Zoe Dodd had just given an emotional presentation to Toronto’s Board of Health when she realized that something wasn’t right. It was mid-November, the COVID-19 pandemic had exacerbated Canada’s runaway toxic drug crisis, and the long-time harm-reduction worker was in tears as she spoke about front-line workers responding to thousands of overdoses and finding bodies in portable toilets and doorways.

“The ripple of death is grim, and it will take decades for people impacted by this loss to heal,” Ms. Dodd told the board. “We are abandoned by all levels of government, who point fingers at one another, and we are burning out.”

A couple of days later, she awoke feeling foggy-headed and disassociated from reality. Her heart raced and the room seemed to vibrate. She felt like she was in another dimension.

Toxic drug crisis, pandemic have left front-line workers struggling to cope in Canada

Statement on behalf of Dejusticia (Colombia), Intercambios Asociación Civil (Argentina), Mexico Unido contra la Delincuencia (MUCD), the Costa Rican Association for the Study and Intervention on Drugs (ACEID), the Latin American and Caribbean Network of People who Use Drugs (LANPUD), the Washington Office on Latin America (WOLA), and the International Drug Policy Consortium (IDPC), a global network of 192 organisations working to promote human rights-based drug policy, the Washington Office on Latin America (WOLA), and the International Drug Policy Consortium (IDPC), a global network of more than 190 organizations working to promote drug policies based on human rights, human security, social inclusion, development and health.

Declaración en nombre del Centro de Estudios de Derecho, Justicia y Sociedad (Dejusticia), Intercambios Asociación Civil, México Unido contra la Delincuencia (MUCD), la Asociación Costarricense para el Estudio e Intervención en Drogas (ACEID), la Red Latinoamericana y del Caribe de Personas que Usan Drogas (LANPUD), la Oficina en Washington para Asuntos Latinoamericanos (WOLA), y el Consorcio Internacional de Política de Drogas (IDPC), una red global de más de 190 organizaciones, que trabajamos promoviendo políticas de drogas basadas en los derechos humanos, la seguridad humana, la inclusión social, el desarrollo y la salud pública.

Notamos con preocupación que la participación de la sociedad civil en escenarios hemisféricos y multilaterales, que tuvo un periodo de consolidación hace algunos años, se ha debilitado recientemente. Las circunstancias de la pandemia y la virtualidad, que requieren celebrar estas reuniones en modalidad virtual, podrían propiciar convocatorias más amplias, considerando que se eliminan las barreras de gastos de viaje, y en este sentido, alentamos a los Estados miembros a promover de manera más decidida la participación de la sociedad civil en estas instancias.

La pandemia y la crisis social y económica que vive la región como efecto del virus mismo, y de las medidas para contrarrestar el contagio, tienen también repercusiones en la vida de las personas involucradas con economías ilícitas y drogas. Por ejemplo, en los centros penitenciarios de la región, algunos con índices de hacinamiento de hasta el 200 por ciento, se requerían urgentes medidas de descongestión, así como priorizar a las poblaciones allí para su vacunación, hechos que no ocurrieron, con efectos devastadores para las personas privadas de la libertad. Las poblaciones rurales que dependen de economías ilícitas como única alternativa de subsistencia, quedaron aún más aisladas en medio de los confinamientos, y a merced del control de actores armados.

También resulta de suma importancia incorporar en la agenda medidas relacionadas con la respuesta al VIH en la región, tomando en cuenta que este año se discutió en Naciones Unidas la Declaración política sobre el VIH y el SIDA: acabar con las desigualdades y estar en condiciones de poner fin al sida para 2030. Esta declaración menciona la necesidad ampliar la cantidad y cobertura de los programas de reducción de daños y tratamiento para el consumo de sustancias, así como la necesidad de reformar leyes restrictivas que marginan y discriminan a las personas que usan drogas, como aquellas que penalizan la tenencia para consumo personal o el auto-cultivo. El estigma y la discriminación asociados son barreras para el acceso a dispositivos sanitarios y sociales.

Este año se celebran dos aniversarios amargos. Los 60 años de la Convención Única de Estupefacientes y los 50 años de la declaración de la guerra contra las drogas de Presidente Nixon. El tratado global, en sus enunciados fundamentales, buscaba proteger el bienestar de la humanidad, pero en este aniversario lo que las Américas han visto son 60 años de fortalecimiento de las redes del narcotráfico, con poder devastador en violencia y corrupción, a la par de efectos desalentadores en materia de derechos humanos, como es el encarcelamiento desproporcionado y masivo, los contagios evitables de enfermedades transmisibles, la crisis por falta de alivio de dolor, entre tantas otras tragedias de la prohibición. Por su parte, los 50 años de la guerra que declaró Nixon, transformaron y potenciaron conflictos armados internos y fortalecieron una mirada de estigmatización hacia personas que usan drogas, sin mejorar sus condiciones de vida y salud. En resumen, en estos aniversarios se conmemoran décadas de fracaso.

