The film is directed by Ko Si Thu Aung, who shot the film in the extremely remote Township Mawlaik. Situated at the Chindwin River near the Indian border, the township is known for its spectacular views, running through deep jungles and lofty mountains, as well as for its lumber mills, and close proximity to coal and gold mines, and hydro power plants.

Myanmar is confronted with a unique HIV, HCV, TB, and drug use syndemic in most remote, hard-to-reach mining, border, and conflict areas. Drug use in Myanmar is closely related to subsistence day labor (in rural areas) and drug-using migrant workers in logging, gold, ruby, and jade mines. Most clients of the Asian Harm Reduction Network (AHRN), people who use or inject drugs, and sex workers are in the lowest economic strata, experiencing endemic poverty coupled with the socio-economic consequences of drug use. The intense markers of marginalisation are key drivers of the challenge of reaching these people, complicating prevention, impacting health seeking behaviour, obstructing enrolment into treatment and care, as well as compliance and adherence, compounded by contextual barriers such as proximity to clinics and travel costs, among others.

Reaching the unreached in Myanmar

When you're stuck at the bottom of the world, you take what you can get. For Claire*, that's cocaine and ketamine, occasionally MDMA. Or at least that's what she hopes she's getting. She knows she's not, not all the time. There's a difference from bag to bag, dealer to dealer, "especially with things like 'cocaine', which is probably just methamphetamine and washing powder". Since returning from Berlin, where quality drugs were cheap and plentiful, the 34-year-old Aucklander doesn't take drugs as often; they're "s…" here. But that doesn't stop a lot of Kiwis. It's that "she'll be right" attitude, Claire says.

It's a mentality Wendy Allison knows too well. The director of drug testing service KnowYourStuffNZ, her last five summers have been spent on the festival circuit, picking out pesticides and bath salts before they slip past the lips and nostrils of unsuspecting festival-goers. Last year they tested 805 samples across 13 events – more than double the previous year.

She's seen some worrying things: cathinones, or bath salts, are the big one. If someone thinks they've got MDMA and they haven't, bath salts are the likely imposter – and while some of the effects are similar, users may also experience anxiety attacks, heart arrhythmia and fits. Overdosing is more likely because people don't get the high they're expecting, so they go back for more. Deaths overseas and hospitalisations in New Zealand have cathinones to blame.

Super-strength MDMA is another concern. Four years ago, the pills started showing up in Europe and the UK, linked to hospitalisations and deaths; two summers later they were here. Allison is expecting to see more of the pills this season, with some containing up to four times the average dose of MDMA.

But it's the Kiwi attitude to drugs that worries her most. Drugs in New Zealand have historically been of low and fluctuating quality. Without any way of finding out what's in them, Kiwis have been "trained to take things without knowing what they are", she said. "There's a resigned attitude that in order to have a good time, you've got to go through this risk of having a not-so-good time – and as long as you don't die, that's fine."

But give people information and they will use it: 87 per cent of clients surveyed by KnowYourStuff last summer said their behaviour had changed as a result of using the service. Sixty-two per cent of people whose drugs weren't what they thought said they wouldn't take them.

KnowYourStuff does more than test people's drugs and send them on their way. For starters, they don't give any substances back after testing; they are destroyed in the process. The first thing they tell people is that taking any drugs is risky. The next is what the specific risks are, and what users can do to reduce them, discussing dosages, symptoms, what could go wrong, what not to mix.

Testing one person's drugs might prevent one death, but changing how people approach drug use will have the biggest effect on harm, Allison said. The shift from "she'll be right" is starting, with people more aware of risks and less willing to accept dodgy drugs as normal.

It's not just that there's no legal imperative to offer harm reduction facilities for drug users – it's difficult, bordering on illegal. Section 12 of the Misuse of Drugs Act makes it a crime to knowingly permit a venue to be used for drug use, which means festival testing operates in a legal grey area.

No-one has been charged for having it on-site, but the threat looms large. It's hard to get past councils, insurers, police and stakeholders, even when the promoters themselves are keen. And they are: they don't want a death on their hands.

