Time has come to embrace a different approach and adopt policies that are based on public health, community safety, human rights and development. Only such policies will deliver on the promise to improve people’s lives; only such policies will truly allow Myanmar to reduce the harm caused by problematic drug use, trafficking and production. This policy briefing was drafted by a group of local and international organisations with indepth knowledge and extensive experience of drug-related issues in Myanmar. It is structured around a set of five strategic interventions, each of which comes with concrete recommendations that are adapted to the Myanmar context. It contains reliable, up-to-date information and examples of evidence-based practices from Myanmar and around the world.

We identify the following 5 key strategic interventions.

Increase access to health, harm reduction and voluntary drug treatment for people using drugs

End the criminalisation of drug users and small-scale farmers

Refocus law enforcement efforts on violent organised crime and large-scale drug production and trafficking

Promote development projects in opium growing areas

Include civil society and affected communities in policy reform

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Addressing drug problems in Myanmar

Increasing civil society engagement and participation in the policy planning and implementation process underlines the complementary relationship with representative democracy. Civil society organisations (CSOs) bring knowledge and independent expertise to the process of decision making. This has led governments at all levels, from local and regional to national, as well as international institutions, to draw on the relevant experience and competence of NGOs to assist in policy development and implementation. This also applies to the area of drug policy.

Civil society involvement in policy planning and delivery is an obligation in a democratic society. To ensure influence, relevance, added value and practical applicability of civil society involvement in policy planning and delivery – to the benefit of all stakeholders; the civil society actors themselves, the policy makers and society as a whole – it is necessary to define the opportunities, levels and means of participation. This requires taking into account the following aspects:

Determining the specific benefits of CSO participation in the different steps of the policy process should be agreed: agenda setting, drafting, decision, implementation, monitoring, review, reformulation.

Levels of participation: provision of information, consultation, dialogue and partnership between CSOs and public authorities.

Ways to identify the appropriate partners.

Means and tools that enable and support the process of participation.

Government interaction with civil society

In this foreword to the annual report of the International Narcotics Control Board (INCB) for 2016, I would like to recognize the tremendous efforts that went into the thirtieth special session of the General Assembly, which was held in April 2016. Over the past two years, we have seen the global community examine in depth the successes and challenges faced in addressing the world drug problem, and INCB applauds the results of this hard work, as reflected in the outcome document of the thirtieth special session, entitled “Our joint commitment to effectively addressing and countering the world drug problem”.

INCB notes that, in the outcome document, Member States underscored the role of the three international drug control treaties as the basis for international cooperation, ensuring the availability of narcotic drugs and psychotropic substances for medical and scientific purposes, preventing illicit drug crop cultivation and production and addressing drug trafficking and abuse. Governments have demonstrated that they intend to fulfil their joint commitments to cooperate on demand and supply reduction as well as on preventing diversion. At the special session of the General Assembly, the international community reaffirmed the pivotal role of the conventions and reiterated its commitment to their implementation. However, some actors will continue to talk about a need to “modernize” the treaties and their provisions; INCB is of the view that the international drug control system continues to provide a modern and flexible structure that can meet the world’s drug control needs of today and tomorrow.

INCB Annual Report 2016

A previous version of this briefing can be found here

The 2016 UNGASS on drugs was hailed as an opportunity ‘to conduct a wide-ranging and open debate that considers all options’. Although the UNGASS fell short of expectations, it was nonetheless a critical moment for global drug policy reform. The next opportunity to build on progress made will be in 2019, when the 2009 Political Declaration and Plan of Action will be up for review. The document established 2019 ‘as a target date for States to eliminate or reduce significantly and measurably’ illicit drug supply and demand, the diversion and trafficking of precursors and money laundering. Evidence from the UN itself shows that these targets are unachievable.

