By Tiana Herring / Prison Policy Initiative

After skyrocketing for decades, overall incarceration rates have finally been on a slow decline since 2008. But a closer look at the data reveals a major exception: women. From 2009 to 2018, the number of women in city and county jails increased by 23% — a rise that effectively cancelled out more than 40% of the simultaneous 7.5% decrease in the men’s jail population. Meanwhile, reductions in state and federal prison populations have mostly affected men.

Women make up about 10% of people in jails and prisons. This means that patterns unique to women’s incarceration are easily obscured when we focus exclusively on the larger, overall incarcerated population. And when we overlook incarcerated women as a unique group, we also fail to address the additional challenges they face — including different health care needs and a greater likelihood of being a primary caretaker of young children — that make their growing numbers all the more alarming.

Since public health research shows that women are also affected in unique ways by the opioid crisis, we decided to see whether drug enforcement trends and substance abuse could be contributing to the rising number of women behind bars.

Over the past 35 years, total arrests have risen 15% for women, while decreasing 40% for men. The increase among women is largely driven by drugs: During that period, drug related arrests increased nearly 190% for women, compared to 34% for men.

Since you asked: What role does drug enforcement play in the rising incarceration of women in the US?

While the world has been fixated on the results of the presidential election in the United States, less attention has been paid to another outcome of last Tuesday’s vote: significant steps toward decriminalization of drugs in several US states. One state – Oregon – is now set to abolish criminal penalties for possession of small quantities of all illegal drugs, from heroin to methamphetamine. This approach should be applauded – and adopted far more broadly.

According to 2018 data, about 269 million people around the world use illicit drugs, including 11 million who do so by intravenous injection – a method that carries additional risks. Nearly half of those who inject drugs are living with hepatitis C, and a staggering 1.4 million are living with HIV. According to the United Nations Office on Drugs and Crime, in 2017 alone, more than a half-million people died as a result of drug use. This is an entirely preventable tragedy, fueled by the cruel and counter-productive approach exemplified by the so-called war on drugs. Launched in the 1970s by US President Richard Nixon, drug possession today is a criminal offense in most countries, and users face severe social stigma.

The war logic is simple: the risk of harsh punishment will act as an effective deterrent, causing drug use to diminish. But this isn’t what happens at all. Despite increasingly punitive approaches, global drug sales and use continue to increase, causing more overdoses, HIV, hepatitis C, and tuberculosis.

The threat of punishment and discrimination doesn’t drive people to quit or avoid drugs, but rather to hide their use, including from their doctors. By discouraging those who use drugs from engaging with health systems, criminalization and stigmatization – as well as racism, which compounds drug-related discrimination – contribute to negative health outcomes for individuals and communities that extend far beyond the drugs themselves.

There is a better way. Rather than attempting to force people to forswear all drug use, we should be attempting to minimize its negative impact on their health and well-being. So-called harm-reduction interventions include needle-exchange programs, whereby people can access sterile needles and syringes; drug-consumption rooms, where people can safely use drugs without risking an overdose; opioid agonist therapy, such as methadone replacement; and housing and employment initiatives.

A safe retreat from the war on drugs

The cannabis referendum result was released today with 46.1% of New Zealanders voting in favour of legalisation, and 53.1% against. The gap will likely close to some degree when remaining votes are counted, but the jury is still out on whether it can close entirely.

However, even those who campaigned for a ‘no’ vote publicly accepted that cannabis use should be treated as a health and social issue, and decriminalised.

“Although a majority of New Zealanders did not vote for the proposed model of legalisation, the debate has shown a clear public desire for legal change in some form” said the Chair of the Drug Foundation, Tuari Potiki, today.

The Drug Foundation notes the strong mandate for decriminalisation that has been evident in public debates on the referendum and calls for an end to criminal penalties for those who use cannabis and other drugs, and for those who grow small quantities of cannabis at home for personal use.

