The 2016 special session of the United Nations General Assembly on the world drug problem will be convened at United Nations headquarters in New York from 19 to 21 April 2016. Its purpose is to review the progress made in implementation of the Political Declaration and Plan of Action on International Cooperation towards an Integrated and Balanced Strategy to Counter the World Drug Problem, including an assessment of the achievements and challenges in countering the world drug problem within the framework of the international drug control conventions and other relevant United Nations instruments.

In resolution 69/201, the General Assembly reiterated its call upon the relevant United Nations agencies and entities and other international organizations to mainstream efforts to counter the world drug problem into their programmes and reaffirmed its decision that the special session of the General Assembly shall have an inclusive preparatory process allowing organs, entities and specialized agencies of the United Nations system, relevant international and regional organizations, civil society and other relevant stakeholders to fully contribute to the process.

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Public health dimension of the world drug problem including in the context of the UNGASS, to be held in 2016

As per usual, the World Drug Report of the United Nations Office on Drugs and Crime (UNODC or Office) for 2015 contains a great deal of useful data on the global drug situation. In keeping with a trend that has been apparent for some years, the tone is moderate and there is relatively little political content. This is especially valuable and important in the approach to the 2016 United Nations General Assembly Special Session (UNGASS) on drugs. In addition, the Report acknowledges to a greater extent than ever before the depth, uncertainty and complexity of the ‘world drug problem’, as well as the ongoing provisionality of its own analyses. Moreover, it is impressively transparent regarding the construction of the data sets utilised in reporting and analysing its domain of inquiry.

Within the following pages we aim to provide an overview of the data and topics presented in, as well as the key themes emerging from, the World Drug Report 2015. As is the norm, where appropriate we will offer critical analysis of and comment on all three, including a full discussion of thematic chapter two that this year focuses on alternative development.

IDPC response to the 2014 World Drug Report

IDPC response to the 2013 World Drug Report

IDPC response to the 2012 World Drug Report

IDPC response to the 2011 World Drug Report

IDPC response to the 2010 World Drug Report

IDPC response to the 2009 World Drug Report

IDPC response to the 2008 World Drug Report

IDPC response to the 2007 World Drug Report

IDPC response to the 2006 World Drug Report

IDPC response to the 2015 UNODC World Drug Report

Cannabis use has never posed major problems in Indonesia, yet prohibitionist policies prevail. Despite the high prevalence of cannabis use, local or national discussions on cannabis policies are nearly non-existent, exacerbated by strong anti-drug views and public institutions' failure to design and implement comprehensive policies based on evidence.

Cannabis in Indonesia

People with opioid dependence are overrepresented in correctional settings (AIHW, 2013; Indig et al., 2010). Opioid substitution therapy (OST) is an effective treatment for opioid dependence, reducing illicit opioid use (Mattick, Breen, Kimber, & Davoli, 2009, 2014) and mortality (Degenhardt et al., 2011). OST is provided in correctional settings in many jurisdictions around the world (HRI, 2014), but there has been limited examination of the patient experience of opioid substitution therapy (OST) in correctional settings. Unexplored issues include reasons for entering (or not entering) treatment; patient perceptions of advantages and disadvantages of OST in prison; and preferences to cease or remain in treatment on release from prison. This latter issue is of particular importance, as clinicians report that patients often wish to cease OST prior to release, even when informed of the risk of overdose and benefits of remaining in treatment.

This qualitative study aimed to examine patient motivations for, and perceptions and experiences of, OST in prisons in New South Wales (NSW), Australia. Forty-seven participants were recruited from seven correctional centres across NSW between September 2012 and October 2013. All participants had a recorded history of opioid use and/or dependence. To ensure a broad range of perspectives were obtained, participants were selected on the basis of specific exposures to OST:

 (n=7): New inductions to OST. These individuals were within 28 days of commencing OST at the time of interview. They may have been in OST previously, in community or custodial settings;

 (n=11): Continuing OST from the community. This group of patients had been in OST prior to custody, and were in treatment in custody for at least 28 days before interview (i.e. had some familiarity with the opioid treatment program in prison).

 (n=10): Commenced OST in custody. These participants were in treatment for at least 28 days before interview (i.e. had some familiarity with the opioid treatment program in prison).

 (n=9): Voluntarily ceased OST in custody.

 (n=10): Patients who reported heroin use on reception to prison, but have not entered OST or have declined to be placed on the OST waiting list during this custodial sentence.

The sample was predominantly male (n=32; 68%), and 18 participants (38%) identified as Aboriginal and/or Torres Strait Islander. The average age of participants was 35 years. Three-quarters (n=35, 75%) of the sample were sentenced, 11 were on remand, and one participant was unsure of sentencing status. The majority (n=42; 89%) reported a previous incarceration history. Twenty-eight participants were currently prescribed OST (methadone n=27, 57%; buprenorphine-naloxone-naloxone n=1, 2%).

Patient motivations, perceptions and experiences of opioid substitution therapy in prison

Brief interventions are psychosocial techniques designed to help recipients recognise harmful patterns of substance use, and to motivate and support them to address that use. Studies suggest that brief interventions in an emergency department maximise the benefit of a unique ‘window of opportunity’ for engaging with people with substance use problems who do not necessarily receive assessment, referral or intervention.

