analizzando i disastri di questa guerra, fece tremare i palazzi proibizionisti nazionali e planetari. Questo, sia per i suoi contenuti, sia per le firme di molti pezzi grossi dell’establishment internazionale, a partire dall’ex segretario generale dell’Onu Kofi Annan, assistiti da una scelta schiera di esperti. Dopo il rapporto del 201, la Commissione ha seguitato a lavorare su specifici problemi, per esempio i costi dell’applicazione della legge penale e la riduzione del danno (vedi il rapporto fra droghe, Hiv/Aids ed epatite C; v. http://www.globalcommissionondrugs.org/ ). Finché il 9 settembre scorso è stato pubblicato il nuovo rapporto 

Taking Control: Pathways to Drug Politics that Work

 – “Prendere il controllo: percorsi verso politiche delle droghe che funzionino”.

Qui solo qualche rapido cenno ai contenuti del rapporto, a partire dalle raccomandazioni finali:

spostare il più possibile risorse dalle azioni repressive e punitive agli interventi sanitari e sociali di provata efficacia;

porre fine sia alla criminalizzazione dell’uso e del possesso di droghe per uso personale (l’italica depenalizzazione di uso e possesso è il più delle volte una tragica frode, almeno dalla Jervolino-Vassalli in poi e ancor più negli anni della Fini-Giovanardi), sia ai trattamenti obbligatori (quasi una allusione a certe nostre comunità terapeutiche);

cogliere l’opportunità della prossima assemblea generale Onu sulle droghe (Ungass) del 2016 per cambiare le convenzioni internazionali, sinora ricalcate sul modello proibizionista varato a Vienna nel 1961;

puntare sulle alternative al carcere per i “pesci piccoli” del narcotraffico (piccoli produttori, corrieri al dettaglio, piccoli spacciatori);

permettere e incoraggiare i diversi esperimenti di legalizzazione controllata, a partire da (ma non fermandosi a) cannabis, foglie di coca e parte delle nuove sostanze psicoattive; quindi

puntare a una riduzione del potere delle organizzazioni criminali per ridurre la violenza e l’insicurezza alimentate dalle competizioni tra di loro e con lo Stato; infine

assicurare l’equo accesso ai farmaci essenziali, in particolare gli oppiacei per il dolore (per incidens, l’ultima relazione ad hoc al Parlamento del nostro Ministero della salute mostra qualche progresso, ma anche quanto siamo ancora lontani dagli standard di altri paesi soprattutto del centro e nord-Europa e del nord-America).

Poco spazio resta per le parti analitiche del rapporto. Il fallimento delle strategie di controllo è documentato dagli aumenti di produzioni e consumi di droghe pesanti; il danno alla salute pubblica e alla sicurezza dalla frequenza delle adulterazioni e delle morti da overdose, dalle restrizioni alle strategie di riduzione del danno (solo in Russia 1.800.000 iniettori sono infetti da virus HIV); l’attacco ai diritti umani dagli oltre mille giustiziati all’anno per reati di droghe, dagli innumerevoli carcerati e reclusi in “centri speciali”, dalle gravi discriminazioni a danno delle minoranze etniche e razziali; l’incentivazione della criminalità e dell’arricchimento dei criminali dai quasi quattrocento miliardi di dollari annui di vendite al dettaglio, dall’escalation della violenza e del finanziamento del terrorismo; giù giù, sino ai dati sul dilagare della corruzione, sull’inquinamento dell’economia legale, e chi più ha più ne metta. Insomma, conclude la Commissione, vi supplichiamo, potenti della terra, facciamola finita; e per fortuna, aggiunge, qualcuno qua e là ha iniziato a capire l’antifona.

