In April 2016, a video was leaked to the press showing police and military officials suffocating a woman with a plastic bag and interrogating her while she screamed. The question of what may have happened after the camera was turned off was left hanging in the air.

The video scandalized Mexican society and provoked an unprecedented public apology from the Minister of Defense and the National Security Commissioner. But an apology falls far short of the state’s obligation to address the human rights crisis facing Mexico in which torture and ill-treatment are generalized throughout the country.

This report demonstrates that the Mexican police and armed forces routinely torture and ill-treat women, and that sexual violence is routine during arrest and interrogation. Severe beatings to the stomach, head and ears; threats of rape against women and their families; near-asphyxiation, electric shocks to the genitals; groping of breasts and pinching of nipples; rape with objects, fingers, firearms and the penis – these are just some of the forms of violence inflicted on women.

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Mexico - surviving death: Police and military torture of women in Mexico

International drug control is in a period of crisis and transition, with the ‘Vienna Consensus’ broken despite the veneer of agreement among states. Perhaps the primary signifier of this breakage lies in the establishment of legally regulated cannabis markets, which contravene the core principle of the international drug control conventions that drug use be restricted to medical and scientific use. However, this is not the only factor in the build-up of philosophical and practical differences representing those ‘cracks in the consensus’ that were evident at the Commission on Narcotic Drugs (CND).

This year’s Commission ran from 14th to 22nd March 2016, and was powerfully coloured by its focus on the looming United Nations General Assembly Special Session (UNGASS), held in New York in April. The CND included a special segment on preparations for the UNGASS, including the production of an Outcome Document to be approved at the New York Special Session.

This report aims to provide an overview of the key issues discussed and debated during the special segment on UNGASS preparations and the regular segment of the 59th CND, including during various side events and NGO dialogues. In attempting to go beyond a functional narrative account, it offers some analysis of the prominent topics of debate, as well as highlighting emergent issues of concern and reoccurring themes.

IDPC report of proceedings: The 2015 Commission on Narcotic Drugs and its special segment on preparations for the UNGASS on the world drug problem

IDPC report of proceedings: The 2014 Commission on Narcotic Drugs and its High Level Segment

IDPC report of proceedings: The 2013 Commission on Narcotic Drugs

IDPC report of proceedings: The 2012 Commission on Narcotic Drugs

IDPC report of proceedings: The 2011 Commission on Narcotic Drugs

IDPC report of proceedings: The 2010 Commission on Narcotic Drugs

IDPC report of proceedings: The 2009 Commission on Narcotic Drugs

IDPC report of proceedings: The 2008 Commission on Narcotic Drugs

IDPC report of proceedings: The 2007 Commission on Narcotic Drugs

The 2016 Commission on Narcotic Drugs and its special segment on preparations for the UNGASS on the world drug problem

HIV risk behaviors among crystal-meth users might contribute to increasing HIV prevalence rates in Indonesia. Related risks can be reduced if people have access to crystal-meth related health services. Prior to the development of interventions, a comprehensive understanding of structural, social, interpersonal and personal factors related to the use of crystal-meth in Indonesia is crucial. This includes a better understanding of individual and environment factors surrounding drug use and HIV-related risk behaviors, which will allow for the designing of better interventions. This study aims to gain better knowledge on patterns of meth use and its implications on HIV risk and health seeking behavior among crystal-meth users in Indonesia, including a better understanding of on individual and environmental factors shaping drug use.

A qualitative research design was developed with the aim of producing a deeper understanding of the diverse patterns of meth use and its implications for HIV risk and related health seeking behaviors. The study looked at patterns of initiation of meth use, sustained use and attempts of reducing and stopping the use of the drug, and how the drug use influenced users’ behaviors, including daily activities, HIV risk behaviors, exposure to legal problems, as well as users’ social and sexual networks and health seeking behaviors.

It was found that patterns of meth use are dynamic and that its use is influenced by factors a personal, inter-personal and social level, occurring within a specific setting and situated within the informants’ life experience. Initiation of meth use is strongly influenced by the social network during the informants’ youth. Through the network information and or knowledge on the drug, its effects, and availability are provided. Moreover, various forms of assistance may also be provided by the network (e.g. borrowing of money, pawning things, pooling money, or providing drugs). Temporary cessation or relapse may also be influenced by a user’s social network.

