Saving Lives, Changing Minds: How Portugal is Winning the War on Drugs

Portugal has taken a bold step in its way out of the drug crisis, addressing drug use by choosing to focus on health and support instead of punishment—and the results are remarkable. Since decriminalizing drug possession in 2001, drug-related deaths have dropped sharply, HIV infections have declined, and more people are accessing support services. Portugal’s […]

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Saving Lives, Changing Minds: How Portugal is Winning the War on Drugs

Portugal has taken a bold step in its way out of the drug crisis, addressing drug use by choosing to focus on health and support instead of punishment—and the results are remarkable. Since decriminalizing drug possession in 2001, drug-related deaths have dropped sharply, HIV infections have declined, and more people are accessing support services. Portugal’s approach is inspiring a global conversation about rethinking the war on drugs, shifting focus to prioritize public health over criminalization.
A New Approach: Help Instead of Punishment
Portugal’s drug policy shifts the focus from punishment to rehabilitation. Being caught with small amounts of drugs for personal use no longer leads to arrest or imprisonment. Instead, individuals are referred to “Commissions for the Dissuasion of Drug Addiction.” These teams—composed of psychologists, social workers, and legal experts—assess the individual’s situation.
Their aim is to understand why the person uses drugs and what kind of support they need, whether that’s counseling, treatment, or social services. This innovative approach treats drug use as a health issue rather than a crime, breaking down barriers that often prevent people from seeking help.
Real Results: Fewer Deaths, Better Health
The impact of this shift has been profound. Drug-related deaths in Portugal are now among the lowest in Europe. Before decriminalization, the country faced a public health crisis, with hundreds of deaths and rising HIV rates among drug users.
Today, these numbers have dropped significantly. Portugal’s harm reduction programs, such as the distribution of clean needles and access to voluntary therapy, have played a key role in these improvements. These services reduce the risk of infections like HIV and hepatitis while encouraging people to seek help without fear of legal consequences.
Portugal’s way out of the drug crisis: Building Trust and Preventing Harm
Another critical component of Portugal’s strategy is the establishment of drug consumption rooms. These spaces allow individuals to use drugs under medical supervision, preventing overdoses and ensuring immediate medical assistance when needed. They also provide clean equipment to reduce the spread of infectious diseases and serve as entry points for people to connect with healthcare services. For many, these safe spaces are the first step toward recovery.
Problematic Drug Use and Social Factors
One of the most striking outcomes of Portugal’s policy is the decline in “problematic” drug use—defined as frequent and high-risk use. This has decreased significantly, particularly among young people. Experts attribute this to a combination of decriminalization, education, and accessible support services that are designed to tackle not just the symptoms of drug use but also the root causes.
Portugal’s strategy goes further by addressing the social and economic factors that contribute to addiction. Programs focus on reintegrating individuals into society, offering job training, housing assistance, and social support. By addressing these root causes of addiction, Portugal aims to break the cycle of addiction and improve overall well-being.
A Model for the World?
Portugal’s success is an example of how compassionate, health-focused policies can address drug issues more effectively than punishment. The combination of decriminalization, harm reduction services, and efforts to tackle underlying social issues provides a comprehensive model for sustainable change.
This approach has inspired discussions in countries worldwide. For instance, nations like Canada and Switzerland have implemented similar harm reduction measures, although on a smaller scale. Yet many countries remain hesitant, clinging to punitive measures despite mounting evidence that they are less effective.
This work is licensed under the Creative Common License. It can be republished for free, either translated or in the original language. In both cases, please cite Kontrast / Sophie Wenkel as the original source/author and set a link to this article on TheBetter.news. https://thebetter.news/portugal-drug-policy/

The rights to the content remain with the original publisher. Läs mer…

New ‘best practice’ principles for superannuation products are coming. We asked a panel of experts what should be included

We all know how important it is to save enough money for retirement – but what about spending it wisely when we get there?

Even for those who have built up a suitable nest egg, managing money well in retirement isn’t necessarily straightforward. Now, the federal government has said it wants to make it easier.

On Wednesday, Treasurer Jim Chalmers announced a broad package of reforms to the retirement phase of the superannuation system.

Key aims include expanding access to reliable information, supporting more innovation in super products, and introducing a new reporting framework focused on retirement outcomes.

There’ll also be a new set of voluntary “best practice principles” for the industry, to help it design “modern, high quality” retirement products.

