Map of all states with broadened naloxone access laws and links to the text of the various laws.Unintentional drug overdose is now considered to be a leading cause of preventable death in the United States. Administering naloxone hydrochloride (“naloxone”) can reverse an opioid overdose and prevent these unintentional deaths. To explore these laws use the query box below. This page has been updated through February 2014.

Please click here to have access to the map and the explanations.

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Map of State laws regulating naloxone

Many U.S. cities are taking steps to reduce the role of criminalization in their local drug policies. Seattle, Washington has been at the forefront of this effort, pioneering a novel pre-booking diversion program for minor drug law violations known as Law Enforcement Assisted Diversion (LEAD). Santa Fe, New Mexico and several other cities have begun exploring this promising new strategy to improve public safety and health.

 Law enforcement assisted diversion (LEAD): Reducing the role of criminalization in local drug control

In 2012, a comprehensive national study of drug use was conducted in Pakistan, providing reliable baseline information on the prevalence and patterns of drug use among the population aged 15 to 64. To generate these results, a series of surveys was conducted throughout the four provinces and Pakistan-administered Kashmir, including interviews of 4,533 high-risk drug users; 58 drug treatment centre representatives; 1,198 key informants; and 51,453 participants randomly selected from the general population.

The survey results show considerable past-year use of both plant-based drugs and medical prescription drugs, particularly of cannabis, prescription opioids (painkillers), tranquilizers and sedatives, and opiates (heroin and opium). Drug use in Pakistan is highly differential by gender.

The national population prevalence is a combination of very high levels of use of these substances among men, and generally low levels of use among women offset by considerable levels of misuse of prescription opioids and tranquilizers and sedatives among women.

Although Pakistan is a country with a large population of youth, drug use was more common among those between the ages of 25 to 39 than 15 to 24.

This report provides the basis for implementation of effective prevention, treatment and care services that are evidence-based.

Drug use in Pakistan 2013

These bills are illegal and unconstitutional. Prior to 2011, the only state to pass such a law was Michigan. That law was struck down in 2003 by a federal appeals court. The court upheld a 2000 decision by a U.S. District Court judge that mandatory, suspicionless drug testing for public assistance violates the 4th Amendment’s protection from unreasonable search and seizure, and is unnecessary, given the existence of more effective and less invasive means of detecting drug abuse.

Mandatory drug testing for unemployment benefits and TANF is costly and ineffective

The annual report of the International Narcotics Control Board (INCB) for 2013 marks a particular milestone: the 45th annual report of the Board since it was established in 1968 in accordance with the Single Convention on Narcotic Drugs of 1961.

Over that period, there have been significant emerging challenges and efforts made in addressing the global drug problem. Notably, the 1961 Convention is adhered to by almost all States, illustrating the commitment of Governments to the principle of shared responsibility in ensuring the availability of narcotic drugs for medical and scientific purposes while preventing their diversion and abuse.

To address subsequent drug control challenges such as the abuse of psychotropic substances while ensuring their availability for medical purposes, the use of chemicals in the illicit manufacture of narcotic drugs and psychotropic substances, and drug trafficking, States created and adopted the two other international drug control conventions in force today: the Convention on Psychotropic Substances of 1971and the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988. Those conventions too enjoy almost universal adherence.

This INCB annual report serves as a “stock-taking” of achievements made, challenges faced and additional efforts required for the future.

Report of the International Narcotics Control Board for 2013 

Under Heroin-Assisted treatment (HAT), pharmacological heroin is administered under strict controls in a clinical setting to those who have failed in other treatments like methadone. Every published evaluation of HAT has shown extremely positive outcomes: major reductions in illicit drug use, crime, disease and overdose; and improvements in health, wellbeing, social reintegration and treatment retention. More than a half dozen countries in Europe and Canada have implemented heroin-assisted treatment (HAT) programs.

