Author: Milutin

Executive Director, Drug Policy Network Youth East Europe

European Web Survey on Drugs 2021

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From the EMCDDA press release

The EU drugs agency (EMCDDA) published today results of the European Web Survey on Drugs. The survey ran between March and April 2021 in 30 countries (21 EU and 9 non-EU) when many populations were under COVID-19-related lockdowns. Targeted at people aged 18 and over who have used drugs, the survey aims to improve understanding of patterns of drug use in Europe and help shape future drug policies and interventions.

Close to 50 000 adults (48.469) responded to the survey from 21 EU Member States and Switzerland. Cannabis was the drug used most, with 93% of survey respondents reporting to have used it in the previous 12 months and with little variation between countries. MDMA/ecstasy (35%), cocaine (35%) and amphetamine (28%) were the next most reported illicit substances, with the order of the three drugs varying by country. Around a third of respondents (32%) reported using more (herbal) cannabis and 42% using less MDMA/ecstasy.

The survey revealed that one fifth (20%) of the sample reported using LSD in the last year, 16% using new psychoactive substances (NPS) and 13% using ketamine. Heroin use was reported by 3% of respondents. Although the sample reporting heroin use was small, over a quarter of these respondents (26%) reported using this drug more during the period studied.

New to the 2021 round was the participation of the agency’s partners from the Western Balkans, through an EMCDDA technical assistance project (IPA7).

Over 2 000 adults (2 174) from Albania, Kosovo*, Montenegro, North Macedonia and Serbia responded to the survey. Most respondents (91%) reported using cannabis in the previous 12 months, followed by cocaine (38%), MDMA/ecstasy (22%) and amphetamine (20%). Again, around a third of respondents (32%) reported using more (herbal) cannabis and 34% using less MDMA/ecstasy.

Almost one in six (17%) respondents reported using NPS in the last year, while 9% reported use of LSD. Use of both heroin and methamphetamine was reported by 8% of respondents.

Home was reported as the most common setting for drug use during the period (85% of respondents in the EU-Switzerland survey and 72% in the Western Balkans), a pattern accentuated by COVID-19 lockdowns and closure of nightlife venues. Motivation for the use of different substances sheds some light on these results. The most commonly reported motivations for cannabis use were relaxation, getting high and aiding sleep, while for MDMA/ecstasy, they were its euphoric and socialising effects.

 

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Continuous shrinking of the civic space for several years

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The Balkan Civil Society Development Network (BCSDN) reacted to the DG NEAR Consultations on the first regional call of the IPA Civil Society Facility (CSF) and Media Programme 2021-2023, published on 4 January 2022 on the TACSO website on behalf of the DG NEAR.

In times of declining freedoms, growing constraints to civil society operations in the enlargement countries, and continuous shrinking of the civic space for several years, confirmed by the most influential reports on the state of democracy, as well as the EC reports themselves, the highest priority of the regional call should have been supporting CSOs in protecting civic space and countering back democratic relapse.

BCSDN emphasizes that the EU should put a stronger focus on core and long-term support for CSOs rather than short-term project support. Instead of engaging costly international consultancies or intermediaries, the EU would support the work of CSOs grounded in knowledge of the local needs and challenges, committed to the long-term positive development of their societies.

The EU should show better recognition and consideration of the needs, positions and – even more so – the value of CSOs in the region, and start setting an example to the Western Balkan governments on what enabling meaningful participation of CSOs means.

In November 2021, the BCSDN issued the Non-Paper on the IPA III CSF and Media Programme 2021-2023. Several regional network, including DPNSEE, supported the non-paper.

The BCSDN reaction is available following this link>>>.

 

Reducing incarceration will reduce harm

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The Harm Reduction International published the briefing The Harms of Incarceration: The evidence base and human rights framework for decarceration and harm reduction in prisons. It provides advocates with the evidence base and human rights framework for decarceration and the provision of harm reduction services in prisons.

The document provide evidence that:

  • The first step in reducing harm associated with incarceration is to reduce reliance on incarceration itself.
  • Providing harm reduction is a human rights obligation.
  • Harm reduction services in prisons are an essential, effective and safe public health measure.
  • People in prison are severely underserved by harm reduction services.

The highlights of the briefing inslude:

Over 11 million people are imprisoned worldwide today, the highest number ever recorded. One in five people in prison worldwide is held for drug offences, and 90% of people who inject drugs will be incarcerated at some point in their life. People in prison are at greater risk of HIV, hepatitis C, tuberculosis and COVID-19. When they are released from prison, their risk of overdose increases by up to 69-times.

