The huge toll that substance use and misuse is having on individuals, families, and communities in the USA has culminated in a major public health crisis that shows few signs of abating. Last week, the US Surgeon General released 

Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health—

the Surgeon General's first-ever statement on this topic. This 426-page report addresses the problem of substance use and the wide range of adverse health effects from alcohol and both legal and illegal drugs. It brings together evidence on prevention; treatment; and recovery interventions, policies, and programmes.

There are some alarming statistics. 20·8 million people in the USA have a substance use disorder, equivalent to the number of Americans with diabetes. In 2014, there were 47 055 drug overdose deaths, 28 647 of which involved prescription opioid drugs and heroin. Of the one in seven Americans (14·6% of the population) expected to develop a substance use disorder during their lives, only one in ten will receive treatment. More than 66·7 million people reported binge drinking in the past month. Alcohol misuse contributes to 88 000 deaths in the USA each year. These numbers do not include the millions of people misusing substances who will later develop a substance disorder.

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

Addressing addiction in the USA

My sincere thanks to the Pontifical Academy of Sciences for holding this very important workshop to strengthen science-based solutions to a problem of great concern to all of the international community.

I would also like to take this opportunity to thank your Majesty, for your dedicated efforts to prevent drug abuse around the world, and for your long-standing support for the work of the UN Office on Drugs and Crime, including our launch of the Listen First prevention campaign in New York during the recent UN General Assembly Special Session on drugs (UNGASS).

Today, I would like to focus on the outcomes of the UNGASS and their impact on the international drug control system.

Remarks at the Pontifical Academy of Sciences workshop on narcotics: Problems and solutions of this global issue

Early this year, a disabled former automobile body worker named Greg Vialpando explained to lawmakers in New Mexico how medical marijuana helped his chronic back pain.

State legislators were considering a bill backed by workers’ compensation insurers that would have exempted them from paying for medical marijuana. But Mr. Vialpando and another patient described how smoking the drug let them escape years of stupor caused by powerful prescription narcotic drugs known as opioids.

The lawmakers ended up dropping the bill, and Mr. Vialpando’s expenses for buying marijuana are covered by insurance.

“I would recommend that people use medical marijuana over opioids any day,” Mr. Vialpando, 58, said in a telephone interview.

For businesses and insurers, a string of ballot victories this month for marijuana advocates are adding to an intensifying conundrum about the drug and issues such as insurance coverage, employee drug testing and workplace safety.

USA: where cannabis is the doctor’s orders, will insurers pay?

This series by InSight Crime takes a look at how the metrics used to measure cocaine production across Latin America do not always reflect the facts.

Challenging the Cocaine Figures, Part I: Bolivia

Cocaine seizures in Bolivia have shot up since 2013, reaching record figures this year. Between January and mid-August 2016, the police's antinarcotics unit (Fuerza Especial de Lucha Contra el Narcotráfico - FELCN) registered 16.7 metric tons of cocaine hydrochloride (HCl) seized -- already nearly double the total figure for last year, when 8.6 metric tons were intercepted.

However, coca base seizures, which have historically been much more substantial than cocaine seizures, have in contrast been decreasing sharply since 2012. (Coca base is a paste that can be further refined into HCl, which is the crystalized form of the drug.) This year, less cocaine base was interdicted than HCl.

Seizure figures can illustrate shifting trends in Bolivian drug production or security strategy. For some critics, rising cocaine seizures have been taken as evidence that Bolivia's drug control situation is deteriorating as a result of President Evo Morales' alternative drug policies. A former coca grower, Morales has adopted a liberal policy that allows for coca to be grown legally and monitored through a "community coca control" system.

Whether or not these concerns are plausible very much depends on which set of statistics is analyzed.

Over the year 2016, Colombia has seized a record 300 metric tons of cocaine, Defense Minister Luis Carlos Villegas told reporters on October 21.

Villegas said the figure was "the highest cocaine seizure statistic in our history."

