In September 2011, the Supreme Court of Canada madea bold statement about the importance of harm reduction, and the lives of people who require harm reduction services, by allowing Insite - Vancouver's life-saving supervised consumption site - to remain open without risk of prosecution. The Court recognized that allowing a blanket prohibition on drug possession to apply even on the premises of such a health facility would undermine public health and put people at greater risk of preventable harm, including death from overdose and infection with HIV and hepatitis C. The Court found the Minister's decision to deny an exemption to Insite was "arbitrary" because it would advance neither public health nor public safety. Furthermore, the harms of denying people safe access to the site would be "grossly disproportionate" to any supposed benefit of maintaining a blanket prohibition on drug possession. Therefore, the Minister had violated the constitutional rights of people who use drugs to life, liberty and security of the person and was ordered to renew Insite's exemption.

Having intervened in this landmark case, the Canadian HIV/AIDS Legal Network applauded this important rights-based decision, and was hopeful it would pave the way for similar services in other communities across the country. Alas, three years later, no new supervised consumption services have started up in Canada.

Worse still, the federal government has introduced Bill C-2, which runs counter to the spirit (and the letter) of what the Supreme Court of Canada said in its Insite decision.

Simply put, Bill C-2 will make it more difficult for health authorities and community agencies to offer these badly needed health services to those members of our communities who use drugs in unsafe, unhygienic circumstances that mean a greater risk of overdose or of infection through non-sterile equipment. 

, produced jointly with the Canadian Drug Policy Coalition. Last week, we submitted it to the Public Safety committee currently studying Bill C-2 to help them understand how this ill-conceived legislation will erode the health and human rights of people who use drugs, and in fact also harm the communities that could benefit from such services.

Demonstrating complete ignorance of the amply-documented health and community benefits of supervised consumption services, Bill C-2 focuses on exaggerated risks to "public safety" and perpetuates the stigma and discrimination already facing people who use drugs. Many public health and human rights experts share our concerns and have said so, on record. We have called for this bill to be rejected in its entirety.

Meanwhile, Insite continues to save lives and is a credit to our country. Even with the recent tragic news of 31 heroin overdoses in Vancouver, Insite staff members were able to prevent the deaths of these individuals by providing care and immediate treatment. And this good news story could play out in communities Canada-wide if we, as a country, were to truly rethink our outdated and deadly "war on drugs" policies.

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

Bill C-2's threat to supervised consumption sites - and to community health


Juan Manuel, owner of the first shop dedicated to cannabis merchandising in Montevideo, rolls a joint

Licensed clubs of up to 45 members will be allowed to grow a maximum of 99 plants each year.In August, growing up to six plants of cannabis at home became legal. Uruguay legalised the production and sale of cannabis last December and the government hopes to sell it from pharmacies in the new year.

Uruguay cannabis growers' clubs: Registration begins

The findings of the Home Office drug policy report are not news in terms of the evidence. It is well known in the drug policy field that there is no evidence to support the continued criminalisation of drug use. On the other hand there is a large body of evidence highlighting the very negative outcomes produced by criminalisation. Criminalisation contributes to the spread of HIV and Hepatitis C; it increases the risk of overdose and death; it ostracises people from vital public health and social welfare services; it confers criminal records on people who don’t deserve one and produces many other hugely negative impacts on the lives of people who use drugs.

What makes this report interesting is the political context. It highlights a rift within the Coalition around drug policy, with the Liberal Democrats advocating a re-evaluation of national policies based on evidence and the Conservatives looking to maintain the status quo. The fact that a sitting government is having this debate is the key. Traditionally evidence on this issue has been suppressed when it failed to conform to the ‘war on drugs’ narrative. UK minister Norman Baker claims a similar effort to suppress evidenceoccurred here, but was overcome.

The UK Home Office report on drugs is emblematic of the global shift towards re-evaluating current drug policies

Over a year after the activation of the National Committee for Combating Addiction and a binding ruling by the Court of Cassation, some judges are still refusing to apply the drug law by allowing drug users to seek treatment in lieu of prosecution. Activists and lawyers who spoke to The Daily Star said many prosecutors and judges still perceive addicts as criminals, especially if they are from impoverished or troubled backgrounds.

“Judges are trying to help but are now just recently being educated,” said Rabih Khattab, one of the founders of the Cedar Rehab Center in Hammana, which opened earlier this year. “We’ve gotten phone calls [from judges] where they ask if a patient can be admitted to rehab rather than going to jail, but they only call when they know the patient is ‘not suitable’ to be in a jail cell, suitable meaning somebody coming from a good family.”

Although some judges might assume only wealthy users can afford Cedar’s $7,000-a-month price tag, Khattab said the center operates on a sliding scale and about half of all patients receive financial assistance. The Oum al-Nour association offers inpatient rehabilitation for free, but a spokesperson for the institution refused to discuss its relationship to the judiciary or whether the number of referred cases had risen since the Committee’s formation.

