In regards to current drug trends, particularly methamphetamine (both in crystal and pill form) has become increasingly accessible and affordable throughout Asia, reflecting the trend of rising use of amphetamine-type stimulants (ATS) in the region.

Governments in the SEA region have implemented different kinds of national drug policy reform, including diversion programmes (Indonesia and Cambodia), harm reduction measures (Malaysia and Myanmar), and steps towards decriminalisation of cannabis cultivation and use for medical and scientific purposes (Thailand).

The scale of illicit cultivation of crops continues to be largely influenced by various socioeconomic and political factors such as poverty, conflict, and weak institutions, both in Myanmar and Afghanistan. In areas affected by conflict, households often grow opium poppy as a means of survival in an environment where markets are not accessible.

Lessons can be learned, for instance, from experiences in Thailand or Colombia. The Thai experience demonstrates the importance of integrated rural development as a foundation of AD measures, addressing short-term needs as well as long-term sustainability. This includes community planning, inclusive value-chain development and sustainable land management, among other aspects. Experiences regarding coca cultivation areas and the recent peace agreement in Colombia confirm that multi-stakeholder dialogue is important for being able to access local communities and building trust.

The 9th Asian informal drug policy dialogue

Regulating and legalising cannabis is an idea whose time has come

The so-called ‘war on drugs’ was always built on shaky foundations. Now countries and jurisdictions around the world are dismantling it piece by piece and starting to build a new drug policy architecture that ushers in a new era of health-based policy making fit for the 21st century.

Nowhere are the foundations of this new approach to drugs more obvious than in the global movement towards regulated, legalised cannabis markets. And despite the US being the ostensible leader of the ‘war on drugs’, it has been US states at the forefront of this move. Since Colorado and Washington states legalised cannabis for non-medical use in 2012, and Uruguay became the first country do so in 2013, seven more US states and the District of Columbia have followed in their footsteps.2 The results so far, particularly from the US, are generally positive: confounding critics whilst bringing in additional tax income to fund public services. And this is just the start: in the summer of 2018 Canada will become the first G7 country to legalise cannabis.

Regulating and legalising cannabis is an idea whose time has come. The UK public supports it too: in recent polls 47% of people support selling cannabis in licensed shops. Regulation also has the support of a range of groups from across the political spectrum.

It is time to accept that prohibition is not only ineffective and expensive,but that regulation could – if it is done well – protect vulnerable groups and promote public health. It would also generate both taxes (at least £1 billion annually, but potentially more) and savings, which taken together would mean more resources for health, harm reduction and other public services. It is time for the UK government to catch up with the global shift and take the responsible approach by bringing in a regulated, legal market for cannabis.

Cannabis: Regulate it. Tax it. Support the NHS. Promote public health.

By Caitlin E. Hughes, Monica J. Barratt, Jason A. Ferris, Larissa J. Maier, Adam R. Winstock

Drug law enforcement subsumes the majority of drug policy expenditure across the globe. Fuelled by knowledge that much of this investment is ineffective or counter-productive there have been increasing calls for cross-national comparisons to identify where policing approaches differ and what types of approaches may be more effective. Yet, to date cross-national comparison of drug law enforcement has proven a methodologically hazardous affair. Using a new drug policing module added to the 2017 Global Drug Survey, this study seeks to provide the first cross-national comparison of the incidence, nature and intensity of illicit drug-related police encounters amongst people who use drugs.

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

Drug-related police encounters across the globe: How do they compare?

Thank you for your help in the birth of the Eurasian Harm Reduction Association! 2017 has become almost revolutionary for harm reduction activists in the Central and Eastern Europe and Central Asia (CEECA) region.

