The UK’s first fully-fledged scheme to provide heroin users with a safe and legal supply of the drug has been extended for a further year, after showing “very promising results”.

Heroin-assisted treatment has been used successfully for decades in Switzerland, based in part on Britain’s long-forgotten model of heroin prescribing, and despite “impressive” UK trials, government funding for post-pilot schemes was removed in 2015.

But in Cleveland and Glasgow, police and local health experts have pushed in recent years for the creation of two of the UK’s first fully-fledged centres, both of which are now up and running, providing access to medical-grade diamorphine twice per day and to wider social support.

Campaigners celebrated the first “dramatic” results from Middlesbrough’s scheme on Wednesday, which found a vast reduction in re-offending rates and use of street drugs, and significant improvements in participants’ health and quality of life, including seeing those homeless at the outset placed in accommodation.

Thirteen of the city’s most at-risk heroin users, who had found other treatments unsuccessful and were of concern to criminal justice agencies and health services, accessed the programme – which will now be largely funded by money seized from criminals. Eight remain, while five dropped out or were suspended.

Researchers studied six of the participants over 29 weeks in the programme, who prior to the scheme had been responsible for at least 541 crimes at an estimated cost to the public purse of £2.1m. Between them, they committed just three lower-scale offences over 29 weeks of treatment.

‘Very promising’: UK’s first full heroin-prescribing scheme extended after reductions in crime and homelessness

Community-based organizations in Dar es Salaam, United Republic of Tanzania, with assistance from UNAIDS, are supporting women who use drugs and their families to survive during these difficult times.

“Before the pandemic, life was simple and better. I used to do activities at the beach, such as cleaning fish, helping people load and clean their boats, and they would pay me. I would help my daughter wash her clothes; I would escort her to school and cook food for her. Life was simple,” said Doroth Hassan as she sits in the office of SALVAGE, a sister organization of the Tanzania Network for People who Use Drugs (TaNPUD), in Kigamboni, Dar es Salaam.

Ms Hassan would normally provide for herself and her daughter by doing sex work and other informal jobs, such as the work on the beach. But this has become a challenge since the onset of the COVID-19 pandemic.

“Now life has changed. I live in fear and worry. People who I worked for don’t want to pay, with the excuse that they have no cash because of the coronavirus. Everything changed. Life is tough. Clients disappeared, vanished. And the few who are still coming cheat; they pay less for sex,” said Ms Hassan.

She is not alone in her worry. Most of the women who use drugs in Dar es Salaam survive in the same way as Ms Hassan does, by doing sex work, trading and doing other jobs in the informal sector. They live in camps for people who use drugs or in informal and densely populated settlements.

With support from UNAIDS and other partners, local community-based organizations, including TaNPUD and SALVAGE, have been able to provide some relief to women in the camps and settlements in Dar es Salaam.

Tanzanian community-based organizations support women who use drugs

IDPC is developing a web-portal / mini-site dedicated to our decriminalisation work. This online resource will house our existing resources on decriminalisation, as well as a new decriminalisation advocacy guide, and a new e-learning course dedicated to this topic. We anticipate the new web-portal, and e-learning course, being operational by February 2021.

We are looking for an experienced, knowledgeable writer and content developer to manage, collate and coordinate the development of all necessary content (documents, texts, dialogues, scripts, storyboards, exercises, etc) for the e-learning course. The successful applicant will work closely with the IDPC team, an e-learning expert who will devise the methods, structure and e-learning approach to be used, the website designers, video producers, and the wider IDPC network. IDPC and our members already have a wide range of high-quality resources available on the topic of decriminalisation, so much of the work will be collating and adapting these to fit an engaging, accessible, interactive and flexible e-learning course.

All proposals must be sent to Jamie Bridge, IDPC Chief Operating Officer (jbridge[@]idpc.net) by Sunday, 18 October 2020.

Call for proposals: Content developer for a new e-learning course on decriminalisation

The new security-focused EU Drugs Agenda proposed by the EU Commission was criticised by civil society and member states. The German EU presidency is now in charge of revising it.

