Ketamine is an essential medicine used for anaesthesia. It is the only available anaesthetic for essential surgery in most rural areas of developing countries, home to more than 2 billion of the world’s people. Scheduling ketamine will leave these populations with no alternative anaesthesia for essential surgery, and will further deepen the already acute crisis of global surgery.

The upcoming United Nations General Assembly Special Session on Drugs (UNGASS) in 2016 is an unprecedented opportunity to review and re-direct national drug control policies and the future of the global drug control regime. As diplomats sit down to rethink international and domestic drug policy, they would do well to recall the mandate of the United Nations, not least to ensure security, human rights and development.

Reflections upon this year’s CND are mixed. On the one hand, some states went further than ever before in openly challenging the current regime on the grounds that, after a century, it needs modernising. That the government of Uruguay is currently considering a domestic policy on cannabis that would put it in breach of the Single Convention shows that, in one instance at least, we have moved beyond rhetoric and posturing.

On the basis of the available evidence, the overwhelming majority of Council members consider that khat should not be controlled under the Misuse of Drugs Act 1971. In summary the reason for this is that, save for the issue of liver toxicity, although there may be a correlation or association between the use of khat and various negative social indicators, it is not possible to conclude that there is any causal link.

In the context of a fast changing and well documented market in legal highs, the case of khat (Catha edulis) provides an interesting anomaly. It is first of all a plant-based substance that undergoes minimal transformation or processing in the journey from farm to market. Secondly, khat has been consumed for hundreds if not thousands of years in the highlands of Eastern Africa and Southern Arabia. In European countries, khat use was first observed during the 1980s, but has only attracted wider attention in recent years.

Neuropathic pain affects between 5% and 10% of the US population and can be refractory to treatment. Opioids may be recommended as a second-line pharmacotherapy but have risks including overdose and death. Cannabis has been shown to be effective for treating nerve pain without the risk of fatal poisoning. The author suggests that physicians who treat neuropathic pain with opioids should evaluate their patients for a trial of cannabis and prescribe it when appropriate prior to using opioids. This harm reduction strategy may reduce the morbidity and mortality rates associated with prescription pain medications.

 

The global war on drugs has failed, with devastating consequences for individuals and societies around the world. Fifty years after the initiation of the UN Single Convention on Narcotic Drugs, and 40 years after President Nixon launched the US government’s war on drugs, fundamental reforms in national and global drug control policies are urgently needed.

 

In my view, perceived harms associated with drugs are vulnerable to so many restrictions on reliability and validity that, for the time being, a serious estimate of drug harm per drug is impossible. In my view, it is even invalid to associate harms to drugs alone. Drugs are used by humans, under individual, social and legal conditions, in certain purities and dosages. Whatever the 'effects' of drugs, harmful or not, they cannot be estimated or even discussed without associating the drug with a particular user or user culture. Drugs per se do not meaningfully exist.

To provide better guidance to policy makers in health, policing, and social care, the harms that drugs cause need to be properly assessed. This task is not easy because of the wide range of ways in which drugs can cause harm. This study undertook a review of drug harms with the multicriteria decision analysis (MCDA) approach. This technology has been used successfully to lend support to decision makers facing complex issues characterised by many, conflicting objectives.

There is a long history of psychoactive substances being regarded as dangerous and subsequently being banned or forbidden. Often the bans were introduced on substances new and unfamiliar to a society, which were viewed as more dangerous than substances which were well known and enculturated. With industrialisation and the globalisation brought by European empires, the growing availability of psychoactive substances was increasingly seen as a problem in the 1800s, setting off social and policy reactions – what we know as the temperance movement against alcohol,
and initial UK legislation limiting the sale of ‘poisons’.

In 2007, the Government of New Zealand entrusted an independent agency, the National Law Commission, to review the country’s drug law. The Commission will  present a final report which is likely to feature a new approach to personal pos­session and use of drugs placing less emphasis on conviction and punish­ment and more on the delivery of effective treat­­ment. New Zealand’s approach to drug law reform may provide les­sons for other countries.

 

The article reviews the status of khat, the most recent plant based psychoactive substance to reach a global market, and considers policy making processes in general and the framework of drug control in particular. The risk assessment and classification of psychoactive drugs is a contested arena where political, economic and moral agendas collide, leaving countries that have banned khat, with significant social costs. To best manage the risks arising from the increasing availability of khat it is therefore suggested to draft a regulatory framework with clear objectives and guiding principles.

This briefing offers some background on the issue to amend the UN Single Convention towards a more coherent and realistic stance on the ancient tradition of coca leaf chewing. The issue was raised by Bolivia and adopted at the July 2009 ECOSOC meeting. Noticing confusion amongst some countries about the motives and impact of such amendment, this briefing aims to shed some light on the case.   

 

This is the second edition of the IDPC Drug Policy Guide aimed at national government policy makers. This publication is a collaborative effort by a number of members of the International Drug Policy Consortium (IDPC) and partners, and brings together global evidence and best practices on the design and implementation of drug policies and programmes at national level.

 

This briefing offers some background on the issue to amend the UN Single Convention towards a more coherent and realistic stance on the ancient tradition of coca leaf chewing. The issue was raised by Bolivia and adopted at the July 2009 ECOSOC meeting. Noticing confusion amongst some countries about the motives and impact of such amendment, this briefing aims to shed some light on the case.

This presentation gives a short overview of legislative reforms in Europe and Latin America that provide lessons learned in practice about less punitive approaches intended to reduce drug-related harm to the individual and society.  Evidence suggests that fears that softening drug laws and their enforcement would lead to sharp increases in drug use, have proven untrue.

 

The 1961 UN Single Convention on Narcotic Drugs and the 1971 Convention on Psychotropic Substances, entrust the Expert Committee on Drug Dependence of the World Health Organization (WHO) with the responsibility of assessing substances for abuse liability in order to make recommendations on their control under the two aforementioned Conventions.

The classification of drugs has a profound impact on the lives and well-being of individuals across the world and where the classification is incorrect, people suffer unnecessarily. This is an issue that deserves greater public awareness and greater engagement with citizenry and that where such public awareness is in place it should be galvanised in order to work towards a new democratic answer to this difficult situation.

No one is suggesting that drugs are not harmful. The critical question is one of scale and degree. We need a full and open discussion of the evidence and a mature debate about what the drug laws are for - and whether they doing their job? In `Estimating drug harms: a risky business', Professor David Nutt, of Imperial College London argues that the relative harms of legal drugs such as alcohol and tobacco are greater than those of a number of illegal drugs, including cannabis, LSD and ecstasy.

The principal aim of these guidelines is to put in place a sound methodological and procedural basis for carrying out each risk assessment. The risk assessment has regard to the health and social risks of the use of, manufacture of, and traffic in the new psychoactive substance, the involvement of organised crime and the possible consequences of control measures. The guidelines were finalised and adopted by the EMCDDA’s Scientific Committee in November 2008.