Pero este escenario hemisférico tiene mucho que aportar para asegurar que no se sigan repitiendo y reciclando fórmulas fallidas. La CICAD ya ha estado a la vanguardia de debates que las Américas pueden ofrecer para tomar lecciones aprendidas, definir principios rectores de mejores políticas de drogas, y orientar políticas basadas en la evidencia y en los compromisos comunes de los derechos humanos. Alentamos a los Estados Miembros a asumir liderazgo político y hemisférico que vuelva a poner sobre la mesa debates como el de alternativas al encarcelamiento, enfoque de desarrollo sostenible, y orientación de recursos hacia el desarrollo y la salud pública.

En el escenario internacional, la sociedad civil permanece comprometida, en la medida de sus posibilidades, con participar en instancias de decisión de la política de drogas, y asegurar que los compromisos globales frente a la UNGASS 2016, la Declaración Ministerial de Alto Nivel de 2019, y la Posición Común frente a las políticas de drogas de las Naciones Unidas, avancen con implementación efectiva a nivel regional y nacional. Más recientemente, se publicó elinforme del Grupo de Trabajo de Detenciones Arbitrarias, con énfasis en los impactos a los derechos humanos de detenciones arbitrarias asociadas a políticas de drogas. Desde la CICAD, y en colaboración con el Grupo de trabajo, se debería propiciar un espacio de socialización de los contenidos y recomendaciones del informe para los Estados Miembros.

Profundizar en los enfoques de derechos humanos, políticas basadas en la evidencia, y desarrollo sostenible, son ejes de las organizaciones que hoy represento, pero cuyos contenidos están lejos de la realidad cuando se insiste en medidas criminalizadoras en contra de personas que, por condiciones de vulnerabilidad socio-económicas, se involucran de alguna manera con las drogas ilícitas.

Reiteramos la disposición de las organizaciones que representó para seguir siendo interlocutoras críticas, pero también constructivas en pro de estos objetivos comunes.

Civil society statement to the 69th session of CICAD: Drug policy reform must be back on the agenda

INHSU has collaborated with the International Network of People Who Use Drugs (INPUD), Médecins du Monde (MDM), and Harm Reduction International (HRI) to create a global declaration to inform development of the World Health Organization (WHO)’s Global Health Sector Strategies for HIV, viral hepatitis and STIs.

The World Health Organization is in the process of developing Global Health Sector Strategies for HIV, Viral Hepatitis and Sexually Transmitted Infections (STIs) for 2022-2030. As voted during the World Health Assembly May 2020, the new strategies will be combined into a single document that includes both integrated and disease-specific content.

WHO is conducting various stakeholder consultation activities to inform development of these strategies. It is in this context that we (INPUD, MdM, HRI and INSHU) propose a declaration from the global harm reduction community and its allies, to call for the WHO to uphold the core values we stand for.

The declaration is available to download here and to sign online here.

We strongly believe there is a need for brave and bold leadership to strongly challenge attempts of political interference that will hold back equitable progress towards HIV, viral hepatitis, and STI elimination efforts. We also request that clear focus be given to supporting decriminalization and removal of discriminatory laws and practices as they impact people who use drugs’ access to health services, ensuring the centrality of harm reduction services, and enabling, supporting and encouraging community-led responses and person-centred service delivery.

Declaration to inform development of WHO Global Health Sector Strategies for HIV, Viral Hep and STIs

There is still so much we can achieve together and this year the Rome Consensus 2.0 will be joining the world's largest annual campaign to end overdose, raise awareness and remember without stigma those who have died.

Jamie Bridge - Chief Operating Offficer, International Drug Policy Consortium (IDPC)

Ms. Giovanna Campello - Chief at UNODC Prevention, Treatment & Rehabilitation Section

Massimo Barra - IFRC special envoy for health, founder of Fondazione Villa Maraini, the National Agency of the Italian Red Cross for pathological addictions and creator of the Rome Consensus

More videos convened by the Rome Consensus 2.0 for International Overdose Awareness Day can be accessed here.

Rome Consensus 2.0 launches video series for International Overdose Awareness Day 2021

Anna Conway presented at the NDARC Webinar Series on Thursday 22 July 2021.

This presentation drew on the experiences of people receiving and providing Opioid Agonist Treatment (OAT) during COVID-19.

