'I get my heroin on the NHS'

By Tom Geoghegan BBC News Online

Get caught with heroin and you face seven years in prison. But not Erin O'Mara, one of 440 addicts in the UK to get a regular fix from an NHS prescription - an arrangement she says has turned her life around.

Erin O'Mara is a bright, bubbly magazine editor - hardly the stereotype of someone who injects heroin four times a day.

But her habit, now in its 20th year, does not line the pockets of a drug dealer. The 34-year-old gets her fix from her local chemist in west London. This "perfect prescription", as she calls it, began two years ago and rescued her from a life of prostitution, drug dealing and serious illness.

The downward spiral began with Erin's first taste of heroin aged 15 while in her native Australia, and has included 10 unsuccessful methadone programmes along the way.

To finance her habit, she began working as a masseuse, which led to escort work and then street prostitution. That stopped when she discovered she was HIV positive.

But the prescription has transformed her life. As founder of Black Poppy, a magazine by and for drug users, she addresses drug conferences and is being consulted about pilot projects.

Sitting in her office, she says: "My prescription has meant I have money now, and choices I can make in my life - simple things like what I want for dinner. I can do things I haven't done for years and can think five years ahead. Before I was just thinking about my next 'hit'."

ERIN'S DAILY PRESCRIPTION 4 x 100mg diamorphine (solid) 4 x sterilised water 4 x sterilised needles 4 x swabs pharmaceutically prepared advice leaflet enclosed

Each shot supplied by her chemist is just enough to enable Erin to function properly and prevent the onset of withdrawal. She only feels the buzz if she relaxes.

The NHS allows only licensed doctors to prescribe diamorphine, the medical name for heroin, to addicts if they have failed to respond to methadone treatment. At present just 0.5% of those in treatment are prescribed heroin, but new pilot projects are expected to increase that number.

Supporters of this policy, such as the independent research group DrugScope, say controlled distribution by the state can drastically reduce crime.

They also argue that clean heroin like diamorphine is not in itself dangerous, just incredibly addictive. And a pharmaceutical prescription excludes all the risks associated with unsafe injecting and enables the user to gradually be weaned off the drug.

Topped up doses

Erin believes this approach can save lives. But prescribing heroin is not always the answer, as she herself knows from the first programme she took part in in 1998.

HEROIN & THE NHS Prescriptions peaked in 1960s The UK is one of the few countries to allow it Any doctor can prescribe it for medical conditions, but need Home Office licence to treat addiction Home Office says every £1 spent on drug treatment saves £3 in less crime Source: Drugscope Prescribed heroin 'safe'

"The whole set-up was really oppressive and heavy-handed, but the doses were too low so people were using other drugs and too scared to admit it. No-one was happy and no-one was doing well on it. The carrot and stick approach doesn't work because you can't punish users enough to make them stop".

One patient, a 45-year-old woman, threw herself off a tower block two days after being penalised by having her prescription withdrawn, Erin says.

And with strict attendance requirements and supervised injections, it prevented users from getting full-time employment.

Erin claims she was forced off the course after 18 months when she tried to start a support group. She then founded Black Poppy to give a voice to drug users, and address issues missed by treatment programmes.

Why did I have to wait until I'd finished selling my young body to men?

After leaving the prescription programme, Erin was put on methadone injections, which she topped up with crack. This period was one of her lowest and her veins began to collapse.

When she heard about a vacancy on a pioneering prescription course at the Maudsley Hospital in south London, she cornered the doctor in charge at a drugs conference.

"I remember my sense of complete and total desperation. I felt I could not go on any longer, that if they didn't help me, I didn't know where I would be. I felt that this was my last hope, that I'd tried everything. And I begged."

Her powers of persuasion paid off and she joined what turned out to be a more flexible programme. She was able, for instance, to spend a few months at her mother's in Colchester and pick up her prescription from a local chemist, so long as she visited the doctor every fortnight.

Her immune system strengthened, and two years on she is on a reduced dosage and aims to come off heroin completely.

HEROIN IN THE UK 200,000 heroin users 88,000 in treatment , of which 40,000 on methadone Heroin is an opiate which depresses the nervous system It can combat physical and emotional pain Users can feel warm, relaxed and detached Purity of street heroin varies, with a risk of fatal overdosing Unsafe injecting means risk of HIV, hepatitis, abscesses and ulcers Source: DrugScope, NTA

As she looks to the future, there is a trace of anger about the years spent on and off treatment programmes.

"Why did I have to wait until I'd finished selling my young body to men, until I'd got sick and deeply depressed, until I'd used every vein in my body from my neck to my feet, until I'd contracted both HIV and Hep C?"

But she is optimistic that the government has begun to move in the right direction and listen to what drug users want.

Cocktail of heroin and tik scary - experts

March 26 2009 at 12:48PM

Related Articles Dangers of mothers' new little helper The 'epicentre' of HIV and tik Where do tik addicts come from? New drug mix in the Cape

By Bronwynne Jooste

The number of heroin users in Cape Town is growing steadily and the drug is is also being used with tik in a dangerous new cocktail, according to rehabilitation centres in the city.

The centres said that although tik was seldom used on its own, the use of it with heroin as a secondary drug was scary.

The Western Cape branch of the South African National Council on Alcoholism and Drug Dependence (Sanca) said it had noted a rise in the use of heroin.

'These are two of the most addictive drugs'

Grant Jardine, of the Cape Town Drug Counselling Centre, agreed that their figures showed a steady climb.

"It wasn't as dramatic as tik, which shot up suddenly. But it is the one drug that has increased each year."

Tertius Cronjé, of Sanca, said the number of users they saw with heroin-addiction problems had tripled in the past three years.

