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General interest items edited by Janice Flahiff

2013 World Drug Report notes stability in use of traditional drugs and points to alarming rise in new psychoactive substances

 

Emerging drug problems

 

Marketed as ‘legal highs’ and ‘designer drugs’, NPS  [New PsychoActive Substances]

 

An arrangement of psychoactive drugs

An arrangement of psychoactive drugs (Photo credit: Wikipedia)

 

are proliferating at an unprecedented rate and posing unforeseen public health challenges. Mr. Fedotov urged concerted action to prevent the manufacture, trafficking and abuse of these substances.

 

The number of NPS reported by Member States to UNODC rose from 166 at the end of 2009 to 251 by mid-2012, an increase of more than 50 per cent. For the first time, the number of NPS exceeded the total number of substances under international control (234). Since new harmful substances have been emerging with unfailing regularity on the drug scene, the international drug control system is now challenged by the speed and creativity of the NPS phenomenon.

 

This is an alarming drug problem – but the drugs are legal. Sold openly, including via the internet, NPS, which have not been tested for safety, can be far more dangerous than traditional drugs. Street names, such as “spice”, “meow-meow” and “bath salts” mislead young people into believing that they are indulging in low-risk fun. Given the almost infinite scope to alter the chemical structure of NPS, new formulations are outpacing efforts to impose international control. While law enforcement lags behind, criminals have been quick to tap into this lucrative market. The adverse effects and addictive potential of most of these uncontrolled substances are at best poorly understood.

 

In response to the proliferation of NPS, UNODC has launched an early warning system which will allow the global community to monitor the emergence and take appropriate actions.”

 

 

Full Text Reports...

2013 World Drug Report notes stability in use of traditional drugs and points to alarming rise in new psychoactive substances
Source: United Nations

At a special high-level event of the Commission on Narcotic Drugs (CND), the United Nations Office on Drugs and Crime (UNODC) today launched in Vienna the 2013 World Drug Report. The special high-level event marks the first step on the road to the 2014 high-level review by the Commission on Narcotic Drugs of the Political Declaration and Plan of Action which will be followed, in 2016, by the UN General Assembly Special Session on the issue.

While drug challenges are emerging from new psychoactive substances (NPS), the 2013 World Drug Report (WDR) is pointing to stability in the use of traditional drugs. The WDR will be a key measuring stick in the lead up to the 2016 Review.

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July 17, 2013 Posted by | Health Statistics, Medical and Health Research News | , , , , , , , | Leave a comment

[Reblog] Incarceration’s contribution to infant mortality (and related note to a local “no to war on drugs event”/ Mexican Caravan For Peace)

Yesterday I participated in a walk drawing attention to the failures in the US and Mexico’s failed drug policies.
The participants (about 100) were mainly folks from the Caravan For Peace Campaign which is winding its way from
Tijuana through the US and ending up in Washington DC.
[See related news stories, blog items, and photos below]***

It was heartbreaking to talk a bit with the Mexicans, many who held small signs with pictures of their murdered family members/friends. Most had just disappeared…all because of drug related violence.

I’ve always believed our (US) War on Drugs is failing miserably, our skyrocketing incarceration rate is not solving anything.
In fact, it is having terrible consequences, including adverse health effects including greater susceptibility to disease, stress, and increased risk for infant mortality.

To be honest, I am not sure what the answer is.
Prohibition isn’t working, but I am very unsure about legalization.
Perhaps a fresh new way to address this as a health issue and not a criminal issue.
When I walked and listened to these people, I know that somehow, some way, I just have to get involved.
These people, too, are my community.

From the 27 August 2012 blog post at Family Inequality

recent study in the journal Social Problems by sociologist Chistopher Wildemanshows that America’s practice of mass incarceration may be exacerbating both infant mortality in general and stubborn racial inequality in infant mortality in particular.

Drawing on recent literature by himself and others, Wildeman spells out the case for incarceration’s negative effect on family economies, including: lost earnings and financial contributions from fathers, the expensive burden of maintaining the relationship with an incarcerated parent, and the lost value of the incarcerated parent’s unpaid labor. All of those costs may take a toll on mothers’ health, which is the primary cause of infant mortality.

In addition, family members of incarcerated parents may contract infectious diseases, experience significant stress, and lose support networks — all taking an additional health toll.

Sure enough, his analysis of data from the Pregnancy Risk Assessment Monitoring System confirms that children born into families in which a parent has been incarcerated are more likely to die in the first year of life. The association may not be causal, but it holds with a lot of important control variables.

Does this increase racial inequality? Probably, because parental incarceration is so concentrated among Black families, as Wildeman and Bruce Western reported previously (my graph of their numbers):

To make the connection to racial inequality explicit, Wildeman moves to compare states over time, on the suspicion that incarceration could increase infant mortality rates, and racial inequality in infant mortality rates. That could be because concentrated incarceration undermines community support and income, people with felony records often are disenfranchised (so the political system can ignore their needs), and the costs of incarceration crowd out more beneficial spending that could improve community health.

The results of a lot of fancy statistical models comparing states show that:

the imprisonment rate is positively and significantly associated with the total infant mortality rate, the black infant mortality rate, and the black-white gap in the infant mortality rate.

It’s an impressive article on an important subject, one that thankfully is attracting more attention from good scholars.

I previously reported on Wildeman’s work on how the drug war affect families, here.