Next year, the government will consult on a draft version of these principles. The Conversation asked five experts what they thought the most important focus should be.

Read more:
Chalmers targets reforms to superannuation products and transparency in the retirement phase Läs mer…

Shorten declares himself ‘a proud moderate’, saying Australians ‘in the middle’ shouldn’t be hostage to intolerant fringes

Bill Shorten has declared himself “a proud moderate” in a valedictory speech declaring parliament has the responsibility to ensure the extremes of left and right do not set the terms of political debate.

Shorten, former Labor leader and current cabinet minister, told parliament: “I reject outright the argument that being moderate is a sign of conservatism or apathy.

”You can be in the centre and be a reformer, a humanitarian, or radical in terms of your ambition to get things done for the Australian people.

”Being in the centre is an acknowledgment that Australians hold broad, diverse views. The majority in the middle should never be hostage to the intolerant few on the zealous fringe.”

Shorten retires from parliament in February to take the position of vice-chancellor of the University of Canberra. He was a minister in the former Labor government, and opposition leader from 2013-19, narrowly losing two elections. He is Minister for the National Disability Insurance Scheme and Minister for Government Services and has been devoting his efforts to getting the NDIS back on track after a huge spending blow out.

In his speech, Shorten said parliament “must rise to the big issues and engage with them thoughtfully and respectfully.

”Let’s not be a stage for noisy actors talking at each other, over each other and past each other.

”Parliament has the responsibility to ensure the extremes of the left and right do not set the terms of debate. Otherwise, the ideological trenches become deeper – and the centre ground becomes a no-man’s land”.

Shorten outlined what he saw as some key priorities for the parliament in the future, including being ambitious on climate change and tax reform.

He said the tax system still taxed property lightly and income heavily.

This meant young Australians  carried a disproportionate share of the tax burden and paid  more tax than a generation ago.

It was harder than ever for young people to save for a home, and  increasing supply was an essential  part of solving this problem, Shorten said.

“We must not become a society where  realising the dream of home ownership is dependent on having rich parents.”

Shorten also there was also unfinished business on defence and foreign policy.

“We need to develop even further our own defence capabilities within the bonds of existing alliances.

”And prioritise, even more, Australian foreign  policy with an Australian accent.”

Shorten said parliament had “unfinished business” with First Nations people, including their being recognised in the constitution.

“I remain hopeful that – with good faith on all sides – we can achieve recognition of Indigenous Australians in our nation’s birth certificate.”

He said parliament and Australians generally also had “unfinished business on equal treatment of women.

”Because there is no more shocking measure of inequality between men and women than domestic and family violence.”

Shorten urged the parliament: “Be ambitious for this place. This great democratic institution and its power to forge a path to a more productive, moderate, inclusive, compassionate and equal Australia.

”I’ll be urging you on – and wishing you well.” Läs mer…

The Conversation subsidiary Universal Impact launches newsletter for researchers – and helps evidence reach new audiences

There are so many opportunities out there for researchers – sometimes the challenge is simply knowing how to find them.

One of the most powerful things The Conversation offers academics is the chance to write articles that reach the people who will benefit most from their work – potentially changing the world for the better.

But The Conversation network can now help researchers engage with targetted audiences in other ways, too – through its wholly-owned subsidiary Universal Impact.

Founded and managed by former The Conversation Deputy Editor, Matt Warren, Universal Impact offers specialist training, mentoring and research communication services to researchers and research institutions around the world – donating its profits back to its parent charity. We also produce a weekly newsletter.

In Universal Impact’s Research Reach Roundup newsletter, I curate a handpicked a selection of the best opportunities from across the world of research, communications and policymaking.

This includes hot tips on grants, prizes, job adverts, calls for evidence, parliamentary committees, media opportunities and events – basically anything that might enable researchers to get their work talked about or in front of more key people.

Over the past year, we’ve featured almost 400 different opportunities, including many from across the rapidly growing world of artificial intelligence.

Our newsletter also provides behind the scenes updates from other parts of The Conversation “family”. And there’s been plenty to report.

In just the last few months, The Conversation has launched a new prize, developed its podcast offerings and put on some great events, including a special screening and discussion about what the new Paddington film can teach us about migration.

The extraordinary power of research

At Universal Impact, meanwhile, we’ve worked with a diverse range of research organisations, including ODI Global, The Quadram Institute, Plymouth Marine Laboratory, the Independent Social Research Foundation (ISRF) and Xi’an Jiaotong-Liverpool University (XJTLU) in China.

