Growing numbers of doctors are calling for a health-based approach to be adopted as a cornerstone of global drugs policy as a high-level UN conference highlights what critics say are continued failings in international bodies’ strategies for dealing with global drug problems.

The High-Level Review at the latest annual session of the UN Commission on Narcotic Drugs (CND)—the chief policy-making body for international drug control—in Vienna earlier this month assessed how the UN is meeting goals for dealing with the global drug problem ahead of a UN General Assembly Special Session on Drugs in 2016.

A high-level UN meeting on international drug policy came to a close last week with doctors lamenting the lack of progress on health issues.

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Doctors criticise UN’s approach to global drugs control

Research confirms legalizing medical marijuana does not increase crime.

Researchers at the University of Texas Dallas published an article in 

today that indicates that despite opponents’ fears, legalizing medical marijuana does not increase crime and may actually lower some types of violent crime. The study examined FBI Uniform Crime Report statistics on murder, rape, assault, robbery, burglary, larceny and auto theft from all 50 states, including 11 states that legalized medical marijuana during the course of the study, over a 17 year period from 1990-2006. Controlling for confounding factors, they found no increases in any category of offense and even saw a slight decrease in homicides and assaults.

The study is reminiscent of a University of Chicago study that came out last year showing that, despite opponents’ warnings about increases in unsafe driving behaviors, legalizing medical marijuana was associated with a drop in traffic fatalities. In addition, preliminary figures in Colorado and Washington, the two states to have legalized and regulated marijuana for recreational use, show traffic fatalities in those states have slightly decreased the first year of full legalization.

“It must be difficult to be an opponent of marijuana reform. They can’t make arguments against legalization based on logic and facts so they must constantly resort to fear-based hypotheticals and anecdotes that keep getting proved wrong by systematic study. I feel for them. I really do,” said Major Neill Franklin (Ret.), a police officer for 34 years who now heads Law Enforcement Against Prohibition, a group of law enforcement officials opposed to the war on drugs.

This study is based on U.S. state panel data and suggests that medical marijuana legalisation is not predictive of higher crime rates and may be related to reductions in rates of homicide and assault.

The effect of medical marijuana laws on crime: Evidence from state panel data

Under Russian control, opioid substitution therapy for hundreds of Crimeans could come to an abrupt end. Ed Holt spoke to patients and providers in the peninsula about their concerns.

Russia's annexation of Crimea is threatening to force hundreds of people who use drugs back into addiction or turn them into refugees as opioid substitution treatment (OST) programmes in the region seem set to end.

People who inject illicit drugs in Crimea, which, following a controversial March 16 referendum, will become part of Russia possibly within months, have had access to OST in Ukraine for years. Indeed, Ukraine's recent reduction of new HIV infections has been put down to the widespread implementation of harm reduction programmes.

But Russian law forbids the provision of OST and organisations working to provide services to people who use drugs in Crimea say there is now a question mark over the fate of the more than 800 people receiving OST in the region. Irina Potapova, coordinator for OST for the International HIV/AIDS Alliance in Ukraine, which runs harm reduction programmes in Crimean cities, tells 

: “In the worst-case scenario, hundreds of patients would be forced to become refugees and seek treatment in mainland Ukraine.”

Fears over future of opioid substitution therapy in Crimea

South-Eastern Europe has long served as a corridor for several drug-trafficking routes to Western and Central Europe. Owing to its geographical position between Afghanistan, the world’s most important opiate-producing country, and the large and lucrative markets for opiates in Western and Central Europe, South-Eastern Europe is a crucial stage on one of the world’s most important heroin trafficking routes, the “Balkan route”.

Diverse drug flows come from multiple directions. Externally, cocaine arrives from South America. Internally, South-Eastern Europe produces relatively large amounts of cannabis, most notably in Albania, and the region also has a recent history of producing and trafficking amphetamine-type-stimulants (ATS). Of all these drug flows, however, only heroin flows can be considered strategically significant to consumption markets in Western and Central Europe.

This report shows how South-Eastern Europe countries serve as a corridor for several drug-trafficking routes to Western and Central Europe.

The illicit drug trade through South Eastern Europe

U.S. aid to Colombia has declined considerably since 2008. Counternarcotics and counterinsurgency activities, in which Washington has been heavily involved since Plan Colombia’s inception in 2000, have been steadily “Colombianized.” Now, Colombia is stepping up efforts to export its “know-how” to countries in Central America, the Caribbean, and beyond the Western Hemisphere affected by drug-related crime and violence, largely via South-South cooperation and triangulated efforts with U.S. support. This report explores what seems to be an emerging international security cooperation model in which both Colombia and the United States play key roles.

