Federal health regulators approved a drug overdose treatment device on Thursday that experts say will provide a powerful lifesaving tool in the midst of a surging epidemic of prescription drug abuse. Similar to an EpiPen used to stop allergic reactions to bee stings, the easy-to-use injector — small enough to tuck into a pocket or a medicine cabinet — can be used by the relatives or friends of people who have overdosed.

The hand-held device, called Evzio, delivers a single dose of naloxone, a medication that reverses the effects of an overdose, and will be used on those who have stopped breathing or lost consciousness from an opioid drug overdose. Naloxone is the standard treatment in such circumstances, but until now, has been available mostly in hospitals and other medical settings, when it is often used too late to save the patient.

US Federal health regulators approved the use of a substance that reverses the effects of drug overdoses.

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Hand-held treatment for overdoses is approved in the USA

Russia is home to the world's fastest-growing HIV epidemic. Driven by injection drug use, it is now becoming generalized. A zero-tolerance policy toward drug use in the country bans harm reduction tools and treatment. For many drug users, the only choice is to quit drugs entirely or go to prison.

Outreach workers like Max supply clean needles and health information. Now, with the help of an online network, Max, a former intravenous drug user, also provides legal advice to help people access treatment and overcome abuses in the justice system.

This video features the situation of drug users in Russia and the will of a former drug user to provide legal advice to help people who use drugs to have access to treatment.

In Russia, the fight against HIV goes online 

Monitoring and responding to HIV and hepatitis C among people who inject drugs (PWID) is the focus of two new reports from the EU drugs agency (EMCDDA) and the European Centre for Disease Prevention and Control (ECDC). The reports are the result of two expert meetings organised by the agencies last autumn which brought together key stakeholders from the areas of drug monitoring and infectious disease surveillance.

The meetings had their roots in an ECDC–EMCDDA regional assessment of HIV trends, risks and prevention coverage among PWID conducted in mid-2013. This assessment had identified a low level of prevention coverage in at least one third of European countries, constituting a potential risk of increased HIV transmission among this group.

The first expert meeting held in Bucharest (18–19 November 2013) — 

Detecting and responding to outbreaks of HIV among PWID

 — provided an important opportunity for sharing knowledge and best practice among experts from six countries in the south and south-east of the European region (Cyprus, Greece, Hungary, Malta, Romania and Slovakia). The participants heard about the Greek response to an HIV outbreak among PWID, which started in 2011, and the subsequent scaling up of prevention interventions. This had been guided by monitoring data and research findings and resulted in significant progress in curbing the epidemic. Participants also discussed the situation in Romania, the second country to report an HIV outbreak since 2011. This outbreak has seen additional challenges associated with: high rates of co-infections; changing patterns of drug use among PWID; and the need to address funding gaps through a coordinated country-level response.

The second meeting, a regional Reitox Academy held in Tallinn (21–22 November 2013) — 

Monitoring trends in and responses to drug-related infectious diseases among people who inject drugs

 — contributed to maximising synergies at national level between institutions and experts in the fields of drug monitoring and infectious disease surveillance in four countries (Estonia, Latvia, Lithuania and Poland). The event helped participants from both fields to deepen their knowledge and mutual understanding of the situation; fostered joint initiatives at national level and further strengthened collaboration between neighbouring countries in the Baltic Sea region.

Both meetings acknowledged the critical role and added value of collaboration between the EU agencies in assessing risk and providing technical support to countries as well as in informing policies with evidence-based guidance.

Experts examined progress and defined common priorities regarding actions to be taken forward at national level (e.g. improvements in screening and prevention coverage) and recognised the key role of monitoring and surveillance for evaluating whether prevention efforts to are adequate to avert outbreaks.

EMCDDA and ECDC facilitate sub-regional exchange of knowledge and best practice in monitoring and preventing drug-related infections

This video features information on drug use and harm reduction services for young people in some European countries.

Drugs, harms and youth 

Uruguay is considering using medical marijuana to treat prison inmates addicted to a crude and cheap form of cocaine, one of the country's top health officials said at the United Nations.

The South American country made headlines last year when it became the first in the world to legalize the sale of marijuana. Now, as Uruguay prepares to implement its pioneering legislation, health leaders are considering possible uses for medical forms of marijuana -- including in prisons, where many of the incarcerated are addicted to drugs.

"Pasta base" -- also known as "paco" -- is cocaine base paste, a byproduct of the cocaine refining process. The cheap drug swept through Uruguay and neighboring Argentina during the 2000s, leaving public health officials struggling to control its fallout.

Research on medical marijuana's efficacy in treating addiction to other, "hard" drugs like pasta base appears limited. But other countries, such as Colombia, have begun considering projects seeking to use marijuana to treat addicts.

Uruguay considers using medical marijuana to treat cocaine dependent users in prison

The New Zealand government says its radical new approach to controlling psychoactive substances has led to fewer drugs, fewer retailers, and less harm to health.

