counter in Australia

On October 24, 2015 in the case of Beka Tsikarishvili v. Parliament (application 592) the Constitutional Court of Georgia declared as unconstitutional the imprisonment for purchase and keeping of marijuana for personal use. The court ruled that imposing such punishment is mainly a torture, cruel, inhuman, or degrading treatment.

The Constitutional Court made a big and progressive step for changing the repressive drug policy of Georgia and took a heavy burden out of the society, which in general one more time highlighted Georgia’s rank in democratic index in the region and at an international level.

According to the official website of the Constitutional Court where the information published on 24 October 2015 the court notes that purchase and keeping of 70 grams of marijuana for which the applicant is charged cannot be indicative towards the purposes of sale or its real intent, and imposing the imprisonment amounts to torture,

cruel, inhuman, or degrading treatment confronting the Article 17 of the Constitution. Article 17 § 2 of Georgian Constitution provide: “No one shall be subjected to torture, cruel, inhuman, or degrading treatment or punishment”.

The Court further notes that current legislation considers 50-500 grams of marijuana as a large amount. The Court considers that keeping 70 grams of dry marijuana do not represent such an amount which might indicate to the intention of sale of drug. The court noted that legislature have an obligation to form such provisions which will enable a judge to find the fact if there is an intention of sale during purchase or keeping of marijuana or probability of such an intention and finally impose the imprisonment only in the case of established intention of sale.

Georgia: Imprisonment for purchase and possession of marijuana is unconstitutional 

Russia is home to 69% of all people living with HIV in Eastern Europe and Central Asia, and its HIV epidemic is concentrated among people who inject drugs. In Moscow alone there were more than 30,000 people who use drugs registered with the drug treatment specialists in public clinics in 2013, and the total number of people who use drugs in the city is likely to be higher.

In addition to being at highest risk of HIV in Russia, people who inject drugs are among the most marginalized and stigmatized populations in the country. Criminalization of drug use, quota-based law enforcement and low availability of opioid substitution therapy are major barriers to harm reduction.

Activists in Moscow allege that people who use drugs are frequently denied their rights. An initiative by the Andrey Rylkov Foundation (ARF), a non-governmental organization working in Moscow since 2009, is providing legal support to people who use drugs and seeking justice through the legal system. In late 2013, the Foundation’s Harm Reduction – Moscow Project with support of the Canadian AIDS Legal Network launched a ‘street lawyer’ initiative, which links those who need legal aid with a social workers and a legal advisers. Services include rights counselling, mediation, filing of official requests or complaints to medical practitioners or government offices, and resolution of cases through the justice system. In addition to legal support, the project gives clients moral support and boosts confidence in their ability to access legal recourse. The Foundation also provides expert witness testimony in court and advocates for changes to Russia’s drug policy.

Seeking justice for people who inject drugs in Moscow

Many countries that used to be part of the former Eastern European bloc inherited a legacy of heavy-handed drug policy aiming for the unrealistic goal of “society without drugs” and a harsh re­pression of drug-users. Although the Czech Republic used to be part of the Soviet sphere of influence for decades, it managed to escape this model. Nowadays, “Czech drug policy has been considered modern, pragmatic, rational and sometimes too liberal”. Czech drug policy is now focused on attain­able goals and evidence-based prevention, harm reduction, treatment and rehabilitation program­mes.

Czech drug policy is conducted at three levels – national, regional and municipal, all of them co­or­dinated by the Government Council for Drug Policy Coordination (GCDPC).This Council also pre­pares and submits the two key documents concerning drug policy: National Drug Policy Strategy and Action Plan for the Implementation of the National Drug Policy strategy. Moreover the Council is in charge of the drug policy budget.

The current National Drug Policy Strategy encompasses the 2010-2018 time-framework with four long-term objectives: 1) Reduction of experimental and occasional drug use (particularly among young people); 2) Reduction of intensive drug use; 3) Reduction of drug-related risks (to individuals as well to society); and 4) Reduction of availability of drugs (above all for young people).

The Action Plan for Implementation of the National Drug Policy Strategy is adopted only for three consecutive years and its task is not only to define specific goals to attain the objectives of the above mentioned strategy but also to articulate the priorities within them. The current one was adopted 2013 and the priorities are: 1) Lowering the scale of excessive alcohol consumption and cannabis consumption by young people; 2) Being more concerned with high percentage of metham­phetamine usage; 3) Reform of the financing of drug policy; and 4) Integration of drug policy.

The Czech drug related legislation is quite extensive and includes laws as well as various by-laws. The most important feature of the Czech legislative system is that criminal law does not consider drug use to be a criminal offence.

The Czech Criminal Code (Act No. 40/2009)prohibits the unauthorised production and other han­dling of narcotic and psychotropic substances and poisons (§283), possession of narcotic and psychotropic substances and poisons (§284), unauthorised cultivation of plants containing narcotic and psychotropic substances and poisons (§286), spreading of drug addiction (§287) and production and other handling of substances with hormonal effect (§288).But it is important to note, that if one possesses amount not “greater than small” for personal use only, one is not liable for a criminal of­fence but only for a misdemeanour which is punishable by a fine up to 15.000,- CZK (around 500 Eu­ros).

What is meant by “greater than small” was not enacted in any law or by-law before 2010 and had to be decided case-by-case within the judicial system. This situation changed in 2009 when the government issued a directive setting the amounts. This directive was abolished by a ruling of the Czech Constitutional Court in 2013 because it “asserted that only a law, not a government regulation, could define what a criminal offence is”. Consequently, due to significantly increased prevalence by young people and due to increased numbers of large-scale production facilities, the Czech Supreme court set stricter rules concerning non-criminal amounts. The court allowed 1.5 gram of metham­phetamine, 1.5 gram of heroin, 1 gram of cocaine, 10 grams of cannabis dry matter, 5 units of ecstasy and5 grams of hashish.

