The analysis presented in this report describes a European drug market that remains resilient, with some indicators for cannabis and stimulant drugs, in particular, now trending upwards. Overall, supply data suggest that the purity or potency of most illicit substances is high or increasing. The majority of recent survey data on prevalence also show modest increases in the estimated use of the more commonly consumed drugs.

The drug marketplace is also more complex, with new substances available to consumers alongside more established drugs, signals that medicines are becoming more important, and with polydrug use patterns the norm among those experiencing drug problems.

Interdiction efforts are challenged by the fact that production of cannabis, synthetic drugs and even some opioids and new psychoactive substances now takes place within Europe, near to consumer markets. Taken together this new analysis highlights the need for Europe’s drug policy agenda to embrace a broader and more complicated set of policy issues than has historically been the case.

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

European drug report 2016 - Trends and developments

The current prescription opioid and heroin overdose epidemic has brought greater attention to injection drug use in public spaces. A recent New York Times article noted incidents of public injecting reported by local media in several states, stating:

“With heroin cheap and widely available on city streets throughout the country, users are making their buys and shooting up as soon as they can, often in public places. Police officers are routinely finding drug users — unconscious or dead — in cars, in the bathrooms of fast-food restaurants, on mass transit and in parks, hospitals and libraries.”1

Public injecting poses a significant policy challenge for public health and safety. Injecting in public spaces has been associated with greater risk of overdose and HIV transmission. Many people who use drugs are unable to use them in safe and private environments but instead must turn to venues such as public bathrooms, empty warehouses, and parks. The reasons are complex. Drug use is both illegal and stigmatized; some people who use drugs are homeless, unstably housed or risk loss of housing if found using drugs. This lack of privacy and dignity, particularly when drugs are injected, compromises the health, wellbeing and safety of the people injecting the drugs and of the surrounding community.

Reducing public injection of drugs requires a multipronged approach ranging from accessible drug treatment to affordable supportive housing. This consultation on Alternatives to Public Injection was focused on one solution that has been implemented in a number of countries: supervised injection facilities (SIFs), also known as drug consumption rooms. Supervised injection facilities have received increased attention and consideration in recent months. Legislation to support the establishment of SIFs has been introduced in Maryland and California. SIF proposals are actively under discussion in Seattle, WA and Ithaca, NY. Outside of the United States, new SIFs are expected to open in France, Ireland and Canada.

Currently, there are nearly 100 SIFs in operation outside the United States, but as yet no U.S. jurisdiction has established a supervised injection facility. In light of growing policy interest in this strategy, Harm Reduction Coalition collaborated with Open Society Foundation and amFAR, The Foundation for AIDS Research to convene a consultation on Alternatives to Public Injection on September 30, 2015. Representatives from the NYS Department of Health AIDS Institute and the New York City Department of Health and Mental Hygiene participated in the consultation, along with stakeholders representing harm reduction, drug user health advocates, law enforcement and social service providers. Harm Reduction Coalition invited experts from several countries to share their various SIF models, planning and policy development process, implementation challenges, and evaluation results.

This report by Harm Reduction Coalition is a summary of the proceedings of the consultation. The report provides insights on the potential role of supervised injection facilities in the United States, and considerations for advancing policy, planning and implementation of SIFs based on experiences in other countries.

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

Alternatives to public injecting

Civil society organizations (CSOs) in Middle East and North Africa (MENA) are the principal partners of government in scaling up the response to HIV and in implementing national policies. In return, CSOs expect endorsement of their work by the governments. Some CSOs face weaknesses and need capacitybuilding in order for them to reach the level of response required for reducing drug-related harm in this region. Substance use and the transmission of HIV are increasing in the MENA region. The limited data available on drug use show that there are approximately 630,000 people who inject drugs (PWID) across the region. The HIV epidemic remains concentrated among PWID and other key populations in the region. Comprehensive harm reduction programs which include prevention, care, and HIV treatment for PWID are being implemented by CSOs. This could not happen without the presence of a conducive environment which has been facilitated by the CSOs, and which aims to lead to a positive response in health policies, and thus to harm reduction programs in some countries in the region. However, based on the international data, antiretroviral therapy (ART) coverage remains low in these countries, even if the number of people living with HIV (PLHIV) receiving ART is increasing. This increase can sometimes mask important challenges in equity: in several countries PWID are the most likely to be infected with HIV while being the least likely to be receiving care and ART. Therefore, concentrated efforts need to continue toward the goal of having mainstream harm reduction approaches in region.

