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27th September 2016

Sweden's battle against drugs and prejudice

The Swedish government has launched an investigation on how to prevent drug-related deaths. Last month, Health Minister Gabriel Wikström announced that he wants needle exchange programmes to be managed by county councils instead of councils. County councils cover larger areas in the country. The report will be delivered in April next year.

"Needle exchange programmes are an important measure towards disease control, which we know from Swedish, as well as international, experiences. The aim of these propositions is to make needle exchange programmes available all over the country. This will give us new opportunities to meet groups that have previously been difficult to get hold of," Wikström said in a press release.

For decades, a majority of Swedish political parties have claimed that harm reduction programmes such as needle exchange programmes and drug consumption rooms "encourage" drug use rather than do good. But according to the 2016 annual report by the European Monitoring Center for Drugs and Drug Addiction, Sweden has the second highest death rate from drug use in Europe. Only Estonia has higher drug-related deaths per capita. According to Sweden's National Board of Health and Welfare, 48 percent of drug-related deaths in 2014 were caused by an overdose.

In November last year, UN's Deputy High Commissioner for Human Rights, Flavia Pansieri, criticised Sweden's views on drugs. She told public broadcaster SVT that she was "surprised to see that [Sweden] lags behind a number of other countries in terms of its policies on drugs."

Stockholm's needle exchange programme has been available since 2012. The programmes have since become available at several places including Malmö, Jönköping, and Kalmar. And according to the Public Health Agency of Sweden, they're actually working. "For the individual, these efforts can improve the chances to a life without serious or deadly infectious disease. For society as a whole it all comes down to improving the possibilities of equal health," Johan Carlson, director general of the Public Health Agency said in a statement.

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26th September 2016

Asia: bullets trumps rehab amid a catastrophic failure of war on drugs

The Philippines has launched a bloody "war on drugs" that has killed at least 2,400 people in just two months, while neighboring Indonesia has declared a "narcotics emergency" and resumed executing drug convicts after a long hiatus.

In Thailand and Myanmar, petty drug users are being sentenced to long jail terms in prisons already bursting at the seams.

The soaring popularity of methamphetamine - a cheap and highly addictive drug also known as meth - is driving countries across Asia to adopt hardline anti-narcotics policies. Experts say they are likely to only make things worse.

Geoff Monaghan has seen it all before. He investigated narco-trafficking gangs during his 30-year career as a detective with London's Metropolitan Police, then witnessed the impact of draconian anti-drug policies as an HIV/AIDS expert in Russia.

He believes President Rodrigo Duterte's anti-drugs campaign in the Philippines will fuel more violence and entrench rather than uproot trafficking networks. "I'm very fearful about the situation," he said.

Reflecting the regional explosion in use, the amount of meth seized in East and Southeast Asia almost quadrupled from about 11 tons in 2009 to 42 tons in 2013, said the United Nations Office on Drugs and Crime (UNODC).

Meth was the "primary drug of concern" in nine Asian countries, the UNODC said, including Indonesia, the Philippines, Thailand, Japan and South Korea.

Meth is a transnational business, worth around $15 billion in mainland Southeast Asia alone in 2013, the UNODC says.

The meth explosion carries huge social consequences: overburdened health services, overcrowded prisons, families and communities torn apart.

Thailand launched a popular "war on drugs" in 2003 that rights activists said killed about 2,800 people in three months, a death toll later halved by a government-appointed inquiry. Figures show it had no lasting impact on meth supply or demand in Thailand.

"The world has lost the war on drugs, not only Thailand," the country's justice minister Paiboon Koomchaya told Reuters in July.

Meth addiction is tough to treat, ideally requiring costly and time-consuming counseling. Long-term use can cause changes in brain structure and function.

Less than 1 percent of dependent drug users in Indonesia got treatment in 2014, said the UNODC.

"Rehab" in many countries often means detention at a state facility. In Thailand, thousands of users are held at army camps for four months. Relapse rates at drug detention centers range from 60-90 percent, says the World Health Organisation.

Evidence shows that the most effective treatment is voluntary and community-based. A 2015 study in Malaysia found that half the people at compulsory centers relapsed within 32 days of release, compared with 429 days for those who had volunteered for treatment.

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25th September 2016

China: Prescription drug abuse tied to increased risk of teen suicide

Suicide is a leading cause of death for teens worldwide, and the odds of suicide attempts may be higher when adolescents abuse prescription drugs, a Chinese study suggests.

To explore the connection between suicide risk and misuse of prescription opiates and sedatives, researchers surveyed about 3,300 Chinese teens once when they were about 14 years old and again a year later.

