Policy for Drug Decriminalisation: Portugal+ Moving away from a war on drugs towards harm prevention and education, evidence based voluntary treatment programs, harm reduction practices and investing in the social reintegration of drug abusers. Understanding that: ▪ Drug use can be healthy ▪ Drug use is a health issue, rather than criminal justice ▪ A drug-free society is unattainable ▪ Punitive policies are unethical and ineffectual The Proposal Full Decriminalisation Evidence-informed policy and practice necessitate a total of possession and Drug removal of culpability associated with drugs or drug use, Use absolving users of any notion of guilt. - A Personal- Health approach Wipe record of drug “criminals” to drug use ▪ Release from Prison ▪ Compensation for time spent Maximum amount for personal possession of any drug ▪ Government to consult health experts to establish limits ▪ Above this considered as intended for distribution Integration with NHS Drug abuse must be dealt with on a personal, case by case basis, and Community Health rooted in safe-use spaces. Services - A Public-Health 24/7 Supervised Community Clinics approach to drug ▪ Safe Space with easy and immediate access to health abuse professionals trained in emergency intervention ▪ Drug Consumption Rooms (DCR) ▪ Needle exchange – safe needle disposal, and source for clean needles ▪ Drug Kits ▪ Free of charge methadone ▪ Take home naloxone programs Therapeutic Services ▪ CBT ▪ Counselling ▪ Voluntary recovery support groups ▪ Voluntary-access dedicated rehabilitation services Physical Health Services ▪ Food/water ▪ Beds ▪ Living space ▪ Private treatment rooms ▪ HIV Tests Prison services ▪ Dedicated harm reduction teams in prisons ▪ Prison based syringe exchanges ▪ Prison based free treatment programmes ▪ Methadone and naloxone programmes Mandatory drug testing facilities at UK festivals Training and Education Diversion ventures that take on a harm reduction approach - Cultivate a healthy with easily accessible and effective referral to education, approach to drug assessment, and treatment components. use Doctors, psychologists and nurses to receive education about drugs and addiction as a mandatory part of medical training ▪ Specialist treatment centre roles for experts having worked in addiction services Just transition for Drug Establish community services and integrate with National Distributors Education Service to provide a safe route out of the trap of - Freedom from the black-market labour trap ▪ Connecting community activists: Government to work with on the ground organisations and community groups to support transitions for low level drug distributors towards education and employment ▪ Coordination with National Education Service ▪ Committee similar to Portugal Dissuasion Commission, set up to make decisions case-by-case on preventing and sanctioning distributors. Social work, group therapy, social reintegration programmes including education and employment focuses and/or community service are options for the committee to consider. ▪ Drug trafficking to remain criminalised, but "low-level" distributors to be referred to committee. Drug trafficking to be looked at case-by-case, dependent on factors such as: o Quantity of substance o Effect of substance o Whether selling to finance addiction: referral to services Evidence for Portugal based drug decrim policy ▪ Overdose deaths reduced by 80% following implementation of decriminalisation in Portugal (Domoslawski A, 2011, Open Society Foundations) ▪ New HIV infections fell from 52% in 2000 to 7% in 2015 in Portugal (Domoslawski A, 2011, Open Society Foundations) ▪ Numbers of those entering treatment has increased dramatically in Portugal (Domoslawski A, 2011, Open Society Foundations) ▪ Incarceration for drug offences decreased by over 40% in Portugal For Safe Needle Disposal • Already in use in Sydney and NSW • “We need to dispose of sharps safely to prevent needlestick injury in our public places, at home and for workers who remove waste or clean facilities. Whether or not a community sharp is used for medication or drug use, sharps are to be treated as clinical waste, like they would be in a hospital. Local councils have a number of community sharps bins installed in community centres, libraries, parks and public toilets to encourage sharps waste to be managed separately from general waste. https://www.cityofsydney.nsw.gov.au/community/health-and-safety/alcohol-and-drugs/drug- safety/community-sharps For Drug Consumption Rooms (DCR) Drug consumption room study: https://www.jrf.org.uk/sites/default/files/jrf/migrated/files/9781859354711.pdf • "...studies in Switzerland have revealed that a small percentage (0.5–4.5 per cent) of DCR users report that they had their first injection in a DCR (Hedrich, 2004). This demonstrates that, so long as a DCR is accessible to a broad range of drug users, it is inevitable that a small number will first inject within the premises. Whether or not, in the absence of a DCR, such people would have injected a drug in any case is open to conjecture." (page 37) • "DCR users are usually able to gain access to a range of needle and syringe exchange, medical and social care, counselling and housing services through co-operation between DCRs and other services." (37-38) • "The research evidence from DCRs abroad suggests that they are largely successful in attracting considerable numbers of long-term users, many of whom are socially excluded and out of contact with treatment services and a significant proportion of whom will have never had any contact. DCRs have generally been set up for local users with little evidence of ‘honeypot’ effects. Those who use DCRs regularly tend to be locals. DCRs are rarely used by novice injectors." (39-40) For Mandatory drug testing facilities at UK Festivals • MAST (Multi Agency Safety Testing), launched by harm reduction NGO ‘The Loop’ in 2016. https://wearetheloop.org/mast • “MAST is a form of drug safety testing (or ‘drug checking’) whereby individual service users submit samples for analysis and receive their results as part of a confidential, individually tailored harm reduction package delivered by experienced substance misuse practitioners. In contrast with ‘back of house’ testing of police seizures and ‘halfway house’ testing of emergency service samples, the added value of this model of ‘front of house’ testing is that it facilitates a dialogue directly between individual customers and members of the Loop’s harm reduction team, enabling the vital connection to be made between presumed and actual drug contents. “ • it was built on evidence from similar services that have been running successfully in the Netherlands, Spain, Switzerland and Austria for a number of years.