From the Mountaintops: What the World Can Learn from Drug Policy Change in Switzerland

Reviews Switzerland's drug policy of policing, prevention, treatment, and harm reduction, including low-threshold methadone programs, needle exchanges, and safe injection rooms. Outlines political contexts, health and social outcomes, and lessons learned

The elusive search for rights-centred public health approaches to drug policy: a comment

While it is common for United Nations member states in international meetings to espouse ‘public health approaches’ to drug policy, actual policies appear not to have caught up with this rhetoric. There is a lingering over-emphasis in narcotic drug policies on policing and incarceration at the expense of urgently needed investment in health and social services for people who use drugs. These policies have lethal consequences in the transmission of potentially fatal infections and preventable overdose deaths, and they impede progress in social and economic development. The experience of a number of countries, mostly in the European Union, highlights that bringing public health evidence into the center of drug policy decision-making can have broad social, economic and public health benefits

Informing health-friendly drug policy in Africa: a comment on the challenge of drug consumption data

Considerable resources have been spent on estimating the size of populations of people who use drugs (PWUD) and people who inject drugs (PWID) in Africa. Precise estimates are elusive, not least because of stigma and criminalization faced by these populations. Bio-behavioral surveys focused on injection drug use can be useful but are expensive and have not always been designed and implemented with meaningful participation of PWID themselves. A pan-African effort of the African Union (AU) to collect drug-use data from drug treatment facilities is undermined by the dearth of facilities addressing the drug problems posing the greatest morbidity and mortality risks. Efforts that have involved PWID meaningfully and respectfully in designing and implementing data collection have shown some success in informing health service programming for PWID as well as sustained regular monitoring of drug use. But meaningful participation in data collection may be contingent on both concerted anti-stigma measures and some form of decriminalization of minor drug offenses to reduce the fear of arrest and incarceration experienced by people who use drugs, a change as yet little realized in Africa

The Economics of the Drug War: Unaccounted Costs, Lost Lives, Missed Opportunities

As member states of the United Nations take stock of the drug control system, a number of debates have emerged among governments about how to balance international drug laws with human rights, public health, alternatives to incarceration, and experimentation with regulation. This series intends to provide a primer on why governments must not turn a blind eye to pressing human rights and public health impacts of current drug policies.Fiscally minded policymakers should invest in drug policy reform. Many national drug control policies are centered on aggressive policing and military efforts to reduce drug supplies and punish drug consumers. But these policies come with a very high price tag, rarely resulting in sustained control of drug supply or demand. The economic wastefulness of the drug war is one of the most important motivations for reform.A new report from the Open Society Foundations, The Economics of the Drug War: Unaccounted Costs, Lost Lives, Missed Opportunities, documents both the wastefulness of ill-conceived investment in ineffective policies and the missed opportunity of failing to invest in effective policies and programs that embody good public health practice and human rights norms. The case of Colombia, for example, illustrates the futility—and the harms to individuals and society—of extremely expensive coca eradication efforts. For all the money spent, the efforts merely resulted in a geographical shift of coca production to new and sometimes more environmentally fragile locations. The environmental and health damage caused by aerial spraying of coca crops also negatively impacted the productivity of rural families. Many countries fail to invest in and scale up programs that yield significant economic returns in reduced crime, reduced death from overdose, reduced illness and injury from unsafe injection, and improved productivity of patients who are able to get on with their lives. Programs that provide clean injection equipment are among the most cost-effective interventions in all of public health because they prevent HIV, but too many governments still believe erroneously that they encourage drug use. And overincarceration for nonviolent drug offenses is a drain on public resources that fails to make a dent in drug markets.Health-centered drug policy conceived with human rights norms in mind is effective and cost-effective compared to many status quo approaches. This report explains why less punitive drug policy is good fiscal decision making

Detention and Punishment in the Name of Drug Treatment

As member states of the United Nations take stock of the drug control system, a number of debates have emerged among governments about how to balance international drug laws with human rights, public health, alternatives to incarceration, and experimentation with regulation. This series intends to provide a primer on why governments must not turn a blind eye to pressing human rights and public health impacts of current drug policies.In some countries, people who use, or are alleged to use, illicit drugs may be detained involuntarily after little or no legal process, ostensibly for the purpose of receiving drug "treatment" or "rehabilitation."These detentions are variously described as compulsory treatment centers, drug rehabilitation centers, detoxification centers, or "centers for social education and labor." It is far from clear that all persons detained in this manner are drug-dependent or in need of treatment. If they are, there are international standards to guide treatment of drug-dependence, but drug detention centers often subject detainees to treatment methods that are scientifically unsound, punitive, cruel, inhuman, and degrading. In March 2012, 12 UN bodies—including the Joint United Nations Programme on HIV/AIDS (UNAIDS), WHO, the UN Office on Drugs and Crime (UNODC), the International Labour Organization, and the Office of the High Commissioner of Human Rights—jointly issued a call for the closure of compulsory drug detention centers and an expansion of voluntary, scientifically and medically appropriate forms of treating drug dependence in the health system.The 2012 joint UN statement on compulsory drug rehabilitation centers was a very important step, but a declaration from UN member states condemning these institutions and calling for their closure would advance the cause of ending the abuses they represent. Detention and Punishment in the Name of Drug Treatment highlights considerations that should be brought to bear in the 2016 United Nations General Assembly Special Session (UNGASS) on the world drug problem, toward the goal of ending arbitrary detention and grave human rights abuses in the name of drug treatment.

