This open letter outlines extensive scientific evidence that the indicators used to evaluate drug policy ignore some of the most important community impacts. In response, the open letter includes a preliminary set of suggested indicators that allow for governments to better assess the health, security, development and human rights impacts of their drug policies. By reprioritizing the indicators used to evaluate illicit drug policy, governments will be better able to implement targeted and effective policies that align with community needs. The alternative is to continue the unacceptably high levels of drug-related harms, with grave implications for communities across the globe.

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

 A call for a reprioritisation of metrics to evaluate illicit drug policy

We, representatives of government ministries, law enforcement agencies, drug policy experts and civil society who participated in the Regional Consultation on Drug Policy Reform on “The Road to UNGASS” which was held in Ghana from 19-20 January 2016, which attracted 11 West African countries namely Benin, Burkina Faso, Cabo Verde, Cote D'Ivoire, Ghana, Guinea, Guinea-Bissau, Liberia, Nigeria, Senegal and Sierra Leone hereby make the following declaration with respect to drug policy reform in West Africa;

Reaffirming the Political Declaration and Plan of Action on International Cooperation, the Common African Position towards UNGASS, AU Plan of Action on Drug Control and the ECOWAS Regional Action Plan to address drug trafficking, production and consumption, and calling upon West Africa Member States to take the measures necessary to fully implement the actions set out therein, with the view to attaining, in timely manner their goals and targets.

Acknowledging the serious threat posed by drug trafficking and production to governance, peace and security stability and economic growth in West Africa, a region that has only recently emerged from decades of violent conflict;

Recognising the efforts made by Member States to comply with the provisions of the single Conventions on Narcotic Drug of 1961 as amended by the 1972 Protocol, the Convention on Psychotropic Substances of 1971, and the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988;

Acknowledging the threat of drug use to public health and social development in West Africa;

Mindful of the current drug policy that has fostered abuses of human rights of drug users, burdened the criminal justice system, deterioration of public health, proliferation of violence, spread of HIV, hepatitis, tuberculosis prevalence and taking priority away from effective treatment and rehabilitation for people who use drugs;

Acknowledging that narcotic drugs trafficking is a major problem that threatens security, social welfare, economic development and political stability in West Africa;

Welcoming the opportunity that the United Nations General Assembly Special Session (UNGASS) 2016 on the world drug problem provides the region to review its progress in the International Cooperation against the World Drug problem;

Recalling that the world drug problem remains a common and shared responsibility that requires effective and increased international cooperation;

We hereby recommend the following inputs towards the contribution of Member States to the outcome document of the UN General Assembly Special Session.

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

West African common position towards the UNGASS 2016 on the world drug problem

This submission by the International Network of People who Use Drugs (INPUD) to the Civil Society Task Force to UNGASS on Drugs 2016 is derived from INPUD’s Consensus Statement on Drug Use Under Prohibition: Human Rights, Health, and the Law. The INPUD’s Consensus Statement focusses on human rights, health, and the law in relation to people who use drugs. The document – and this submission – is informed by the perspective of those who are so catastrophically impacted by global prohibition and by the so-called ‘war on drugs’: people who use drugs themselves.

This submission stems from five consultations conducted by the INPUD in 2015 with representatives of drug user organisations internationally. Each consultation was comprised of focus groups with participants. Consultations were undertaken in Dar es Salaam, Tanzania, in Bangkok, Thailand, in London, England, and in Tbilisi, Georgia. A virtual consultation was also conducted. In total, representatives of 24 drug user organisations from 28 countries contributed to the consultations.

The assertions made in this submission are driven by the data, reports, and testimony gathered in these consultations; each assertion made in this document is backed up by first-hand testimony from one or several representatives of drug user organisations globally.

INPUD submission to the civil society task force to UNGASS on drugs 2016

Cannabis use has never posed major problems in Indonesia, yet prohibitionist policies prevail. Despite the high prevalence of cannabis use, local or national discussions on cannabis policies are nearly non-existent, exacerbated by strong anti-drug views and public institutions' failure to design and implement comprehensive policies based on evidence.

Cannabis in Indonesia

Public Health England (PHE) have released a free resource to assist prison staff about new psychoactive substances (NPS) in prisons.

The toolkit has been recently released after the HM Inspectorate of Prisons report ‘Changing patterns of substance misuse in adult prisons and service responses’, published in December 2015, which identified NPS as having “created significant additional harm and are now identified as the most serious threat to the safety and security of the prison system.”

The resource is intended to support custodial, healthcare and substance misuse staff by providing information about the extent of NPS use as PHE currently understand it and about the properties of the various categories of NPS, and by providing advice on how to manage the problem from a clinical, psychosocial and regime perspective.

