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Psychedelic Science Conference Examines MDMA Treatment for PTSD [FEATURE]

At the Multidisciplinary Association for Psychedelic Studies (MAPS) Psychedelic Science 2013 conference in Oakland this weekend there were mind-boggling displays of psychedelic art; tables full of books on LSD, MDMA, peyote, ayahuasca, and other, stranger hallucinogens; weird musical interludes; holotropic breathwork workshops, and indigenous shamans.

Psychedelic art, MAPS 2013
There was also some heavy duty science. Stretching over five days of workshops and conference presentations, the MAPS conference is perhaps the premier confab of psychedelic researchers worldwide. A look at just some of the topics covered in the remarkably broad-ranging affair makes that case.

Researchers from around the country and the world presented findings on three "tracks": clinical ("LSD-Assisted Psychotherapy in the Treatment of Anxiety Secondary to Life Threatening Illness," "The Neurobiology of Psychedelics: Implications for Mood Disorders"), interdisciplinary ("Psilocybin in the Treatment of Smoking Addiction: Psychological Mechanisms and Participant Account," "Ethical Considerations in the Medicinal Use of Psychedelics"), and a special track on the South American hallucinogenic tea, ayahuasca ("Ayahuasca Admixture Plants: An Uninvestigated Folk Pharmacopeia," "Ayahuasca, the Scientific Paradigm, and Shamanic Healing").

One series of research reports of urgent and immediate relevance centered on the use of MDMA ("ecstasy") in the treatment of Post-Traumatic Stress Disorder (PTSD). Although PTSD can be caused by any number of traumas, veterans mustering out after more than a decade of US wars in Iraq and Afghanistan are coming home with PTSD in record numbers. A 2004 study in the New England Journal of Medicine estimated that 18% of returning Iraq combat veterans had PTSD. And a 2008 RAND Corporation report estimated that up to 225,000 veterans will return from the wars with PTSD.

Dr. Michael Mithoefer describes his MDMA PTSD research protocol
The trauma of war is reflected not only in the number of vets suffering from PTSD, but even more ominously, in sky-high suicide rates. US military veterans are committing suicide at a rate of 22 per day, up 20% from just five years ago.

The military and public health workers are keenly aware of the problem, and are attempting to address it through means both conventional and unconventional. The military and the Veterans Administration have been opened to therapeutic interventions including yoga, meditation, and the use of companion dogs; they have also armed themselves with the arsenal of psychotherapeutic drugs -- anti-depressants, anti-psychotics, tranquilizers -- available in the standard pharmacopeia. But those drugs can have some nasty side effects, and their utility in treating PTSD is questionable, and, noting reports of negative consequences, the Army has warned against over reliance on them.

In a Saturday clinical track devoted to MDMA and PTSD, researchers reported on success in Phase II clinical trials (after Phase I studies had proven safety), as well as efforts to get more studies up and running, and the hoops they have to jump through to do so. Canadian researcher Andrew Feldmar perhaps best summed up professional exasperation with the complexities of doing research on drugs governments view with skepticism and suspicion.

"Give me a break!" snorted Feldmar after relating how it took 2 ½ years and three visits from bureaucrats in Ottawa to inspect his pharmacy safe before it was approved before the safe and the study were approved. "This is not science, its politics. Those people from Ottawa were doing what power does -- cover its ass and make people doing what it doesn't want squirm. We are not discovering anything with these studies; we are just proving something we already know. This is all politics."

Indigenous Huichol shaman from Mexico
While Feldmar was at least able to report that his study had been approved, researchers in Australia and England could report no such luck.

 Australian researcher Martin Williams reported that a randomized, double-blind Phase II study there had been stopped in its tracks by a Human Research Ethics Committee.

"The proposal was rejected by the committee with no correspondence," Williams sighed. "We submitted a comprehensive letter of appeal, and it was quickly rejected. Like MAPS in 2000, we're a bit ahead of our time for Australia, where we face war on drugs rhetoric, the psychotherapy community has more a psychopharmacology focus, and we're facing funding and regulatory hurdles."

"For the past eight years, I've been slowly trying to persuade the medical establishment this is worth doing," said British researcher Ben Sessa, who is trying to get a Phase II study off the ground there. "We have lots of war casualties because like the USA, we have a peculiar obsession with imposing democracy around the world."

