In South East Asia, Thailand is lauded for its success in reversing an HIV epidemic in the 1990s, particularly amongst sex workers. Thailand is also known for its success in significantly reducing opium cultivation, and implementing effective alternative development programmes for opium farmers. However, other aspects of the government’s response to illicit drug markets in Thailand undermine these successes and have been characterised by the exclusion and marginalisation of people who use drugs, which has fuelled on-going epidemics of HIV and hepatitis C virus (HCV) among this population.

The Thai government’s response to drug use continues to be one of ‘zero-tolerance’, focused on eradicating drug consumption and production with the imposition of harsh punishment for drug-related crimes, ranging from compulsory detention to the death penalty. This response reflects the regional commitment to achieving a ‘drug-free ASEAN by 2015’.

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IDPC Briefing Paper - Drug control and harm reduction in Thailand

ALICE RAP (Addictions and Lifestyles in Contemporary Europe – Reframing Addictions Project) is the first major Europe wide project studying addictions as a whole and their influence on wealth, health and stealth. The aim of this five year, €10 million, co-financed EU project is to stimulate and feed scientific evidence into a comprehensive public dialogue and debate on current and alternative approaches to addictions.

The AR Policy Paper series aims to provide succinct evidence briefs for decision-makers and advocates working on key addiction-related issues. This third paper focuses on Novel Psychoactive Substances. The emergence of Novel Psychoactive Substances (NPS) over the last decade, and their shifting legal status and points of sale and distribution, poses particular challenges to policy makers. These are substances which are not controlled under United Nations Drugs Conventions, and whilst few have been recommended for control by the Council of the European Union, Member States have introduced their own legislation, leading to a broad array of policy responses.

This AR policy paper gives an introduction into the field of NPS, outlining the current situation regarding the use of these substances, the potential threat to public health and well-being that they pose and describes various policy options and legislative measures that are undertaken across Europe.

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ALICE RAP Policy Paper Series: Novel psychoactive substances – Challenges and policy  responses 

ในภูมิภาคเอเชียตะวันออกเฉียงใต้ ประเทศไทยได้รับการยกย่องว่าประสบความสาเร็จในการพัฒนาการป้องกันการแพร่ระบาดของเชื้อเอชไอวี/เอดส์โดยเฉพาะอย่างยิ่งในกลุ่มพนักงานบริการทางเพศ นอกจากนี้ ยังเป็นที่รู้กันดีว่าประเทศไทยประสบความ สาเร็จในการลดการปลูกฝิ่น รวมถึงประสบความสาเร็จในการดาเนินโครงการพัฒนาอาชีพทางเลือกให้กับเกษตรกรผู้ปลูกฝิ่นได้อย่าง มีประสิทธิภาพอีกด้วย อย่างไรก็ดี ในมุมมองอื่นๆ ต่อรัฐบาลไทยในการจัดการปัญหาการค้ายาเสพติดในประเทศไทยทาให้ลดทอนความสาเร็จต่างๆ เหล่านั้นลง โดยเฉพาะจากการกีดกันและแบ่งแยกผู้ใช้ยาออกจากสังคม ซึ่งยิ่งเป็นการกระตุ้นทาให้เกิดการแพร่ระบาดของเชื้อเอชไอวีและไวรัสตับอักเสบซี ในประชากรกลุ่มนี้มากยิ่งขึ้น.

เพื่อรับข้อมูลเกี่ยวกับประเด็นที่เกี่ยวข้องกับนโยบายยาเสพติด

เอกสารสรุป การปราบปรามยาเสพติดและ การลดอันตรายจากการใช้สารเสพติดในประเทศไทย

Not a great deal has been published on the treaty implications of cannabis policies and even less on possible changes to regulating production and sales to private parties, but we have included a list of the existing publications known to us at the end of this article.

The most extensive publication on this subject is probably “Moving beyond stalemate” by Robin Room et al for the Beckley Foundation.

