Big Events and Risks to Global Substance Using Populations: Unique Threats and Common Challenges

Abstract

In this commentary, we review a set of “Big Events” from around the world that have adversely impacted substance using populations by first identifying common thematic areas between them, and then describing the unique challenges faced by the diverse and vulnerable populations impacted. The Big Events reviewed are multifaceted and complex in nature, and include the recent global financial crisis, economic and trade sanctions, political transition and its impact on ethnic minorities, colonialism and indigenous communities, and ecological disasters. All have led to immense trauma, displacement, and disruption to critical healthcare services/treatment for people who use drugs, populations who are left underserved in the midst of these crises. It is our hope that through this comparative assessment, global policymakers will proactively identify Big Events and prioritize the development of interventions and policy that meet the unique and immediate needs of substance using population in order to mitigate the significant negative short- and long-term impacts on global public health.

Keywords :

• Big Events
• substance use and abuse
• harm reduction
• globalization
• financial crisis
• ecological disasters
• health policy
• HIV/AIDS
• PWIDs

THE AUTHORS

Tim K. Mackey is the director of the Global Health Policy Institute, the associate director of the joint master's program in health policy and law at UC San Diego, and an assistant professor in the Department of Anesthesiology at UC San Diego School of Medicine and Division of Global Public Health.

Steffanie A. Strathdee is the associate dean of Global Health Sciences, Harold Simon Professor, and chief of the Division of Global Public Health in the Department of Medicine at the UC San Diego School of Medicine.

Notes

¹ The Trans-Pacific Partnership Agreement (TPPA) and Transatlantic Trade and Investment Partnership (TTIP) are newly proposed regional free trade agreements (FTAs) that are currently in the process of negotiation. TPPA is an FTA between 12 countries (including the United States and a number of Asia-Pacific countries) and TTIP is an FTA between the United States and the European Union. Countries are pushing to get these trade agreements finalized for economic reasons, but several public health stakeholders have raised serious concerns regarding how obligations in these agreements could adversely impact tobacco control efforts and access to medicines, although the potential impact on substance using populations has yet to be assessed.

² The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.