This report details the findings of a survey conducted by the Scottish Trans Alliance into transgender inclusion in drug and alcohol services. The survey was open to any trans person living in Scotland. For the purpose of the survey, trans was identified as:

“an umbrella term for all people whose gender identity or gender expression is different to the one assigned to them at birth, including trans men, trans women, non-binary people, and cross-dressing people.”

The survey focused on three main areas; people’s use of alcohol or other drugs, the way in which their trans identity impacted on their use of alcohol or other drugs, and their concerns about approaching or experiences of using specialist services.

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Transgender inclusion in drug and alcohol services

The idea of the survey is to get a snapshot in time of what is happening with UK street drug markets. Previous surveys were conducted as telephone interviews with local drugs workers, Drug Action Team staff and police officers with specialist knowledge e.g those working in drug squads. For this survey, drug workers and police officers again comprise the majority of informants excepting that the police input has come primarily from those officers designated as drug expert witnesses and members of the Drug Expert Witness and Valuation Association. Also this time, we have widened the net of respondents to include researchers, drug consultants and trainers and those with contacts at street level together with information culled from published academic papers and official reports. The survey was conducted during October-November 2016 with representatives from 32 organisations and officers from 13 constabularies mainly by telephone, but also email and face-to-face.

Drug scenes can vary enormously within one region or even one city so the survey can only take a broad sweep across the UK. Even so, we have tried to encompass a wide range of geographical areas and for this survey these include: Greater London, Liverpool, Manchester, Birmingham, Nottingham, Edinburgh, Glasgow, Cardiff, Swansea, Belfast, Bristol, Brighton, Blackpool, Bradford, Hartlepool, Sheffield, Lincolnshire, Newcastle and Tyneside, Stoke and the Staffordshire region, Essex and Kent (Southend, Thanet and the Medway towns); Somerset, Devon and Cornwall and East Anglia.

Unprecedented street purity levels for heroin, crack, powder cocaine and ecstasy.

Headline goals for Psychoactive Substances Act achieved but new forms of SCRA street dealing and distribution putting vulnerable groups at risk as rough sleeping numbers increase.

Some reports of young people using heroin to self-medicate from SCRA.

Extension of drug distribution system known as county or country lines.

Increasing numbers coming forward to agencies with cannabis as a primary problem.

Continued reporting of widespread non-medical use of prescription and OTC drugs not necessarily confined to traditional drug treatment service groups.

Highways and buyways: A snapshot of UK drug scenes 2016

This training resource has been designed to support stakeholders to put the UN Bangkok Rules on women offenders and prisoners into practice. It draws on global good practice and research findings to provide practical guidance, using exercises and case studies.

At the end of the ten modules, you will have the tools and knowledge to design gender-sensitive policies and practices
for women offenders and prisoners and apply them in your professional role.

10 modules, with clear learning objectives

case studies to help you apply international standards

good practices to inspire new thinking and provide solutions

additional resources to delve deeper into specific topics

end-of-module quizzes to assess your understanding.

While the Workbook has been designed as a self-learning tool, it can also be used as part of group training sessions. It is designed for prison staff, policy‑makers, healthcare practitioners, representatives of intergovernmental and non-governmental organisations, and other interested stakeholders.

Workbook on women in detention: putting the UN Bangkok Rules on women prisoners into practice

While the adverse consequences of injecting drug use have increased significantly over the years, the services provided for drug users (including prevention, treatment and care) in addition to the advocacy and policy development efforts still remain far from adequate.

Drug use and HIV/AIDS are complex problems with political, social, economic, and cultural determinants. In the MENA region, the issue of drug use is even more complex and sensitive due to the effects of religion, insufficient knowledge on drugs and HR, repressive policies that stigmatize and punish drug users and the prevailing negative and judgmental attitudes towards PWUD. HR programs and services, including gender-sensitive services, are faced with multiple legal, political, financial, societal and cultural obstacles/challenges hindering their work. CSOs have an active role in advocating and promoting the HR approach, as well as delivering services to Key Populations (KPs). In countries of the region, where most services for PWID are driven and implemented by CSOs (MENAHRA, 2014), building the capacity and enhancing the knowledge and skills [of CSOs] to deliver services is a priority issue.

Guide on networking in harm reduction

In March 2015, the Department of Health commissioned Public Health England (PHE) to “review the evidence on: what can be expected of the drug treatment and recovery system and provide advice to inform future policy”.

PHE used a mixed methods approach to review the evidence, drawing on statistical information, engagement with stakeholders including experts by experience, and commissioning external reviews by academic experts.

