The most dangerous thing about MDMA is that it’s illegal

The Beckley Foundation published a policy proposal which examines the acute, sub-acute, and chronic harms related to MDMA use in detail. The report examines the production, distribution, purchase and consumption of the drug; related risks and harms; and the impact prohibition has on these, as well as the potential impact of alternative policies. Crucially, their evidence shows that most harms associated with MDMA use arise from its unregulated status as an illegal drug and that any risks inherent to MDMA could be more effectively mitigated within a legally regulated market.

Authors claim that there is growing evidence to support reorienting drug policy away from an ideologically driven criminal justice-led model to one rooted in pragmatic health and harm reduction principles. Current policy is not meeting its goal of reducing harms, and greater control of MDMA production, distribution, purchase and consumption is needed in order to prevent MDMA-related emergencies.

This policy proposal rests on the following five principles which should underpin all evidence-informed drug policy and practice:

  • Promoting public health and reducing harm
  • Safeguarding vulnerable populations, including children and young people
  • Supporting human rights
  • Promoting social justice
  • Supporting participatory democracy

Roadmaps to Regulation: MDMA has two overarching interlinked objectives:

  • To highlight that the harms associated with MDMA use are predominantly related to its prohibition;
  • To propose an alternative regulatory model that would reduce the harms associated with criminalising MDMA use and minimise the risks associated with its use more generally.

The report outlines, for the first time, detailed recommendations for drug policy reform in order to better control the production, distribution, purchase, and consumption of MDMA products. Reform, and the ensuing reduction in MDMA-related harms, will not happen overnight. The changes outlined, which culminate in a strictly-regulated, legal market for MDMA, would need to be phased in gradually and closely monitored throughout, in order to ensure that health and social outcomes are properly evaluated.

More about the report is available it the video below

To read full report, follow this link>>>

Global Fund 2020 Eligibility List

The Global Fund have just published their 2020 Eligibility List and the updated Projected Transitions List. Some of the changes are related to South East European countries.

Since Bulgaria and Romania are not on the OECD DAC list of ODA recipients, they may be eligible for an allocation for HIV for non-governmental or civil society organizations under Paragraph 9b of the Eligibility Policy only if they have demonstrated barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology. As 2020 is an allocation year, the Secretariat has conducted an assessment and has determined that Bulgaria and Romania don’t meet the requirements under Paragraph 9b of the Eligibility Policy. Therefore, they have been determined not to be eligible for an HIV allocation for the 2020-2022 allocation period.

Kosovo* was classified as an Upper-Middle Income country in the 2019 Eligibility List based on the latest three-year average of GNI per capita data (Atlas method). As a result, the HIV and TB components may be eligible for an allocation of Transition Funding in the 2020-2022 allocation period.

North Macedonia‘s HIV component is now classified as eligible in the 2020 Eligibility List after meeting eligibility criteria for two consecutive eligibility determinations, noting that eligibility does not guarantee an allocation.

Montenegro and Serbia remain eligible for HIV and Romania for Tuberculosis.

 

The 2020 Eligibility List is now available on the Global Fund’s website>>>

The projected transitions list is available following this link>>>

 

Global State of Harm Reduction 2019

Harm Reduction International, a leading NGO dedicated to reducing the negative health, social and legal impacts of drug use and drug policy, just published their annual The Global State of Harm Reduction biennial report. First published in 2008, it involves a coordinated effort across practitioners, academics, advocates and activists to map global data and responses to drug-related harms. The data presented here has been gathered over the course of 2019 from publicly available sources and in cooperation with our partners around the world.

It is the only report to provide an independent analysis of the state of harm reduction in the world and has become the go-to source on global harm reduction developments for researchers and advocates in our sector and beyond.

The Report indicated that:

  • Since 2018, the total number of countries implementing needle and syringe programmes (NSP) has increased by just one, from 86 to 87.
  • The re-introduction of NSPs in Bulgaria and the first NSP opening in Sierra Leone have been countered by the closure of services in Uganda.
  • No new countries have begun implementing opioid substitution therapy (OST) programmes since 2018.

We extracted the data on the situation in countries of South East Europe:

To get full information from the report, follow this link>>>

Should you find any inaccuracies, please contact Harm Reduction International at office@hri.global

EU Drug Markets Report 2019

Drug trafficking is a highly profitable commercial activity and remains a core business for organised crime groups across Europe today. Understanding the reality of the European drug market requires a holistic approach, following the supply chain from production and trafficking to distribution and sales.