Within the association of activists, there has been a challenging process of renovation, the building of a democratic organization with clear processes, and opportunities for activists from all countries of the region to influence the organization’s strategy, policies and activities. It has been possible not only to build a transparent decision-making process, but also to develop an ambitious strategy for our organization through the harmonious and well-coordinated work of the EHRA Steering Committee alongside members and EHRA’s Secretariat. A clear-sighted vision of what is required for sustainable harm reduction programs, and for decent lives of people who use drugs, has helped EHRA to gain strong support from global and regional communities, allies and partner organizations that has encouraged us to build from scratch a solid management system for the organization. From the very beginning of its active operation in 2017, EHRA has already started to implement 9 advocacy projects and has been supporting community groups of people who use drugs in countries of our region; EHRA has also maintained its leadership in regional advocacy to ensure sustainability and efficiency of harm reduction services and for drug policy reform to shift towards being based on public health and human rights.

Now it’s time to mobilize all resources. Drug policy in countries has not improved, but rather has worsened. In most cases, governments are more likely to pay for policemen and prisons than provide social and medical assistance to people who use drugs. In all countries of the region, it has become obvious that we need to change the approach to harm reduction services because the drug scene is changing and people who use drugs are also changing. The issue of government funding of harm reduction services has become very relevant for most of the countries of the CEECA region with international funding rapidly declining and, therefore, EHRA sees its priority in supporting communities in their advocacy for sustainable funding of quality harm reduction services from national sources.

I am proud to be a part of a cohesive and strong team which is ready to fulfill an ambitious strategy!

A good start gives hope for further success!

Ganna Dovbakh, Executive Director of the Eurasian Harm Reduction Association

EHRA in 2017: A good start

Subject Recently, the government of Ghana proposed the Narcotics Control Commission Bill of 2017 (NCC) to replace the current Narcotic Drugs (Control, Enforcement, and Sanctions) Law of 1990 (PNDCL 236) that criminalizes all drug-related activities including drug use, possession, trade, and production. NCC aims to decriminalise drug consumption in Ghana. The initiative is a recognition of the grave impact on public health of the country’s current drug legislation, which imposes punitive sanctions on those engaged in the consumption, production, and trafficking. However, the ramifications of legal change could be felt beyond the country as Ghana could become a norm entrepreneur in the region for harm reduction policies.

Analysis Global Trends Historically, national drug policies have taken a punitive approach to suppress the trade in ‘narcotic’ substances in line with the UN-based international drug control conventions, which have arguably contributed to a range of failed policies including Plan Colombia and mandatory sentencing in the United States. After decades of harsh drugs policies, the United Nations Office on Drugs and Crime (UNODC) found in 2015 that about a quarter of billion people from the age of 15-64 consumed illicit drugs. The result of these measures are high levels of drug use and the harms that are associated with them has resulted in a shift in some parts of the world towards legalisation and decriminalisation models. For example, in 2001, Portugal decriminalised drug procession for personal use. In 2017, Uruguay became the first country to legalise cannabis for recreational purposes. Furthermore, 29 states within the United States have legalised the recreational and medicinal use of cannabis. Ghana’s reconsideration of drug laws is in line with this trend through the decriminalisation of Ghana’s Narcotic Control Commission Bill of 2017.

Regional trends Regionally, there have been indications of changing attitudes to drug policy, linked to better understanding of the counter-productive effects of criminalisation. For instance, in its 2014 report, the West Africa Commission on Drugs (WACD), called for the decriminalisation of possession for personal use. The report provided evidence showing that criminalisation of drug use worsens health and social problems, puts undue pressure on the criminal justice system and fosters corruption.

Ghana strives for a more humane drug policy

Chairperson Eggleton, Deputy Chairperson Petitclerc, Deputy Chairperson Seidman, and other distinguished members of the Standing Committee on Social Affairs, Science, and Technology, thank you very much for the opportunity to testify before you today. I am a senior policy researcher at the RAND Corporation, where I co-direct the Drug Policy Research Center. I have studied cannabis policy for more than 15 years, and my cannabis research has been published in leading journals, such as Addiction, American Journal of Public Health, and New England Journal of Medicine. In 2016, I co-authored a book on cannabis legalization that was published by Oxford University Press.

Over the past two years, I have been fortunate enough to travel to Canada multiple times to meet with researchers and policymakers about cannabis policy and provide an objective assessment of cannabis legalization in the United States. Today, I will focus my remarks on the issue of cannabis potency. RAND does not have a formal position on cannabis policy, and it does not advocate for or against legislative bills or ballot initiatives. My goal for today is to help inform cannabis policy debates at the federal, provincial, and local levels.