The review begins with a brief summary of the current nature and prevalence of drug misuse, the history of drug treatment in England, and the outcomes it achieves. The international research literature on treatment effectiveness is then summarised, with comparisons made to effectiveness in England. Comparisons to treatment data from other countries are made where possible. The impact of housing problems, unemployment and social deprivation on treatment engagement and outcomes is reviewed. Finally, the review uses modelling to consider the likely size, characteristics and needs of the drug treatment population in the next four years, and reflects on the challenges for local treatment systems and recommends how treatment outcomes might be measured, maintained and improved.

An evidence review of the outcomes that can be expected of drug misuse treatment in England

Cannabis is a neglected drug in public health discourses, a reality which is at odds with the growing number of people in England who are now seeking support for problematic cannabis use. The disparity of how cannabis is prioritised by drug and alcohol service providers, wider community services, local authority commissioners and public health bodies has limited the amount of support available and impeded quality.

Among people experiencing problematic cannabis use, there is a perception that their needs will not be effectively met at treatment centres.

Some drug and alcohol service providers and commissioners are being attentive to cannabis but overall, cannabis has not been appropriately prioritised.

One to one interventions relating to cannabis are mostly confined to drug and alcohol treatment centres. Wider community services reported that they do not have the capacity or the ability to offer brief, initial interventions.

There are limited amounts of public resources available, some of which are lacking in levels of quality and accessibility.

A wider structural barrier is that the sector does not have a clear strategy for linking people experiencing problematic cannabis use into support and guidance. With the current illegal and unregulated market reducing the visibility of cannabis use, practitioners reported that ‘we’re just fumbling around in the dark trying to find them’.

Black Sheep: An investigation into existing support for problematic cannabis use

The Colorado Department of Public Health and Environment (CDPHE) was given statutory (In 25-1.5-110, C.R.S.) responsibility to:

“... monitor changes in drug use patterns, broken down by county and race and ethnicity, and the emerging science and medical information relevant to the health effects associated with marijuana use.”

Patterns of drug use are typically determined by using population-based surveys that ask specific questions about substance use. Colorado has created and manages several population-based surveys to assess the prevalence of a variety of health conditions and behaviors of specific populations. In addition, there are a few national surveys that collect state level data on marijuana use. The data from these surveys are compiled here to meet the reporting requirements set forth in 25-1.5-110, C.R.S. These data also have been presented to the Retail Marijuana Public Health Advisory Committee, which was charged with the duties outlined in 25-1.5-110, C.R.S. to “...establish criteria for studies to be reviewed, reviewing studies and other data, and making recommendations, as appropriate, for policies intended to protect consumers of marijuana or marijuana products and the general public.”

Reviewing marijuana use patterns in Colorado provides important insight to the committee members as they consider public health recommendations.

Monitoring health concerns related to marijuana in Colorado: 2016

Drugs policy over the last two decades in the UK, and other countries, such as the US and Australia, has been very strongly influenced by the assumed link between drugs and crime (HM Government, 2010; Home Office, 2011, 2016) and the idea that tackling drug use will affect crime. Existing evidence suggests a strong link between illicit drug use and involvement in crime (Bennett, Holloway, & Farrington, 2008), especially incomegenerating, acquisitive crime (Bukten et al., 2011b). The association has been observed primarily among arrestees (Pierce et al.,2015b), prisoners (Johnson, 2006) and people entering drug treatment (Darke et al., 2009). However, these groups may not be representative of the wider drug-using population as offending rates can be atypical in the period immediately prior to arrest, imprisonment or treatment (McGlothlin, Anglin, & Wilson, 1978); and drug-using offenders may be more likely than non-using offenders to be apprehended (Bond & Sheridan, 2007).

The drug-crime link appears particularly compelling among individuals with frequent and problematic use of opiates, such as heroin (Kaye, Darke, & Finlay-Jones, 1998), and/or crack cocaine (Bennett et al., 2008; Comiskey, Stapleton, & Kelly, 2012). Evidence synthesis concludes that the odds of offending are six times greater for crack users than non-crack users and three times greater for heroin users than non-heroin users (Bennett et al., 2008). Opiate/ crack users comprise 81% of those in receipt of structured drugtreatment services in England and are the group predominantly targeted by policy initiatives to divert drug-using offenders into treatment (Home Office, 2011; PHE, 2014). For these reasons, our review focuses on opiate/crack users.

Pathways through opiate use and offending: A systematic review

The project was a pilot that was focussed on working with Black and Minority Ethnic communities (BAME) to:

Increase community awareness of the relationship between drug policy, inequality and violence in BAME communities;

Explore how to build community capacity, leadership and resilience to enable lobbying for change at local, regional and national levels;

Establish a multi-platform presence that will increase knowledge and provide leadership and

Begin to build an asset-based community development and social action approach in relation to policies and practices that damage BAME communities.