Prendere il controllo: percorsi verso politiche delle droghe che funzionino

In a joint submission the International Network of People Who Use Drugs (INPUD), International Network of Women who Use Drugs (INWUD), the Women and Harm Reduction International Network (WHRIN), National Advocates for Pregnant Women (U.S.A.) (NAPW), SisterReach, the Sexual Rights Initiative, Family Law & Cannabis Alliance (U.S.A.) (FLCA), and Native Youth Sexual Health Network, have produced this report which focuses on the United States of America’s failure to address and curtail the growing body of counterproductive and regressive state laws, policies, and practices that are increasingly being used to substantially undermine women’s dignity and status as persons under the law.

Based on a devastating combination of ideological prejudice and misinformation, prosecutors, courts, and legislators across the United States are overtly discriminating against many of society’s most traumatized and marginalized pregnant women. This is manifested in the reinterpretation of existing laws and the creation of new laws to punish pregnant women for the circumstances or outcomes of their pregnancies.

The arrest and incarceration of pregnant women and new mothers, coupled with interventions by child welfare authorities not only deprive women of their fundamental rights, but also threaten maternal, fetal and child health across the United States. The effect of these policies is most devastating to women who are marginalized by race, socioeconomic status, and use of prescribed or illicit drugs.

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

INPUD human rights submission against USA's treatment of pregnant women

Eastern Europe and Central Asia continue to see rapid increases in HIV infections among men, women and children. Despite some notable successes in responding to the epidemic, it is unlikely that the Universal Access targets and the Millennium Development Goals (MDGs) related to HIV/AIDS will be achieved. Access to antiretroviral treatment is still among the lowest in the world, and stigma and discrimination that violate the basic rights and dignity of people living with and affected by HIV, including children, are hampering further progress in prevention, care and support.

This report brings to life the experiences of children, families and young people living with HIV. It gives voice to their stories of despair, stigma and social exclusion, as well as to their courage and hope. It explores the systemic failures in responding to their needs and outlines some good practices. It also describes the contradictions that children and young people, particularly those who are most at risk of HIV, face on a daily basis: societies insist that they conform to social norms, yet exclude them and brand them as misfits; health and social protection systems do not serve their needs and diminish their chances of living normal lives, but blame them when they fail to cope. The report also features some compelling photographs of the realities of living on the edge.

Policy reforms, programmatic shifts and a reallocation of resources to strengthen health and social protection systems are required if the further spread of the epidemic is to be halted. Reforms must aim to expand and grant equitable access to services for all, including those who are currently excluded and missed. Successes in HIV prevention, treatment and care can only be increased and sustained if they are underpinned by social environments that advance human and child rights, gender equality and social justice. Blame and Banishment is a call to address the remaining gaps in the response to HIV in the region. It is a call for protecting the rights and dignity of children and young people who are vulnerable, at risk and living with or affected by HIV. It is also a call to build an environment of equity, trust and care rather than blame and banishment.

Blame and banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia

It is unfortunate that 35 years after the first chemical spraying in the Sierra Nevada de Santa Marta, we are still writing about aerial sprayings in Colombia, demanding the current government – how many governments have not happened since! –to definitely defer an ecocide and incompetent policy. Throughout these years we have seen increasing national and international voices opposing the spraying of coca with the herbicide Roundup (glyphosate).

To the protests of the affected rural communities, soon began to join environmental and human rights NGOs, political groups, a neighboring country (Ecuador) affected by the spraying at the border, researchers associated with respectable academic institutions, the Inter-American Commission on Human Rights (IACHR), and more recently even the United Nations.

Colombia, more than three decades of toxic spraying. Enough!

This paper focuses on the often neglected set of individuals who engage in both the use and selling of illicit drugs; user-dealers. It reports the findings of a qualitative study conducted among cocaine dealers operating in Parisian techno parties, highlighting the routes into and out of using-dealing, the particular risks faced by this population, and the need for health and criminal justice agencies to better understand and address these issues.

