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Pike, Brigid (2011) In brief. Drugnet Ireland, Issue 39, Autumn 2011, p. 27.

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In February of this year In brief reported on the work of the Latin American Commission on Drugs and Democracy and the Inter-American Dialogue on rethinking US drug policy(see Drugnet Ireland Issue 37). It also noted that a Global Commission on Drug Policy had been established to review the assumptions, effectiveness and consequences of the ‘war on drugs’ approach.   

In June 2011 the Global Commission on Drug Policy published its report. The report sets out the following ‘key principles and recommendations’:
·         End the criminalisation, marginalisation and stigmatisation of people who use drugs but who do not harm others. Challenge rather than reinforce common misconceptions about drug markets, drug use and drug dependence.
·         Encourage experimentation by governments with models of legal regulation of drugs to undermine the power of organised crime and safeguard the health and security of their citizens. Apply this recommendation especially to cannabis, but also experiment in the decriminalisation and legal regulation of other substances.
·         Offer health and treatment services to those in need. Ensure that a variety of treatment modalities are available, including not just methadone and buprenorphine treatment but also heroin-assisted treatment programmes. Implement syringe access and other harm reduction measures. Respect the human rights of people who use drugs.
·         Apply the same principles and policies stated above to people involved in the lower ends of illegal drug markets, such as couriers and petty sellers. The Commission comments, ‘Many are themselves victims of violence and intimidation or are drug dependent. Arresting and incarcerating these people in recent decades has filled prisons and destroyed lives and families without reducing the availability of illicit drugs or the power of criminal organisations.’
·         Invest in activities that can both prevent young people from taking drugs in the first place and also prevent those who do use drugs from developing more serious problems. Eschew simplistic ‘just say no’ messages and ‘zero tolerance’ policies in favour of educational efforts grounded in credible information and prevention programs that focus on social skills and peer influences. The Commission points out that the most successful prevention efforts may be those targeted at specific at-risk groups.
·         Focus repressive actions on violent criminal organisations, but do so in ways that undermine their power and reach while prioritising the reduction of violence and intimidation. Law enforcement efforts, according to the Commission, should focus not on reducing drug markets per se but on reducing their harms to individuals, communities and national security.
·         Begin the transformation of the global drug prohibition regime. Replace drug policies and strategies driven by ideology and political convenience with fiscally responsible policies and strategies grounded in science, health, security and human rights – and adopt appropriate criteria for their evaluation.
·         Break the taboo on debate and reform.
On 14 June 2011 the Think Tank for Action on Social Change (TASC) launched a report on health inequalities in Ireland. Authored by TASC Head of Policy Sinéad Pentony and Sara Burke, health policy analyst and journalist, Eliminating health inequalities – a matter of life and deathoutlines the interrelationship between economic inequality and inequality of health outcomes. At the launch, Professor Joe Barry, Chair of the TASC Health Inequalities Advisory Group, said: ’This report illustrates how responses to the current economic crisis are disproportionately impacting on low-income and vulnerable groups, to the detriment of their health in both the short and the long term. The publication of this report is timely, as it coincides with the launch of the Government’s consultation on a new public health policy.’ Recommendations in the report include:
·         the establishment of an independent review of health inequalities, to report within 12 months;
·         an equality statement to be published as part of the annual budgetary process, examining the distributional impact of proposed taxation and spending measures on all income levels and on specific demographic groups;
·         taxation to be gradually raised to Western European levels, with the increased revenue to be used for higher health and education spending;
·         increased and targeted investment in early childhood care and education;
·         implementation of a universal social health insurance model. www.tascnet.ie
In June 2011 The Lancet publishedan article onthe findings of a study of psychiatric disorders and mortality among people in homeless shelters in Denmark between 1999 and 2009.1  The study had found increased rates of psychiatric morbidity (particularly substance abuse) and vastly increased mortality rates, but had also found that homeless people with mental disorders did not have increased mortality compared with homeless people who were not mentally ill, although there was a relative increase in people with substance abuse. A separate commentary on the findings observed:2
 … any additive risk between mental and physical illness on rates of mortality seems to be limited to substance abuse. This finding is interesting and might indicate that mentally ill homeless people who are not substance abusers have better access to health services than do homeless people without mental illness, perhaps as a result of specialist services introduced after the identification of the high rates of mental illness. … Mentally ill people who do not abuse substances might also spend less time homeless than do those with alcohol and drug problems, and substance abuse might be associated with a higher number of risk factors for natural and non-natural causes of death. … The findings suggest that integrated psychiatric and substance abuse treatment is necessary to address inequalities, and further treatment trials on the best strategies to treat dual-diagnosis homeless patients and homeless young people are needed. Such enhanced treatment is likely to confer additional benefits, including reduction in violent crime, specific causes of mortality including suicide, and victimisation. Services need to be integrated and flexible: assertive community treatment could offer one approach, possibly with community support.
(Compiled by Brigid Pike)
1. Nielsen SF, Hjorthøj CR, Erlangsen A and Nordentoft M (25 June 2011–1 July 2011) ‘Psychiatric disorders and mortality among people in homeless shelters in Denmark: a nationwide register-based cohort study’ in The Lancet, 377(9784): 2205–2214.
2.   Geddes JR and Fazel S (25 June 2011–1 July 2011)‘Comment – Extreme health inequalities: mortality in homeless people’ in The Lancet, 377(9784): 2156–2157.
Item Type
Publication Type
Irish-related, International, Open Access, Article
Drug Type
All substances
Issue Title
Issue 39, Autumn 2011
Page Range
p. 27
Health Research Board
Issue 39, Autumn 2011
Accession Number
HRB (Available)

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