On 20 September 2013 a seminar on policy and practice of cannabis in Albania has been organized by the Association Diogenis, Drug Policy Dialogue in Southeast Europe, and the Albanian NGO Aksion Plus. The aim of the meeting was to bring together policy makers, experts and representatives of relevant institutions and non-governmental organizations in order to exchange information and experiences on the current situation, national legislation in Albania, law enforcement and its impact on production marketing and distribution of cannabis, prevention programmes and related issues in the everyday practice.

The presentations and the discussion resulted in several recommendations to improve the situation, promote opportunities for cooperation between authorities, civil society and international organizations. The seminar was a successful collaboration between the Association Diogenis and NGO Aksion Plus in Albania. The UNODC Regional Office in Tirana, supported the organization of the seminar and participated actively in the discussions. The report refers to the presentations and the discussion of the following topics: cannabis trafficking routes in Southeast Europe, the Albanian legislation on cannabis, the illicit production and trafficking and the sanctions for possession and use, cannabis / toxicological aspects , health disorders, abuse of substances and emergency treatment, education, awareness and demand reduction of drugs and other dangerous substances and recent developments in international policy on cannabis.

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Cannabis policy, Albania September 2013

In Kenya, the rights of people who use drugs (PUD) are often violated. On the one hand, the country’s Constitution and recently developed health policies and guidelines recognise the human rights, including the health rights, of PUD. On the other hand, the group is criminalised under the country’s laws related to drugs. As part of the Bridging the Gaps programme, Mainline and its partner organisations in Kenya recently conducted research to provide insight into this contradictory situation and the impact on their work aiming at HIV and hepatitis C prevention.

Mainline’s partners in Kenya that work on promoting the human rights of PUD, particularly their health rights, face the challenge that these rights are often violated by the government, law enforcement agencies, health workers, and the community. PUD are criminalised under the Kenyan Narcotic Act, resulting in stigmatisation and discrimination. They are frequently harassed by the police and denied access to health care, prevention services, and treatment by general health workers.

Please click here to read the full article.

Protecting the rights of people who use drugs in Kenya

Psychosocial Support Programme that is designed for patients on Methadone Maintenance Therapy (MMT) in Hasan Sadikin hospital has been implemented as a pilot project for two years. In mid 2013, Rumah Cemara (RC) evaluated the programme since its initiation. As a part of operational research design, the evaluation specifically aimed to look at barriers in relation to human resources, implementation and programme management. It also identified how far can the materials and methods of the programme improve patients’ life quality. The assessment also enables improvements for the programme to reach its highest quality.

The evaluation was done through qualitative approach with RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) focus to reach the set goals. Data was collected through in-depth interview and focus group discussion involving 45 participants including clients of MMT receiving psychosocial support, clients of MMT not receiving psychosocial support, closest relatives of clients, MMT clinic officers, and programme implementers.
Findings from this evaluation have revealed that the programme has the potential to support clients for better quality of life, particularly in considering several improvements needed to increase the scope of the programme.

Successes have been found in improvements in communication and relationship with family, as well as clients are motivated to be financially independent. However, these successes have not been the programme’s maximum and further supports are still required such as, clients’ motivation; participants recruitment procedure; programme implementation guidelines; standardised curriculum; success measurement tool; availability and management of human resources from RC; and programme integration with MMT clinic have been important elements for programme improvement.

Psychosocial support programme for methadone clients 

This edition of Policy Talk reviews current knowledge of new psychoactive substances, a category of substances that is challenging government controls across the world, and compares how health authorities are responding to the challenges, with special reference to Australia and New Zealand.

New psychoactive drugs: No easy answer

This May, Colombia’s largest guerrilla group, the Revolutionary Armed Forces of Colombia (FARC), will be 50 years old. Of all armed conflicts in the world that claim 1,000 or more lives a year, the one in Latin America’s third most populous country is the oldest. In 2012, the Colombian government and the FARC began their fourth attempt to negotiate an end to the fighting. This time, the talks are beginning to stick: negotiators in Havana, Cuba have gotten significantly further than ever before. It is not unreasonable to expect an accord by the end of 2014.

The Havana talks have an agenda covering five substantive topics or political reforms, plus a discussion of how to operationalize what has been agreed. As of April 2014, after 21 ten-day rounds of talks, negotiators have reached agreement on two of these five substantive topics, and are nearing accord on a third.

Ending 50 years of conflict : The challenges ahead and the U.S. role in Colombia

The 2014 Global Drug Survey (GDS2014) conducted during November / December 2013 was the biggest survey of current drug use ever conducted. Published in 8 languages and promoted through media partners in 17 countries, it received almost 80,000 responses. The results from each participating country were released through media partners on April 14th 2014 along with some key global comparisons.

Participating countries included USA, UK, Australia, Germany, France, Republic of Ireland, Scotland, Belgium, the Netherlands, Denmark, New Zealand, Hungary, Spain, Portugal, Switzerland, Mexico, Slovenia and Brazil.

Please click here to read the full survey.

The global drug survey 2014 findings

The authors evaluated the impact on crime of a localized policing experiment that depenalized the possession of small quantities of cannabis in the London borough of Lambeth.

impact the demand for cannabis in Lambeth as users move there to purchase cannabis;

enable the Lambeth police to reallocate effort towards other types of crime.