Yet the existence of a ten-year Plan of Action from 2009 inherently implies a review, renewal or some form of closure in 2019. The holding of the 2016 UNGASS – an event that was originally unforeseen in the lead up to 2019 – has resulted in procedural uncertainties for the mandate, procedure, coordination, nature or outcomes of the 2019 event. The 60th Session of CND will be a key opportunity for member states to discuss the 2019 process, in particular with the negotiation of Resolution E/CN.7/2017/L9. entitled ‘Preparations for the sixty-second session of the Commission on Narcotic Drugs in 2019’.

To inform the discussions, this IDPC advocacy note outlines key issues and possible options for 2019, drawing lessons from the 2009 process.

What comes next? Post-UNGASS options for 2019/2020 – Version 2

There is a significant academic debate about decriminalization of marijuana in the country, and this has received some degree of political and public support. Some have argued that decriminalization will open a floodgate for drug use in the country, while others (like myself ), do not agree and see it instead as the best way to reduce drug use in the country. In practice, repressive drug laws have neither succeeded in reducing drug consumption nor put traffickers out of their lucrative business. Instead, these laws have only driven and expanded the trade underground.

This is a massive failure. This situation has not only stigmatized people who use drugs, it has also led to misguided and harmful policy making. It has also contributed to an ongoing concerted effort to overstate the dangers of drugs – the primary actors being politicians, law enforcement agencies, and ill-informed media – and led to a situation where billions of people are unable to access essential medicines for pain relief and palliative care.

Decriminalising drug use: Why it is important for Ghana

As the first forum of its kind since 1998, the United Nations General Assembly Special Session (UNGASS) on drugs was highly anticipated and there was a clear sense of urgency from reform-minded stakeholders. However, hopes for a major breakthrough seemed all but lost as theUNGASS Outcome Document was approved, by consensus, at the opening session of the Special Session.

The negotiation of the Outcome Document has been criticised for its opaque preparatory process and diluted outcomes. The 26-page-long Outcome Document falls short of the ‘short, substantive, concise and action-oriented document’ it had promised to be, and inadequately reflects the wide-ranging debate that took place in Vienna, Geneva and New York since the UNGASS was first called for in 2012. It has also been strongly criticised for its failure to explicitly acknowledge the devastating consequences of an overly punitive approach to drug control, its continued promotion of a world ‘free of drug abuse’, and the fact that most progressive paragraphs are heavily caveated with wording such as ‘as appropriate’ and ‘in accordance with national legislation’, among many other issues.

Nevertheless, the UNGASS and its Outcome Document represent a key milestone in the international debate on drug control. Firstly, the debates exposed the fault lines in the fractured global drug control ‘consensus’, with countries diverging on key issues such as the death penalty, harm reduction, decriminalisation, the legal regulation of drug markets and the negative impacts of the current regime. And secondly, although the Outcome Document fell short of expectations, it does signal an unprecedented shift towards ensuring public health, development and human rights concerns are not peripheral, but central to drug policy. The new seven-themed structure of the Outcome Document has largely contributed to this shift, departing from the traditional three-pillar structure which narrowly focused on demand reduction, supply reduction and international cooperation.

As the implications of the UNGASS continue to be fleshed out,this IDPC briefing paper highlights some of the key paragraphs within the Outcome Document, and explores how these could help civil society, governments, UN agencies and other relevant stakeholders in their ongoing efforts to promote drug policy reform. As such, the guide does not seek to provide a thorough analysis of the Outcome Document, but rather draws out some of the most progressive language included in the text, and explains how to use it for advocacy purposes.

How to capitalise on progress made in the UNGASS Outcome Document: A guide for advocacy

Drug use and supply have been a sensitive and high-priority issue for successive governments in China since at least the Opium Wars in the mid-19th century. China’s policy response to drug use relies on punishment and coercion as central components, including compulsory detoxification, detention in labour camps or so-called ‘rehabilitation’ facilities, and compulsory registration with law enforcement authorities resulting in surveillance and random interrogations.