Mitch Lowe has had some success getting drug-testing across the line, but only at smaller events such as Raglan and Timaru Soundsplash. At the major festivals he puts on – Bay Dreams, One Love – it's been a "flat no". He can't see the sense in that - the more people, the greater the risk, the more potential there is for reducing harm.

"It's frustrating to have something that's right there, that has evidence that shows it's something that reduces risk, and for us to not be able to put that into effect," Simon Wallace says. He's one of the people behind Friendly Potential, an Auckland club night that has spawned two festivals. Organisers weren't dealing with situations where people might take drugs, he said – they did.

With the number of people taking drugs on the rise, we're starting to see some movement on festival testing. Earlier this month, the Government announced a $59,000 study that will take place this summer, looking at the effectiveness of drug testing as a harm reduction tool.

A Victoria University of Wellington criminology team will be going to events, conducting interviews and sifting through data provided by KnowYourStuff. The evidence they come back with will be used to shape any potential next steps by the Government.

At the moment, National opposes drug testing. NZ First only recently came around to it after a heated debate from its youth wing at its annual conference. Allison hopes the evidence to come out of this summer will be enough to secure a law change. But right now they're going headfirst into festival season with Section 12 as it is, and that worries her.

"If we are unable to attend a particular event because of the Government's lack of action on this and somebody dies at that event, I will be blaming the Government for that," she said.

Sometimes it takes a tragedy to prompt action, Green MP Chlöe Swarbrick said, pointing to the pastoral care laws passed in the wake of the death of University of Canterbury student Mason Pendrous, who lay dead in his room for weeks. She has been leading the charge for drug law reform, and said she welcomed this summer's research project as a way of strengthening the case for legal drug checking.

When politicians consider whether to change the law, Allison said they would be dealing with one fundamental question: "Should we or should we not try to save the lives of people who have broken the law?"

"For us the bad thing is that they die – not that they take drugs."

Pingers, parties and politics: How festival drug testers are trying to save lives

Consumers resort to drug trafficking five times less, according to a study, but police sources say seizures of illegal marijuana have remained at the same level.

RIO DE JANEIRO, BRAZIL - The government of Uruguay has seen a sharp reduction in illegal marijuana trafficking in the first four years after legalization under state control.

However, according to the police, the seizures have remained relatively constant since the adoption of this pioneering measure worldwide.

The contradiction, which still has no clear explanation, exemplifies the difficulties in gauging the real progress of marijuana drug trafficking.

Uruguay records drop in marijuana trafficking after legalization

Imagine going on a night out with friends, planning to share some “ecstasy” pills you bought locally. What if you first wanted to know the quality and purity of your drugs, but didn’t have the means to check? And what if you wanted to find local harm reduction organizations, information and services that could help keep your drug use safer?

The developers behind TripApp sought to provide some answers.

The free app—which launched this month and is so far available in Spain, Italy and Germany—shares real-time data from the Trans-European Drug Information Project (TEDI), an international illicit drug checking network. It also collects data from consumers who check their own drugs with reagent kits or test strips. It constantly updates its data in order to alert consumers when adulterated or high-risk drug batches are detected in their location.

“We wanted the people to be the primary beneficiaries of this data.”

“We realized that in discussions about drug use, there’s a lot of talk about monitoring and controlling people who use drugs, but when do we ever consider talking to them?” Florian Scheibein, deputy director of Help Not Harm and one of the app’s founders, told 

. “People who use drugs and their communities are often excluded from having data about the quality of their drugs, that’s normally collected by governments and academic institutions. We instead wanted the people to be the primary beneficiaries of this data.”

TripApp is the latest mobile innovation to make drug use safer

In 2019, about 12 people die every day from an opioid-related overdose. It’s Canada’s most significant public health threat since 1919, when 55,000 people died from the Spanish flu. Not only are opioid-related deaths among the top 10 causes of mortality in our country, but the number grows each year. The likelihood of death from overdose is higher than ever because illicit—otherwise known as “street”—drugs are increasingly contaminated with fentanyl and its analogues, contributing to 82 per cent of accidental opioid-related deaths in Canada.

