Hosted by IDHDP, IAHPC, and the Republic of Lithuania

Part 1
Part 2
Dr Oanh Khaut
Drug dependence a health issue. Harm reduction effective in protecting health. Does not increase drug use. The world Drug report shows that number of new HIV infections has gone down, despite availability of opioids going up. Number of injecting drug users has also gone down as more countries roll out harm reduction programmes.

In Vietnam HIV prevalence has gone down since 2000.  Number of people living with HIV has decreased.

Why are we still talking about harm reduction if it is so effective?

Compares rate of death from drug-related causes world wide to who has died in real wars. Vietnam war killed fewer people total than have died in one year of the drug war. Like war, most drug-related deaths are preventable.

There are not many countries that go the full length to provide harm reduction services.
77 countries with some substitution therapy
86  countries with some needle and syringe programmes
97 Countries with policies support harm reduction
158 countries with injecting drug users

There is a lack of funding for harm reduction
Australia spends 33 times more on law enforcement than harm reduction and is considered progressive compared to other countries.

Drugs are made illicit. Being caught at any stage, even if its the first time, means being roughed up by police, go through justice system, might get compulsory treatment. Stigma for the rest of life.  Friends might also be considered criminal for organising drug use.

Health must be the corner stone of drug policy. Policies that punish drug users should be changed.

Dr Jim Cleary
Video about how morphine is unavailable in India due to laws.
History of morphine and development of other opioids and opiates.
Single convention on narcotic drugs in 1961.
Dame Cecily Saunders reported that morphine made for better quality of life.
Brompton Cocktail, developed in 1893.
1977 WHO essential medicine
Morphine and codiene been on this list
In 1986 three step ladder for managing cancer pain.
Wisconsin Cancer Pain Initiative
1994 at least 42% of patients were being under treated for their pain.
1996 see a bump in going up.
Drug control measures should not interfere with medical treatment of patients.
There is a disparity in consumption of opioids.
Western countries consume significantly more opioids than the rest of the world.
Ukraine has up until recently only had injectable morphine available.
There is a list of medicines for palliative care. Needs to be expanded.
Laws, concerns about addiction: lots of reasons for no availability
“Agitate, educate, integrate and communicate.”
Quotes from Antonio Costa former UNODC Executive Director.