Taking such an approach, two EU agencies – the EMCDDA and Europol – have joined forces to provide their third state-of-the-art overview of the European illicit drug market in the form of the EU Drug Markets Report 2019.

The analysis presented in this report spans numerous topics such as the links between drugs and other crimes, the licit economy and society more generally as well as the processes and players involved in the trade, from production and trafficking to distribution. Taking an evidence-based approach, the report reviews the markets for heroin, cocaine, cannabis, amphetamine, methamphetamine, MDMA and new psychoactive substances. It also provides action points to inform policy development at EU and national level. This publication is an essential reference for law enforcement professionals, policymakers, the academic community and indeed for anyone seeking up-to-date information and analysis on drug markets in Europe.

The latest data show that overall drug availability within Europe remains ‘very high’ and that consumers have access to a wide variety of high-purity and high-potency products at steady, or falling, prices. An important cross-cutting theme in the report is the environmental impact of drug production, including deforestation and the dumping of chemical waste, which can result in ecological damage, safety risks and high clean-up costs.

The report highlights the increasing importance of Europe, both as a target and drug-producing region, and shows how the violence and corruption, long seen in traditional drug-producing countries, are now increasingly evident within the EU. Among the wide-ranging consequences of the drug market presented in the analysis are its negative impacts on society (e.g. gang violence, drug-related homicide) and the strain on public institutions and governance. The drug market’s links to wider criminal activity (e.g. human trafficking, terrorism) are also explored, along with its negative repercussions on the legal economy (e.g. how money laundering associated with the drug trade undermines legitimate businesses).

To read full report, follow this link>>>

A short presentation of the main highlights from the EU Drug Markets Report 2019, targeting policy and practice is available in a separate document available here>>>

 

Our initiative presented at the Global Fund Board meeting

The Developing Country NGO Delegation at the Global Fund published a statement with the 42nd Board Meeting highlights, including 8 important matters they pushed for at the meeting, with ways that civil society can move them forward. The statement is available following this link>>>

The initiative of the three regional networks: Correlation – European Harm Reduction Network, Eurasian Harm reduction Network and Drug Policy Network South East Europe to respond to the critical situation concerning the sustainability of harm reduction services in Albania, Bosnia and Herzegovina, Bulgaria and Romania was among the issues that the Delegation raised at the Global Fund Board meeting. It is mentioned in the point 4 of the statement:

Addressing civil society concerns: The Developing Country NGO brought to the Board and bilateral meetings concerns raised by civil society organisations including those by nearly 100 NGOs about the ending of multi-country grants in West Africa; cases of the failed transitions and interruption of services for key populations, including the lack of funding for harm reduction programs in Albania, Bosnia and Herzegovina , Romania and Bulgaria; and exploring next steps to ensure access to health services, treatment and care in Venezuela.

We hope that the Global Fund will make some concrete steps in helping us find a quick response to the urgent needs and building a sustainable solution in these countries.

 

Who is responsible for prosecuting cannabis in Slovenia?

There is still no official translation of the 1961 Convention, but the Ministry of Health is commissioning a study on other countries

In April, The National Assembly Health Committee called on the ministry to prepare the grounds for cannabis cultivation by the end of this year.

Where is the sticking point?

The Ministry of Health has announced a low-value study for analyzing the costs and benefits of regulating cannabis cultivation for medical purposes in Slovenia, while SD representative Bojana Muršič is asking Minister Minister Aleš Šabeder for the purpose, as all the explanations have been gathered in 2016. Members of Parliament have been misled for years.

The analysis should include an overview of cannabis cultivation regimes for medical purposes in the EU countries, identifying the varieties of cannabis that are most in demand on the market, as well as the presentation and dissemination of the results, which will take a year. It won’t be cheap; providers must prove they have completed at least two comparable health surveys worth at least € 25,000 in five years.

All these years, the officials of the ministry you lead ensure that the risks and costs outweigh the benefits that are minimal. In a public debate that has intensified in recent years, on a number of occasions from a number of different sources the ministry has been presented credible information, publicly and clearly, which they want to collect now through the public procurement and (re)use of public funds“, Muršič warns the minister and adds that in April, the National Assembly Health Committee called on the ministry to prepare the grounds for cannabis
cultivation by the end of this year.

cannabis
Photo: Voranc Vogel/Delo

The Convention does not classify hemp plants as illicit drugs; that is a Slovenian particularity that was added by an unofficial translation from ten years ago.