This total vastly outstrips seizures over the past few years. Authorities intercepted 219 metric tons of cocaine in 2015, 133 metric tons in 2010, and 92 metric tons in 2003, the defense minister stated.

The year's record numbers are likely linked to the recent boom in coca leaf plantations, which doubled in size between 2013 and 2015.

The record figures trumpeted by the Colombian government appear surprising when considering how much cocaine the country is believed to be producing. By US government estimates, Colombia has already seized nearly three-quarters of all the cocaine produced last year -- an estimated 420 metric tons.

By UNODC figures, Colombia has seized nearly half of its estimated pure cocaine production -- which the international body calculated to be far higher at 646 metric tons.

As countries are generally thought to seize about 10 percent of all their illegal drug flow, these figures may seem unrealistic. However, they have some possible explanations.

Challenging the Cocaine Figures, Part III: Peru

At first glance, estimates of Peru's coca cultivation and eradication figures simply don't add up, which has led to claims of statistical manipulation. InSight Crime takes a closer look at the numbers to determine what's behind the discrepancies in the data.

As a drug trafficking expert recently noted, in certain areas of Peru the amount of coca destroyed by the Interior Ministry's eradication program vastly exceeds the estimated number of hectares of coca actually under cultivation. These figures are published yearly by the United Nations Office on Drugs and Crime (UNODC), and are the main source of data for the Peruvian government.

Jaime Antezana, a specialist in drug trafficking in Peru, recently told Diario UNO that this showed that the UNODC and the Peruvian government are publishing false coca crop figures.

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

 Challenging the cocaine figures: Bolivia, Colombia and Peru

The prison population throughout Latin America has been growing steadily for the past few decades. Harsh drug laws and anti-gang policies have led to a massive increase of the number of people incarcerated, leading to overcrowding in underfunded and often neglected penitentiary systems. The majority of prisoners have yet to be tried, and may wait for years for a hearing. In some countries, gangs continue to operate and recruit new members from inside prisons, and gang leaders order extortion and homicides from behind bars.

This phenomenon can be clearly seen in Brazil, which has recently attained the unfortunate distinction of having the world’s fourth highest rate of incarceration. In the last fifteen years, the country’s incarceration rate grew by 7 percent annually, ten times faster than its population growth. Over the past 25 years, Brazil’s prison population rose from 90,000 to almost 600,000. It is projected to rise to 1.9 million by 2030 if current rates persist.

The Brazilian prison system: Challenges and prospects for reform

The meeting with the Minister of Health, Mr. Ksanthos, took place on Monday 14/11/2016, with representatives of the “Greek NGO Platform on Psychoactive Substances”. The meeting took place at the request of partner organizations, which are based on multi and interdisciplinary experience in the implementation of interventions in the field of psychoactive substances and drug policy, presented the priorities and requests to the Minister.

Click here to read the positions and proposals of the platform

NGOs meet with Greek Minister of Health to discuss drug policy reform

Under a flyover of concrete, alongside a road full of afternoon commuters, a group of people flock around a van. One of them, a woman in a colourful summer dress and a golden necklace, looks like she came to see a show at the nearby theatre. However, just like the man in his unwashed jeans in front of her, she is here for her daily dose of methadone. It will get her through the night.

"Drugs started when my father brought me to the south of Portugal, to the Algarve, where I met people who were in the scene," the woman tells Al Jazeera on condition of anonymity.

"Life was glamorous in these days. Everything sparkled. My boyfriend was a dealer, and I started to push drugs for him, too. We made loads of money. Now he is out of my life, but the addiction has always stayed with me."

Portugal: Fifteen years of decriminalised drug policy

People from black, Asian and minority ethnic backgrounds are more likely to be jailed for some crimes than those who are white, according to a government-commissioned report.

While black people are known to be almost four times more likely to be in prison than white people, the study, headed by the Labour MP David Lammy, reveals racial disparities at many stages of arrest, charging, prosecution and imprisonment.