The authors investigated whether the depenalization policy impacts the level and composition of crime, using administrative records on criminal offences by drug type, and for seven types of nondrug crime. They found that depenalization in Lambeth led to significant increases in cannabis possession offences that persisted well after the policy experiment ended. They found evidence that the policy caused the police to reallocate effort towards crimes related to the supply of Class-A drugs, as well as reallocating effort towards non-drug crime: there are significant reductions in five types of non-drug crime, and significant improvements in police effectiveness against such crimes as measured by arrest and clear-up rates.

Crime and the depenalisation of cannabis possession: Evidence from a policing experiment

The National Advisory Committee on Drugs (NACD)* was established in July 2000 to advise the Government in relation to the prevalence, prevention, treatment/rehabilitation and consequences of problem drug use in Ireland, based on the analysis of research findings and information. The Committee oversees the delivery of a work programme on the extent, nature, causes and effects of drug use in Ireland.

A Steering Group, set up under the auspices of the former National Drug Strategy Team, carried out an assessment of the need for prison-based needle exchange in Ireland in 2009. The primary conclusions were that prison needle-exchange constitutes a viable, effective means of addressing the drug problem and associated health risks within Irish prisons. However, it was acknowledged that data measuring the prevalence of drug use, including intravenous drug use, among the prison population is either dated or based on a proxy approach. The Steering Group therefore recommended that a study should be carried out to measure the extent of drug use, including intravenous drug use, and the prevalence of blood-borne viruses among the prisoner population before consideration is given to introducing needle exchange into a prison setting.

The study aimed to estimate the prevalence of drug use, including intravenous drug use, among the prisoner population in Ireland in order to determine the need for drug treatment and harm reduction (including needle exchange) services in Irish prisons.

Study on the prevalence of drug use, including intravenous drug use, and blood-borne viruses among the Irish prisoner population

Deaths in prison are a serious public health issue, raising questions as to the quality of care and supervision provided by correctional authorities. Reflecting such concerns, deaths in prison usually result in extensive postmortem inquiries and may also lead to litigation against correctional authorities and healthcare providers.

Unnatural deaths in prison are of particular concern due to their preventable nature. Unnatural deaths include suicides, violent or drug-induced deaths and other injury-related deaths. Studies in developed countries have found that unnatural deaths comprise 48–59% of all deaths in prison, with suicide being the most common cause of unnatural death. These figures suggest considerable opportunities to reduce unnatural deaths in prison.

Opioid-dependent people commonly experience imprisonment and there are several reasons to believe that opioid-dependent prisoners may be at particular risk of unnatural death in prison. Drug withdrawal has been implicated as a possible trigger for suicide in the first days of incarceration. Additionally, use of illicitly obtained opioids while in prison carries with it the risk of overdose. To the best of our knowledge, deaths in prison specifically among opioid-dependent people have not been described previously. Furthermore, no studies have considered whether treatment for opioid dependence during incarceration reduces mortality risk, as it does among opioid-dependent people residing in the community. In this study, we describe deaths in prison in a cohort of opioid-dependent people and examine whether receiving opioid substitution therapy (OST) reduces the risk of death in prison.

Opioid substitution therapy as a strategy to reduce deaths in prison: Retrospective cohort study

Opioid dependence is a complex, relapsing condition requiring a model of treatment and care much like any other chronic health problem. The Ministry of Health’s investment in opioid substitution treatment (OST) has ensured that people with opioid dependence have access to a comprehensive treatment package that provides them with the opportunity to recover their health and wellbeing.

Specialist OST services are specified by the Minister of Health under section 24 Misuse of Drugs Act 1975 and notified in the 

. Specialist services are the entry point for all people requiring OST unless there are exceptional circumstances and subject to the approval of the Director of Mental Health.

This document provides clinical and procedural guidance for specialist services and primary care providers who deliver OST.

New Zealand practice guidelines for opioid substitution treatment

Poor adherence to treatment diminishes its individual and public health benefit. Financial incentives, provided on the condition of treatment attendance, could address this problem. Injecting drug users are a high-risk group for hepatitis B virus (HBV) infection and transmission, but adherence to vaccination programmes is poor. We aimed to assess whether contingency management delivered in routine clinical practice increased the completion of HBV vaccination in individuals receiving opioid substitution therapy.

Modest financial incentives delivered in routine clinical practice significantly improve adherence to, and completion of, HBV vaccination programmes in patients receiving opioid substitution therapy. Achievement of this improvement in routine clinical practice should now prompt actual implementation. Drug treatment providers should employ contingency management to promote adherence to vaccination programmes. The effectiveness of routine use of contingency management to achieve long-term behaviour change remains unknown.

Use of contingency management incentives to improve completion of hepatitis B vaccination in people undergoing treatment for heroin dependence

The Inter-American Commission for Human Rights (IACHR) celebrated, for the first time, on March 25 a public hearing to analyze the severe impact that drug policies have had on human rights. The hearing raised the need to review the approach of current drug policies, highlighting the need for these to put human rights and reduction of violence as its core objectives.

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