Teens who said they used prescription drugs for non-medical reasons at the start of the study were almost three times as likely to report a suicide attempt a year later, and the risk was more than tripled for youth who abused opiates, researchers report in JAMA Pediatrics.

"Baseline opioids misuse, sedatives misuse, and nonmedical use of prescription drugs were positively associated with later suicidal ideation," said lead study author Dr. Lan Guo of Sun Yat-sen University in Guangzhou.

Those thoughts were more likely to turn into suicide attempts with "baseline opioids misuse and nonmedical use of any prescription drugs", Guo added by email.

Less than 3 percent of the teens reported misuse of any prescription drugs, with 1.8 percent saying they used opiates or stimulants for nonmedical reasons and about 1 percent reporting abuse of sedatives.

Overall, 17 percent of the participants reported suicidal thoughts, and 3 percent reported suicide attempts in the survey at the end of the study.

The link between drug abuse and suicide persisted even after researchers accounted for teens who reported experiencing depression at the start of the study.

While the study doesn't examine why abuse of prescriptions and other drugs might be linked to a greater suicide risk, it's possible that these drugs might alter teens' moods or lower inhibitions in a way that allows suicidal impulses to flourish, the authors conclude.

It's not surprising that the same teens who are prone to abusing drugs would also be susceptible to suicidal thoughts, said Dr. Bernard Biermann, an adolescent psychiatry researcher at the University of Michigan's C.S. Mott Children's Hospital in Ann Arbor.

It's essential that parents keep an eye on teens for changes in behavior that go beyond temporary moodiness to suggest a bigger problem, said Dr. Benjamin Shain, a researcher at the University of Chicago and head of child and adolescent psychiatry at NorthShore University HealthSystem.

"Growing up has always been difficult and life now is even more complicated," Shain, who wasn't involved in the study, said by email. "Parents should take seriously severe or persistent distress and changes in behavior, such as isolation or falling grades, and bring their teen to their primary care physician or a mental health professional with any signs."

Parents should also try to make it harder for teens to get their hands on things to harm themselves, said Dr. Yolanda Evans, an adolescent medicine specialist at Seattle Children's Hospital who wasn't involved in the study.

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24th September 2016

‘Digital heroin’: How screens turn kids into psychotic junkies

Many parents intuitively understand that ubiquitous glowing screens are having a negative effect on kids. We see the aggressive temper tantrums when the devices are taken away and the wandering attention spans when children are not perpetually stimulated by their hyper-arousing devices. Worse, we see children who become bored, apathetic, uninteresting and uninterested when not plugged in.

There’s a reason that the most tech-cautious parents are tech designers and engineers. Steve Jobs was a notoriously low-tech parent. Silicon Valley tech executives and engineers enroll their kids in no-tech Waldorf Schools. Google founders Sergey Brin and Larry Page went to no-tech Montessori Schools, as did Amazon creator Jeff Bezos and Wikipedia founder Jimmy Wales.

We now know that those iPads, smartphones and Xboxes are a form of digital drug. Recent brain imaging research is showing that they affect the brain’s frontal cortex — which controls executive functioning, including impulse control — in exactly the same way that cocaine does. Technology is so hyper-arousing that it raises dopamine levels — the feel-good neurotransmitter most involved in the addiction dynamic.

This addictive effect is why Dr. Peter Whybrow, director of neuroscience at UCLA, calls screens “electronic cocaine” and Chinese researchers call them “digital heroin.”

That’s right — your kid’s brain on Minecraft looks like a brain on drugs. No wonder we have a hard time peeling kids from their screens and find our little ones agitated when their screen time is interrupted. In addition, hundreds of clinical studies show that screens increase depression, anxiety and aggression and can even lead to psychotic-like features where the video gamer loses touch with reality.

According to a 2013 Policy Statement by the American Academy of Pediatrics, 8- to 10 year-olds spend 8 hours a day with various digital media while teenagers spend 11 hours in front of screens. One in three kids are using tablets or smartphones before they can talk. Meanwhile, the handbook of “Internet Addiction” by Dr. Kimberly Young states that 18 percent of college-age internet users in the US suffer from tech addiction.

Developmental psychologists understand that children’s healthy development involves social interaction, creative imaginative play and an engagement with the real, natural world. Unfortunately, the immersive and addictive world of screens dampens and stunts those developmental processes.