'No' vote not a vote for inaction: Decriminalisation urged in New Zealand

By Department of Social Development South Africa

The Deputy Minister for Social Development Ms Hendrietta Bogopane-Zulu officially launched the South African Network of People Who Use Drugs (SANPUD) in Durban Kwa-Zulu Natal Province, on the 28th October.

Established in 2017, SANPUD aims to support its members, regional networks of people who use drugs by providing them with financial, logistical, administrative and technical support.

SANPUD envisions a world where people are able to make conscious, well-informed decisions about how and when to use, or not to use, drugs. A vision where drug policies do not increase the harms to people who use drugs, restrict access to health care, or limit autonomy. In addition, the responses to people who use drugs should not bolster marginalisation, stigmatisation and economic exclusion.

The National Drug Master Plan (NDMP) is a five-year programme of action focusing on demand reduction, supply reduction and harm reduction strategies in the general population, in particular on youth and those who are high-risk and vulnerable groups. The NDMP is premised on the understanding that the scale of drug abuse and illicit trafficking in South Africa requires the mobilisation and the resolve of all key sectors of society and local communities.

Deputy Minister for Social Development launches the South African Network of People who Use Drugs

By Dr Adam Holland - Public Health Physician

A short film exploring some of the misconceptions fueling the persistence of punitive drug policy in the UK.

Professor Alex Stevens - University of Kent

Andria Efthimiou - John Mordaunt Trust - http://usersvoice.org

Ann Fordham - International Drug Policy Consortium - https://idpc.net

Cedric Charvet - International Network of DCRs - www.drugconsumptionroom-international.org

Professor David Nutt - Imperial College London, Drug Science - https://drugscience.org.uk/

Duncan Stephenson - RSPH - www.rsph.org.uk

Eberhard Schatz - Correlation Harm Reduction Network - https://www.correlation-net.org/

Dr Jason Horsley - Public Health Consultant

Kirstie Douse - Release - https://www.release.org.uk/

Naomi Burke-Shyne - Harm Reduction International - https://www.hri.global/

Neil Woods - Law Enforcement Action Partnership - http://ukleap.org/

Dr Nuno Capaz - Lisbon Dissuasion Committee

Detective Superintendent Scott MacKechnie

Putting UK drug policy into focus - A short film

COVID-19 has made a severe overdose crisis much worse. Border closures have caused major disruptions to drug supplies, increasing the need to “cut” the existing supply with substances such as fentanyl or benzodiazepines. Social distancing requirements have reduced the capacity and reach of lifesaving harm reduction programs. And more people are having to use their drugs alone, with no one to respond if they overdose.

In the United States, local and state-level estimates are suggesting fatal overdoses have increased dramatically over the course of the pandemic, in line with preliminary national data for early 2020. In Canada, provinces such as British Columbia and Alberta have seen record-breaking numbers of overdose deaths since March.

Calls for more access to treatment and supervised consumption services have been joined by growing support for drug decriminalization. In Canada, mayors of major cities, public health officials and the Canadian Association of Chiefs of Police all support it. In the US, Measure 110, moving to decriminalize personal-quantity possession of illicit drugs, is on Oregon’s November ballot.

While needed, none of these measures address the tainted drug supply that is directly behind the overdose surge.

Seeking to do so, British Columbia released “safe supply” guidelines in April—allowing people who use drugs and are at high risk from COVID-19 to access prescribed opioids, benzodiazepines and stimulants to avoid withdrawal and stay “comfortable.”

The inclusion of stimulants in BC’s safe supply program was significant. It signaled that health officials were finally acknowledging that overdose risk and a tainted drug supply extend beyond opioids.

The need for a safe supply of drugs includes stimulants

On the 1st of November was International Drug Users’ Day, where the global community of people who use drugs came together to celebrate their history and affirm their rights. Twelve years ago today INPUD was formally launched on International Drug Users’ Day by drug user rights activists seeking to create an international platform where members of our community could confidently and proudly advocate for the health and human rights of people who use drugs globally. Every year since, we have marked this day with a celebration of our diverse, vibrant communities’ accomplishments, while also acknowledging our work is more critical than ever.