User-Dealer, those who have been forgotten by harm reduction

The hepatitis C virus (HCV) is highly prevalent globally among people who inject drugs (PWID). Among the estimated 15.9 million PWID worldwide, 10 million are estimated to be HCV antibody-positive, compared with about three million who are HIV-positive. Australia has relatively good coverage of harm-reduction initiatives among PWID, with low HIV prevalence and incidence. Conversely, high prevalence and incidence of HCV among Australian PWID have been documented.

Between 1995 and 2010, HCV prevalence among needle and syringe program (NSP) attendees nationwide remained between 50% and 60%,6and an incidence rate of 44.1/100 person-years was observed in a community-based cohort of PWID in south-western Sydney in 1999–2002. However, a reported decline in HCV infection at the population level suggests that the epidemiology of HCV among PWID in Australia may be changing. There have been no recent data from community-based cohorts of PWID to evaluate whether population-level reductions in HCV incidence may be related to a reduction in the PWID population size 

 reduced risk among individual PWID. Such data would also provide key indicators for evaluating the impact of Australia's National Hepatitis C Strategy.

The authors examined the acquisition of HCV among PWID enrolled in a prospective observational study based in Sydney, New South Wales. Specifically, they assessed HCV incidence from 2009 to 2011, and risk and protective factors associated with incident infection, including uptake of NSPs and opioid substitution therapy (OST — methadone or buprenorphine).

The study concluded that HCV incidence was substantially lower than the incidence of 30.8/100 py observed a decade earlier in a similar NSW-based cohort, suggesting a decline in HCV incidence among PWID. This is likely due to increased coverage of OST, combined with a probable decrease in the population of PWID.

Opioid substitution therapy protects against hepatitis C virus acquisition in people who inject drugs

This report outlines important suggestions by international experts to improve the health of people in prison and to reduce the risks posed by imprisonment to both health and society. In particular, it aims to facilitate better prison health practices in the fields of:

It is aimed at professional staff at all levels of responsibility for the health and well-being of detainees and at people with political responsibility. The term “prison” covers all institutions in which a state holds people deprived of their liberty.

Prisons and health

New psychoactive substances are so diverse that they cannot be controlled by international law. Many countries, including Australia, have experienced considerable difficulty responding to the steadily increasing number of new psychoactive substances arriving on the black market. In the European Union, 41 new substances were identified in 2010, 49 in 2011 and 73 in 2012. Over 200 new psychoactive substances have been identified in the European Union since 2005. The number of new psychoactive substances available in Australia, prevalence of current use and harms caused by these drugs are not known.

Countries race to identify and ban new substances even though this is expensive and ultimately futile. As soon as one new psychoactive substance is banned, the next appears. While demand for psychoactive substances remains strong, there will always be a supply. Globalisation, the internet and social media have increased the already considerable difficulty of interrupting supply of these drugs in the face of continuing strong demand. But the development of these new psychoactive drugs is a direct consequence of the prohibition of other drugs.

The Psychoactive Substances Bill, passed by the New Zealand Parliament on 11 July 2013, aimed to “protect New Zealanders, particularly young New Zealanders, from the harm caused by untested drugs and an unregulated market”.

New psychoactive substances: reducing the harm caused by untested drugs and an unregulated market

É necessário um regime global de controle de drogas novo e aperfeiçoado, que proteja melhor a saúde e a segurança de indivíduos e comunidades no mundo todo. Medidas duras baseadas em ideologias punitivas devem ser substituídas por políticas mais humanas e eficazes, baseadas em evidências científicas, princípios de saúde pública e direitos humanos. Esta é a única maneira de reduzir simultaneamente as mortes, doenças e o sofrimento relacionados às drogas e a violência, o crime, a corrupção e os mercados ilícitos associados a políticas proibicionistas ineficazes. As implicações fiscais das políticas que defendemos, há de ser ressaltado, são insignificantes em comparação aos custos diretos e consequências indiretas geradas pelo atual regime.

