Health and Medical News and Resources

General interest items edited by Janice Flahiff

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

Drug Database Dilemma

From the 26 April 2012 edition of StatelineDaily

No one disputes the need for more information about prescription drug abuse. But who should have access to the information is a divisive issue.
Dr. Shawn Jones, an ear, nose and throat surgeon in Paducah, Kentucky, was conducting a routine office appointment when he got a phone call from a worried pharmacist. The pharmacist had just received a prescription from Jones for 90 Percocet pain pills, an unusually large order for a doctor who rarely prescribes more than 20 pills at one time.

Jones asked the pharmacist to fax over the prescription, and he immediately recognized it as a forgery. It was for a female patient he hadn’t seen in five years. She had somehow gotten hold of one of his prescription pads. Jones asked the pharmacist to delay filling the prescription, went back to the exam room and talked with a policeman who happened to be in the office at the time. The policeman called in to the precinct to have the woman arrested.

Under Kentucky’s current prescription drug laws, only a vigilant pharmacist could have stopped these fraudulent prescriptions. The regulations don’t allow physicians to monitor their own prescribing habits to check for fraud, and the Kentucky board of medical licensure can look up a prescribing record only if a formal complaint against a physician is filed.

That will change under new legislation passed last week in a special session. To deal with the growing problem of prescription drug abuse, Kentucky legislators enacted tougher regulations on doctors and pain management clinics. The law mandates that all physicians and pharmacists who prescribe schedule II and III drugs, such as oxycodone (OxyContin) and hydrocodone (Vicodin), check the patient’s prescription record before writing or filling a prescription. They also have to register prescriptions for those drugs in a state database within 24 hours of writing or filling the prescription.

Currently, only about 25 percent of the states’ doctors use the database.  Now, all of them will be expected to.

Privacy issues
All of this may not sound very controversial. But it is. The database can also be a tool for law enforcement investigations, and these agencies want as much access to it as they can get. This has created a debate about how to balance patient privacy and law enforcement needs in fighting a serious criminal and public health problem….

April 27, 2012 Posted by | Public Health | , , , , , , | Leave a comment

   

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