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.

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

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.

Regional drug strategies across the world

This paper was created by young professionals and activists working in the fields of harm reduction, drug treatment, public health, social policy and human rights in various European countries: United Kingdom, Italy, Poland, Montenegro, Serbia, Albania and Romania. We are all members of Youth Organisations for Drug Action, a network that connects and supports young people who are working to reform drug policies in Europe, towards a model based on the principles of scientific evidence, human rights and cost-effectiveness. All contributors have both some educational background and work experience in areas related to the topic of this paper.

In this paper we aim to discuss the current situation regarding drug use in Europe among young people (aged 15-30, with variation in definition across countries) and the availability of services aimed at young drug users or potential users. We will also compare approaches adopted in examined countries to show which has proven to be to be most effective at reducing overall drug prevalence among young people as well as related risky behaviours and harms. Regional differences in drug culture, historical context and developing trends will also be taken into account.

Drugs, harms and youth: The state of drug use and harm reduction amongst youth in European countries

The initiative of the Ombudsman for Drug Dependent People was established in 2009 by The Polish Drug Policy Network and the Association of Patients in Substitution Treatment JUMP'93. The impetus to start with the Ombudsman's activity was an urgent need to ensure that drug addicts and users would receive decent legal aid and information on issues which were vitally important for them. There was also a need to improve the situation of drug treatment in Poland.

This is the second edition of the report written by Agnieszka Sieniawska and Jacek Charmast of the office of the Ombudsman for Drug Dependent People. Specific criminal cases discussed in the first report clearly demonstrated the gap between the objectives of the Act on Counteracting Drug Addiction, and the practice of its enforcement. Analysis of the cases included in this report shows that despite the announced changes, law enforcement continues to produce criminals prosecuting recreational users and addicted people instead of effectively eliminate drug dealers.

It is difficult to resist the temptation to abuse laws that criminalize the possession of minor amounts of drugs. This law makes it easy, simple, almost effortless to obtain excellent statistical results.This applies to police, prosecutors and the judiciary. The report clearly shows that despite the announced changes, the courts still deal with the cases of possession of small amounts of marijuana. People get labels of criminals, obtain criminal records, the prison become overcrowded.

Poland's drug law 

With the UN General Assembly Special Session (UNGASS) on the world drug problem approaching in 2016, there was hopeful expectation that the mid-term review of the 2009 Political Declaration and Plan of Action on drugs would help to set the scene for a transparent, inclusive and wide ranging debate. It was hoped that the UNGASS would take into account the new realities confronting drug control systems – which are evolving at the political level and on the ground.

The CND must ensure transparent, inclusive and comprehensive dialogue so that strategies, policies, and programmes are adapted to address new realities and challenges.

IDPC Advocacy Note - Can the UN Commission on Narcotic Drugs develop policies that meet the challenges of drug control in the 21st century?

The cannabis plant has been used for spiritual, medicinal and recreational purposes since the early days of civilization. In this report the Transnational Institute and the Global Drug Policy Observatory describe in detail the history of international control and how cannabis was included in the current UN drug control system.

Cannabis was condemned by the 1961 Single Convention on Narcotic Drugs as a psychoactive drug with “particularly dangerous properties” and hardly any therapeutic value. Ever since, an increasing number of countries have shown discomfort with the treaty regime’s strictures through soft defections, stretching its legal flexibility to sometimes questionable limits.

Today’s political reality of regulated cannabis markets in Uruguay, Washington and Colorado operating at odds with the UN conventions puts the discussion about options for reform of the global drug control regime on the table. Now that the cracks in the Vienna consensus have reached the point of treaty breach, this discussion is no longer a reformist fantasy. Easy options, however, do not exist; they all entail procedural complications and political obstacles. A coordinated initiative by a group of like-minded countries agreeing to assess possible routes and deciding on a road map for the future seems the most likely scenario for moving forward.

There are good reasons to question the treaty-imposed prohibition model for cannabis control. Not only is the original inclusion of cannabis within the current framework the result of dubious procedures, but the understanding of the drug itself, the dynamics of illicit markets, and the unintended consequences of repressive drug control strategies has increased enormously. The prohibitive model has failed to have any sustained impact in reducing the market, while imposing heavy burdens upon criminal justice systems; producing profoundly negative social and public health impacts; and creating criminal markets supporting organised crime, violence and corruption.

After long accommodating various forms of deviance from its prohibitive ethos, like turning a blind eye to illicit cannabis markets, decriminalisation of possession for personal use, coffeeshops, cannabis social clubs and generous medical marijuana schemes, the regime has now reached a moment of truth. The current policy trend towards legal regulation of the cannabis market as a more promising model for protecting people’s health and safety has changed the drug policy landscape and the terms of the debate. The question facing the international community today is no longer whether or not there is a need to reassess and modernize the UN drug control system, but rather when and how to do it.

The rise and decline of cannabis prohibition

By taking cues from users’ self-regulation strategies, it is possible to design innovative operational models for drug services as well as drug policies, strengthening Harm Reduction as an alternative approach to the disease model.

A significant body of research on cocaine users recruited outside captive populations – that is, studies based on samples of users who have not been enrolled through drug addiction services – has been carried out in many European countries and outside Europe. These studies show a variety of patterns and trajectories of use other than “addictive” use.

This paper illustrates the aim of encouraging users’ informal controls while reducing the harm caused by punitive laws and policies.

Cocaine: towards a self-regulation model

Portugal enacted one of the most extensive drug law reforms in the world when it decriminalized low-level possession and use of all illicit drugs more than a decade ago. Results of the Portuguese experience demonstrate that drug decriminalization – alongside a serious investment in treatment and harm reduction services – can significantly improve public safety and health.

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