• Abstract and Figures
• Public Full-text

Regional Overview 2.3 Latin America & the Caribbean 99 2.3 LATIN AMERICA & THE CARIBBEAN ANTIGUA AND BARBUDA ARGENTINA THE BAHAMAS BOLIVIA BARBADOS BRAZIL BELIZE COLOMBIA BERMUDA COSTA RICA CUBA CHILE DOMINICA ECUADOR DOMINICAN REPUBLIC EL SALVADOR GRENADA GUATEMALA GUYANA HONDURAS HAITI MEXICO JAMAICA NICARAGUA PUERTO RICO PANAMA SAINT KITTS AND NEVIS PARAGUAY SAINT LUCIA PERU SAINT VINCENT AND THE GRENADINES URUGUAY SURINAME VENEZUELA TRINIDAD AND TOBAGO 100 Global State of Harm Reduction 2020 TABLE 2.3.1: Epidemiology of HIV and viral hepatitis, and harm reduction responses in the Latin America and the Caribbean Country/ People who HIV Hepatitis C Hepatitis B Harm reduction response territory with inject drugs prevalence (anti-HCV) (anti-HBsAg) reported injecting among prevalence prevalence Peer drug use1 people who among among distribution inject drugs people who people who NSP2 OAT3 DCRs4 of (%) inject drugs inject drugs naloxone (%) (%) Argentina 8,144[2] 3.5[3] 4.8[4] 1.6[4] x (M)[5] x x The Bahamas 0[6] nk nk nk x x x x Bolivia nk nk nk nk x x x x Brazil nk 5 9.9 [7]6 nk nk x x x x Chile nk nk nk nk x x x x Colombia 14,893[8] 5.5[9] 31.6[9] nk [10,11] (M)[10,11] x x Costa Rica nk7 nk nk nk x x x x Dominican Republic <1,359[13]8 3.2[13]9 22.8[14]10 nk 2[15] x x x Ecuador nk nk nk nk x x x x El Salvador nk nk nk nk x x x x Guatemala nk nk nk nk x x x x Guyana nk nk nk nk x x x x Haiti nk nk nk nk x x x x Honduras nk nk nk nk x x x x Jamaica nk nk nk nk x x x x Mexico 164,157[18] 11 4.4[19] 12 96[20] 13 0.2[4] [17] (M)[21] [21] x14 Nicaragua nk nk nk nk x x x x Panama 5,714[22] nk nk nk x x x x Paraguay nk nk 9.8[23] nk x x x x Peru nk nk nk nk x x x x Puerto Rico 28,000[24] 11.3[25] 15 78.4 - 89[27,28] 16 nk [29] (M,B)[29] [29] x Suriname nk[30] 17 nk nk nk x x x x Uruguay nk nk nk nk x x x x Venezuela nk nk nk nk x x x x nk = not known 1 Countries with reported injecting drug use according to Larney et al in 2017. The study found no reports of injecting drug use in Antigua and Barbuda, Barbados, Belize, Cuba, Dominica, Grenada, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines or Trinidad and Tobago.[1] 2 All operational needle and syringe programme (NSP) sites, including fixed sites, vending machines and mobile NSPs operating from a vehicle or through outreach workers. 3 Opioid agonist therapy (OAT), including methadone (M), buprenorphine (B) and any other form (O) such as morphine and codeine. 4 Drug consumption rooms, also known as supervised injecting sites. 5 Unpublished data from a national household survey coordinated by Francisco Bastos found very little evidence of injecting drug use in Brazil. 6 Based on data collected in 2009 in eight Brazilian cities. 7 Civil society organisations indicate that injecting drug use is minimal in Costa Rica.[12] 8 There are an estimated 56,632 people who use illegal drugs in the Dominican Republic, less than 2.4% of whom are reported to be people who inject drugs. 9 Estimate from 2012 for people who use drugs. 10 Based on data from 2008. 11 Based on data from 2011 National Addiction Survey. There may be limitations to the representativeness of this data, as household surveys are known to exclude people living out- side traditional households, such as people who are homeless or incarcerated.[16] Civil society organisations believe that this figure may be an overestimate, with the true number of people who inject drugs in the country being around 30,000.[17] 12 Based on data collected in 2006-2007. 13 Based on data collected in 2005. 14 Though one DCR operates in Mexicali, Mexico, this is not officially sanctioned by the state.[21] 15 Based on subnational data from 2015. 16 Based on subnational data from 2006-2015. Civil society organisations report that there is no effective system monitoring viral hepatitis infection among people who inject drugs in Puerto Rico.