He said people were mostly using the cheaper, less pure form of the drug.

In line with research from the South African Medical Research Council, Cronjé said most users smoked the drug.

According to the council, the Western Cape is the only province in the country where the majority of users took the drug in this way. In other areas, most users injected the drug.

Cronjé said this could be attributed to the fear of contracting HIV and Aids.

Research showed that the recovery rate for heroin users was dismal. But, he said, the most alarming new development was the use of heroin in conjunction with tik.

He said the combination held devastating effects for the user.

"These are two of the most addictive drugs. Using them in tandem is as bad as addiction gets. It's very difficult to come off; you can't really win here."

It was made worse by the fact that heroin carried a major risk of overdosing, while tik held severely damaging psychological effects.

Jurgens Smit, the director of Western Cape-based Faces and Voices of Recovery South Africa, said the combination of the two drugs was "a disaster".

"We first saw this surfacing around two years ago. But it has been spreading, especially across the Cape Flats."

Smit said early intervention was needed to clamp down on the spiralling drug problem.

"We need to start intervention programmes early, targeting children as young as six years old. Society is responsible for offering young people healthy alternatives," he said.

Drug policy for methamphetamine use urgently needed

During 2004 there have been media reports of a dramatic
increase in the use of methamphetamine (MA), locally known
as ‘tik’, in the Western Cape. These reports have been
supported by findings from the South African Community
Epidemiology Network on Drug Use (SACENDU) Project.1
SACENDU is an alcohol and other drug (AOD) sentinel
surveillance system operational in Cape Town, Durban, Port
Elizabeth (PE), Mpumalanga, and Gauteng (Johannesburg/
Pretoria). The system monitors trends in AOD use and
associated consequences on a 6-monthly basis from multiple
sources, including over 50 specialist treatment centres.
SACENDU findings reveal that the proportion of clients at
specialist substance abuse treatment centres reporting MA as
their primary and/or secondary drug of abuse increased
significantly between the first half of 2002 and the first half of
2004, from 4 patients seen at 23 centres to 241 patients seen at
25 centres (Table I). The sharp increase in the number of
clients seeking treatment for MA-related problems is
unprecedented in the country. Data from other sites suggest
that while MA use is increasing elsewhere the extent of use is
greatest in Cape Town.2 In addition, in Cape Town MA has
rapidly become the third most commonly reported primary
illicit substance of abuse (after methaqualone and cannabis),
where previously it was rarely reported as a problem drug.3
Not only does the rapidly growing popularity of MA point to
the urgent need to address this problem in the Western Cape,
but the demographic profile of clients in treatment for MArelated
problems also highlights this urgency. MA is the drug
of choice for young people; the average age of patients who
reported MA as their primary substance of abuse in the first
half of 2004 was 20 years, with 60% of patients being younger
than 20 years of age. This is cause for concern given that
adolescents are particularly vulnerable to the neurotoxic effects
of MA.
More specifically, MA’s potent and toxic action on the
sympathetic and central nervous systems makes a strong case
for the urgency with which MA use should be addressed,
especially in the Western Cape. Positron emission tomography
(PET) imaging and postmortem studies in humans provide
evidence of MA’s neurotoxicity, with regular users showing a
loss of dopamine nerve terminals in the caudate and putamen,
reduced glucose metabolism in the thalamus, caudate and
putamen, and increased glucose metabolism in the parietal
cortex.4 These structural brain changes are associated with
long-term impairment in cognitive processing, memory and
emotion.5 Other MA-related chronic health problems include
cardiovascular and pulmonary complaints such as myocardial
infarction, arrhythmias, cerebral oedema, hyperpyrexia, chronic
pulmonary congestion, seizures and strokes; psychiatric
consequences such as paranoia, acute and chronic MA-induced
psychosis, hallucinations, depression, anxiety and
uncontrollable anger; dermatological problems; malnutrition
and weight loss; and the risk of overdose and death.5 In
addition, the behaviours associated with MA use, which
include high-risk sexual behaviours, place MA users at
increased risk for HIV and other infectious disease
transmission.6
Based on a review of the international literature and advice
from colleagues in other countries, it is clear that there are a
variety of potentially useful interventions that should be
considered in dealing with this new public health threat.
Raising awareness and providing accurate information to the
public and policy makers on MA and introducing specific,
science-based prevention programmes that target individual,
family and community risk and protective factors for substance
use appear to be the most promising prevention strategies.
In terms of treatment, consideration should be given to: (i)
ensuring that there is adequate access to affordable and
effective treatment in general; (ii) establishing MA treatment
protocols in public hospitals and specialised care facilities; (iii)
training health and social service providers to identify, assess
and manage MA-induced psychosis, anxiety, withdrawal and
Drug policy for methamphetamine use urgently needed
Table I. Patients in specialist substance abuse treatment centres in Cape Town with methamphetamine as primary or secondary substance of
abuse (2002 - 2004)
2002a 2002b 2003a 2003b 2004a
N % N % N % N % N %
Primary 4 0.3 13 0.8 38 2.3 38 2.3 241 10.7
Secondary 7 0.4 19 1.2 43 2.6 83 5.0 188 8.3
Overall* 11 0.7 32 2.1 81 4.8 121 7.3 429 19.0
Total no. of
patients 1 608 1 551 1 686 1 659 2 255
* Patients who have methamphetamine as primary or secondary substance of abuse.
a = data collected between January and June; b = data collected between July and December.
SCIENTIFIC LETTER
overdose; (iv) specifically equipping primary health care
providers and emergency room personnel to provide brief
screening and interventions; and (v) introducing science-based
models of substance abuse treatment into community settings,
especially cognitive-behavioural approaches.
Interdiction strategies should include: (i) monitoring the
distribution and use of precursor chemicals used in the
manufacture of MA; (ii) investigating companies that distribute
precursor chemicals (e.g. pseudoephedrine, ephedrine,
anhydrous ammonia and red phosphorous) or equipment used
in clandestine methamphetamine laboratories; (iii) expanding
community policing strategies to engage the public in MA
issues; and (iv) continuing to put pressure on drug-related
organised crime (especially focusing on drug-related crimes
such as perlemoen (abalone) smuggling and high-intensity
drug dealing/trafficking areas).
Provincial responses during 2004 have focused almost
exclusively on social service and policing interventions. Given
the likely future burden of MA on the health sector, a greater
public health response to this threat is urgently required.
C D H Parry
B Myers
A Plüddemann
Alcohol and Drug Abuse Research Group
Medical Research Council
Tygerberg
1. Parry CDH, Bhana A, Plüddemann A, et al. The South African Community Epidemiology
Network on Drug Use (SACENDU): Description, findings (1997 - 1999), and policy
implications. Addiction 2002; 97: 969-976.
2. Plüddemann AP, Parry CDH, Bhana A, Harker N, Potgieter H, Gerber W. Monitoring alcohol
and drug abuse trends in South Africa (July 1996 - December 2003): Phase 15. SACENDU
Research Brief 2004; 7(1): 1-12.
3. Myers B, Parry CDH, Plüddemann A. Indicators of substance abuse treatment demand in
Cape Town. Findings from the SACENDU Project 1998 - 2002. Curationis 2004; 5: 27-31.
4. McCann UD, Ricaurte GA. Amphetamine neurotoxicity: accomplishments and remaining
challenges. Neurosci Biobehav Rev 2004; 27: 821-826.
5. Brecht ML, O'Brien A, von Mayrhauser C, Anglin MD. Methamphetamine use behaviours
and gender differences. Addict Behav 2004; 29: 89-106.
6. Semple SJ, Patterson TL, Grant I. The context of sexual risk behaviour among heterosexual
methamphetamine users. Addict Behav 2004; 29: 807-810.