This year’s International Drug Users’ Day comes amidst a time of global uncertainty and upheaval. The COVID-19 pandemic has magnified the injustices caused by drug criminalisation, laying bare the fragility of our health systems, economies, and political institutions. Since the implementation of lockdown measures in March 2020 people who use drugs have faced major disruptions to the essential harm reduction services we rely on. This is especially troubling in countries and regions where such services were already sparse or non-existent, once again putting the responsibility of protecting people who use drugs solely on the shoulders of the community. Movement restrictions have disrupted the global supply chain of essential supplies and made it harder than ever for people who use drugs to travel to their harm reduction services. Additionally, the supply of drugs has been limited or cut off entirely in some areas forcing people into involuntary withdrawal. While some communities have been able to adapt to the delivery of services, others have struggled to do so in the absence of state support or funding for peer-led networks. Throughout all this the resurgent Black Lives Matter movement has brought renewed focus to the global function of drug criminalisation as a mechanism of state-sanctioned violence against Black, Indigenous, immigrant and other minority communities.

INPUD statement on International Drug Users Day 2020 

It was as a child in 1983 that Mark Owori first began using drugs. He started by supplying them to his sister, Lucky, who was a soldier in Uganda’s bush war. Eventually, he also became both involved in the war and an addict.

This was under the rule of Ugandan independence leader Milton Obote and during a conflict in which Owori says that everyone had a role – from spying to looking for food. His was to keep soldiers supplied with drugs.

Even now, he says, he doesn’t regret it and he considers his contribution was important to Uganda’s liberation from British colonial rule. But today he is using this experience as a child soldier to ensure that other children don’t go through the same.

Today Owori is 48 and still a drug user, but he is also part of a small group of men known as the “street uncles”, who rehabilitate addicts in Kisenyi, a slum in the capital, Kampala, that is infamous for high levels of drug use among its estimated population of almost 24,000 people.

“People look at the drugs and not the person or the humanity that they have,” he says. “We look at the talent we have and not the drugs we take.”

Owori, or “Uncle Mark”, as he is known, says his own experience in rehab inspired him in 2001 to open a centre in Kisenyi where street children and adults with addiction problems could find other avenues of self-expression beyond using the cheap and toxic drugs available in the slum.

The other street uncles helping to rehabilitate drug users are Musa Ssebagala, 36, Matua Francis, 31, Sam Mugadi, 20, and 25-year-old Kyikabi David. They advocate against the criminalisation of drug users and encourage responsible use among adults.

Hasifa Nakibuli, a 17-year-old who uses cannabis and “jet fuel” [aviation fuel], is one of the estimated 500 children and adults who either live at the centre or visit regularly. For her, limiting her drug use to just two substances is progress.

Uganda's 'street uncles' transform young lives in the slum

The Australian Injecting and Illicit Drug Users League (AIVL) and Hepatitis Australia are highlighting international calls for Needle and Syringe Programs (NSPs) in prisons, along with a greater focus on harm reduction initiatives, ahead of International Drug Users Day on 1 November. The release of the Global State of Harm Reduction 2020 [i]report reinforces calls in Australia’s current National Blood Borne Viruses (BBV) and Sexually Transmissible Infections (STI) Strategies [ii]for the implementation of NSPs in custodial settings.

“This is the first time the Global State of Harm Reduction report has included a chapter on hepatitis C. This is crucial because globally an estimated 48.5% of all people who inject drugs are living with hepatitis C and more than half of the 585,000 drug-related deaths in 2017 were due to hepatitis C. Australia is reversing the trend of hepatitis C for people who inject drugs, incredibly the proportion of those living with chronic infection has declined from 51% in 2015 to 18% in 2019. The leadership from people who inject drugs is fundamental to this achievement. Australia’s hepatitis C success in this cohort is attributable to a range of factors including community education, unrestricted access to direct-acting antiviral cures, evidence-based harm reduction strategies including community needle and syringe programs, and a coordinated approach guided by national strategies delivered in partnership with affected communities, peak bodies, clinicians, researchers and governments,” explained Carrie Fowlie, Chief Executive Officer (CEO) of Hepatitis Australia.