People in prison retain their human rights, which includes their right to health. By withholding health services such as harm reduction from them, states are violating this right. In some cases, withholding essential services like opioid agonist therapy amounts to torture. The UN Special Rapporteur on Health, the European Convention on Human Rights, and the Nelson Mandela Rules on the treatment of prisoners all oblige states to provide health services in prisons.

Harm reduction works. Robust evidence shows that harm reduction services reduce transmission of HIV and viral hepatitis, reduce risk behaviours, reduce deaths from all causes, and can even reduce chances of people coming back to prison. This is why the World Health Organisation, UNAIDS and UN Office on Drugs and Crime all support harm reduction in prisons.

Even though states are obliged to provide the same standard of healthcare inside and outside prisons, when it comes to harm reduction, they do not do so. In nearly a third of countries where opioid agonist therapy is available, people in prison have no access. In 88% of countries where needle and syringe programmes operate, there are none in prisons. Even where services are available in prisons, there are frequently barriers that make them inaccessible in practice.

To read full briefing, follow this link>>>.

 

COVID-19 vaccinations for prison populations and staff

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People in prison continue to be left behind in COVID-19 responses despite facing heightened risk of infection and illness due to cramped and unsanitary living conditions and lack of hygiene supplies in many detention facilities, as well as the poorer health status of prison populations compared to the general population. Even in countries with relatively high standards for places of detention, people detained and working in prisons have been infected and died of COVID-19. The latest available figures indicate that as of July 2021, over 575,000 cases have been recorded in prisons and over 4,000 people in prison have died in 47 countries due to COVID-19.

Penal Reform International (PRI) and Harm Reduction International (HRI) carried out the first ever global mapping of policies & practices related to COVID-19 vaccination in prisons across 177 countries.

This report presents the findings of global mapping of COVID-19 national vaccination plans and their roll-out in prisons. It provides analysis on how, and to what extent, prisons are included (and prioritised) in national vaccination plans, and documents the progress to-date in rolling out the vaccine in prisons. In doing so, this report sheds light on a critical aspect of COVID-19 responses in prisons, namely vaccinations, which are an important tool for ensuring that people deprived of liberty – who too often remain invisible to society and at risk of infection or in need of medical care – are not forgotten.

The report is available following this link>>>.

 

COVID-19 and Sex Workers/Sex Worker-led Organisations

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As a criminalised population, sex workers have been disproportionately impacted by the COVID-19 pandemic, often living in precarious economic situations and excluded from social protection systems. The policy brief COVID-19 and Sex Workers/Sex Worker-led Organisations, produced by the Global Network of Sex Work Projects (NSWP), includes feedback directly from sex worker-led organisations and sex workers on their experiences of the COVID-19 pandemic, including its impact upon access to services, supplies of HIV treatment, and prevention commodities. It also highlights how the already extremely limited funding available for both advocacy and programming for sex workers continues to shrink.

This brief documents how sex worker-led organisations supported sex workers where states failed to provide adequate assistance in their social protection mechanisms and emergency responses. Finally, this paper examines the threats to sex workers and sex worker-led organisations as the world emerges from the pandemic, looks at how we can mitigate the harms and prepare sex worker-led organisations for future crises, and asks what lessons can be learned that might strengthen advocacy for sex workers’ rights going forward.

You can download this Policy Brief followint this link>>>. It is also available in Russian, Chinese, French and Spanish.

 

A new daily centre

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Our member organisation Healthy Options Project Skopje (HOPS) from North Macedonia opened the new Daily Centre for Rehabilitation and Resocialization of Drug Users and Their Families. The centre is located at a new location – 16 Kosta Kirkov Street in the city centre of the capitol Skopje.

The working hours of the centre are from 10 to 15 h. The centre continues to provide services: psychiatrist, psychologist and pedagogue. Depending on the needs of clients, all other services of the organization are also available – support from a social worker, lawyer, etc.

In partnership and with financial support from the City of Skopje, Department of Social, Child and Health Protection, HOPS, opened the Daily Centre back in September 2012.

 

A long-acting injectable pre-exposure prophylaxis for HIV prevention approved

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The United States Food and Drug Administration announced its first approval of a long-acting HIV prevention medication on 20 December 2021. The long-acting injectable cabotegravir (CAB – LA) is approved as a pre-exposure prophylaxis (PrEP) for adults and adolescents who are at risk of acquiring HIV sexually in the United States of America. Apretude is given first as two initiation injections administered one month apart, and then every two months thereafter. Patients can either start their treatment with Apretude or take oral cabotegravir (Vocabria) for four weeks to assess how well they tolerate the drug.