"Towards 2010: Safety is not just for those who can buy it"

No mention of harm reduction...

"Towards 2010: Safety is not just for those who can buy it"

The affluent are obsessed with crime, but it is the poor that fight daily for survival, writes Irvin Kinnes. Only when we realise that all lives are equal can the safety of World Cup visitors be assured

May 16, 2007 Edition 1

How safe is Cape Town? Do we think that our preparations for 2010 will increase safety or will they only provide safety for certain sections of our population? Can Cape Town truly proclaim itself an inclusive, world-class city when it comes to safety?

There is a common illusion that Cape Town is a world-class city - not only because it attracts the lion's share of the tourists who visit South Africa, but because it is able to provide tourists with a host of services that compare very well with those of other international destinations. In addition, it has much else to offer.

But this is not what makes a world-class city.

The safety of its residents, its streets and its capacity to deal with crime are also determining factors. Implicit in the definition of a world-class city is the notion of human security. The UN Commission on Human Security argues that:

"Human security means protecting vital freedoms. It means protecting people from critical and pervasive threats and situations, building on their strengths and aspirations. It also means creating systems that give people the building blocks of survival, dignity and livelihood. Human security connects different types of freedoms - freedom from want, freedom from fear and freedom to take action on one's behalf."

If we see Cape Town in this context then we have to ask a few serious questions when it comes to crime and crime strategies.

There is the notion of two Cape Towns that bedevils its world-class ambitions - one rich and one poor. Despite the fact that crime affects people of all races and religious persuasions, the notion of safety for the rich and poor are two diametrically opposed realities in our divided city.

Many people who are comfortable behind high walls, security fences and security cameras are also those who are obsessed with criminals. For many people on the Cape Flats - who do not have access to water, sanitation, safety or security guards - survival is uppermost in their minds. Having something to eat for supper seduces them.

So fear is a temporary thing when you have to live side by side with your local criminal - as long as he does not interfere with you or your family.

Those who can afford long-term planning to protect their family and possessions do so with insurance and security booms. To the people of Joe Slovo in Langa, who have had their houses burned for the umpteenth time, security is the last thing on their minds when they have to worry about how they will find a roof over their heads.

I make this point because the realities of crime are so different for so many people in this city of ours. And yet, when you read the newspapers, you will believe that the areas where the rich live are completely under siege!

Our realities are different.

Our crime statistics paint a very bleak and sobering picture of this reality, despite the fact that there are those who do not want to know how the crime patterns have changed over the years.

Historically, Cape Town has had different crime patterns for different parts of the city.

If we examine the statistics, we find that crimes against women and children in particular have been particularly acute in the northern suburbs and Mitchell's Plain, where particularly brutal attacks have occurred against children in the last two years.

We also see that violent crimes such as murder, rape and armed robbery have risen in areas such as Khayelitsha, Nyanga, Kuils River and Mitchell's Plain.

Drugs have been synonymous with areas such as Woodstock, Salt River and Cape Town. Areas such as Lavender Hill, Hanover Park, Nyanga and Manenberg have faced a high incidence of firearms and ammunition.

Pinelands, Melkbosstrand and Simon's Town have high incidences of residential burglary. The statistics are uneven and fit neatly into the stereotype of a divided city where violent crime is perpetrated against (and by) inhabitants of the poorer sections of the city.

It is this view of Cape Town crime that persists in the minds of its inhabitants when it comes to the fact that we are about to host the Fifa World Cup in 2010.

However, today that crime trend is changing fast. That is the central issue that we have to come to terms with. The patterns of crime will change for a variety of reasons before and after 2010.