Discrimination persists in drug law application in Lebanon

On 19-21October 2014, a regional dialogue was organized in Tbilisi, Georgia. It focused on the regional proposal regarding access to treatment for vulnerable groups in Eastern Europe and Central Asia, which is being prepared by ECUO and EHRN for submission to the Global Fund (GF). Information is already available on our website regarding an initial proposal that was submitted to the GF and supported by it at the stage of an expression of interest.

The meeting of key populations, vulnerable groups, people living with HIV, governmental specialists and international agencies was very fruitful. Not only was the common goal of the future regional project agreed upon, but there was also a detailed discussion of its objectives as well as a common way of interaction between the partners.

The main issues discussed, both at the plenary session and within the working groups, were the fundamental challenges that are relevant not only to the project, but also to ensuring the viability and effectiveness of the response to the epidemic in our region.

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

What is the HIV care continuum and how can we ensure access to it by vulnerable groups?

November 1st has been observed as International Drug Users Day since 1995. Globally, there is a growing movement by activists and policy experts calling for de-criminalisation of drug users.

India has a long history of cannabis and opium use for social, cultural, religious and medical purposes. There are several examples of the use of these substances being sanctioned by particular communities. In sharp contrast today, India’s explicit constitutional aspiration to eliminate all forms of drug use from society is possibly the single most dangerous ideal that has fueled utter disregard for the health and rights of people who use drugs in India.

Political apathy is evident from the 2014 amendment to the principal Indian drug law, NDPS Act 1985, which leaves very little space for the promotion of evidence-informed and rights-based programming for drug users. The amendment does have a few positive features in its handling of harm reduction, treatment and recasting the death penalty. However, it enhances punishment for consumption and possession of small quantities for personal use from 6 months to 1 year, which is in direct contrast to developments in countries like Portugal, Spain, Italy and even America where the War on Drugs originated. The response in India to drug use has primarily been a health services-based approach. Though it mitigates some aspects of vulnerability, this approach fails to address the central role that rights protections play in ensuring the overall wellbeing of drug users.

India: End the war on drug users

Lib Dem Home Office Minister Norman Baker said politicians were out of step with public opinion and called for an end to "robotic mindless rhetoric".

Backbench Conservatives also expressed doubts about current policy but Downing Street said there would be no change.

A report found no obvious link between tough laws and levels of drug use.

The findings of the Home Office report, commissioned by the Liberal Democrats to compare drugs policies in different countries, prompted a row at the top of the coalition.

Lib Dem deputy prime minister Nick Clegg accused his Conservative colleagues of trying to block the report, and of a "totally misplaced, outdated, backward-looking view".

Downing Street in turn accused Mr Clegg of sending "an incredibly dangerous message" and said that drug use in the UK was "plummeting" because of existing policy.

But during the Commons debate brought by Green MP Caroline Lucas, Conservative MPs Robert Syms, Bob Stewart and Zac Goldsmith expressed unease with the current approach.

Mr Syms said: "Contrary to press reports, there are many of us on these benches, the Conservative benches, that believe in evidence-based reform to have a more effective policy in dealing with the scourge of drugs."

End 'robotic rhetoric' on drug policy, says UK Minister

There are an estimated one million crack users in Brazil, many of whom reside in Cracolândias (Cracklands)—open-air drug markets where users freely smoke in a de facto legal environment. The largest of these markets is located in São Paulo, where a new approach has recently been implemented. The Open Arms program, launched in January 2014, is a city-sponsored harm reduction initiative that provides housing, food and job training to users without asking participants to quit using.

Harm reduction in Brazil’s Cracolândias

What happened to North America's boldest drug policy experiment?

In 2001, after much campaigning by activists, academics and public health officials, Vancouver's municipal council approved the boldest, most progressive drug policy in North America: 

A Framework For Action: A Four-Pillar Approach to Vancouver's Drug Problems.

The philosophy was simple but revolutionary: government should lessen the harms associated with drug use, even if those drugs are illegal. Heroin prescription, methadone maintenance and supervised injection are some of the ideas you will find in the document's 36 recommendations.

was passed over 13 years ago. Where do they stand today? This is our season-opening 5-part series, 

podcasted on iTunes and syndicated at the University of British Columbia, the University of Victoria and Simon Fraser University.

To read the articles and listen to the files, click on the links below or go to the series page.