The toolkit also discusses the various challenges that are associated for healthcare staff, such as the covert nature of use, unpredictable effects the various drugs have, the delay in seeking medical help, as well as multiple challenges for the wider prison regime.

New psychoactive substances in prisons: A toolkit for prison staff

Fom October 1-3, 2015 a regional meeting of NGOs, policy makers and scientists/researchers from the countries of Southeast Europe, was organized by Diogenis Association in Belgrade, to discuss the UN General Assembly Special Session on Drugs (UNGASS, April 2016) and its significance for Southeast Europe. The meeting closed with the formulation of some conclusions relevant for the situation in the SEE countries.

The UNGASS 2016 and its significance for SEE: Statement of NGOs in South East Europe

Globalisation has facilitated cultural exchange between indigenous traditions and Western practices, which has led to a growing interest in the ritual, religious and therapeutic use of ayahuasca

Indigenous peoples in the Amazon have used ayahuasca for centuries as a remedy for physical and psychological health, and to ensure the life and wellbeing of their communities. In the past two decades, the use of this decoction has expanded beyond Amazon indigenous spheres. Globalisation, and with it the contact between populations, has facilitated cultural exchange between indigenous traditions and Western practices, which has led to a growing interest in the ritual, religious and therapeutic use of ayahuasca.

People who participate in the sessions have a positive perception of its use; while most scientific research over the past decade supports the subsequent benefits attributed to it. But the increased use of ayahuasca has not been free from challenges, such as its excessive commercialisation in the Amazon, linked to ayahuasca tourism, or the exploitation of natural resources used for its preparation. Despite not being a controlled substance at the international level, and not banned in almost any national jurisdiction, in recent years there have been an extraordinary number of detentions and judicial prosecutions in Europe, the United States and Latin America for ayahuasca importation and use. This contradiction has produced a number of uncertainties regarding its legal and political status, which varies between countries.

In this policy brief, ICEERS and TNI offer an analysis of the challenges associated with the globalisation of ayahuasca.

Ayahuasca: From the Amazon to the global village

The Bridging the Gaps programme aims to increase access to HIV prevention, treatment, care and support and ensure full human rights for key populations, who are most affected by HIV but least supported. The right to lead a healthy and fulfilling life is universal but not accessible for all. In order to improve the access to healthcare services for key populations, the Bridging the Gaps programme aims to integrate specific services for these groups into general healthcare systems, because:

In many countries, key populations which include people living with HIV face social exclusion, discrimination and stigma within the general health system. This negatively affects the access to HIV prevention, treatment, care and support.

Evidence shows that integration of services for key populations increases access to health services.

Providing accessible HIV-related health services for key populations shows a significant reduction in a country’s HIV prevalence.

Integration of services has the potential to be sustainable and cost-efficient for both providers and service users, strengthens health systems and

Lastly, all people have the right to equal access to health services.

Although integration of services is not a new theme, evidence related to implementing and evaluating integration programmes is not readily available. There is little guidance for planners and decision-makers on how to plan and implement integrated health service delivery for key populations. Evidence for low and middle income countries is especially scarce. This document provides lessons learnt of the Bridging the Gaps programme linked to the global strategy of the WHO on integrated and people-centred services for key populations. In 2015 Bridging the Gaps, in collaboration with VU University Amsterdam, conducted qualitative research to collect best practices, lessons learnt and critical facilitators for integrating services in South Africa, Kenya, Uganda, Indonesia, Vietnam and Kyrgyzstan.

Integrated services for key populations: Lessons learnt from the Bridging the Gaps programme

The Scottish National Naloxone Programme has proven to be effective in lowering the number of Opioid-Related Deaths (ORDs) in people recently released from prisons according to a newly published report.

The report entitled ‘Effectiveness of Scotland's National Naloxone Programme for reducing opioid-related deaths: a before (2006-10) versus after (2011-13) comparison’, was published in the Society for the Study of Addiction's journal 'Addiction'.

The study aimed to assess the effectiveness for Scotland’s levels of ORDs between the two time periods, as well as to assess cost-effectiveness of the programme.

The report found that In 2006-2010, 9.8% of ORDs (193 out of 1,970) were in people released from prison within 4 weeks of death, whereas only 6.3% of ORDs in 2011-2013 followed prison release (76 out of 1,212); this represented a reduction of 3.6%.

This reduction in the proportion of prison release ORDs translates into 42 fewer prison release ORDs during 2011-13, when 12,000 naloxone kits were issued at current prescription-cost of £225,000.

In conclusion, the report found that Scotland's National Naloxone Programme, which started in 2011, was associated with a 36% reduction in the proportion of opioid-related deaths that occurred in the 4 weeks following release from prison.

Click here to read the full article (restricted access).