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

Crystal meth in Indonesia

2015 saw a significant HIV outbreak among people who inject drugs in Glasgow, with 47 new diagnoses compared to a previous annual average of 10. New cases continue to occur. Initial investigations suggested a link between the outbreak and injecting in public places in the city centre, with the majority of cases interviewed reporting this risk factor.

“Taking away the chaos” The health needs of people who inject drugs in public places in Glasgow city centre

Opioid overdose represents a major cause of premature death and accounts for the majority of deaths among injection drug users (IDUs) world-wide. Opioid overdose deaths are preventable through timely administration of naloxone, a potent mu-opiate antagonist that rapidly reverses opiate-induced respiratory depression.

In 2014, the World Health Organization (WHO) launched guidelines on the community management of opioid overdose, recommending that ‘people likely to witness an opioid overdose should have access to naloxone and be instructed in its administration’.

The community-based provision of naloxone rescue kits to opioid users (‘take-home naloxone’, THN) was first proposed in the 1990s. THN programmes typically involve training opioid users and/or their family members or peers in overdose risk awareness, overdose emergency management and naloxone administration. During the past 15 years, THN programmes have been implemented in Europe, North America, Asia and Australia. However, the vast majority of evaluations have been pilot schemes with uncontrolled study designs.

The evaluation of THN programmes is challenging: randomized controlled trials (RCTs) are often considered the gold standard of scientific study of clinical impact, but conducting such trials in this context would often be unethical and fraught with methodological difficulties, given the infrequency and unpredictability of overdose.

Are take-home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria

HIV infection among people who inject drugs (PWID) in Kenya is at 18%, and has been attributed to risky injecting practices. The risk environment enabling these practices has not been explored. This paper reports findings from Access to Care, a qualitative study in Kenya. Using in-depth interviews with PWID, we explore how the introduction of needle and syringe programmes (NSP) has impacted on needle and syringe sharing. PWID report significant reductions in sharing injecting equipment following NSP, although sharing continues, linked to challenges in supply and amongst PWID living with HIV, linked to hopelessness for the future. We conclude that NSP should expand across Kenya, linked to efforts to overcome delivery challenges and efforts to support people living with HIV.

Implementing needle and syringe programmes in Kenya

Global evidence indicates that mandated treatment of drug dependence conflicts with drug users’ human rights and is not effective in treating addiction. 

 argue that drug treatment policies must be evidence based and meet international standards

During 2013 to 2015 the Russian Federation (Russia) amended its laws to enable courts to force people who use drugs to have treatment for addiction. The laws give courts the ability to mandate sentenced offenders with drug dependence to undergo dependence treatment in combination with non-custodial measures such as fines or coercive labour. Russian authorities have stated that the new laws were enacted as motivation for treatment. Our analysis globally examines the acceptability and efficacy of legislative approaches mandating treatment of drug dependence.

Increasing drug use in Russia led to parallel HIV epidemic

Drug use in Russia, consisting mostly of injectable heroin, increased after the break-up of the Soviet Union. There were over 540 000 drug users registered in Russia but the United Nations Office on Drugs and Crime estimated that were about 1.8 million opiate users in the country in 2014. The prevalence of injecting drug use (2.29%) among 15-64 year olds is almost 10 times the global prevalence estimate of 0.27%.

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

Mandatory addiction treatment for people who use drugs: global health and human rights analysis

On 24 March 2016, STOPAIDS convened over 60 representatives from government, multilateral organizations, NGOs, academic institutions, private foundations and activists living in middle income countries from across the international development field to generate ideas and debate around how to engage with middle income countries. The symposium revealed the overall futility of the middle income country category, reminding participants that the issue at hand was not middle income countries (MICs) vs. lower income countries (LICs) vs. higher income countries (HICs), but rather how to reach the people most in need of development assistance, wherever they are. Four central themes were discussed throughout the day: indicators for assessing development, leaving no one behind, the role of civil society, and transitions away from aid.

