The United States surgeon general issued a rare national advisory on Thursday urging more Americans to carry naloxone, a drug used to revive people overdosing on opioids.

The last time a surgeon general issued such an urgent warning to the country was in 2005, when Richard H. Carmona advised women not to drink alcohol when pregnant.

Naloxone is a medication designed to immediately reverse an opioid overdose. It blocks the brain’s opioid receptors and restores normal breathing in people who have overdosed on fentanyl, heroin or prescription painkillers. Its effects last for 30 to 90 minutes, which ideally buys enough time to get medical attention.

“Active drug users, people who live with or love drug users, and people on methadone or buprenorphine, who are often coming out of treatment and know people at high risk of overdose,” said Robert Childs, executive director of the North Carolina Harm Reduction Coalition in Wilmington, N.C. The surgeon general also listed patients who take high doses of prescribed opioids.

People who are coming out of prison or detox programs should carry the drug, because detox lowers tolerance, Mr. Childs said. Those who work in places where there are public bathrooms or where drug users congregate, such as shopping center parking lots, should consider getting trained to use naloxone and keep it on hand.

Naloxone stops opioid overdoses. How do you use it?

When the wave of adult marijuana legalization in some states started in 2013, the position of the federal authorities regarding the government’s international obligations to prohibit drugs was based on a flexible interpretation of the United Nations drug conventions, commonly known as the Brownfield doctrine. The legality of this interpretation has been questioned by the U.N. convention-control bodies. But as the U.S. administration grows more suspicious of multilateralism, is the United Nations still equipped, technically and politically, to be heard?

At the U.N. Special Session on drugs (UNGASS) held in 2016, almost every country that spoke in the General Assembly hall emphasized how high drugs were on their national agendas. Yet they all agreed that the 2019 review of the decennial U.N. political declaration and the plan of action on drugs would take the form of simple ministerial meeting at a subsidiary U.N. commission based in Vienna, the Commission on Narcotic Drugs (CND). This can be interpreted as proof that drug policy is not taken as seriously, despite how it impacts people’s lives on the ground.

International drug policy is different from other highly covered topics in the multilateral system for one main reason: no global player or P5 member has any apparent interest in opening a reform discussion, unlike for environmental, HIV or migration policies that benefit from large human, financial and communication resources.

The United States, which initiated the global war on drugs over 50 years ago, finds itself in a situation where its states are legalizing cannabis by ballot or legislative votes in contradiction with the U.N. drug conventions, while the country faces an unprecedented opioid overdose crisis that undermines every belief that prohibition results in effective drug control or is able to act as a deterrent for use.

International drug policy: Is the UN becoming irrelevant?

David Lammy MP is one of many who has suggested that a tougher approach to drug law would reduce knife crime..

This morning, during an interview about London's soaring knife crime problem, David Lammy MP told BBC Radio 4's 

 programme that "the police and our country has lost control of [the] drugs market". To some degree, he's right – but arguably, neither the government nor law enforcement ever had control of the drugs market in the first place, something the Home Office acknowledged in a 2017 report evaluating the national drugs strategy.

Lammy rightly said "there is no single cause" for the spike in fatal stabbings, but in denouncing the police's approach also seemed to be arguing that more drug policing would lead to a reduction in violent crime – a sentiment echoed by many on social media. The evidence, however, would suggest otherwise.

If politicians and police really want to tackle the rise in knife crime, drug policy reform is an important part of the solution. We should move away from the same old prohibitionist policies and instead focus on implementing strategies that treat drug use as a health and education issue, rather than a criminal justice matter. In recent weeks we have increasingly heard calls for an intensification of stop-and-search to tackle knife crime. However, these calls fail to properly analyse how this police power is currently used in London and how stop-and-search can contribute to young people losing trust in the police, leading them to take matters into their own hands.

Harsher drug policing will not stop knife crime in the United Kingdom

A new app has been launched to help the thousands of people prosecuted for drug possession every year in England and Wales.

 was developed by lawyers at Release, the UK’s centre of expertise on drugs and drug laws. It provides a step-by-step guide for dealing with a drug possession offence, including informing people of what to say and do in the police station and in court. The aim of the app is to get the best possible result for the individual depending on their personal situation.

