Heroin maintenance is coming to Denmark. And it's about time -- how about here too? The evidence is in, and it's only ideology that stands in the way of saving lives that now are being needlessly lost.

In the meanwhile, watch the video from the Hungarian Civil Liberties Union and the Danish Street Lawyers about the new program:

Last month, a Romanian presidential committee recommended decriminalizing the possession of "soft" drugs, implementing n

Hit hard by a double whammy of drought and economic slowdown, California's Central Valley has become a hotbed of methamphetamine and other injection drug use.

The UN Office on Drugs and Crime (UNODC) warned Wednesday that the traffic in Afghan opiates is spreading drug use and addiction along smuggling ro

In a meeting in Bangkok last weekend, more than two dozen drug users from nine different countries came together to put the finishing touches on the creation of a new drug user advocacy organizatio

In a meeting in Bangkok last weekend, more than two dozen drug users from nine different countries came together to put the finishing touches on the creation of a new drug user advocacy organization, the Asian Network of People who Use Drugs (ANPUD). The Bangkok meeting was the culmination of a two-year process began at a meeting of the International Congress on AIDS in Asia and the Pacific in Colombo, Sri Lanka, in 2007, and resulted in creating a constitution and selecting a steering committee for the new group.

ANPUD adopts the principles of MIPUD (Meaningful Involvement of People who Use Drugs), and in doing so, aligns itself with other drug user advocacy groups, including the International Network of People who Use Drugs (INPUD), of which ANPUD is an independent affiliate, the Australian Injection and Illicit Drug Users League (AIVL),the Vancouver Area Network of Drug Users, and the Nothing About Us Without Us movement.

ANPUD currently has more than 150 members and sees its mission to advocate for the rights of drug users and communities before national governments and the international community. There is plenty to do. Asia has the largest number of drug users in the world, but is, for the most part, woefully retrograde on drug policy issues. Not only do drug users face harsh criminal sanctions—up to and including the death penalty—but Asian has the lowest coverage of harm reduction services in the world. Access to harm reduction programs, such as needle exchanges and opioid maintenance therapy, is extremely limited.

"People who use drugs are stigmatized, criminalized and abused in every country in Asia," said Jimmy Dorabjee, a key figure in the formation of ANPUD. "Our human rights are violated and we have little in the way of health services to stay alive. If governments do not see people who use drugs, hear us and talk to us, they will continue to ignore us."

The Director of the UNAIDS Regional Support Team, Dr. Prasada Rao, spoke of the urgent need to engage with drug user networks and offered his support to ANPUD, saying that "For UNAIDS, HIV prevention among drug users is a key priority at the global level," said Dr. Prasada Rao, director of the UNAIDS Regional Support Team. "I am very pleased today to be here to see ANPUD being shaped into an organization that will play a key role in Asia's HIV response. It is critical that we are able to more effectively involve the voices of Asian people who use drugs in the scaling up of HIV prevention services across Asia."

"When I go back home, I am now responsible for sharing the experiences with the 250 or so drug users who are actively advocating for better services at the national level," said Nepalese drug user and newly elected steering committee member Ekta Thapa Mahat. "It will be a great way for us to work together and help build the capacity of people who use drugs in Asia."

"The results of the meeting exceeded my expectations," said Ele Morrison, program manager for AVIL's Regional Partnership Project. "The participants set ambitious goals for themselves and they have achieved a lot in just two days to set up this new organization. The building blocks for genuine ownership by people who use drugs is definitely there."

While the meetings leading to the formation were organized and managed by drug users, the process received financial support from the World Health Organization, the UNAIDS Regional Task Force, and AIVL.

Southwest Asia: Afghan Opium Trade Wreaking Global Havoc, UNODC Warns

The UN Office on Drugs and Crime (UNODC) warned Wednesday that the traffic in Afghan opiates is spreading drug use and addiction along smuggling routes, spreading diseases, and funding insurgencies. The warning came in a new report, Addiction, Crime, and Insurgency: The Threat of Afghan Opium. "The Afghan opiate trade fuels consumption and addiction in countries along drug trafficking routes before reaching the main consumer markets in Europe (estimated at 3.1 million heroin users), contributing to the spread of HIV/AIDS and other blood-borne diseases," the report said.

