BMJ editorial on the important role that primary care practitioners can play in improving targeted screening for Hepatitis

This issue highlights IDHDP activities, upcoming conferences, new publications, and more.

This document produced by SMMGP gives an update on current clinical documents for August and September 2012.

A study which quantifies the effect of opiate substitution treatment in relation to HIV transmission among people who inject drugs.

This study demonstrates increased respiratory disease in people who use drugs, but the structure of this study could under-report the respiratory issues in people receiving care in specialised substance misuse or shared care clinics.

A cartoon strip by Stuart McMillen.

This edition of the newsletter is focused on the topic of overdose

Hepatitis Australia highlights that investment in new hepatitis C treatment will cure more people of a chronic and costly condition and provide substantial economic benefits for society in the long term.

The 2013–15 strategy is built around three top-level commitments: (a) providing a relevant, timely and responsive analysis of the drug situation; (b) efficiency: deriving maximum value from activities and investments; (c) communication and a customer-orientated approach.

The Count the Costs initiative aims to highlight the negative impacts of the war on drugs in seven key policy areas: development and security; public health; human rights; stigma and discrimination; crime; the environment; and economics.

Australia’s prisons currently have a major focus on reducing the supply of drugs with programs that are rarely evaluated and in the end fail to stop the availability or use of drugs in prisons.

With the arrival of simple, efficient and safe interferon-free treatment regimens, hepatitis C virus (HCV) therapy will have the potential to be successfully used for the majority of infected patients and prevent associated morbidity and mortality. With the current treatment uptake rates, only a very small proportion of HCV-infected patients are reached. Paradoxically, treatment rates are lowest in the most affected at-risk group – people who inject drugs (PWID) – which is the major driving force behind the spread of HCV infection.

This Special Issue takes a pragmatic look at opportunities and barriers and it examines some of the factors that have determined the conflictual relationship between law enforcement and the protection of public health. It suggests that policing, when well conceived and implemented, actually constitutes a largely untapped resource in HIV prevention benefiting substance users and the rest of the population.

This issue highlights IDHDP activities, upcoming conferences, new publications, and more.

A substantial body of evidence shows that expanding naloxone availability and training potential overdose witnesses to administer naloxone is a remarkably safe and effective intervention for preventing opioid overdose fatalities, with the potential to prevent opioid overdose related injury.

Chris thinks about decriminalisation in response to Release’s report. We know criminalisation of individuals can impact them for the rest of their lives, affecting employment and education, not to mention their health and welfare. It stigmatises people and can push them further into the margins of society. As doctors, many of us may not have thought much about decriminalisation and its potential to improve the health and overall well-being of people who use drugs, but even for those of us who have, read this report: it is an eye opener.

The EMCDDA guidelines have been revised to better reflect the realities of today’s drug situation and changes in treatment services and data monitoring systems. They follow a three-year revision process involving experts from the EU Member States, Croatia, Turkey, Norway and Switzerland.

The report calls on the EU to step in to fill the gaps left by global donors to countries within and neighbouring its borders.

This report provides an update of the 2004 study of supply, demand and harm reduction strategies in Australian prisons (Black, Dolan and Wodak, 2004). Since the 2004 report, the Ministerial Council on Drug Strategy (MCDS) launched the first National Corrections Drug Strategy in 2008, designed to guide the provision of supply, demand and harm reduction strategies in prisons throughout Australia (Ministerial Council on Drug Strategy, 2008).

The purpose of this assessment was to collect information on the scale and quality of the existing MAT services for people who inject drugs (PWID) in Kazakhstan, and to identify any gaps in such services.

IDHDP supports the efforts in communities around the globe to prevent drug overdose fatalities and calls for greater governmental and international policymaker leadership.

To expand country planning of programs to further reduce HIV burden and increase coverage among key populations (KPs), PEPFAR has developed a strategy consisting of technical documents on the prevention of HIV among people who inject drugs (July 2010) and prevention of HIV among men who have sex with men (May 2011), linked with regional meetings and assistance visits to guide the adoption and scale-up of comprehensive packages of evidence-based prevention services for KPs.

This study investigates the association between persistent cannabis use and neuropsychological functioning. They used a birth cohort of 1,037 individuals from Dunedin, New Zealand, who were born in 1972/3.

Two Scottish doctors debate, the efficacy of methadone maintenance (under attack in the Scottish media). IDHDP member, Dr Roy Robertson, makes the case that methadone has been well tested, is cheap and acceptable to the patient and results in visible improvement. Dr Daniels argues that methadone treatment is philosophically ill-conceived, ethically dubious, and costly. He also highlights evidence that the treatment is potentially harmful to both patients and those in contact with them.

IDHDP joins the distinguished Global Commission on Drug Policy in condemning the drug war as a failure and a major factor sustaining the global HIV/AIDS epidemic. We support their call for immediate, major reforms of the global drug prohibition regime to correct the policy distortions that favor criminal justice over public health evidence-based addiction treatments such as methadone and burprenorphine maintenance, and proven public health interventions like overdose prevention training with naloxone, and sterile needle and syringe and condom distribution in addressing the harms of drugs.

Students from 62 low- and middle-income countries may apply for full scholarships (including living expenses) to the Dutch Summer Institute on Alcohol, Drugs and Addiction. The Summer Institute is a 2-week, intensive multidisciplinary program that offers graduate-level and continuing professional development training in addiction, while also promoting opportunities for international networking. Application deadline 1 October 2012.

Narrative data collected from semi-structured ethnographic interviews with 25 relatively stable drug-using couples from two New York City areas. The analyses, concentrates on the retrospective accounts of the initiation to injection in current or former intimate partnerships.

An opinion piece by Chris Ford stressing the need for much greater attention to drug-related HIV issues and to reach the goal of an AIDS-free generation. Emphasizing that the AIDS strategies must include people who use drugs, and most importantly, decision makers and the rest of the field need to address this group of people with respect, and we should all fight against their discrimination and criminalisation. (page 16 and 17)

UNODC’s new policy brief highlights two guiding principles, namely that "prison health is good public health" and that a human rights-based approach and the principle of equivalence of health in prisons are key. The report proposes a comprehensive package of 15 interventions to address HIV in prisons settings.

Global Commission on HIV and the Law presents a coherent and compelling evidence based report on human rights and legal issues relating to HIV and how evidence and human rights based laws can end an epidemic of bad laws and transform the global AIDS response. .