Drug policy and harm reduction in the Middle East and North Africa: The role of civil society

In this manifesto, the Scottish Police Federation proposes some changes in the approach to the problem of drug users. Of particular importance, the document suggests authorities should not focus law enforcement efforts on people who use drugs.

Tackling drug and alcohol misuse Scotland has had a long, turbulent relationship with alcohol and drugs. But decades of arresting and prosecuting those with dependency problems has failed to tackle the root cause.

There will always be those who end up in the criminal justice system as a consequence of their actions. Where prosecutions are necessary, the punishment should be swift and decisive.

The SPF is not advocating the legalisation or decriminalising of drugs, but efforts should be better directed in trying to help those with problems overcome addictions.

Courts should be free to impose disposals that mandate participation in health and education programmes, with traditional criminal sanctions preserved for those preying on the vulnerable and peddling misery.

The SPF believes it is time to stop persecuting users and start concentrating on the dealers. Working in collaboration, the SPF believes that health, education and justice services stand a better chance of ending cycles of offending.

While intoxication is not a medical emergency, the consequences can be. Locking up drunk people in cells is no longer an acceptable way to manage that risk.

The SPF believes that safe, secure facilities should be created to manage those who present themselves as intoxicated and avoid the need to shuttle people between police cells and hospitals. Such facilities should be managed by skilled personnel from across the police, health and social care services, charities and other appropriately skilled personnel.

Scotland: Manifesto - Programme for policing 2016 - 2021

Injecting drug use is a global health and social issue from which various health and social harms often arise. These harms include health problems, such as HIV/AIDS, viral hepatitis and fatal overdose, as well as social and legal problems, and others. In recent years, an increase in drug use has been reported in many countries in the Middle East and North Africa (MENA) region. The number of People Who Inject Drugs (PWID) from the 20 countries covered by the Middle East and North Africa Harm Reduction Association (MENAHRA) is estimated to be around 570,000 (MENAHRA, 2014).

In many countries of the MENA region, unprotected sex and unsafe injecting drug use are the primary drivers of the HIV epidemic. However, the response has not been appropriate to the size of the problem (MENAHRA, 2014).

An estimated 90,000 people who inject drugs are living with HIV/AIDS within the region, which represents an HIV prevalence of over 15 percent in this population. There is also sufficient evidence showing that injecting drug use contributes significantly to the Hepatitis C Virus (HCV) epidemic in this region (MENAHRA, 2014).

MENAHRA communication guide on harm reduction

In recent years, Member States have increasingly recognized the importance of a development-oriented approach to address the world drug problem, including alternative development, to reduce the cultivation of illicit crops, notably opium poppy and coca bush, used for the production of narcotic drugs. There is also growing consensus on how to define and understand alternative development, namely as a long-term holistic approach that is integrated into national development strategies. Alternative development primarily addresses poverty, which in most cases is the root cause of illicit crop cultivation. The adoption of the United Nations Guiding Principles on Alternative Development by the General Assembly in December 2013 contributed to the promotion of alternative development. The Guiding Principles and global acknowledgement of illicit drug cultivation as a development issue were further recognized at the second International Workshop and Conference on Alternative Development hosted by the Royal Thai Government, in collaboration with the Government of the Federal Republic of Germany, the Government of the Republic of the Union of Myanmar and the United Nations Office on Drugs and Crime in November 2015.

Taking development seriously: Alternative development in the UNGASS 2016 process

In many countries, very large numbers of people in prison have not been convicted of a criminal offence but are waiting for their guilt or innocence to be established by a court. Some will eventually be acquitted of any crime; all should be presumed innocent.Yet in many cases their period of detention on remand may last months or years. Conditions are often worse than for convicted offenders and in many countries detainees are subject to highly restricted regimes with limitations on visits and on opportunities to take part in education, training or work. Countries with the highest levels of overcrowding also have prison populations with the highest proportions of pre‑trial detainees. In 40 countries more than half of prisoners are held on remand.