Renewed calls for needle and syringe programs in Australian prisons ahead of International Drug Users Day

New Zealanders have voted not to legalise cannabis in a referendum that painted a portrait of a country starkly divided over drug policy.

The yes vote for legalising cannabis finished with 48.4% of the vote, trailing the no vote on 50.7% – or just 67,662 votes out of 2.9m.

In the lead-up to the October election polls showed a country divided, with support for legalising cannabis ranging between 30-50%.

In the non-binding referendum, voters were asked to decide whether they wanted to pass a bill that would legalise cannabis and regulate how it is used and sold. This would have included producing and selling fresh and dried cannabis, including plants and seeds – for people over 20 years old. The change would also have imposed more stringent restrictions than the rules around sales of alcohol and tobacco.

Andrew Geddis, a law professor at the University of Otago, said while there was no legal imperative for an incoming government to abide by the referendum result, it would be “pretty hard for them not to act” on the vote

The prime minister, Jacinda Ardern, has repeatedly refused to state her position on cannabis but said she would let the public know how she had voted once the results were released.

New Zealand narrowly votes no to legalising cannabis in referendum

We still don’t know with certainty who will be the next president of the United States. But this year’s election results have given us a lot more clarity on one thing: American voters, even conservative ones, are ready to reel back the US’s war on drugs.

In every state where a ballot measure asked Americans to reconsider the drug war, voters sided with reformers. In Arizona, Montana, New Jersey, and South Dakota, voters legalized marijuana for recreational purposes. In Mississippi and South Dakota (separate from the full legalization measure), voters legalized medical marijuana.

In Oregon, voters decriminalized — but not legalized — all drugs, including cocaine and heroin. Also in Oregon, voters legalized the use of psilocybin, a psychedelic drug found in magic mushrooms, for supervised therapeutic uses. In Washington, DC, voters in effect decriminalized psychedelic plants, following the lead of several other cities.

With its vote, Oregon became the first state in the US in modern times to decriminalize all drugs. And marijuana is now legalized in 15 states and DC, although DC still doesn’t allow sales.

But this maybe isn’t that surprising: Over the past decade, polls have shown marijuana legalization, for example, is increasingly popular. In several polls, it gets majority support even among Republican voters, despite their greater levels of resistance to drug policy reform in general.

Together, these ballot measures’ successes amount to a significant repudiation of America’s war on drugs. US drug policy has for decades been built on the principle that drugs should be illegal, with the criminal justice system acting as a deterrent to use and addiction. Voters clearly want to move away from that.

Election Day was a major rejection of the war on drugs

The Covid-19 pandemic disrupted life-saving harm-reduction services for people who use drugs across the globe, the latest Global State of Harm Reduction report has revealed. It is the most comprehensive independent analysis on harm reduction policy and practice around the world.

People who use drugs were unable to access exchange programmes (where they swap their used needles for sterile ones) or opioid substitution therapy (OST) where health workers prescribe legal drugs — such as methadone or buprenorphine — that quell withdrawal symptoms.

People who inject drugs are at high risk of being infected with HIV, hepatitis B and hepatitis C if they don’t have access to harm reduction programmes. A 2011 study published in the 

Bulletin of the World Health Organisation

 showed that OST programmes help to decrease the use of illegal drugs, deaths caused by overdose and new HIV infections among people who use drugs.

The latest report states that movement restrictions during the pandemic made it difficult, and in many instances impossible, for people who use illegal drugs to access these programmes, while service providers had to reduce their number of working days or close entirely.

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