This is a national public health emergency. But you wouldn’t know it from the discourse in our recent federal election. It barely registered in public debates or party communications, probably because the solutions to the crisis are politically unpopular. The way out is difficult to explain, and few are ready to push for it.

The topic must not be dismissed as one affecting only marginalized people. It’s estimated that a million Canadians are at risk of exposure to toxic opioid products. They are our relatives and neighbours: people use drugs in city centres but also in suburbs, small towns and remote regions; they use drugs in urban areas, but also alone at home or in the washroom cubicles of your neighbourhood fast food restaurant.

If you don’t already know someone who has lost a loved one because of an accidental opioid overdose, it’s only a matter of time until you will. If every life is of value, then it’s time to get beyond our prejudices and political biases and implement the steps that will save lives.

The solutions are not mysterious. In the last four years Canada has made progress on drug policy. We made naloxone (a drug that temporarily reverses the effects of opioids) available without prescription and in multiple formats. We passed Bill C-37 to reintroduce harm reduction and facilitate approval of supervised consumptions sites. We overturned a ban on use of prescription heroin for people with substance dependence, and enabled bulk imports.

Canada can do more by implementing international best practices. Two changes can be adapted from drug policies in Europe. Following Portugal’s lead, we should decriminalize the possession of small amounts of drugs—a 10-day personal supply. Following Switzerland’s lead, we should expand access to safe supply.

Decriminalisation is not a radical solution to the opioid crisis. And it would work.

Although the drug strategy adopted by the Hungarian government in 2013 aimed to make the country drug-free by 2020, the (not so) new synthetic drugs still rule the country. After the municipal elections, there is some hope that harm reduction can return to Budapest.

Illicit drug markets have been behaving strangely in Hungary for the last ten years. The decline of Ecstasy and the boom of new synthetic drugs was happening all across Europe after 2009 – but what made this small Central European country peculiar was the almost total collapse of the heroin and amphetamine markets, replaced by new stimulants. A similar trend could only be observed in Romania (where it seems heroin is now back, unlike in Hungary). Despite (or partly due to?) all efforts of law makers to ban new substances as soon as possible, the market for designer drugs has been stabilising.

There are two types of these drugs: synthetic cannabinoid agonists, which are dubbed as “herbal” or “bio” by Hungarian users, and cathinones, dubbed as “crystal” on the street. Almost every year a new substance comes to dominate the designer market. This year the dominant stimulant was ethyl-hexedrone (replacing pentedrone) and the dominant synthetic cannabinoid agonist was 5F-MDMB-PINACA (replacing ADB-FUBINACA). God knows what comes next year but we can be almost sure the designers will throw something new into the market.

There are some signs (police seizures for example) that the designer market boom peaked around 2014, and that its rise is now somewhat slower, or even stagnating. But there is no chance that they will be gone any time soon. According to the latest epidemiological study among the adult population, the use of “herbal” is the most prevalent among illicit substances. That is if we trust the results – it is very hard to make accurate estimations of illicit drug use trends in Hungary due to the restrictive and stigmatising political environment.

The unchallenged rule of designer drugs in Hungary

DRUG COURTS, WHICH which differ from other courts in Ireland, were set up with the aim of reducing crime through drug rehabilitation.

Under this system, you are a person most likely experiencing problematic drug use, yet you are considered an offender, not a participant or patient of the drug courts.

Offender and health are not terms we consider as being complementary to one another.

The Drug Courts recruit based on a guilty plea and prescribe to a clean urine programme, which rules out many other drug users who are harder to reach, engage and support due to the chaotic nature of their drug use.

Imagine if we had a localised multi-agency and disciplinary team, consisting of nurses, drugs workers, counsellors and educators.

Well, in many areas we do, or we can have with the right resources and policy support.

A Drug Court has many of these, but a judge oversees it, and your involvement is court-ordered, and your addiction is still an offence.

It is just another system that will benefit a tiny percentage of drug users, and to succeed, you have to be a model patient, or in this case, offender.

