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Perspective: To Prevent AIDS in Russia, Drug Addicts Need Care

Location: 
Russia
Russia has one of the fastest spreading HIV epidemics in the world, driven largely by the government's refusal to institute measures to treat the country's drug addicts — measures that have dramatically reduced HIV infections in drug addicts in other countries, including the U.S.
Publication/Source: 
TIME (US)
URL: 
http://healthland.time.com/2011/01/18/perspective-to-prevent-aids-in-russia-drug-addicts-need-care/

Safe Shooting: Downtown Needle Exchange Cactus Montreal Says It Will Open A Safe Injection Site Next Year, With Or Without Provincial Approval

Location: 
Montreal, QC
Canada
If a Montreal needle exchange has its way, Quebec will soon become the second Canadian province to offer a safe-injection site — whether the provincial government wants it or not. Cactus Montreal, announced last week that it will offer IV drug users space to inject drugs under medical supervision at their office on Ste-Catherine E. and Sanguinet. Their goal is to reduce HIV and hepatitis C infection and prevent accidental overdose deaths.
Publication/Source: 
The Mirror (Canada)
URL: 
http://www.montrealmirror.com/wp/2010/12/09/news/safe-shooting/

Portuguese Drug Reformers Look Beyond Decriminalization [FEATURE]

The Portuguese government has garnered well-earned plaudits for its nine-year-old policy of the decriminalization of drug possession, first last year from Glenn Greenwald in a White Paper commissioned by the Cato Institute, and just last month in a new academic study in the British Journal of Criminology. But while they applaud the Portuguese government for embracing decriminalization, some drug user advocates there are saying there is more to be done.

Lisbon, capital of Portugal
Portugal broke new ground back in July 2001 when it decriminalized the possession of up to a 10-day supply of all illicit drugs. Under the new policy, drug users caught with drugs are not arrested, but are instead referred to regional "committees for the dissuasion of addiction." Those committees are empowered to impose warnings or administrative penalties, including fines, restrictions on driving, and referral to treatment.

But in most cases, the committees simply suspend the proceedings, meaning that, in effect, no punishment is meted out. The decriminalization policy has been accompanied by increased investment in treatment and harm reduction services, including methadone maintenance for people addicted to heroin.

As Greenwald found last year, and researchers Dr. Caitlin Hughes and Professor Alex Stevens last month, decriminalization is working. Hughes and Stevens found that while there had been a modest increase in drug use by adults, it was in line with increases reported by other southern European countries.

While drug use increased modestly, Hughes and Stevens were able to report that the harms associated with drug use had decreased under decriminalization. They found a reduction in the rate of spread of HIV/AIDS, a reduction in drug-related deaths, and a reduction in drug use by adolescents. They also found that drug seizures had increased under decriminalization.

"Contrary to predictions, the Portuguese decriminalization did not lead to major increases in drug use," the researchers concluded. "Indeed, evidence indicates reductions in problematic use, drug-related harms and criminal justice overcrowding.”

For Hughes and Stevens, the Portuguese experiment was also significant because it showed that decriminalization reduces harm for all drugs, not just marijuana. "Such effects can be observed when decriminalizing all drugs," they wrote. "This is important, as decriminalization is commonly restricted to cannabis alone."

Speaking in New York last week, Stevens elaborated: "The evidence from Portugal suggests that we could end the criminalization of users of all types of drugs -- and not just marijuana -- without increasing drug use and harms. It also shows the importance of continued investment in treatment services and harm reduction to reduce drug-related deaths and HIV."

But while Portugal's decriminalization is gathering praise from abroad, the view from the ground is a bit more nuanced. Decriminalization has improved the lives of drug users, but much remains to be done, said Jorge Roque, a Portuguese attorney who works with the European Coalition for Just and Effective Drug Policies (ENCOD), the International Network of People Who Use Drugs (INPUD), and the Portuguese group Diferenca Real, which attempts to improve conditions for drug users there.