In this note we would like to refrain from an extensive analysis of all international treaties on substance use and stick to the ins and outs of cannabis regulation in the scope of the treaty at the basis of all “drug treaties”, the UN Single Convention of New York, 1961.

 If a Party permits the cultivation of the cannabis plant for the production of cannabis or cannabis resin, it shall apply thereto the system of controls as provided in article 23 respecting the control of the opium poppy.


 This Convention shall not apply to the cultivation of the cannabis plant exclusively for industrial purposes (fibre and seed) or horticultural purposes.


 The Parties shall adopt such measures as may be necessary to prevent the misuse of, and illicit traffic in, the leaves of the cannabis plant.

International legal aspects of cannabis policy reform

The objective of this study was to evaluate the cost-effectiveness of distributing naloxone to illicit opioid users for lay overdose reversal in Russian cities. The research showed that naloxone distribution to heroin users for lay overdose reversal is highly likely to reduce overdose deaths in target communities and is robustly cost-effective, even within the constraints of this conservative model.

Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal in Russian cities

L'International Drug Policy Consortium (IDPC), previa un' ampia consultazione con i suoi numerosi affiliati - tra i quali Forum Droghe - nei cinque continenti, ha di recente varato la sua risposta al Rapporto Mondiale sulla Droga 2013 dell'Agenzia ad hoc delle Nazioni Unite (UNODC). Il documento riconosce il lodevole sforzo compiuto per fornire nel rapporto una mole notevole di dati, compresa una analisi particolareggiata della proliferazione delle Nuove Sostanze Psicoattive (NSP). Tuttavia, pur con molto garbo, evitando accuratamente i toni "sopra il rigo", fa notare una serie di aspetti negativi o che almeno suscitano perplessità: a cominciare dall'affermazione contenuta nel Rapporto che produzioni, traffici e consumi delle droghe illecite, notoriamente in continua tumultuosa trasformazione con incessanti variazioni dei flussi, si sono "stabilizzati" (e laddove si ammette che vi sono aumenti, si tenta di spiegarli con la crescita della popolazione mondiale). Un'altra affermazione contestata è quella che i sistemi di controllo nazionali e internazionali funzionano a dovere - tradotto in volgare, "un pò di pazienza, siamo sulla buona strada per vincere la guerra alla droga", quella guerra cioè che tutti coloro che hanno cognizione di causa sanno esser da tempo irrimediabilmente perduta.

Scrutando un pò più a fondo nel documento IDPC si comprendono meglio i meccanismi coi quali sono state costruite queste conclusioni con metodi poco scientifici. In primo luogo, il rapporto UNODC si basa su questionari inviati alle singole autorità nazionali, questionari le cui percentuali di ritorno variano enormemente (dal 10 al 90 %!) tra le varie aree geografiche; e per buona giunta, senza alcuna verifica diretta sulla affidabilità delle informazioni restituite nei questionari stessi. Infatti i dati forniti sono caratterizzati da un possibile divario tra minimo e massimo pari a un raddoppio e oltre: tra 169 e 315 milioni il totale planetario dei consumatori di droghe illecite; tra 16 e 39 milioni i consumatori "problematici"; tra 13 e 20 milioni i consumatori di oppio ed eroina; tra 11e 20 milioni gli iniettori; tra 1,2 e 3,9 milioni gli iniettori con HIV (particolarmente criticati dall'IDPC i metodi usati per queste ultime due stime, p. 4-5).

Assai criticati sono anche alcuni dei suggerimenti forniti dall'UNODC per un "ulteriore perfezionamento" delle strategie di controllo del narcotraffico, in particolare la proposta di intensificare i controlli sul traffico marittimo. Ma hanno contato quante navi e quanti container sono quotidianamente in movimento o impegnati nei porti di tutto il mondo in operazioni di carico e scarico? E quanta parte di questa gigantesca movimentazione potrebbe esser controllata da capo a fondo senza congelare il commercio mondiale? (Il lettore italiano conosce tale problema grazie allo zoom sul porto di Napoli in "Gomorra" di Saviano, che documenta come la massima parte del movimento sia in pratica esente da qualsiasi controllo: al punto che non si identificano neanche i container clandestini con codici inventati o clonati rispetto a quelli in regola - come le banconote false emesse in serie doppia al centro dello scandalo della Banca Romana di fine '800).

