The Providence Crosstown Clinic in Vancouver is pioneering a new step in harm reduction by enabling some of its patients to take home medical-grade heroin.

The program is the first of its kind in North America.

Dr. Scott MacDonald, the physician lead at the Providence Crosstown Clinic, said the change came about partly because of the COVID-19 pandemic.

Some of the patients at the clinic that had COVID-19 were forced to isolate at home or in a hotel. Staff at the clinic, supported by the health authority, were able to deliver diacetylmorphine syringes (medical-grade heroin) to the patients so they could successfully isolate for 10 to 14 days.

"Having done that and done that successfully without any problems, we were able to show and demonstrate the strict requirement of the medication to only be [administered] at the clinic was not necessary," MacDonald told guest host Bal Brach on CBC's On The Coast.

Canada: Vancouver clinic first in North America to offer take-home medical-grade heroin

Following the arrest of a young couple for possession of cannabis cookies and the news that they will be investigated under Section 39(b) of the Dangerous Drugs Act 1952, which is punishable with death by hanging, lawmakers are questioning when much-discussed changes to drug laws will materialise.

“The All-Party Parliamentary Group Malaysia (APPGM) on reforms of prison and detention centres is still awaiting further details and the actual wording of the new Drug and Substance Abuse Act 2020 - which has been touted by Home Minister Hamzah Zainudin - to replace the Drug Dependents (Treatment & Rehab) Act 1983.

“This gives us cause to hope for easing recourse and access to drug treatment and rehabilitation instead of extreme punitive measures, which has only harmed and worsened drug abuse in this country,” Permatang Pauh MP Nurul Izzah Anwar (

Calls for reform to drug laws and punishment have long been voiced by many quarters, including politicians and NGOs, urging the government to take action.

Malaysia: What's happening to drug law changes, ask Nurul Izzah and ex-health minister

The regulatory framework related to the eradication of illicit drug crops in Mexico is a complex one. On the one hand, there are the international conventions on the control of substances; on the other, the national legal framework that shapes the prohibitionist drug system. Additionally, there is the by-law that regulates government actors that are participants in the eradication campaigns. The issue becomes more complex if it is considered that the main institution in charge of these tasks is the Department of National Defense (Secretaría de la Defensa Nacional – SEDENA in Spanish), which for a long time has lacked norms that define its participation in activities to combat drug trafficking.

For these reasons, the analysis of the evolution of the regulatory framework on the matter is just a necessary element, but insufficient, to understand the role of civil authorities and the Armed Forces in eradication tasks; its reading must be accompanied by additional documents included in this text.

However, observing the evolution of regulations – that is, what laws have been created, what reforms have undergone, and which institutions have been conferred powers – also offers a clue about government priorities. Indeed, in compliance with the international treaties signed, and under pressure from the US government but also obeying its own internal logic, Mexico has been progressively modifying and adapting its legal framework to reinforce the prohibitionist system of drugs. Also, it has been determining the functions of the public corporations that would participate in the campaigns to eradicate illicit crops, where it is possible to see a clear interest in legalizing the actions of the Armed Forces in this area.

This article, first refers to the international drug control conventions signed by Mexico, as well as the internal laws that gave content to the prohibitive drug system, focusing on poppy cultivation. Second, it exposes the evolution of the regulatory framework of the Mexican authorities participating in the eradication of illicit crops. Third, it presents the two instruments that currently regulate the actions of said authorities: the MEXK54 Project “System for the Monitoring of Illicit Crops in Mexican Territory”, and the National Protocol for the Destruction of Illicit Crops. Finally, some conclusions are presented on the development of the regulations and the role played by the institutions that today are in charge of eradicating poppies in Mexico.

The regulatory framework for the eradication of illicit crops in Mexico

Previously a stark example of the harms of synthetic opioids, Estonia successfully implemented a range of harm-reduction programmes that reversed its bleak opioid public health crisis.

