Federal and provincial governments agree the death toll from opioid overdoses amounts to a national health crisis.

In British Columbia — where the situation has been declared a public emergency — advocates say a "safe supply" of drugs is needed.

Exactly what it sounds like. In a February 2019 'concept document' provided to Vancouver City Council, the Canadian Association of People Who Use Drugs describes "safe supply" as "a legal and regulated supply of drugs with mind/body altering properties that traditionally have been accessible only through the illicit drug market."

The supply would include heroin and other opioids, cocaine, crystal methamphetamine, hallucinogens such as MDMA and LSD, and marijuana — free of charge.

Thousands of Canadians have lost their lives to the opioid crisis in recent years. The dead include people of all ages from every walk of life.

Last July, the City of Vancouver approved a "safe supply statement" to share with other levels of government and to advocate for access to a regulated drug supply.

"We often hear this crisis referred to as an overdose crisis, but really, we are in a drug poisoning crisis," the statement reads.

"One of the primary causes of overdose is the contamination of the illicit drug supply, and we believe that future deaths could be prevented if people could access a regulated safe supply."

What is a 'safe supply' of drugs and how would it work in British Columbia?

By Catherine Cook / Harm Reduction International and FCAA

What are the possible reasons a donor might begin/enter into funding harm reduction work?

Donors choose to fund harm reduction because it is evidence based, cost-effective, and has been proven to reduce HIV transmission. We will not end AIDS by 2030 without a significant scale-up of harm reduction programming:

 There is an abundance of scientific research showing the effectiveness of harm reduction interventions in preventing HIV infection. The priority interventions for people who inject drugs – as outlined in World Health Organization, United Nations Office on Drugs and Crime, and UNAIDS technical guidance – are needle and syringe programmes and opioid substitution therapy. However, only 1% of people who inject drugs live in countries with high coverage of harm reduction interventions. Consequently, HIV infections among people who inject drugs continue to rise in many countries in the world, particularly in Eastern Europe and Central Asia, and the Middle East and North Africa. Funding for harm reduction in low- and middle-income countries falls far short of need. Harm Reducation International (HRI) research found this to reach only 13% of the $1.5 billion that UNAIDS estimate is required to cover 90% of people who inject drugs with services by 2020.

Harm reduction has been demonstrated to be a high impact, “value for money” investment for donors. Harm reduction interventions are relatively inexpensive to implement and are proven to be cost-effective HIV prevention measures. HRI summarised some of this evidence in our report 

The Case for a Harm Reduction Decade: Progress Potential and Paradigm Shifts

 (p.11). It is becoming increasingly important for civil society and community advocates to be able to convey cost-effectiveness evidence when advocating for harm reduction funding.

Resourcing harm reduction blog series: Harm Reduction International

MANILA (Reuters) - The Philippines will not allow visits by the United Nations to investigate its bloody war on drugs, its foreign minister said on Wednesday, calling its human rights experts “bastards” who had already demonstrated prejudice.

The United Nations Human Rights Council approved a resolution in July to compile a comprehensive report on President Rodrigo Duterte’s three-year crackdown, during which at least 6,700 people have been killed in what police say were shootouts with dealers who resisted arrest.

Thousands of mostly urban poor drug users have also been killed, many in mysterious circumstances. Human rights groups accuse police of systematic cover-ups and summary executions of anyone associated with drugs, which police reject.

Asked in a television interview if U.N. investigators would be allowed to work in the Philippines, Foreign Secretary Teodoro Locsin said: “No. Because they have already prejudged.”

'Not a chance' - Philippine minister says no access for U.N. drugs war probe

Despite recommendations of global community-led networks, the International AIDS Society (IAS) have chosen the United States as the site for its next International AIDS Conference in 2020. We will not be participating in this 2020 International AIDS Conference being organised in San Francisco and Oakland. We are proud to stand in solidarity with GNP+, ICW, NSWP, MPACT, ITPC, and with Mexican HIV activists and networks of people who use drugs, who are working hard to plan a community centred, alternative gathering to be held between the 5th and 7th July 2020.

The IAS decision to hold the AIDS Conference in the United States shows a disregard for their own organisational values, which include an explicit focus on human rights and inclusivity, whilst encouraging meaningful engagement of people living with HIV and key populations. Moreover, it highlights a concerning willingness to ignore community voices and further marginalise and exclude already marginalised and discriminated against populations.

INPUD Statement: HIV2020

 in June, Junnosuke Taguchi was just another pop star-turned-minor actor. Dressed in funereal black, Mr Taguchi prostrated himself in contrition before a scrum of reporters after his release on bail for drugs charges. A police raid on his apartment in Tokyo had uncovered rolling papers, a seed-grinder and 2.2 grams of marijuana (enough to roll a couple of joints).