The COVID-19 pandemic required Opioid Agonist Treatment (OAT) services to adapt quickly to ensure continuity of care. The CHOICE Study uses data collected from 70 in-depth interviews (40 people receiving OAT; 30 providers) to explore how OAT services in Australia responded to COVID-19 and the wider implications of the pandemic for people receiving OAT. Study findings will inform clinical practice and health policy, and highlight areas of future research for people who are dependent on opioids.

The impact of COVID-19 on people receiving Opioid Agonist Treatment (OAT) in Australia

Today, International Drug Users Remembrance Day, is one day among all the others when the people we have lost continue to pop up in our thoughts through little memories, good or bad. It’s a day to acknowledge and value all the lives needlessly lost worldwide.

I’m just one young drug user among millions, living in Halifax, Nova Scotia, Canada. Each passing year, I lose three or four friends and comrades due to the toxic drug supply and the policy conditions and prejudice that create it.

The first one over the past 12 months that really shocked me and hit me hard was Jesse Harvey, who died in September 2020. It seems like everything we find out these days is through our phones or social media. It takes on a surreal, sinister feeling when you scroll and see your favourite harm reduction journalist tweet: “I’m at a loss of words this morning #HarmReduction has lost yet another one of its quiet heroes”—and then you realize you knew him well.

Jesse was such a brave young advocate, creating and effecting change as co-founder of the Church of Safe Injection in Maine. He was one of the first non-Canadian advocates I spoke with in depth as my commitment to international advocacy grew. We actually talked about maybe setting up a Canadian chapter, but at that time most of my focus was on working to open up our local overdose prevention site. Jesse was passing out safe using supplies, naloxone and fentanyl testing strips even when doing so was illegal, because that’s who he was. He talked about his battles to register the Church as a nonprofit and win it religious exemption from US drug laws.

“We’re not saying it’s our religious belief to use heroin. No, not at all,” he told 

the year before his death. “We’re saying that it’s our sincerely held religious belief that people who use drugs don’t deserve to die when there are decades of solutions.”

What International Drug Users Remembrance Day means to me

Ruth Birgin coordinates the Women and Harm Reduction International Network according to which drug policy presents the single greatest threat to the health and well-being of women who use drugs

Can you introduce yourself and explain the work of the Women and Harm Reduction International Network (WHRIN)?

 Certainly. My name is Ruth Birgin and I work as WHRIN Coordinator. Women who use drugs along with members of the international harm reduction community recognized the need to establish a mechanism to focus on gender responsive harm reduction services, leading to the development of the Women and Harm Reduction International Network (WHRIN), formed in 2009 and led by women who use drugs. The goal of WHRIN is to improve the availability, quality, relevance and accessibility of health, social and legal services for women who use drugs.

Women who use drugs face specific problems as compared to men… Can you explain what they are?

 Without a doubt the challenges faced by women who use drugs are overwhelmingly linked with and exacerbated by prohibition rather than the substances themselves. When combined with the social and structural impacts of gender inequality it is little wonder that, for example, rates of HIV prevalence are higher among women who use drugs than their male counterparts. (I list more women-specific challenges in other questions)

Could you explain why and in what ways women who use drugs are stigmatized, and what messages would you like to convey in this regard?

Women who use drugs face compounded stigma where gender inequality and punitive drug policy converge to mete out unique punishments and risks. Women who use drugs are doubly demonised for challenging gender stereotypes of women as conventional, demure mothers/daughters/sisters etc., simply by using drugs, with criminalization and media sensationalism and misinformation further exacerbating gendered stigma and discrimination.

This places women who use drugs in a unique situation, restricting access to health services while elevating the risk of violence and BBV transmission. Our key messages include that drug use does not equate with bad parenting, it is part of the human condition and that the world is in dire need of humane drug policy where women who use drugs are no longer criminalised, pathologized or infantilised – but instead enjoy the same human rights as other people.

Support, don't punish women who use drugs!

Nat Gombos hesitated before participating in a new campaign encouraging young professionals to speak openly about their illicit recreational drug use.

“I still struggle with it, thinking through the potential ramifications” the 28-year-old says. “I ask myself if it’s smart. But nothing happens without people agitating for change. By not speaking up, I contribute to the wall of silence harming people.”

The solicitor from Sydney, who takes drugs such as MDMA, ketamine, cocaine and cannabis every few months, says this silence presents a false narrative of what drug-taking looks like.

Gombos is participating in a campaign by registered charity Unharm called 

 One of the major tactics Unharm is employing to achieve their “legal and safe” drug use goal is mimicking the strategy of gay equality law reform movements: by persuading people to “come out” about their use – especially those who dispel stereotypes. Unharm’s ultimate goal is to decriminalise all drug use in Australia by 2030.

