Psychoactive substances have been used throughout human history in spiritual and religious rituals, for medicinal purposes, and by significant proportions of populations for individual reasons and as part of social interactions. Human interaction with these substances ranges from abstinence to a spectrum of use from beneficial to non-problematic, potentially harmful use, and the development of substance use disorders.

Societies manage the health, social, and economic consequences of these substances in a variety of ways with varying degrees of success. The effects of these approaches on the health of populations, however, are often overshadowed by attention to the direct effects of substance use on individuals. Currently, western societies manage illegal psychoactive substances largely through prohibition and criminalization. The laws and systems to control these substances often reflect the times and prevalent issues when they were developed, early in the 20th century, and do not coincide with current scientific knowledge and measurable experience concerning harm to individuals, families, or communities.

There is growing evidence, awareness, and acceptance that prohibition and criminalization are not achieving their intended objectives of reducing drug use and associated harms. Furthermore, it is becoming clear that prohibition has engendered an environment that fuels the growth of illegal markets, organized crime, violent injuries, and the deaths of users, dealers, and police. It also has adverse public health consequences such as accelerating the spread of HIV and hepatitis C, and increasing overdose deaths from concentrated and contaminated products.

The purpose of this paper is to review the available information concerning the use, management, and harms of currently illegal psychoactive substances, and to provide recommendations for a future direction.

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A new approach to managing illegal psychoactive substances in Canada

The illicit drug market in the Golden Triangle – Burma, Thailand and Laos – and in neighbouring India and China has undergone profound changes. This report documents those changes in great detail, based on information gathered on the ground in difficult circumstances by a group of dedicated local researchers. After a decade of decline, opium cultivation has doubled again and there has also been a rise in the production and consumption of ATS – especially methamphetamines. Drug control agencies are under constant pressure to apply policies based on the unachievable goal to make the region drug free by 2015.

This report argues for drug policy changes towards a focus on health, development, peace building and human rights. Reforms to decriminalise the most vulnerable people involved could make the region’s drug policies far more sustainable and cost-effective. Such measures should include abandoning disproportionate criminal sanctions, rescheduling mild substances, prioritising access to essential medicines, shifting resources from law enforcement to social services, alternative development and harm reduction, and providing evidence-based voluntary treatment services for those who need them.

The aspiration of a drug free ASEAN in 2015 is not realistic and the policy goals and resources should be redirected towards a harm reduction strategy for managing – instead of eliminating – the illicit drug market in the least harmful way. In view of all the evidence this report presents about the bouncing back of the opium economy and the expanding ATS market, plus all the negative consequences of the repressive drug control approaches applied so far, making any other choice would be irresponsible.

Bouncing back: Relapse in the Golden Triangle 

This new briefing from "Drogas en Movimiento" highlights the stigma and discrimination against women who use drugs during pregnancy.

Drug use in pregnancy: Hunting witches in the 21st century

Cannabis is the world’s most widely used illicit drug. But for how much longer? In a short space of time we have moved from absolute global prohibition of the drug, with the emergence of legalised and regulated production and retail not in just one nation (Uruguay) but also, surprisingly, in two US states (Colorado and Washington). Do these and other new permissive models in Spain and Belgium, for example, point to a tipping point in the debate? Could cannabis step out of the shadows and join the ranks of alcohol and tobacco, the world’s most popular legal and regulated drugs?

Even in the Netherlands, so long at the forefront of forward thinking policies on cannabis, local politicians have joined forces to urge the government to go much further and complete the job it started nearly 40 years ago when it agreed to tolerate the licensing of “coffee shops” to sell cannabis in small quantities. Then, it stopped short of legalising the cultivation and distribution of cannabis, leaving the supply side to criminal gangs, whose activities today increasingly tarnish an otherwise successful policy.

But at this crucial stage—as other countries and US states keenly watch the fortunes of the pioneers Colorado, Washington, and Uruguay and no doubt marvel at the tax windfalls—can regulatory approaches to the use of cannabis reduce health and social harms more effectively than prohibition? Is the commercial model pursued in Colorado, for example, where shops sell customer friendly goods such as edible cannabis in the form of candy “gummy bears,” really a solution that public health can get behind? Perhaps the stricter government control favoured by Uruguay is the model to watch.

Click here to read the full publication (restricted access).

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

Cannabis regulation: High time for change?

La Relazione europea sulla droga (EDR) 2014 dell’EMCDDA presenta una nuova analisi della situazione delle droghe, seguita da una panoramica degli sviluppi riguardanti gli interventi e le politiche. Basata su un esame completo di dati sia europei sia nazionali, il pacchetto EDR contiene una varietà di prodotti interconnessi, il più importante dei quali è costituito dalla relazione Tendenze e sviluppi. Adottando un approccio multidimensionale, vi si presenta un’analisi approfondita di temi chiave unitamente a una panoramica più globale delle principali questioni e tendenze a lungo termine. Si tratta di una prospettiva valida che permette di comprendere le diverse esperienze nazionali nel contesto più ampio offerto dai dati di livello europeo.

Relazione europea sulla droga 2014

O Relatório Europeu sobre Drogas 2014 do EMCDDA apresenta uma nova análise da situação em matéria de droga, acompanhada de uma panorâmica das evoluções sofridas pelas intervenções e políticas neste domínio. Baseado num exame exaustivo dos dados europeus e nacionais, o pacote do Relatório Europeu sobre Drogas é constituído por uma série de produtos interligados em cujo centro figura o relatório Tendências e evoluções. A abordagem adotada é multidimensional, sendo feita uma análise aprofundada dos temas fundamentais em paralelo com uma cuidada panorâmica das principais questões e tendências a longo prazo. Trata-se de uma perspetiva muito útil na medida em que permite compreender as diversas experiências nacionais inserindo-as no contexto mais geral oferecido pelos dados a nível europeu.