Harm Reduction

As member states of the United Nations take stock of the drug control system, a number of debates have emerged among governments about how to balance international drug laws with human rights, public health, alternatives to incarceration, and experimentation with regulation. This series intends to provide a primer on why governments must not turn a blind eye to pressing human rights and public health impacts of current drug policies.Harm reduction is based on the idea that people have the right to be safe and supported even if they are not ready or willing to abstain from illicit drug use. A harm reduction approach involves giving people who use drugs choices that can help them protect their health. For many people who use drugs, harm reduction services are the most likely entry point into health care and the most likely means of protection from life-threatening conditions. As United Nations agencies have noted, the effectiveness of harm reduction services for HIV prevention and prevention of drug-related mortality is beyond dispute. The UN General Assembly Special Session on drugs in 2016 is an opportunity to re-energize the commitment to harm reduction pledged by UN member states at the 2001 UNGASS on HIV/AIDS. Funding for proven and cost-effective harm reduction services that protect not only people who use drugs but entire communities should be a top priority. This report details how harm reduction is a central pillar of effective drug response, critical to reaching people who use drugs with services that can help protect them, their families, and their communities

The 1998 Fedele F. and Iris M. Fauri Lecture, University of Michigan School of Social Work

The Fedele F. and Iris M. Fauri Lecture is presented annually in recognition of former University of Michigan Vice President and School of Social Work Dean Fedele F. Fauri and his wife, Iris. Dean Fauri's leadership in the field of child welfare spanned nearly 50 years, with much of the current social welfare legislation at both state and federal levels being a product of Dean Fauri's activities, first as director of the Michigan Department of Social Services, and then during his years in Washington, DC, where he held numerous leadership positions. His accomplishments in child welfare and social work education brought national and international acclaim to Dean Fauri, the School of Social Work, and the University of Michigan. This lecture series is funded by gifts from alumni, faculty, and friends, and is intended to serve as a forum for discussing ideas and proposals to enhance the well-being of young people.The Fedele F. and Iris M. Fauri Family; School of Social Work; alumni, faculty, and friends of the School of Social Workhttp://deepblue.lib.umich.edu/bitstream/2027.42/49502/3/1998 Fauri Lecture Csete.pd

Methamphetamine: Fact vs. Fiction and Lessons from the Crack Hysteria

The purpose of this report is to provide a critical examination of the available evidence on illicit methamphetamine use and its consequences in the United States and internationally. It is the aim of this report to dispel some of the myths about the effects of methamphetamine and other illicit drugs using the best available scientific data. Further, it is our hope that this analysis will lead to more rational policies for dealing with both legal and illegal amphetamine. The report begins with an examination of the lessons learned from the "crack cocaine scare" in the 1980s. In this way, the reader can draw parallels between society's response to crack cocaine then, and methamphetamine now. The report then describes distinctions and similarities between methamphetamine and other amphetamine-type stimulants. Also examined is the prevalence of methamphetamine use and public policies in response to the perceived increased use of the drug and perceived drug-related problems. Finally, the report critically reviews the scientific literature on the effects of methamphetamine on the brain, physiology, and behavior. The data show that many of the immediate and long-term harmful effects caused by methamphetamine use have been greatly exaggerated just as the dangers of crack cocaine were overstated nearly three decades ago. Recommendations are made in an effort to remedy this situation and to enhance public health and safety

Harm Reduction: Spanish

As member states of the United Nations take stock of the drug control system, a number of debates have emerged among governments about how to balance international drug laws with human rights, public health, alternatives to incarceration, and experimentation with regulation. This series intends to provide a primer on why governments must not turn a blind eye to pressing human rights and public health impacts of current drug policies.Harm reduction is based on the idea that people have the right to be safe and supported even if they are not ready or willing to abstain from illicit drug use. A harm reduction approach involves giving people who use drugs choices that can help them protect their health. For many people who use drugs, harm reduction services are the most likely entry point into health care and the most likely means of protection from life-threatening conditions. As United Nations agencies have noted, the effectiveness of harm reduction services for HIV prevention and prevention of drug-related mortality is beyond dispute. The UN General Assembly Special Session on drugs in 2016 is an opportunity to re-energize the commitment to harm reduction pledged by UN member states at the 2001 UNGASS on HIV/AIDS. Funding for proven and cost-effective harm reduction services that protect not only people who use drugs but entire communities should be a top priority. This report details how harm reduction is a central pillar of effective drug response, critical to reaching people who use drugs with services that can help protect them, their families, and their communities