In the Republic of Georgia, there is one crime that is punishable with more prison time than rape or even murder: possession of more than one gram of heroin, regardless of intent.

Georgia positions itself as a model for government reform and new thinking. We have one of the youngest prime ministers in the world and government buildings of glass to symbolize transparency and visible change. But on drugs, old-school punitive policies remain the norm. Starting in 2007, the government enacted a policy of wide-scale street sweeps, drug testing, crippling fines, and harsh sentences.

Each year, police in Georgia detain tens of thousands of people in the streets and subject them to urine drug tests. If this single test is positive (contrary to standard practice, no confirmatory test is used) a fine equaling twice the monthly salary of the average Georgian is imposed. Subsequent positive tests during a 12-month period can result in prison time.

A new study by me and colleagues from the addiction research center Alternative Georgia takes a hard look at the impacts of this approach. We found that these punitive measures didn’t stop people from using drugs—in fact, 89 percent of people punished for drug use after positive urine tests returned to drugs immediately.

But the street sweeps did result in behavior change, though presumably not the kind authorities intended: drug users adopted risky practices to avoid being identified by the police.

For instance, many people switched from heroin to buprenorphine or amphetamines to evade standard the drug tests. These drugs are commonly used in a way that requires a group of injectors to collaborate, either because the drug is expensive or because a group of people is required to procure and cook the substance. In either instance, injection often happens with several people sharing a common container, filters, or large-volume syringes used for loading smaller syringes, increasing the risk of blood-borne infections.

Chemicals are used for processing many of the homemade stimulants and opioids that people switched to in order to avoid police detection. Some of these—such as phosphorus, iodine, potassium permanganate, and gasoline—cause serious soft tissue damage, necrosis, gangrene, and neurological side effects.

Police crackdowns have also driven people who use drugs into their homes, where they more often inject alone to avoid detection, increasing their risk of dying from an overdose. And attempts to self-medicate and substitute traditional drugs with new ones have resulted in most drug injectors switching to unstructured poly-substance use, meaning they consume whatever drugs are available at the time, often in combination, in an effort to mimic the effect of their drug of choice.

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

In Georgia, living proof that harsh punishments don’t stop drug use

The Rights Reporter Foundation (RRF) is now accepting submissions to the “Let's Get Real About Drugs!” poster contest, as part of our campaign to raise awareness on alternatives to punitive drug policies. The contest is targeting the 20-year review of global drug control efforts at the United Nations General Assembly Special Session (UNGASS) on drugs in New York, April 2016. For details and the rules of the contest, please see below.

What is the UNGASS and why is it significant in drug history?

In April 2016, the UN will hold a General Assembly Special Session (UNGASS) on drugs – a meeting of high-ranking government officials in New York to review the past 20 years of global drug control efforts and to adopt an outcome document. The last UNGASS on drugs took place in New York 20 years ago, in 1998. That meeting was dominated by the slogan “A drug-free world: we can do it!” and, accordingly, the target adopted was to significantly reduce the demand and supply of illicit drugs within 10 years.

Twenty years later, we can see that member states have failed to achieve these targets. The problem is, that drugs are here to stay - a drug-free world is an illusion. However, we have learned in these 20 years what really works instead of more repression: more prevention, more treatment and more harm reduction. What works is not punishment - but investing in public health, respecting human rights and providing social care for vulnerable people. We have robust scientific evidence proving that programs such as needle and syringe programs, community treatment, street outreach, drug consumption rooms, opiate substitution treatment, drug checking, interactive school prevention, social reintegration are not only very effective in reducing drug-related harms, but save money for the whole of society. Still, governments spend trillions of dollars on drug law enforcement, but only a fragment of what would be needed on harm reduction programs. The first draft of the UNGASS outcome document does not event mention harm reduction programs. This is unacceptable in the 21st century!

For further reading on the UNGASS 2016 and its significance, see:

What is UNGASS 2016? (Open Society Foundations)

The International Drug Policy Consortium’s official website

UNGASS: Weighing the Chances (Drugreporter)

We can see from recent UN statements that there is a spirit of reform in the air – but without pressure from civil society, we cannot expect governments to do anything other than congratulate themselves for what they have done already. There is very little knowledge or discussion, amongst the general public, about the failure of the punitive drug policies and the success of harm reduction – therefore we need to raise public awareness of the harms caused by this system, and promote alternatives to the current framework. This is the intended purpose of the posters we are calling for. The posters will be exhibited in New York City during the UNGASS in April.

