Young people who inject drugs have specific developmental, social and environmental vulnerabilities. They are less likely to use harm reduction and treatment services and are less informed about risks and their rights. Early onset of injecting, and being a new injector, have been associated with increased risks of HIV and hepatitis C transmission, while specific groups of young people, especially those that are street involved, are at considerably higher risk.

The legal status of being a minor, meanwhile, raises challenges for both achieving a better understanding of the situation and for the development of targeted harm reduction interventions.

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Injecting drug use among under-18s

The 55-page report documents the experiences of people recently confined in the centers, who described being thrashed with rubber water hoses and hit with sticks or branches. Some described being punished with exercises intended to cause intense physical pain and humiliation, such as crawling along stony ground or standing in septic water pits. Former female detainees described rape and other sexual abuse by male guards. Many detainees said they were forced to work unpaid in the centers – and in some cases, on construction sites – and those who refused were beaten.

Mistreatment of drug users and “undesirables” in Cambodia’s drug detention centres

This study explores the civil society organisations that engage in drug policy advocacy in Europe. An Internet search in English, French and Spanish combined with information from national sources in 30 countries identified 218 organisations actively seeking to influence drug policy. The paper categorises the organisations, looking at their advocacy objectives and orientations, how they pursue these, and at what political levels they operate.

EMCDDA report - Drug policy advocacy organisations in Europe

There are growing concerns regarding the link between amphetamine-type stimulant (ATS) use and the transmission of HIV and other blood-borne viruses (BBV) in the Southeast Asian region. In January 2011, the Australian National Council on Drugs, through its Asia–Pacific

Drug Issues Committee and with funding provided by the Expert Advisory Committee on Asia–Pacific Regional Drug Issues, commissioned a review to investigate these concerns. This review focuses on the 11 countries in Southeast Asia (Brunei Darussalam, Cambodia, China (including Hong Kong and Macau), Indonesia, Lao People’s Democratic Republic (PDR), Malaysia, Myanmar, Philippines, Singapore, Thailand and Viet Nam) and covers four key areas:

the link between ATS use and the risk of HIV and BBV transmission via injecting or sexual routes

an analysis of HIV risk among ATS users compared to the HIV risk of opioid users

the interventions currently in place, both internationally and at the Southeast Asian regional level, to address ATS use in terms of HIV prevention and the effectiveness of these interventions, and

The link between amphetamine-type stimulant use and the transmission of HIV and other blood-borne viruses in Southeast Asia 

After initial training in qualitative research, the research team of the Omari Project, KANCO and LSHTM focused on interviews in Malindi, on the Kenyan coast.

This first wave of qualitative interviews were undertaken in a place called Kisumu Ngogo, which comprises around 4,000 small houses, connected by a series of small paths and alleyways.

This data from the first few months of data collection is giving clear insight in to some of the risks PWID on the Kenyan coast face. The difficulty of accessing, storing and using needles and syringes is clear, leading to risks of HIV transmission, but also of arrest and imprisonment.

Access to care: Qualitative research study in Kenya

In a report to the United Nations, the International Narcotics Control Board (INCB) stated:

One of the fundamental objectives of the international drug control treaties is to ensure the availability of narcotic drugs and psychotropic substances for medical and scientific purposes and to promote the rational use of narcotic drugs and psychotropic substances.

Countries that signed the 1961 Single Convention on Narcotic Drugs as Amended by the 1972 Protocol, hereafter referred to as the Single Convention, are expected to abide by the Convention’s provisions on the control of certain drugs while ensuring that these drugs are available for medical purposes. The Single Convention established a medicolegal principle of balance: governments have a dual obligation to prevent the diversion and abuse of narcotic drugs and to ensure adequate provision of opioid analgesics for legitimate medical and scientific purposes.

In this paper, we use the word “balance” in the way it is used by international organizations, such as the United Nations Economic and Social Council, the INCB, the World Health Organization (WHO) and the Commission on Narcotic Drugs.

