The idea for this book arose due to the fact that there was no comprehensive reference material for what was going on across East and Southeast Asia in regard to drug policy efforts. The book includes a historical account of drug use in the region, the effects of criminalisation, the role of police in supporting health efforts, the death penalty in relation to drugs, the links between socioeconomic development and drug use and cultivation, human rights of persons who use drugs, the rise of amphetamine-type substances and current treatment methods, and case studies of Taiwan, Thailand, China and Vietnam.

The book begins with Reid and Crofts describing opium use in pre-1900 China, India and Burma, and moves ahead with more contemporary developments, including the 1961 Single Convention on Narcotic Drugs and draconian measures being adopted across Asia. Lee, Jacka and Crofts go on to describe harm reduction and triggers for harm reduction being adopted in the region. Csete and Rahman then describe human rights violations in the region and the responses of Asian governments towards increasing human rights-based drug policy across the world.

These introductory chapters provide useful background and context for chapters which deal with specific issues in the book. Des Jarlais et al. address HCV epidemiology in Southeast Asia, and interesting revelations of HIV among ethnic minority groups in China. Mannava et al. address the links, causes and effects between socioeconomic development and effective drug control. They state: ‘Rural underdevelopment, conflict, and economic crises can drive illicit drug production, whilst poverty, unemployment, marginalization, and changing social norms create vulnerability to drug consumption.’

Rahman writes about the death penalty for drugs, particularly in relation to China, Malaysia and Indonesia, and notes that many abolitionist countries retain strong public opinion in favour of the death penalty, and hence abolition is mainly dependent on political will. She also details recent cases occurring in the abovementioned countries. Baldwin and Thomson highlight developments in regard to compulsory treatment in the region, and provide comprehensive and damning arguments as to the inefficacy of compulsory treatment programs.

McKetin and Li arguably deal with the most difficult issue rising in East and Southeast Asia: amphetamine-type substances and other related stimulants. As is widely known, ATS is undergoing a major boom in the region, and in tandem with prohibition harms associated continue to propagate. The authors detail history of ATS in the region, comorbidities associated with use, efficacy of treatments available currently, and contemporary trends.

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

Drug Law Reform in East and Southeast Asia

In a recent contribution, Wilkins and Sweetsur (2012) underline that, although there have been no changes in the statutory penalties (a maximum of three months in prison and a fine of $500) related to cannabis use in New Zealand for over 35 years, there has been a substantial reduction in police arrests for cannabis use, leading to similar declines in associated prosecutions and convictions.

While such analysis is extremely valuable, it may indirectly suggest that cannabis use has been 

 decriminalised in New Zealand and that considering 

In this Viewpoint, the authors wish to remind the reader that the trend described above is not universal and that 

 decriminalisation is indeed desirable to avoid arbitrary enforcement of the law.

This report specifically depicts some recent trends in cannabis use criminalisation in France, where the number of police arrests for cannabis use has increased in recent years.

De jure decriminalisation of cannabis use matters: Some recent trends from France

The report shows clearly that the stigma and discrimination underpinning repressive drug policy is part of a wider project of social spoiling or stigmatization directed at the marginalization and demonization of other communities including LGBTQ people and sex workers.

The report concludes by calling for sex workers, people who use drugs, and other similarly marginalized communities to engage in “parallel battles for autonomy and empowerment in the face of crosscutting social exclusion, control, stigmatisation, and an undermining of agency and self-determination, battles against the same modes of silencing, pathologisation, and disempowerment.”

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

The harms of drug use: Criminalisation, misinformation and stigma

In 2016, the UN General Assembly will hold a Special Session (or ‘UNGASS’) on the issue of illicit drugs. People who inject drugs are a key population for HIV, with around 10% of global HIV infections linked to risky injecting practices. Much like the 2001 UNGASS on HIV/AIDS and the 2011 High-Level Meeting on AIDS, the UNGASS on drugs is crucial for the adoption of more effective and more humane policies.

Drug policy is an important issue for those working on the HIV response – we cannot hope to end AIDS until we end the global war on drug users. In order to do this, the voice of civil society around the world must be strong and united.

The preparations for the 2016 UNGASS have already begun at the UN Commission on Narcotic Drugs (CND) in Vienna, Austria – with a high-level review of international drug policies scheduled for March 2014 (countries are currently negotiating a ‘Joint Ministerial Statement’ on the progress made so far and the remaining challenges).

We urge NGOs working on HIV/AIDS in Africa to engage in this process – which is every bit as crucial to their work as the UNGASS on HIV.