This contest aims to contribute to the above aim by highlighting the unintended consequences of drug control efforts on public health, crime, environment, human rights – by articulating personal stories and tragedies, lost opportunities and liberties, and the irreversible damage that has been caused to lives and property. We are also looking for posters pointing out what really works instead of punishment: harm reduction and treatment programs, reality-based education, pragmatism, success stories, lives spared and money saved. We are looking for creative, attention-grabbing and poignant images which will graphically express the everyday reality and impact of the global drug war on public health, public security and human rights.

Deadline for poster submission is the 15th of March, 2016

Click here to have more information about the contest rules, recommended topics and prizes.

Let's get real about drugs - Poster contest

In the early 1990s, drug production in Colombia diversified to include heroin as well as cocaine, and since then the country's role in the heroin trade has substantially increased. According to the United Nations Office on Drugs and Crime, Colombia produced approximately 70 to 100 metric tons of heroin between 1998 and 2004. Studies have found an increase in local heroin use since the mid-1990s. This is a strong cause for concern, given the potential for HIV to spread through networks of injection drug users and disseminate to the general public.

In 1999 the Colombian Ministry of Health confirmed the first cases of HIV among people who inject drugs (PWID). The threat of an HIV/AIDS epidemic in Colombia may be especially pressing, as increased incidence of heroin injection has accompanied the rise in heroin use. However, despite such concerns, drug injection in Colombia remains a largely understudied practice.

A recent study by Pedro Mateu-Gelabert, PhD, principal investigator with New York University's Center for Drug Use and HIV Research (CDUHR) and NDRI, Inc., examined injection risk behaviors among heroin injectors in the Colombian cities of Medellín and Pereira to explore the implications for possible increased HIV transmission within PWID.

"The two cities were chosen because they are epicenters for street level drug sales and preliminary research indicated a sizeable number of young PWID in both cities," said Dr. Mateu-Gelabert.

, the study, "Heroin Use and Injection Risk Behaviors in Colombia: Implications for HIV/AIDS Prevention," began with six non-randomly selected PWID "seed" participants over the age of 18, who were chosen to recruit their peers, who in turn recruited their peers. Through six to seven waves of recruitment in each city, the study accumulated a total of 540 participants. Field researchers conducted a structured hour-long interview with each participant, and collected a small blood sample via finger prick to test for HIV. On average, participants were 25 years of age, with the median age being 24. By sample design, all participants injected heroin.

For their first time injecting, most participants (60%) report they were assisted by a close friend, 12% reported they were helped by other known people, and 17% reported they self-injected. On average, participants started injecting drugs at 21 years of age. Participants reported an average of 3.2 injections per day, 73% responded one to three times a day, and the other 27% reported injecting four or more times per day.

"Syringe sharing was quite common among participants," says Dr. Mateu-Gelabert. "42% said they used previously used syringes provided by other PWID. Forty-nine percent of participants also reported sharing cookers, filters, or rinse water."

Implementing harm reduction interventions among people who inject drugs (PWID) to prevent HIV epidemic in Colombia

The government has in recent years increasingly embraced various public health interventions for reducing exposure to harm by people who use drugs. First was the introduction of the needle and syringe programmes and more recently, the Medically Assisted Treatment (MAT) using methadone – a substitute drug for treating heroin addiction – under what is known as the Harm Reduction strategy.

Harm Reduction refers to policies, programme and practices that aim to reduce the dangers associated with use of psychotropic drugs in people unable or unwilling to break drug addiction.

The recent increase in drug use in the country, coupled with the rising HIV epidemic among key populations calls for a critical review of how drug using populations are managed. The National Aids and STIs Control Programme estimates that people who inject drugs are responsible for 3.8 per cent of new HIV infections. The prevalence rate among this population is 18 per cent, three times that of the general population (5.6 per cent).

With an estimated 18,000 people in Kenya who inject drugs, it is crucial to scale up drug dependency treatment.

The MAT programme was consequently initiated and now acts as an effective tool and evidence-based treatment meant to help wean people from injecting drug use and reduce their risk of HIV infection.

It is largely due to successes in this regard that the United States President’s Emergency Plan for Aids Relief (PEPFAR) chose to make this programme part of a package of services to address the needs of those most vulnerable to HIV infection. Mathari Teaching and Referral Hospital in Kenya hosts the country’s first-ever MAT programme funded by the United States Agency for International Development (USAID).

But these gains notwithstanding, drug policies around the globe have conventionally focused on the principle of deterrence and demand reduction. This has been done through attempts to eliminate production, distribution, sale and use of drugs. To achieve this, severe penalties and fines have been imposed on those involved in the drugs trade or consumption. It was believed that such punishment or the threat of it would reduce, and eventually cripple the global drug market.