This EMCDDA paper considers five systematic reviews and 16 randomised controlled trials and points to the potential benefits of brief interventions, albeit with a need for more research.

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

 Emergency department-based brief interventions for individuals with substance-related problems

Public Health England (PHE) have released a free resource to assist prison staff about new psychoactive substances (NPS) in prisons.

The toolkit has been recently released after the HM Inspectorate of Prisons report ‘Changing patterns of substance misuse in adult prisons and service responses’, published in December 2015, which identified NPS as having “created significant additional harm and are now identified as the most serious threat to the safety and security of the prison system.”

The resource is intended to support custodial, healthcare and substance misuse staff by providing information about the extent of NPS use as PHE currently understand it and about the properties of the various categories of NPS, and by providing advice on how to manage the problem from a clinical, psychosocial and regime perspective.

The toolkit also discusses the various challenges that are associated for healthcare staff, such as the covert nature of use, unpredictable effects the various drugs have, the delay in seeking medical help, as well as multiple challenges for the wider prison regime.

New psychoactive substances in prisons: A toolkit for prison staff

HIV-related point-of-care testing technologies have become widely available in last the few years and can potentially play a major role in achieving the UNAIDS 90–90–90 targets through increasing access to diagnostics in low- and middle-income countries. However, challenges remain regarding the appropriate use of point-of-care testing to ensure accurate patient results. Maintaining a high quality of testing while increasing access is critical for better patient care.

This handbook, produced by the World Health Organisation, has been created to address the weaknesses identified in existing point-of-care testing programmes and to assist service providers in adhering to a new set of minimum standards that promote and ensure quality assurance for HIV-related point-of-care testing.

This handbook describes the quality assurance cycle, a three-phased process developed to assist health-care providers and stakeholders in planning, implementing and sustaining quality assurance for HIV-related point-of-care testing.

Improving the quality of HIV-related point-of-care testing: Ensuring the reliability and accuracy of test results

Fom October 1-3, 2015 a regional meeting of NGOs, policy makers and scientists/researchers from the countries of Southeast Europe, was organized by Diogenis Association in Belgrade, to discuss the UN General Assembly Special Session on Drugs (UNGASS, April 2016) and its significance for Southeast Europe. The meeting closed with the formulation of some conclusions relevant for the situation in the SEE countries.

The UNGASS 2016 and its significance for SEE: Statement of NGOs in South East Europe

This chapter describes four main displacement effects of the supply-reduction strategy in Latin America: the “balloon effect” (the displacement of the targeted activity to another location), the “cockroach/diaspora effect” (the displacement of the targeted criminal groups to another territory), the “butterfly effect” (the displacement of the impact of state intervention), and the “short-sheet effect” (the displacement of budget priorities).

To explore recent changes in the drug market and organized crime in the region, the chapter analyzes cocaine trafficking in 2000-2013, identifying a tipping point of the supply-reduction strategy in 2006-2008. In the tipping point, three sets of policy changes with respect to drug production and trafficking were introduced. First, Colombia shifted tactics in drug interdiction and weakened the major criminal organizations; second, Mexico intensified its offensive against trafficking organizations; and, third, the United States stepped up its control over its Southwest border with Mexico.

Displacement effects of supply‐reduction policies in Latin America

This new publication in the Bulletin of the World Health Organization discusses the issues of morphine shortage in Egypt today.

Medical treatment is the main element in cancer pain management and for most patients, relatively inexpensive drugs like morphine are effective. For many years, morphine has been on the World Health Organization (WHO) model list of essential medicines as the strong opioid of choice because of its suitability for management of moderate to severe cancer pain. However, global data on licit opioid consumption shows very low levels in many countries, suggesting that pain control may be inadequate for a large number of patients worldwide, and Egypt is one of these countries. This represents a great inequality between people in countries with access to such essential medication and people in countries without sufficient medication access.

A shortage of oral morphine in Egypt

A central task for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is to produce an annual report of the latest data available on drug demand and drug supply in Europe. This paper is intended to facilitate a better understanding of, and easier access to, the main quantitative European level data sets available in 2015.

The European reporting system formally covers all 28 European Union (EU) Member States, Norway and Turkey and incorporates multiple indicators alongside an early warning system (EWS) on uncontrolled new psychoactive substances (NPS). While epidemiological information is based largely on registries, surveys and other routine data reported annually, the EWS collects case-based data on an ongoing basis. The 2015 reporting exercise is centred primarily on a set of standardized reporting tools.

The most recent data provided by European countries are presented, including data on drug use, drug-related morbidity and mortality, treatment demand, drug markets and new psychoactive substances, with data tables provided and methodological information. A number of key results are highlighted for illustrative purposes.

The drug situation in Europe: An overview of available data

The 3rd newsletter of the Drug Policy Network South East Europe covers the period November to December 2015 and covers topics such as:

The UNGASS regional consultation meeting between Eastern Europe and Central Asia

The “Drug Startegy and Drug legislation” meetings in Albania and Serbia

The opening of the 1st rehabilitation center for female addicts

20 years of preventing drug addiction in Novi Sad

Publications