We’ve supported the 2024 Vitae Three Minute Thesis (3MT®) competition – a masterclass in research communications, which challenges academics to race against time to explain their work – and mingled with researchers at conferences in Brighton, York and Warsaw.

We were hosted in the Polish capital by the ISRF, which we’ve proudly partnered with to support their mission to find new solutions for today’s most pressing issues.

We’ve also provided communications and policy uptake support for the UCL-led, £4-million ESRC project, the International Public Policy Engagement Observatory (IPPO), which assesses and reports global evidence on Covid recovery, inequality and net zero for the benefit of UK policymakers.

At Universal Impact, we believe in the extraordinary power of research to shape society, the economy and policy for the better. And in 2025, we’ll be looking forward to using our communications expertise to support more experts than ever before.

If you’re a researcher or research institution and you’re interested in working together, do get in touch – or subscribe to our newsletter to find out more. Läs mer…

A new stage adaptation of Peter Carey’s Jack Maggs is a delightful homage to theatrical storytelling

Jack Maggs is a delight and a homage to theatrical storytelling in Australia.

Based on Peter Carey’s bestselling novel, Jack Maggs follows the ex-convict as he lands back in London and sets out to find his “son”. Adapted by Samuel Adamson for the State Theatre Company of South Australia, Adamson’s layered play tells the story of Maggs’ return through the eyes and perspective of Mercy Larkin, the maid.

Carey’s novel is a retelling of Dickens’ Great Expectations, so the resonances telescope further and further as we are brought into the world of Dickensian London, and its brutal counterpart in New South Wales.

Brilliantly directed by Geordie Brookman, the world he creates is lively, physically inventive and glorious. With a nod to early Australian theatre, Georgian London footlights and grime, the worlds of Sweeney Todd and Oliver Twist, Brookman’s ensemble are comic, heartbreaking, immersed and transformative.

We are never allowed to forget, however, that this is a story and in the telling, the world is all smoke and mirrors.

The world is all smoke and mirrors.
Matt Byrne/STCSA

Brookman and Adamson centre our focus on the idea of “home” and the search for that sense of homecoming within ourselves. Every person in the audience who has ever longed to go back to “the mother country”, whatever that is for them, shared in Maggs’ determination to shake off his convict past and embrace his home. Maggs however finds his home is a chimera, where he is reviled, tricked, cornered and shut out.

Actors as storytellers

The play begins with the actors as storytellers: we enter the theatre to find actors, wearing 18th century white(ish) well-worn underwear, warming up and wandering the stage.

They transform into the characters by putting on a costume item or two, tell the story, and return at the end to speak to us as actors.

By reframing the narrative as Mercy Larkin’s story, which ends up in colonial Australia, we are reminded of how many of colonial “success stories” had brutality at their start.

Ahunim Abebe is theatre magic as Mercy Larkin.
Matt Byrne/STCSA

The ensemble appear suddenly to give melodic voice to the horrors in ex-convict Maggs’ head, to sing colonial ballads and to create unsettling or comic street scenes. Brookman has them changing scenes in choreographed or cheeky movements, creating sound effects from the sides, singing in harmony, creating set pieces and staging shadow puppet plays to help tell the gothic parlour stories contained in Maggs’ story.

Ahunim Abebe is theatre magic as Mercy Larkin. She shines, sparkles and charms, moving effortlessly from knockabout nosy maid to stillness and sorrow, directly addressing the audience. Then, in a heartbeat, sitting within an intimate monologue.

Mark Saturno’s Maggs is mesmerising, unsettling and enigmatic, and one of his best performances from an impressive list of credits. His slow revelation of the layers of love and hurt beneath the formidable exterior, peeled away by Mercy’s insistence, is thrilling to watch.

Mark Saturno (centre) as Jack Maggs is mesmerising, unsettling and enigmatic.
Matt Byrne/STCSA

Theatre icon Jacqy Phillips is wonderful as Old Mercy, Ma Britten and Mrs Halfstairs. She revels in the physicality and vocal qualities of each character. You can’t take your eyes off her; it is a joy to see her on stage.

Dale March, Nathan O’Keefe, Rachel Burke and Jelena Nicdao are all excellent, multitalented performers. They find depth, humour, pathos and comedy in their contrasting characters, seamlessly moving from scene to scene and story to story. O’Keefe’s physical comedy as the spineless Percy Buckle is masterful.