While other countries legalise marijuana or instruct the police to turn a blind eye to casual use, Japan maintains strict prohibition. Possession is punishable by up to five years in prison—seven if the intent is to profit from distribution. Teams of detectives are dispatched to raid the homes of pot-smokers in remote rural areas. Every summer police comb the cooler northern countryside for wild cannabis, methodically pulling up millions of plants and incinerating them in bonfires.

Strict enforcement of the Cannabis Control Act leaves most young people with little exposure to the sort of drug-taking that is commonplace elsewhere, says an official with the justice ministry, and so narrows the “gateway” to harder substances. Hard drugs are indeed vanishingly rare: police reported only 14 heroin-related crimes last year. But the anti-cannabis regime is not purely punitive. Nearly half of offences go unprosecuted, and even those that are often end in suspended sentences. The emphasis, at least for young, first-time offenders, is on rehabilitation.

Read the full article here (restricted access).

Japanese law and social mores still treat users of "soft" drugs severely

People on the front lines of the opioid crisis have long said creating a supply of clean drugs and removing the criminal element will cut down on the number of people dying of overdoses in British Columbia.

Over 4,500 people have died from drug overdoses in B.C. since 2016, the year the province declared a public health emergency, and coroners reports show fentanyl was involved in approximately 85 per cent of those deaths.

As the body count mounts, the calls from health-care workers, addiction specialists and politicians for decriminalization and a safe drug supply are getting louder.

Last month, the B.C. Nurse Practitioner Association and the Harm Reduction Nurses Association, representing thousands of nurses, called on the province to decriminalize drugs. This month, the City of Vancouver released a video calling for a regulated safe supply. On Wednesday, addiction medicine physician Derek Chang published an op-ed calling on Canadians to make decriminalization a federal election issue.

Melissa Nicholson, a clinical nurse educator at Providence Health Care's Urban Health Program, said the overdose prevention site at Vancouver's St. Paul's Hospital has had 12,400 visits since it opened in May 2018. She said the opioid epidemic is so bad because of the abundance of contaminated street drugs.

"I think a lot of people would advocate that a regulated drug supply is really what we need to be seeing," she said, adding that frontline workers do not have anything but band-aid tools to help addicts for the time being.

'We don't have a choice': Experts call for the decriminalisation and safe supply of drugs in British Columbia

The NCPI Data Platform is the online platform for policy data related to the AIDS response collected in line with the global commitments outlined in the 2016 United Nations Political Declaration on Ending AIDS by UNAIDS and the World Health Organization (WHO). The purpose of the platform is to make policy data available, promote accountability and support joint analysis of policy information with other relevant data to inform national AIDS responses.

The main data source is the National Commitments and Policy Instrument (NCPI), a component of Global AIDS Monitoring (GAM). The 2016 Political Declaration adopted at the United Nations General Assembly High-Level Meeting on Ending AIDS in June 2016 mandated UNAIDS to support countries in reporting on the commitments in the Political Declaration. UNAIDS, WHO and the United Nations Children’s Fund have collected country progress reports from United Nations Member States to monitor the current and previous political declarations every two years since 2004 and every year since 2012.

The NCPI has been a component of global AIDS monitoring since 2003 and was implemented every two years until 2014. The NCPI underwent an extensive review between 2014 and 2016. The new version of the NCPI was implemented for the first time in 2017; it is included in GAM every two years. A shorter questionnaire consisting of a subset of NCPI questions is included in GAM during interim years.

The NCPI is a questionnaire consisting of two parts: part A, completed by national authorities, and part B, completed by civil society representatives and other nongovernmental partners involved in the AIDS response. During the recommended process for completing the NCPI and GAM reporting overall, countries are encouraged to conduct a validation workshop to jointly analyse indicator data, including on AIDS expenditure, and policy data, in order to identify progress, gaps, challenges and the next steps towards national targets and commitments.

UNAIDS: Laws and policies analytics

Instead of stemming the flow of narcotics, the global “war on drugs” has only managed to cause untold suffering to millions of people across the world. The voice of communities involved in illicit cultivation have long been excluded from national and international policymaking platforms. What alternative approaches are there to current regime? Is it possible to put human rights first? Guests: 

Martin Jelsma: Director Drugs & Democracy programme, TNI.

TNI's State of Power podcast: Alternative approaches to drug policy 

By Australian Associated Press and Guardian staff

Welfare recipients who test positive for drugs will be placed on income management under draft laws to go to federal parliament next week.

A previous bill stalled in the Senate amid concerns about unfairness, and lapsed at the end of the last parliament.