Ten-point plan on reducing pre-trial detention

В настоящем докладе рассказывается о применении смертной казни по приговору суда за период с января по декабрь 2015 года. Как и в предыдущие годы, информация собиралась из разных источников, включая официальные данные; сведения от приговорённых к смерти, их родственников и представителей; сообщения других организаций гражданского общества; публикации в СМИ.

Оставайтесьвкурсесобытийнаркополитики, подписавшисьна

Cмертные приговоры и казни 2015

This report covers the judicial use of the death penalty for the period January to December 2015. Amnesty International reports only on executions, death sentences and other aspects of the use of the death penalty, such as commutations and exonerations, where there is reasonable confirmation. In many countries governments do not publish information on their use of the death penalty, making confirmation of the use challenging.

Death sentences and executions report 2015

Opium farmers and representatives of their communities came together to discuss the challenges they face in their lives, and to share experiences and find ways to solve their problems. This is their statement.

We, opium farmers and representatives of Kayah, Kayan, Shan, Pa-O, Lahu, Ta- ang (Palaung) and Kachin opium farming communities from Kayah State, Southern, Eastern and Northern Shan State, and Kachin State, came together in Loikaw, in Kayah State in Myanmar, to discuss the challenges we face in our lives, and to share experiences and find ways to solve our problems.

We would like to make the following recommendations to the new government of Myanmar:

We grow opium because we are poor and do not have other livelihood opportunities to feed our families and send our children to school, as well as for medicinal and traditional uses. We are not involved in the drug trade, we are not criminals, and we are not commercial farmers. Some of us also grow it for traditional and medicinal uses. It is important to differentiate between small- holder farmers like us, and those people who grow opium commercially and/or who invest in it.

The government should not carry out any force eradication of our opium fields unless and until they have provided access to sustainable crop substitution programmes and alternative livelihoods to our communities. Eradication should especially not take place during the harvest season. By that time we have already invested a lot and also cannot grow another crop anymore that season.

Statement of the 4th Myanmar opium farmers’ forum

Participants in markets for illegal goods and services are not afforded the usual protections of legal systems that govern fair business conduct. Contracts and agreements within criminal networks are deliberately ambiguous or absent, a result of actors’ attempts to evade prosecution, making dispute resolution even more difficult (Reuter, 2009). Given these conditions, violence (e.g. assault, homicide) may be utilised as a tool for resolving disputes between networks and within networks (Reuter, 2009), as well as for maintaining reputation, recovering losses and to enact vengeance (Topalli, Wright, & Fornango, 2002). This kind of drug-related systemic violence was defined by Goldstein (1985) as the traditionally aggressive patterns of interaction within the system of drug distribution and use. In addition to drug market participants being barred from legal redress, these markets may be characterised by violence because full-time market participants typically come from lower socio-economic backgrounds, where they are more likely to have experienced violence as a normal dispute resolution strategy (Andreas & Wallman, 2009).

It is not always the case that illegal markets involve systemic violence or that violence will be employed uniformly (Friman, 2009). Specific drug markets that have notorious reputations for violence are not experienced as violent by participants, for example, Australia’s Cabramatta heroin market as described by Coomber and Maher (2006). In more recent work, Coomber (2015) compared two heroin/crack markets located in different UK cities, finding that the extent of market violence was contingent on the local cultural circumstances, rather than predicted by systemic conditions. In fact, Pearson and Hobbs (2001) describe violence within drug trading as a sign of market dysfunction. They argue that if everything is working well, everyone is making a profit and no-one needs to resolve disputes with overt violence, which is likely to attract police attention or rival retaliation. As further evidence that violence signals a dysfunctional market, Werb et al. (2011) found that law enforcement efforts to disrupt markets exacerbated the problem of drug market violence by increasing instability within and between criminal networks.

Safer scoring? Cryptomarkets, social supply and drug market violence

The aim of this document is to provide an orderly and systematic approach towards the history of addiction treatment in Portugal over the past five decades (1958-2014). It contains a rigorous and detailed compilation of events relating to the sector's emergence and development based on data from different sources and a substantial amount of scattered information that is not easy to understand even for specialists although laymen are also able to express their critical views, based on published facts.

Publications