***

September 6, 2012 Posted by | Public Health | , , , | Leave a comment

How the Global War on Drugs Drives HIV and AIDS

Global Commission Calls for Drug Decriminalization and Expansion of Proven, Cost-Effective Solutions to Reduce HIV/AIDS – Including Sterile Syringe Access, Safer Injection Facilities, and Prescription Heroin Programs

 

From the 29 June 2012 article at Time.com

The war on drugs is driving much of the global AIDS pandemic, increasing new infections among injection-drug users in the U.S. and elsewhere, according to a new report from the Global Commission on Drug Policy...

(A PDF of the report may be found here***)

bout one-third of all new infections outside of sub-Sarahan Africa occur in injection-drug users.

Since the 1990s, effective public-health strategies to curb HIV transmission in drug users have led to drops in new infections in most countries. But over the same time period, seven countries have seen a 25% increase in new infections. Not coincidentally, five of these countries — mainly in Eastern Europe and Central Asia — employ aggressive drug war strategies, such as arresting and incarcerating users for drug or needle possession…

…These tactics have been shown to be ineffective not only for controlling drug use, but also for reining in the spread of HIV. Why? Because the fear of recrimination prevents drug users from seeking clean needles — a major risk factor for HIV infection. In the U.S. as well, areas with the highest infection rates are those that have the most aggressive drug policies, the report shows. The solution is straightforward, if drastic; it requires a complete overhaul of current drug policy: drug users need treatment, not imprisonment, and drug possession needs to be decriminalized, the authors argue.

 

***

The Commission’s recommendations are summarized here. They include:

– Push national governments to halt the practice of arresting and imprisoning people who use drugs but do no harm to others.

–  Measure drug policy success by indicators that have real meaning in communities, such as reduced rates of transmission of HIV and other infectious diseases, fewer overdose deaths, reduced drug market violence, fewer individuals incarcerated and lowered rates of problematic substance use.

– Respond to the fact that HIV risk behavior resulting from repressive drug control policies and under-funding of evidence-based approaches is the main issue driving the HIV epidemic in many regions of the world.

– Act urgently: The war on drugs has failed, and millions of new HIV infections and AIDS deaths can be averted if action is taken now.

How the drug war fuels the HIV pandemic:

– Fear of arrest drives persons who use drugs underground, away from HIV testing and HIV prevention services and into high-risk environments.

– Restrictions on provision of sterile syringes to drug users result in increased syringe sharing.

– Prohibitions or restrictions on opioid substitution therapy and other evidence-based treatment result in untreated addiction and avoidable HIV risk behavior.

– Deficient conditions and lack of HIV prevention measures in prison lead to HIV outbreaks among incarcerated drug users.

– Disruptions of HIV antiretroviral therapy result in elevated HIV viral load and subsequent HIV transmission and increased antiretroviral resistance.

– Limited public funds are wasted on harmful and ineffective drug law enforcement efforts instead of being invested in proven HIV prevention strategies.

June 29, 2012 Posted by | Public Health | , , , , , , , , | Leave a comment

Towards a smarter drugs policy | Addiction & Recovery News

Development of a rational scale to assess the ...

IA rational scale to assess the harm of drugs. Data source is the March 24, 2007 article: Nutt, David, Leslie A King, William Saulsbury, Colin Blakemore. "Development of a rational scale to assess the harm of drugs of potential misuse" The Lancet 2007; 369:1047-1053. (PMID 17382831; doi:10.1016/S0140-6736(07)60464-4)

Towards a smarter drugs policy | Addiction & Recovery News

From the 8 January 2012 Addiction and Recovery News blog posting

The new issue of the Lancet focuses on drug policy***. One piece offers key points for formulating policy:

  • Drug policy should aim to promote the public good by improving individual and public health, neighbourhood safety, and community and family cohesion, and by reducing crime.
  • The effectiveness of most drug supply control policies is unknown because little assessment has been done, and very little evidence exists for the effectiveness of alternative development programmes in source countries.
  • Supply controls can result in higher drug prices, which can reduce drug initiation and use but these changes can be difficult to maintain.
  • Wide-scale arrests and imprisonments have restricted effectiveness, but drug testing of individuals under criminal justice supervision, accompanied by specific, immediate, and brief sentences (eg, overnight), produce substantial reductions in drug use and offending.
  • Prescription regimens minimise but do not eliminate non-medical use of psychoactive prescription drugs. Prescription monitoring systems can reduce inappropriate prescribing.
  • Screening and brief intervention programmes have, on average, only small effects, but can be widely applied and are probably cost-effective.
  • The collective value of school, family, and community prevention programmes is appraised differently by different stakeholders.
  • The provision of opiate substitution therapy for addicted individuals has strong evidence of effectiveness, although poor quality of provision reduces benefit. Peer-based self-help organisations are strongly championed and widely available, but have been poorly researched until the past two decades.
  • Health and social services for drug users covering a range of treatments, including needle and syringe exchange programmes, improve drug users’ health and benefit the broader community by reducing transmission of and mortality due to infectious disease.

It’s good stuff. I particularly like its willingness to give credit where credit is due. For example, supply control can help but the benefits are often unstable and have a lot of unintended consequences. I also like the affirmation of the diversity of perspectives on the benefits of policies…..

Read the entire article

*** The Lancet site has abstracts of the articles. Full text access is by paid subscription only.
For suggestions on how to get the articles for free or at low cost, click here.

However, the Lancet site for these articles has  

  • An 8 minute video interview featuring one of the authors – Drug policy and the public good: evidence for effective interventions
  • An 11 minute MP3 Video where Author Wayne Hall discusses the series with Richard Lane

January 10, 2012 Posted by | Public Health | , , , | 1 Comment

   

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