As the Dickens figure Tobias Oates, James Smith revels in the desperate and social-climbing writer, thoroughly enjoying the morally murky depths of Carey’s “story thief”. His “mesmerist” scenes with Maggs, where he records the convict’s story without his knowledge, are horrific while entrancing. The writer’s obsession is palpable.

The use of what’s to hand

Dominating the stage is a massive patched curtain, reminiscent of a much-mended sail from a tall ship. Raised on command at the beginning of the play, it creates backdrops for rooms, walls of streets and houses, and the shadow puppet screen.

The use of “what is to hand” to make costumes, sets and character reminds us Australian theatre itself started with convicts (a production of The Recruiting Officer in 1789).

Ailsa Paterson’s detailed design is a symphony of the “mend and make do” reality of both the penal colony and of theatre: old, patched once-grand costumes are hitched, tied, bunched and tacked on in a delicious riot of theatrical invention.

Ailsa Paterson’s detailed design is a symphony of ‘mend and make do’.
Matt Byrne/STCSA

The audience willingly colludes in the suspension of disbelief to create the characters’ finery and the set: hanging garments from a large Georgian furniture frame become curtains in a coach, cupboard doors become front doors, desks and chairs whisk past stationary characters to show the passing of time.

Nigel Levings’ detailed and rich lighting design wonderfully invokes the grimy, fog-filled streets, Maggs’ sudden pain and nightmare voices, storms, stuffy genteel houses, and candlelit drawing rooms.

Nigel Levings’ lighting design wonderfully invokes the grimy, fog-filled streets.
Matt Byrne/STCSA

Music elements are woven throughout, expertly set and arranged by Hilary Kleinig. The use of colonial ballad-style singing, using words from Maggs’ story as lyrics, is inspired.

Opening night of Jack Maggs was on International Men’s Day. The juxtaposition of a play about a man by a man, based on a book by a man, in response to a book about a man, by a man, meant centring the story as Mercy Larkin’s – without developing her story or character except in relation to Maggs’ – wasn’t quite enough to address gender imbalance in this particular story.

It is nonetheless an impressive production. Jack Maggs is energised, playful, multi-layered theatre; so thoroughly enjoyable that, at interval, I wanted to go back in and see the first half again.

Jack Maggs is at the State Theatre Company of South Australia until November 30. Läs mer…

7 things you can do if you think you sweat too much

Sweating is our body’s way of cooling down, a bit like an internal air conditioner.

When our core temperature rises (because it’s hot outside, or you’re exercising), sweat glands all over our skin release a watery fluid. As that fluid evaporates, it takes heat with it, keeping us from overheating.

But sweating can vary from person to person. Some people might just get a little dewy under the arms, others feel like they could fill a swimming pool (maybe not that dramatic, but you get the idea).

So what’s a normal amount of sweat? And what’s too much?

Why do some people sweat more than others?

How much you sweat depends on a number of factors including:

your age (young kids generally sweat less than adults)
your sex (men tend to sweat more than women)
how active you are.

The average person sweats at the rate of 300 millilitres per hour (at 30°C and about 40% humidity). But as you can’t go around measuring the volume of your own sweat (or weighing it), doctors use another measure to gauge the impact of sweating.

They ask whether sweating interferes with your daily life. Maybe you stop wearing certain clothes because of the sweat stains, or feel embarrassed so don’t go to social events or work.

If so, this is a medical condition called hyperhidrosis, which affects millions of people worldwide.

People with this condition most commonly report problematic armpit sweating, as you’d expect. But sweaty hands, feet, scalp and groin can also be an issue.

Hyperhidrosis can be a symptom of another medical condition, such as an overactive thyroid, fever or menopause.

But hyperhidrosis can have no obvious cause, and the reasons behind this so-called primary hyperhidrosis are a bit of a mystery. People have normal numbers of sweat glands but researchers think they simply over-produce sweat after triggers such as stress, heat, exercise, tobacco, alcohol and hot spices. There may also be a genetic link.

OK, I sweat a lot. What can I do?

1. Antiperspirants

Antiperspirants, particularly ones with aluminium, are your first line of defence and are formulated to reduce sweating. Deodorants only stop body odour.