Confusion due to wrong translation

Even in the order, the ministry points out that the regulation on hemp use in our country is based on three UN conventions, first a single drug convention of 1961 and related protocols of 1972. “The basis for the classification of the cannabis plant as well as the resin in the illicit drug list is thus the Single Convention as well as the 1988 Convention on Illicit Traffic in Narcotic Drugs and Psychotropic Substances. The Single Convention allows the cultivation of cannabis for medical purposes under certain conditions”, the ministry writes.

But here’s the catch. The Convention does not classify hemp plants as llicit drugs; that is a Slovenian particularity that was added with an unofficial translation from ten years ago. Exactly three years ago, this translation of the convention was removed from the websites of all bodies, including the Ministry of Justice. Thus, Slovenia does not have an official translation of the convention, thus violating said convention. Even worse, this unofficial translation is still used by the courts and police in criminal proceedings.

cannabis
Photo: Roman Šipić/Delo

According to the Rules of Procedure, the Drugs Commission should operate in the Slovenian language, which is not easy when the Single convention is available in Serbian and French, since Slovenia succeeded it from Yugoslavia.

Who is responsible?

Responsibility for the professional preparation and coherence of the material, which appears everywhere from the government commission to the World Health Organization (WHO) regional organization, is in the Health promotion and control of chronic non-communicable diseases and conditions department of the Ministry of Health.

Author: Borut Tavčar, Delo

 

New issues for monitoring

Every year in autumn, The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) organises Reitox meeting – the European information network on drugs and drug addiction. The 8th Extended Reitox network meeting was held on 12 November in the EMCDDA premises in Lisbon, Portugal. It brought together representatives from circa 50 countries, including: the Heads of the 30 Reitox national focal points from the 28 EU Member States, Norway and Turkey; representatives from the 6 Western Balkan countries covered by the European Instrument for Pre-Accession Technical assistance project (IPA7) and representatives from 15 European Neighbouring Policy area countries.

This year’s meeting will be dedicated to the topic ‘New issues for monitoring’. The agenda included issues like Drug policy debates: how routine monitoring data used?, Introduction on new proposal of the UNODC Annual Reports Questionnaire (ARQ) and Cannabis: latest developments.

During the session on Prevention of infectious diseases, DPNSEE Executive Director Milutin Milošević presented Situation in the Western Balkan countries. Besides presenting the Network and briefly describing the type of data that are available to us, a detailed view on the situation in the Western Balkan countries was given including prevalence of HIV, HCV, HBV among people who inject drugs, provision of harm reduction services and access to treatment, barriers and challenges and relevant policies in the region.

Participation in the Reitox meeting was an excellent opportunity to present the potential of the Network for partnership and discuss modalities for further cooperation with EMCDDA and national drug agencies

Emergency situation concerning the sustainability of harm reduction services in Albania, Bosnia and Herzegovina, Bulgaria and Romania

The three regional networks: Correlation – European Harm Reduction Network, Eurasian Harm reduction Network and Drug Policy Network South East Europe were informed by our members organisations about the situation with sustainability of  harm reduction services in Bosnia Herzegovina which is characterised by lack of strategy, policy and funding caused by the delay in establishing national Government for more than a year after the elections, withdrawal of international donors and misunderstandings and low level of cooperation between the governmental institutions and civil society, but also inside the civil society sector providing harm reduction services. The national Strategy for prevention and control of HIV and AIDS has ended (2016) and the Transition plan, developed by the Country Coordinating Mechanism during implementation of The Global Fund funded programme has not been implemented. As a result, the harm reduction services are closed in Sarajevo, Mostar, Bihać and Banja Luka and exist only in Zenica and Tuzla relaying on voluntary work of unpaid Staff and with all supplies already on minimum.

The three Networks expressed our deep concern about the situation and willingness to give contribution to finding solution and ensuring both quick response to the urgent needs and building a sustainable solution. We are ready to provide non-partisan support in identification and advocacy for the best possible approaches to urgently start provision of services to the populations of people who use drugs, sex workers and prisoners and other affected populations and to properly advocate for the sustainability of governmental funding.