Keep up-to-date with drug policy developments by subscribing to the

Effectiveness of Scotland's National Naloxone Programme for reducing opioid-related deaths

The Scottish Drugs Forum's Annual Report 2014/15 has been published following the successful Annual General Meeting and seminar event that took place on Wednesday the 11th of November.

The document includes reports from the Chair at SDF George Allan and SDF Director David Liddell, alongside articles explaining key aspects of work carried out by the various departments of SDF and a number of the exciting highlights from the past year.

The Scottish Drugs Forum's Annual Report 2014/15

The Third Myanmar Opium Farmers’ Forum was held in September 2015 in Pyin Oo Lwin, Myanmar. It brought together around 30 representatives of local communities involved in poppy cultivation in Myanmar’s major opium growing regions: Chin State, Kachin State, northern and southern Shan State and Kayah State. Farmers and community representatives from Chin, Kachin, Kayah, Kayan, Pa-O, Shan and Ta-ang (Palaung) ethnic communities took part in the forum.

Current drug control polices in South-east Asia are repressive and criminalise opium farmers, greatly affecting the lives of communities cultivating opium. Most policy responses – including from some armed opposition groups – focus on eradication of poppy fields and the implementation of strict bans on opium cultivation. As these communities depend on opium as a cash crop to solve immediate food security problems and sustain their livelihoods, such repressive policies are driving communities further into poverty. Currently only very few Alternative Development (AD) programmes are offered to opium-growing communities to address these problems. Furthermore, opium cultivation often takes place in conflict-affected areas, and links between drugs and conflict affect local communities.

Until now these communities have had little or no influence on the design of the drug control policies that have great impact on their lives and livelihoods. They have also had little participation in the design, implementation and monitoring and evaluation of AD programmes that are supposed to help them. The forum’s aim was to identify the main concerns of opium farmers, and formulate alternative policy options that respect the rights of producer communities and involve them in the decision-making processes. To this end the forum adopted a statement with recommendations to policy makers nationally and internationally.

Report from third Myanmar opium farmers’ forum

Sex workers and people who use drugs are subject to widespread violations of their human rights, which, for the most part, go unchallenged. Globally, these groups are subjected to repressive and discriminatory laws, policies and practices. These policies and practices fuel stigma, discrimination, widespread violence, and significantly increase the risks and vulnerabilities of both populations to sexually transmitted infections and blood borne viruses, notably HIV and hepatitis B and C. In settings that have detrimental and punitive drug and sex work laws and policies, sex workers who use drugs1 2 experience interconnected layers of risk and vulnerability, caused by the compounded effects of criminalisation, stigma, and discrimination.

Sex workers and people who use drugs – specifically, people who inject drugs – are now recognised as key populations in the global HIV response. However, this recognition often fails to translate into funding commitments of appropriate scale and reach, and at times results in health programmes that are not implemented from a rights-based perspective.

Furthermore, there is a worrying lack of recognition of the intersections between various communities. Sex workers who use drugs are often overlooked, crudely categorised as being within one community or the other. This approach fails to engage with people’s nuanced realities.

In a context where services are designed and implemented through the targeting of one key population or another, there is a substantial risk of sex workers who use drugs’ needs going unmet. This group is rendered invisible in research, epidemiological statistics and policy discussions, which results in invisibility in policy and programming. This invisibility was highlighted by sex workers who use drugs at the 

International AIDS Conference in Melbourne 2014

, where conversations reflected the frustration of this community. Notably, sex workers who use drugs (particularly those who inject drugs) experience stigma and discrimination from within sex worker communities and communities of people who used drugs. Even among sex workers who use drugs, some non-injecting sex workers actively distance themselves from the stigma of injection drug use.

These discussions resulted in the development of this joint INPUD and NSWP briefing paper.

This joint briefing paper highlights the specific needs and rights of sex workers who use drugs, as a community that spans two key populations. This document provides an overview of some of the most endemic and substantive ways in which sex workers who use drugs face double criminalisation and associated police harassment, intersectional stigma, compounded marginalisation and social exclusion, heightened interference and harassment from healthcare and other service providers, infantilisation, pathologisation, and an associated undermining of agency, choice, and self-determination.

This paper also examines how compounded stigma and discrimination, as well as issues specific to sex workers who use drugs, place this community at heightened risk of negative health impacts and human rights violations.

This paper uses case studies that highlight efforts to meet the needs, and advocate for the rights, of sex workers who use drugs. These case studies draw on in-country examples of joint work between sex worker and drug user networks/communities. These case studies were developed from INPUD and NSWP consultations for the purposes of this document. Alongside references to secondary sources, these case studies demonstrate the positive outcomes of partnerships meeting the intersectional and overlapping needs, and advocating for the rights of sex workers who use drugs.