Aluminum chloride hexahydrate, aluminium chloride or the weaker aluminum zirconium tetrachlorohydrex glycinate react with proteins in the sweat glands, forming a plug. This plug temporarily blocks the sweat ducts, reducing the amount of sweat reaching the skin’s surface.

These products can contain up to 25% aluminium. The higher the percentage the better these products work, but the more they irritate the skin.

Make sure you’re buying antiperspirant and not deodorant.
Okrasiuk/Shutterstock

2. Beat the heat

This might seem obvious, but staying cool can make a big difference. That’s because you have less heat to lose, so the body makes less sweat.

Avoid super-hot, long showers (you will have more heat to loose), wear loose-fitting clothes made from breathable fabrics such as cotton (this allows any sweat you do produce to evaporate more readily), and carry a little hand fan to help your sweat evaporate.

When exercising try ice bandanas (ice wrapped in a scarf or cloth, then applied to the body) or wet towels. You can wear these around the neck, head, or wrists to reduce your body temperature.

Try also to modify the time or place you exercise; try to find cool shade or air-conditioned areas when possible.

If you have tried these first two steps and your sweating is still affecting your life, talk to your doctor. They can help you figure out the best way to manage it.

3. Medication

Some medications can help regulate your sweating. Unfortunately some can also give you side effects such as a dry mouth, blurred vision, stomach pain or constipation. So talk to your doctor about what’s best for you.

Your GP may also refer you to a dermatologist – a doctor like myself who specialises in skin conditions – who might recommend different treatments, including some of the following.

4. Botulinum toxin injections

Botulinum toxin injections are not just used for cosmetic reasons. They have many applications in medicine, including blocking the nerves that control the sweat glands. They do this for many months.

A dermatologist usually gives the injections. But they’re only subsidised by Medicare in Australia for the armpits and if you have primary hyperhidrosis that hasn’t been controlled by the strongest antiperspirants. These injections are given up to three times a year. It is not subsidised for other conditions, such as an overactive thyroid or for other areas such as the face or hands.

If you don’t qualify, you can have these injections privately, but it will cost you hundreds of dollars per treatment, which can last up to six months.

Injections are available on Medicare in some cases.
Satyrenko/Shutterstock

5. Iontophoresis

This involves using a device that passes a weak electrical current through water to the skin to reducing sweating in the hands, feet or armpits. Scientists aren’t sure exactly how it works.

But this is the only way to control sweating of the hands and feet that does not require drugs, surgery or botulinum toxin injections.

This treatment is not subsidised by Medicare and not all dermatologists provide it. However, you can buy and use your own device, which tends to be cheaper than accessing it privately. You can ask your dermatologist if this is the right option for you.

6. Surgery

There is a procedure to cut certain nerves to the hands that stop them sweating. This is highly effective but can cause sweating to occur elsewhere.

There are also other surgical options, which you can discuss with your doctor.

7. Microwave therapy

This is a newer treatment that zaps your sweat glands to destroy them so they can’t work any more. It’s not super common yet, and it is quite painful. It’s available privately in a few centres. Läs mer…

The government has introduced laws for its social media ban. But key details are still missing

The federal government today introduced into parliament legislation for its social media ban for people under 16 years.

Communications Minister Michelle Rowland said:

This is about protecting young people, not punishing or isolating them, and letting parents know we’re in their corner when it comes to supporting their children’s health and wellbeing.

Up until now details of how the ban would actually work have been scarce. Today’s bill provides a more complete picture.

But many ambiguities – and problems – still remain.

What’s in the bill?

Today’s bill is an amendment of the Online Safety Act.

It introduces a new definition for an “age-restricted social media platform” whose sole or significant purpose is to enable users to post material online and interact socially with other users.

This includes platforms such as Facebook, Instagram, TikTok and Snapchat, but also many more minor platforms and services. It includes an exclusion framework that exempts messaging apps such as WhatsApp, online gaming platforms and services with the “primary purpose of supporting the health and education of end-users” (for example, Google Classroom).

The bill will attempt to force owners of newly defined age-restricted platforms to take “reasonable steps” to prevent people under 16 from having a user account. This will include young people who have an existing account. There are no grandfather provisions so it is unclear how platforms will be required to manage the many millions of existing users who are now set to be excluded and deplatformed.

The bill is also vague in specifying how social media platforms must comply with their obligation to prevent under 16s from having an account – only that it “will likely involve some form of age assurance”.