Yet, in the late-1990s, in a policy move that appeared to emphasize healthcare instead of punishment for people who inject drugs, China began implementing the world’s largest scale-up provision of opioid substitution therapy (OST) and needle and syringe programmes (NSP) – two critical harm reduction measures for preventing HIV transmission. However, the overall approach towards people who use drugs remains punitive and stigmatising in China. As drug use continues to rise and expand across a greater range of drugs (especially synthetic drugs such as methamphetamine), as well as amongst younger age groups, China requires a comprehensive system of evidence-based and humane drug treatment and harm reduction services capable of advancing the health and quality of life of individuals and communities.

This IDPC briefing paper provides an analysis of the current drug treatment system in China and offers recommendations for ensuring its effectiveness.

Drug dependence treatment in China: A policy analysis

Questa ricerca sull’esperienza italiana di distribuzione del naloxone ai consumatori e nella comunità sociale (Take Home Naloxone – THN) nasce dalla necessità di colmare un vuoto di conoscenza, di informazione e di comunicazione attorno ad una esperienza ormai più che ventennale di riduzione del danno (RdD) e di limitazione dei rischi correlati (LdR) all’uso di oppiacei.

La letteratura scientifica sul THN italiano è assai scarna, si limita a pochi studi locali e datati, tanto che le più recenti rassegne internazionali paradossalmente non includono o trattano per cenni una delle poche esperienze nazionali di THN significative in termini di durata, continuità e ampiezza degli interventi. Un esempio emblematico: gli studi citati indicano il 1996 come anno di avvio dei primi interventi di THN in Italia, mentre già nel 1991 gli interventi di strada avevano adottato questa modalità, anticipando quanto sarebbe avvenuto in seguito in altri paesi.

Non è certamente, questa lacuna, responsabilità dei ricercatori internazionali, che avevano ed hanno la difficoltà di reperire fonti e dati sull’esperienza italiana.

Mantieniti informato degli sviluppi delle politiche riguardo le droghe iscrivendoti al

Prevenire le morti per overdose de oppiacei - una recerca sul modello italiano di distribuzione del naloxone

From the mid 90s in Italy the distribution of naloxone (Take Home Naloxone, THN) to people who use drugs (PWUDs) and their family and friendship networks, has been implemented: nowadays 57 harm reduction services distribute naloxone all over the Country, even if not in every Region. The research “Preventing opioid overdose deaths. A research on the Italian naloxone distribution model” is the first study on THN experience in Italy carried out by Forum Droghe with the collaboration of Eclectica, a research body, and three Public Addiction Departments (ASL 2, and ASL 3 in Turin and ASL 1 in Naples). It is a quant-qualitative research based on a dual perspective, from both health workers and PWUD, which analyzes and evaluates strong and weak points in the Italian model of THN. The results of the study show that THN is effective, sustainable, cheap and identifies how THN practices work together to increase awareness of risks, skills for intervention and self-efficacy among PWUDs, in a respectable process of social learning and health promotion. It demonstrates also the basic lack of risks or side effects to its feasibility and sustainability.

Preventing opioid overdose deaths: research on the Italian naloxone distribution model

In the Americas the world drug problem manifests as an increasingly complex, dynamic and multi-causal phenomenon that has adverse effects on health, social cohesion, citizen security, the integrity of democratic institutions, development and economic activities in the countries of the region, with political, economic, social and environmental costs. This requires a comprehensive, balanced, multidisciplinary and evidence-based approach that takes into account the causes of the problem, in full respect of human rights and fundamental freedoms.

