第一个毒品消费室于1986年在瑞士的伯尔尼成立。从那时起，大约90个这样的设施在全球范围内被建立起来。英语版本拥有更多信息，请阅读下文。

随时掌握与药物政策发展相关的最新信息。

The earliest examples of drug use being allowed in drug service centres, either unofficially or on a semi-official basis, date back to the 1970s in the Netherlands (the Prinsenhof and the HUK Amsterdam) and from the early 1980s in Switzerland (‘Fixerraum-Experiment’ at the AJZ in Zurich). These initiatives were fundamentally different from today’s drug consumption rooms, as the supervision of drug use or distribution of hygienic equipment was not their primary objective. They primarily focussed on protected places for the consumption of drugs and further on to get in contact with people who use drugs. These facilities attracted large numbers of people who use drugs (PWUD) and also suppliers, which created problems both in terms of the dynamics between service users and also in maintaining a safe environment. These experimental initiatives were stopped after a relatively short period of time either by the agencies themselves or after police intervention.

The first drug consumption room (DCR), in a modern sense, was established in Bern, Switzerland in 1986. This was at a time of increasing concern about the spread of HIV/AIDS, the significant increase of drug related deaths, and the growth of public drug scenes in a number of European cities. At that time, it became evident that drug policy focusing exclusively on abstinence (e.g. via detoxification treatment, drug free rehabilitation or imprisonment) was ineffective. It was during this period that ‘harm reduction’ approaches began to emerge, including needle and syringe exchanges (NSP) and opiate substitution treatment (OST).

There are approximately 90 DCRs worldwide, including DCRs outside Europe in Canada (Vancouver) and Australia (Sydney). In Europe, DCRs are well established in countries like Spain, Germany, the Netherlands and Switzerland. These success stories have stimulated debates about DCRs in a number of countries and, in European countries like Portugal, France, Great Britain and Austria, campaigning groups have been established to champion the cause of DCRs in their countries.

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

欧洲毒品消费室：模型，最佳实践和挑战

The Indian Harm Reduction Network organized the third regional consultation with the regional partner organisations for strengthening the regional harm reduction network. 27 participants from the member states attended this consulation held in New Delhi.

The final consultation is aimed at the following objectives for strengthening the synergy among IDU service providers:

To explore the current situation of IDU related HIV services in the Northern states;

To identify strengths, weaknesses and opportunities of NIHRN as a functional network & strengthen its role in the region;

To develop a short term and long term working strategy for NIHRN as a network to address capacity gaps that needs collective action including SWOT exercise, advocacy needs assessment & advocacy strategy with action plan with defined roles and timeline;

To orient service providers & stakeholders about the GFATM 9 HIFAJAT Project and on areas where it can supplement and compliment IDU services through its existing mechanisms of working through STRCs and Learning Sites and networking through IHRN.

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

Strengthening regional harm reduction in India

In 2008 and the years that followed, Europe experienced a severe economic crisis, which presented a grave challenge to public finances. This report examines public expenditures on public order and safety, health and social protection, as these are the areas where most drug-related activities and services are provided.

It concludes, first, that austerity led to reductions in spending in those categories of government activity that encompass most drugrelated initiatives; second, that countries that experienced greater levels of austerity tended to show greater reductions in expenditure; and, third, that bigger cuts in public expenditure were registered in health than in public safety and social protection.

The available national estimates of drug-related public expenditure do not reveal the full impact of the 2008–09 economic recession on the public financing of drug policy in Europe. However, it is possible to conclude that the impact of austerity on drug policy was more severe in the countries that were hardest hit by the economic crisis.

Nevertheless, in most European countries, recession has led to a reassessment of public financing of specific drug policies and often to their adjustment. Drug budgets became more likely to be subject to revision, often resulting in cuts. In addition, austerity has raised policymakers’ awareness of the need for more cost-effective policy measures. In some countries, reorganisation of drug services has been attempted.

Financing drug policy in Europe in the wake of the economic recession 

The roots of the opium production problem in Southeast Asia go back to the 19th century. The region is home to the “Golden Triangle”, an area long associated with opium and heroin production, located where the borders of Myanmar, Lao People’s Democratic Republic (Lao PDR) and Thailand converge along the Mekong River. Twenty years ago, the Golden Triangle was the largest heroin‐producing area in the world, supplying the region’s own demand as well as exporting its surplus to North‐east Asia, Europe and the United States of America. In the 1990s and early 2000s, national and regional efforts succeeded in reducing both opium production and trade in the region, though they subsequently increased.