A common warning for those consuming cannabis edibles—especially new users—is to “start low and go slow” to prevent overconsumption of δ-9-tetrahydrocannabinol (THC), the cannabinoid most responsible for intoxication. Today, I would like to raise the question about whether this approach should also be applied when considering the potency of cannabis products to be sold in Canada’s nonmedical market should C-45 become law.3 With a “start low and go slow” approach, regulations may start with a smaller range of legal activities and products and a tighter set of rules, allowing regulators and other decisionmakers the option to relax them over time.

Should Canada "start low and go slow" when it comes to cannabis potency?

For decades, Colombia has faced the challenge of promoting economic development and peace in its coca growing regions while quelling the flow of coca for unlawful purposes. During this time, the country has rarely considered promoting economic development with coca, partly because national and international frameworks and policies have written off coca growers as one of the main drivers of the drug trade.

The 2016 peace agreement marked the first significant shift towards a paradigm that prioritizes human rights, rural development, and local governance in the issue of coca. Within the context of the provisions of the peace accord, concrete policy innovations were introduced in 2017. The National Training Service (SENA), a government entity in charge of offering vocational training in vulnerable communities, a peacebuilding organization, and members of the Lerma coca-growing community formed a partnership that became the key to success in advancing policy reform.

Coca Industrialization: A Path to Innovation, Development, and Peace in Colombia 

presents coca as an agricultural product with ample industrialization opportunities that fit within the existing national and international legal arrangements. This report explores coca’s diverse potential in applications as varied as nutrition, natural medicine, personal care, and agro-industry—as well as coca’s historical cultural uses.

The report suggests seeing the coca plant (

) as an agricultural product for lawful uses as well as the challenges and opportunities that have influenced industrialization. It proposes building a coca leaf industry that guarantees a sound income for farmers; provides good quality, sustainable raw materials for manufacturers; and ensures traceability, and control across the supply chain, with adherence to international laws.

 explores the potential that the coca leaf holds and sets out the parameters for a system that could significantly expand coca industrialization in a manner that makes the most of its social, political, economic, and environmental benefits.

Coca industrialization: A path to innovation, development and peace in Colombia

Consumption of cannabis afects cognitive and psychomotor performance in ways that can impair driving (Verstraete and Legrand, 2014; Hall et al., 2016). Cannabis contains a variety of cannabinoids, the most important being tetrahydrocannabinol (THC) and cannabidiol (CBD), which have very diferent efects on the brain. Te relative amounts of these and other cannabinoids in cannabis plants and cannabis products vary widely. Te THC in cannabis provides the predominant psychoactive efects and is considered to be mainly responsible for the impairment of function that afects driving ability.

Cannabis is a widely used substance. Within the general population, young adults have the highest rates of cannabis use (Canadian Centre on Substance Use and Addiction, 2017; EMCDDA, 2017) and are the age group at highest risk of motor vehicle crashes in the European Union (EMCDDA, 2012), Canada (Beirness and Porath, 2017), the United States (Substance Abuse and Mental Health Services Administration, 2017) and Oceania (Australian Institute of Health and Welfare, 2017).

The recreational use of cannabis has been legalised in nine states in the United States and in Uruguay (as of April 2018) and the Canadian government plans to legalise it in 2018. Tese developments have heightened concerns about cannabis and driving, for two broad reasons. First, they mean that, in these jurisdictions, cannabis use will no longer be illegal in itself, so laws on driving after consuming cannabis might become much more like those for alcohol. Second, if cannabis legalisation increases the number of individuals in the population who use the drug, then the number of people who drive after using cannabis may also increase. Te extent to which such an increase actually occurs is not clear (see question ‘Has cannabis legislation increased the number of cannabis-impaired drivers?’ on page 11). Evaluation of the impact of legalisation on both the extent of driving under the infuence of cannabis and the impact on road trafc accidents and associated injuries is therefore important.

