Danish Drug Policy: Between Repression and Harm Reduction

Mapping Intimacies ◽

10.16993/bbo.b ◽

2021 ◽

pp. 13-36

Author(s):

Esben Houborg ◽

Kim Møller

Keyword(s):

Drug Use ◽

Harm Reduction ◽

Drug Policy ◽

Problematic Drug ◽

Liberal Position

The development of drug policy in Denmark has moved from a relatively liberal position to a stricter policy. The 2020s is marked by both criminalization and harm reduction and the development can be characterized as following a dual track where people with a problematic drug use are being cared for.

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Harm Reduction and Moral Desert in the Context of Drug Policy

Health Care Analysis ◽

10.1007/s10728-020-00411-z ◽

2020 ◽

Vol 28 (4) ◽

pp. 362-371

Author(s):

Lindsey Brooke Porter

Keyword(s):

Drug Use ◽

Harm Reduction ◽

Drug Policy ◽

Health And Safety ◽

People Who Use Drugs ◽

Moral Desert ◽

Problematic Drug ◽

To Come ◽

State Of Affairs ◽

The Right

AbstractThe target of my discussion is intuitions lay people have about justice in the context of drug policy—intuitions that take on a more or less moral-desert-based shape. I argue that even if we think desert is the right measure of how we ought to treat people, we ought still be in favour of Harm Reduction measures for people who use drugs. Harm Reduction measures are controversial with members of the public, and much of the opposition seems to come from something like an appeal to a desert conception of justice—the notion that a just state of affairs is one in which everybody gets what they deserve, no more, no less. A recent study, for example, found that ‘moral outrage’ predicts a preference for prevalence reduction (criminal sanction, etc.) over Harm Reduction. The thinking seems to be that, since drug use is wrong, letting people who use drugs suffer and/or die as a consequence of their use is just. Aiding their health and safety, while perhaps compassionate, is unjust. I argue that there is a bad desert fit between using drugs and suffering avoidable harm even if using drugs is morally wrong. Many of the possible harms of drug use are socially/policy driven, and much problematic drug use is context dependent, not cleanly attributable to the decisions of the person who uses drugs. This means that even if drug use is wrong, people who use drugs deserve Harm Reduction policies, at minimum.

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‘We Realised We Needed a New Approach’: Government and Law enforcement Perspectives on the Implementation and Future of the Drug Decriminalisation Policy in Vietnam

10.21203/rs.3.rs-18285/v1 ◽

2020 ◽

Author(s):

Hai Thanh Luong ◽

Luc Trong Hoang ◽

Toan Quang Le ◽

Tuan Anh Hoang ◽

Mai Thanh Vu ◽

...

Keyword(s):

Law Enforcement ◽

Drug Use ◽

Harm Reduction ◽

Drug Policy ◽

Drug Control ◽

People Who Use Drugs ◽

Community Based ◽

Drug Law ◽

Drug Law Enforcement ◽

Law Enforcement Officials

Abstract Background In 2009, Vietnam officially decriminalized drug use through amendments to the criminal law. The amendments specifically outlined that drug use would be seen as an administrative sanction, but not a criminal offence. This legal transition has not been without its implementation challenges and police particularly are have struggled to balance their role between drug law enforcement and decriminalisation. Despite being a health-orientated drug policy amendment, in practice it has meant that police can send suspected drug users to compulsory treatment centres without judicial oversight and people who use drugs continue to face challenges in their interface with law enforcement which can negatively impact access to harm reduction and community-based treatment programs. This paper explores the perspectives of policy makers and law enforcement officials in Vietnam and provides some insights and considerations into how the amended law was implemented and how it could be made more effective in improving both health and safety for all people in Vietnam. Methods To understand government and policing perspective on amended changes to the Criminal Code in 2009 and its subsequent implementation, this mixed methods research combined content analysis of a number of core legislations in terms of drug control policies in Vietnam with perspectives and insights from 14 key informant interviews from people representing a range of relevant Vietnamese Government (n=10) and non-government agencies (n=4). Results While most interviewees recognised that decriminalizing drug use in Vietnam was designed as a a progressive and health-oriented drug policy, many participants acknowledged the ongoing disconnect between the health intent of the policy and the police-led oversight of its implementation in the community. Part of this disconnect was explained by the lack of training and clear protocol that would enhance the police in their ability to contribute to the health intent of the policy rather than continue to view drug use through a drug law enforcement only lens. A current pilot initiative by Hanoi’s People Committee to implement a model of assisted referral for people who use drugs to community-based health, social and legal support may provide an example of how to situate decriminalisation policy within a broader context of harm reduction interventions through the design and trial of clear protocols for how law enforcement agencies can actively engage and support the process of diversion into harm reduction and community-based treatment. Conclusions Since the inception of the amended law there has been very little review and analyses of its implementation progress and its challenges. This is the first study to review and assess the progress of decriminalizing drug use since the policy intervention in 2009 with a specific focus on the perceptions of the policy for Vietnam’s drug control in policing. It discusses insights and considerations from government, law enforcement officials and civil society organisations to develop a deeper understanding of how harm reduction interventions – including decriminalisation – can co-exist within a broader and entrenched drug control strategy in Vietnam.