It was revealed at the online annual plenary meeting of the Civil Society Forum on Drugs that Member States did not accept the new EU Drugs Agenda proposed by the EU Commission. The Horizontal Working Party on Drugs (HDG) decided that a new EU strategy will be prepared by the German presidency.

In a previous article we made some critical remarks about the new EU Drugs Agenda presented by the EU Commission. We concluded that this document 1) contains a war on drugs language and posits drug use on par with child abuse and arms trafficking; 2) does not reflect the findings of the evaluation of the previous strategy that show the a need to refocus resources on public health rather than law enforcement; 3) unlike the previous action plan, this does not have measurable indicators and 4) civil society was not involved appropriately in the process.

Later in August the International Drug Policy Consortium (IDPC) sent an open letter to the members of the HDG. This letter called member states to reject the EU Drugs Agenda and prepare a new document that reflects the position of the EU presented at the UN meetings, that is, a shift from the traditional supply reduction focus to a new paradigm based on human rights, development and public health.

A new EU drug strategy is being prepared by the German Presidency

Recent public attention to police brutality, systemic racism and oppression has brought calls for changes to a policing structure that manifestly fails to promote community health and safety. These run the gamut from radical defunding and abolition to reformed models of policing, where officers partner with trusted mental health professionals like social workers or psychiatric nurses. Social worker Dr. Sheila Vakharia of the Drug Policy Alliance* argues that this approach will “exacerbate our profession’s already fraught role as agents of social control,” and “will not fundamentally change even one of the myriad harms inflicted.”

Nurses are members of another “helping profession” that is simultaneously undervalued and tasked with solving an overwhelming number of health and societal problems. They are also frequently used by the healthcare system as agents of surveillance and control.

Nurses who work in hospital settings spend more time with patients than most other clinicians providing direct care, and often build the strongest, most trusting relationships. In the intensive care unit, for example, close monitoring by nurses is vital to detecting changes in a patient’s condition that require immediate intervention.

While our advocacy on behalf of patients is often extremely beneficial for those whose needs may be overlooked by others on the healthcare team, our near-constant monitoring of patients—in both inpatient and outpatient settings—can also inadvertently hurt them.

We are nurses, not police. The US methadone system expects otherwise

Some of New Zealand’s most experienced public health experts have thrown their support behind legalising marijuana, a week out from the country’s general election.

In an editorial in the New Zealand Medical Journal, specialists from the fields of addiction treatment, public health, health promotion and epidemiology have urged New Zealanders to tick yes in the referendum, days after a poll showed the vote on a knife-edge.

The referendum is a “once-in-a-generation opportunity” to legalise cannabis, and promote health equality, the editorial said.

Prof Michael Baker from the University of Otago, one of the key architects of the country’s successful Covid-19 response, says New Zealand had shown it was a world leader in utilising “innovative and evidence-informed approaches” to complex public health problems.

“It’s time to take the same fresh approach to cannabis law and put public health first,” Prof Baker says.

“Our prohibition model for cannabis is outdated and doesn’t work. Supporting law reform is about reframing cannabis use as a health issue which opens up new, more effective ways of minimising harms caused by this drug.”

New Zealand health experts back reform of 'outdated' cannabis laws

Mexico’s marijuana revolution is on display steps from the nation’s Senate, where for the last nine months activists have maintained a fragrant cannabis garden.

Each day, hundreds of people stroll amid a labyrinth of towering green plants, freely lighting joints and getting high.

Their wafting smoke is meant to serve as a reminder to senators, who have to walk through the plumes to get to work. Lawmakers have until Dec. 15 to pass pot legislation under orders from the Supreme Court, which two years ago struck down a marijuana ban as unconstitutional.

After decades of restrictive drug policies that fueled deadly cartel wars, Mexico is poised to become the biggest legal cannabis market in the world.

The looming deadline has intensified debate over exactly what legalization should look like and whom it should benefit. Among the questions dogging lawmakers: How easy or difficult should it be for users to buy and consume pot? And should the estimated 200,000 families growing it now be protected from competition with the large, foreign marijuana firms that have been jockeying for influence?