Oddly, the bill won’t stop people under 16 from watching videos on YouTube or seeing content on Facebook – it is primarily designed to stop them from making an account. This also means that the wider ecology of anonymous web-based forums, including problematic spaces like 4chan, are likely excluded.

Age-restricted platforms that fail to prevent children under 16 accessing their platforms will face fines of nearly A$50 million.

However, the government acknowledges that it cannot completely stop children under 16 from accessing platforms such as Instagram and Facebook.

Australia should be prepared for the reality that some people will break the rules, or slip through the cracks.

The legislation will take effect “at least” 12 months after it has passed parliament.

Minister for Communications Michelle Rowland introduces the Online Safety Amendment (Social Media Minimum Age) Bill in the House of Representatives at Parliament House.
Mick Tsikas/AAP

How did we get to this point?

The government’s move to ban under 16s from social media – an idea other countries such as the United Kingdom are now considering – has been heavily influenced by News Corp’s “Let Them Be Kids” campaign. This campaign included sensitive news reports about young people who have used social media and, tragically, died by suicide.

The government has also faced pressure from state governments and the federal opposition to introduce this bill.

The New South Wales and South Australian governments last month held a summit to explore the impact of social media on the mental health of young people. However, Crikey today revealed that the event was purposefully set up to create momentum for the ban. Colleagues who attended the event were shocked at the biased and unbalanced nature of the discussion.

The announcement and tabling of the bill today also preempts findings from a parliamentary inquiry into the impact of social media on Australian society. The inquiry only tabled its report and recommendations in parliament this week. Notably, it stopped short of recommending a ban on social media for youth.

There are evidence-based alternatives to a ban

The government claims “a minimum age of 16 allows access to social media after young people are outside the most vulnerable adolescent stage”.

However, multiple experts have already expressed concerns about banning young people from social media platforms. In October more than 140 experts, me included, wrote an open letter to Prime Minister Anthony Albanese in which we said “a ‘ban’ is too blunt an instrument to address risks effectively”.

The Australian Human Rights Commission has now added its voice to the opposition to the ban. In a statement released today it said:

Given the potential for these laws to significantly interfere with the rights of children and young people, the Commission has serious reservations about the proposed social media ban.

In its report, the parliamentary inquiry into the impact of social media on Australian society made a number of recommendations to reduce online harm. These included introducing a “duty of care” onto digital platforms – a measure the government is also moving ahead with, and one which is more in line with best evidence.

The inquiry also recommended the government introduce regulations which ensure users of social media platforms have greater control over what content they see. This would include, for example, users having the ability to change, reset, or turn off their personal algorithms.

Another recommendation is for the government to prioritise the creation of the Children’s Online Privacy Code. This code will better protect the personal information of children online.

Taken together, the three measures above manage the risks and benefits of children’s digital media. They build from an evidence base, one that critically includes the voices and perspectives of children and parents. The concern then is how a ban undermines these efforts and possibly gives platforms a hall pass to avoid obligations under these stronger media policies. Läs mer…

Phenergan for under 6s is now banned due to hallucination fears. Here’s what to use instead

Australia’s drug regulator has issued a safety warning over the medicine Phenergan and related products containing the antihistamine drug promethazine.

The Therapeutic Goods Administration said the over-the-counter products should not be given to children under six due to concerns of serious side effects including hyperactivity, aggression and hallucination. Breathing can also become slow or shallow, which can be fatal.

When high doses are given, young children may also experience difficulties in learning and understanding, including reversible cognitive deficit and intellectual disability, the TGA said.

The latest alert follows international and Australian concerns about the medicine in young children, which is commonly used to manage conditions such as hay fever and allergies, travel sickness and for short-term sedation.

What is promethazine?

Promethazine is a “first generation” antihistamine that has been sold over the counter at pharmacies in Australia for decades for a range of conditions.

Unlike many other drugs, first generation antihistamines can cross the blood-brain barrier. This means they affect brain chemistry, resulting in people feeling drowsy and sedated.

In adults this may be useful to bring on sleep. But in children, these drugs can have serious side effects on the nervous system, including those listed in this week’s safety alert.

We’ve known about this for a while

We’ve known about the serious side effects of promethazine in young children for some time.

Advice about 20 years ago in the United States was not to use the drug in children under two years of age. In 2022, the Australian Advisory Committee on Medicines issued its own recommendation to increase the age to six. New Zealand issued a similar warning and advice in May this year.

