Author: Justin Mckibben
This past October the 24th International Harm Reduction Conference 2015 was held in Kuala Lumpur, and many accounts showed how there was some serious differences in the way drug policy is handled around the world, but it also brought some hope to many that the necessary change in culture and climate was coming for fighting stigma and establishing effective treatment for drug addicts.
So how did we see this issue on an international level, and how is harm reduction being set to make an impact?
Death Penalty for Drug Trafficking
Overall, 33 countries still have the death penalty on their books and about seven still hold regular executions including:
- Saudi Arabia
Oh yea… and the United States!
Although here in America it seems we don’t follow through nearly as much as some of the other countries on the list.
While the exact number of executions is unknown, since most of these countries carry them out in secret, executions for drug trafficking have caused international friction between countries on several occasions in the past few years.
The thing is, academic studies have reported an overwhelming average of information showing that the death penalty is not a sufficient method to deter drug trafficking or drug use. At the International Harm Reduction Conference a panel on death penalty policies exposed how statistically the disciplinary drug policies of the last few decades have been largely ineffective at stopping drug trafficking or even reducing addiction rates. But what it has done is contributed to major issues such as:
- Widespread health disparities
- Inhumane treatment of people who use drugs
Indonesian human rights lawyer, Ricky Gunawan, who represents death penalty cases said in a statement concerning this discussion at the conference:
“It’s all political. Current policies are not effective at stopping drug use, only at sending the message that people who use drugs are not worthy of rights, dignity, or even life.”
Unfortunately, despite the fact that evidence of the derogatory effects of purely punitive drug policies is overwhelmingly clear, it’s still hard to convince public officials to change policy. Some other countries seem light-years away from America’s current uprising of compassionate and supportive alternatives to punishment for addicts.
The American Influence
In the 1980s after the US launched its own War on Drugs there were several institutions all over the world that created extreme and harsh penalties related to drug policy, and some say the War on Drugs inspired a more aggressive view of attacking drugs in other countries, making addicts the enemy instead of seeing they were the ones suffering.
Some have said that American policies have influenced the countries where we invest, and some other countries interpret the message created by the War on Drugs in America in a much more intense way: people who use drugs are not entitled to the same rights and protections as everyone else.
While we may not take things to such an extreme, other countries are not holding back when it comes to taking the rights away from users in order to try and smother the issue. But it was not all bad news.
Change the Contrast
When looking at the addiction and drug abuse issue on a global scale there is such a severe contrast in some views of drug policy. In more places harm reduction programs such as syringe exchange movements are a routine part of public health policy, like Europe and North America. But then many countries still believe harm reduction is not an acceptable route, while the concept of government funding is laughable, and advocates struggle for years to obtain small victories for basic human rights in order to save lives.
Rick Lines, executive director of Harm Reduction International, held up a briefing paper drafted by the United Nations Office of Drugs and Crime (UNODC) that stated:
“treating drug use for non-medical purposes and possession for personal consumption as criminal offences has contributed to public health problems and induced negative consequences for safety, security and human rights.”
The document was made in an effort to encourage Member States to consider decriminalizing drug use and possession for personal consumption.
The contrast to that was shortly before the conference, the UNODC released a statement claiming that the paper had been prematurely leaked and refused to endorse anything it said, which personally causes a great deal of confusion as to whether or not the United Nations will stand behind the statement on the page.
Hopefully harm reduction advocates will have an answer soon, as the UN General Assembly has called for a Special Session on Drugs in New York in 2016, the first time a session like this has been called since 1998. Harm reduction advocates are hopeful that the past decades of failed War on Drugs policies, which have only exacerbated disease and death with no decrease in drug manufacturing or use, will motivate the United Nations to actively pursue a path more humane and actively compassionate.
Police, politicians, educators and community leaders are constantly working together to try and create a change in perspective, and part of this shift is harm reduction. While it might not be the perfect solution, harm reduction is designed to keep people alive long enough to get the help they need that could save them from their addiction. If you or someone you love is struggling with substance abuse or addiction, please call toll-free e 1-800-951-6135
Author: Justin Mckibben
This past February there was news from state health officials that changed all optimism regarding the decline in prescription drug abuse and heroin in southeastern Indiana, informing us that at least 26 people in the region were diagnosed with HIV in just a 3 month period, and most of them contracted it after injecting drugs.