Cannabis and driving - Questions and answers for policymaking

Subject Between June and July 2017, two law enforcement actions targeted the cryptomarkets AlphaBay and Hansa Market, closed them, and arrested their operators, seizing millions of dollars in assets in the process. These operations, dubbed ‘Operation Bayonet’ (AlphaBay) and ‘Operation GraveSac’ (Hansa) saw a shift in the strategy and tactics that law enforcement agencies are using to target cryptomarket activity on the Tor network.4 By deconstructing the operation, this situational analysis aims to provide pertinent lessons on how law enforcement agencies have adapted their approach towards tackling cryptomarkets.

On June 20th, 2017 the Netherlands National High Tech Crime Unit (NHTCU) infiltrated Hansa Market and took over the site’s operations (Operation GraveSac), without alerting users or disrupting illicit sales.5 This was done with the help of private cybersecurity company Bitdefender that supplied information that enabled the NHTCU to compromise a server in the Netherlands. This action led to German authorities arresting the two Hansa Market administrators, who provided information on another server in Germany and the main server’s location in Lithuania. A link was then set up between the servers in Lithuania and the Netherlands that allowed law enforcement to create a realtime copy of the market database within NHTCU jurisdiction. They also obtained the cryptomarket source code that enabled them to modify the site and thus improve their intelligence collection capabilities.

A takedown operation on July 5th (Operation Bayonet) headed by U.S. law enforcement agencies closed AlphaBay and revealed 25-year-old Canadian Alexandre Cazes as the site’s administrator ‘alpha02’. He was arrested in Thailand pending extradition to the United States. Despite being the largest cryptomarket at the time, law enforcement made no official announcements of the arrest, leaving the user community to speculate about the market’s downtime.7 Initial reaction was that the administrators had performed an exit-scam, a theory that gained traction when members of the community noticed large bitcoin transactions they suspected as originating from the cryptomarket’s wallet.

Following the shutdown of AlphaBay, Hansa Market saw an eight-fold increase in new registrations.9 The administrators (NHTCU) announced they would temporarily close registration to cope with the influx and continue to fulfil orders.10 This kind of action had been previously taken by cryptomarkets that experienced large jumps in their user base following rival market closures and therefore it did not raise the suspicions of Hansa’s community.

Cazes committed suicide in his Thai prison cell on July 12th and news broke out shortly afterwards that linked his arrest and subsequent death to a law enforcement operation that had taken down AlphaBay. At this point the cryptomarket community was still unsure about law enforcement’s involvement in AlphaBay’s closure. Users were also unaware of any law enforcement links between AlphaBay and Hansa Market.

On July 20th the US Federal Bureau of Investigations (FBI) and Europol released a joint statement confirming the operations and posted seizure notices on both Hansa and AlphaBay. Europol claimed that during the 27 days the NHTCU had control of Hansa as part of Operation GraveSac they monitored approximately 1,000 daily transactions. Additionally, they gathered 10,000 postal addresses along with thousands of messages from Hansa customers. Regarding Operation Bayonet the FBI estimated over 200,000 customers, 40,000 vendors and over 350,000 listings on AlphaBay.12 This included 250,000 listings in illegal drugs plus over $1bn in total transactions since its inception in 2014, making it the largest cryptomarket to date.

Crypto-market enforcement - New strategy and tactics

This document provides EU/EEA Member States with evidence-based scientific advice on active case finding options. These options can be applied to the planning and implementation of interventions that promote the early diagnosis of communicable diseases in prison settings.

Compared with the general public, people in prison in the EU/EEA have a higher burden of communicable diseases such as human immunodeficiency virus (HIV), hepatitis B, hepatitis C, syphilis, gonorrhoea, chlamydia and tuberculosis (TB). Increased disease prevalence in this population is recognised as a significant public health concern, both for people living and working in prisons and for the general population at large because the vast majority of people held in prisons eventually return to their communities. Yet, incarceration may represent a unique opportunity to make adequate healthcare services available to people and target groups that are usually hard to reach when in the community. Active case finding is one of the key measures for the prevention and control of communicable diseases that should be considered for broader implementation in prison settings. It supports early diagnosis, ensures that infected people can receive early treatment and care, and thus contributes to prevent onward disease transmission. The successful implementation of evidence-based interventions in prison settings requires an in-depth knowledge of structural hurdles, individual barriers, and the characteristics and behaviours of the prison population.