New Zealand regulates drugs

Whether it was transporting silk, spices, tobacco, or opium, for centuries, the Silk Road from the Far East towards European countries passed through Serbia. Read how heroin permeated the country and made the region a transport hub for illicit substances.

During the 1970s, injecting drug users in Belgrade and Serbia used opium originating in the former Yugoslavian Republic of Macedonia. Macedonia and Serbia were at the time part of the same country, Yugoslavia, so opium was transported without much trouble, satisfying 90 percent of the opiate drug market. The remaining 10 percent consisted of heroin reaching Belgrade in small quantities. Belgrade's heroin market grew slowly, since at that time there was no organised supply. Dealers were themselves users, and in many cases they were buying heroin in the Middle East and Asian countries. A smaller part of the market was covered by heroin coming from Kosovo. Albanians from Kosovo, with family connections in the Middle and Far East, were trying to organise their (at that time, rather poorly-developed) network of heroin distribution towards Western Europe. Heroin was transported to Yugoslavia from the Middle and Far East via Turkey and Bulgaria. It was then repackaged in Kosovo, to continue its journey towards Western Europe.

At that time, according to drug users, it was harder to arrange contacts with suppliers in Kosovo, due to ethnic and religious distrust, than with suppliers in the Middle East. Students from countries in the Middle East brought heroin to Belgrade for the first time. The street price at that time was 65 – 80 euro per gram.

The role of heroin in Serbian history

For the first time ever, a key human rights body in the Americas has begun studying the impact of drug policies on human rights.

In a hearing before the Inter-American Commission on Human Rights, 17 organizations from across the Americas, including Open Society grantees Conectas, DeJusticia, and the Washington Office on Latin America, among others, argued that the war on drugs has worsened violence, strained criminal justice systems, and reinforced hardline security policies.

The commission’s effort is another step forward in the drug policy reform debate in Latin America. In some countries, this debate is well underway. In others, it is just beginning.

The problems with current drug policies are well established and common across the region. The militarization of efforts to counter drug trafficking in countries such as Colombia and Mexico has fueled violence and resulted in serious human rights violations by armed forces and law enforcement. The eradication of illicit crops has provoked clashes between armed forces and farmers, environmental damage due to aerial fumigation, and abuses against rural populations in Bolivia, Colombia, and Peru, among others.

The Inter-American Commission hearing creates a path to focus on the impact of drug policy on human rights through dialogue among government and civil society representatives.

In Latin America, drug policy is a human rights issue

On Monday, March 31, 2014, a press conference "Drugs decriminalization becomes a reality around the world" took place in the Polish Parliament. During the conference, the report "A quiet revolution: drug decriminalization policies in practice across the globe" was presented for the first time in Poland. This report, prepared and published by a British organization Release, accurately describes changes in drug policy that have occurred in recent years, including issues on legalization of drugs and departing from punishment for their possession (the report is available 

The conference was attended by Ryszard Kalisz, member of the Polish Parliament, Tomasz Lipiński, musician, Piotr Kładoczny, lawyer of the Helsinki Foundation for Human Rights, Paweł Siłakowski, addiction therapist, and Maja Ruszpel from The Polish Drug Policy Network.

The conference participants mainly discussed the existing drug law provisions in our country.

“The current drug law in Poland, even though the amendment was adopted in 2011, is one of the most restrictive in the world,” Ryszard Kalisz said. “The countries that conduct rational drug policy, drugs, both soft and hard, should be decriminalized,” he emphasized.

Kalisz mentioned that decriminalization had been introduced in the Czech Republic in 2010, Estonia in 2002 and Portugal in 2001. He also discussed the changes in Uruguay and in the State of Colorado in the U.S.A., where the sale and consumption of marijuana had been legalized.

In Poland, however, any person who has a small amount of illegal substance for personal use is punishable by imprisonment up to 3 years. This problem was not solved by the amendment of 2011 which allowed the prosecutor to withdraw from the prosecution in case of possession of small amounts of drugs for personal use.

“It turned out that today, we have a crisis of prosecution, as prosecutors are afraid,” Ryszard Kalisz said. “If for a whole province, there is only a dozen of decisions of discontinuation, it means that the prosecutor prefers to prepare an indictment to ensure easy conviction as a success, rather than terminate the case,” he stressed.

The reason for such a situation is in fact the lack of drug amount reference tables to define precisely what is an "insignificant" amount of drugs possessed for personal use. These tables are successfully used in many European countries. Based on the drug amount, they specify whether the drug possession is a crime or only a misdemeanor (sample reference tables can be found in the report). However in Poland, such a tool, although needed, does not exist.

“We visited a number of prosecutors' offices, and all prosecutors would tell us: please prepare specific standards, rules that identify what is an insignificant amount, for every substance,” Dr. Piotr Kładoczny said.

A special guest of the conference, musician and artist previously associated with bands TILT and Brygada Kryzys, Tomasz Lipiński stressed that the current drug laws in Poland had been created based on the myths and uperstitions.