Drug courts are not the solution to Ireland's drug problem - Senator Lynn Ruane

By West Africa Drug Policy Network, Drug Policy Network -Ghana, Harm Reduction Alliance Ghana, Students for Sensible Drug Policy- Ghana, YouthRISE International, Students for Drug Policy Reform Ghana, Hemp Association of Ghana

We have read the CSOs petition to the President and the Speaker of parliament on why Ghana should not legalize cannabis.

First and foremost, we want to emphatically state, the current narcotics bill before parliament is not seeking to legalize drugs, the bill before parliament is seeking to decriminalize drug use and place the health and well-being of its citizens at the forefront of its constitutional mandate by treating drug use as a health issue.

Ghana is a signatory to the 3 international conventions, that is the 1961, 1971 and 1988 convention and the preamble-of these conventions mandates all member states to place the health and well-being of its citizens in the implementation of these conventions. Fairly, is continuous punishment of people who use drugs a fulfillment of that commitment of Ghana? Absolutely no, it’s in clear violation of the letter and spirit of these very conventions.

The Conventions provide a very clear provision whereby drug use does not need to be criminalized. The 1961 Convention, Article 36 (b) explicitly states “when abusers of drugs have committed such offences, the Parties may provide, either as an alternative to conviction or punishment or in addition to conviction or punishment, that such individuals shall undergo measures of treatment, education, after-care, rehabilitation and social reintegration in conformity…”.

This is then repeated in the 1971 Convention (Article 22b) and the 1988 Convention (Article 3, Para 4 c and d). Please take note of a commentary on the 1988 Convention “It will be noted that, as with the 1961 and 1971 Conventions, paragraph 2 does not require drug consumption as such to be established as a punishable offence” (UN, 1988). Moreover, the term personal use has not been defined in the International drug Conventions (Marks, 2019). The International Conventions rather criminalizes possession with the intention for trafficking and not possession for personal use.

We should not forget that, imposing on this very population with criminal records for the use of cannabis or any other drugs have ripple effects, this very population gradually become the fulcrum of any country's economy so why burden them with criminal records for the rest of their lives for committing just minor non-violent drug offences?

Setting the records straight: Response to CSOs calling for criminalisation of drug use in Ghana

ROME — Growing small amounts of marijuana at home for private use is not a crime, Italy’s top court has ruled, putting an end to a yearslong legal dispute and adding Italy to the short list of countries to allow cultivation of recreational cannabis.

A 1990s law prohibits the cultivation and sale of marijuana in Italy, but conflicting court decisions, and a 2016 amendment that opened a loophole in the law, created confusion over how it should be interpreted.

The country’s highest court appears to have settled at least part of the question, writing in a one-page statement of its findings that “at home, small-scale cultivation activities are to be considered excluded from the application of the penal code.”

The judges produced the document on Dec. 19 and it was first publicized on Thursday by the news agency AGI. A full, detailed ruling remains weeks or months away, so the court’s complete reasoning has not been made public.

Among the unanswered questions is how much cannabis qualifies as “small-scale cultivation,” but the ruling stemmed from a case in which the defendant had two plants.

Growing a little marijuana at home is not a crime, Italy’s top court says

Since September, I’ve asked Vox’s readers to tell me their stories about drug addiction treatment for our Rehab Racket project. In less than four months, we’ve gotten a lot of responses — now more than 1,000.

From all of these experiences, one theme emerges: Addiction treatment in the US is expensive, hard to navigate, and far too often fails people. In the middle of an opioid epidemic that’s helped lead to more than 700,000 drug overdose deaths since 1999, America’s main defense against addiction is deeply flawed.

The stories we’ve published so far speak to these problems. Kim and Tim Blake spent more than $110,000 on treatment for their oldest son, yet much of the treatment was unhelpful and he died anyway. Michel Cote’s daughters went through $200,000 worth of treatment over a decade before they finally found something that worked for them. Nan Warren faces financial ruin after she lost her oldest son to addiction and has spent years trying to avoid the same fate for her surviving daughter.

Health insurance alone is not enough to protect patients from high costs and low quality. Maureen O’Reilly lost her son to addiction after their health insurance plan wouldn’t cover addiction care near home and he was sent to shoddy treatment facilities — some of which were later shut down — in Florida.

