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Global drug policy has undergone significant change over the past decade, especially with the advent of the 2016 UN General Assembly Special Session (UNGASS) on drugs. This was a catalyst moment both in highlighting the need for a gender perspective in drug policy, and in initiating a review of the indicators used to evaluate progress in drug policy.

To date, the UN has not adequately tracked gender-specific data in drug policy. This is symptomatic of the lack of focus granted to the specific vulnerabilities and needs of women in the illicit drug trade. This has resulted in a knowledge and understanding gap in relation to the issues faced by women worldwide.

The importance of quantitative and qualitative data and analysis of how and why women are involved in the illicit drug trade, and how this relates to their age, ethnicity, socio-economic status, family situation and history of trauma, violence and mental illness cannot be understated. Without adequate indicators on the underlying factors of their engagement in the trade, the differentiated impacts that both drugs and drug policies have on their lives, and the vulnerabilities they may face, policy makers will be unable to design and implement drug policies that are truly effective.

This chapter provides a historic overview of how data on women has so far been tracked by the UN. The chapter will then look to the future, focussing on opportunities to identify more meaningful indicators within a revised Annual Reports Questionnaire, and also by leveraging the Sustainable Development Goals, UN human rights mechanisms and civil society research.

The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales.

A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017).

Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison.

Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.

The opioid epidemic in the USA, the new psychoactive substances emerging on the market and the recent increase in cocaine treatment demands in Western Europe, all emphasise the importance of monitoring the use and harms of drugs over time. To be informed about new consumption patterns, this study aims to study the trends among people entering treatment for substance use in Belgium.

Belgian data from the Treatment Demand Indicator collected between 2015 and 2019 were used. A reference group of treatment units was selected to allow for comparisons between the different years. Trend analysis was performed by using a joinpoint regression among different regions and groups of clients.

The drugs of choice that were most frequently mentioned among the 23,000 analysed treatment episodes were alcohol and cannabis. Both remained relatively stable over time. Heroin seemed to be decreasing significantly at the national level, but increased in Brussels. Benzodiazepines decreased significantly in Flanders and Brussels, but not in Wallonia. On the other hand, reports of crack cocaine increased significantly in the three regions with a more pronounced trend in Wallonia and Brussels. Substances such as fentanyl, methamphetamine, ketamine or volatile inhalants have been mentioned significantly more by people entering treatment in 2019, although their contribution to the total number is still limited.

To the best of the authors’ knowledge, this study is the first to evaluate trends for all drugs of choice at a national and regional level. These results might not only benefit national policymakers but also other countries with similar alcohol or drug use patterns.

This study aims to document the incidence and causes of deaths in custody in Senegal from 2017 to 2019 and to describe the demographic and criminal justice characteristics of decedents.

The authors examined medical records and death reports relating to all deaths occurring between January 1, 2017 and December 31, 2019 during a period of incarceration in Senegal.

Among the estimated 83,568 people incarcerated in Senegal during the study period, 83 deaths were recorded in custody; 24 in 2017, 32 in 2018 and 27 in 2019. This resulted in a rate of 1.0 deaths per 1,000 incarcerated people. Of the 83 decedents identified, 79 (95%) were males. Similar proportions of decedents were serving custodial sentences (n = 44; 53%) and awaiting trial (n = 39; 47%) at the time of death. Most deaths were recorded as being because of natural causes (n = 67; 81%); the most common causes recorded were cardiovascular disease (n = 22; 27%), cancer (n = 12; 15%) and infectious diseases (n = 11; 13%). Two people (2.4%) died by suicide, and one (1.2%) died as a result of interpersonal violence. Most deaths (n = 59; 71%) occurred in hospitals, 14 (17%) occurred in prisons and 7 (8%) occurred in prison health centers.

The authors observed a higher rate of death and a markedly lower proportion of deaths in custody in Senegal because of suicide and violence, when compared with similar studies from high-income countries. The findings of this study point to a need for greater investment in screening, health care and health promotion in custodial settings to reduce potentially preventable deaths among people in custody in Senegal.

Over the past decade, an increase in the numbers of women prosecuted, sentenced and imprisoned for drug-related offences has prompted concern and debate amongst criminal justice practitioners and policymakers. The female prison population in Southeast Asian countries is high compared to other regions. The direction of national drug policies and law enforcement are critical determinants of this situation. This chapter discusses the trends in the illicit drug market, the different types of policy responses, and the impacts on correctional services in the region. It provides an overview of women prisoners’ profiles, their backgrounds and their involvement in drug-related crimes. Key issues relating to the treatment of women in Southeast Asian prisons are analysed and addressed through the lens of the relevant provisions of the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders.

This chapter paints a picture of the war on drugs, and the structures of prohibition and punishment that drive it, as extensions of broader systems of state and interpersonal violence. I outline the failures of prohibition through the criminalisation of drug-related activities and put forward a framework for harm reduction that has as its foundation a radical critique of punishment in all spheres of our lives. This chapter urges those who advocate for drug policy reform to build broader alliances with the many communities around the world that organise against the continuation of the prison industrial complex (PIC) as a whole, including: people in prison, gendered, racialised and LGBTQI+ communities, sex workers and prison abolitionists. I conclude by offering a vision for abolitionist drug policy, whose ultimate goal is to resist the expansion of the PIC globally and in doing so, to foster greater community resilience both across difference and beyond our increasingly siloed fields of expertise. As drug policy experts, the author can choose to situate the millions of people who use drugs worldwide within global contexts of ongoing state violence and control, so that the reforms the author advocate for match the fullness and complexity of the people and worlds the author are fighting for and tackle the root causes of the many harms our communities face.

This chapter explores the norms and assumptions that frame and sustain international drug policy and the international drug control regime. Drug policy is conceptualised as a ‘policy fiasco’ that persists despite extensive evidence of goal failure. The absence of effective monitoring and evaluation, impact assessment, stakeholder participation and mainstreaming of rights-based approaches, conflict sensitivity and gender sensitivity is emphasised, substantiating the argument that drug policy is a case study of ‘institutional path dependence’. Drug policy has repeatedly missed targets for achievement of a ‘drug free world’. This is explained through reference to the counterproductive and ‘unintended consequences’ of a drug policy approach of criminalisation. The impacts of drug policy enforcement are shown to be negative, pernicious and disproportionately born by the poor, by vulnerable communities and those subject to discrimination on account of race, gender and class.

This chapter presents a broad introduction to women’s varied interactions with drugs and drug markets. It provides a brief overview of the international framework of drug control and the ways in which drug policy enforcement differently impacts women and men. It highlights the negative and disproportionate impacts on women of criminalisation-based approaches and how drug policy serves to reinforce existing problems of structural discrimination. This provides context for the contributions to this edited collection, which are summarised in the introduction. The book situates drug policy reform as a crucial and underlooked feminist issue.

Cryptomarkets on the dark web have emerged as a hub for the sale of illicit drugs. They have made it easier for the customers to get access to illicit drugs online while ensuring their anonymity. The easy availability of potentially harmful drugs has resulted in a significant impact on public health. Consequently, law enforcement agencies put a lot of effort and resources into shutting down online markets on the dark web. A lot of research work has also been conducted to understand the working of customers and vendors involved in the cryptomarkets that may help the law enforcement agencies. In this research, we present a ranking methodology to identify and rank top markets dealing in harmful illicit drugs. Using named entity recognition, a harm score of a drug market is calculated to indicate the degree of threat followed by the ranking of drug markets. The top-ranked markets are the ones selling the most harmful drugs. The rankings thus obtained can be helpful to law enforcement agencies by locating specific markets selling harmful illicit drugs and their further monitoring.