In collaboration with the Eurasian Harm Reduction Network (EHRN), HPP has designed a policy decision model focused on persons who inject drugs (PWID). The PWID decision model identifies the existence of restrictive, poorly written, or absent enabling policies that may serve as obstacles for programs to provide both sustained and accessible HIV counseling and testing, antiretroviral therapy, hepatitis, tuberculosis, opioid substitution therapy, and sterile needle and syringe program services for PWID. It is also inclusive of issues such as stigma and discrimination, gender-based violence, and criminal justice systems.

While designed for global adaptation and application, the decision model specifically addresses policy barriers common in Eastern Europe.

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

Policy analysis and advocacy decision model for HIV-related services: People who inject drugs

The Health Policy Project (HPP) HIV policy analysis and advocacy decision models are systematic structures and methodologies designed to help stakeholders create an inventory of country policies, analyze these policies against international best practices and human rights frameworks, assess policy implementation, and create a strategic advocacy plan.

Decision models are grounded in international human rights and best practices and allow for policy analysis and comparison across country and regional borders. The primary goal of the model is to identify the policies that most directly affect access to and sustainability of key services and the needs and opportunities for policy advocacy that will improve access to services in both near and longer terms.

Designed to help country stakeholders build a public policy foundation that supports access to and implementation and scale-up of evidence-informed services for MSM/TG/SWs, the Decision Model helps to clearly identify and address policy barriers to services. Its policy inventory and analysis tools draw from the extensive body of international laws, agreements, standards, and best practices related to MSM/TG/SW services, allowing the assessment of a specific country policy environment in relation to these standards. This customizable, in-depth, and standardized approach will build stakeholders’ capacity to identify incremental, feasible, near-term opportunities to improve the legal environment and the resulting quality of and access to services for MSM/TG/SWs while long-term human rights strategies are implemented.

Policy analysis and advocacy decision model for services for sex workers, transgender, and males who have sex with males

Though famous for its coffee shops, where cannabis can be purchased and consumed, the Netherlands has accomplished many enviable public health outcomes through its drug policy. These include low prevalence of HIV among people who use drugs, negligible incidence of heroin use, lower cannabis use among young people than in many stricter countries, and a citizenry that has generally been spared the burden of criminal records for low level, nonviolent drug offenses.

Coffee Shops and Compromise: Separated Illicit Drug Markets in the Netherlands tells the history of the Dutch approach and describes the ongoing success of the country’s drug policy. This includes the impact of the Dutch “separation of markets,” which potentially limits people’s exposure and access to harder drugs.

Though coffee shops have traditionally commanded the most media attention, the Netherlands also pioneered needle exchange and safer consumption rooms, decriminalized possession of small quantities of drugs, and introduced easy-to-access treatment services.

These policies, coupled with groundbreaking harm reduction interventions, have resulted in the near-disappearance of HIV among people who inject drugs and the lowest rate of problem drug use in Europe.

Coffee shops and compromise: Separated illicit drug markets in the Netherlands

Crime rates in Canada are at their lowest point since 1972 yet last year, Canada’s federal government introduced sweeping legislative reforms to our criminal justice system. The stated goal of these expansive and expensive measures is to increase the safety and security of Canadians by getting “tough on crime” and holding offenders accountable.

The Safe Streets and Communities Act (SSCA), alternately known as Bill C-10 and the “Omnibus Crime Bill” was passed by Parliament on March 12, 2012. When the SSCA was debated in Parliament, Canadians were told that many provisions of the Act, including the introduction of mandatory minimum sentences for a number of drug offences, would target “serious organized drug crime” rather than people struggling with drug dependence. Many well-respected commentators, including the Canadian Bar Association, the Canadian Centre for Policy Alternatives, and the Assembly of First Nations have argued, however, that these amendments will affect a spectrum of drug offenders, including people involved in the sale and/or production of illicit substances as a result of their struggle with drug dependence.

Pivot Legal Society undertook this research in order to assess the potential scope and nature of the effects of the Safe Streets and Communities Act on low-income drug users. We also sought to examine whether new criminal law provisions were likely to raise constitutional issues, particularly when applied to members of Charter-protected groups, such as Aboriginal people and people with disabilities (including drug dependence).

Throwing away the keys: The human and social cost of mandatory minimum sentences

The coming on the market of the products called “Research Chemicals” or “legal highs” is no accident. It corresponds to an evolution in the drug using community, based on several elements:

The new generation has seized the Internet tool and spends an enormous amount of time “online”, in the world of the “web” where pleasure seeking is continually expressed. This new generation of users shares its experiments of the use of NPS (New Psychoactive substances) through Internet forums and it has now acquired a real expertise.

New businesses have emerged on the market of online sales of psychoactive substances, providing an ever moving and international offer. The emergence of these new drug routes has contributed to the development of a new “ Mafia”, that has adapted its strategies to this “Geek Generation”.