In that regard, the Hemispheric Plan of Action on Drugs 2016-2020 is a supporting guide for continuing the implementation of the established guidelines in the Hemispheric Drug Strategy (2010) and the commitments undertaken by member states in the Declaration of Antigua, Guatemala, "For a comprehensive policy against the world drug problem in the Americas" (2013); in the Resolution of Guatemala, "Reflections and guidelines to formulate and follow up on comprehensive policies to address the world drug problem in the Americas" (2014); and in the outcome document of the Special Session of the United Nations General Assembly on the world drug problem, held from April 19-21, 2016 in New York City, entitled, "Our joint commitment to effectively addressing and countering the world drug problem" (2016), among other relevant resolutions approved in this area during the past four years. Additionally, the Plan of Action acknowledges the 2030 Agenda on Sustainable Development and notes that the efforts made towards achieving the Sustainable Development Goals and to effectively address the world drug problem are complementary and mutually reinforcing.

Through this Plan of Action, member states reiterate their commitment to continue furthering progress in the Hemisphere, addressing the world drug problem, placing individuals at the core of drug policies and taking into account gender, age and cultural issues, as well as, when appropriate, inputs from civil society and other social actors, and addresses the new challenges faced by countries, within the framework of the three international drug control conventions and other relevant international instruments, in full respect of the purposes and principles of the United Nations Charter, international law and the Universal Declaration of Human Rights.

Hemispheric Plan of Action on Drugs 2016-2020

Cannabis Social Clubs (CSCs) are a model of non-profit production and distribution of cannabis among a closed circuit of adult cannabis users. CSCs are now operating in several countries around the world, albeit under very different legal regimes and in different socio-political contexts.

In this paper we describe and compare the legal framework and the self-regulatory practices of Cannabis Social Clubs in three countries (Spain, Belgium, and Uruguay). The objective of our comparative analysis is to investigate how CSCs operate in each of these countries. To foster discussions about how one might regulate CSCs to promote public health objectives, we conclude this paper with a discussion on the balance between adequate governmental control and self-regulatory competences of CSCs.

We identified a number of similarities and differences among the CSCs’ practices in the three countries. Formal registration as non-profit association seems to be a common standard among CSCs. We found nevertheless great variation in terms of the size of these organisations. Generally, only adult nationals and/or residents are able to join the CSCs, upon the payment of a membership fee. While production seems to be guided by consumption estimates of the members (Spain and Belgium) or by the legal framework (Uruguay), the thresholds applied by the clubs vary significantly across countries. Quality control practices remain an issue in the three settings studied here. The CSCs have developed different arrangements with regards to the distribution of cannabis to their members.

By uncovering the current practices of CSCs in three key settings, this paper contributes to the understanding of the model, which has to some extent been shaped by the self-regulatory efforts of those involved on the ground. We suggest that some of these self-regulatory practices could be accommodated in future regulation in this area, while other aspects of the functioning of the CSCs may require more formal regulation and monitoring. Decisions on this model should also take into account the local context where the clubs have emerged. Finally, the integration of medical supply within this model warrants further attention.

Read the full article here (behind pay-wall)

Regulating cannabis social clubs: A comparative analysis of legal and self-regulatory practices in Spain, Belgium and Uruguay

Since you are reading this booklet, we assume you are looking for help for opioid dependence – addiction to heroin, fentanyl, oxycodone or any number of other pills. Or maybe someone close to you needs this help. This booklet talks about opioid substitution treatment (OST) – medication-assisted treatment with methadone or Suboxone (buprenorphine/naloxone). These medications are also opioids, but they provide stable, long-acting relief from withdrawal and cravings. They replace the heroin or fentanyl that is causing the problem with a regular dose of a medication that allows for a stable life.

This handbook has been written by a group of patients in British Columbia. We all have long experience with medication-assisted treatments for opioid dependence. The language about drug use is complex. The latest version of the manual that defines diseases and disorders (DSM-V) no longer refers to “dependence” and uses “addiction” instead. In this handbook, we continue to use “dependence” to refer to our experience of “needing the drug” and significant withdrawal symptoms when trying to quit or cut down on our use. Deciding to seek help is an important step in any process of recovery. You are making a wise decision to seek help now. People dependent on opioid drugs and not receiving opioid substitution treatment (OST) are many times more likely to die or be seriously harmed by problem drug use.

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