We also know that kids are more prone to addictive escape if they feel alone, alienated, purposeless and bored. Thus the solution is often to help kids to connect to meaningful real-life experiences and flesh-and-blood relationships. The engaged child tethered to creative activities and connected to his or her family is less likely to escape into the digital fantasy world. Yet even if a child has the best and most loving support, he or she could fall into the Matrix once they engage with hypnotic screens and experience their addicting effect. After all, about one in 10 people are predisposed towards addictive tendencies.

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21st September 2016

Decriminalizing of drugs, the only pathway

2016 has been a pivotal year for drug policy on a global level. The review of a half-century of prohibition has led countries as diverse as Jamaica, Canada and Mexico to adopt reforms that would have been considered unimaginable only a short while ago.

In April, the United Nations General Assembly Special Session on Drugs (UNGASS) clearly showed that the decades-long consensus based on drug prohibition and punitive approaches is broken. Rather than propose innovative policy solutions, however, the final declaration of UNGASS on drugs continues to uphold prohibitionist strategies.

Effective approaches to drug policy based on scientific evidence and shared national experiences must be at the center of the current focus. The preparations for UNGASS mobilized governments, scientists, non-governmental organizations, and international agencies in charge of development, health and human rights, highlighting their commitment to propose innovative and viable solutions.

Prohibition and the goal of drug-free societies have caused what the United Nations agency in charge of this international drug control system refers to as "unintended consequences". These include huge profits from an illegal market worth US$320 billion per year, which fuels violence, corruption and instability.

According to a study by the United Nations Office on Drugs and Crime, 83 per cent of total global drug-related offenses are for simple drug possession, even though criminalization blocks prevention measures, risk reduction, access to health care, and feeds HIV/AIDS and hepatitis C epidemics. Thirty-three countries still apply the death penalty for drug-related offences. Thirteen of them even have a mandatory death penalty sentence for drug-related arrests. This situation is unbearable: mandatory sentences deprive judges of their discretion and undermine the principle of proportionality, two elements that are the basis for democratic, independent judicial systems.

Some countries have implemented public policies that are person-centered, recognize the human rights of people who use drugs, seek to increase the security of all citizens, and to reduce the harms of both drug use and drug policies.

Many European countries have implemented comprehensive harm reduction programs that include needle exchanges and substitution therapy. Portugal and the Czech Republic have replaced punitive sanctions with social measures. Jamaica recently passed a law that decriminalizes all uses of cannabis while Uruguay paved the way in drug policy reform in 2013 when it adopted comprehensive legislation regulating the production, distribution and consumption of cannabis for medical and personal use.

Monitoring and evaluating the Uruguay model will take several years; however, there is already evidence to show that countries imposing punitive penalties are no more likely to deter drug use than countries imposing less punitive sanctions. On the contrary.

Now is the time to recognize that as long as we fail to address drugs correctly—respecting human rights and concentrating our efforts on organized crime—drug abuse and illicit trafficking will never be overcome.

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20th September 2016

Egypt: Establishment of departments in hospitals that provide free treatments to addicts

Amro Osman, Director of the Fund for the fight against drug abuse and addiction treatment at the Ministry of Social Solidarity, explained the vital role played by the Fund's hotline, "16023", during the eighth annual conference organized by the department of psychiatry at Al Azhar University. The conference was attended by a group of psychiatry professors, doctors, psychologists, sociologists and students, during which the hotline was praised for its efforts in the field of addiction treatment.

Amro Osman said today, Saturday, that the Hotline provides treatment services for free and confidentially, by receiving phone calls from patients and their families every day of the week 24 hours a day; In addition to the opening of departments devoted to the most vulnerable groups such as adolescents, children and girls to be treated for free, especially after the decline of the age of drug abuse to 12 and the continual increase of addiction rates among women. The hotline also provides after treatment support services for the social rehabilitation of former patients encouraging them to participate in sports and artistic events and the launch of the initiative "new beginning" to finance small projects in parallel to providing training courses for professions and maintenance of mobile devices.

The director of the Fund for the fight against drug abuse and addiction treatment explained that the hotline’s role expanded to receive complaints against school bus drivers and addicts complaints against phantom centers for the treatment of addiction. He stressed that the hotline also offers treatment programs in prisons and is in the process of mapping the problem of addiction in Egypt through the analysis of data it receives. The hotline has also offered support to build hospitals with the gift of 1 million and 300 thousand pounds in the last two years.

He also stressed that the number of incoming calls to the hotline reached 71 000 telephone calls during 2015, increasing thus by 34% compared to 2014, and the Web page of the Fund pertinent to the fight against drug is increasingly receiving interaction from people eager to receive treatment.

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