As government data shows, a huge number of people continue to face criminal convictions for possessing small quantities of drugs for personal use. In 2016, a staggering 23,000 people in England and Wales were prosecuted for simple drug possession, among which 95 per cent were found guilty.

Due to government cuts to legal aid, most people who are prosecuted for simple drug possession in the UK are required to represent themselves in court – without a lawyer – if they cannot afford to pay for representation. If a person representing themselves fails to put forward relevant mitigation, or fails to accurately demonstrate their financial circumstances, they may face a harsher sentence or financial penalty. Essentially, under current conditions, poorer people may face unfair and disproportionate legal consequences for simple drug possession.

For example, someone found in possession of cannabis for personal use for the first time should receive a cannabis warning. However, someone without legal representation may be unaware of this, and may then accept a caution or conviction for cannabis possession, both of which can have far-reaching consequences - from hindering job applications to disqualifying them from obtaining certain international visas.

These consequences of criminalisation are compounded for people who have other issues besides their drug charge – including people with mental health problems or dependencies on drugs or alcohol – as their ability to represent themselves may be hindered further.

Kirstie Douse, Release’s head of legal services, said that the 

app will help address this inherent inequality in the UK’s legal system.

“It goes beyond providing knowledge of legal process and principles, and helps reduce the harms caused by the criminalisation of drug possession. We hope that this tool empowers people to engage with the law in order to ensure that it is applied accurately and fairly, preventing poor decisions.”

New app will help if you’re arrested for drug possession in the United Kingdom

On May 9-10, the board of the Global Fund to Fight AIDS, TB and Malaria will meet in Skopje, Macedonia to approve a new policy on which countries are eligible for funding.

I’ve been immersed in this labyrinthine policy as a consultant for the three civil society delegations on the board of the Fund: Developing Country NGO Delegation, Developed Country NGO Delegation and Communities Delegation. They came together to press for an overhaul of the policy. For a variety of reasons, that didn’t happen.

But there has been some progress; there are some big questions for civil society to weigh in on before May, and some critical areas to monitor if the current version is approved. Here’s an overview: heads up, it’s a long blog.

Why an eligibility policy? Funds are limited, lives are literally at stake, and difficult choices must be made about where to invest. What are the principles that should be used when you’re facing three global crises – the epidemics of HIV, TB and malaria? This is not just a question of health economics – it is also an ethical challenge.

It’s a problem that dates to the beginning of the Fund, when grants were in the millions, not hundreds of millions. To solve it, the World Bank offered to draft an approach. Sixteen years later, with over $10 billion to allocate, the criteria the World Bank identified over a decade ago still define Global Fund eligibility: national income and disease burden.

Changes to the Global Fund eligibility policy: An overview

The Zimbabwe government has been called upon to decriminalise drug use in the country and instead put in place measures that will allow users to access, treatment, counselling and rehabilitation at public health centres.

The call was made by Wilson Box, the Zimbabwe Civil Liberties and Drug Network director at a workshop on; “Mainstreaming drug use harm reduction in public health and community development interventions,” held at the ZESA Training Centre in Harare.

The Workshop was also attended by medical doctors, senior police officers, drug users and officials from various non-governmental organisations in public health delivery.

Presenting a paper titled; “Illicit drug use in Zimbabwe and Drug Policy Reform”, Box said there was need in Zimbabwe to decriminalise drug use.

“Decriminalising drug use is not legalising use of illicit drugs. But it is putting in place measures that will allow users to have access to treatment, counselling and rehabilitation,” he said.

Zimbabwe Civil Liberties and Drug Network April Update

As more countries move away from drug prohibition, Indonesia is about to step up its efforts to defend it. Proposed revisions to the country's criminal code promote harsh penalties for the use and possession of narcotics - including society's ultimate sanction, the death penalty - instead of a health-oriented approach. Rather than enabling a safer, healthier future for the world's fourth largest population, the changes guarantee a surge in prison overcrowding, inflated public health costs, decreased access to health care, and increased drug trafficking, availability, and misuse.