Lammy, the MP for Tottenham in north London, said: “These emerging findings raise difficult questions about whether ethnic minority communities are getting a fair deal in our justice system. We need to fully understand why, for example, ethnic minority defendants are more likely to receive prison sentences than white defendants. These are complex issues, and I will dig deeper in the coming months to establish whether bias is a factor.”

United Kingdom: Ethnic minorities more likely to be jailed for some crimes, report finds

In a display of political discipline and maturity unlike anything we’ve seen in Washington lately, Colombia’s government and the FARC guerrilla group have produced a new peace accord [PDF]. It took them only 41 days to get from the original version’s narrow (50.2 to 49.7 percent) rejection in an October 2 plebiscite, to this new document announced on November 12 and published on November 14.

These 41 days included extensive consultations between government negotiators and representatives of sectors that supported the “No” vote in the October 2 plebiscite, among them former president Álvaro Uribe. The government and “No” supporters came up with a document outlining more than 500 proposed changes to the original 297-page peace accord. Government negotiators then took this package of proposals to FARC leaders in Havana, where they spent about two weeks negotiating around the clock.

The changes to the accord are numerous: see this side-by-side comparison of the old and new accords that somebody helpfully posted to draftable.com. They reveal that the FARC leadership gave ground on several key points. The main ones are the following.

Colombia: Key changes to the new peace accord

President Rodrigo Duterte warned on Friday night that he may be forced to suspend the writ of habeas corpus if lawlessness in the country escalates, but he quickly added that he would not declare martial law.

Mr. Duterte made the statement in a speech after mentioning the rebellion in Mindanao, the worsening battle with the Maute group, and the alleged widespread illegal drug operations in the country. The Maute gang is a self-styled group of militants based in Lanao del Sur blamed for a September bombing that left 15 dead in Davao city.

“If lawlessness becomes widespread, I might be forced to—I don’t want to do it, I don’t want to. It’s just my warning to them. I don’t want it because it’s not good,” Mr. Duterte said in a mix of Filipino and English in a speech at an event to honor his mother’s humanitarian efforts.

Duterte warns of suspension of habeas corpus writ

The Forum, chaired by Maria Phelan (Harm Reduction International) and Fay Watson (EURAD) is a diverse group of NGOs representing different fields, regions and ideological approaches. It has four working groups. The first, led by Marie Nougier from the International Drug Policy Consortium, is the biggest and busiest. It coordinates institutional relations with the EU – that is, it feeds into the discussions at the Horizontal Working Party on Drugs (HDG), the monthy decision-making forum of the EU Council, where all member states represent themselves. This twenty-member working group has submitted several papers to the HDG, and its recommendations were reflected in the EU's position at the UN General Assembly Special Session on Drugs in April, 2016.

The fact that the EU has championed the cause of abolishing the death penalty, as well as harm reduction and access to essential medicines, was partly the result of the intensive advocacy efforts of the CSF, which continues to provide advice to EU member states, both in implementing the UNGASS outcome document, and in preparing for the next big global UN drug policy meeting in 2019. The group is calling for more emphasis on public health, human rights and civil society participation. Issues such as the legal regulation of drugs divide the Forum, which is an ideologically-diverse group of NGOs.

EU Civil Society Forum on Drugs calls for more inclusion

Sometimes good news can distract you from what's going wrong under the surface. Earlier this month, the UK reported a 79% drop in the number of 18-to-24 year olds seeking treatment for heroin dependence. It was hailed as a success by anti-drug campaigners, but these figures mask worrying trends in the response to drug use.

As Harm Reduction International (HRI) report today shows, we're seeing a sudden decline in efforts to get health interventions like needle and syringe programmes (NSPs) and opioid substitution therapy (OST) to people who inject drugs. These interventions are part of the harm reduction approach to drug use. It's about trying to reduce the negative health, social and human rights impacts of drug use and policy, rather than just focusing on criminal justice.

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