Peyote-infuenced Huichol art
But his government grant was denied, with regulators saying there was insufficient proof of concept, the trial would be underpowered (because it was small), and the inclusion of patients with recreational drug histories was problematic.

"Those reasons are all rubbish," snorted Sessa, who said he was revising his protocol in hopes of it being accepted. "We went for the Rolls Royce and didn't get it; maybe we'll get the Skoda," he said.

Researchers at the University of Colorado in Boulder have gotten approval for a Phase II study of MDMA with people with chronic, treatment-resistant PTSD, but it wasn't easy. Sometimes the regulatory niggling borders on the absurd, they said.

"We started two years and were waiting on approval from the DEA," said researcher Marcela Ot'alora, who is doing the study with Jim Grigsby. "We thought they read the protocol and would let us know if we were doing something inappropriate, but that wasn't the case. We had to get a 500-pound safe and we put it in the therapists' office, but no, it had to be in the treatment room. Then, we get a second inspection by the DEA, and they said we had to install alarms. We did so, and thought we were good to go. The next day, the DEA and the city zoning department came together. The zoning department said we had to have a half bath instead of a full bath, and no kitchen."

Psychedelic Homer Simpson, MAPS 2013
Ot'alora showed slides of workers obediently demolishing the bath tub, but their travails weren't finished just yet.

"The zoning department said we had to find a place zoned for addiction and recovery, and my office met that criteria, so we moved the safe and alarms for a third time, then had a third DEA inspection," she related. "The local DEA said yes, but it also needed approval from headquarters. We had a congressman write a letter to the DEA to speed up the process, and now we have final approval and are screening our first participants. We hope to enroll the first one by the beginning of May."

That would appear to be a good thing, because other researchers reported that when they actually got studies up and completed, they were seeing good results. Israeli researcher Keren Tzarfatyl and Swiss researcher Peter Oohen both reported promising preliminary results from their studies.

But it was US researchers Michael and Annie Mithoefer who reported the most impressive results. They reported on a 2004 Phase II clinical trial with veterans, firefighters, and police officers. The research subjects were given MDMA (or a placebo) and psychotherapy sessions. MDMA-assisted therapy resulted in "statistically significant" declines in PTSD as measured by standard scales, the Mithoefers reported.

"We're doing Phase II studies, giving the substance to people who are diagnosed with PTSD and measuring the treatment effects. The results continue to be extremely impressive," said Michael Mithoefer. "These tools have so much promise for healing and growth. There are lots of reasons to think these will be useful and promising tools."

Existing treatments for PTSD -- cognitive-behavioral therapies, psychodynamic psychotherapies, pharmacological interventions -- too often just don't work for large numbers of sufferers, Mithoefer said. He cited estimates of 25% to 50% who don't respond favorably to existing treatments.

"We have looming problems with veterans coming back from Iraq and Afghanistan, and most of them are not getting the treatment they need," said Mihoefer. "The Veterans Administration is overwhelmed, but also many vets just don't show up for treatment or stay in it. People with PTSD have a lot of trouble with trust, making it hard to form a therapeutic alliance. They can also either be overwhelmed by emotion and then drop out, or they are in avoidance, emotionally numb, and then the therapy doesn't work. If MDMA can increase trust and decrease fear and defensiveness, maybe it can help overcome these obstacles to successful treatment."

But even so, the research effort is starved for funds.

"This would not be happening if not for these remarkable non-profits supporting research," said Mithoefer, referring to groups like MAPS and the Beckley Foundation, which co-hosted the conference. "The government is not funding this, Big Pharma isn't funding this; the community is funding it. We are trying to build bridges, not be a counterculture, and we hope the government will get involved."

What they've found so far is definitely worth pursuing, Mithoefer said.

"We've established that for this kind of controlled use with well-screened people, there is a favorable risk-benefit ratio and no indication of neurotoxicity," he explained, although a small numbers of participants reported unhappy side effects, such as anxiety (21%), fatigue (16%), nausea (8%), and low mood (2%).

With a follow-up three years later, the Mithoefers found that the benefits of MDMA-assisted therapy remained largely intact.