The UNGASS on drugs in 2016: A milestone for HIV/AIDS NGOs policy in Africa

This is the first issue of Drugs – Policies and Practices. Healthy Options Project Skopje (HOPS) put together this magazine quite quickly, but we went a long way until it materialized. The authors of the articles are people who have been working on drug related issues for a long time and are very well informed about both the situation in Macedonia, and about global trends and currencies. Their knowledge is supported by their long-term experience and hands-on work and contacts with people who use drugs, and also by their participation in initiatives related to the creation of a more humane drug policy and treatment for drug dependent persons. Of course, this magazine presents the experiences, opinions and needs of people who use drugs, also.

This magazine aims to serve as an incentive to widen the debate and produce more responsible actions towards the implementation of policies and practices for a humane treatment of people who use drugs, and at the same time will serve as a source of knowledge and information regarding drug related topics.

HOPS Magazine - Treating drug dependencies

Advances in medicine, nutrition, and other factors have allowed people to live longer. Yet one aspect of life is constant. Human mortality remains 100 percent; we all eventually die. While where and when we die is regularly studied, how we die is often avoided or ignored. This has led to an unacceptable amount of unnecessary suffering worldwide during the last year of life. Each year, over 100 million people would benefit from palliative care, yet fewer than 8 percent of those in need access it.

This is a global tragedy, but it is one that can be effectively remedied. We recognize that different countries are at different stages of establishing end-of-life care – for some the creation of 24/7 community services will be the key development. For others it will be providing access to pain and symptom-controlling essential medicines and staff trained to administer them.

This report present a five-step strategy for improving quality of life at the end-of-life with specific examples of innovations that have proven effective at reducing unnecessary suffering and improving end-of-life care in different settings and cultures.

Dying healed: Transforming end-of-life care through innovation

SE European countries have adopted –to a greater or lesser extent– a national strategy within the limits of international conventions and the European Strategy on Drugs model, but much room exists for substantial changes and improvements. The major problems encountered arise from the differences that emerge between the institutional framework formally declared and the policies ultimately applied in practice. Furthermore, these issues deteriorate because most of these legal orders fall short in assessing their relevant strategies and formal mechanisms.

According to the majority of national strategies, the importance of the role NGOs need to play is emphasized. It is noteworthy that, according to most National Strategies of SE European countries, it is acknowledged that NGOs and civil society should play an important and active role, especially in the fields of treatment and rehabilitation, but also in harm reduction policies. However, a significant deviation is observed between the provisions of national strategies and their practical application, mainly attributed to lack of or insufficiency of relevant funding. The influence of NGOs in legislative decision-making is still quite limited. Neverthe-less, while positively recognizing the need for an interdisciplinary and multi-sector approach and addressing of the drug legislation issue, criminal law firmly persists as a determining factor and the chief regulator of the situation in most coun-tries of the region.

Trends and developments in drug legislation in South Eastern Europe

The report on the current state of play of the Council Recommendation of 18 June 2003 on the prevention and reduction of health-related harm associated with drug dependence PDF has been finalised. The report results of the work of experts from Gesundheit Österreich Forschungs - und Planungsgesellschaft mbH (GÖ FP GmbH) and SOGETI, in close collaboration with EAHC, EMCDDA, DG SANCO, and DG JUST.

It presents the updated overview of the implementation of the Council Recommendation in the EU countries, Croatia and several candidate countries, including country profiles, as well as analyses of regional and EU epidemiological trends.The study also assesses the availability of - access to- and -coverage of- harm reduction measures based on the answers to a policy survey.

The available scientific evidence regarding interventions to prevent and reduce health-harms associated with drug dependence was analysed and five systematic Literature Reviews PDF were produced.

The epidemiological background data, using data available at the EMCDDA, as well as other relevant information, and trends from 2003 to 2011 were analysed as well as main trends in availability and coverage of harm reduction measures introduced by the Council.

Current state of play of the 2003 Council recommendation on prevention and reduction of health related harm associated with drug dependence 

By 2012, UNAIDS estimated that 270 000 people were living with HIV in the countries of the MENA region. With the exceptions of Djibouti and Somalia, the majority of HIV epidemics in this region, are concentrated among key populations at higher risk, typically among people who inject drugs, men who have sex with men and sex workers.

While understanding of the nature of the region’s HIV epidemics has increased, critical gaps still exist and need to be addressed.In recent years many countries have been affected by social and political unrest and conflict. Cumulatively, these have potentially serious implications for the region’s HIV epidemics. Not only do unrest and conflict disrupt implementation of prevention and advocacy programmes and interfere with service delivery (e.g. including distribution of anti-retroviral therapy), they can also create the kind of conditions and vulnerabilities that exacerbate HIV epidemics. While some countries are primarily affected by internal unrest, others are affected by the consequences of unrest within neighbouring countries.

Some, such as Egypt, are affected by both. Several countries have adapted their responses to HIV to reflect these new realities. Eleven countries undertook Mid-Term Reviews5and assessed their progress in relation to each of the ten targets. The table that follows this section demonstrates the extent to which each target has been identified as a priority, whether or not it is included in the national strategic plan and whether or not countries consider themselves to be on track to achieve the target. The overall tone in these self-assessments is one of optimism but for several targets this appears to be unwarranted.