A recent European study taking stock of the Estonian response to the rise drug-related deaths since the turn of the century demonstrates how harm reduction is an essential part of any public health programme.

Synthetic Opioids prevalence, use and overdose in Europe

 (SO-PREP) European project, which aims to produce evidence-based recommendations to prepare for a potential synthetic opioid crisis, their Estonian report described how synthetic opioids entered the country, and how the national Health Institute responded.

Estonian harm reduction programme brilliantly reverses its overdose epidemic

AMSTERDAM, Sept 15 (Reuters) - Judges at the International Criminal Court on Wednesday approved a formal investigation into possible crimes against humanity allegedly committed under the leadership of Philippine President Rodrigo Duterte in the context of his "war on drugs".

The ICC said in a statement that judges had approved a request by prosecutors to begin the investigation into potential murder as a crime against humanity.

Judges' assessment of material presented by prosecutors, was that "the so-called ‘war on drugs’ campaign cannot be seen as a legitimate law enforcement operation", but rather amounted to a systematic attack on civilians.

Human rights groups accuse Duterte of inciting deadly violence and say police have murdered unarmed drug suspects on a massive scale as part of the campaign. Police deny this, and Duterte says the police are under orders to kill only in self-defence. The government in Manila could not immediately be reached for a reaction late on Wednesday.

International court backs probe into Philippines' 'war on drugs'

The momentum for cannabis regulation is growing around the world. The US is debating federal legalisation. Eighteen states—around a third of the US population—have already legalised non-medical cannabis since 2012. Uruguay legalised recreational use of cannabis in 2013, Canada in 2018, and Mexico is considering following suit. In Europe, Switzerland and Luxembourg have announced formal moves to implement a legally regulated market. The Netherlands is finally establishing a legal supply for its long-tolerated “coffee shop” sales, and Malta is allowing people to grow their own plants while eyeing more formal legalisation.

The arguments for such moves are founded in evidence. Prohibition has proved costly and ineffective—failing to deter use or eradicate supply. By regulating cannabis, governments can regain control of the market, including by managing the quality, potency, and price of available products, and how and where they are licensed to be sold. Governments can take profits away from organized crime groups and generate significant tax revenue, while ending law enforcement practices that have disproportionately criminalised and incarcerated minorities and marginalised populations. But as the debate shifts from questions of 

 to do it responsibly, there are important lessons to be learnt from the successes and failures of regulating other drugs. Not all regulatory frameworks are equal, and the history of the tobacco industry is a testament to that.

In a new report published by the International Drug Policy Consortium (IDPC), in collaboration with other NGOs, we explain how major transnational tobacco companies have been complicit in the illicit tobacco trade—playing an active role in smuggling their own cigarettes to enter protected markets, circumventing effective health regulations, and lobbying governments to decrease taxation or any form of regulation that impacts their bottom line. They have deployed their legal, lobbying, and PR machines to maximise profits, with little concern for the health and social costs of their actions. Many of these schemes were revealed in the late 1990s, thanks to a trove of internal tobacco industry documents released as part of various lawsuits.

Why we can’t let cannabis become the next Big Tobacco

Global outrage regarding human trafficking and sexual slavery has had a major effect upon how women engaged in sex work are represented. No longer publicly imagined as morally corrupt or bad women 

, they are now more likely assumed to be victims of sexual slavery and trafficking. As a result, punishment and discipline have given way to more neoliberal mechanisms of control under the guise of ‘rescue’. Prostitution has been increasingly re-classified as a crime that uniquely victimises women and children, and as this US-led conflation of prostitution with trafficking has spread ‘raid, rescue and rehabilitation’ operations have increased throughout southeast Asia and other Global South contexts. These morality-based agendas make help and support conditional on exiting sex work and/or abstinence rather than prioritising rights, recognition and respect.