Viene anche criticata per l'impostazione"fuori bersaglio" dell'analisi del traffico illecito, sempre assai consistente, di analgesici e psicofarmaci. Più appropriato sarebbe stato un approccio mirato a individuare quanta parte di questo commercio sia legato alla mancata risposta per vie lecite ai bisogni terapeutici. L'Italia sotto questo profilo è in una posizione particolarmente delicata: infatti, malgrado i provvedimenti degli scorsi anni che hanno consentito un incremento dei consumi di oppiacei narcotico-analgesici per la terapia del dolore, tali consumi restano molto al di sotto dei fabbisogni reali, come mostrano i confronti con i vari paesi del mondo occidentale.

Infine, proprio un aspetto del rapporto UNODC 2013 che in prima battuta pareva costituire un progresso rispetto ai rapporti precedenti - la maggiore attenzione per le NSP - è bersaglio di dure critiche metodologiche, che evidenziano la scarsa utilità dei dati forniti. Infatti il rapporto non si basa su di una analisi che tenga conto delle tipologie assai diversificate delle NSP - sotto controllo internazionale o meno - dalle quali dipendono i rischi della loro assunzione, ma di fatto fa di ogni erba un fascio.

Come è esplicitato già dal sommario del rapporto, in molti paesi si sono avviate sperimentazioni, delle quali spesso qui si è detto, che vanno oltre i limiti di flessibilità previsti dalle convenzioni internazionali - .ultima la legalizzazione controllata della cannabis decisa in Uruguay. E allora, visto che la Guerra alla Droga è bella che persa, che l'ammontare dei danni che essa ha provocato e continua a provocare è ormai incalcolabile, il documento dell'IDPC chiede che la notevole expertise a disposizione dell'UNODC sia indirizzata ad aiutare gli stati membri a "facilitare l'adozione di una gamma variata di risposte flessibili, che tengano conto sia delle specificità di questo amplissimo panorama di sostanze, sia delle diverse specificità locali sociali ed economiche in funzione delle quali il loro uso deve essere gestito"

E qui chiudiamo con una considerazione che il documento IDPC diplomaticamente omette. Il narcotraffico della cannabis e dei suoi derivati vale circa la metà del totale dei profitti criminali fatti sulle droghe: per lo più riciclati al punto di inquinare una buona parte dell'economia legale, e inoltre attirando nella Geenna dell'illegalità innumerevoli soggetti che altrimenti avrebbero potuto essere normali donne e uomini della strada. Una legalizzazione controllata della cannabis su scala mondiale equivarrebbe quindi per i narcotrafficanti a un dimezzamento del loro spazio di mercato. Il fatto che di tale "dettaglio" nelle convenzioni internazionali si seguiti a non tener conto dà la misura della forza incontrollabile degli interessi economici, politici e corporativi che impediscono i necessari cambiamenti delle politiche internazionali e nazionali sulle droghe.

Tienitiaggiornato congli sviluppi politicidi drogamediante la sottoscrizione diAlert IDPC mensile.

IDPC response to the 2012 World Drug Report

IDPC response to the 2011 World Drug Report

IDPC response to the 2010 World Drug Report

IDPC response to the 2009 World Drug Report

IDPC response to the 2008 World Drug Report

IDPC response to the 2007 World Drug Report

IDPC response to the 2006 World Drug Report

La riposta dell'IDPC al World Drug report 2013

UNODC launched the Global Synthetics Monitoring:Analyses, Reporting and Trends (SMART) Programme in September 2008. The Programme seeks to enhance the capacity of Member States and authorities in priority regions, to generate, manage, analyse and report synthetic drug information, and to apply this scientific evidence-based knowledge to design the policies and programmes. The Global SMART Programme is being implemented in a gradual phased manner, with East Asia being the first focus priority region. Operations in Latin America started in 2011.

