Drug Policies Beyond the War on Drugs Dr Joanne Csete Dr John - - PowerPoint PPT Presentation

▶

Mar 30, 2023 432 likes •757 views

Hosted by LSE Works: LSE IDEAS Drug Policies Beyond the War on Drugs Dr Joanne Csete Dr John Collins Professor Lawrence Commissioner, Lancet Executive Director, International Phillips Commission on Drug Policy Drug Policy Project, LSE

SLIDE 1

Hosted by LSE Works: LSE IDEAS

Drug Policies Beyond the War on Drugs

Dr John Collins

Executive Director, International Drug Policy Project, LSE Hashtag for Twitter users: #LSEworks

Professor Lawrence Phillips

Emeritus Professor of Decision Sciences, LSE

Dr Michael Shiner

Head of Teaching, IDPP and Associate Professor of Social Policy, LSE

Dr Mary Martin

Chair, LSE

Dr Joanne Csete

Commissioner, Lancet Commission on Drug Policy

SLIDE 2

Public health as smoke‐screen in drug policy reform

Joanne Csete PhD, MPH Columbia University

Feb. 2017

SLIDE 3

SLIDE 4

SLIDE 5

Public health approach to drug control?

SLIDE 6

SLIDE 7

Health pillar of drug policy?

China

SLIDE 8

Public health approach to drug control?

SLIDE 9

SLIDE 10

Is “non‐adversarial” better?

SLIDE 11

HIV incidence linked to injection remains high

SLIDE 12

Prevalence of HIV infection: people who inject drugs vs. general population

SLIDE 13

SLIDE 14

U.S. federal prisoners by type of conviction, 2014

SLIDE 15

Incarceration and TB epidemics, Europe & C. Asia: Net ↑ in incarceraon  2/3 of increase in TB incidence

(Stuckler et al., Proc Natl Acad Sci 105(36):13281, 2008)

SLIDE 16

Modelled incidence of HCV among people who inject drugs from effects of incarceration in several settings

(Vickerman et al. for Lancet Commission)

SLIDE 17

Methadone and HIV incidence in Iranian prisons

1.56 1.81 3.12 3.83 2.78 3.05 3.24 2.83 1.71 2.01 1.54 1.37 1.28 1.01 100 300 1,400 2,800 8,040 19,539 25,407 25,000 28,826 38,256 40,952 41,111

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

HI V I ncidence MMT Expansion

SLIDE 18

Proportion of people who inject drugs living with HIV who receive ART, by region

SLIDE 19

Opioid overdose hits the middle‐class white population

Case & Deaton, Proc Natl Acad Sci USA 2015; 112: 15078–83

SLIDE 20

Missing out on a good investment

Nguyen et al., AIDS Behav. 18(11):2144, Nov. 2014

SLIDE 21

SLIDE 22

SLIDE 23

Rich research base for consumption rooms:

verdose ↓, needle sharing ↓, link to other services ↑

SLIDE 24

SLIDE 25

Punitive drug policy undermines measures to address overdose

SLIDE 26

SLIDE 27

Missed research opportunities on drugs?

SLIDE 28

Opioid overdose and medical marijuana: Will NIDA fund the obviously needed research?

Bachhuber et al., JAMA Int Med 2014; 174 (11):

ecological study: lower opioid overdose rates in states with medical marijuana

Boenhke et al., J Pain (epub 2016 Mar 18, doi:

10.1016/j.jpain.2016.03.002): cross‐sectional survey of pain patients: Patients with chronic pain in Michigan are replacing opioids with cannabis

SLIDE 29

Lancet Commission: What really is a public health approach?

Lancet 387(10026): 1427–1480, 2 April 2016

SLIDE 30

Timing of accelerated U.S. drug war no accident: Putting blacks in their place following passage of civil rights laws

SLIDE 31

Top Nixon aide J. Erlichman (1994): “The Nixon White House had two enemies: the antiwar left and black people….We knew we couldn’t make it illegal to be against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes…, vilify them night after night on the evening news…. Did we know we were lying about the drugs? Of course we did.”

D. Baum, Harper’s, Apr 2016: from the horse’s mouth

SLIDE 32