The law of 1970 is now forced into a virtual corner by these phenomena. These synthetic products are many, and their effects and their risks difficult to evaluate; their commercial profile and their online sale make them easily available on a large scale. Payments are carried out online by credit cards, using official bank routes; in all these aspects they go beyond law enforcement, which seems to have stalled in front of them.

As these NPS are conducive to risk taking, the addiction service providers need to work out new harm reduction strategies, which will fully, involving the users.

The new psychoactive products

This report focuses on drug treatment services in England, given the significant changes in policy and implementation over the last year. Many of the recommendations, for example on harm reduction and on services for people who inject drugs, are of course as relevant to Scotland, Wales and Northern Ireland as they are to England.

This report acts as a helpful prompt to both drugs and HIV/BBV sectors to protect and maintain with vigilance the health successes of the last three decades, whilst responding innovatively and promptly to change.

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

HIV and injecting drug use

In order to provide the reader with a better understanding of the selected terms, we have created a list of definitions that intend to shatter prejudice and avoid the interchangeable use of terms that are not synonyms. In addition, this guide pretends to help the reader to identify him/herself within the wide spectrum of positions that are discussed and defended in the public sphere –from supporters of prohibition to advocates of liberalisation, through to those who propose, in turn, the legal regulation of drugs.

As in most -serious- debates regarding public policy, the debate on drugs is a diverse, complex, and intellectual one. It is not because “us” reformers advocate for the “legalization of marihuana” or the “decriminalization of cocaine use” that we cease to be professionals, dedicated to the study of public policies, programmes, and governmental feats. In the same sense, and despite the growing “normalisation” of a discussion that was once taboo, the debate on drugs is neither unscientific, nor one of personal perceptions or singular and monolithic approaches. On the contrary, the drug policy debate is one in which a series of opinions and nuances are expressed and, although, sometimes complementary, such approaches will often remain different.

Guidelines for debate: Drug jargon, 5 terms that must be defined

A number of research studies and policy papers have highlighted the relationship between street based prostitution and problem drug us and the barriers that can prevent women involved in prosti tution from accessing services to change their lives and achieve recovery.

Nevertheless, there has been little research that has documented in detail the nature of the problems faced by this particular group, the extent and nature of current provision and the adequacy of coverage. This wide ranging study seeks to fill this gap and provide a platform for the further development of services to meet the needs of this particularly marginalised group who may fall into the gaps between services.

The stigma associated with both drug use and prostitution means that this will be a largely hidden group of women and there are no good estimates of the number of people affected in this way.

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

The challenge of change: Improving services for women involved in prostitution and substance use

In early 2013, the Institute of Development Studies (IDS) hosted the Global Drug and Development Policy Roundup, a new forum for discussing the nexus between the production, trade and use of illicit drugs, and development. It was conceived in response to persisting concerns that the international development and drug policy communities do not communicate sufficiently with one another, and that broader strategic cooperation is highly necessary.

Bringing development in: Tackling the negative effects of illicit drugs and drug policy on development

At the Sixth Summit of the Americas in Cartagena, Colombia, the presidents of the hemisphere’s 34 countries acknowledged the multidimensional nature of the drug phenomenon and the challenges it poses. Aware of the increasingly intense debate on the topic and the growing sense that there is a need to reform current policies and explore other alternatives, the heads of state and government said they had begun an “

invaluable discussion on the global drug problem [and had agreed] on the need to analyze the results of the current policy in the Americas and to explore new approaches to strengthen this struggle and to become more effective.”

 They issued the OAS a mandate to that end.

Report on the Drug Problem in the Americas

 is the tool for compliance with that agreement and mandate. Consisting of two different but complementary sections, the report includes a broad technical study of drug 

consumption, production, transit, commerce 

in the hemisphere, and examines the public policies adopted to address the problems of public health, illegality and violence it causes, as well as its social and political impact on society. The study’s conclusions are called the 

The scenarios, presented as a series of narratives with a time frame from 2013 to 2025, illustrate the possible outcomes of four different policy approaches which, although not mutually exclusive, emphasize different areas, such as 

of the international drug control system, reconstruction of the 

The drugs problem in the Americas – An analysis of the OAS report

This study represents the most comprehensive assessment of Global Fund investments in harm reduction. This funding, while substantial, falls short of the estimated needs. Investments in harm reduction must increase if HIV transmission among people who inject drugs is to be halved by 2015.

Read here the full publication (restricted access)

Global Fund investments in harm reduction from 2002 to 2009

A better understanding of the complex science of ‘addiction’ can improve responses to drug problems. This report contains a critical review of existing addiction theories and explores how these can be organised into an overarching structure to inform how we assess, prevent and treat addictive behaviours. This model is not limited to illicit drugs, but can also be applied to alcohol, tobacco and even non-pharmacological addictions, such as gambling or compulsive use of the Internet.

 delivers the message that understanding the biological basis of addiction, along with the broader social and psychological aspects of addictive behaviour, can lead to successful prevention and treatment responses.

Publications