Over the past ten years, 235 cases of severe side effects to promethazine in both children and adults have been reported to the TGA. From the 77 reported deaths, one was a child under six.

The reported side effects for both adults and children included:

13 cases of accidental overdose (which resulted in 11 deaths)
eight cases of hallucination
seven cases of slow or shallow breathing (which resulted in four deaths)
six cases of lowered consciousness (which resulted in five deaths).

The TGA’s safety alert comes after an internal investigation by the manufacturer of Phenergan, Sanofi-Aventis Healthcare. This investigation was prompted by the 2022 advice from the Advisory Committee on Medicines. The company has now updated its information for consumers and health professionals.

What can you use instead?

For allergies or hay fever in young children, non-sedating antihistamines such as Claratyne (loratadine) or Zyrtec (cetirizine) are preferred. They offer relief without the risks of sedation and the other worrying side effects of promethazine.

For cold or cough symptoms, parents should be reassured these typically get better with time, fluids and rest.

Saline nasal sprays, adequate hydration, a humidifier, or elevating the child’s head can alleviate congestion associated with hay fever. Oral phenylephrine products, marketed for nasal congestion, should be avoided, as evidence shows they are ineffective, but nasal spray formulations of the drug are fine to use.

For fever or discomfort, paracetamol remains a safer choice.

What else can I do?

If you have a bottle of Phenergan or a related product, avoid tipping the medicine down the sink or throwing the bottle in the bin, as this can harm the environment. Instead, return it to the pharmacy for safe and responsible disposal.

A pharmacist can also advise on choosing the most appropriate treatments for your child, and knowing when to seek medical attention.

If your child has concerning side effects from taking promethazine, or any other medicine, call the Poisons Information Centre immediately on 13 11 26. In an emergency in Australia, call 000. Läs mer…

Indonesian social forestry often excludes women from decisions, risking greater inequality

Our analysis of Indonesia’s social forestry permits shows that women remain underrepresented in forest management bodies despite efforts to boost their presence, leaving them out of decisions about their forests.

Social forestry redistributes forest management rights to local communities to advance sustainability and local livelihoods. In 2021, the country revised its social forestry regulations to allow one family representative to participate in social forestry management bodies, ‘giving equal opportunity to both men and women.’

However, our analysis of 400 most recent social forestry permit documents, combined with extended, multi-method field research at four sites, shows that women are often excluded from management bodies but are more involved in social forestry business groups (Kelompok Usaha Perhutanan Sosial or KUPS). These groups focus on the processing and sale of forest products.

This low level of participation in management excludes women from decisions about who receives benefits such as land for cultivation, seedlings, equipment, extension training, and technical information provided by the government and NGOs. The absence of women’s presence may deepen local inequalities and hamper effective forest management.

Gender gaps in social forestry

We reviewed the 400 most recent decree letters issued in 2024 that granted forestry management rights. These included 100 permits each for the managements of Village Forests (Hutan Desa) and Community Forests (Hutan Kemasyarakatan) and their respective KUPS (Table 1). Village Forests are rights collectively held and managed by village administrations, while Community Forests are issued to specific farmer or community groups.

Our analysis found that across Indonesia women are often underrepresented in management groups. On average, only 19.54% of members in Village Forest’s management bodies were women, with participation ranging from none to 80%. This number was even lower in Community Forests, averaging 13.95% women, with some groups having no female members and others up to 56.52%.

However, the available data often lacked details about gender in KUPS-related decrees. Only 19 of 100 Village Forests’ KUPS decrees and 23 of 100 Community Forests’ KUPS decrees included this information.

When gender data was included, women were more involved in KUPS of Village Forests, with an average of 46.32% participation. In contrast, their participation in Community Forests’ KUPS was just 13.06%.

These numbers show that progress in gender representation in Indonesia’s social forestry is mixed. While women are more active in economic activities linked to KUPS, they are still sidelined in formal management roles and decision-making.

Understanding uneven participation

Our field research also highlighted how women and men are participating in, and deriving benefits from, social forestry in Indonesia, while exploring factors influencing women’s (and men’s) involvement.

We focused on four social forestry sites — two Village Forests (Sintang; West Kalimantan province, and Muara Enim; South Sumatra province) and two Community Forests (Gunungkidul; Special Region of Yogyakarta, and Enrekang; South Sulawesi province). We selected sites that reflect different levels of women’s participation.