If we are to make any inroads, then the opportunity to influence and shape a positive outcome is upon us.

The staging of the World Cup has historically stopped wars, if even for just over one hour, as the Iran-Iraq wars have shown.

We should now use this golden opportunity to mobilise our communities to fight crime irrespective of race, geography and economic means. We have to do this because our much-maligned crime statistics have been showing a disturbing trend.

Drugs are becoming common in all communities, rich and poor. The incidence of drug availability, particularly to children, has to force a change in attitude by all - especially police agencies. If anything other than race can tear a community (and most definitely a city) apart, then it is drugs. If one considers the growth in the incidence of drugs then we should all be very proactive to combat the scourge of tik and other drugs affecting our youth. The statistics of the UN Office for Drugs and Crime, the Medical Research Council and indeed the Human Sciences Research Council all agree that drugs have by far shown a greater increase than other types of crime.

If we are to look at Figure 1 we can see that there has been a definite decrease in the corresponding years for murder in Cape Town. Notice the complete disparity when comparing the figures of Simon's Town, Table View and Pinelands as opposed to Khayelitsha, Nyanga and Mitchell's Plain.

The graph is so instructive that I will not even attempt to disaggregate the percentage drop in murders over the last six years.

If, on the other hand, we look at the same suburbs with respect to drugs, we see a different pattern, as Figure 2 demonstrates. If we were to add a trend line to this figure, no doubt it would rise at close to a 45° angle. This is because in areas such as Mitchell's Plain, drug cases have increased by a massive 580%!

Interestingly this trend affects all suburbs and communities including the well-off communities. Areas such as Melkbosstrand, Pinelands, Table View and Simon's Town all show increases above 50%.

The actions of vigilantes regarding this issue have clearly not borne fruit. Killing drug dealers has not led to less availability of drugs. On the contrary, it has led to a proliferation of drugs … and now they are in the hands of our children.

Studies undertaken by Luke Dowdney, of the Children Involved in Organised Armed Violence, in 10 areas which included Kingston, Medellin, Rio de Janeiro, Cape Town, Lagos, Chicago, Belfast, El Salvador, Ecuador and the Philippines, point to social marginalisation and lack of leisure facilities as reasons why young people turn to crime, gangs and drugs.

The social conditions that are driving young people into gangs, drugs and crime are not diminishing; they are becoming more acute and the disparity between haves and have-nots is increasing, thereby increasing the risk factors that drive young people to a life of crime.

That is why the initiatives shown by the Mitchell's Plain community become so important. In any community the greatest deterrent against criminals succeeding is a good relationship between the local police and the community. The name and shame campaign of the Mitchell's Plain community, under the leadership of director Jeremy Veary, has some drawbacks and issues with sustainability and right to privacy, but on the whole it activates a whole street, a whole section and finally a whole community to act against drugs and take back the streets.

The other example of a community coming to terms with crime, in a very different manner, is the Proudly Manenberg initiative, which mobilises the community to confront its identity and fear by involving everyone in developing the building blocks of survival, dignity and respect. We should not underestimate the potency of these campaigns in that they are the start of a fire that has captured the imagination of other Cape Town communities.

However, one has to caution against opportunists and vigilantes who will try to usurp positive community action in order to change the agenda. Only by safeguarding all communities and developing policy with respect to criminal threats and opportunities can the police and other law enforcement agencies hope to provide protection and support to communities.

A tremendous amount of goodwill has been generated as a result of the initiatives in Manenberg and Mitchell's Plain. One can only hope that the SAPS will grab the opportunity and assist in mobilising other communities.

The window of opportunity may soon close as we approach another taxi war on the Cape Flats. The police have to act fast, efficiently and professionally when it comes to these threats against the residents of Cape Town. When it comes to taxi wars, gangs and drugs, time is fast running out if we want to secure the city and make it a home for all.

Only when we realise that the lives of all people in Cape Town are equal, can the safety of tourists and football fans be assured.

Only then can we begin to look forward to a World Cup that delivers new standards for operational efficiency when it comes to policing. In order to see real benefits for all, we have to plan for way after 2010 and look forward to a city that begins to include all in the delivery of safety.

We can change Cape Town by having a joint city and provincial initiative to fight drugs, gangs and crime by:

Bringing on board community members willing to volunteer to deal with our tik-addicted youth.

Creating safety zones in each of our communities where people can claim the space and begin to organise safety in other areas.

Establishing programmes that advise families on where to go and what to do when children are at risk of being drawn in by gangs or drugs.

Encouraging residents to do voluntary work at hospitals so that patients can get better treatment; and by making more treatment centres available.

Getting the SAPS and metro police to develop a strong public relations partnership; work with communities affected by crime, and improve service delivery.

Encouraging participation in sport and building sports clubs, especially football, among the youth and other sectors in the community.

Developing a sense of ownership of the World Cup that has all communities working together.

Dealing with gangs and drugs in a more sustainable, imaginative manner through co-operation between the province and the city, together with the community and business.

We cannot live with the illusion that Cape Town is safe for all its peoples. Safety is not only for those who can afford it.

The architects of the Freedom Charter long ago spoke of a South Africa where "there shall be peace and friendship". Many of our brothers, sisters, mothers, fathers and children have died fighting for this ideal. We dare not disappoint them.