UNODC started annual Opium Surveys in Lao PDR in 2000, and Myanmar in 2002, in order to measure trends in the cultivation of opium poppy and help formulate an effective response to it. The surveys undertaken from 2000 to 2006 underscored the fact that efforts to counter opium production had succeeded in eliminating much of the cultivation in the Golden Triangle, but more recent opium surveys have indicated a resurgence in production over the last few years. As the Southeast Asia region also continues to include high levels of demand, the large quantities of opium produced provide opportunities for transnational crime networks and pose a challenge to the stability and development of the region.

The Southeast Asia Opium Survey 2014 provides an overview of the latest available data on opium production in the Southeast Asia region. It serves as evidence that transnational organized crimes, such as the production and trafficking of drugs, can be a challenge to development and need to be prioritized by both the region itself and the
international community.

Southeast Asia opium survey 2014

This summary note outlines how the world drug problem and drug control regimes intersect with gender equality and women’s empowerment. It is not comprehensive or prescriptive, but it is meant to inform the work of the UN System Task Force on Transnational Organized Crime and Drug Trafficking as Threats to Security and Stability in its preparation for the 2016 Special Session of the UN General Assembly. UN Women does not address the drug problem directly, either in its first Strategic Plan (2011-2013) nor its current one (2014-2017), but is a member of the task force and shares its main message that transnational organized crime, including drug trafficking, fuels violence, corruption, and income inequality, inhibits legitimate social and economic activity, poses a serious threat to public health and international peace and security, and undermines gender equality and women’s empowerment.

Women’s rights or gender equality rarely feature in discussions about the world drug problem. Men are, after all, a large majority of those using or trafficking drugs. Women’s roles, both as participants and victims, are underestimated and understudied.

However, it is clear that the world drug problem is undermining gender equality, and that a gender perspective is needed in all efforts to prevent and respond to this issue. For example, in the Northern Triangle in Central America (Honduras, El Salvador, and Guatemala), the drugs problem is mainly responsible for the skyrocketing levels of violence in those countries, with the highest homicide rates in the world. In Honduras, femicide has increased by 93 percent since 2009. This is directly linked to increasing levels of sexual violence and sex trafficking, and the humanitarian crisis provoked by tens of thousands of unaccompanied boys and girls trying to cross the US-Mexico border in 2013 and 2014. In Colombia, women in rural areas are mainly responsible for the food safety of their families, but the fumigation of coca crops affects other crops and water sources, while crop substitution programmes mainly benefit men, who are traditional title holders and often the sole beneficiaries of agricultural extension services, training, credit, and tools. In Afghanistan, only 4 percent of female drugs users have access to treatment facilities, despite the high rates of opium and heroin use among women. As just one example of how drugs and violence against women are interrelated, in December 2013 an addicted husband cut the nose and lips of his wife in front of their children when she refused to give away her jewelry to exchange it for drugs.

A gender perspective on the impact of drug use, the drug trade, and drug control regimes

Rio de Janeiro is at the centre of a series of large-scale sporting events intended to show off Brazil’s capabilities and economic power. The city hosted matches for the 2014 FIFA World Cup and will be the first South American host of the Olympic Games in 2016. However, since March 2014, the city’s inhabitants have also witnessed a return of urban warfare.

After six years of a pacification programme that includes the permanent presence of security forces, state institutions, and services in previously violent favelas (slums), organised criminal groups have staged a counterattack. Whereas between 2008 and 2013, criminal groups that had controlled the favelas for decades preferred to withdraw and avoid confrontation with the pacification forces, in 2014 they have staged bold attacks and adopted new tactics. These attacks caused eight deaths within the police force in the year to November, the highest number of casualties in ‘pacified’ favelas since the programme was first implemented in 2008, and more than double the three deaths recorded in 2013.

The wave of violence registered in some of the city’s largest favelas represents the first co-ordinated effort by criminal groups to undertake a sustained campaign against the Police Pacification Units (Unidades de Polícia Pacificadora: UPPs). The units were set up as a way to control strategic points in the city where criminal groups posed a threat to major highways and transit areas between hotels and sporting sites. Attacks in October added a symbolic challenge to state power, with criminal actions increasing days before the first round of presidential and local elections on 5 October. One criminal group, the Friends of Friends (Amigos dos Amigos: ADA), launched direct attacks on police and military units.