To this aim, the European Centre for Disease Prevention and Control (ECDC) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) have joined forces to develop a common evidence-based guidance for the prevention and control of communicable diseases in prison settings in the EU/EEA. This document provides EU/EEA Member States with evidence-based scientific advice on active case finding options. These options can be applied to the planning and implementation of interventions that promote the early diagnosis of communicable diseases in prison settings.

This guidance focuses on high-burden communicable diseases in prison settings. It covers diseases for which evidence on active case finding interventions in prison settings could be retrieved though a systematic review of the literature, i.e. viral hepatitis (B and C), HIV, sexually transmitted infections (STIs) and TB. This guidance focuses on adults aged 18 years or older who are detained in prison for custody, remand, or awaiting trial. In certain instances, people visiting correctional facilities or intervening in various capacities, and prison staff may be included.

The target audiences for this guidance are national policymakers, professionals and institutions responsible for the planning of healthcare services in the national/subnational custodial system, professionals and entities responsible for the planning and provision of healthcare services in prison institutions, civil society organisations, and nongovernmental organisations with an interest in prison health.

Research findings relevant to this guidance have been reviewed and assessed using evidence-based medicine (EBM) principles adapted to a public health framework. To produce this guidance, scientific evidence from peer-reviewed and grey literature was assessed. Results were combined with expert advice and considerations on harms and benefits, human rights, equity, ethics, and user preferences. Country-specific care models also contributed to the development of intervention options for national and subnational public health programmes in European prison settings.

Public health guidance on active case finding of communicable diseases in prison settings

In its resolution 32/31, the Human Rights Council requested the United Nations High Commissioner for Human Rights to prepare a report compiling information on procedures and practices in respect of civil society involvement with regional and international organizations, including United Nations bodies, agencies, funds and programmes, and the contribution of civil society to their work, challenges and good practices.

The present report highlights the important role played by civil society in terms of advocacy, expertise and implementation in its engagement with regional and international organizations. It summarizes good practices adopted by some of those organizations in terms of civil society participation, including in relation to accreditation, access to information and accountability mechanisms. The report also identifies the challenges that civil society encounters in its engagement, such as reprisals, lack of transparency and access and limited diversity in civil society representation. On the basis of international human rights norms, the report recommends that regional and international organizations establish clear and effective channels for meaningful and equal civil society participation and engagement.

Procedures and practices in respect of civil society engagement with international and regional organizations

Drugs can act as facilitators for all types of violence, including drugrelated homicide (DRH). Addressing this phenomenon is of importance not only given the severity of a homicide event and its high costs to society, but also because DRH has the potential to act as a valuable indicator of wider drug-related violent crime. Comparing DRH levels between countries can be a valuable tool for identifying trends and new threats. As part of its programme for developing and improving drug supply indicators, the EMCDDA has been expanding its monitoring to include measures of wider drug-related crime, including DRH. However, there appears to be a significant gap in the available European data on DRH. This Paper aims to identify relevant European data sources on DRH, to assess the role of drugs in national homicide data, and to assess these sources and data in terms of monitoring potential. A critical review was conducted of existing national and international homicide data sources.

Data on DRH is systematically prepared in the Czech Republic, Denmark, Finland, Germany, Italy, the Netherlands, Norway, Slovakia, Sweden and the United Kingdom (England, Wales, and Scotland). Available data suggests both between- and within-country variability in relation to the role of drugs in homicide events. Based on these findings, four key obstacles can be identified in terms of the current ability to monitor DRH: missing data, fragmented data, comparability issues and data quality reservations. To overcome these obstacles there is a need to define and operationalise concepts, based on common definitions and integrate them into the EMCDDA monitoring system.

Publications