The European Union (EU) has had some form of formal drug strategy since the early 1990s. These successive strategies have attempted to articulate a common Europe-wide position, and set out the role for the European Commission (EC) and other agencies in supporting the activities of EU member states given that the main decisions on policy, strategy and resource allocations are made at the national level.

Reviewing successive versions of the EU Drug Strategy, a clear trend of increasing scope, sophistication and clarity can be observed. Over the last 20 years, European governments and institutions have led the way globally in collecting information about the drug problem and government responses;1 in implementing and learning from the experience of a wide range of supply reduction, demand reduction, and harm reduction activities; and in developing a consensus around a balanced approach to strategy that avoids the more extreme forms of repressive law enforcement, and encourages significant investment in harm reduction and treatment services for people who use drugs.

In this advocacy note, the International Drug Policy Consortium (IDPC) analyses the extent to which the Strategy, and its initial Action Plan, are effective in articulating activities and plans that are appropriate to this challenge, and that reflect the best evidence and experience in this sector. We also comment on the extent to which the process of development of these documents has lived up to the Strategy objective to: ‘Promote and encourage the active and meaningful participation and involvement of civil society… in the development and implementation of drug policies, at national, EU and international level.’

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

IDPC Advocacy Note - The European Union Drugs Strategy 2013-2020

This advocacy note is not intended to provide a thorough analysis or critique of the content of the two reports presented by the OAS, which together with the annexes referred to above cover hundreds and hundreds of pages. Rather, the purpose here is to highlight some of the key points presented in the OAS analytical and scenarios reports that, in the view of the International Drug Policy Consortium (IDPC), especially merit further debate and discussion.

The challenge for governments, civil society groups and citizens across the hemisphere is to use the report as a tool for debating present drug policies and ultimately crafting alternative approaches that are both more humane and effective.

IDPC Advocacy Note - Launching the debate: The OAS Reports on Hemispheric Drug Policy

The burden of liver disease could be dramatically reduced by increasing treatment for hepatitis C infection among people who inject drugs, suggest new recommendations developed by researchers from the Kirby Institute at UNSW, in collaboration with colleagues from the International Network on Hepatitis Care in Substance Users (INHSU).

In Australia, 226,000 people are living with chronic hepatitis C and over 10,000 new cases are reported every year. Hepatitis C can lead to serious liver complications such as liver failure or cancer, which are associated with considerable costs to the health care system. Although almost 80 per cent of all infections occur among people who inject drugs, only one per cent of these people currently receive treatment.

“Treatment for hepatitis C infection among people who inject drugs remains unacceptably low,” said

Dr Jason Grebely, Senior Lecturer at the Kirby Institute, UNSW, and co-lead author of the recommendations. “Clinicians have been hesitant to recommend treatment in this population because of a lack of understanding about how lifestyle factors may impede successful treatment.”

But research supporting the first set of international recommendations ever released for treating hepatitis C in people who inject drugs has shown that treatment can be very successful when barriers are addressed within a supportive environment.

“Reducing the significant burden of liver disease related to hepatitis C in Australia and internationally will require improved assessment and treatment of the population most affected: people who currently inject drugs and those who have injected drugs in the past,” says Philip Bruggmann, President of INHSU. “By providing appropriate care to this group, we can reduce the burden of hepatitis C-related liver disease in this vulnerable population and slow the spread of this world-wide epidemic. These new recommendations serve as a first step towards elimination of hepatitis C.”

The global recommendations are published online today in the journal 

 ahead of World Hepatitis Day on July 28. They are part of a supplement entitled “Prevention and Management of Hepatitis C Virus Infection Among People Who Inject Drugs: Moving the Agenda Forward”, developed in collaboration with INHSU.

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

Prevention and management of hepatitis C virus infection among people who inject drugs: Moving the agenda forward

The periodic evaluation of implementation of the WHO strategy requires an initial baseline survey of all Member States. In mid-2012, WHO, in collaboration with the World Hepatitis Alliance, conducted such a survey, asking Member States to provide information relating to the four axes of the WHO strategy. In particular, Member States were asked whether key prevention and control activities are being conducted. This report presents the results.

