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LACK OF HARM REDUCTION
SERVICES IMPEDING HIV
PROGRESS, WARNS UNAIDS
AROUND 99 PER CENT OF PEOPLE WHO INJECT
DRUGS LIVE IN COUNTRIES THAT ARE FAILING TO
PROVIDE ADEQUATE HARM REDUCTION SERVICES,
says a report from UNAIDS. Despite overall new
HIV infections declining globally, infection rates
among people who use drugs remain unchanged,
says Health, rights and drugs: harm reduction,
decriminalisation and zero discrimination for
people who use drugs.
Although ensuring comprehensive harm
reduction service coverage such as NSP
programmes, substitute prescribing and HIV
testing would ‘kick start progress’ on stopping
new infections, few UN member states were
living up to the 2016 agreement that came out of
the UN General Assembly Special Session (UNGASS) on
the World Drug Problem to establish an effective public
health response (DDN, May 2016, page 4). Investment in
harm reduction measures is falling ‘far short’ of what is
needed for an effective HIV response, says the document
– in a third of low and middle-income countries, more
than 70 per cent of spending on HIV services for people
who use drugs came from external donors.
More than half of the 10.6m people who inject drugs
were living with hepatitis C, and one in eight were living
with HIV, says the report. UNAIDS is calling for the full
implementation of comprehensive harm reduction
services, as well as ensuring that people who use drugs
have access to prevention, testing and HIV and hepatitis
medication.
Criminalisation and ‘severe punishments’ remain
commonplace despite the evidence showing that
decriminalisation of personal use and possession can
increase the uptake of health and treatment services, says
UNAIDS. Around one in five prisoners worldwide is
incarcerated for drug-related offences, of which around 80
per cent are for personal use only.
‘UNAIDS is greatly concerned about the lack of progress
for people who inject drugs,’ said executive director Michel
CRISIS TALKS
‘We must act if it can be
shown to reduce harm and
save lives.’ Joe FitzPatRick
THE SCOTTISH GOVERNMENT IS
CONVENING AN EXPERT GROUP to
look at ways to address the
country’s rising rates of drug-
related deaths. ‘The status quo is
simply not an option,’ wrote public health
minister Joe FitzPatrick in an article for the
Daily Record, adding that ‘even if a
proposed course of action is controversial,
we must act if it can be shown to reduce
harm and save lives’. While the Scottish
Government supports the introduction of
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‘Put people
first and seek
to safeguard
their health,
wellbeing
and future.’
Sidibé. ‘By putting people at
the centre and ensuring that
they have access to health
and social services with
dignity and without
discrimination or
criminalisation, lives can be
saved and new HIV infections
drastically reduced.’
Meanwhile, a ministerial
declaration emphasising a
‘health and rights-based’
approach to global drug
yuRy Fedotov
challenges was adopted at
the 62nd session of the UN
Commission on Narcotic Drugs in Vienna last month.
Responses that ‘put people first and seek to safeguard
their health, wellbeing and future’ were vital, said
UNODC executive director Yury Fedotov. A separate
report, What we have learned over the last ten years, from
the UN’s Chief Executives Board, described punitive
policies as ‘ineffective’ in reducing drug use and
trafficking.
Reports at www.unaids.org and www.unodc.org
consumption rooms and heroin-assisted
treatment, legislative power remains in
Westminster. ‘If the UK government
continues to refuse to act, we call on
them to pass powers to the Scottish
Parliament so we can do what is
necessary,’ he wrote.
SURVIVORS’ STORIES
DRUG AND ALCOHOL SERVICES need to ‘make
the link’ between childhood sexual abuse as
an underlying trauma
for many people with
substance misuse
issues, says a report
from the One in Four
charity. The trauma
of childhood abuse
remains a ‘poorly
understand area’, it
states, affecting
people’s emotions
and ability to relate
to others. Services
should be
anonymously
recording and collating disclosures of abuse as
well as considering how they are ‘supporting
and signposting survivors to appropriate
support’, it says. They also need to make sure
that all staff are trained to respond to
disclosure and have an agreed process to
support survivors. Numbing the pain:
survivors’ voices of childhood sexual abuse and
addiction at www.oneinfour.org.uk
See feature, page 10
POTENT CONCLUSIONS
DAILY CANNABIS USE WAS ASSOCIATED WITH
‘INCREASED ODDS’ OF PSYCHOTIC DISORDER,
according to a study across 11 cities
published in The Lancet Psychiatry. Although
‘disentangling causality where complex and
confounded behaviours might be impacting
on even more complex mental health
outcomes is notoriously challenging’, the
study concluded that differences in
frequency of daily cannabis use and use of
high-potency cannabis contributed to a
‘striking variation in the incidence of
psychotic disorder’, something that – given
the increasing availability of high-potency
cannabis – had ‘important implications for
public health’. Cannabis and psychosis:
triangulating the evidence at
www.thelancet.com
WASTED CITIES
COCAINE RESIDUES IN CITY WASTEWATER
were highest in Belgium, the Netherlands,
Spain and the UK – particularly Bristol –
according to EMCDDA’s latest analysis. The
project studied wastewater in 73 cities across
Europe, and found increased traces of cocaine,
amphetamine and MDMA in most cities.
Methamphetamine, meanwhile, which had
traditionally been concentrated in parts of
Eastern Europe, was now present in Spain,
Finland, Norway, Germany and Cyprus.
Wastewater analysis and drugs: a European
multi-city study at www.emcdda.europa.eu
April 2019 | drinkanddrugsnews | 5