First implemented in 2008 in Rio’s small favelas, the pacification programme was conceived by State Security Secretary José Mariano Beltrame, and described in his autobiography, as “a logic to implode the power of drug trafficking by shaking its territorial structure".

Out of control: Criminal gangs fight back in Rio's favelas

The development of a HIV prevention, treatment and care programme in Ukraine by the Government has been spearheaded through support from Alliance Ukraine and its many local NGO partners across the country. A major achievement in this regard is that over the past 3 years, HIV prevalence among PWID under the age of 25 years has decreased. Such a reduction is largely due to the implementation of a comprehensive HIV prevention programme, including harm reduction, led by Alliance Ukraine and its partners, a response that began at the end of 2000 and was accelerated from 2004 to the present day at national scale. It is the national scale of this response by Alliance Ukraine through its partners that is of particular note for possible replication elsewhere.

The International HIV/AIDS Alliance is an international nongovernmental organization with its international secretariat in Brighton, United Kingdom, and currently comprises 40 nationally based, independent, civil society organizations around the world as well as seven Technical Support Hubs, all of which are dedicated to ending AIDS through community action. The Alliance seeks to work with communities through local, national and global action on HIV, health and human rights and is committed to collective action that will lead to a world without AIDS in which the lives of all human beings are of equal value, and everyone has the right to access the HIV information and services that they need for a healthy life.

The purpose of this review is to document the work of Alliance Ukraine and to assess whether such work is a ‘good practice’ that could be replicated in other countries faced with a serious HIV/AIDS epidemic driven largely by unsafe injecting behaviours. The review was undertaken during July 2013 and data was updated were available in April 2014. Criteria have been developed to undertake a comprehensive assessment of the full range of support given by Alliance Ukraine and its local NGO and Government partners relating to the implementation, management and ongoing development of the national HIV prevention programme throughout Ukraine.

Good practices in Europe: HIV prevention for people who inject drugs

In 2012, voters in the US states of Washington, Colorado and Oregon were given the opportunity to vote in ballot initiatives for the creation of legally regulated cannabis markets. Washington’s Initiative 502 and Colorado’s Amendment 64 both passed with 55.7% and 55.3% of the vote respectively. Oregon’s Measure 80 failed with 53.4% of those voting rejecting the measure. As calls for and legal processes towards the initiation of cannabis policy reform become more common within US states, it is a timely and useful exercise to reflect upon the campaigns for reform in Washington (WA), Colorado (CO) and Oregon (OR) and examine why the public supported cannabis policy reform in some instances and not others.

Within the United States of America there is a broad and growing consensus that the policy of prohibiting the use of cannabis for anything other than scientific and medical purposes is failing. Yet, most voters still view recreational cannabis use in a negative light. Moreover, as the policy landscape shifts, there is mounting concern that overly commercial and under regulated cannabis policies, particularly those that could harm youth, are not desirable either. Polling and interviews with experts from WA, CO, and OR indicate that swing voters, crucial to passing ballot initiatives, desire to have cannabis policies that are well thought out and not overly ideological. Strong regulations, dedicating tax revenue to education and public health programmes, and strong protections for youth seem to be particularly important to voters. As will be shown, these policy features also align with political messages that most strongly resonate with voters.

Drawing on and developing further the discussions within the GDPO Policy Report, Legally regulated markets in the US: Implications and possibilities, this policy brief will review and analyse what may lie behind the successes and failures of the ballot measures in Washington, Colorado and Oregon, as well as examine the changing national context for cannabis reform. It concludes by bringing together some of the lessons learned within these states in what has been referred to as the process of ‘selling’ policy ideas to the voting public.

Selling cannabis regulation: Learning from ballot initiatives in the United States in 2012

Patterns of illicit narcotics cultivation are among the understudied topics. Some studies estimate the prevalence of illegal crops using imagery and remote sensing data. These studies rely heavily on the availability and quality of the related images, which is often an issue for many countries known as major drug producers.

Using official drug crop eradication data, this study examines the patterns of illegal drug cultivation in Mexico at the municipality level. Species distribution models of ecology were used to guide the selection of environmental variables. A number of sociodemographic variables were incorporated into the model to describe human factors. Global and local models were compared to discern the determinants of marijuana and opium cultivation.