Colombia, the United States, and security cooperation by Proxy

Legal threshold quantities for drug trafficking, over which possession of an illicit drug is deemed ‘trafficking’ as opposed to ‘personal use’ are used in most Australian states and territories. Yet, in spite of known risks from adopting such thresholds, most notably of unjustified conviction of users as traffickers, the capacity of Australian legal thresholds to deliver proportional sanctioning has been subject to limited research.

In this study, the authors use data on patterns of drug user consumption and purchasing to evaluate Australian legal threshold quantities to see whether Australian drug users are at risk of exceeding the thresholds for personal use alone. The results indicate that some, but not all users are at risk, with those most likely to exceed current thresholds being consumers of MDMA and residents of New South Wales and South Australia. The implication is that even if the current legal threshold system helps to convict and sanction drug traffickers, it may be placing Australian drug users at risk of unjustified charge or sanction. The authors highlight a number of reforms that ought mitigate the risks and increase capacity to capture Australian drug traffickers.

 Australian threshold quantities for ‘drug trafficking’: Are they placing drug users at risk of unjustified sanction?

Use of alcohol, illicit drugs and other psychoactive substances during pregnancy can lead to multiple health and social problems for both mother and child. Use of alcohol during pregnancy can lead to fetal alcohol syndrome and other harms such as spontaneous abortion, stillbirth, low birthweight, prematurity and birth defects.

Dependence on alcohol and other drugs can also severely impair an individual’s functioning as a parent, spouse or partner, and instigate and trigger gender-based and domestic violence, thus significantly affecting the physical, mental and emotional development of children.

Pregnancy may be an opportunity for women, their partners and other people living in their household to change their patterns of alcohol and other substance use. Health workers providing care for women with substance use disorders during pregnancy need to understand the complexity of the woman’s social, mental and physical problems in order to provide appropriate advice and support throughout pregnancy and the postpartum period.

Guidelines for the identification and management of substance use and substance use disorders in pregnancy

Misunderstandings and misreporting of actual and proposed changes to Dutch cannabis policy in 2011 have led some opponents of cannabis reform to suggest the country is retreating from its longstanding and pragmatic policy of tolerating the possession, use and sale of cannabis.

In reality, most of the more regressive measures have either not been implemented, have been subsequently abandoned, or have had only marginal impacts. Additionally, there is growing public support for wider, progressive reform, including a system of legal cannabis regulation similar to that adopted in Uruguay, and efforts are underway by numerous municipalities to establish such models of production and supply.

This report by Transform shows that all signs point to there being broad popular and political support for continuing Netherlands’s historically progressive stance on cannabis.

Cannabis policy in the Netherlands: Moving forwards not backwards

Secondo il rapporto rilasciato oggi dal Transnational Institute e dal Global Drugs Policy Observatory “la domanda per la comunità internazionale oggi non è se vi è la necessità di rivedere il sistema di controllo della droga delle Nazioni Unite, ma piuttosto quando e come farlo”.

L'attuale processo internazionale verso una regolamentazione legale del mercato della cannabis è diventato irreversibile e richiede un dialogo urgente da parte degli Stati membri delle Nazioni Unite sui migliori modelli per la protezione della salute e della sicurezza delle persone. Lo sostiene il nuovo rapporto "

The Rise and Decline of Cannabis Prohibitio. The History of Cannabis in the UN Drug Control System and Options For Reform

" rilasciato dal Transnational Institute e dal Global Drugs Policy Observatory proprio il giorno prima della riunione a Vienna degli Stati membri dell'ONU nell'ambito della Commissione ONU sulle sostanze stupefacenti (CND). Secondo il rapporto "la domanda per la comunità internazionale oggi non è se vi è la necessità di rivedere il sistema di controllo della droga delle Nazioni Unite, ma piuttosto quando e come farlo".

Il rapporto svela la lunga e poco conosciuta storia della regolamentazione della cannabis dalla fine del 19esimo secolo, quando fu ampiamente utilizzata per scopi medici, cerimoniali e sociali al periodo post seconda guerra mondiale quando sotto la pressione degli Stati Uniti e di un potente mix di retorica moralistica e dati scientifici inaffidabili l'ONU ha classificato nella Convenzione unica sugli stupefacenti del 1961 la cannabis come una sostanza con proprietà 'particolarmente pericolose' alla pari dell'eroina. Sono ricostruiti anche gli sviluppi più recenti come il numero crescente di paesi hanno cercato di barcamenarsi all'interno delle Convenzioni attraverso "defezioni soft": dalla semplice depenalizzazione, alla politica olandese della tolleranza dei coffeeshop sino ai cannabis social club e ai regimi "generosi" di applicazione della marijuana a fini medici come in California.