This annual report is the fourth regional situation assessment for East and Southeast Asia put forward under the Global SMART Programme. It forms one of the essential key steps in providing consolidated up-to-date analysis, based on the information shared by the member countries. It is hoped that the information on drug trends presented in this report will make a practical contribution to addressing the significant threat posed by the illicit ATS manufacture, trafficking and use in the East and Southeast Asia region, and place policymakers in a better position to evaluate the drug situation, and to make informed decisions on intervention and prevention strategies.

This report provides an overview of the ATS situation in the region. It outlines several key issues and emerging threats throughout the region and their implications for the neighbouring regions. While the data presented point towards the increased efforts by the countries in the region to tackle the ATS problem, it also highlights the need for continued and joint efforts, both at the national as well as regional levels. It is hoped that this report and the forthcoming national and regional updates, will help in the better understanding of the ATS problem and in designing effective strategies to combat it.

Patterns and trends of Amphetamine-Type Stimulants (ATS) and other drugs - Challenges for Asia and the Pacific 2013

Taking stock of an off-track AIDS response: During 2011-2012, Uganda attracted concern—and criticism—as a result of its troubling epidemiological trends, indicating an off-track response to HIV. The Uganda AIDS Indicator Survey showed that prevalence had risen from 6.4 to 7.3% between 2006 and 2012 and incidence also rose during the same period. Condom use by men and women declined starkly over the same period—reported condom use during sex with a non-cohabitating partner declined significantly between 2005 and 2011 from 47% to 29% and from 53% to 38% among women and men, respectively. Importantly, Uganda was the only PEPFAR “Focus Country” reporting rising HIV incidence—all other PEPFAR focus countries have consistently reported declines in incidence as well as prevalence in recent years.

At the same time, recent game-changing scientific advances in HIV prevention and clinical care are making it possible for all high-burden countries to begin to achieve an “AIDS Free Generation,” defined as a halt to sexual transmission, an end to disease progression for those who are HIV positive, and an end to perinatal transmission. In particular, recent data show that HIV treatment is not only life saving but is also one of the most powerful prevention tools available—groundbreaking new research shows that earlier treatment of HIV positive people—at CD4>350—results in 96% reduction in the risk of HIV transmission through sex with an uninfected partner,4 is highly cost effective, and provides significant clinical benefit.6 Uganda’s faltering response means an attaining an AIDS Free Generation will take stronger, more urgent action—with bolder leadership.

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Ending AIDS in Uganda: What will it take?

People who inject image and performance enhancing drugs, such as anabolic steroids and melanotan, are at greater risk of HIV, hepatitis B and hepatitis C infection than previously thought. In England and Wales, the level of HIV infection among this group is similar to that among people who inject psychoactive drugs, such as, heroin and crack-cocaine. The proportion that had ever been infected with hepatitis B is lower than that among people who inject psychoactive drugs, although recent survey findings suggest the level of infection has increased over time.

Infections remain common among people who inject psychoactive drugs. Overall around half of this group have been infected with hepatitis C; around one in every 100 has HIV; and almost one-third report having a recent symptom of an injecting site bacterial infection. Hepatitis B infection among people who inject psychoactive drugs has declined, probably reflecting the marked increase in the uptake of the hepatitis B vaccine.

Needle and syringe sharing is lower than a decade ago, although around one in seven of people who inject psychoactive drugs continue to share needles and syringes. There has been a recent increase in the injection of amphetamines and amphetamine-type drugs, such as, mephedrone. Though these psychoactive drugs are much less commonly injected than opiates, crack-cocaine, or image and performance enhancing drugs, there is evidence that their injection is associated with higher levels of infection risk. Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

Shooting up: Infections among people who inject drugs in the UK in 2012

In the first decade of the 21st century the United States began to experience a shift in the 30-year buildup to a world record prison system. Although the decade ended with an increased number of people in prison, the rate of growth overall was considerably below that of previous decades and since 2008 the overall number of people in state prisons has declined slightly each year.