Geographically weighted regression was proved overall more effective than global ordinary least square regression despite the spatial variation of its explanation power. The models explained the spatial patterns of opium poppy cultivation are better than those of marijuana cultivation, suggesting the possible presence of more complicated local factors for growing illicit marijuana crops. A number of human factors such as law enforcement, gang activities, and transportation accessibility were found significant for illicit cultivation.

Click here to read the full article (restricted access)

Illegal drug cultivation in Mexico: An examination of the environmental and human factors

At its 34th meeting, the UNAIDS Board, called for Member States and the UN Joint Programme to pursue, in line with the UNAIDS vision of the three zeros, a clear commitment in the post-2015 development agenda to ending the AIDS epidemic as a public health threat and an obstacle for overall sustainable development by 2030, provisionally defined as the rapid reduction of new HIV infections, stigma and discrimination experienced by people living with HIV and vulnerable populations and key populations, and AIDS-related deaths by 90% of 2010 levels, through evidence based interventions to include universal access to HIV prevention, treatment, care, and support, such that AIDS no longer represents a major threat to any population or country. A process of establishing new targets for 2020 and 2030 is underway, within which targets and commitments on reducing HIV transmission among people who inject drugs will be considered.

There is now three decades of available scientific research data assessing the evidence regarding the effectiveness and cost effectiveness of harm reduction services and the right to health for people who inject drugs. This data shows that evidence-based harm reduction interventions such as Needle and Syringe Programmes (NSP) and Opioid Substitution Therapy (OST) are effective, pragmatic and cost effective—provided they are delivered in a way which is accessible and acceptable to people who inject drugs, for example at sufficient scale. Nevertheless, in many countries this evidence has not been translated into programmes of sufficient size or reach.

Halving HIV transmission among people who inject drugs

It is almost two decades since life-saving treatment for human immunodeficiency virus (HIV) became available. Life expectancy among people living with HIV, for whom optimal therapy is initiated timely, is now close to that of the general population. Despite this, an estimated 1.6 million people died from acquired immunodeficiency syndrome (AIDS)-related illnesses globally in 2012, and the number who died within the World Health Organization (WHO) European Region reached almost 100,000. A large proportion of these deaths occur in the eastern part of the Region, and without changes in the HIV response, the death toll in this region is likely to continue to increase in the coming years. Conversely, in the west, the risk of AIDS-related death continues to decline, reflecting some positive progress.

The majority of AIDS-related deaths would be preventable if available evidence were to be fully implemented. Research findings reported in this issue of 

 exemplify the challenges we face as we enter the fourth decade of the epidemic. Better and more comprehensive testing strategies aimed at persons most at risk of contracting HIV are needed, linked to HIV care and treatment programs. Implementation research needs to be at the core of the HIV response.

Diagnosis at a late stage of HIV infection and subsequent delays in starting treatment with antiviral agents are the important factors for the high death toll in parts of Europe and certain subgroups. Pharris et al. in this issue present the latest trends in HIV diagnoses in the European Union/ European Economic Area [4] and show that, based on countries where information is available, about half of the 300,000 people diagnosed with HIV over the past decade had a CD4 cell count of 350 copies/mL or less at the time of diagnosis (defined as ‘late diagnosis’). Consequently, their risk of death within the year of their diagnosis was more than 10 times higher than that of individuals diagnosed early and entering care promptly; those diagnosed late aged 50 years and over carried an even greater risk. This is of particular concern given the increase in the number of persons diagnosed at an older age in Europe with almost two thirds diagnosed at a late stage of infection (personal communication Anastacia Pharris, November, 2014).

Death from AIDS is preventable, so why are people still dying of AIDS in Europe?

The main objective of the report is to examine alternatives to incarceration that have been used in different countries of the world for drug-related offenses. It is intended to offer Member States a wide range of options to move forward in the design and implementation of policies that are both effective and uphold human rights.

Drafted for the 56th Meeting of the CICAD in November 2014 in Guatemala City, this four-part document provides a four-part synopsis of the major findings and alternatives identified by the TSG.

The first part of the document explains the rationale behind the project, laying out why it is important to design and implement alternatives to incarceration for drug-related offenses. The second part outlines the legal, conceptual and methodological approaches guiding the TSG’s work. The third part provides essential information about the alternatives identified in this exercise, arranging these experiences by their most salient components and proposing a system of categorization thereof, as well as a few specific examples. Lastly, in the fourth part, conclusions are drawn and a list of guiding principles is provided for the adoption and development of alternatives, recognizing the importance of taking into account the context and particular needs of each country.

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