If passed, a two-year drug testing trial will be rolled out in three locations – Logan in Queensland, Canterbury-Bankstown in New South Wales and Mandurah in Western Australia.

About 5,000 new recipients of Newstart and the youth allowance will be tested for ice, ecstasy, marijuana, cocaine and heroin.

Anyone testing positive will be placed on income management for a period of 24 months or the duration of the trial.

'Demeaning': Critics condemn reintroduction of bill to drug test welfare recipients in Australia 

Idris Azizi speaks softly when he relates how, as a person living with HIV, he was told to sit in the trunk of a car, with the door open, when traveling to a 2017 Global Fund committee meeting in Kabul, Afghanistan. The two doctors from the Ministry of Public Health with whom he was traveling sat in the car cabin.

“The [committee] members were not comfortable with me⁠—these were doctors,” Azizi (pictured above, right) told 

. “When they were going to the oversight meeting⁠, they did not tell me. They didn’t share the schedule, the meals, the car,” he said, referring also to the per diems that cover costs during official meetings. “And the one time that they did share the car, they put me the trunk.”

With his easy-going demeanor, he could easily be talking about an unfortunate misunderstanding. But Azizi is an official spokesperson for PLHIV, or People Living with HIV, and paid a monthly stipend of 10,160 AFN a month ($129) through Afghanistan’s Global Fund. He speaks on behalf of Afghans who do not feel safe disclosing their HIV status.

The Global Fund, which was set up by the United Nations, describes itself as an organization dedicated to fighting AIDS, tuberculosis and malaria, all of which are present in Afghanistan. To ensure that people directly impacted by these diseases have a say in how resources are used within their countries, the Fund set up the Country Coordinating Mechanism (CCM), with an oversight committee made up of community members, like Azizi, as well as technical experts, such as the doctors who shunned him.

Afghanistan struggles with insecurity, ongoing war, poverty and one of the highest unemployment rates in the world. In a country where the poppy harvest produces more than 90 percent of the world’s illicit heroin, despite the US military’s failed efforts to prevent this, opiates have provided solace to populations affected by mental traumas or physical health issues. People use them to manage stress and physical pain. But visible use can lead to people being pushed from society.

The empowering and dangerous work of harm reduction in Afghanistan

Johns Hopkins University is ready to study the benefits of tripping.

The university is launching a Center for Psychedelic and Consciousness Research within John Hopkins Medicine. It's believed to be the first of its kind in the U.S. and the largest research center of its kind in the world, according to the school.

"Johns Hopkins is deeply committed to exploring innovative treatments for our patients," said Paul B. Rothman, dean of the medical faculty at the Johns Hopkins University School of Medicine, in a statement. "Our scientists have shown that psychedelics have real potential as medicine, and this new center will help us explore that potential." The center is funded by a group of private donors, who collectively donated $17 million to start the center. Its focus will be on how psychedelic drugs affect the brain -- looking specifically into brain function, behavior, learning and memory, the brain's biology and mood. That also means that the center will research the medical benefits of psychedelics. The center has already said its researchers will study psilocybin, the chemical naturally found in "magic mushrooms," and see whether the compound helps with things like opioid addiction, Alzheimer's disease, post-traumatic stress disorder, post-treatment Lyme disease, anorexia and alcohol use in people with major depression.

Johns Hopkins has launched the first center devoted exclusively to researching psychedelic drugs in the U.S.

To promote the development of medical marijuana products, U.N. member state Thailand has removed low-level cannabis and hemp extracts from its banned narcotic substances list, according to officials. Hemp seed and oil derivatives will be allowed.

Thailand legalized medical marijuana last year.

“The intention is to allow extracts to be used in medicine, cosmetics and food and support hemp as a cash crop,” Tares Krassanairawiwong, Secretary-General of the Food and Drug Administration in Thailand, told reporters.

“So far, only hospitals and research facilities are allowed to apply for licenses to develop medical extracts from cannabis, but businesses see an opportunity,” according to 

CBD extracts from cannabis and hemp plants containing less than 0.2% THC, were removed from the Category 5 narcotics scheduling, according to a Thai regulator. Under the terms of Thailand’s Measure for Suppressing Narcotic Offenders Act, which is similar to the United States’ current federal drug scheduling system, Category 5 includes psychedelic mushrooms, cannabis and kratom. Category 5 drug offenses are actionable by up to 15 years in prison and fines of up to 1.5 million baht ($48,954).

Vertical integration for cannabis is limited to licensed domestic producers for five years to protect the nascent industry, according to Tares. However, reviewing regulations that would allow businesses to apply for permits is currently underway.

Upwards of 334 permits are already issued, primarily to hospitals and health agencies, according to the FDA website.