Drug laws

Drug Law Enforcement Revisited: The “War” Against the War on Drugs

From the closure of London’s nightclub Fabric to Duterte’s drug war, law enforcement has become the policy choice par excellence for drug control by stakeholders around the globe, creating a rift between theory and practice, the former vehemently dismissing most of its alleged benefits. This article provides a fresh look on the said regime, through examining its implications in the key areas of illicit drug markets, public health, and broader society. Instead of adopting a critical stance from the start, as much of the literature does, the issue is evaluated from the perspective of a focus on the logic and rationality of drug law enforcement approaches, to showcase from within how problematic the latter are. The article concludes by suggesting at least a reconceptualization of the concept, to give way to more sophisticated policies for finally tackling the issue of illegal drugs effectively.

Characteristics of injection drug users who participate in drug dealing: implications for drug policy

So-called "balanced" drug policy couples enforcement initiatives targeting drug dealers with health-focused interventions serving addicted individuals. There are few evaluations of this approach, and little is known about how these two populations may overlap. We evaluated factors associated with drug dealing among injection drug users (IDUs) in Vancouver, Canada, and examined self-reported drug-dealing roles and reasons for dealing. Among 412 IDUs seen from March through December 2005, 68 (17%) had dealt drugs during the previous six months. Variables independently associated with drug dealing included: recent incarceration (adjusted odds ratio [AOR] = 2.9; 95%CI: 1.4-6.0); frequent heroin injection (AOR = 2.5; 95%CI: 1.4-4.6); frequent cocaine injection (AOR = 2.0; 95%CI: 1.1-3.8); and recent overdose (AOR = 2.7; 95%CI: 1.0-7.3). The most common drug-dealing roles were direct selling (82%), middling (35%), and steering (19%), while the most common reasons for dealing included obtaining drugs (49%) and money (36%). Drug dealing among IDUs was predicted by several markers of higher intensity addiction, and drug-dealing IDUs tended to occupy the most dangerous positions in the drug-dealing hierarchy. These findings suggest that elements of "balanced" drug policies may undermine each other and indicate the need for alternative interventions.

Injection drug users' perceptions of drug treatment services and attitudes toward substitution therapy: A qualitative study in three Russian cities

This study explored injection drug users' (IDUs) perceptions of drug abuse treatment and treatment providers in three Russian cities as well as their attitudes toward opiate substitution therapy, which is currently not available in Russia. Data were collected from 121 qualitative interviews with IDUs conducted in 2003-2004. Negative perceptions of available treatments were related to poor treatment outcomes, judgmental service providers, lack of psychologic services, and short lengths of stay in treatment. Positive perceptions were associated with receiving psychosocial care and nonjudgmental attitudes from providers. Most participants had heard about opiate substitution therapy, and some had treated themselves using methadone from the black market. Although respondents had doubts that opiate substitution therapy could work effectively in Russia, most agreed that this type of treatment would help IDUs function better in the society.

Barriers to accessing drug treatment in Russia: a qualitative study among injecting drug users in two cities

OBJECTIVES

To assess factors influencing access to drug treatment among injecting drug users (IDUs) in two Russian cities.

METHODS

Eighty-six qualitative interviews were conducted with IDUs in Volgograd and Barnaul in 2003. IDUs were recruited through local drug treatment services, needle exchanges, and drug user networks.

RESULTS

Three main barriers to treatment assess were identified: financial constraints, fear to registration as a drug user, and perceived low efficacy of available treatment services. Registration of drug users was associated with loss of employment, breaches in confidentiality. and stigma. Some participants did not think that drug treatment services could respond appropriately and effectively to their treatment needs.

CONCLUSIONS

These findings highlight the importance of environmental factors in mediating IDUs access to drug treatment, which might suggest the need for social and structural interventions. Access to drug treatment services should be enhanced by reducing the financial burdens of drug treatment and minimizing the stigma associated with drug user registration. Russia should shift from a highly medicalised model of treatment toward a more holistic approach that recognises the diversity of treatment needs among IDUs. These priorities are especially timely given the urgent need to integrate drug treatment as part of wider HIV prevention responses in Russia.