The first chapter provides an introduction to viral hepatitis and to the global response to this group of diseases. The second chapter provides a global overview of the survey findings. Chapters three through eight present findings from the six WHO regions, including summaries of data from all responding countries. Additional survey data, study methodology information and the survey instrument can be found in Annexes A–E.

Global policy report on the prevention and control of viral hepatitis

The New Founding Model (NFM), launched in 2013 by the Global Fun to Fight AIDS, Tuberculosis and Malaria, enables greater flexibility, predictability, and simplicity in the application process while promoting the engagement of stakeholders in all Global Fund activies. Aiming to have an improved impact and management of grants, the NFM will continue this year and be open to al countries by 2014.

The purpose of this guide is to make clear to civil society the key elements of the NFM application process, with a focus on the Standard Applicants who will be submitting applications in 2014 and beyond.

Civil society global fund application preparedness guide

The report relies on the Federal Bureau of Investigation’s Uniform Crime Reporting Pr ogram and the United States Census’ annual county population estimates to document arrest rates by race per 100,000 for marijuana possession. This report is the first to examine marijuana possession arrest rates by race for all 50 states (and the District of Columbia) and their respective counties from 2001 to 2010.

The report founds that between 2001 and 2010, there were over 8 million pot arrests in the U.S. That’s one bust every 37 seconds and hundreds of thousands ensnared in the criminal justice system. Enforcing marijuana laws costs us about $3.6 billion a year, yet the War on Marijuana has failed to diminish the use or availability of marijuana.

Marijuana use is roughly equal among Blacks and whites, yet Blacks are 3.73 times as likely to be arrested for marijuana possession.

The war on marijuana: In black and white

The aim of this study, conducted by the Clinical Addiction Research Education Unit of the Boston University School of Medicine, is to evaluate the impact of state supported overdose education and nasal naloxone distribution (OEND) programs on rates of opioid related death from overdose and acute care utilization in Massachusetts.

It was conducted among opioid users at risk for overdose, social service agency staff, family, and friends of opioid users in 19 Massachusetts communities.

It concludes that opioid overdose death rates were reduced in communities where OEND was implemented. This study provides observational evidence that by training potential bystanders to prevent, recognize, and respond to opioid overdoses, OEND is an effective intervention.

Read here the full publication (restricted access)

Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis

In collaboration with the Eurasian Harm Reduction Network (EHRN), HPP has designed a policy decision model focused on persons who inject drugs (PWID). The PWID decision model identifies the existence of restrictive, poorly written, or absent enabling policies that may serve as obstacles for programs to provide both sustained and accessible HIV counseling and testing, antiretroviral therapy, hepatitis, tuberculosis, opioid substitution therapy, and sterile needle and syringe program services for PWID. It is also inclusive of issues such as stigma and discrimination, gender-based violence, and criminal justice systems.

While designed for global adaptation and application, the decision model specifically addresses policy barriers common in Eastern Europe.

Policy analysis and advocacy decision model for HIV-related services: People who inject drugs

The Health Policy Project (HPP) HIV policy analysis and advocacy decision models are systematic structures and methodologies designed to help stakeholders create an inventory of country policies, analyze these policies against international best practices and human rights frameworks, assess policy implementation, and create a strategic advocacy plan.

Decision models are grounded in international human rights and best practices and allow for policy analysis and comparison across country and regional borders. The primary goal of the model is to identify the policies that most directly affect access to and sustainability of key services and the needs and opportunities for policy advocacy that will improve access to services in both near and longer terms.