[26] 17 A 2008 government study estimated that 0.3% of Suriname’s estimated 1,000 people who use drugs are people who inject drugs. Regional Overview 2.3 Latin America & the Caribbean 101 BERMUDA MAP 2.3.1: Availability of harm reduction services THE BAHAMAS DOMINICAN REPUBLIC CUBA PUERTO RICO ANTIGUA BELIZE & BARBUDA MEXICO JAMAICA HAITI HONDURAS SAINT KITTS DOMINICA & NEVIS BARBADOS GUATEMALA SAINT LUCIA NICARAGUA SAINT VINCENT EL SALVADOR GRENADA & THE GRENADINES PANAMA TRINIDAD AND TOBAGO COSTA RICA VENEZUELA GUYANA COLOMBIA SURINAME ECUADOR PERU BRAZIL BOLIVIA CHILE PARAGUAY ARGENTINA URUGUAY Both NSP and OAT available OAT only NSP only Neither available Not known DCR available Peer-distribution of naloxone 102 Global State of Harm Reduction 2020 2.3 Harm reduction in Latin America and the Caribbean NEEDLE AND SYRINGE PROGRAMMES (NSPs) Transition to domestic funding applies primarily MEXICO to services for people who inject drugs, and there remain few funding opportunities for services for the majority of people who use drugs in the region who do not inject. <5% CIVIL SOCIETY ORGANISATIONS ESTIMATE THAT LESS THAN 5% OF THE PEOPLE WHO INJECT DRUGS IN MEXICO ACCESS NSPs. 20% COCAINE IN LATIN AMERICA APPROXIMATELY 40% OF PEOPLE IN CONTACT WITH THE CRIMINAL APPROXIMATELY 20% OF PEOPLE IN JUSTICE SYSTEM HAVE BEEN ARRESTED ON THE PRISON IN LATIN AMERICA ARE CHARGED BASIS OF COCAINE-RELATED OFFENCES’ WITH A DRUG OFFENCE. Regional Overview 2.3 Latin America & the Caribbean 103 Author: Author: Author: Sam Shirley-Beavan Jorgelina Di Iorio Carolina Ahumada Harm Reduction Intercambios Intercambios International 1. Overview There are approximately 5.5 million people who Harm reduction programmes for people who inject drugs, use non-injected illegal drugs in Latin America and including opioid agonist therapy (OAT) and needle and the number of people who inject drugs is very low syringe programmes (NSP), operate in Colombia, the compared with other regions.[31,32] This is largely due Dominican Republic, Mexico and Puerto Rico.[11,15,21,29,45] to the fact that, currently, injecting use is relatively In Mexico, primarily in the north close to the border rare outside Mexico and Colombia[33] and because the with the USA, they also function as overdose prevention rate of use of cocaine and its derivatives (which are programmes, distributing naloxone and offering fentanyl commonly not injected) in the region is among the strips. La Sala, a safe consumption space for women highest in the world.[5,31,34] who use drugs, is the first drug consumption room (DCR) in the region, though it is not authorised by the The production and use of cocaine and coca derivatives is Mexican government.[46] prevalent in South America, specifically Bolivia, Colombia and Peru, which are responsible for virtually all the world’s Drug checking programmes (also known as substance coca leaf cultivation.[35,36] The smokable use of cocaine paste analysis) have increased in the region since 2018, and (an intermediate product in the production of cocaine are managed by civil society organisations, including in also known as basuco, paco, base paste or oxi) is greater Colombia, Mexico, Peru and Uruguay.[11,39,44] There are other than that of opioids in Argentina, Brazil, Chile, Colombia, peer education projects in clubs and festivals that offer Ecuador, Paraguay, Peru and Uruguay.[5,32,37–39] It is a cheaper assistance, information and hydration points to reduce risk alternative to cocaine in South America and people who related to recreational drug use.[5,43] use cocaine paste, as well as those who use crack cocaine, are usually from socially marginalised groups, are more There are several examples from recent years of regression stigmatised and face more barriers to access to health towards more punitive drug policies in Latin America. care and harm reduction programmes than other people. For example, new governments in Brazil and Bolivia [5,11,12,34] have explicitly rejected harm reduction as a response to illegal drug use and closed successful programmes, The rate of opioid use in Latin America and the Caribbean is replacing them with abstinence-based, rehabilitation lower than that of amphetamine-type substances (ATS) or and law enforcement-led projects.[36] In several other other new psychoactive substances (NPS). However, opioid countries such as Costa Rica, the Dominican Republic, El use is prevalent in Colombia, the Dominican Republic, Salvador, Guatemala and Honduras, the response to drug Mexico and Puerto Rico.[11,15,21,29,31] NPS use is increasing in use continues to be dominated by abstinence-centred Argentina, Brazil, Colombia, Costa Rica, Mexico, Peru and programmes.[12,15] Uruguay. MDMA is the most common substance among ATS, and NPS such as ketamine, synthetic cannabinoids and With reductions in funding from international donors, the synthetic hallucinogens are also used in some countries. funding landscape for harm reduction in Latin America is [11,12,21,32,37,39–41] becoming increasingly difficult. Due to the socio-economic crisis in the region caused by the COVID-19 pandemic, Harm reduction programmes for people who use non- national government funding has also decreased.

Load more

  16

Copy Link