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New Initiative Harnesses Power of Peers, Parents to Stop Teen Drug Use: White House Drug Policy Office to Debut New Ads on Super Bowl Sunday

PsycEXTRA Dataset ◽

10.1037/e508042006-001 ◽

2004 ◽

Keyword(s):

Drug Use ◽

Drug Policy ◽

Super Bowl ◽

White House

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Missing Data, Moral Eyesores, and Marginalized People: Opposition to Needle Exchange and Harm Reduction in Drug Policy

10.3390/wsf-4-i002 ◽

2014 ◽

Author(s):

Kyle Bridge

Keyword(s):

Missing Data ◽

Harm Reduction ◽

Drug Policy ◽

Needle Exchange

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High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach

Harm Reduction Journal ◽

10.1186/s12954-021-00510-7 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Lisa J. Messersmith ◽

Rose Adjei ◽

Jennifer Beard ◽

Angela R. Bazzi ◽

Joel J. Earlywine ◽

...

Keyword(s):

Drug Use ◽

Harm Reduction ◽

Population Size ◽

Sex Workers ◽

People Who Inject Drugs ◽

Syringe Sharing ◽

Unsafe Sex ◽

Lack Of Information ◽

Sex With Men ◽

Major Drug

Abstract Background Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana’s National Strategic Plan for HIV/AIDS 2016–2020 identifies PWID as a key population, but efforts to address the needs of PWID have lagged behind those targeting sex workers and men who have sex with men. Lack of information about PWID is a critical barrier to implementing effective HIV prevention and treatment. We aimed to learn more about the vulnerability of the PWID population in order to inform much-needed harm reduction interventions. Methods From April to July 2018, we conducted a mixed methods study in Kumasi, Ghana, to identify all major drug using locations, count the numbers of PWID to obtain rough population size estimations, and administer anonymous surveys to 221 PWID regarding drug use and sexual behavior. We also tested for HIV, HCV, and HBV from syringes used by survey participants. Results Key informants identified five major drug using locations and estimated the total PWID population size to be between 600 and 2000. Enumerators counted between 35 and 61 individuals present at each of the five bases. Sharing syringes and reusing discarded syringes are common practices. Over half of survey participants (59%) reported past-month syringe sharing (34% used a used syringe and 52% gave away a used syringe). Individuals with higher injection frequency (≥ 21 times weekly) and who injected with four or more people had higher odds of syringe sharing. Of the survey participants reporting sex in the last month (23%), most reported having one partner, but only 12% used condoms. Nearly all women (11/13) reported exchanging sex for drugs and 6/13 reported exchanging sex for money in the last six months. Fifteen percent of participants (all men) reported paying for sex using drugs or money. Of the used syringes, prevalence estimates were 3% (HIV), 2% (HCV), and 9% (HBV). Conclusions Our findings confirm the urgent need to implement harm reduction interventions targeting PWID and to build a strong and enabling legal and policy environment in Ghana to support these efforts.