Irvin Kinnes is an independent criminologist and reasearcher, and co-founder of the Proudly Manenberg campaign

We’re Peers from INPUD –

Now fighting together against the War On Drugs(users)

We are peers from INPUD - using banned drugs for pleasure and recreation

We are denied our human rights - stolen by the single convention

We are judged by prejudice - deemed scapegoats by politicians and society

We are beaten and raped - our drugs entirely controlled by profit and cartels

We have lost our kids - taken away to be raised by the society

We are human beings – we are your own brother and sister

We are the victims of prohibition - and the dreadful war on drugs

We are mugged, bugged, tabbed, chased, caught and interrogated

We are millions of incarcerated - we have peers at any rotten prison worldwide

We are even executed - in the name of perverted law and justice

We are detained at compulsory treatment and rehabilitation centers

We are crammed into thorn-tree cages and exposed to lobotomy experiments

We are dying lonely in thousands – by overdoses – tuberculosis, hepatitis and AIDS

We are human beings – we are your own brother and sister

We are the victims of prohibition - and the dreadful war on drugs

We are now the internationally - INPUD - affiliated peers on drugs

We have a solid board of clever and trusted peers – we’re all fighting side by side

We have many friends and supporters – and science speaks in our favor

We are dreaming of sensible human rights – with freedom for all individuals

We are hoping to be unchained and soon given peace and a right to responsible use

We are human beings – we are your own brother and sister

We are the victims of prohibition - and the dreadful war on drugs

© JK March 2009 – Users unite & enjoy.

Human Rights Abuses in the Name of Drug Treatment

Resource: Human Rights Abuses in the Name of Drug Treatment
Open Society Institute
*********

Title: Human Rights Abuses in the Name of Drug Treatment: Reports from
the Field

Publisher: International Harm Reducation Development (IHRD) Program,
Open Society Insitute (OSI)

Around the world, governments commit flagrant and widespread human
rights violations against people who use drugs, often in the name of
"treating" them for drug dependence. Suspected drug users are subject to
arbitrary, prolonged detention and, once inside treatment centers,
abuses that may rise to the level of torture. Drug users who voluntarily
seek medical help are sometimes unaware of the nature or duration of the
treatment they will receive. In fact, treatment can include detention
for months or years without judicial oversight, beatings, isolation, and
addition of drug users' names to government registries that deprive them
of basic social protections and subject them to future police
surveillance and violence.

The accounts in this fact sheet, drawn from published literature and
interviews with people who have passed through treatment in Asia and the
former Soviet Union, detail the range of abuses practiced in the name of
drug dependence treatment, and suggest the need for reform on grounds of
health and human rights.

Download the fact sheet at this link:
http://www.soros.org/initiatives/health/focus/ihrd/articles_publications
/publications/treatmentabuse_20090318/treatmentabuse_20090309.pdf

No more prison for drug users, Supreme Court tells judges

Irawaty Wardany , THE JAKARTA POST , JAKARTA | Sat, 03/21/2009 11:32 AM | National
The Supreme Court has ordered judges not to send drug addicts to prison any more, instead they should be put in rehabilitation centers.
The nation’s top court also issued an edict that the Attorney General’s Office (AGO) make clear deadlines for death-row convicts to make appeals, to reduce uncertainties.
The court issued a circular on Friday ordering judges to send convicted drug addicts to rehabilitation centers instead of prisons.
“Sending drug addicts to prison is not the right step because that means we will have ignored their treatment and healing process,” Supreme Court spokesman Nurhadi told The Jakarta Post on Friday.
Besides, he said the issuing of the circular took into consideration the conditions of overcrowded prisons across the country, and that detention facilities did not support healing treatment for drugs users.
“Their condition will get worse when they have to mingle together with other drug addicts and the conditions in state penitentiaries and detention facilities do not suit their healing process,” Nurhadi said.
“That’s why we expect judges to send them to rehabilitation centers as stipulated in Article 41 and 47 of the 1997 law on narcotics and psychotropics.

The law allows judges not to convict drugs addicts but instead to order them to get treatment at rehabilitation centers.
Supreme Court chief justice Harifin A. Tumpa also said his office has issued an edict on how to manage convicts who are on death row.
The edict was issued on March 17, 2009 in response to a proposal submitted by the AGO on Feb. 23.
“The edict stipulates that the AGO can determine an appropriate period of time for death-row convicts to file requests for case reviews,” Harifin was quoted as saying on Friday by Antara news agency.
He said no law was in place to regulate the time limit for death-row convicts to request their cases be reviewed and to seek presidential clemency.
This mean’t there was no certain legal framework for convicts on death row. Harifin added.
“The determination of the appropriate time will refer to Article 69 of the 1985 law on the Supreme Court,” he said.
This article, he added, gives 180 days as the time limit for justice seekers to file a case review.
The chief justice said the edict also ordered the AGO to be strict and inform any death-row convict in the case of the implementation of a death sentence. “If they do not file a case review then the execution can be carried out after 180 days (from their conviction) ,” he said.

Source: http://www.thejakartapost.com/news/2009/03/21/no-more-prison-drug-users-supreme-court-tells-judges.html

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INPUD: The Long March to Vienna 2009

By inpud

placard used for Drug Peace Protest in Vienna

NOTE: . Following on from this will be a special feature from ‘Inside the INPUD Drug Peace Protest’, covering the thoughts and views of INPUD members on the protest and the future of INPUD.

The Songs of the Silent - Vienna 2009

Board members from The International Network of People who Use Drugs (INPUD) and 20 of its representatives from over a dozen countries across the world, met in Vienna on the 11th March for the UN High Level Segment Commission on Narcotic Drugs. INPUD’s aim at the event was to promote the human rights of drug users on an international level, increase the visibility and voice of the drug community, and expand grassroots involvement. Crucially important was the development of relationships and constructive discussion with a range of politicians, NGO’s, individuals and delegates. At the centre of this approach was the first INPUD international protest calling for a Drugs Peace, in the face of such a damaging drugs war.