"Decriminalization allowed drug users to stop being persecuted by the police and helped many of them realize they are not criminals simply because they chose to use drugs," said Roque. "And many people are now receiving help from the drug attendance centers," where addicted drug users may be sent after being caught. "Many drug users are trying hard to stay within the law, because if one isn't a criminal just for using drugs and one can pay for his drugs through his job, he doesn't want to be identified as a criminal, which was impossible before decriminalization."

Decriminalization has also led to changes in policing, said Roque. "After some time, the police shifted from arresting drug users to going after small-time dealers," he noted. "The police realized that arresting the small-timers is the best way to catch the big sharks," he said, alluding to the continuing black market drug trade. "The black market remains. Decriminalization didn't stop that," Roque said.

"The majority of drug-related crime wasn't caused by using a drug," the attorney continued, "but by committing an offense to buy drugs. Decriminalization is an important step, but it is only a step. Drug distribution is still forbidden in Portugal, and that means traffickers have a monopoly on the drug supply, and as a result, the prices are very high. So many people commit small thefts to buy their drugs, and the police try to control them and the drug neighborhoods with all the usual abuses."

The Portuguese government should not be sitting on its laurels, Roque said. While it deserves praise for what it has done, it has not done enough, he said.

"We are completely happy that the government decriminalized drug use, but the drug situation is very complex and touches on many different aspects -- legal, political, health, social, economic, morality -- and we have some demands that we think the government is not addressing because it is satisfied with what it has done with decriminalization," said Roque.

That point was echoed by Joep Oomen, head of ENCOD. If the Portuguese government stops with just decriminalization, it will be just as hypocritical as any other government, he said.

"By decriminalizing the use and possession of small quantities of illegal drugs, Portugal has reduced the immediate damage of drug prohibition," Oomen said. "The police don't persecute users and petty dealers as much, and problematic users find their way to health services. But decriminalization has not solved the main problem of prohibition: Drugs continue to be distributed by traffickers who inflate the price, impose criminal marketing methods, and have minimal concern for product quality or the safety of consumers. If Portuguese authorities do not take the next step toward legal regulation of the market, their policies will remain as hypocritical as those of any other country," he said.

But that's unlikely any time in the near future, said Roque. Even other drug reforms this side of ending prohibition are now stalled, he said.

"After all the international news reporting on the success of decriminalization in Portugal, the politicians' egos are so big they think they don't need to do anything else," said Roque. "But many drug users want to see safe injection sites, heroin maintenance programs, and the like, instead of just decriminalizing use. Similarly, the cannabis reform bill is still stuck in parliament waiting for approval. The government says it is busy with the international financial crisis and now our own public deficit, and can't do anything, even though this could mean revenues for the government."

With its drug decriminalization policy, Portugal has indeed become a beacon to the world, a model of progressive drug reform that could and should be emulated elsewhere. But as Roque and Oomen make clear, decriminalization is only half the battle.

Portugal

Canadian Coalition Calls for Injection Site for Drug Users

Location: 
Montreal, QC
Canada
Saying the billions spent on the war on illegal drugs have done nothing other than fuel the transmission of HIV and hepatitis C, a coalition of Quebec addiction support centers is calling for the creation of a supervised injection site for drug users in Montreal.
Publication/Source: 
The Gazette (Canada)
URL: 
http://www.montrealgazette.com/health/Group+calls+injection+site+drug+users/3902154/story.html

Half of Canadians Say Legalize Marijuana

Exactly 50% of Canadians support legalizing marijuana, according to poll results released Monday by Angus-Reid Public Opinion. Some 44% oppose legalization, with 6% undecided. 

Support for legalization has declined slightly when compared to Angus-Reid polls in 2008 and earlier this year. In both those polls, support for legalization was at 53%. But the difference is within the poll's +/- 3.1% margin of error.

Support for pot legalization was highest in Manitoba and Saskatechewan (61%), British Columbia (54%), and Ontario (51%). Support was weakest in Alberta (45%).

The poll also asked about support for legalizing drugs other than marijuana. In no case was support for legalizing hard drugs higher than 10%. 