This politics of ‘rescue’ has resulted in multiple forms of abuse, and opposition to the approach has galvanised sex workers across the globe. This activism and advocacy, however, has been undercut and ignored. Friends have also been difficult to find. There has been a distinct lack of support from other communities and organisations negatively impacted by discrimination and criminalisation. Instead of taking up calls for decriminalisation and labour rights, potential allies have remained on the side-lines rather than standing in solidarity.

This is true of most anti-trafficking organisations. The image of the feminised sex slave has become so enmeshed in the public imagination that NGOs are afraid to embrace sex workers’ rights amid concerns that backing decriminalisation will potentially erode public and state support for trafficking victims. They are also worried that taking a stand in support of decriminalisation would open up their organisations to attack and put their funding and donations at risk.

Perhaps more perplexing has been the lack of engagement with sex workers’ rights by those spearheading campaigns for the decriminalisation of illicit drugs, including in the UK. Some drug policy reform organisations do see the parallels and are vocal in their support. Yet for others, there is a clear sense of ‘fence-sitting’ when it comes to supporting the full decriminalisation of prostitution. This is hard to understand. Both sex workers’ rights groups and drug reform groups understand the harms created by criminalisation and stigma, and spend their days fighting to reduce them. They also have overlapping constituencies. Yet despite this common ground many refuse to offer their support. Perhaps most concerning are the politicians who champion the right of people to use drugs, yet somehow find it in themselves to also embrace the ‘rescue’ of sex workers.

The common cause of drug reform and sex workers’ rights

By Marie Nougier (IDPC) for Dianova International

2021 marks several drug policy anniversaries: the 60th and 50th anniversaries of the 1961 Single Convention on Narcotic Drugs and of the 1971 UN Convention on Psychotropic Substances, the 5-year anniversary of the 2016 UNGASS on drugs, and last but not least, the 50th anniversary of the ‘war on drugs’ declared by Richard Nixon.

These anniversaries offer a key opportunity for policy makers and advocates alike to take stock of the global state of drug policies. Unfortunately, the political landscape is rather bleak.

Earlier this year, the International Drug Policy Consortium published a report evaluating progress made since the 2016 UNGASS on drugs, in which we assessed moves towards reform in the areas of human rights, health, development, civil society participation, UN system coherence and monitoring and evaluation of drug policies.

Repressive drug policies fuelling human rights abuses

The report puts in stark relief the blatant human rights abuses that communities all over the world continue to face as a result of repressive drug policies. Countries like Brazil, Colombia, the Philippines and others have recently reverted back to a war on drugs approach after several years of progress made towards more humane approaches. The consequence has been a devastating rise in extrajudicial killings, increased levels of violence and a surge in prison overcrowding. These examples also show how fragile any positive move towards more humane drug policies can be.

Over the past year, we have paid particular attention to the issue of prison overcrowding, as punitive drug laws remain a key driver of incarceration all over the world. Addressing prison overcrowding has become all the more critical in the context of the COVID-19 pandemic.

Prison overcrowding and women deprived of liberty

According to the UN, 2.2 million people globally are currently in prison for a drug-related sentence. This represents about 20% of the world prison population. Equally concerning is the fact that those targeted by drug law enforcement belong to the poorest and most marginalised communities, and to ethnic communities. Women are particularly affected, with 35% of the female prison population being incarcerated for a drug offence – a proportion that rises to 50-80% in various Latin American and Asian countries.

Devastating impacts on the health of people who use drugs

The ongoing criminalisation of people who use drugs has also been a major driver of incarceration, with at least 470,000 people incarcerated worldwide for simple possession. Fear of criminalisation, police violence, stigma and discrimination – as well as lack of access to, and funding for, harm reduction and treatment services – have largely contributed to high HIV and hepatitis C prevalence among people who inject drugs and overdose deaths. During 2017 and 2018 alone, the UN recorded a staggering one million drug use-related deaths. This is heart-breaking, when we know that these deaths could have been avoided with drug policies focused on promoting social justice, human rights and public health, and with improved access to services such as sterile needles and syringes, naloxone and drug checking.