Tom Blickman ricercatore del Transnational Institute e co-autore del rapporto ha detto: "gli organismi di controllo delle droghe dell'ONU, come l'INCB e UNODC, spesso trattano le tre convenzioni sulle droghe (1961, 1971 e 1988) come le tavole di pietra di Mosè: pilastri immutabili della verità che non possono essere messi in discussione, né riformati. La storia del controllo della cannabis, come indicato nella relazione, rivela tuttavia che le decisioni prese in passato erano spesso basate su negoziati politici, accuse infondate e atteggiamenti di stampo colonialista e razzista. Secondo Blickman: "l'inclusione della cannabis nel sistema di controllo delle droghe delle Nazioni Unite più di 50 anni fa è stato un errore storico e deve essere rivalutato."
Martin Jelsma del Transnational Institute e co-autore aggiunge: "è tempo per le Nazioni Unite e gli Stati membri di aprire gli occhi e riconoscere che, a causa di difetti sistemici e di disposizioni anacronistiche contenute nelle convenzioni, i paesi in cerca di alternative politiche sulla cannabis non hanno altra scelta che violare i trattati al fine di meglio tutelare la salute delle persone, la sicurezza e i diritti umani".

Il rapporto delinea le opzioni per la riforma e la regolamentazione legale e valuta il loro potenziale di successo. Queste opzioni includono la revisione della classificazione della cannabis da parte dell'OMS, la modifica dei trattati anche solo per alcuni stati, o l'uscita dal trattato e il successivo rientro con riserva come recentemente avvenuto per la Bolivia (al fine di difendere i diritti degli indigeni e l'uso della foglia di coca nella sua forma naturale).
Dave Bewley-Taylor, co-autore del rapporto e direttore della Global Drug Policy Observatory ha commentato: "la via da seguire è riunire un gruppo di paesi che la pensano allo stesso modo e lavorare insieme per valutare le diverse opzioni giuridiche e stabilire una tabella di marcia per l'aggiornamento delle politiche e delle convenzioni. Questo potrebbe portare alla sostituzione dei trattati sul controllo della droga esistenti con un nuovo quadro normativo internazionale, più coerente con gli altri trattati delle Nazioni Unite sui diritti dell'uomo e in linea con le più recenti evidenze scientifiche sui modelli migliori per ridurre i danni associati al consumo di droga."

Gli incontri a Vienna di questa e della prossima settimana, che esaminano la dichiarazione politica 2009 e il Piano d'azione sul 'problema mondiale della droga', e cercano di delineare i piani per la sessione speciale dell'Assemblea generale delle Nazioni Unite sulle droghe nel 2016, sono il momento ideale per iniziare questo dialogo.

Tienitiaggiornato congli sviluppi politicidi drogamediante la sottoscrizione diAlertIDPCmensile.

Ascesa e declino della proibizione della cannabis

As the Commission on Narcotic Drugs (CND) conducts its high-level review of the implementation of the Political Declaration and Plan of Action, there remains a significant discrepancy between what science has shown actually works, and what in reality is being implemented in countries most affected by HIV and hepatitis C epidemics driven by unsafe injecting drug use.

It is estimated that, of the estimated 13 (9-22) million people who inject drugs worldwide, 13% are living with HIV and more than 60% live with the hepatitis C virus with large regional variation.

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

Science addressing drugs and HIV: State of the art

If a group of men grab you off the street, call you a danger to society, and lock you in a “treatment” facility where you are beaten for trying to escape, who should protect you? This is one of the many troubling questions raised in a new report edited by the UN Special Rapporteur on Torture and funded by the Open Society Foundations.

Though human rights groups have criticized government-run drug detention centers for practices including forced labor and torture in countries in East and Southeast Asia, private centers—often run by vigilante groups or religious institutions—can be just as abusive. Accounts of life in these centers have also emerged from Russia and Serbia.

Even countries throughout Latin America—a region of the world has lately lauded for its increasingly progressive stance on drugs—allow these punitive institutions. Governments in these countries at best turn a blind eye, and at worst are complicit.

This report seeks to address existing gaps in law and policy to prevent torture and ill-treatment in the name of medical treatment in health care settings worldwide.

Torture in Healthcare Settings: Reflections on the Special Rapporteur on Torture’s 2013 Thematic Report

This paper offers a comparison of the drug strategies and plans adopted over the last five years by six intergovernmental organisations engaging 148 countries in four continents.

It informs decision-makers, professionals and researchers working in the area of international drug policy about the way in which countries of the same region have decided to strategically approach drug-related security, social and health problems.

Drug strategies and plans offer interesting insights both when analysed individually and when compared across regions. This paper describes the way in which drug strategies are structured and addresses their priorities and objectives.

It looks at the main approaches to demand and supply reduction and analyses the manner in which these interventions are referred from region to region. The content analysis reveals interesting similarities but also important differences. When seen in the light of the current international drugs policy debate, regional drug strategies may provide an important contribution for assessing the drug problem at international level.

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