The Commission for Narcotic Drugs event in Vienna holds particular importance for the drug using community as 25million dependent drug users around the world continue to bear the brunt of the todays ‘collateral damage’ in the global war on drugs – or - the war on drug users.

During the High Level sessions held over 11-12th March, Ministers and delegates from 139 member states discussed the effectiveness of past drug control and prohibition strategies and, tackled the task of reviewing the Commission for Narcotic Drugs previous 10 year Declaration on Drugs. This year however, the sessions held a more historic note in that member states were finally piecing together the next decades global Political Declaration on Drugs, a document with potentially critical ramifications for many countries and indeed civil society itself..

The summit has come in the wake of high-profile indictments of the UN’s drug strategy as a European Commission report published on the 10th March stated the strategy had not made any progress in cutting supply and demand, which is most of the focus of the CND remit. However, in opening the talks in Vienna, the UN’s top drug control official Antonio Costa told the CND addiction to illicit drugs had “stabilised” in the past few years although he admitted that a “dramatic unintended consequence” of the battle to stamp out the illicit trade was that drug cartels had become so rich they could destabilise impoverished and vulnerable nations such as in Africa and South America.

He also warned, (clearly speaking to the law reformers present), that drug control has had “a dramatic unintended consequence: a criminal black market of staggering proportions” that is “undermining security and development and causing some to make a dangerous wager in favour of legalization”. “Drugs are not harmful because they are controlled, they are controlled because they are harmful”, said Mr. Costa, a known right wing conservative on drug policy.

Nevertheless, the political declaration was signed despite many NGO’s and member states remaining vocal yet again, about the term ‘Harm Reduction’ being totally excluded from the Declaration, leaving its many supporters extremely frustrated and worried for the future. Witharguably the two most important words not appearing even once in the entire document, Alan Campbell, who led the UK delegation, could be correct for stating that the British delegates were disappointed with the outcome.

“We will of course be signing up to the declaration, but there are a number of criticisms we will be making quite clear.” Britain had supported the inclusion of harm reduction strategies in the document with Mr Campbell stating he did not think the emerging strategy was ” bold enough”.

Campaigning groups including Human Rights Watch and the International Aids Society also said the proposed political declaration lacked “critically important measures for treating and stemming the spread of HIV”.

It was inspiring however, to see YouthRise, an international youth network for reducing drug related harms, continuing to spread? their important messages. Speaking at the Demand Reduction Roundtable of the High Level Segment of CND, Caitlin Padgett of YR received warm applause however, in private she remained frustrated at the “unwelcoming, inflexible and bureaucratic structures within the CND and UNODC that are preventing young people from constructive participation” within this type of event. Repeatedly and rather ironically, political messages throughout the day pointed to ‘protecting our young people’ yet when a delegation of articulate, passionate and knowledgeable youth were available for the highest levels of discussion, Caitlin spoke of her colleagues being viewed with suspicion, their ID tags repeatedly checked, and of generally being ignored. YouthRise’s sheer determination and ability has ensured that however, is set to change. Perhaps one of the most staggering statistics to emerge from Caitlin’s speech was the news that almost 50% of new infections of HIV are from those under 25 years of age….

placard 2

Historic: OPEN DRUG USER IN UK DELEGATION

Mat Southwell was the first open drug user to be part of any governments delegation attending the high level sessions. Funded by International Harm Reduction Assoc, Mat delivered a speech that spoke clearly of missed opportunities to involve drug users in policy and of the CND/UNODC’s questionable participative processes with civil society.

“My community is routinely denied the human rights that this organisation was founded to defend.” (Mat Southwell)

Although perhaps constrained by the need to follow the UK government line, Mat was still able to pack a significant punch to those listening. Wearing a bright blue shirt in a row of exclusively dark suits, Southwell clearly appeared as ‘isolated’, a visual proclamation which reverberated around the room as he spoke of the exclusion of the drug using community in the coordination of global drug policy. Following diplomatic protocol when finishing his speech Mat said, “We, the International Network of People who Use Drugs, offer our hand in friendship and invite you to begin negotiations to bring to an end this failed war on drugs”.

THE PROTEST! SUPPORTING A DRUGS PEACE

On the morning of the 11^th, directly outside the Vienna International where the UNODC meetings were being held, INPUD members liaised with many other NGO’s (from HCLU, ENCOD, YouthRISE and Students for Sensible Drug Policy) rallying around the arranged open air press conference which was organized just prior to the official protest. The speakers pointed out the huge gap between reality and UN targets in the field of drug policy. There were 8 foot tall iron cages erected at the entrance to the Sessions symbolizing the incarceration and exclusion of the using community, and many speakers spoke eloquently - and some urgently- from within the cages about the damage the drugs war is wrecking on millions of lives. Containers filled with symbolic urine samples on podiums gave delegates a quick insight into some of the more absurd rituals of the war on drugs.

INPUD members had a clear strategy on how they wished their protest to be perceived. An INPUD spokesperson said “Rather than confront the participants with information on how their policies harm drug users, INPUD proposes a ceasefire and a ‘roadmap to peace’. The war on drugs, or the war on drug users, must end.”

Working with the main event organizers, the Hungarian Civil Liberties Union (HCLU), INPUD activists greeted delegates as they arrived at the summit carrying placards which read “The war on drugs destroys lives” and “We are not Collateral Damage We are People’ and ‘Drug war PEACE’.