The poll also queried respondents on whether Canada has a "drug problem" and how serious it is, as well as their positions on several drug policy-related government proposals. Slightly more than a third (37%) thought Canada has a drug abuse problem that affects the whole country, while 41% thought the drug abuse problem was reserved for "specific areas and people." Only 11% thought Canada did not have a serious drug problem, and 10% had no opinion or didn't know.

When it came to policies, there was strong (81%) support for a National Anti-Drug Strategy, including a national youth awareness campaign to keep kids off drugs. But the Conservative government's push against harm reduction measures, such as needle exchanges and Vancouver's safe injection site was supported by only 35% of respondents and its scrapping of the previous Liberal government's pot decriminalization proposal was supported by only 33%.

But somewhat paradoxically, while half of Canadians support pot legalization and nearly as many (47%) support the Liberal decriminalization plan, nearly two-thirds (64%) support the Conservatives' bill to impose mandatory minimum sentences on people growing as few as five pot plants, as well as people convicting of selling other drugs. That number may, however, be an artifact resulting from the question design, which conflated "marijuana grow operators" and "drug dealers."

It appears that marijuana is indeed related to schizophrenia--at least in the Canadian political psyche.

Fraser Health Authority Urged to Push Needle Exchanges Into Hostile Cities

Location: 
Canada
Injection drug addicts are at much greater risk of catching and spreading disease in the Fraser Health region because health authority officials have failed to deliver on the promise of their harm reduction policy, reform advocates charge. They say access to needle exchanges, safe injection sites and methadone clinics is much poorer than in the Vancouver area – largely due to opposition from hostile city councils and police forces who think an abstinence policy is best.
Publication/Source: 
Hope Standard (Canada)
URL: 
http://www.bclocalnews.com/fraser_valley/hopestandard/news/106728428.html

Swiss Drug Policy Should Serve As Model: Experts

Location: 
Switzerland
Switzerland's innovative policy of providing drug addicts with free methadone and clean needles has greatly reduced deaths while cutting crime rates and should serve as a global model, health experts said. Countries whose drug policy remains focused on punishing offenders, including Russia and much of Eastern Europe and Central Asia, should learn from a Swiss strategy based on "harm reduction" that protects both users and communities, they said.
Publication/Source: 
Reuters
URL: 
http://www.reuters.com/article/idUSTRE69O3VI20101025

Sydney Safe Injecting Site Trial Ends

Location: 
Sydney, NSW
Australia
Sydney, Australia's safe injecting site at Kings Cross will become a permanent fixture after operating on a trial basis since 2001. Legislation lifting the center's trial status will also confirm it will remain the only safe injecting center of its kind in New South Wales.
Publication/Source: 
The Sydney Morning Herald (Australia)
URL: 
http://news.smh.com.au/breaking-news-national/sydney-drug-injecting-centre-trial-ends-20100915-15b4b.html

Canadian Medical Association Journal Article Sides with Drug Injection Site

Location: 
Vancouver, BC
Canada
An article in the Canadian Medical Association Journal slams the federal government for its efforts to shut down Insite in downtown Vancouver, Canada's only safe injection site for drug addicts.
Publication/Source: 
CBC Radio-Canda (Canada)
URL: 
http://www.cbc.ca/consumer/story/2010/08/30/con-insite-cmaj.html

A Failed "War on Drugs" Prompts Rethinking on HIV Infections Among Injection Drug Users

Drug policy has focused on a policing approach of prohibition and incarceration, which has contributed to spreading HIV within the injection-drug community. Comprehensive drug reform policies are showing better results. Despite massive investments in drug law enforcement in the past three decades, with much of the international interdiction effort paid for by the U.S. government through assistance to national military and police forces, there is "a general pattern of falling drug prices and increasing drug purity" throughout the world, according to the Vienna Declaration.
Publication/Source: 
Scientific American (NY)
URL: 
http://www.scientificamerican.com/article.cfm?id=a-failed-war-on-drugs

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