It has now been widely admitted that this approach has failed to reduce the scale of the drug market and spawned negative consequences, which include an increased number of people in prisons around the world due to drugs.

Kenya: Drug users need doctors not policemen

In a U.N. meeting on February 9, Geir O. Pedersen, Norway’s permanent U.N. representative, said. “Drug use and related complications are primarily public health issues and should be addressed by the healthcare system, on a basis of humane and evidence-based treatment.” And in a press release on February 12, the Norwegian government announced that it was expanding its drug court program, and called it “voluntary.”

Nothing could be further from the truth. The so-called “alternatives to incarceration” (drug courts and urine testing contracts) which Bent Høie, the Norwegian Minister of Health, among others, is advocating, are based on regular supervised urine controls.

If subjects fail tests, the government will revert back to a punitive sanction: imprisonment, fines, and a criminal record. With relapse being a symptom of addiction, the policy is far from progressive or humane as the government claims. Some alternatives may be worse, due to a net widening-effect – resulting in more people coming into contact with the judicial system and sanctions being more intrusive. In some cases, a sentence will end up being longer when a drug court participant is sent back to prison. The result is a lack of security under the rule of law.

Norway has some of the strictest drug laws in Europe. Mere use will result in a fine and a criminal record, and repeat offenders face prison time. For harder drugs, the limits to when police can give a fine and a criminal record instead of prison are quite low (a single dose). Dealers can receive sentences on par with those handed out for murder, as recently seen in a large cannabis case, where one of the defendants was given 16 years. It is therefore absurd, that ambassador Pedersen, at the same U.N. meeting, went on to claim that “drug related offenses do not meet the threshold of the most serious crimes.”

Pedersen also claimed that “children should not be subject to criminal prosecution.” However, Norway has not reformed its sentencing practice in respect of children. Instead, they are pressured into demeaning and intrusive drug control contracts that frequently do not include any therapy.

Norway promotes forced drug treatment under a false flag 

Current drug policies continue to have negative health and social impact in CEECA, and also to result in human rights violations, corruption and emergence of new drugs. This negative impact is regarded as a side effect or unintended consequences of zero tolerance policy and criminalization of drug use and drug possession.

High-level decision-makers may not always understand links between police raids and increased overdose mortality. They may not know how criminalization of drug use may lead to police violence against women. The relation between the lack of state support for substitution treatment programs and high HIV mortality rates may be also unclear to those who are in charge of drug policy on the country level.

EHRN encourages you to make these links known to your countries' decision-makers by a strong regional action. Document and submit online examples of 

Based on your submissions, EHRN will produce educational and advocacy materials which you can use in the process of preparation for UNGASS on Drugs and your further drug policy advocacy work.

To submit your examples of unintended consequences of drug policies, please fill in this questionnaire.

Survey: Share your examples of unintended consequences!

The “War on Drugs” has failed and we all know it, but the stories of why and how it will end are just beginning to be told. That is why Global Exchange is hosting an international video contest, as part of our Peace, Life and Justice Caravan project We want to hear your story, and those of your community!

We invite you to create a 1-3 minute original video on the drug war’s impact in your community and what people are (or aren’t) doing about it. Convey to an international audience the urgency for action to end the drug war tragedy.

The creators of the top 3 videos will win great prizes:

First prize: A chance to join the Caravan as part of the audiovisual team in charge of the documentation of the Caravan for Peace, Life, and Justice, March 28th until April 19th, 2016, from Honduras to New York, with all expenses paid, including airfare, accommodations, transportation, and food!

Upload your video to YouTube and send us the link at caravana2016@gmail.com by March 8, 2016 and generate “votes” in the form of social media shares and likes through March 13, 2016. Winners will be announced March 16, 2016. Details below Your story will be part of the growing movement to end the war on drugs!!

The objective of the Caravan is to open a necessary debate about the war on drugs, promoting a paradigm shift in which governments’ actions cannot be limited to the use of violence while leaving behind fundamental aspects such as education, prevention, public health programs, and real measures against money laundering and the corrupting power of the mafias that control the high-level drug trade.

Each country holds histories of people that reflect concretely the challenges that we face as societies with respect to our drug policies, such as: the stigmatization and persecution of peasant farmers; the drastic penalties against people who sell small amounts of drugs while the large cartels remain intact; the incarceration, murder, and attacks against migrants, young people and people living in poverty who appear as “perfect culprits”; the moral double standard of societies which tolerate the disproportionate use of alcohol but impede information and education about other substances, while recriminating and persecuting the people who use those substances; and the stigmatization of ancestral cultures that use substances and plants that could be alternative treatments for different ailments.