It was heralded as a success and raised the profile significantly of INPUD and it’s determination to get the voices and issues of the drugs community heard at an International level. On the evening of the 12^th as the majority of the drug using community packed up and headed for home, INPUD board member Jude Byrne from Australia was heard over the worlds airwaves as her interview with the world service rang out across the globe. She spoke powerfully and directly about the human rights violations suffered by the drugs community, and the very real urgency to end the war on drugs and drug users. Jude was also heard outlining the new political strategy for INPUD in pursuing a drug peace – cleverly polarizing those who still wish to follow the current disastrous drugs war. Good on ya Jude!

Point of interest:

President Evo Morales of Bolivia said he was at the CND to correct the “historical mistakes” of the 1961 Single Convention that phased out traditional consumption of coca over a 25-year period. Since coca is not a narcotic it cannot be scheduled, he said, adding that even the Convention stated that coca-chewing did not cause addiction. Morales held up a coca leaf to the hundreds of delegates and said “I am not a criminal. If I am a criminal throw me in jail. Throw the President of Bolivia in jail!”. Brilliant!

Well done to everyone who took part. This was written from a UK context, a further article on the full protest from day 1 and day 2 will be forwarded this week as will an extended version of INPUDs members thoughts and views on INPUD, the event, and the future before March 25^th.

(written by Erin O’Mara, editor of Black Poppy Magazine, The UK’s health and lifestyle magazine for drug users www.blackpoppy.org.uk

see photos and text:

video: http://drogriporter.hu/en/demonstration

information: www.IHRA.net

blogg on Vienna UNODC / CND www.cndblogg.org

additional info www.UNODC.com

Alan Campbell, UK Home Office Minister and Maria Ovchinnikova, former drug user and human rights and harm reduction activist...

Alan Campbell, UK Home Office Minister and Maria Ovchinnikova, former drug user and human rights and harm reduction activist, at the Commission on Narcotic Drugs

http://www.unodc.org/unodc/vplayer.html?vf=/documents/video/cnd2009/UNCNDMeeting2.flv

Harm Reduction Psychotherapy

Harm Reduction Psychotherapy

THE CURRENT CONTEXT: WHAT IS WRONG WITH THIS PICTURE?

Mainstream abstinence-oriented treatment of alcohol and drug users in the United States today continues to have poor success by anyone's criteria. Clinical observations and empirical studies typically report that a majority of clients seen initially do not successfully complete treatment or maintain their gains after treatment. These poor outcomes are evident ill residential and outpatient programs and across different theoretical approaches. The Substance Abuse and Mental Health Services Administration reported that between 1992 and 1997 only 47% of patients completed American drug and alcohol treatment programs with another 12% referred to other pro- grams (SAMHSA, 1999). Several treatment outcome studies suggest that only 20-40% of patients who complete treatment achieve long-term success even when abstinence and moderation are both considered as successful outcomes (Keso & Salaspuro, 1990; Nordstom & Berglund, 1987). For example, Helzer and colleagues (Helzer et al.. 1985) looked at three-year outcomes of four abstinence-oriented programs of patients who met D.S.M. III criteria for alcohol dependence. They found only 15.1% reported total abstinence and 18.4% reported some form of problem-free drinking. Ditman et al. (1967) did a one-year follow up of 301 "chronic drunk offenders" who were randomly assigned to no treatment, Alcoholics Anonymous, or clinic treatment as a condition of probation. Using re-arrest for a drinking- related offense as the primary outcome measure, they found that 68% of the clinic group, 69% of the AA group, and 56% of the no treatment group were re-arrested; the differences were not statistically significant. And, more recently, a large scale controlled study, Project MATCH (Project MATCH Research Group [1997]) was funded by the National Institute on Alcohol Abuse and Alcoholism to compare patients' responses to different treatment approaches. 1,726 people with alcohol use problems were randomly assigned at sites across the country to twelve sessions of 12-Step Facilitation Therapy (TSF), Cognitive- Behavioral Therapy (CB11, or Motivational Enhancement Therapy (MET). Using complete abstinence during the year after treatment as the measure of success, 24% of individuals in the TSF group were abstinent, 14% of those in the CBT group, and 15% of those in the MET' group.

Standard approaches are not equipped to address serious emotional or socioeconomic problems accompanying substance use problems. These statistics for fail~re in substance abuse treatment do not include people with drug and alcohol problems who never seek traditional treatment, a group that represents the majority of problem users in this country. The United States Department of Health and Human Services (USDHHS, 1997) estimated in 1997 that about 15 million adult Americans are alcohol dependent or abusing. SAMHSA ( 1999) estimated that there were 2,207,375 admissions to 15,000 American in- and outpatient treatment facilities in 1997. Assuming that some of these were multiple admissions by some people, it is likely that approximately two million people were treated in that year. These data suggest that close to 85% of individuals with alcohol problems in 1997 were untreated in this country. This is sup- ported by the Institute of Medicine's (1990) estimate that 80% of American alcoholics have never made contact with self-help or professional treatment and by the National Institute on Alcohol Abuse and Alcoholism's (1999) estimate of 10 million untreated American alcoholics. I think it is safe to assume that the statistics for other drug users are comparable. For example researchers at SAMHSA (Woodward et al. .1997) estimated that 48% of the need for drug treatment, excluding treatment for alcohol problems, is not being met. If the helping profession of addiction treatment was a Fortune 500 company, it would have gone out of business long ago.

Tom: Harm Reduction to Moderation by Andrew Tatarsky

Tom called me four years ago because he was concerned about "drinking too much and at the wrong times," and he wanted "to get it under control." He called me specifically because he had heard of my reputation as an alcohol treatment specialist who will work with problem drinkers who do not want to stop drinking.