A Comissão Global propõe cinco caminhos para aperfeiçoar o regime global de política de drogas. Após posicionar a saúde e a segurança da população no cerne da questão, urge-se que os governos garantam o acesso a medicamentos essenciais e de controle da dor. Os Comissários pedem o fim da criminalização e do encarceramento de usuários, em conjunto com estratégias de prevenção, redução de danos e tratamento direcionadas a usuários dependentes. Para reduzir os danos relacionados às drogas e minar o poder e os lucros do crime organizado, a Comissão recomenda que os governos regulamentem o mercado de drogas e adaptem as estratégias de suas forças da lei para mirar nos grupos criminosos mais violentos e destrutivos, ao invés de punir quem atua nos patamares inferiores do sistema. As propostas da Comissão Global são complementares e abrangentes, e pedem que os governos repensem a questão, façam o que pode e deve ser feito imediatamente e que não ignorem o potencial transformador da regulação responsável.

Registe-se para recever as Alertas mensais do IDPC e obter informação sobre questões relacionadas com as políticas de drogas.

Sob controle: caminhos para políticas de drogas que funcionam

A new and improved global drug control regime is needed that better protects the health and safety of individuals and communities around the world. Harsh measures grounded in repressive ideologies must be replaced by more humane and effective policies shaped by scientific evidence, public health principles and human rights standards. This is the only way to simultaneously reduce drug-related death, disease and suffering and the violence, crime, corruption and illicit markets associated with ineffective prohibitionist policies. The fiscal implications of the policies we advocate, it must be stressed, pale in comparison to the direct costs and indirect consequences generated by the current regime.

The Global Commission proposes five pathways to improve the global drug policy regime. After putting people ́s health and safety at the center of the picture, governments are urged to ensure access to essential medicines and pain control. The Commissioners call for an end to the criminalization and incarceration of users together with targeted prevention, harm reduction and treatment strategies for dependent users.

Taking control: Pathways to drug policies that work

Over the last two decades, illicit drugs have emerged as a growing social problem in the Arab Gulf states. Dubai is no exception, in spite of its reputation as an economic success story. Dubai has been affected in two ways: through the increased use of hard drugs, notably heroin, especially among its nationals; and through the role of transnational organised crime in moving illegal drugs through the sovereign space of the Emirate and onwards to larger markets. In spite of this growth, the authorities have been slow to respond.

Where policy development has taken place it has emphasised the supply side, within which it has privileged law enforcement. There has been a zero tolerance approach on the demand side, which is only now beginning to soften at the edges. State provision for detoxification and rehabilitation is plainly inadequate.

Wider society is to some extent complicit in this reality, as Emirati nationals tend to frown on such ‘weaknesses’.

Narcotic drugs in Dubai: Lurking in the shadows

In Thailand, a country contending with a longstanding dual epidemic of opioid use and HIV among IDUs, methadone was approved for opioid substitution therapy in 2000, although having been provided as tapered detoxification regimens rather than as a maintenance therapy. In 2008, methadone was added to the universal healthcare coverage scheme. In Bangkok, methadone treatment is primarily provided by the BangkokMetropolitanAuthority (BMA) throughits 17 public health centers, two hospitals and one stand-alone clinic.

The Thai government has for many years implemented aggressive drug prohibition approaches. A recent qualitative study of IDU in Bangkok has highlighted that the police often conduct surveillance of people accessing methadone clinics; harass methadone atients with extortion and urine drug testing; and arrest patients who test positive for an illicit drug. In response, some interviewees reported feeling discouraged from continuing their methadone treatment (Hayashi et al., 2013a). While these reports are consistent with international literature indicating that aggressive policing can impede IDU’s access to healthcare, few studies have quantitatively evaluated the impact of policing around health service sites. Therefore, we sought to examine the prevalence and correlates of noticing police presence around methadone clinics among methadone-treated IDU in Bangkok.

The findings suggest a need to address police interference with methadone treatment.

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

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