Here are four lessons from the project so far -

1) Poor insurance coverage leads to high addiction treatment costs

This is a big problem nationwide: Based on the National Survey on Drug Use and Health, federal researchers estimated that roughly 314,000 people in the US in 2018 needed drug addiction treatment but couldn’t get it because they didn’t have health coverage and couldn’t afford the costs. About 100,000 couldn’t get it because, while they had health coverage, it didn’t cover treatment at all or it didn’t cover the full cost. (There’s some overlap between the groups because participants were able to select multiple responses.)

2) We know disturbingly little about addiction treatment in America

While reporting on addiction treatment in the US and asking experts about the evidence for addiction care, there has been one answer I’ve gotten used to hearing a lot: “I don’t know.”

It was a common response when I asked if certain addiction treatments worked. Many facilities, for example, now use equine therapy, in which patients connect with horses. But we have next to no research on whether this works. The same is true for wilderness therapy that emphasizes outdoors activities, which also has little reliable scientific evidence behind it.

3) We don’t make good use of what we do know about addiction treatment

For example, the research shows that medications for opioid addiction — methadone, buprenorphine, and naltrexone — are very effective: Studies show they cut the mortality rate among opioid addiction patients by half or more and keep people in treatment better than non-medication approaches.

Yet in the US, the majority of addiction treatment facilities don’t offer any medications. According to federal data, only 42 percent of the nearly 15,000 facilities tracked by the Substance Abuse and Mental Health Services Administration (SAMHSA) provide any type of medication for opioid addiction. Less than 3 percent offer all three federally approved medications.

When writing about anything addiction-related, there’s an explanation I can expect for just about any problem: stigma. Indeed, it’s the thing that ties the lessons on this list together.

This has stuck with me ever since I went to Vermont in 2017 to see how the state built up its addiction treatment system. When I asked officials about the hurdles to building up the new system of care, I expected to hear a lot about money (a common problem in policymaking). But officials told me, in fact, that money wasn’t that big of a deal. Instead, the main barrier was stigma around addiction, fueled by the notions that addiction is a moral issue — not a health issue — and people with addiction don’t deserve public resources. Once that stigma was overcome, the money came easily.

1,000 people sent me their addiction treatment stories in the United States. Here’s what I learned

The proposal for a new Norwegian drug policy was tabled by the Drug Reform Committee on Thursday, December 19. The proposal marks a historic step away from punishment as a reaction for use and possession of drugs in Norway. As the title "From punishment to help" indicates, people who use drugs will now be met with offers of help and treatment. Although the use and possession of drugs will still be prohibited, it will no longer be punishable as a criminal offence.

The committee proposes a model where drug users are summoned to a meeting with a municipal counselling service. Although there is a duty to attend, failure to attend will not be punished. The report states: “The duty to attend is intended to clarify that the use of drugs is still illegal, while the meeting itself is intended to provide the basis for people to receive help and follow-up as needed. People will also be informed about potential consequences and risk factors associated with drug use.”

If people are caught with large amounts of drugs, they can be prosecuted for sale or distribution, as is the case today.

Norwegian Drug Reform Committee report: Remove penalties for use and possession

At a seminar held in Brussels today, the Civil Society Forum on Drugs urged the European Parliament to prioritize and fund drug policies based on evidence and human rights.

On 5 December 2019, the EU Civil Society Forum on Drugs (CSFD), an expert group of the European Commission, organized a seminar for Members of the European Parliament (MEPs) entitled ‘The Future of European Drug Policy’.

The event comes at a time when the EU is facing significant challenges in tackling the illicit drug market. Despite the EU’s efforts to counter the drug problem, drug trafficking and production remain among the most profitable criminal activities in the region, while the health and social harms associated with drug use continue to rise, with more than 8,000 drug-related deaths reported in 2019. Drug-related issues affect millions of people within the EU, bringing with them complex health, security, social and criminal justice issues.

The expiry of the current European Drugs Strategy (2013-20) and Action Plan (2017-20) represent a key opportunity to be seized by the EU. It is a chance to review successes and failures of European drug policy and to build on the learnings and challenges from the last decade, by continuing to prioritize a drug policy approach grounded in the principles of public health and human rights.

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