The first case that has been considered part of the outbreak in southeastern Indiana was diagnosed in early December according to the deputy commissioner and director for health outcomes at the Indiana State Department of Health Dr. Jennifer Walthall. By January 23rd the total of newly diagnosed HIV cases had already spiked to 11 in a region that typically experiences less than 5 new cases annually. There have been around 90 cases reported thus far, the most in Indiana’s history.
The HIV outbreak among intravenous drug users in this part of the state prompted local health care officials to take a harm reduction approach more seriously, and they began work to start a needle-exchange program. With addicts using and sharing needles to inject drugs, a lot of infections are easily passed around, and hopefully this program can change that.
What is Needle Exchange?
Just a little background on what this all means, a needle and syringe program (NSP) or syringe-exchange program (SEP) is a social service that allows injecting drug users (IDUs) to attain hypodermic needles and related paraphernalia at little or no cost, but often requiring users to turn in used syringes for new ones.
Needle exchange programs are built on the philosophy of harm reduction, and the idea is to reduce the risk factors of spreading diseases such as HIV/AIDS and hepatitis.
A comprehensive 2004 study by the World Health Organization (WHO), which was later supported by the American Medical Associate (AMA) found a determined that needle exchange programs substantially reduce the spread of HIV among IV users, and do so without evidence of exacerbating injecting drug use, and they have proven to be cost effective and efficient.
Breaking the Ban in Indiana
Last week the ball got rolling when Republican Governor Mike Pence signed an emergency executive order in an attempt to control Indiana’s most intense HIV outbreak the population has ever seen. The executive order actually suspended Indiana’s ban on needle-exchange programs for the next 30 days. The ban has only been localized to Scott County, just 30 miles north of Louisville, Ky.
According to the local news sources in Jerome Adams, Indiana’s Health Commissioner, Governor Pence has clearly expressed that he does not support needle exchange as anti-drug policy on an ongoing basis. However those reports suggest that Pence has been adamant about his concern over this recent HIV outbreak, and has taken a critical step to end it.
While Pence voices his concerns about such programs, it doesn’t hurt to look at the evidence from several NIH funded studies that consistently reveal a 33% decrease in the frequency of HIV cases where people participate in needle exchange programs.
A Trial Run
30 days is 30 days, and while to some it may not seem like much, 30 days can be plenty to make a dent in an addiction issue when properly utilized. The 30 day needle-exchange program is based in the Community Outreach Center located in Austin, Indiana. Strategically officials chose this location based on the fact that this may very well be ground-zero in terms of where the most HIV cases have been reported, with 84 confirmed cases of HIV.
As part of this trial run, there are some regulations in place to keep a controled grasp on the program. Each individual will be able to receive:
- 1 week worth of clean syringes
- Access to free HIV screenings
- Hepatitis A and B vaccinations
- Drug treatment referrals
Health Commissioner Adams reiterated that one should not feel ashamed to seek help as this is now an issue of public health. But with the governor seemingly unsupportive of this program, it may seem like needle exchange in southeastern isn’t being used to its fullest potential. The executive order is able to be extended if needed, and if it proves to make a difference then hopefully this program will get the time it needs to help curb the epidemic, as well as provide the drug users in the area with adequate information to get drug treatment.
Harm reduction has been speculated to be a huge part of the new wave in the war on drugs in America, and while it may not be an indefinite solution, it can surely save lives and improve the quality of others in an effort to get more people the treatment they need for the recovery they deserve. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
The anti-drug stance and policies that have come from the “war on drugs” are to blame for rising rates of hepatitis C all over the world, according to a new report by the Global Commission on Drug Policy (GCDP).
The cost of enforcing drug laws totaled approximately $545 billion over the past 40 years – and that was just in the US. That doesn’t take into account the billions more spent the world ‘round.
Experts argue that resources being poured into this futile “war” are better redirected towards treatment and prevention for the estimated 16 million people worldwide who use drugs intravenously. Of that number, 10 million are living with hepatitis C.
Increase in Hepatitis C Infection Related to the War on Drugs
Hep C is an infectious liver disease that is often contracted by sharing needles. The Global Commission—which includes seven former presidents, ex-UN chief Kofi Annan and other world leaders—says that, by criminalizing drugs, it only makes it harder for IV drug users to get public health services, and therefore increases the spread of hep C infection.
“The war on drugs is a war on common sense,” says commissioner Ruth Dreifuss, who is also the former president of Switzerland. “Repressive drug policies are ineffective, violate basic human rights, generate violence and expose individuals and communities to unnecessary risks. The hepatitis C epidemic, totally preventable and curable, is yet another proof that the drug policy status quo has failed us all miserably.”
