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The Role of Drug Policies: How Science & Policy Can Work Together

The Role of Drug Policies: How Science & Policy Can Work Together. Adeeba Kamarulzaman University of Malaya. Current Coverage NSP,OST, ART. Injecting drug use reported in 151 countries In 2010, 93 countries and territories support a harm reduction approach

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The Role of Drug Policies: How Science & Policy Can Work Together

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  1. The Role of Drug Policies:How Science & Policy Can Work Together

    AdeebaKamarulzaman University of Malaya
  2. Current CoverageNSP,OST, ART Injecting drug use reported in 151 countries In 2010, 93 countries and territories support a harm reduction approach National Policy on Harm Reduction – 79 countries
  3. Needles-syringes distributed, per IDU, per year 2010 - 82 countries 2008 – 77 countries Globally, overall, only 22 needles-syringes (range 12-42) are distributed per IDU per year
  4. Opioid substitution therapy (OST) Present in 75 countries Absent in 76 countries where injecting occurs Globally, overall, only 8 people on OST (range 6-12) for every 100 IDUs
  5. 2011 UN High Level Meeting on HIV/AIDS 1. Renewed commitment and action toward the goal of universal access to comprehensive HIV prevention, treatment, care and support for people who inject drugs through the financing, implementation and scale-up of evidence-based harm reduction interventions; and 2. Commitment to removing legal and policy barriers to achieving the aims above, particularly a reorientation of punitive drug policies toward evidence- and human rights-based approaches.
  6. What are the obstacles?
  7. Percentage of countries reporting laws, regulations or policies that present obstacles to services for injecting drug users 100 80 60 Percentage of countries (%) 40 20 0 North America (1) South and South- East Asia (13) Eastern Europe and Central Asia (16) Middle East (4) Western and Central Europe (13) Latin America (19) East Asia (3) Sub- Saharan Africa (41) Caribbean (12) Oceania (7) Source: UNGASS Country Progress Reports 2008. 5.11

  8. Country Examples

  9. Australia the adoption in1985 of harm minimisation as the official national drug policy; the realisation in 1985 that, based on the US experience, HIV among and from PWIDs had to be taken seriously; advocacy for NSP and OST increased - in a more favourable environment a civil disobedience on NSP started on 12 November 1986 NSW government decided not to prosecute and decided to set up their own NSP network including pharmacies; by 1990 whole country covered with NSP and OST - now > 35 million needles & syringes/year; In 2000s Return on Investment studies I and II show huge health and economic benefits
  10. Taiwan
  11. Development of methadone program in TYPC At first we didn’t even know where our patients were Try and error phase Rapid growth, expand quickly Devoted superintendent Support from DOH, CDC, county government Professional, innovative, and friendly Computer assisted system
  12. Case number of Heroin addicts BEFORE MMT Not covered by insurance Mainly short term treatment Abstinence Only
  13. 行政院衛生署桃園療養院 Case load of Heroin addicts AFTER MMT Person-visits Taoyuan Mental Hospital, Department Of Health
  14. Needle Syringe Program
  15. National MMT Program
  16. “This significant change in policy signals a new sense of urgency. As drug dependency is a health issue that should be treated medically, there is a need to take a bolder but softer approach rather than a punitive one………. This is why efforts must be stepped up to decriminalise drug dependency, actively address the issue of the stigma of addiction………………………. NST March 2011
  17. Canada
  18. Conclusion More countries adopting harm reduction programs Continue to strengthen programs – ensure they are evidence based Continue to provide the evidence for its effectiveness, particularly cost-effectiveness of programs
  19. Acknowledgements Alex Wodak Evan Woods SangeethKaur MahmoodNazar
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