Heroin-Assisted Treatment 

With less than 5 percent of the world’s population but nearly 25 percent of its incarcerated population, the United States imprisons more people than any other nation in the world – largely due to the war on drugs. Misguided drug laws and draconian sentencing requirements have produced profoundly unequal outcomes for communities of color. Although rates of drug use and selling are comparable across racial and ethnic lines, blacks and Latinos are far more likely to be criminalized for drug law violations than whites. The drug war drives mass incarceration and racial disparities in U.S. judicial systems.

The drug war, mass incarceration and race

One solution to reducing the number of people swept into the criminal justice system for drug law violations is to enact various forms of decriminalization of drug use and possession. Decriminalization is the removal of criminal penalties for drug law violations (usually possession for personal use). Roughly two dozen countries, and dozens of U.S. cities and states, have taken steps toward decriminalization. By decriminalizing possession and investing in treatment and harm reduction services, we can reduce the harms of drug misuse while improving public safety and health.

Approaches to decriminalizing drug use and possession

Supervised injection facilities (SIFs) are controlled health care settings where people can more safely inject drugs under clinical supervision and receive health care, counseling and referrals to health and social services, including drug treatment. There is overwhelming evidence that SIFs are effective in reducing new HIV infections, overdose deaths and public nuisance – and that they do not increase drug use or criminal activity. There are currently 92 such facilities operating in 62 cities around the world – but none in the U.S.

SIFs can play a vital role as part of a larger public health approach to drug policy. SIFs are intended to complement – not replace – existing prevention, harm reduction and treatment interventions.

 Supervised injection facilities

Undoubtedly, the most prominent development we can see in global drug policy today is that more and more players, including countries, are admitting the need to move away from law-enforcement-dominated approaches in drug policy towards approaches that are based on public health instead.

Most notably, in recent years in Latin America there has been an intensifying debate about the failure of prohibition, and most recently even sitting presidents started loudly criticizing the ‘war on drugs’, saying that the Conventions should be more flexible to allow for experimentation with innovative approaches, especially where drug production and trafficking have caused a prolonged political and humanitarian crisis.

But what are these conventions that have bound the hands of politicians of decision-makers so much in Latin America and elsewhere?

Recent trends in drug policy reform and UNGASS 2016

A bio-behavioral HIV survey among injecting drug users (IDUs) was carried out in October 2013 in Ramallah, Hebron, and Bethlehem governorates using time location sampling (TLS) methodology.

The study aimed to assess the prevalence of HIV, HBV, and HCV, as well as to analyze the patterns and correlates of HIV-relevant risk-taking behaviors. The study recruited 288 IDUs: 105 in Ramallah, 100 in Hebron, and 83 in Bethlehem.

Only one of the surveyed IDUs was female. Age range in the sample was 16-64, with the mean age of 39.2 (SD = 11.11; median age = 41). A majority of participants had only primary education or less (69.0%) and were married (59.7%). Only a quarter of the sample reported a full or part-time employment (26.2%).

No HIV cases were found in the study. Nineteen participants (6.6%) tested positive for hepatitis B surface antigen, while 117 participants (40.6%) tested positive for HCV. A small minority of participants (14.7%) answered correctly to all five standardized HIV knowledge questions (UNAIDS, 2013).

However, when asked specifically about HIV risks related to injecting drug use, most participants seemed well-informed: 94.1% correctly stated that HIV can be transmitted by syringe sharing, while 88.9% knew that sharing a needle or syringe washed in water may result in getting infected with HIV. HIV knowledge was highest in Bethlehem and lowest in Hebron, but the differences were slight.

Bio-behavioural HIV survey among injecting drug users in the West Bank, 2013 

There is an extensive body of literature documenting the stigma associated with alcohol and other drug problems. No physical or psychiatric condition is more associated with social disapproval and discrimination than substance dependence. For people who use drugs, or are recovering from problematic drug use, stigma can be a barrier to a wide range of opportunities and rights. For people who use drugs, or are recovering from problematic drug use, stigma can be a barrier to a wide range of opportunities and rights.

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