The urgent action we are taking is to explore opportunities for emergency bridging funding to ensure survival of existing harm reduction services in the country. The situation is alarming and requires direct action and mobilisation of the international community. The three network have limited resources, so we are now contacting some of our partners and donors, explaining the situation and calling for immediate and urgent support. This could include short-term funding and technical support to ensure a minimum of harm reduction services. So far, we have a promise from the Open Society Foundations for a small grant which would cover basic need for the month of November.

We plan to develop and implement a comprehensive process to achieve sustainable long-term solutions. The activities for long-term solutions target local governments and policy-makers with the aim to ensure sustainable funding for harm reduction services. We already offered our expertise and support in this process, In addition, we would like to engage and involve other relevant stakeholders, such as donors and funders.

As the first concrete long term action we decide to send an appeal to the Global Fund to review their eligibility model of supporting middle income countries, besides Bosnia Herzegovina also Albania, Bulgaria and Romania.

In advance of the upcoming 42nd meeting of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) as well as the Global Fund Regional Meeting for Eastern Europe and Central Asia to take place in Istanbul on 26-27 November, 2019, we – civil society and community organisations and networks working in the Eastern Europe and Central Asia (EECA) region for the benefit of key affected populations, including people who use drugs – would like to express our profound concern as to the current lack of sustainable harm reduction services in the South East European countries of Albania, Bosnia and Herzegovina, Bulgaria and Romania, respectively. Taking into consideration the successful results of the recent Sixth Replenishment Conference, we would like to invite the Global Fund to safeguard a part of the catalytic investment funds available for the 2020-2022, including multi-country grants, matching funds and strategic initiatives, in order to sustain life-saving services for people who inject drugs and other vulnerable groups and to incentivise domestic investment in harm reduction in each of these post-transition countries.

41 civil society organisations from Easter Europe and Central Asia supported the letter. We hope that the Global Fund shall understand the situation and support our proposal.

The letter to the Global Fund is available following this link>>>

 

Drug overdoses in Europe

Drug overdose deaths in Europe have risen for the fifth consecutive year, with a record 9 461 lives lost in 2017 (EU 28, Turkey and Norway). Reducing drug-related deaths is therefore a major public health challenge. Fighting this problem, the EU drugs agency (EMCDDA) launches today three new resources looking at drug overdoses in Europe and the interventions in place to prevent them.

Most overdose deaths in Europe are linked to the use of opioids (heroin or synthetic opioids), although cocaine, other stimulant drugs and medicines also play a role. In a new online resource, Prevention of drug-related deaths in Europe, the agency provides an overview on the issue and the risk factors involved.

Drug-induced deaths in the European Union, Norway and Turkey, 2017

The EMCDDA illustrates how overdose prevention can be addressed on three levels: reducing vulnerability to overdose (e.g. accessible treatment and services); reducing the risk of overdose (e.g. retention in opioid substitution treatment, prison aftercare and overdose risk assessments); and reducing the likelihood of fatal outcomes (e.g. take-home naloxone policies and supervision of drug consumption). Currently, 87 supervised drug consumption facilities exist in 8 EU Member States, Norway and Switzerland providing a safer drug-using environment.

While naloxone – a medicine used to reverse opioid toxicity – has been used in hospitals for over 40 years, it is also now available in the community in many countries. The EMCDDA launched its first overview of Take-home naloxone (THN) programmes in Europe.

Practical solutions have been found to allow non-medical personnel to receive and administer injectable naloxone and enable the distribution of the medication to the homes of potential bystanders. Some countries now make the emergency medication available without a prescription to, or have lifted prescription regulations for, specific establishments or those registered as formally trained. The resource summarises the different products used in THN programmes, including naloxone nasal spray, authorised in 2017 by the European Commission for marketing in all EU countries.

Where have drug-related deaths increased most over the last 10 years? Are women and men affected equally? What are the current concerns in Europe? These are some of the questions answered in new Frequently asked questions (FAQs): drug overdose deaths in Europe published on the EMCDDA website. These present the overdose situation and trends as well as a range of maps and graphics. The EMCDDA monitors closely alerts on harms related to fentanyl and its derivatives due to the very high toxicity of these substances and their potential to result in large clusters of incidents and deaths.

Through its Strategy 2025, the EMCDDA is committed to contributing to a healthier Europe. While opioids are involved in the vast majority of overdose fatalities, other substances (e.g. cocaine, benzodiazepines, synthetic cannabinoids) also contribute to the overdose burden and should not be neglected. The resources contribute to a better understanding of drug overdoses and responses to them in Europe to support sound policymaking in this area.