Do national drug control laws ensure the availability of opioids for medical and scientific purposes?

Contradictory evidence on cannabis adds to the climate of confusion regarding the health harms related to use. This is particularly true for young people as they encounter and make sense of opposing information on cannabis. Knowledge translation (KT) is in part focused on ensuring that knowledge users have access to and understand best evidence; yet, little attention has focused on the processes youth use to weigh scientific evidence. There is growing interest in how KT efforts can involve knowledge users in shaping the delivery of youth-focused public health messages. To date, the youth voice has been largely absent from the creation of public health messages on cannabis.

Weeding out the information: An ethnographic approach to exploring how young people make sense of the evidence on cannabis

GENEVA, 30 January 2013 - The countries of Central and Eastern Europe and the Commonwealth of Independent States (CEE/CIS) have the fastest growing HIV epidemic in the world. The number of people living with HIV has almost tripled since 2000 and there are currently over 1.4 million people living with HIV in CEE/CIS.

The HIV epidemic is affecting ever younger, vulnerable adolescents in CEE/CIS, and yet it is masked by official overall HIV prevalence rates that are, for the most part, relatively low. Still, within these countries, we are seeing sub-groups of young people with infection rates on a par with the worst-affected populations in sub-Saharan Africa.

The spread of HIV in this region goes hand in hand with the social exclusion of those who are most vulnerable. Those who are most likelyto become infected with HIV are those who are already shut out of society or denied services because of their poverty, ethnicity and behaviours that put them at risk, or who are made vulnerable because of family breakdown, violence, social exclusion or conflict with the law.

Experiences from the field: HIV prevention among most at risk adolescents in Central and Eastern Europe and the Commonwealth of Independent States

In November 2012, voters in two US states – Washington and Colorado – approved ballot initiatives to establish legally regulated markets for the production, sale, use and taxation of cannabis (commonly referred to in the US as marijuana). This is the first time anywhere in the world that the recreational use of the drug will be legally regulated – the wellknown coffee shop system in the Netherlands is merely tolerated rather than enshrined in law.

Needless to say, with implications both within and beyond US borders, the drug policy community is watching Colorado and Washington closely. The votes not only put these US states in contravention of US federal law, but also generate considerable tension between the federal government and the 1961 United Nations Single Convention on Narcotic Drugs, the bedrock of the international drug control regime that the US has so worked so hard to construct and sustain.

Legally regulated cannabis markets in the US: Implications and possibilities

The response of national governments to illicit drugs is a challenging area of public policy for many reasons. In most countries it is an extremely politicised domain in which repressive policy measures may be adopted despite evidence suggesting that they are ineffective, often rather because political leaders want to show that they are “tough on drugs”. In addition, sometimes the evidence on which even the best-intended policies could be built is patchy or unreliable.

This report analyses the situation of West Africa as regards drug trafficking and consumption of illicit drugs.

Telling the story of drugs in West Africa: The newest front in a losing war?

Situated along the ancient Silk Road linking Europe to Asia, Kyrgyzstan has become an increasingly important transportation corridor for Afghani opium and itinerant labor. This has fueled epidemics of bloodborne and sexually-transmitted infections (STIs) among people who inject drugs (PWID), sex workers, and migrants.

The prevalence of HIV reaches 50 times and 5 times the background rate among PWID and sex workers, respectively; three-quarters of Kyrgyz HIV cases can be directly or indirectly attributed to injection drug use (World Health Organization, 2009).

Kyrgyzstan's experience suggest that police trainings have the potential to improve the integration of policing and public health efforts targeting at-risk groups.

Police education as a component of national HIV response: Lessons from Kyrgyzstan

Scaling up HIV prevention interventions in Central Asia will demand greater attention to the structural, health-care-related and social factors that facilitate HIV risk and impede service utilization among PWID. Multi-level combination prevention interventions should be developed with a focus on the sexual partners and risk networks of PWID, aiming at early detection of HIV, timely enrollment in HIV care, and retention in HIV care.

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