“Superstition is the understanding that drugs is something that concerns the social margins or very young people who aspire towards the margin. This is not true. Today, in the second decade of the 21st century, the drug is something that every young person comes in contact with everywhere in Poland. If this is true, the young people who grow up must be ready for it. Does the current law prepare them? No, it doesn't. It is to frighten them, and it fails to frighten, because you cannot educate anyone by fear,” Lipinski said.

Paweł Siłakowski, addiction therapist, added: "The situation of punishment for psychoactive substances caused something that was to be expected. Namely, a number of substances, which in themselves are legal, appeared on the market. And - worst of all - these are substances that can be also bought legally," he referred in this way to the phenomenon of designer drugs and other similar substances.

"Let us make drug law that is based on the lessons learned so far," Tomasz Lipiński said. "Dear MPs, please stop acting based on myths when you create the law, start working lead by knowledge and wisdom".

In the concluding part of the conference, Maja Ruszpel of the Polish Drug Policy Network provided statistical data that showed the effect of the current drug law: "In Poland, every three minutes someone is being detained on suspicion of possessing illicit psychoactive substances. Annually, there are 30,000 of them, and the majority are not criminals but young people experimenting with drugs or addicts. Such ineffective law generates costs amounting to 80 million Polish zlotys every year.

This press conference aimed at raising awareness of the different models of decriminalisation developed around the world and how these could be adapted in Poland.

"Drugs decriminalisation becomes a reality around the world"- Press conference in Polish Parliament

Like many addicts, Ammario Reza became hooked on opiates as a result of a doctor’s prescription. Four years ago the Carleton student, now 26, was prescribed oxycontin for a kidney stone and a crushed molar.

“I wouldn't say I got addicted to it right away, it was more of a gradual thing, I thought it was a miracle drug at the time because it was great and it took the pain away, but then after a time I started to realize that I couldn’t really function or start my day without having it in my system,” said Reza.

Reza said that in time, fear of experiencing the painful symptoms of opiate withdrawal came to dominate his life. It took him four years to seek treatment, and when he did, he was prescribed Suboxone.

Suboxone is a relatively new drug that is taken in pill form, unlike methadone. It works by blocking opiate receptors in the brain, preventing withdrawal.

For three weeks, Reza said things went well and he was receiving his Suboxone at a pharmacy in Hintonburg.

Addiction specialists worry that stigma will discourage people dependent on drugs from getting treatment.

Recovering addicts feel like 2nd-class citizens in some pharmacies

Some 800 patients in the region are currently receiving opioid substitution therapy (OST). This treatment is prohibited in Russia and current stocks of methadone and buprenorphine on the Crimean peninsula will only last for another few weeks at most. With the blocking of highways that connect Crimea to the mainland, getting medical supplies through is challenging and there are concerns that a major public health crisis will arise as a result.

According to Andriy Klepikov, Executive Director of the International HIV/AIDS Alliance in Ukraine (pictured above): “When the supply of these medicines is interrupted or stopped, a medical emergency will ensue as hundreds of OST patients go into withdrawal, which will inevitably lead to a drastic increase in both acute illness as well as increases in injecting as people seek to self medicate.

“The Russian Federation has extremely repressive drug laws,” he said, “and its punitive approach to people who use drugs means that it now experiences one of the highest rates of new HIV infections in the world. Injecting drug users represent nearly 80 percent of all HIV cases in the country. ”

The Alliance expressed alarm at the future of people who inject drugs in Crema following its annexation by Russia.

Annexation of Crimea will cut off 14.000 drug users from critical HIV prevention services

The Organization of American States (OAS) today hosted a Policy Roundtable on the topic “Women, Drug Policy and Incarceration in the Americas,” at the headquarters of the hemispheric institution in Washington DC, in which the report of the Inter-American Commission of Women (CIM) titled “Women and drugs in the Americas: a policy working paper” was presented.

The Executive Secretary of the CIM of the OAS, Carmen Moreno, highlighted in her presentation, among other aspects, that the female prison population has grown at a greater rate than the male population in Latin America, that the majority are imprisoned for drug related crimes, and that 80 percent are in preventative prison. “This is a critical indicator of the overload our justice systems are facing, caused in large part by the hemispheric drug problem,” said Ambassador Moreno.

“The tendency to penalize in a special and often disproportionate way crimes related to drugs has contributed to the significant increase in the number of women imprisoned in the region,” said the Executive Secretary of the CIM, and expressed her hope that, with mechanisms like the Roundtable, “we can move forward in addressing this issue, from a focus on human rights, gender equality, and sustainable development, particularly heading toward the Special OAS General Assembly which will be held this September in Guatemala to continue the debate over drugs and their impact in the Americas.”

The keynote presentation of the Roundtable was delivered by Gabriela Olivera, from the National Secretariat for Drugs of Uruguay, who spoke of the experiences of her country on the issue, the importance of alliances with civil society, and the study on the relationship between Uruguayan women and microtrafficking networks carried out by her office. Olivera explained that in her country “there is in the National Secretariat for Drugs a Secretariat for Gender that has as its aim the transversalization of the aspects and foci of gender in drug policies, above all in the practice in programs of prevention, treatment and reintegration.”

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