As this report shows, some countries have made significant and impressive progress and achievements. However, in still too many countries, denial, stigma and discrimination appear to determine the nature of the response, in some cases even preventing gathering of the basic information necessary to plan appropriate responses.

2013 regional report for the Middle East and North Africa 

Drug trafficking is not a new phenomenon in the Argentinian city of Rosario. Since the 1990s, and largely under the public radar, the distribution of illicit drugs in the poor, peripheral neighbourhoods of the city has been managed by family-run gangs and small-time dealers; poverty and social marginalisation have facilitated the trade; young gang members, known as

, have fought over territory; local demand for illegal drugs has provided the engine; illicit profits have been laundered in collaboration with local lawyers and financial advisors; and corruption among the police and local officials has ensured that the main traffickers, while their identities are widely known, can operate with few concerns other than threats from rivals. This last element appears to explain why, until the issue was forced into the public domain, there had been a conspicuous lack of political concern with drug trafficking in the city.

The change came on New Year’s Day 2012. That day, three community activists were shot and killed in the Villa Moreno neighbourhood by gang members who mistook them for rivals. The killings were not unique, but the victims were: unlike the usual casualties, the activists had a movement behind them. Their deaths led to local demonstrations and calls for action. The press and local officials were suddenly impelled to pay attention to drug trafficking and related violence. Since then, a spate of official investigations has deepened public understanding of the nature of the drug trade in the city. They have also provided further evidence of the complicity of the security forces and the negligence of the state that have long been known to facilitate trafficking.

Maintain the focus on the leadership of the most powerful and violent gangs, including following the money trail, and reverse the trend where simply increasing the number of security forces in violent areas is considered a sufficient policy response.

Re-focus the judiciary away from a two-tiered approach: recognize underage gang members as a vulnerable population, and that confronting the culture of violence will require special initiatives.

Root out corruption in the local and provincial security forces, recognise the way the state's approach facilitates this complicity, and produce more reliable statistics to better inform policymakers.

Eyes wide shut: Corruption and drug-related violence in Rosario

India has a long history of opium and cannabis use, especially for medicinal, religious and recreational reasons. State regulation and community tolerance ceased after the enactment of the Narcotic Drugs and Psychotropic Substances Act (NDPS) in 1985, which created a restrictive regime around drugs. Clampdown on cannabis and opium in the late 1980‟s purportedly triggered more dangerous use – chasing and injecting heroin and other opioids.

The NDPS Act, 1985 is one of the harshest laws in the country. It prohibits cultivation, production, possession, sale, purchase, trade, use and consumption of narcotic drugs and psychotropic substances except for medical and scientific purposes under license. The Act has been amended twice; in 1989 and 2001. The first amendments in 1989 leaned towards greater stringency by introducing mandatory minimum sentences of 10 years, restrictions on bail and mandatory capital punishment for repeat offenders. Following the amendments, persons caught with small amounts of drugs faced long prison sentences, without the possibility of release on bail. Courts criticized the harsh and disproportionate sentencing structure, which led to a fresh set of reforms in 2001 to rationalize punishment on the basis of whether the quantity of drugs involved is ‘small’, ‘commercial’ or ‘intermediate’ and provide some leniency towards drug offenders who also use drugs.

The narcotic drugs and psychotropic substances act: Ignoring health, infringing rights

This year’s Southeast Asia Opium Survey shows that despite eradication efforts, opium poppy cultivation in the region continues to increase. Poppy cultivation in Myanmar rose 13% from the previous year to 57,800 hectares, more than doubling since 2006. In Lao cultivation levelled off but remains a concern.

The combination of an increase in both cultivation and yield of opium poppy in Myanmar in 2013 resulted in a rise in opium production of some 26% in comparison to 2012. The best estimate for 2013 opium production in Myanmar alone is some 870 tonnes, the highest since assessments by UNODC and the Government began. Heroin seizures in East and Southeast Asia in 2012 were just over nine tonnes, compared to 6.5 tonnes in 2010, while there were 2.7 tonnes of opium seized in 2012 compared to two tonnes in 2010.

Surveys of farmers in poppy-growing villages, indicate that the money made from poppy cultivation remains an essential part of family income. Villagers threatened with food insecurity and poverty need sustainable alternatives, or they will continue out of desperation to turn to growing this cash crop. Another troubling trend that must be addressed is the rise in demand in nearby markets, which may be fuelling the resurgence in cultivation and production.

In Myanmar and Lao PDR, the use of opium, heroin and synthetic drugs – another growing threat in the region –, remains high. Moreover, the number of registered heroin and synthetic drug users in China has been going up since 2007.

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