Registe-se para recever as Alertas mensais do IDPC e obter informação sobre questões relacionadas com as políticas de drogas.

Relatório Europeu sobre Drogas 2014

In its report, the Committee on Economic, Social and Cultural Rights raised concerns about the punitive approach adopted by Ukraine towards persons who use drugs that translates into the high number of such persons being imprisoned, as well as about existing regulations that restrict access to opioid substitution therapy (OST) and needle and syringe exchange programmes (NSP).


The Committee also recommended that Ukraine adopt a human rights-based approach in addressing the problem of drug use, including by conducting awareness-raising programmes about the serious health risks associated with drug use; addressing the discrimination against drug dependent persons; providing appropriate health-care, psychological support services and rehabilitation to such persons, including effective drug dependence treatment such as OST; and allocating financial resources for the proper operation of OST and NSP and increasing their coverage, ensuring inter alia better access to such programmes in prison settings.

ECOSOC concluding observations on the sixth periodic report of Ukraine

This technical update was prepared in November 2013 in collaboration with key experts, the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). Its primary objective is to synthesize experiences, research and policies on HIV self‑testing to inform stakeholders who are considering or already implementing HIV self‑testing.

HIV self‑testing is a process whereby a person who wants to know his or her HIV status collects a specimen, performs a test and interprets the test result in private. HIV self‑testing does not provide a definitive diagnosis; instead, it is a screening test for the presence of HIV-1/2 antibodies or the HIV-1 p24 antigen. Any positive HIV result must be confirmed by a health worker in accordance with national testing algorithms.

HIV self‑testing enables individuals to test themselves for HIV in private. By providing an opportunity for people to test themselves discreetly and conveniently, HIV self‑testing may provide people who are not currently reached by existing HIV testing and counselling (HTC) services with information about their HIV status.

Short technical update on self‑testing for HIV

The Good Practice Guide: HIV and Human Rights is an accessible and user-friendly guide to explain:

what human rights-based HIV programming is

the different ways that organisations can integrate human rights into their HIV programmes.

It brings together international guidance as well as good practice experience from across the world on HIV and human rights programming.

The guide assists programmers to integrate human rights through all stages of theHIV programming cycle, from design, development and implementation throughto M&E. It gives practical guidance on the kinds of human rights programmes recommended by the Alliance and the Joint United Nations Programme on HIV/AIDS (UNAIDS) for protecting and promoting human rights in the context of HIV, and for creating change at individual, community, service provision and law, and policy levels. It provides accessible and practical planning tools, as well as programmatic examples of how to address human rights in a way that includes affected populations, builds capacity, responds to the inequalities underlying HIV and AIDS, and promotes universal access to HIV-related health services. It also includes reference to further information and resources for more in-depth information about human rights, HIV and rights-based programming for HIV.

Good practice guide: HIV and human rights

Andrey Rylkov Foundation for Health and Social Justice together with the Canadian HIV/AIDS Legal Network submitted a Shadow Report to the UN Human Rights Committee in relation to the review of the 7th Periodic Report of the Russian Federation.

The focus of the Shadow Report is violation by Russian Federation of the rights and freedoms of people who use drugs. The authors say that RF systematically violates many of the rights and freedoms of IDUs as enumerated in the International Covenant on Civil and Political Rights (ICCPR), including: freedom from discrimination; the right to life; freedom from torture and cruel, inhuman and degrading treatment; the right to liberty and security of person; humane treatment of persons deprived of liberty; the right to equality before courts and tribunals and to a fair trial; freedom of expression including the right to freedom of information. These violations stem primarily from the government’s use of punitive approaches, based on absolutely no scientific evidence, to address what the international community classifies as a health problem, namely drug dependence, a condition with globally sanctioned and effective evidence- and human rights-based responses.

Every fifth inmate is in prison for drug crime in Russia. Up to two-thirds of all people who use drugs (PWUD) have been in custody at least once in their life.

the underlying drug policy document of the Russian Federation — the Strategy of State Drug Policy until 2020, which was approved by Decree of thePresident — makes zero mention of human rights. Aimed at punishing people for using drugs and coercing people into abstinence, Russia’s official drug policy disregards the health nature of drug dependence

The report includes the statistics, facts of the human right violations of drug users and also recommendations to the government of RF, particularly: “

the government of the Russian Federation should develop and adopt a human rights-based federal law regulating drug-demand reduction and drug-related harm reduction through social and medical measures, rather than through law enforcement

Shadow Report to the UN Human Rights Committee in relation to the review of the 7th Periodic Report of the Russian Federation

The findings of the largest European project to date in the emerging science of wastewater analysis are taken up in this 'Perspective on drugs'. The project in question analysed wastewater in over 40 European cities (21 countries) to explore the drug-taking habits of those who live in them. The results provide a valuable snapshot of the drug flow through the cities involved, revealing marked geographical variations.

Wastewater analysis and drugs - a European multi-city study

The Internet is now recognised as a plausible vehicle for delivering drug and alcohol education, prevention and treatment programmes in a range of settings. This 'Perspective on drugs' charts developments in Internet-based drug treatment (IBDT), which has expanded in Europe over the past 10 years, and explores some of the benefits it can offer.

Publications