This is the first time an injectable antiretroviral drug becomes available as a pre-exposure prophylaxis for prevention of HIV. The long-acting formula is a step forward and a valuable addition to the HIV prevention toolbox and will make acceptance and adherence easy.

Companies holding new technologies should share their knowledge and recipes with generic producers to ensure availability and affordability in low and middle-income countries. UNAIDS called for this new drug to quickly be made available and affordable to people who need it most not just in the United States of America but everywhere in the world. The mistakes of three decades ago when lifesaving drugs were only available to those who could afford it must not be repeated. Market strategies such as generic competition and public health-oriented management of intellectual property rights, either through voluntary agreements or the use of TRIPS flexibilities must be used to make this new drug widely available.

To make this drug available equitably across the world, a series of actions are essential. Firstly, the drug has to be approved by regional and national regulatory authorities in a speedy manner. It is encouraging to see that the developer of CAB-LA, has already submitted to the South African Health Products Regulatory Authority (SAHPRA) for approval and an outcome is expected in early 2022. However access must go much further. Secondly the selling price must come down through a combination of measures such as licencing and involvement of generic producers. Thirdly, national HIV prevention programmes must prepare roll out plans and prepare their health systems and communitiues to deploy this new HIV prevention option as soon as they are available.

Current pre-exposure prohylaxis – Tenofovir plus Emtricitabine – tablets have to be taken daily as oral PrEP. They are highly effective in preventing HIV acquisition among persons at substantial risk when taken as prescribed. However many find it challenging to take a daily tablet. Another option – dapiviringe vaginal ring – is becoming available as additional prevention option for women at substantial risk of HIV infection.

The CAB-LA option could be a game-changer for the HIV response, making PrEP simpler or less burdensome for all genders. This may also circumvent the stigma associated with daily oral therapy and improve correct dosing and adherence which is critical for PrEP effectiveness.

Drug Decriminalisation [e]Course

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The International Dug Policy Consortium (IDPC) in partnership with Mainline, Health[e]Foundation and Frontline AIDS designed the Drug Decriminalisation [e]Course to support and equip partners from around the world to advocate for the decriminalisation of drug use and personal possession.

The Course includes seven modules:

  1. Introduction, definitions and support for decriminalisation (Available in English and French)
  2. Existing models of decriminalisation (Available in English and French)
  3. Making the case for decriminalisation (Available in English and French)
  4. Designing decriminalisation – part 1: selecting the model of decriminalisation (Available in English)
  5. Designing decriminalisation – part 2: defining drug possession for personal use (Forthcoming)
  6. Designing decriminalisation – part 3: sanctions and intrusiveness (Forthcoming)
  7. The ‘gold standard’ for decriminalisation (Forthcoming)

Ahead of the December break, I share the good news that Module 4 was presented. It is the first of three modules delving into the complex and important challenge of designing decriminalisation models, addressing key issues such as the model’s normative basis and key decision-makers.

This e-course was designed to strengthen our movement’s capacity to advance effective and full decriminalisation and is entirely free.

To register and access the course click here>>>.

 

Malta approves legalisation of cannabis for personal use

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The Parliament of Malta approved the legalisation of cannabis and its cultivation for personal use on 14 December 2021 with 36 votes in favour and 27 against. Malta is the first country in the European Union to make that move.

Equality Minister, Owen Bonnici, said the “historic” move would stop small-time cannabis users from facing the criminal justice system, and would “curb drug trafficking by making sure that users now have a safe and regularised way from where they can obtain cannabis”.

Possession of up to seven grams of the drug will be legal for those aged 18 and above. It will permissible to grow up to four cannabis plants at home, with up to 50g of the dried product storable.

Possession of up to 28 grams will lead to a fine of €50-€100 but with no criminal record. Those under the age of 18 who are found in possession will go before a commission for justice for the recommendation of a care plan rather than face arrest. Those who consume cannabis in front of a child face fines of between €300 and €500.

It will be legal for non-profit cannabis clubs to cultivate the drug for distribution among their members, similar to organisations tolerated in Spain and the Netherlands. Club membership will be limited to 500 people and only up to 7 grams a day may be distributed to each person, with a maximum of 50 grams a month. The organisations, which cannot be situated less than 250 metres from a school, a club or a youth centre, may also distribute up to 20 seeds of the plant cannabis to each member every month.