The current criminal code (KUHP) is nearly identical to the penal code issued by the Dutch colonial authorities in 1918, which was retained when Indonesia gained independence in 1945. Its long-overdue revamp, which is in the final stages of deliberation in the House of Representatives, contains a new set of alarming provisions, including some that criminalise homosexuality, extramarital sex, and criticism of the president.

The latest draft revisions have been widely condemned by rights organisations. The United Nations human rights chief deemed the proposed amendments "inherently discriminatory", arguing that their sanctions fall disproportionately on the most marginalised segments of society. Last month, activists from the so-called Civil Society Alliance to Reject the Draft Criminal Code organised several protests rejecting the parliament's proposals. Indonesia's National Commission on Human Rights warnedagainst the rushed adoption of the current criminal code revisions, calling for more input from the public.

Yet while the media and public have focused on the wider set of KUHP amendments, the inclusion of strict penalties for non-violent drug users has nearly slipped in unnoticed.The draft bill contains 22 articles on the use, possession, couriering, and smuggling of narcotics, all of which are treated as criminal offenses punishable with jail time, or in severe cases, death by firing squad.

Indonesia criminal code overhaul a step backwards for drug policy

The nation’s chief doctor wants more Americans to start carrying the overdose antidote naloxone to help combat the nation’s opioid crisis and save lives.

Speaking at the National Rx Drug Abuse & Heroin Summit in Atlanta on Thursday morning, U.S. Surgeon General Dr. Jerome Adams issued his office’s first national public health advisory in 13 years.

Adams said he hopes those who are at risk — as well as their friends and family members — will keep the antidote on hand and learn how to use it.

“You don’t have to be a policeman or a firefighter or a paramedic to save a life,” said Adams, who pointed out that more than half of opioid overdose deaths in the U.S. occur at home.

According to federal data, more than 42,000 Americans suffered fatal opioid overdoses in 2016, more than double the number who died in 2010.

Naloxone can restore a person’s breathing after it is injected or sprayed in the nostrils, quickly bringing overdose victims back from near-death.

The drug, which is often referred to by the brand name Narcan, is available without a prescription in most states and is regularly used by first responders across the country. Another product, Evzio, is available with a prescription and delivers naloxone via a hand-held auto-injector.

Adams said 95 percent of all insured Americans are covered to purchase naloxone. First responders and community organizations can purchase Narcan nasal spray, one of the most widely available products, at group discounts of $37.50 per dose, drugmaker Adapt Pharma said in a news release.

Opioid crisis in the US: Top doctor urges access to overdose antidote

OPEN LETTER TO NETFLIX CEO MR. REED HASTINGS

Immediately cancel the streaming of “AMO” that promotes war on drugs in the Philippines – #CancelAMO

Bangkok (April 6, 2018) – The Asian Network of People who Use Drugs (ANPUD) and the International Network of People who Use Drugs (INPUD) have released an open letter to Mr. Reed Hastings, Chief Executive Officer (CEO) of Netflix. In the letter, the two human rights organizations demand that Netflix immediately cancel plans to stream the Philippines drug war series 

 that actively promotes murder, extrajudicial killings, violence, and the war on drugs in the Philippines.

The organizations believe that “AMO” actively promotes the state-sanctioned extrajudicial killings of tens of thousands of Filipinos, the state-endorsed murders of more than 20,000 people[i] – many of them children – ostensibly suspected of using or selling drugs since June 2016. Filipino President Duterte’s war on people who use drugs, that is often referred to as a ‘War on Poor’, has brought destitution and anguish to hundreds of thousands of lives, including thousands who are imprisoned under inhumane conditions.

“First Apple and Google made those insensible games available through their app stores. Now 

 is promoting Duterte and his bloody war on people who use drugs as the right thing to do. Seriously, what is wrong with the corporate sectors?”, said Anand Chabungbam, Regional Coordinator of the Asian Network of People who Use Drugs (ANPUD). “Apple did the right thing by removing those games and we truly expect nothing less from Netflix”, he added.