Scholars are beginning to analyze the relative contributions of changes in crime rates, criminal justice policies, economics, and demographics to the slowing growth rate of the prison system, but one area that has gone largely unexplored is the impact of such changes on racial disparities in imprisonment. As is well known, black/white
disparities in the use of incarceration have been profound for quite some time. Since the 1980s a series of analyses have documented these trends at the national level as well as examining variation in disparity among the states.

The changing racial dynamics of women's incarceration

More than two billion people in middle-income countries (MICs) lack access to essential medicines. Medicines are expensive, and consume 25 to 65 percent of the total private and public spending on health, and 60 to 90 percent of household expenditure in MICs. In the public sector, there is poor availability of medicines and patients are forced to purchase medicines from the private market. The Global Burden of Diseases 2010 study shows that MICs rather than experiencing a classic ‘epidemiological transition’ in which infectious diseases dissipate and non-communicable diseases (NCD) emerge, are facing a ‘dual burden’ in which infectious diseases are still prevalent, especially HIV, viral hepatitis and tuberculosis, while NCD rates are rising. Access to affordable medicines is therefore of central importance in ensuring universal access to health care in these countries.

Middle-income countries (MICs) are facing a crisis of containing costs for treating people living with HIV. These countries carry a high burden of HIV, and transmission of the virus is often concentrated amongst key populations: people who inject drug (PWID), men who have sex with men (MSM), sex workers (SW), transgender (TG), prisoners and migrants. The highest numbers and the highest prevalence of PWID with HIV are in East and Southeast Asia (17 percent), Eastern Europe (27 percent), and Latin America (29 percent). HIV prevalence is on average 13 times higher among MSM compared to the general population. In most parts of the world, sex workers experience higher prevalence of HIV than the general population. Access to treatment can be a challenge for key populations given the structural barriers such as laws and legislation that criminalize their behavior, stigma and discrimination, and lack of general acceptance in society. But even when such barriers are overcome, medicines including ARVs may not be available (‘stocked out’), largely because of the high costs as well as poor procurement and distribution system. The high cost of medicines are often the reasons governments claimed to have prevented them from including or limiting access to treatment as part of the public health insurance or social security system. Moreover, a country’s ability to pay is not always commensurate to
willingness to pay especially when it involves key populations.

Access challenges for HIV treatment among people living with HIV and key populations in middle-income countries

This report is the second publication in a series where we examine funding shortages for TB and HIV programmes in Eastern Europe and Central Asia (EECA).The first publication, “Bridging the Gap: Whythe European Union must address the Global Fund’s funding crisis to tackle the escalating HIV and TB epidemics in Eastern Europe and Central Asia” explored the cancellation of the Global Fund to Fight AIDS, Tuberculosis and Malaria’s eleventh funding window in 2011 and how this left some countries without the financial support needed to aggressively combat their disease epidemics. This report builds on our previous publication by analysing three cases studies to demonstrate the continued impact of TB and HIV in the region and to show the effects of international donor aid diminishing in middle-income countries. The current situation for TB and HIV programmes in the region remains serious. These diseases urgently require sustained political and financial support from both domestic and international sources, including regional level aid from the European Union.

The Global Fund to Fight AIDS, TB and Malaria, historically the largest international donor for TB and HIV programmes in the EECA region, has adopted a New Funding Model (NFM) that will significantly reduce the amount of support available for middle-income countries. This includes support to civil society organisations that deliver TB and HIV services and are essential to creating environments where national governments are held accountable for properly addressing the health needs of their citizens. A Global Fund modelling of funding allocations under the NFM indicated that just three percent of total resources would be allocated to EECA. This represents a 50 percent decrease compared with what was previously available.

Publications