By taking cues from users’ self-regulation strategies, it is possible to design innovative operational models for drug services as well as drug policies, strengthening Harm Reduction as an alternative approach to the disease model.

A significant body of research on cocaine users recruited outside captive populations – that is, studies based on samples of users who have not been enrolled through drug addiction services – has been carried out in many European countries and outside Europe. These studies show a variety of patterns and trajectories of use other than “addictive” use.

This paper illustrates the aim of encouraging users’ informal controls while reducing the harm caused by punitive laws and policies.

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Cocaine: towards a self-regulation model

Portugal enacted one of the most extensive drug law reforms in the world when it decriminalized low-level possession and use of all illicit drugs more than a decade ago. Results of the Portuguese experience demonstrate that drug decriminalization – alongside a serious investment in treatment and harm reduction services – can significantly improve public safety and health.

Drug decriminalization in portugal: A health-centered approach

Personal sovereignty informs both the LGBT liberation and drug policy reform movements. Police surveillance and repression, along with stigma and moral panic, have been used to great effect against both LGBT individuals and people who use drugs.

We need drug policies that move away from the criminal justice system, and address drug overdose, dependence, and use through a health-oriented framework.

 LGBT communities and drug policy reform

The current system for classifying illegal (and most legal) drugs is flawed, outdated and unscientific. Marijuana should be reclassified in order to facilitate research, ensure patient access, and permit its legal regulation. Established by the federal Controlled Substances Act (CSA) of 1970, this system erroneously places marijuana in the most restrictive class, Schedule I, reserved for drugs with a "high potential for abuse”, "no currently accepted medical use" and a “lack of accepted safety."

Marijuana reclassification: Removing marijuana from the controlled substances Act

On October 21-23, 2013, the Washington Office on Latin America (WOLA) and the Drug Policy Alliance (DPA) hosted in Denver, Colorado, the workshop “Launching Legal Marijuana: Regulatory Challenges and Options.

The overall goal of this workshop was to create a forum to learn from the unfolding experiences in the U.S. states of Colorado and Washington in implementing the legislation recently passed to regulate marijuana, as well as to debate ideas, lessons learned and best practices on this issue. The workshop was attended by delegations from Brazil, Mexico, Canada, the United States, and Uruguay involved in the regulation processes in their respective countries.

What follows is a summary of the meetings and discussions during those days. This document aims at providing an overview of the perpsectives shared during the meeting, as well as pointing out the questions and challenges identified by the participants regarding regulation of the marijuana market. Nonetheless, it should be noted that the individual views included in this document do not necessarily represent the general opinion of the meeting’s participants.

Launching legal marijuana: Regulatory challenges and options

Map of all states with broadened naloxone access laws and links to the text of the various laws.Unintentional drug overdose is now considered to be a leading cause of preventable death in the United States. Administering naloxone hydrochloride (“naloxone”) can reverse an opioid overdose and prevent these unintentional deaths. To explore these laws use the query box below. This page has been updated through February 2014.

Please click here to have access to the map and the explanations.

Map of State laws regulating naloxone

Many U.S. cities are taking steps to reduce the role of criminalization in their local drug policies. Seattle, Washington has been at the forefront of this effort, pioneering a novel pre-booking diversion program for minor drug law violations known as Law Enforcement Assisted Diversion (LEAD). Santa Fe, New Mexico and several other cities have begun exploring this promising new strategy to improve public safety and health.

 Law enforcement assisted diversion (LEAD): Reducing the role of criminalization in local drug control

These bills are illegal and unconstitutional. Prior to 2011, the only state to pass such a law was Michigan. That law was struck down in 2003 by a federal appeals court. The court upheld a 2000 decision by a U.S. District Court judge that mandatory, suspicionless drug testing for public assistance violates the 4th Amendment’s protection from unreasonable search and seizure, and is unnecessary, given the existence of more effective and less invasive means of detecting drug abuse.

Mandatory drug testing for unemployment benefits and TANF is costly and ineffective

Under Heroin-Assisted treatment (HAT), pharmacological heroin is administered under strict controls in a clinical setting to those who have failed in other treatments like methadone. Every published evaluation of HAT has shown extremely positive outcomes: major reductions in illicit drug use, crime, disease and overdose; and improvements in health, wellbeing, social reintegration and treatment retention. More than a half dozen countries in Europe and Canada have implemented heroin-assisted treatment (HAT) programs.

Heroin-Assisted Treatment 

With less than 5 percent of the world’s population but nearly 25 percent of its incarcerated population, the United States imprisons more people than any other nation in the world – largely due to the war on drugs. Misguided drug laws and draconian sentencing requirements have produced profoundly unequal outcomes for communities of color. Although rates of drug use and selling are comparable across racial and ethnic lines, blacks and Latinos are far more likely to be criminalized for drug law violations than whites. The drug war drives mass incarceration and racial disparities in U.S. judicial systems.

The drug war, mass incarceration and race

One solution to reducing the number of people swept into the criminal justice system for drug law violations is to enact various forms of decriminalization of drug use and possession. Decriminalization is the removal of criminal penalties for drug law violations (usually possession for personal use). Roughly two dozen countries, and dozens of U.S. cities and states, have taken steps toward decriminalization. By decriminalizing possession and investing in treatment and harm reduction services, we can reduce the harms of drug misuse while improving public safety and health.

Approaches to decriminalizing drug use and possession

Supervised injection facilities (SIFs) are controlled health care settings where people can more safely inject drugs under clinical supervision and receive health care, counseling and referrals to health and social services, including drug treatment. There is overwhelming evidence that SIFs are effective in reducing new HIV infections, overdose deaths and public nuisance – and that they do not increase drug use or criminal activity. There are currently 92 such facilities operating in 62 cities around the world – but none in the U.S.

SIFs can play a vital role as part of a larger public health approach to drug policy. SIFs are intended to complement – not replace – existing prevention, harm reduction and treatment interventions.