Neighboring countries, especially Iran, Pakistan, and the Central Asian republics, are among the hardest hit, said UNODC. According to the report, Iran now has the highest opiate addiction rates in the world. "Iran faces the world's most serious opiate addiction problem, while injecting drug use in Central Asia is causing an HIV epidemic," UNODC said.

But the impact of the multi-billion flow of Afghan opiates could have an especially deleterious impact on Central Asia, UNODC chief Antonio Maria Costa warned in remarks accompanying the report. "The Silk Route, turned into a heroin route, is carving out a path of death and violence through one of the world's most strategic yet volatile regions," Costa said. "The perfect storm of drugs, crime and insurgency that has swirled around the Afghanistan/Pakistan border for years is heading for Central Asia."

In Pakistan and Afghanistan, the opium trade is funding violent radicals. "The funds generated from the drugs trade can pay for soldiers, weapons and protection, and are an important source of patronage," the report said. In Afghanistan, the Taliban generated between $90 million and $160 million annually in recent years, the UNODC estimated. In Pakistan, the UNODC estimated the trade at $1 billion annually, with "undetermined amounts going to insurgents."

Although Afghan opium production declined slightly last year, the country is producing—and has produced—more opium needed than to meet global supply. As a result, the UNODC estimates that there is an unaccounted for stockpile of 12,000 tons of opium—enough to satisfy every junkie on the planet for the next three to four years. "Thus, even if opiate production in Afghanistan were to cease immediately, there would still be ample supply," the report said.

Unsurprisingly, the UNODC report did not address the role that global drug prohibition plays in exacerbating problems related to opiate use and the opiate trade. Prohibitionist attitudes restrict the availability of harm reduction programs, such as needle exchanges, that could reduce the spread of blood-borne diseases. And it is global drug prohibition itself that creates the lucrative black market the UNODC says is financing insurgencies and spreading political instability.

Substance use and thus drug related harm occur within the context of people's lives including their experiences of trauma.

This half-day training is for anyone working with opiate users who may be at risk for overdose.

One of the articles we are finalizing for publication in Drug War Chronicle tonight deals with needle exchange, and the state of legislation in Congress to end the ban on use by states of federal AIDS funds to support needle exchange programs. A bill has passed the House of Representatives -- good news -- but it includes a provision that would render it nearly useless. This provision would require that needle exchange programs receiving federal funds not operate "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, or university, or any public swimming pool, park, playground, video arcade, or youth center, or an event sponsored by any such entity."

I'm not sure how any program could track where all the different such entities decide to hold events. More importantly, the rule would basically prevent needle exchanges from operating at all, because the area encompassed is pretty much everywhere inside any city.

Dr. Russell Barbour, at Yale School of Medicine's Center for Interdisciplinary Research on AIDS, has produced several charts that advocates are using now on the Hill, illustrating the impact the provision would have on AIDS prevention efforts in Chicago and San Francisco. He graciously provided them to us. Check them out here:

(more below the fold)

In a report released Wednesday, the Centers for Disease Control (CDC) has found that drug-related deaths -- the vast ma

Three weeks ago, Drug War Chronicle reported on cocaine cut with the veterinary agent lev

In a report released Wednesday, the Centers for Disease Control (CDC) has found that drug-related deaths—the vast majority of them overdoses—increased dramatically between 1999 and 2006, and that drug-related deaths now outpace deaths from motor vehicle accidents in 16 states. That's up from 12 states the previous year and double the eight states in 2003.

More people died from drug-related causes than traffic accidents in the following states: Massachusetts, New Hampshire, Rhode Island, Connecticut, New York, New Jersey, Maryland, Pennsylvania, Ohio, Michigan, Illinois, Colorado, Utah, Nevada, Oregon and Washington.

According to CDC researchers, who examined death certificate data from around the country, some 45,000 died in traffic accidents in 2006, while 39,000 people suffered drug-related deaths. About 90% of the drug deaths were from overdoses, but researchers also included in that figure people who died of organ damage from long-term drug use.

Researchers reported a sharp increase in deaths tied to cocaine and to the opioid analgesics, a class of powerful drug that includes fentanyl, methadone, morphine, and popular pain relievers like Vicodin and

Oxycontin. Cocaine-related deaths jumped from about 4,000 in 1999 to more than 7,000 in 2006, but methadone-related deaths increased seven-fold to about 5,000, and other opioid deaths more than doubled from less than 3,000 to more than 6,000. Oddly enough, heroin-related deaths actually declined slightly, hovering just below 2,000 a year throughout the period in question.