This has been done to varying degrees by other countries: Canada and 18 US states have legalised cannabis use and supply, and Portugal decriminalised all illicit drug use in 2001 and it has been regarded as a success, with fewer drug-related deaths and less drug-related crime. Germany, Spain, Switzerland, Chile, Peru, Uruguay and the US state of Oregon have also all decriminalised drug use in one way or another.

Coming out about illicit drug use: ‘The hush-hush attitude has to end’

Overdose deaths soared to a record 93,000 last year amid the COVID-19 pandemic, the United States government reported on Wednesday.

That estimate far eclipses the high of about 72,000 drug overdose deaths reached the previous year and amounts to a 29 percent increase.

“This is a staggering loss of human life,” Brandon Marshall, a Brown University public health researcher who tracks overdose trends, told the Associated Press.

The nation was already struggling with its worst overdose epidemic but clearly “COVID has greatly exacerbated the crisis,” he added.

Lockdowns and other pandemic restrictions isolated those with drug addictions and made treatment harder to get, experts have said.

‘Staggering loss’: Overdose deaths spike in US during pandemic

Since 2009, the Andrey Rylkov Foundation has been on the streets of Moscow, offering clean syringes so people can inject addictive drugs without the added risk of HIV. The Russian government isn’t a fan of this type of initiative, known as harm reduction — even though it’s recommended by the World Health Organization. Moscow prefers to take a harder line on drug use and prevent HIV by pushing traditional moral values.

That approach isn’t working. Initially fueled by injection drug use, lately the epidemic has been spreading beyond drug users to the general population, affecting well more than one in 100 Russians. (Diagnoses dropped in 2020, but according to the federal HIV monitoring center, that’s likely because testing decreased during the pandemic.) Pre-COVID, cases were on the rise in Russia.

So the Andrey Rylkov Foundation’s work isn’t just about distributing needles and the opiate overdose treatment Naloxone. They’re campaigning against Russia’s war on drugs — a mission that’s gotten much more difficult since they were forced to register under Russia’s “foreign agent” rules in 2016, which requires political organizations that receive assistance from abroad to jump through a bunch of extra hoops.

The new AIDS epidemic: Pushing past Putin

IDPC’s Drug decriminalisation [e]Course is a free-to-access online learning course that is open to anyone interested in this important topic.

When done properly, the decriminalisation of drug use and personal possession can have significant benefits for the health, wellbeing and rights of people who use drugs - yet this approach can sometimes be difficult to advocate for as it runs counter to decades of public and political messaging from a global ‘war on drugs’. To support and equip partners from around the world, the Drug Decriminalisation [e]Course was created in 2021 by IDPC in partnership with Mainline, Health[e]Foundation and Frontline AIDS includes seven modules:

Introduction, definitions and support for decriminalisation

Thresholds and defining drug possession for personal use

Designing decriminalisation: sanctions and intrusiveness

The ‘gold standard’ for decriminalisation 

It has been designed so that participants can take just one module, or all seven, and in any order they prefer. The [e]Course host, Marie Nougier, provides guidance throughout the modules – each of which should take between 1 and 2 hours to complete, including videos and activities – and participants receive a certificate at the end of each Module.

Click here to register and access the free course!

Introducing the Drug Decriminalisation [e]Course

The publication of the second phase of Dame Carol Black’s Independent Review of Drugs will, hopefully, mark a sea-change in approaches to treatment in this country. The report pulls no punches in describing the extent to which funding has been slashed in recent years, and it makes a call for an additional £550 million to be allocated to treatment over the next five years - bringing spending back to 2012 levels. Though even if the UK Government does agree to this additional funding - and we sincerely hope they do - it is worth comparing with the Scottish Government’s commitment to an additional £250 million over the same time period, for a much smaller population.

The report also calls for an overhaul of quality oversight, commissioning models and workforce development. All of which are urgently needed. The drug (and alcohol) treatment sector has been shamefully neglected in recent years, contributing to the appalling increases in drug-related deaths that we have witnessed over the same period. Carol Black is clearly committed to addressing the problems in the sector, and to improving the lives and prospects of those who need support for drug-related problems.

However, the report is disappointing in other respects. Unlike the Phase 1 review, which laid out in forensic detail the scale and impact of drug markets, this review is light on the evidence it brings to bear. It notes that key, evidence-based approaches such as Housing First are vital to holistic treatment approaches, but while calling for expansion of this model the body of the report, Housing First doesn’t make it into the actual recommendations.

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