Transition from Global Fund support to national funding: role, opportunities and priorities for civil society in Albania

Source:

The workshop “Transition from Global Fund support of HIV and TB programs to national funding: role, opportunities and priorities for civil society in Albania” took place in Tirana, the capital city of Albania, on 23 – 24 of October and gathered 29 participants including civil society representatives, CCM members, representatives of the Global Fund CRG Team and CCM Hub (online), experts from neighbouring countries and representatives of the governmental structures.

Albanian HIV and TB components became ineligible for regular funding after the 2014–2016 allocations were announced and therefore Albania became eligible to receive transition funding. It will receive a three-year transition grant within the 2017-2019 allocation period. This transition grant is expected to start in January 2020 and will be a significantly lower level of investment—about one third the value of current Global Fund grants. The implementation of the current Global Fund HIV and TB grant is ending in December 2019.

According to the estimated annual needs to sustain HIV and TB responses prior to submitting the transition grant request, Albania’s needs approximately US $3 million to address its two epidemics effectively. Hence US $9 million is required over 2020-2022, the three-year period of the transition grant. With an allocation of just under US $6 million within the current HIV and TB grants, roughly 60% of the funding need is currently being met. Without significant increases in domestic funding, the funding gap is expected to grow in the coming years. Moreover, the services for key affected populations (KAPs) are largely implemented by civil society. Their scale, quality and delivery models are to be improved under the new transition grant. So far, these services have not been funded from domestic resources, though there is an office for civil society and general funding for civil society groups in the country. The national strategies on HIV and TB are expiring in 2019. The Global Fund, under its pilot ‘CCM Evolution Project,’ supports Albania’s HIV and TB governance reforms although with no clear outcome so far.

Community and civil society advocacy is critical at this conjunction of processes to ensure sustainability of the response. But at the same time the transition Funding Request 2020- 2022 poses a direct challenge to the services provided by NGOs being sub-recipients of the Global Fund grant. It is expected that starting from 2020 the number of NGOs supported by Global Fund will become twice lower, decreasing from 12 to 5. It is not clear what happens with the activities implemented by those 7 NGOs left behind and which exactly NGOs this will be.

Taking this context into account, the Eurasian Harm Reduction Association (EHRA) in coordination with the Global Fund Secretariat, decided to organize a workshop for civil society and community representatives in Albania. The workshop aimed to help improve the understanding of local civil society representatives involved in the country’s HIV and TB responses, of the Global Fund transition-related processes currently taking place in country and also to stimulate ideas, plans and opportunities for their meaningful engagement into such processes to ensure the sustainability of HIV and TB response among key affected populations in Albania.

The participants first heard the information about the steps being taken by the government to prepare for transition of HIV/TB prevention interventions from the Global Fund’s support and also about the transition-related risks for HIV response and civil society services. Representatives of the Ministry of Finance and Ministry of Health updated the participants on the work being done to secure funding and social contracting from national and local authorities including on the public budget cycles, possibilities to advocate and influence the budget at central and local level. Guest activists from North Macedonia and Montenegro shared their lessons learnt from the transition experiences of their countries with regard to budget advocacy efforts being taken by civil society in these countries to sustain HIV response among KAPs. The representative of the Agency for Support of Civil Society informed the participants about the opportunities of funding available for NGOs, including those related to public health. On the second day of the event the participants also had the opportunity to discuss and plan the advocacy steps need to be taken by civil society in nearest future to ensure the sustainability of services for KAPs as well as to discuss their Global Fund related TA needs and plan the possible content of the potential requests for the support within the Global Fund CRG TA Program.

DPNSEE President Vlatko Dekov presenting lessons learnt from North Macedonia

Genci Muçollari, Executive Director at DPNSEE member organisation Aksion Plus who participated in the workshop, thinks that “It was an interesting workshop though we were expecting high level presentation from the GF and the Ministry of Health and Social Protection (MHSP). World Health Organisation representatives were attending, other NGOs as well. Above all discussions among partners, the role of the MHSP and the Albanian government is very important to ensure a gradual transition from Global Fund to state funds through social contracting and other ways of contribution both in money and in kind to programs and activities covered before by GF. The workshop organizers presented some of the funding opportunities from other regional donors and call for proposals in order to support activities after the GF.

The event was organized by the Regional Platform for Communication and Coordination for the EECA Region, hosted by Eurasian Harm Reduction Association (EHRA).