And despite all the alarums about young people dying of drug overdoses, the 15-24 age group had the lowest drug-related death rate of any group except those over 65. Only about three per 100,000 young people died of drug-related causes in 2006, compared to six per 100,000 among the 25-34 age group, eight per 100,000 in the 35-44 age group, and 10 per 100,000 in the 45-54 age group.

CDC researchers did not discuss causes for the increase in overall drug-related deaths or the rate of drug-related deaths, but several plausible (and complementary) explanations come to mind: the introduction and widespread use of Oxycontin, the fentanyl-tainted heroin epidemic that appeared in 2006, the increasing non-medical use of prescription pain relievers, and the increasing use of methadone as a pain reliever.

This new video by the Hungarian Civil Liberties Union highlights the Danish group Gadejuristen -- "Street Lawyers" -- a 10-year old Copenhagen based organization that advocates for the human rights of drug users in Denmark and which has played an important role in the promotion of innovative harm reduction programs.

Earlier this year, the Danish government commenced heroin maintenance programs for addicts. But according to HCLU, Denmark still has no safe injection sites, and the many users who therefore take heroin on the streets can face police harassment. A particular problem is that "no-go-zones" designated by local police can make it difficult for users to get to their needle exchange programs.

Responding to years of agitation by harm reductionists and public health advocates, the Pennsylvania Board of Pharmacy Saturday published

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Responding to years of agitation by harm reductionists and public health advocates, the Pennsylvania Board of Pharmacy Saturday published new regulations that will allow pharmacies to sell syringes without a prescription. The change goes into effect immediately. The move was lauded by activists as a significant public health victory in the battle against the spread of HIV/AIDS and Hepatitis C via injection drug use.

Under previous regulations, pharmacies could sell syringes only to people who obtained a doctor’s prescription. The new regulations carry no limit on the number of syringes that can be purchased at a time, nor do they have age limits.

“This change is particularly important in Pennsylvania because we have only two locations--Pittsburgh and Philadelphia--in which legally authorized syringe exchange programs operate,” said David Webber, an attorney for the AIDS Law Project of Pennsylvania. “These two programs alone are simply not adequate to address this problem across the entire state, but syringe exchange programs continue to be crucial in providing sterile syringes as well as access to drug treatment and health care for injection drug users.”

“This is a chance for every pharmacy to become part of HIV prevention in Pennsylvania,” said Scott Burris, professor at Temple University’s School of Law and a national authority on syringe regulation and HIV prevention. “The pharmacy board has taken an important step forward for evidence-based policy.”

It didn’t come swiftly or easily. Activist organizations including the Pennsylvania Aids Law Project, Prevention Point Pittsburgh, Prevention Point Philadelphia, as well as legislators, HIV workers, and others had lobbied for the change for a decade. In August 2007, the pharmacy board proposed new regulations allowing for over-the-counter syringe sales and opened them up for public comment. Thanks to concerns expressed by harm reduction and public health groups during the comment period, the board removed age and quantity restrictions.

The board rejected record-keeping requirements requested by the House Professional Licensure Committee, saying it “does not believe that maintaining a record and requiring individuals to provide a name or other identifying information would advance the public health and safety.” Similarly, it rejected a number of concerns from the Pennsylvania Medical Society that the rule change would increase drug use.

The board’s action reflected well-established scientific evidence that access to clean syringes is a critical component of stemming the spread of blood-borne diseases such as HIV and Hep C among injection drug users.

Now the number of states that do not allow syringe sales without a prescription is down to two: Delaware and New Jersey.

On the last day of August, media outlets around the country ran an Associated Press

In the last eight days, the decriminalization of drug possession has gone into effect for 150 million Latin Americans. Last Thursday, as part of a broader bill, Mexico (pop.

Another video from the Hungarian Civil Liberties Union, this time in partnership with the Swedish Drug Users Union. Sweden's government is one of the world's most prohibitionist, but nevertheless has moved toward harm reduction in recent years by expanding needle exchange into a national policy. Previously needle exchange was happening only in two cities in the nation's south.

Well, there's still no needle exchange in Stockholm, according to HCLU, it's even hard to get into a methadone maintenance program, and those who do often face negative attitudes from the program's staff. Check out the video below, or here.

In a report that was actually completed last October but not published until this week in the New England Jo