Table 2 highlights a disparity: while women actively engage in forest land use — such as collecting and processing non-timber forest products and cultivating social forestry land — in two sites (Enrekang and Muara Enim) they are not involved in management bodies where decisions about land use, forest resources and benefit distribution are made.

For example, Masna (pseudonym), a farmer and forest user from Enrekang, shared that her involvement in her village’s forest management body (Kelompok Tani Hutan) was limited to preparing snacks while men made decisions.

Why does this happen?

Deeply rooted gender norms significantly limit women’s involvement in social forestry in some sites. These norms often designate unpaid household and care-giving duties to women, positioning men as the primary decision-makers. This affects women’s confidence and participation in village meetings, where forest management decisions are made reduce women’s participation.

Our findings align with earlier studies showing how gender roles, influenced by discourse promoted by the New Order regime, continue to shape these practices of recognising men as breadwinners and landowners, reinforcing their dominance in formal discussions and decision-making bodies.

Although there are no educational requirements for joining social forestry, research shows that those with more education tend to have more influence. In our study, women in social forestry households averaged fewer years of education (6.6 years) compared to men (8.1 years). Lower education levels, socio-economic challenges, and low confidence in public forums, where education often boosts credibility, can further exclude women.

Geographic barriers such as remote forest locations, rough terrain, and poor roads also hinder women’s participation, making travel difficult and limiting their ability to be involved.

Assistance helps, as do local women leaders

In the Sintang and Gunungkidul sites, women have taken on greater roles in forest management bodies.

In Sintang, support from the Indonesian NGO PUPUK (Association for the Improvement of Small Business) significantly boosted women’s participation in the village forest management body. PUPUK facilitated discussions, provided training at convenient times for women, and encouraged male leaders to back greater female involvement. The number of female members increased from just one in 2018 to 12 women and nine men in a newly formed management body in 2022.

The Tapang tree, sacred in Sintang, West Kalimantan, supports bee nests, providing honey as a vital livelihood source.
Author provided (no reuse)

The social forestry group in Gunungkidul – initially a male-dominated, government-led reforestation project – evolved into a community-driven initiative with strong female leadership. Support from both government and NGOs enabled women to take more active roles in forestry and agriculture, especially as many men (and some women) left to seek work elsewhere.

A university-educated woman now leads this group and has inspired younger women to join forest management and KUPS activities. These include producing traditional herbal drinks (wedang uwuh) and making snacks from taro, cassava, and arrowroot grown on forest land.

Across the study sites, women involved in KUPS have developed skills in forest management, financial planning, product processing, and marketing, earning modest incomes. These activities have also shifted gender roles. For example, in Sintang, when Mirna (pseudonym) became head of the KUPS, her husband started taking on domestic chores like cooking and childcare to support her work.

What’s next?

Tackling gender disparities in social forestry requires targeted policies to ensure women’s voices, especially from marginalised groups, are heard in decision-making processes that affect their livelihoods and access to resources.

Introducing quotas or affirmative measures for forest management bodies can help close the gender gap and ensure more equitable benefit distribution. Evidence from other Global South regions suggests that at least 30% female representation in forest management bodies is necessary for meaningful participation, enabling women to influence decisions more effectively.

Inclusive governance also depends on fair representation of different ethnic and socio-economic groups, particularly poorer households. When disadvantaged groups are poorly represented, the distribution of benefits suffers, limiting the equitable flow of resources and opportunities.

Partnerships with NGOs and civil society groups skilled in addressing gender differences can empower women and marginalized men with the skills and confidence needed to engage in decision-making bodies.

Creating safe spaces is also vital. This includes holding gender-specific discussions in local languages at times that fit with both women’s and men’s schedules.

The government must also commit to regularly monitoring women’s participation by collecting and publishing accurate gender-disaggregated data, specific to each site and region.

A decree issued by Ministry of Environment and Forestry in August introduces a policy shift that allows individuals — not just groups — to apply for social forestry. This could boost women’s participation, provided targeted support helps them step into leadership roles. Without this backing, the risk remains that social forestry will continue to be dominated by elite men.

Rahpriyanto Alam Surya Putra, the director of The Asia Foundation’s Environmental Governance program in Indonesia, and Ike Sulistiowati, Director of PUPUK Indonesia, contributed to this study. Läs mer…