In February 2018, the ICC launched an initial inquiry into allegations of crimes against humanity committed by Duterte in his brutal anti-drugs crusade.[ii]Supporters of Duterte and his war on drugs in the Philippines have been developing mass media tools to counter national and international criticisms. Different smartphone apps, short films and television programs like “AMO” are the means by which Duterte maintains and cultivates his public image.

Executive Director of INPUD, Judy Chang says, “Glorifying President Duterte’s war on drugs is the glorification of mass murder, killings and human rights abuses. This has real implications for causing further harm to the lives of people who use drugs, their families and communities in the Philippines and beyond. The lives of people who use drugs – our lives – are not tools and instruments to be used for political capital nor public entertainment”.

It is entirely inappropriate and grotesque for Netflix to be promoting a drug war that has resulted in thousands of brutal murders. The open letter urges that Mr. Hastings:

undertakes a formal review of the series “AMO” in light of the human rights principles and the ongoing crisis in the Philippines.Immediately cancels the streaming of “AMO”.

References:[i] Senator: Rodrigo Duterte’s drug war has killed 20,000: https://www.aljazeera.com/news/2018/02/senator-rodrigo-duterte-drug-war-killed-20000-180221134139202.html[ii] ICC launches crimes against humanity inquiry into Duterte’s war on drugs: https://www.theguardian.com/world/2018/feb/08/icc-claims-crimes-against-humanity-duterte-philippines

Please, consider signing this petition by Luzviminda Siapo, an overseas Filipino worker, whose 19-year-old son was tortured and killed amidst the Philippine war on drugs

Duterte’s drug war is star of first Filipino drama on Netflix: https://www.thenational.ae/arts-culture/television/duterte-s-drug-war-is-star-of-first-filipino-drama-on-netflix-1.717895

The Philippines’ Duterte Incites Vigilante Violence: https://www.hrw.org/news/2017/04/19/philippines-duterte-incites-vigilante-violence

“License to Kill” Philippine Police Killings in Duterte’s “War on Drugs”: https://www.hrw.org/report/2017/03/02/license-kill/philippine-police-killings-dutertes-war-drugs

Philippine police kill 32 in bloodiest night of Duterte’s war on drugs: https://www.theguardian.com/world/2017/aug/16/philippines-police-bloodiest-night-duterte-war-drugs

Philippines: Duterte Threatens Human Rights Community: https://www.hrw.org/news/2017/08/17/philippines-duterte-threatens-human-rights-community

Secretary-General’s remarks at the UN Correspondents Association Reception: https://www.un.org/sg/en/content/sg/statement/2016-06-08/secretary-generals-remarks-un-correspondents-association-reception

Statement by the UNODC Executive Director on the situation in the Philippines: http://www.unodc.org/unodc/en/press/releases/2016/August/statement-by-the-unodc-executive-director-on-the-situation-in-the-philippines.html

INCB expresses concern about reports of violence against persons suspected of drug-related crime and drug use in the Philippines: https://www.incb.org/incb/en/news/press-releases/2016/press_release030816.html

Int’l Criminal Court chief prosecutor warns PH over drug killings: http://cnnphilippines.com/news/2016/10/14/Intl-Criminal-Court-chief-prosecutor-warns-PH-over-drug-killings.html

45 UNHRC members call for end to killings: http://www.philstar.com/headlines/2017/05/12/1699064/45-unhrc-members-call-end-killings

Over 300 NGOs call on the United Nations to take immediate action on the hundreds of extrajudicial killings of suspected drug offenders in the Philippines: http://idpc.net/media/press-releases/2016/08/over-300-ngos-call-on-the-united-nations-to-take-immediate-action-on-the-hundreds-of-extrajudicial-killings-of-suspected-drug-offenders-in-the-philippines

‘Mass murder’ complaint filed against Philippines’ President Duterte at ICC: https://www.theguardian.com/world/2017/apr/25/mass-complaint-launched-against-philippines-president-duterte-at-icc