Middle income countries: reclassified symposium outcome document

The emergence of NPS over the last decade poses an important challenge to drug policy (UNODC, 2013). While prevalence levels of NPS use remain low in the general European population, there are important concerns with more problematic forms of use and harms in particular risk groups across different health and social settings.

Important public health issues have arisen as a consequence of their use, although the real extent of these harms across Europe remains unknown. Initial responses to NPS in Europe have largely been regulatory, focusing on their supply using legislative tools (EMCDDA, 2015a) but, as the phenomenon evolves, it has increasingly become a priority to formulate and implement effective public health responses. Yet, while information on and our understanding of the availability and use of NPS have increased, there are still considerable knowledge gaps in current practices and even in the challenges and needs of European health professionals who are responding to the use of and harms caused by these novel substances.

Health responses to new psychoactive substances

A health study in schools of Colorado has shown that cannabis use did not increase despite legalisation.

"Marijuana Use Four out of five Colorado high school students have not used marijuana in the last 30 days, a rate that remains relatively unchanged since 2013. Colorado does not significantly differ from the national average in lifetime or current marijuana use"

Colorado: Stable cannabis use among young people

The 26th June is the International Day against Drug Abuse. It is a day that embodies laws and policies that have criminalised, subjugated, excluded, and violated the human rights of people who use drugs and the communities in which they live. It is a day that stands for an ideology that has done untold harms. And it is a day that perhaps well-reflects a difficult half-year in global drug policy.

Not least of all was the United Nations General Assembly Special Session on Drugs 2016, with the UNGASS outcome document failing to take into account the needs and human rights of people who use drugs. Indonesia has announced plans for a new round of executions for drug-related offences, while the Philippines' President-elect has made the horrific call for people who use and/or sell drugs to be killed extrajudicially, both by citizens and the police. Then there was the UK introducing a blanket ban on all psychoactive substances.

Though it seems that in many corners of the world things are moving backwards, though the exclusion of the voices of people who use drugs in the formation of law and policy has continued, though the violence, stigma, and discrimination to which people who use drugs are subject have been encouraged, though the criminalisation of people who use drugs in some regions has been ramped up, we must persevere.

On this day, the International Network of People who Use Drugs (INPUD) emphasises that people who use drugs are not the problem. We are a fundamental part of the solution, a solution to the so-called ‘world drugs problem’. The problem is not drugs themselves, nor the people who use them. The problem is driven by punitive prohibition; it is driven by criminalisation; it is driven by stigma, discrimination, social exclusion, and violence; it is driven by a systemic denial of human rights to people who use drugs and their communities. And things are beginning to move in the right direction. More countries than ever before are pushing in the direction of drug policy reform; momentum is building for positive change, for an end to prohibition.

Support and empowerment for and by people who use drugs

For almost 20 years, Harm Reduction International has been a leader in promoting the harm reduction approach to drug use and policy around the world. What started initially as a forum for organising the annual International Harm Reduction Conferences in the 1990s has grown in the past ten years to become one of the world’s leading independent sources of research and policy analysis on harm reduction and human rights issues, and on advocating for policy change alongside our regional and global partners.

The past year saw many important achievements for us at HRI. However, the clear highlight was the success of our 24th International Conference in Kuala Lumpur, staged in partnership with the Malaysian AIDS Council. For over two decades, the HRI conference has been the main international gathering of people and organisations working on harm reduction. In Kuala Lumpur, we were pleased to welcome over 900 delegates from more than 70 countries, demonstrating once again the truly global nature of our movement, and the vibrancy and dedication of the broad harm reduction community. We look forward to celebrating the milestone of our 25th conference in Montreal in 2017.

2015 was also the year in which our 10 by 20 campaign kicked into full gear. 10 by 20 is a coordinated advocacy platform to advance our broader work on increasing global funding for harm reduction, which is a key objective of our strategic plan. Created in consultation with our global and regional partners, it calls on governments to redirect 10% of the money currently spent on the ‘war on drugs’ into harm reduction services. The campaign was launched during the 2015 meeting of the UN Commission on Narcotic Drugs, and was a visible presence at every key global event during the year, including our conference. The campaign will continue to be a central theme of our collective advocacy as we head towards a UN General Assembly Special Session on drugs in April 2016.

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