 Prevention, treatment, harm reduction, and enforcement—Vancouver’s four pillars. It’s the most progressive drug plan of any city in North America. But its authors fear that the pillars are crumbling. More >>

 Do you remember DARE? It’s a drug education program, but researchers say that it doesn’t work because it exaggerates the harms of drug use. We profile people who say we need to try something new: tell kids the truth. More >>

When somebody decides that it’s time to kick drugs, who is there to help them? In this explosive expose, we reveal a chronically underfunded drug treatment system that is dominated by unregulated flop houses, questionable pharmacists and dogmatic providers. More >>

 This summer, an activist named Ann Livingston signed a lease for a bubble tea cafe in the heart of the busiest drug market in suburban Vancouver. Ann has one goal: invite the drug users in and start a political movement. The Bubble Helping Centre in Surrey is to be that movement’s headquarters. But how will the neighbourhood react? More >>

: The authors of Vancouver drug policy always wanted to end the ‘War on Drugs’ but they made a compromise. While their fight against prohibition has stalled, Seattle is forging ahead. Will Seattle's compromise get any closer? More >>

The Four Pillars revisited: A 5-part series about Vancouver drug policy

Public discussion of cannabis legalisation has leaped to a new high in Austria after the neoliberal newcomer in parliament, the Neos party, has voted to push the issue at its annual general meeting last weekend.

Party chairman Mat(thias) Strolz, who was first surprised that his economy oriented party showed a majority interest in cannabis, came out after a two day hiatus, fully supporting the decison.

"We support self responsibility and liberty. Legalisation makes sense", said Strolz in a first statement on Tuesday. Recommending a step-by-step plicy towards legalisation, the Neos fully support "grow your own" as a first move that would especially benefit Austria’s legion of cannabis patients who nurture their medicine in grow closets at home. A next step towards regulation may be the distribution via pharmacies, Strolz said further, lifting the spirits of tens of thousands currently criminalised cannabis patients who still face jail if they get caught with their medicine of choice.

"Decriminalisation would immediately benefit one in 8 Austrians. It is estimated 500,000 Austrians light up regularly and another 500,000 occasionally", said Toni Straka, chairman of the Hanf-Institut (Austria).

The Neos are the first party to officially jump the legalization bandwagon after a first parliamentary citizens initiative to unhinge cannabis from current drug laws. With so far almost 27,000 signatories the initiative jumped into third place of the most successful citizens activism in Austria’s history.

A huge leap forward in Austria: ‘Neos’ party votes for legalisation of cannabis

Naloxone kits, which help reverse the effects of an overdose, were introduced in Scotland in 2010. New figures reveal the distribution of the kits by health services and prisons has increased from 3,878 in 2012-2013 to 6,472 in the past year. Health statistician Prof Sheila Bird believes the programme has helped to save more than 40 lives.

Naloxone works like an epi-pen, which are used to treat allergic reactions. Drug users suffering an overdose can be given the treatment easily by family members or a friend, giving extra time for emergency services to arrive.

A national naloxone programme was introduced three years ago with Scotland the first country in the world to make such a move.

More naloxone drug overdose reversal kits distributed in Scotland

Arriving in Baltimore the night before the 10th National Harm Reduction Conference last week, I walked out of the hotel to get my bearings and buy a sandwich. Downtown was a desert, with banks and other businesses closed for the night. Turning a corner, I suddenly came upon a brightly lit cluster of exotic dance clubs and sex shops, guarded by intimidating bouncers, with people milling around with their hoods up, some intoxicated, the young women tottering on heels. There was a Subway open.

I learned at a panel the next morning that this incongruous patch is known in Baltimore as “The Block.” And since 2008 it’s benefited from an outreach program, thanks to activists, volunteers and the city health department. A van parks up regularly to hand out syringes and other supplies to cut the risk of HIV and hepatitis C infections for people who use drugs. “On The Block are some of the riskiest dance clubs,” said Susan G. Sherman of Johns Hopkins Bloomberg School of Public Health. “Some are like unsanctioned brothels.” A study she’s engaged in found that 42% of the women working in these clubs exchange sex, and that 55% currently use heroin, or crack or powder cocaine. The concentrated nature of The Block and its high turnover of dancers and clients means that intervening here has great potential to impact HIV and at-risk populations across Baltimore.

A woman who has worked on The Block stood up to share her knowledge: “Girls are absolutely doing things without condoms. The higher the drug use in the club, the more that is happening. The bartenders prefer it when the girls are on drugs because the girls are motivated [to make more money].”

Recently, a second van joined the needle exchange vehicle. Staffed by a doctor and an assistant, this one offers on-board pregnancy testing, STI testing and contraception. “We learned that combining needle exchange and reproductive health is feasible and affordable,” said Mishka Terplan, an OB/GYN who volunteers on the van. The team had to learn to work fast: “Most of the women have a very brief period of time, basically a cigarette break, to do the paperwork, receive the services and get back to work before they get in trouble.” But they now have over 500 clients. “This marriage of needle exchange and reproductive health is exciting,” said Terplan. “Preventing unplanned pregnancies is harm reduction.”

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