Because it is of great importance to know these stories in order to amplify the perspectives around such a complex issue, which needs to be analyzed from all possible angles, the Caravan for Peace, Life, and Justice is launching an international video contest about drugs and human rights.

The videos will be shared on the Caravan website, on the Strutta website, and through the social networks Facebook, Twitter, and YouTube, in order to receive the impressions of the general public (which will be part of the selection criteria); the author is free to share far and wide on their social media platforms.

Videos can be sent from January 28th until (11:59pm) on March 8th, 2016. (The time of submission will be determined by the local time of the sent email.)

Videos can be voted on until (11:59pm) of March 13th, 2016.

The winners will be announced on March 16th, 2016.

Winners will be contacted in order to validate prizes.

Click here to find further information about the selection criterias and the participation form.

International video contest on drugs and human rights

In my experience, good public policy is best shaped by the dispassionate analysis of what in practice has worked, or not. Policy based on common assumptions and popular sentiments can become a recipe for mistaken prescriptions and misguided interventions.

Nowhere is this divorce between rhetoric and reality more evident than in the formulation of global drug policies, where too often emotions and ideology rather than evidence have prevailed.

Take the case of the medical use of cannabis. By looking carefully at the evidence from the United States, we now know that legalizing the use of cannabis for medical purposes has not, as opponents argued, led to an increase in its use by teenagers. By contrast, there has been a near tripling of American deaths from heroin overdoses between 2010 and 2013, even though the law and its severe punishments remain unchanged.

This year, between April 19 and 21, the United Nations General Assembly will hold a special session on drugs and the world will have a chance to change course. As we approach that event, we need to ask ourselves if we are on the right policy path. More specifically, how do we deal with what the United Nations Office on Drugs and Crime has called the "unintended consequences" of the policies of the last 50 years, which have helped, among other things, to create a vast, international criminal market in drugs that fuels violence, corruption and instability? Just think of the 16,000 murders in Mexico in 2013, many of which are directly linked to drug trafficking.

Kofi Annan on why it's time to legalise drugs

It wasn’t until several years after the birth of the couple's daughter that they learned the mother had contracted the hepatitis C virus (HCV) during an operation shortly after her pregnancy.

They also soon learned that, in Kyrgyzstan, the best options for treating hepatitis C were only for the rich—an effective medicine called Pegasys (pegylated interferon) would cost as much as $25,000 for the treatment cycle. But help came in the nick of time—a representative from Kyrgyzstan’s Ministry of Health was going to India to secure access to an affordable generic version of sofosbuvir, a new hepatitis C treatment. After a month of treatment on these generics, the mother's viral load was down to zero.

They were lucky—there are 220,000 other people in Kyrgyzstan infected with hepatitis C, the vast majority of whom can’t afford $25,000 worth of treatment.

Sofosbuvir is on the WHO Model Lists of Essential Medicines. At the end of 2015, three generic versions of this high-efficiency drug were registered in the Kyrgyz Republic. Two versions are made in India and one in Egypt, all permitted by Gilead Sciences, the drug company holding the patent. Supply of these generics in Kyrgyzstan is planned for the near future.

The introduction of the Egyptian drug was made possible by amendments to Kyrgyzstan’s patent law, which were adopted by the parliament after advocacy work by patients suffering from hepatitis C, as well as civil society organizations, including the Open Society Foundations.

The amendments to the patent law not only helped to resolve the issue of HCV treatment, but will also facilitate the supply of high-quality generic drugs for the treatment of cancers, multidrug-resistant tuberculosis, and other diseases in the future. The previous revision of the law had made it impossible to import high-quality generic versions of drugs protected by manufacturers’ patents. High-quality generics have the same efficiency as “original” drugs, but are affordable for far more patients.

When we began this work in 2011, we were criticized by various organizations and experts who said that HCV treatment will always be expensive for patients in poor countries. But beginning this year, a full three-month HCV treatment course of generic sofosbuvir will cost about $1,000—a small fraction of the cycle of branded pegylated interferon. In addition, the sofosbuvir generics have fewer side effects and are easier to administer than pegylated interferon’s intramuscular injection. Moreover, the new drugs boast 95 percent curability of any HCV genotype, whereas the old treatment regimen curability rate was as low as 45 percent.

Patient organizations and the Open Society Foundations will continue working to reduce drug prices and to secure state funding for treatment of vulnerable groups. The lives of people suffering from HCV and other diseases shouldn’t hang in the balance when affordable generic medicines are merely a legislative victory away.