The GDCP’s report revealed that the highest number of Hepatitis C infections are in the US, China and the Russian Federation – which just so happen to be some of the countries that are the strictest when it comes to their drug policies.
People who inject drugs are still one of the main sources of hepatitis C infection, according to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). In fact, they just might be the leading source of the potentially fatal, highly infectious (read: contagious) liver disease.
A recent report from the agency estimates that as many as a million people who have injected drugs may be living with hepatitis C. In addition, anywhere from 40% to 90% of European IV users in a given population are infected. Even worse, the EMCDDA estimates that 30% of patients with untreated hep C go on to develop cirrhosis of the liver in later years.
And injecting drug users are more frequently infected with hepatitis A, B, and D viruses as well.
Then you have proactive countries that have employed harm reduction strategies in order to address what they recognize as a public safety issue. The Commission has lauded Scotland’s Hepatitis C Action Plan, launched in 2006, which has shown to have decreased the rates of infection by offering health services and sterile injecting equipment to users.
“If you compare rates of hepatitis C in drug users in countries with good harm reduction and more enlightened drug policies with those in countries without, it is clear that regarding drug use exclusively as a criminal justice issue is a health disaster,” says a spokesperson for the World Hepatitis Alliance. “Hepatitis C, its prevention, care and treatment must be addressed and must be addressed as the health issue it is.”
Harm reduction strategies like needle exchange programs can be just one way to combat the spread of all types of hepatitis. Furthermore, the EMCDDA also recommends a combination of opioid substitution treatment, such as methadone maintenance or buprenorphine (Suboxone), and needle exchange programs.
If you or someone you love is struggling with substance abuse or drug addiction, there are ways to stop the cycle and begin to heal. If you have contracted Hep C or another disease, there are new treatments that can improve your health, along with recovering from your substance abuse disorder. Please call toll-free 1-800-951-6135.
Author: Justin Mckibben
Harm reduction has taken some leaps and bounds in recent years as far as a growing movement to confront the rise in drug use and the devastation of addiction on an individual and community level. With the rapid passage of overdose prevention and syringe decriminalization laws, extended access to overdose reversal drugs, and welcomed endorsements from previously skeptical agencies, harm reduction seems to be convincing many people of it’s usefulness.
Apparently, 2015 is just going to take it even further. With Here are just 3 reasons why.
- New Naloxone Opportunities
Big Pharma seems to be taking some serious interest in naloxone (also known as Narcan), the overdose reversal drug used to combat opiates.
When naloxone first debuted on the market in 1961, emergency departments and ambulances stock piled the miracle drug and pharmaceutical companies all made effort to produce. Once that demand was met, the drug was no longer considered profitable and companies lost interest in producing it.
By 2008 Hospira was the only company that held a monopoly on inject-able naloxone, while another, IMS/Amphastar, sold the only form of naloxone that could be adapted for intranasal use.
Now thanks to recent progress in community-based harm reduction programs, distribution of naloxone to people at risk for opioid overdose has begun to grow, as states are moving to make this life-saving medication more available to counter the growing opiate epidemic in America.
Demand for naloxone has skyrocketed over the past three years due to the rash of opioid-related deaths and greater public awareness. Americans take home over 200 million prescriptions for opioids every year, and now since naloxone is something that is considered a necessity in all homes with opiate users in it, Big Pharma is now interested.
This past year the FDA fast-tracked approval for a new auto-inject-able naloxone device, so we should soon see what contribution to the war on drugs this will make, so beginning 2015 expect to start see the market flooded with user-friendly naloxone gadgets from a variety of new pharmaceutical companies.
2015 also holds promise to see naloxone available in a capacity that will hopefully meet the problem in the streets head-on, by being stocked at local pharmacies. Some states continue to push for laws to allow health departments and community-based organizations to distribute naloxone without a doctor present, but other are moving beyond the ogranizations reach to the next frontier: over-the-counter.
- Hepatitis Medication
Naloxone won’t be the only medication in 2015 that will be making a lot of waves in the harm reduction community. It will also be a defining year in the relationship between harm reduction and the pharmaceutical industry thanks to the new hepatitis C treatment.
Last year Gilead Sciences introduced a medication with up to a 90% effectiveness rate in treating hepatitis C. The cure for hepatitis C could finally be within reach thanks to this progressive treatment.