How to improve the social justice response: Decriminalisation

Thankfully, several countries have made (small) strides towards policies that seek to address, and redress, the harms of punitive drug control. Removing criminal sanctions for drug use and possession for personal use has been one of the ways in which some countries have sought to improve the lives of people who use drugs.

As of today, 50+ jurisdictions in 31 countries, from Portugal to Czechia, Uruguay, South Africa and Jamaica, have decriminalised drug use and possession for personal use. Not all models of decriminalisation are equal however, and their impacts on the lives of people who use drugs vary greatly. For instance, while Russia has technically decriminalised drug possession, people continue to be targeted by drug law enforcement authorities and imposed harsh administrative sanctions, including detention.

However, when done well, decriminalisation can be instrumental in facilitating access to life-saving health services, reducing stigma and discrimination, and ending police abuse and the overuse of incarceration.

How to improve the health response: harm reduction

Improving access to health services for people who use drugs also remains critical – especially in the context of budget constraints and further social and economic hardship caused by the COVID-19 pandemic and related restrictions. Improved coverage of gender-sensitive services for women who use drugs also remains vital as most services are not adapted to the needs and realities of women. Finally, increased funding for harm reduction is as critical as ever: today, only 5% of funding needs for such services is being met in low- and middle-income countries, and this needs to change.

Pushing back against shrinking civil society space

Most importantly, the meaningful involvement of civil society and affected communities is essential to achieving a human rights, social justice, gender-sensitive and health-focused approach to drug policy. And yet, the rise in authoritarianism, populism and COVID-19 restrictions have severely restricted civil society space at all levels of governance. Crucially, civil society engagement is considered as a ‘ticking the box’ exercise. Rather, we should be considered as critical partners and experts who should be consulted seriously at all stages of the decision making, implementation, monitoring and evaluation processes in the field of drug policy.

There is still hope that drug policies can truly respect, protect and fulfil the human rights of communities worldwide. But policy shifts need to happen now, as we cannot wait for another 60 years for this dire situation to change.

60 years of the war on drugs: What needs to change

UK drug policy is a mess. As Carol Black’s review showed in detail, the UK’s consumption of illegal drugs is growing across all sectors of society and our treatment system is near collapse. Our drug related death rate is one of the highest in Europe, and the availability of drugs remains stubbornly high despite both covid-19 and regular much publicised drug busts.

Current drug policy fails everybody. But it fails black communities in particular. Black people are six times more likely to be stopped and searched than their white counterparts, and nine times more likely when the reason given is suspected drug possession. And this is despite white people reporting higher rates of drug consumption.

Suspicion of drug possession—often merely the claim that an officer can smell cannabis in the vicinity of the target—is the most common reason for searches by far. Black people are also much more likely to be arrested, charged, and imprisoned for drug offences.3 In 2017, black people were eight times more likely to be prosecuted for drug offences and nine times more likely to be sent to prison than white people.

United Kingdom: Our drug laws are racist, and doctors must speak out

By National Institute for Health Research (NIHR)

Scientists have revealed a new method of delivering hepatitis C testing and treatment to people who inject drugs which will help bring the world a step closer to eliminating the virus.

Scientists publish first blueprint for getting hepatitis C treatment out to people who inject drugs in their own communities

New expert guide pioneered in NHS Tayside will help the roll out of treatment across the UK and around the world

Scottish Government hails recommendations a "valuable resource" in eliminating the virus in Scotland.

A team of experts, led by Glasgow Caledonian University (GCU) and the University of Bristol, in collaboration with NHS Tayside and the Scottish Drugs Forum (SDF), have just published a ‘game-changing’ blueprint on how best to get hepatitis C treatment to those who need it most after a successful three-year trial in NHS Tayside.