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Civil society involvement in harm reduction drug policy: reflections on the past, expectations for the future

Harm Reduction Journal ◽

10.1186/s12954-020-00426-8 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Aileen O’Gorman ◽

Eberhard Schatz

Keyword(s):

Civil Society ◽

Harm Reduction ◽

Lived Experience ◽

Political Institutions ◽

Drug Policy ◽

Policy Development ◽

Policy Decision ◽

People Who Use Drugs ◽

Annual Conference ◽

Health Crisis

Abstract Background A range of civil society organisations (CSOs) such as drug user groups, non-governmental/third sector organisations and networks of existing organisations, seek to shape the development of drugs policy at national and international levels. However, their capacity to do so is shaped by the contexts in which they operate nationally and internationally. The aim of this paper is to explore the lived experience of civil society participation in these contexts, both from the perspective of CSOs engaged in harm reduction advocacy, and the institutions they engage with, in order to inform future policy development. Methods This paper is based on the presentations and discussions from a workshop on ‘Civil Society Involvement in Drug Policy hosted by the Correlation - European Harm Reduction Network at the International Society for the Study of Drugs Policy (ISSDP) annual conference in Paris, 2019. In the aftermath of the workshop, the authors analysed the papers and discussions and identified the key themes arising to inform CSI in developing future harm reduction policy and practice. Results Civil society involvement (CSI) in policy decision-making and implementation is acknowledged as an important benefit to representative democracy. Yet, the accounts of CSOs demonstrate the challenges they experience in seeking to shape the contested field of drug policy. Negotiating the complex workings of political institutions, often in adversarial and heavily bureaucratic environments, proved difficult. Nonetheless, an increase in structures which formalised and resourced CSI enabled more meaningful participation at different levels and at different stages of policy making. Conclusions Civil society spaces are colonised by a broad range of civil society actors lobbying from different ideological standpoints including those advocating for a ‘drug free world’ and those advocating for harm reduction. In these competitive arena, it may be difficult for harm reduction orientated CSOs to influence the policy process. However, the current COVID-19 public health crisis clearly demonstrates the benefits of partnership between CSOs and political institutions to address the harm reduction needs of people who use drugs. The lessons drawn from our workshop serve to inform all partners on this pathway.

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Could 30 years of political controversy on needle exchange programmes in Sweden contribute to scaling-up harm reduction services in the world?

Nordic Studies on Alcohol and Drugs ◽

10.1177/1455072520965013 ◽

2020 ◽

pp. 145507252096501

Author(s):

Niklas Karlsson ◽

Torsten Berglund ◽

Anna Mia Ekström ◽

Anders Hammarberg ◽

Tuukka Tammi

Keyword(s):

Harm Reduction ◽

Drug Policy ◽

Grey Literature ◽

Scale Up ◽

Valuable Insight ◽

Control Drug ◽

Policy Domain ◽

The World ◽

Key Events ◽

Exchange Programmes

Aims: To end the hepatitis and AIDS epidemics in the world by 2030, countries are encouraged to scale-up harm reduction services and target people who inject drugs (PWID). Blood-borne viruses (BBV) among PWID spread via unsterile injection equipment sharing and to combat this, many countries have introduced needle and syringe exchange programmes (NEP), though not without controversy. Sweden’s long, complicated harm reduction policy transition has been deviant compared to the Nordic countries. After launch in 1986, no NEP were started in Sweden for 23 years, the reasons for which are analysed in this study. Methods: Policy documents, grey literature and research mainly published in 2000–2017 were collected and analysed using a hierarchical framework, to understand how continuous build-up of evidence, decisions and key events, over time influenced NEP development. Results: Sweden’s first NEP opened in a repressive-control drug policy era with a drug-free society goal. Despite high prevalence of BBV among PWID with recurring outbreaks, growing research and key-actor support including a NEP law, no NEP were launched. Political disagreements, fluctuating actor-coalitions, questioning of research, and a municipality veto against NEP, played critical roles. With an individual-centred perspective being brought into the drug policy domain, the manifestation of a dual drug and health policy track, a revised NEP law in 2017 and removal of the veto, Sweden would see fast expansion of new NEP. Conclusions: Lessons from the Swedish case could provide valuable insight for countries about to scale-up harm reduction services including how to circumvent costly time- and resource-intensive obstacles and processes involving ideological and individual moral dimensions.

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