Unfortunately for many, the new medications already run at just about $1,000 per pill, taken daily for 12-24 weeks. Currently harm reductionists are lobbying for donations, but even if they succeed it means they are relying on gifts, which creates a risky dependency on the pharmaceutical industry.
2015 will be a year to watch how Big Pharma continues to handle the hepatitis medication situation.
- Changing the Stigma in the South
2015 shows great promise to make some major changes on stigma in the South. For too long, harm reduction has been dismissed as a hopeless tactic to treating drug abuse in this area of the country. Southern states are possibly decades behind the north in terms of harm reduction programs such as:
- Legal syringe exchange
- Naloxone access
- Disease prevention
So far this year several Southeastern states passed 911 Good Samaritan and/or naloxone access laws, including:
- North Carolina
North Carolina and Georgia have actually went even further, and have launched statewide overdose prevention programs. Even more impressively, there were 5 of these states in a region where syringe exchange is currently illegal that are planning to introduce syringe legislation in 2015, including:
- North Carolina
To discuss these plans and strategize, advocates will gather this June for the 2015 Southern Harm Reduction and Drug Policy Conference in Asheville, North Carolina. That creates an important opportunity for the regions officials and experts to put their heads together and device a game-plan for changing the way they address these important issues.
Ultimately, the harm reduction community hopes that 2015 will hold a lot of opportunity that will transform not just the way some people see addiction, but in how the nation is willing to address these issues in a effective and positive way.
If harm reduction organizations are able to turn the conversation on drug use away from criminality and towards the promotion of health and compassion for the addict who still suffers, 2015 could truly become a progressive and revolutionary year.
While many still don’t put too much value in concept of harm reduction, it does seem that while the substance abuse and addiction problem continues to climb and threaten countless lives across the country, putting effort toward taking some of the sting off the table and bringing in more awareness is definitely a worthy cause. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
By Cheryl Steinberg
As a recovering IV drug user, I can say absolutely, without a doubt that yes, you can be addicted to the needle and to that ‘needle high.’
For many, if not all drug addicts, the ritual of using – preparing the drug in whatever form they prefer to use, whether it’s crushing and snorting pills or cooking dope and shooting it up – is just as ‘exciting,’ if you will, as the actual high from the drug.
When I was out there using, I would feel a level of excitement and anticipation, especially after I finally had my DOC in my possession. Then it was all about setting the scene. Whether it was a public bathroom or my bedroom, there was a specific ritual that went into the preparation of the drug and the needle. I’d start sweating and feel the strong urge to pee. I would get so shaky that, many times, I’d actually spill the dope before I could actually draw it up into the needle. Which sucked so bad.
So, Can You Really Be Addicted to The Needle?
To sort of prove my point that you can be addicted to the needle, I can tell you that I’ve heard other IV users say that there were times where, even if they ran out of drugs, they’d ‘push’ water or shoot alcohol just to get that needle high. And I’d be lying if I said that I didn’t do that a couple times, myself, when I was in my active addiction and desperate for a high.
I knew I was making progress, though, when I was still at the IOP (intensive outpatient program) level of treatment and went over to my sponsor’s house to do some step work. She had some friends over and forgot to mention to me that one of them is an insulin-dependent diabetic, which means that he has to inject insulin periodically. Now, this is all important to my little story because, at one point, I walked into the kitchen to get a glass of water and there he stood, at the peninsula counter facing me, with his “works” all laid out right in my line of vision. The needle was even the same exact kind I had used in my active addiction; the skinny ones with the orange caps. And, honestly, I didn’t even flinch.
I shared about my little experience in group the next day, not really realizing just how meaningful it was to my progress in my recovery. As the therapist facilitating the group pointed out, the fact that my first thought upon seeing the syringe was about diabetes and medical use meant that I had broken the association with that needle high and being addicted to the needle, and using drugs, in general. Overall, it was an optimistic sign of growth and healing.
And today, with nearly 2 years clean and sober, I can tell you that things definitely get better and that craving for that needle high goes away. In fact, not only do I not associate syringes with illicit drug use anymore, the sight of them and thought of people injecting actually grosses me out.
Recovery is possible and help is available. If you are struggling with IV drug use or any other substance abuse or addiction issues, call us toll-free at 1-800-951-6135 to speak directly with an Addiction Specialist. We are available around the clock to answer your questions and share with you our resources. You are not alone.