“You have a broad spectrum of people who want to be involved,” said Avis Bulbulyan, a Glendale-based consultant who has advised several U.S. weed companies looking to expand to Mexico. “The question becomes: ‘Who gets to profit off this?’”

A bill that would allow private companies to sell marijuana to the public is likely to pass in the Senate within two weeks and then go to the lower house of Congress, said Senate leader Ricardo Monreal.

The activists who planted their first marijuana crop in February next to the Senate have criticized an early draft of the legislation as unfairly favoring big business. One stipulation is that commercial marijuana be traceable from seed to sale, which would require expensive, high-tech testing that would be cost-prohibitive for smaller growers.

The draft law also limits individual growers to six plants and requires anybody who wants to consume to obtain licenses from the government.

Mexico is poised to become the biggest legal marijuana market in the world. Who will most benefit?

The US arrest of Mexico’s former defense minister on drug charges confirms what has been alleged by traffickers themselves: that the country’s military, which plays an outsized role in the fight against organized crime, has been thoroughly corrupted.

On October 15, the US Ambassador to Mexico, Christopher Landau, informed Foreign Minister Marcelo Ebrard that former general Salvador Cienfuegos Zepeda, Mexico’s defense secretary under former President Enrique Peña Nieto (2012-2018), had been arrested at Los Angeles’ international airport.

The arrest order from the US Drug Enforcement Administration (DEA) came after Cienfuegos — dubbed “El Padrino,” or the “Godfather” — was charged with three counts of drug conspiracy and one count of money laundering, according to an indictment filed in August 2019 in the Eastern District of New York.

The charges stem from allegations that he colluded with the H-2 Cartel between 2015 and 2017, according to court documents. The H-2 Cartel — which has its roots in the Beltrán Leyva Organization — was formerly led by Juan Francisco Patrón Sánchez, alias “H2,” who was shot and killed by Mexican Marines in early 2017. US federal prosecutors accuse the former general of using his “public position to help the H-2 Cartel … operate with impunity” in exchange for bribes, according to an October 16 letter from prosecutors to Eastern District judge Carol B. Amon.

Evidence cited includes “thousands of [intercepted] Blackberry Messenger communications” that allegedly show Cienfuegos shielded the group from military operations, secured maritime transport of drug shipments, warned the group about US law enforcement investigations and introduced its members to other corrupt Mexican officials, prosecutors said. Cienfuegos’ assistance ensured the H-2 Cartel operated without “significant interference from the Mexican military,” allowing the crime group to import “thousands of kilograms of cocaine, heroin, marijuana and methamphetamine into the United States,” prosecutors alleged in the letter.

What the US arrest of former Defense Minister tells about drug traffickers and the military in Mexico

By Kassandra Frederique, Director, Drug Policy Alliance / Truthout

In 1970, the Controlled Substances Act (CSA) was passed by the Nixon administration, codifying a national strategy to prohibit drug use and target certain communities. Since then, the “war on drugs” has failed to reduce supply or demand, while steadily increasing drug overdose deaths and perpetuating the stigmatization of individuals with addiction. It has fueled wide-scale militarized policing, cost taxpayers over $1 trillion since its inception, and expanded punitive institutions outside of the criminal legal system — including punishment-oriented systems embedded in schools, hospitals and social service agencies. After 50 years of failures and substantial evidence that drug prohibition is not only ineffective but also incredibly counterproductive, we clearly cannot afford another 50 years of the same. The time has come to repeal the Controlled Substances Act and transition toward a more evidence based and realistic approach to drug use in our society.

On its face, the CSA’s stated purpose to create a tiered system with five categories based on potential for problematic use, medical use and safety sounds like a reasonable plan. But the reality is far more grim. It has been primarily wielded as a political hammer to justify arbitrarily criminalizing and targeting certain marginalized communities, and used to restrict research that might prove any kind of medicinal benefits.

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