The breakthrough in getting treatment to those who inject drugs – studied as part of the National Institute for Health Research (NIHR)-funded EPIToPe (Evaluating the population impact of hepatitis C direct-acting antiviral treatment as prevention for PWID (people who inject drugs) project – will help guide efforts in Scotland to eliminate hepatitis C by 2024.

Key recommendations include introducing a nurse-led community service for hepatitis C testing and treatment, recruiting peer workers who know the local drug culture and creating close ties between existing community services for people who inject drugs.

Scientists reveal new method of getting hepatitis C treatment to people who inject drugs

The Global Drug Policy Index (GDPI) is an exciting new project supported by the Robert Carr Fund, and led by the Harm Reduction Consortium. Through this project, we will develop, launch and use a new “composite index” that scores and compares national government policies related to the illegal drug market. The GDPI will initially focus on 30 countries, providing each one with a score or ranking to show how much their drug policies compare to the UN System Common Position on Drugs across four dimensions – criminal justice responses, health and harm reduction, access to controlled medicines, and development (while also exploring key issues such as civil society engagement, decriminalisation, proportionality of sentencing, and funding for harm reduction). The GDPI will track both policies and their implementation.

Complete the GDPI Survey for Civil Society Experts!

A major part of the data collection phase for the Index relies on a civil society survey which will truly enable us to assess how drug policies are actually being implemented on the ground.

For this first iteration, the survey is going to cover 

: Afghanistan, Argentina, Australia, Brazil, Canada, Colombia, Costa Rica, Georgia, Ghana, Hungary, India, Indonesia, Jamaica, Kenya, Kyrgyzstan, Lebanon, Mexico, Morocco, Mozambique, Nepal, New Zealand, North Macedonia, Norway, Portugal, Russia , Senegal, South Africa, Thailand, Uganda, United Kingdom.

If your country is included in the list, please help us by filling in the survey and share it widely with your civil society colleagues! The deadline for filling in the survey is Friday, 1 October Wednesday, 6 October 2021.

English: https://survey.sogosurvey.com/r/uxeFhy

Portuguese: https://survey.sogosurvey.com/r/ZqIYzk

Russian: https://survey.sogosurvey.com/r/9ZToWf

Arabic: https://survey.sogosurvey.com/r/UrmVaS

French: https://survey.sogosurvey.com/r/F8TUg5

Spanish: https://survey.sogosurvey.com/r/kygi7w

The Harm Reduction Consortium behind the Global Drug Policy Index is comprised of: International Drug Policy Consortium (IDPC); Harm Reduction International (HRI); Youth RISE; Women and Harm Reduction International Network (WHRIN); Middle East and North Africa Harm Reduction Association (MENAHRA); European Network of People who Use Drugs (EuroNPUD); Global Drug Policy Observatory / Swansea University (GDPO); Eurasian Network of People who Use Drugs (ENPUD); Eurasian Harm Reduction Association (EHRA); West Africa Drug Policy Network (WADPN).

Global Drug Policy Index (GDPI) survey for civil society experts!

Following the official launch of the Drug Decriminalisation [e]Course on 30th of June 2021, as a result of our collaborative project together with the International Drug Policy Consortium (IDPC), Mainline Foundation, and Frontline AIDS to end the punishment and stigmatisation of people who use drugs, a total of 240 participants from over 55 countries have started their online learning journey. Seven highly interactive, engaging e-modules enriched with videos, exercises, and key information equip participants with knowledge and tools to move the world towards decriminalisation and away from the war on drugs.

Expanding on this initial success and to engage with a broad and global audience, the course will be translated into French with funding support from the AIDS and Rights Alliance for Southern Africa (ARASA). By providing this free online course in multiple languages IDPC, Mainline Foundation, Frontline AIDS, and Health[e]Foundation aim to support partners worldwide on ending the criminalising approaches to drug use and personal possession.

Join for free and learn how to become an impactful advocate and influencer via the IDPC / Health[e]Foundation e-learning platform: https://idpc.healthefoundation.eu.

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