We conclude from this work that more needs to be done to work with Black communities to develop a more informed and rounded position in relation to drugs policy reform. Given the extent to which the “War on Drugs” has been a proxy war on Black people and other poor communities, it is inevitable but unacceptable that Black people in the UK have not been more involved in the debate and campaign for change.

Address structural state racism and inequality in the UK, or drug policy reform will have little traction or impact amongst Black communities.

Increase community access to quality information about drug policy, drugs and their impact to enable the development of sustainable community responses.

Increase community access to education, prevention and treatment interventions around drugs including co-production and delivery.

Continue the progress made as a result of this consultation process in order to develop strong and dynamic Black community perspectives about drugs policy in the UK

A paradigm shift from silo thinking to systems thinking around the impact of all government policies (including drugs) to tackle institutional racism.

Support the progress made as a result of this consultation process in relation to the development of Black community leaders and Black led organisations (such as Blaksox) in order to develop strong and dynamic Black community perspectives about drugs policy in the UK

Include succession planning and “legacy” initiatives within Community leadership projects, actively supported by the local and central government and charitable trusts.

Structural racism as UK drug policy

President Rodrigo Duterte has made no secret of how he views people linked to drugs or crime; for him, they are less than human and deserving of death. Since taking office in the Philippines on 30 June 2016, his administration’s “war on drugs” 1 has borne that out to a devastating degree. Statistics from the Philippine National Police indicate that police officers and unknown armed persons2 collectively carried out 7,025 drug-related killings between 1 July 2016 and 21 January 2017, roughly an average of 34 per day.

In the poorest neighbourhoods of the Philippines, police officers on operation and unknown armed persons on motorcycles regularly target people with an alleged connection to drugs. Family members visit morgues to identify their loved one amongst the many other bodies that arrive each night riddled with bullet holes. The sight of bodies on the street has become commonplace; the fear of being or knowing the next victim, pervasive. Despite repeated denunciations by activists within the Philippines and by foreign governments, the relentless incitement and killings both continue unabated.

This report examines the human rights violations associated with President Duterte’s violent campaign against drugs. It is based primarily on field research carried out in the Philippines in November and December 2016, during which Amnesty International delegates interviewed 110 people, including direct witnesses to extrajudicial executions; relatives of those killed; people who currently use drugs; police officers and paid killers involved in anti-drug operations; local authorities; and civil society activists.

“If you are poor, you are killed": Extrajudicial executions in the Philippines "war on drugs"

In 2004, European and Central Asian countries held a high-level conference ‘Breaking the Barriers – Partnership to fight HIV/AIDS in Europe and Central Asia’. The conference resulted in the Dublin Declaration, which aimed to galvanise political action to tackle the epidemic in the region. The European Centre for Disease Prevention and Control (ECDC) monitors the implementation of the Dublin Declaration in Europe and Central Asia.

This report incorporates data from countries in the European Union/European Economic Area (EU/EEA) reported to ECDC for Dublin Declaration monitoring in 2014 and 2016, 2015 HIV surveillance data reported to ECDC and WHO’s Regional Office for Europe, and country data reported in 2016 to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). In 2016, the focus of data collection for Dublin Declaration monitoring was prevention, testing and treatment for HIV, and this report is structured along the same lines. However, the report starts with a brief overview of the trends of HIV and AIDS diagnoses in the EU/EEA.

The status of the HIV response in the European Union/European Economic Area, 2016

With this report we would like to inform the Committee on Economic, Social and Cultural Rights (CESCR) about the following serious violations of Articles 3 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR):

The Russian Federation did not fulfil CESCR recommendations given in paragraph 29 of June, 2011 Concluding Observations; Russian authorities retaliated against civil society organization which called upon them to fulfill these recommendations. As a result, HIV epidemic in Russia continues growing. Nearly two-thirds of European HIV cases are now in Russia. Up to 1.8 million of people who inject drugs remain a group of people most vulnerable to HIV, Hepatitis C, Tuberculosis (TB), and lethal drug overdoses. Moreover, Russian authorities obstruct the activities of HIV and harm reduction service providing non-governmental organizations by labeling them “foreign agents”, which bares significant humiliating connotation in Russia.

The Government of the Russian Federation does not ensure gender sensitive medical and social care for women who use drugs, including women living with drug dependency and drug dependent women with children.

Shadow Report to the Committee on Economic, Social and Cultural Rights in relation to the review of the 6th Periodic Report of the Russian Federation (E/C.12/RUS/6)