global implementation of harm reduction
TRANSCRIPT
ISAM Policy
“Physicians in addiction medicine will together formulate empirically-grounded policies for addressing this illness on the national and international level”
http://isamweb.org/about_isam/mission/
Focus: injection drug useInjection drug use has been reported in 158 countriesEstimates of numbers of people who inject drugs (PWID):8.9-22.4 millionHow many already are infected with HIV? Between 0.9-4.8 millionOpioid overdose is the leading cause of preventable drug related mortality
Global State of Harm Reduction 2014;World Drug Report, UNODC
Harm Reduction Principles
Accepts, for better and or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.Encompasses a continuum of behaviors from heavy drug use to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others. Establishes quality of individual and community life and well-being–as the criteria for successful interventions and policies.Recognizes that the realities of poverty, class, racism, sex-based discrimination and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.
Harm Reduction CoalitionHarmreduction.org
Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populationsWorld Health Organization 2014
Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populationsWorld Health Organization 2014
Needle and Syringe Programs Globally
Global State of Harm Reduction 2014
Opioid maintenance treatment globally
Global State of Harm Reduction 2014
Prevention Works for NYS’s IDUs As the annual number of syringes exchanged increases, the number of new HIV infections among IDUs decreases
Newly Diagnosed HIV Cases by Transmission RiskNew York State, 2002-2012*
0
1000
2000
3000
4000
5000
6000
2002 2004 2006 2008 2010 2012
MSM Fem. Pres. Het. Heterosexual UnknownIDU MSM/IDU Pediatric Blood Prod.
10
*December 2013 NYSDOH/AI/BHAE
Changes in reported cases of HIV in Ukraine
International HIV/AIDS Alliance in Ukraine, 2012 report
Decriminalization- De jureWritten into lawNo offense: UruguayPolice discretion: SpainAdministrative decision: Portugal, Czech RepublicCriminal Justice Decision: Germany, Peru, Estonia
International Drug Policy Consortium
Decriminalization- De factoNo sanction: NetherlandsPolice diversion: USA: SeattleCriminal justice diversion: USA in many states
International Drug Policy Consortium
International Drug Policy Consortium5 Asks1: Ensure an open and inclusive debate2: Re-set the objectives of drug policies3: Support policy experimentation and innovation4: End the criminalization of the most affected populations5: Commit to the harm reduction approach
Funding levelsThe global budget for drug law enforcement almost certainly exceeds US$ 100 billion every yearIt is estimated that 10% of this budget could fund much of what is needed
International Drug Policy Consortium
Potential asks for addiction physiciansAccess to evidence based medications including but not limited to methadone and buprenorphine in general and in the criminal justice systemOverdose prevention with treatment and naloxoneAccess to clean injection equipmentExploration of models of decriminalizationDrug use in pregnancy as a medical issueAccess to optimal pain management
AcknowledgementNew York and Vienna Nongovernmental Organizations Committees on Drugs
International Drug Policy Consortiumhttp://idpc.net/