Cannabis policy in the Czech Republic

“We need to change the law. There should be no more [distinction about] users … so that dealers don’t shield themselves behind the definition of a user,” said Budi Waseso, the new chief of the Indonesian National Narcotics Board (BNN), who recently proposed an end to BNN-funded rehabilitation programs.

Despite being home to millions of drug users, Indonesia has long been known for its hardline attitudes towards drug-related issues, ranging from its disproportionate prison sentencing, problematic rehabilitation programs, to the stigmatization and generalization of drug use.

It all began to intensify when President Joko Widodo (Jokowi) declared war on drugs. Jokowi, who was initially known for his down-to-earth attitudes and promises in regard with improving the nation's welfare system and accountability, suddenly decided to raise the issue of drugs following the dramatic executions of drug traffickers in April. Since then, the largest Southeast Asian nation has strengthened its anti-narcotics stance, working together with other ASEAN countries as one of the major supporters of the outdated prohibitionist approach towards drugs.

While facing criticisms, Jokowi argued that 40 to 50 people died each day because of illicit drug consumption, while 4,5 million Indonesians required rehabilitation programs. This statistic raised many questions due to its highly problematic research methodology, expressed through an open letter initiated by the Indonesian Drug Users' Network (PKNI) as well as signed by 16 prominent academics, religious leaders, and human rights activists in Indonesia. Despite this, the aforementioned number kept resonating in the media, accompanied by the increasing amount of news reports on drug arrests and seizures.

Indonesia and the new war on drugs

Quebec - Needle and syringe programmes in prison: it can be done

The United Nations Office on Drugs and Crime has responded to the ‘leak’ of its briefing paper calling for the decriminalisation of drug possession for personal use. Before considering this response, it’s important to be clear this wasn’t really a ‘leak’ in the classic sense. The document was to be presented by the UNODC at the International Harm Reduction Conference in Kuala Lumpur, and an embargoed copy had already gone to select media (the norm for such publication events). When it was then pulled at the last minute, the BBC, which had already filmed a news segment on it, decided to release it anyway. Richard Branson was filmed for the segment as a member of the Global Commission on Drug Policy, and was sufficiently annoyed when the UNODC backtracked, that he broke the story himself on his blog.

The UNODC response claims that the briefing is not a final or formal document, and does not amount to a statement of its policy position. It also rejects the allegation that the briefing was stopped from being launched as a result of political pressure. This does, however, feel distinctly like an organisation backtracking under pressure (even if that is something, of course, they would never own up to). It would certainly not be the first time member state presssure has led to supression of a controversial UN drugs paper. Its impossible to know what pressure might have been applied, but this report from New York Times at least strongly suggests that it was the US (as widely suspected) that derailed the publication (ironically having found out about it via a New York Times approach for comment).

Firstly, while the agency now says its decriminalisation paper “cannot be read as a statement of UNODC policy”, the paper itself explicitly says “This document 

”, before going on to deliver its damning critique of criminalisation and its recommendation to decriminalise personal drug possession and low-level drug dealing offences, all carefully referenced to the relevant UN statements, evidence and international law.

Secondly, it is entirely normal for departments within UN agencies (in this case the HIV/AIDS section of UNODC) to provide briefings and guidance on areas within their specific remit. In no way does every utterance from a UN agency require sign off from the director and board. Last year, for example, the World Health Organization recommended the decriminalisation of drug possession deep within a technical report on how to respond to HIV among key populations. Documents like this are quite rightly taken as statements of institutional positions – in the UNODC’s case, the paper’s own introduction sets the document up as clarification and guidance from a UN agency, not merely from an individual consultant or staffer.

Thirdly, to provide some context missing from much of the coverage, this is a guidance paper that has come about following longstanding pressure from, and discussions with, a range of civil society organisations, notably the International Drug Policy Consortium (IDPC), Harm Reduction International (HRI), and the International Network of People who Use Drugs (INPUD). They have demanded the UNODC clarify its position on decriminalisation – especially in light of evolving positions elsewhere in the UN. The UNODC committed to produce such a document almost two years ago. So to somehow suggest this has spontaneously appeared from one rogue staffer without thought or discussion is ludicrous. Contrary to the Telegraph’s reporting of the story, this document has in fact been developed and discussed internally within the UNODC, over a period of more than a year. Monica Beg and the UNODC’s HIV team – who the UNODC media spokesperson in Vienna has rather disgracefully been attempting to scapegoat – are in fact the heroes of the hour for driving this long overdue clarification through to publication.

It is also crucial to note that a range of other UN bodies and officials – including UNAIDS, the UN Development Programme, UN Women, the UN Office of the High Commissioner for Human Rights – have already clearly and publicly stated their support for decriminalisation.

The truth behind the UNODC's leaked decriminalisation paper

The Civil Society Task Force held its 6th Civil Society Hearing at United Nations Headquarters on the margins of the General Assembly Third Committee negotiations of Commission on Narcotic Drugs resolution “Special session of the General Assembly on the world drug problem to be held in 2016” and the annual drugs “omnibus” resolution. The goal of the hearing was to update member states on Civil Society Task Force activities as well as to provide valuable input from civil society in preparation for the 2016 UNGASS on Drugs

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