ICC launches crimes against humanity inquiry into Duterte’s war on drugs: https://www.theguardian.com/world/2018/feb/08/icc-claims-crimes-against-humanity-duterte-philippines

Darker and more dangerous: High Commissioner updates the Human Rights Council on human rights issues in 40 countries – Human Rights Council 36th session, Opening Statement by Zeid Ra’ad Al Hussein, United Nations High Commissioner for Human Rights: http://www.ohchr.org/EN/NewsEvents/Pages/Media.aspx?IsMediaPage=true

Apple removes Philippines leader Duterte execution games: http://www.bbc.com/news/world-asia-42165328 | http://www.anpud.org/apple-removes-games-promoting-dutertes-war-drugs/

Open letter to Netflix CEO: Immediately cancel the streaming of “AMO”, which promotes the war on drugs in the Philippines

Chemsex has led the French community-based HIV organisation AIDES to bring two previously separate strands of its work together, Fred Bladou told the recent European Chemsex Forum in Berlin. AIDES began to talk about drug use with gay men and to talk about sexuality with people who inject drugs, he said.

The first part of its strategy was to develop a new approach to sexual health promotion and education. On the edge of Paris’ gay district le Marais, AIDES has opened a community health centre called ‘Le Spot’ that provides HIV testing, easy access to condoms and other prevention materials, and helps develop community understanding of pre-exposure prophylaxis (PrEP) and undetectable = untransmittable (U=U). There is also a strong emphasis on peer support, including weekly peer-to-peer meetings for men involved in chemsex - described as a space that allows men to be listened to and supported, recreating social connections for men who have become isolated.

The second part of the strategy was to develop a new approach to harm reduction, including adapting it to a new population who are taking different substances. Education is provided on safer injecting practices, including staff observing an individual’s injecting practice and giving feedback on how it could be safer. Users can bring substances they have purchased in for testing, to better understand what drugs they are actually taking. Sterile equipment is provided.

A similar approach has been taken in 15 French cities where AIDES works and where chemsex is an issue. Outreach is done at private sex parties, saunas and sex clubs. The organisation also moderates a private Facebook group with around 1200 participants and a WhatsApp group, both of which allow men to share information and feel less isolated.

Stephan Vernhes of AIDES said that the weekly Paris meetings were attended by around 15 men each time, with a total of around 180 men attending in the past year. Establishing ground rules was crucial to creating a safe space, Vernhes said. Each week, participants are reminded of guidelines on non-judgement, confidentiality, active listening and related issues.

To maintain interest, different themes are addressed each week, such as sexuality and pleasure; dealing with cravings; screenings of documentaries on drug issues; and presentations by sexologists, psychiatrists and addiction specialists. As an increasing number of participants now have a goal of abstinence, some sessions now address life without drugs or sex without drugs.

The chemsex response is reshaping sexual health services and reinventing harm reduction

Tutorial on overdose intervention by Villa Maraini Foundation

Politicians often escalate drug war rhetoric to show voters that they are doing something. But it is rare to ignore generations of lessons as President Trump did earlier this month when he announced his support for the execution of drug traffickers.

This idea is insane. But the war on drugs has never made any sense to begin with.

Executing a few individual smugglers will do little to stop others because there is no high command of the international drug trade to target, no generals who can order a coordinated surrender of farmers, traffickers, money launderers, dealers or users. The drug trade is diffuse and can span thousands of miles from producer to consumer. People enter the drug economy for all sorts of reasons — poverty, greed, addiction — and because they believe they will get away with it. Most people do. The death penalty only hurts the small portion of people who are caught (often themselves minorities and low-level mules).

Indeed, on the ground, the threat of execution will even help those who aren’t caught because they can charge an increased risk premium to the next person in the smuggling chain. The risk of capture and punishment increases as drugs move from farm to processing lab, traversing jungles, through cities, across oceans, past borders, distributed by dealers and purchased by consumers. The greater the risk to smugglers in this chain, the more they can demand in payment.