Kyrgyzstan’s long fight for generic drugs is finally paying off

The Special Session of the General Assembly on the World Drug Problem (UNGASS 2016) will be convened from 19 – 21 April 2016 at United Nations Headquarters in New York. The UNGASS will feature a general debate plenary and five interactive, multi-stakeholder round tables conducted in parallel with the plenary.

A selection process is now open to identify speakers from civil society, the scientific community, academia, youth groups and other relevant stakeholders that may participate in the special session. Eleven (11) speakers will be selected: six (6) for the plenary and five (5) - one for each of the interactive round tables. Please note that travel funding is available for speakers chosen through this process. The final selection of speakers will be made by the Office of the President of the General Assembly, in collaboration with the Civil Society Task Force (CSTF) for UNGASS 2016. For more information on the CSTF, please click here.

The following criteria will be used when selecting speakers:

Must represent an organization actively working in the drug field and be authorized to speak on behalf of that organization;

Geographical balance and in the case of equal qualification, representatives from the Global South will be prioritised;

Thematic balance in terms of approaches to drug policies;

The call is open to representatives of ECOSOC and non-ECOSOC accredited NGOs.

In addition, selected representatives must:

be able to speak compellingly within the context of an intergovernmental plenary or the respective round table;

be available to be in New York on 19 April;

have a visa for travel to New York, if applicable, or be able to obtain one within 4 weeks for travel to New York. The selected speakers will be responsible for obtaining the visa for travel and for any costs associated with obtaining the visa.

To apply to speak at UNGASS 2016, please complete the form available here.

For more information about the special session, please visit the website.

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

Applications for speakers at the Special Session of the General Assembly on the World Drug Problem (UNGASS 2016) now open

In 2001 the use of all drugs was decriminalised meaning possession of drugs was now identified as a public health issue rather than a criminal offence. Today, whilst drugs remain illegal, users do not receive a criminal record and are instead referred to rehabilitation and treatment programmes. Drug related deaths, HIV infection rates and use of legal highs are at an all-time low.

This edition of My Perfect Country traces the development of the policy over the last 15 years and asks whether other countries should use this model for their own legislation on drug control. The architect of Portugal’s policy Joao Goulao explains how the policy was implemented and Doctor Rodrigo Coutinho explains how it was taken on by health services. Our roving ambassador hears from the volunteers of mobile units that doesn’t wait for patients to come to them and hears emotional recovery stories from former users. The My Perfect Country panel of presenter Fi Glover, academic Henrietta Moore, professor Alex Stevens from Kent University of Tony Duffin of the Ana Liffey drug project in Ireland discuss how far Portugal’s policy has been successful and whether it would work in the perfect country.

My perfect country: Portugal

In April, the world will come together to talk about drugs. The United Nations will host a General Assembly Special Session on Drugs (UNGASS), the most significant high-level international drug policy event in almost two decades. At the last UNGASS in 1998, the international community met under the slogan "A drug free world - We can do it!" and committed itself to this unrealistic goal. Fortunately, we've come a long way since then. This time, when global leaders meet at the UN to discuss drugs once again, the farce of a drug free world will be far away. Influential voices from around the world are calling for new approaches to drug policy, countries and cities are experimenting with innovative reforms, and a global movement has emerged calling for an end to the failed prohibitionist policies of the past. From April 18 to 21, people from all over the world will be descending upon New York City to demand change.

The UN shapes international drug policy. National drug laws must adhere to three UN treaties on drugs that prohibit the production and supply of certain drugs, and criminalize people who use them. The most significant of these treaties, the Single Convention on Narcotic Drugs, was ratified in 1961, over half a century ago. These treaties represent an outdated framework from a bygone time. There is ample evidence of the overwhelming failure of drug prohibition, and the human costs associated with it. This includes mass incarceration for drug offenses in the US, hundreds of thousands killed in drug war violence in Latin America, insufficient access to treatment and harm reduction services around the world, environments and livelihoods destroyed in forced crop eradication, and thousands executed for drug offenses, not to mention the fact that neither drug use nor supply has diminished.

At the 1998 UNGASS, instead of using the opportunity to critically evaluate the global drug control regime, countries decided to perpetuate the failed policies of the past. But things have since shifted. There is growing consensus even within the UN that these policies do not work. And we have a strong movement of individuals and groups affected by the war on drugs that will come to NY in April to appeal to the UN to use the historic opportunity of this UNGASS to charter a different path for international drug policy. These groups will be rallying under Stop the Harm, a diverse, broad, and powerful movement of organizations from around the world who have united around one common purpose: rectifying the catastrophic failures of the current global drug policy regime through campaigning for a new course firmly grounded in health, compassion, and human rights.

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