There is an extensive body of literature documenting the stigma associated with alcohol and other drug problems. No physical or psychiatric condition is more associated with social disapproval and discrimination than substance dependence. For people who use drugs, or are recovering from problematic drug use, stigma can be a barrier to a wide range of opportunities and rights. For people who use drugs, or are recovering from problematic drug use, stigma can be a barrier to a wide range of opportunities and rights.

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

Stigma and people who use drugs

The global war on drugs is severely jeopardizing the fight against AIDS. Criminalizing drug use drives the HIV pandemic not just among people who use drugs – but also among their families and communities.

Criminalization creates barriers to treatment and encourages unsafe injecting practices. Evidence consistently shows that repressive drug law enforcement practices are strongly associated with higher HIV rates. Fear of arrest drives many people who inject drugs into environments where HIV risks are greatly elevated, and away from HIV testing, prevention and other public health services. Criminalization also erects multiple barriers to both HIV and drug treatment. Research clearly demonstrates that people who use drugs tend to have lower rates of antiretroviral therapy utilization and higher rates of death due to HIV/AIDS.

The drug war: Fueling the HIV/AIDS pandemic

While men are more likely to be targeted by drug law enforcement, many of the drug war’s victims are women. Largely as a result of draconian drug laws, women are one of the fast growing segments of the U.S. prison population. Most women behind bars are mothers, many of them sole caregivers. Women, and particularly women of color, are disproportionately affected by drug law enforcement, by social stigma, by laws that punish those unable or unwilling to inform on others, by regulations that bar people with a drug conviction from obtaining public assistance, and by a drug treatment system designed for men.

Women, prison, and the drug war

After first attempting to prohibit various synthetic drugs, New Zealand realized that simply banning these substances was unrealistic and ineffective. In July 2013, the country’s Parliament enacted an historic new law that will regulate and control – rather than criminalize – so-called “bath salts” and other new synthetic drugs.

New Zealand's groundbreaking regulatory model for new synthetic drugs

report on Scotland’s First Harm Reduction Café 

held in Glasgow in November last year. The event was a great success and we received a lot of positive feedback on the night and subsequently.

To mark the event and capture some of the atmosphere, learning and other outputs from the café, we have produced a report which will hopefully inspire and assist others to organise such an event. Along with partners at Turning Point Scotland and Crew we thank those who attended and contributed for all their efforts.

This report intends to support anyone wanting to host a harm reduction cafe in their local area.

1st Scottish Harm reduction cafe report

The economical crisis has a huge impact on the public health situation in most of the European countries. Severe budget cuts and austerity measures aimed at NGO’s and low threshold services strongly affect the social and health situation of marginalised and vulnerable groups.

This newsletter is devoted to this urgent issue and presents examples and reports from Correlation partners in South and South East Europe. Greece, for example, is in the middle of a public health disaster. To meet budget-deficit reduction targets set by the European Central Bank, European Commission, and International Monetary Fund (the so-called troika), Greece’s public health budget has been cut by more than 40%. As Greece’s health minister observed, “these aren’t cuts with a scalpel, but with a butchers knife.

The spending was reduced to 6% of GDP, a figure lower than the UK, at 8%, and Germany, at 9%.As a result, HIV infections have jumped by more than 200% since 2010, mainly affecting intravenous drug users, as needle-exchange programme budgets were cut in half.

Policy paper: Who is paying the price for austerity?

The UN Special Rapporteur on Torture has joined the growing list of health experts and human rights bodies urging a move long advocated by the Legal Network: the implementation of prison-based needle and syringe programs (PNSPs). In fact, we were among the invited experts at a meeting convened by the Special Rapporteur last year, to examine how to strengthen the UN's existing Standard Minimum Rules for the treatment of prisoners and people in other places of detention.

Informed by that meeting, the Special Rapporteur's latest report (see "Latest reports") to the UN General Assembly highlights the particular vulnerability to abuse in detention of people living with HIV, people who use drugs, women, sex workers, and LGBT people. It reaffirms that health care in prisons should be equivalent to that in the community, going so far as to state that the new UN rules on prisons should oblige states:

"to ensure that all harm-reduction measures, including ... needle and syringe exchange programmes and evidence-based substance abuse treatment, are available to people who use drugs at all stages of their detention."

The Special Rapporteur also reiterated (from a previous report) concerns about the practice in some settings of withholding methadone or other drug dependence treatment as an interrogation technique.

This latest report represents a significant step forward in the international recognition of the rights of prisoners and people who use drugs. Nevertheless, the Canadian government continues to resist scientifically proven harm reduction services, even working to undermine them at the international level. Such recalcitrance only underscores the necessity of our ongoing court case seeking the implementation of needle and syringe programs in federal prisons, as well as the need for us to keep our engagement internationally as UN member states begin a review of global drug policy over the next two years.

UN Rapporteur on Torture: Provide clean needles in prisons

Criminal justice and public health systems can work together to provide comprehensive HIV prevention and treatment inside and outside correctional facilities. Incarceration presents a window of opportunity for primary prevention, screening, treatment and establishing comprehensive, pro-active transitional linkages for persons approaching release and follow-up.

What is the role of prisons and jails in HIV prevention? 

To coincide with the 17th International Conference on AIDS and STIs in Africa (ICASA), the International AIDS Society, Médecins du Monde (MdM), the International Drug Policy Consortium (IDPC), and the United Nations Office on Drugs and Crime (UNODC) hosted this High Level Panel for around 50 participants including policy makers, journalists and programme managers.

This High Level Panel was the first event of its kind in Africa, warning the participants about the HIV response thoughout the country.

The High Level Panel was expertly chaired by Anso Thom, a leading health journalist from SECTION27 in South Africa – who reminded participants that this was the first event of its kind in Africa, following similarly themed meetings in Asia and elsewhere.

Report from the high-level panel on HIV, drug policy and public health in Africa

This new report aims to assess the various policy responses to new psychoactive substances (so called "legal highs") in five European countries - Hungary, Poland, Portugal, Romania and Serbia - , from the perspective of researchers, service providers, law enforcement officials and activists working with the most affected communities of people who use drugs.

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

The not-so-balanced approach: Policy responses to new psychoactive substances

The Affordable Care Act (ACA) represents a remarkable opportunity for criminal justice and drug policy reform advocates to advance efforts to enact policy changes that promote safe and healthy communities, without excessively relying on criminal justice solutions that have become so prevalent under the war on drugs, and which fall so disproportionately on low-income communities and communities of color.

Even with its challenges, the ACA sets the stage for a new health-oriented policy framework to address problems such as substance use and mental health disorders by more appropriately and effectively casting substance use and mental health disorders as matters of public health and not of criminal justice.

To assist advocates in navigating this new terrain, 

Healthcare Not Handcuffs: Putting the Affordable Care Act to Work for Criminal Justice and Drug Law Reform

 outlines some of the major provisions of the ACA immediately relevant to criminal justice and drug policy reform and explores specific applications of those provisions, including program and policy examples and suggested action steps.

Healthcare, not handcuffs: Putting the Affordable Care Act to work for criminal justice and drug policy reform

The report shows clearly that the stigma and discrimination underpinning repressive drug policy is part of a wider project of social spoiling or stigmatization directed at the marginalization and demonization of other communities including LGBTQ people and sex workers.

The report concludes by calling for sex workers, people who use drugs, and other similarly marginalized communities to engage in “parallel battles for autonomy and empowerment in the face of crosscutting social exclusion, control, stigmatisation, and an undermining of agency and self-determination, battles against the same modes of silencing, pathologisation, and disempowerment.”

Publications from IDPC Members