Designed to help country stakeholders build a public policy foundation that supports access to and implementation and scale-up of evidence-informed services for MSM/TG/SWs, the Decision Model helps to clearly identify and address policy barriers to services. Its policy inventory and analysis tools draw from the extensive body of international laws, agreements, standards, and best practices related to MSM/TG/SW services, allowing the assessment of a specific country policy environment in relation to these standards. This customizable, in-depth, and standardized approach will build stakeholders’ capacity to identify incremental, feasible, near-term opportunities to improve the legal environment and the resulting quality of and access to services for MSM/TG/SWs while long-term human rights strategies are implemented.

Policy analysis and advocacy decision model for services for sex workers, transgender, and males who have sex with males

Though famous for its coffee shops, where cannabis can be purchased and consumed, the Netherlands has accomplished many enviable public health outcomes through its drug policy. These include low prevalence of HIV among people who use drugs, negligible incidence of heroin use, lower cannabis use among young people than in many stricter countries, and a citizenry that has generally been spared the burden of criminal records for low level, nonviolent drug offenses.

Coffee Shops and Compromise: Separated Illicit Drug Markets in the Netherlands tells the history of the Dutch approach and describes the ongoing success of the country’s drug policy. This includes the impact of the Dutch “separation of markets,” which potentially limits people’s exposure and access to harder drugs.

Though coffee shops have traditionally commanded the most media attention, the Netherlands also pioneered needle exchange and safer consumption rooms, decriminalized possession of small quantities of drugs, and introduced easy-to-access treatment services.

These policies, coupled with groundbreaking harm reduction interventions, have resulted in the near-disappearance of HIV among people who inject drugs and the lowest rate of problem drug use in Europe.

Coffee shops and compromise: Separated illicit drug markets in the Netherlands

Crime rates in Canada are at their lowest point since 1972 yet last year, Canada’s federal government introduced sweeping legislative reforms to our criminal justice system. The stated goal of these expansive and expensive measures is to increase the safety and security of Canadians by getting “tough on crime” and holding offenders accountable.

The Safe Streets and Communities Act (SSCA), alternately known as Bill C-10 and the “Omnibus Crime Bill” was passed by Parliament on March 12, 2012. When the SSCA was debated in Parliament, Canadians were told that many provisions of the Act, including the introduction of mandatory minimum sentences for a number of drug offences, would target “serious organized drug crime” rather than people struggling with drug dependence. Many well-respected commentators, including the Canadian Bar Association, the Canadian Centre for Policy Alternatives, and the Assembly of First Nations have argued, however, that these amendments will affect a spectrum of drug offenders, including people involved in the sale and/or production of illicit substances as a result of their struggle with drug dependence.

Pivot Legal Society undertook this research in order to assess the potential scope and nature of the effects of the Safe Streets and Communities Act on low-income drug users. We also sought to examine whether new criminal law provisions were likely to raise constitutional issues, particularly when applied to members of Charter-protected groups, such as Aboriginal people and people with disabilities (including drug dependence).

Throwing away the keys: The human and social cost of mandatory minimum sentences

The coming on the market of the products called “Research Chemicals” or “legal highs” is no accident. It corresponds to an evolution in the drug using community, based on several elements:

The new generation has seized the Internet tool and spends an enormous amount of time “online”, in the world of the “web” where pleasure seeking is continually expressed. This new generation of users shares its experiments of the use of NPS (New Psychoactive substances) through Internet forums and it has now acquired a real expertise.

New businesses have emerged on the market of online sales of psychoactive substances, providing an ever moving and international offer. The emergence of these new drug routes has contributed to the development of a new “ Mafia”, that has adapted its strategies to this “Geek Generation”.

The law of 1970 is now forced into a virtual corner by these phenomena. These synthetic products are many, and their effects and their risks difficult to evaluate; their commercial profile and their online sale make them easily available on a large scale. Payments are carried out online by credit cards, using official bank routes; in all these aspects they go beyond law enforcement, which seems to have stalled in front of them.

As these NPS are conducive to risk taking, the addiction service providers need to work out new harm reduction strategies, which will fully, involving the users.

Publications