Tom appeared at my office for our first meeting looking scared and shaking. The faint odor of alcohol accompanied him as he entered my office. I found myself feeling somewhat anxious and wondered if this would interfere with our work. As it turned out, this first meeting ended with us feeling optimistic about the possibility of doing some valuable work together, a feeling that has grown and strengthened over the past four years of weekly psychotherapy.

Tom is a somewhat heavy man, at that time looking his 43 years of age, wearing a neatly trimmed mustache and a hoop earring in his right ear. Along with his neat, casual style of dress, he projected the image of a hip, downtown, arty man trying to look younger than he was. His initial wariness and guarded manner melted quickly in response to my interested, accepting stance. He seemed painfully lonely and hungry for contact, and he expressed intense gratitude for my willingness to help him on his terms, that is, while he continued to drink. This also seemed to reflect a desperate need for validation of his adequacy as a person. He was exploring whether I might be able to offer that to him. As Tom talked, I also quickly formed the impression that he was a very bright, honest, emotionally-vulnerable, and talented man. I immediately liked him and felt optimistic about embarking on a psychotherapeutic journey together.

Tom described himself as''!, 43-year-old single Italian-American gay man who-lived alone in New York City. He said that he was glad to be gay, although there were certain changes in the gay world that had become increasingly problematic. While he was vague at this point, these problematic changes would become clear over the course of our work together; they were powerfully related to his drinking problem and a number of other emotional and lifestyle problems.

During the next few meetings, Tom revealed himself as sensitively attuned to the nuances of my reactions to him, belying both a keen attention to detail and a particular sensitivity to the emotional responses of others. He expressed a strong need for emotional sup- port and reassurance, frequently asking if I thought he was "doing it right," showing me things that he had done to address his problems and asking for my approval. He didn't actually want my opinion but rather my approval for the decisions that he had already made. These aspects of him revealed a very fragile sense of self and an intense reliance on the approval of others to maintain a positive self-image. I felt as if I was being invited to play the role of mother, applauding and feeling proud of his baby steps toward learning to take better care of himself in the world. Not only did it seem to me that he wanted my approval to maintain a good feeling about himself, but as a kind of mother /father, he wanted me to help him to construct a more firm and more effective self. I wondered if this vulnerability in his sense of self might be directly related to his drinking, a suspicion that was to be supported in several important ways.

Tom said that he indeed saw his drinking as a problem, though the most important factor motivating him to seek treatment was pressure from his job. Tom had a responsible position as curator at an art museum. Prior to his visit, Tom's supervisors had given him an ultimatum: go in for alcohol treatment as the condition for keeping his job. Tom was in a crisis in his workplace. He was extremely disturbed by the way his coworkers had responded to his excessive drinking and felt that he was being misjudged and misunderstood. Our session was Tom's second attempt at seeking help for alcohol use. His first experience was a coercive intervention that occurred nine months prior to our meeting. Tom's colleagues had staged a semi- theatrical intervention to get him into an intensive treatment program, assuming for him that he had no other options. As Tom spoke, he was controlling strong feelings of anger and sadness. Without warning, his colleagues had confronted him publicly, at the start of the workday, and told him that they had made arrangements for him to be evaluated by a well-known alcohol treatment program that morning and that a car was waiting just outside to take him there. At that moment Tom realized that he had no choice but to go unless he wanted to risk losing his job of twenty-three years......

Outcome

Because the focus on alcohol receded into the background at this point, I will end the detailed description of Tom's treatment here. The treatment is still alive and productive at the time of this writing. During this period, he has generally maintained his moderate drinking with a few minor slips similar to those discussed previously. These occurred around emotionally charged interpersonal situations and were used as opportunities for further learning that deepened Tom's work in therapy. The central focus of therapy has been on strengthening Tom's ability to maintain his self- esteem in more autonomous ways. He thinks differently about these insecurities and is able to take constructive actions in the world that give him direct feedback about his value as a person. A related focus has been on working through the threatening fears and fantasies that have kept Tom from freely expressing his emotional needs in relationships. Therapy has helped Tom to feel more confident about and successful at pursuing satisfying relationships in his life. During this period his depression has not returned.

Tom has" demonstrated an ability to cope without alcohol with many challenging situations that had been triggers for excessive drinking in the past. These strategies have become familiar tools in his repertoire of coping skills. This, in conjunction with his awareness of his emotional vulnerabilities and continuing commitment to his emotional growth, suggest a very good prognosis for the future.

simonloxton sent you a video: "Stijn Goossens - What is INPUD?"

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simonloxton has shared a video with you on YouTube: Stijn Goossens - What is INPUD? Stijn is the head of the International Network of People Who Use Drugs (INPUD), more info: www.inpud.org Interview at the International Conference on Drug Related Harms, Warsaw, 2007
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South African drug users; active and preveous

This is the fist post in what will hopefully become the beginning of action and information where it comes to the rights of drug users and drug policies in South Africa. I hope to act as a South African ambassador for INPUD (International Network of People who Use Drugs)

In south Africa we do not have much presently in terms of an accepted model for the assistance of people who use drugs; besides the abstinence and religious models which are outdated and set most of the population up for failure especially when it comes to receiving therapy and preventing the spread of viruses and diseases.

You would think that with the current "success" rates we would be taking another look at what is an obvious failure at treatment if you go by the statistics. These models would however appeal to those that profit from drug treatment; because they are guaranteed repeat customers.

Harm reduction is the next step and people who use drugs deserve rights; same as any other citizen. This does not condone or condemn drug use but aims to remove risk as I think by now its quite clear that you can not win a war on drugs.

For more current news keep following this first attempt to introduce what we have been lacking and behind the rest of the world by ten years or more in terms of progress when it comes to these important issues.

Thank you for your time and interest.

http://www.youtube.com/watch?v=BzR5EYXIogU