"For most people, the benefits in terms of PTSD symptoms were maintained," Mithoefer reported. "With people who completed the assessment, 88% showed a sustained benefit, and assuming that those who didn't relapsed, that's still a 74% sustained benefit."

The Midhoefers are now in the midst of another Phase II study and are finding similar results.  They are finding reductions in PTSD symptoms as measured by standard measures. They are also finding lots of interest among PTSD sufferers.

"More than 400 vets have called us from around the country," said Mithoefer. "The need is so great. It's heartbreaking that we can't accommodate them all."

Anna Mithoefer read to the audience some of the responses from their research subjects.

"It's like PTSD changed my brain, and MDMA turned it back," reported a 26-year-old Iraq veteran.

"Being in Iraq was bad, but what was worse was having my body back here and part of my mind still in Iraq," said a 27-year-old who had served as a turret gunner in Iraq. "This helped me come home."

"MDMA helped me in so many ways, it feels like it is gradually rewiring my brain," said a female military sex trauma survivor. "The MDMA sessions were the crack in the ice because the trauma was so solid before that. It was incredibly intense around the MDMA sessions -- a lot like popping a big bubble from the unconscious."

The Phase II studies underway or completed strongly suggest that MDMA is useful in the treatment of PTSD. The Phase II studies trying to win approval around the world could strengthen that case -- if they can overcome the political and regulatory obstacles before them. In the meantime, another 22 veterans are killing themselves each day.

Oakland, CA
United States

Modest Changes in Obama's FY 2014 Drug Budget

The Obama administration released its Fiscal Year 2014 budget proposal Wednesday, including its 2014 federal drug budget. Pundits and politicians on both sides of the aisle quickly pronounced the Obama budget dead on arrival, but it does provide both a window into administration thinking on drug policy and a starting point for negotiations.

Obama's 2014 drug budget came out Wednesday. (whitehouse.gov)
There's not much new. The historic 2:1 ratio between law enforcement and interdiction spending and treatment and prevention spending, representing what critics have long called an over-reliance on enforcement, is slightly attenuated. The Obama 2014 drug budget allocates 58% of spending to enforcement vs. 42% to treatment and prevention. It is a slight improvement over the FY 2013 drug budget, where the figures were 62% and 38% -- starting to climb away from 2:1, if it continues, but not dramatically.

In a post on its web site, the Office of National Drug Control Policy's Rafael Lemaitre writes that treatment and prevention spending now tops domestic law enforcement spending, and "that's what a 21st Century approach to drug policy looks like," but that post does not include interdiction and international drug enforcement spending. When those are included, the Obama drug budget is clearly weighted on the side of law enforcement -- very much what a late 20th Century drug policy looked like.

Still, the budget calls for an 18% increase in treatment funding, and cuts in interdiction and international enforcement funding, as welling as reducing funding for the High Intensity Drug Trafficking Area (HIDTA) program, which generates ever more drug arrests working with state and local drug task forces. But spending for both the DEA and Bureau of Prisons is going up, and that raised the hackles of one drug reform activist.

"The administration deserves some credit for moving this ratio slightly in the right direction over the years, but a drug control budget that increases funding for the DEA and the Bureau of Prisons is simply not the kind of strategy we need in the 21st Century," said Tom Angell, spokesman for the Marijuana Majority. "At a time when a majority of Americans support legalizing marijuana, and states are moving to end prohibition, this president should be spending less of our money paying narcs to send people to prison, not more. If, as administration officials say, 'we can't arrest our way out of the drug problem,' then why are they continuing to devote so many resources to arresting people for drug problems?"

The administration also deserves "some credit" for reducing HIDTA funding, said Angell, but "still $193 million for the program is $193 million more than should be used to arrest people for drugs in the 21st Century."

Is the International Narcotics Control Board Ignoring Human Rights?

A recent report by the UN special rapporteur on torture charged that compulsory drug treatment centers in some countries, particularly Vietnam and Thailand, constitute "forced labor" camps that engage in "torture." Long-time addiction writer Maia Szalavitz wrote about this in Time last week, and Phil did in our newsletter last Monday. The report is online here.

photo from the 2011 HRW report on Vietnam's so-called drug rehabilitation centers
The issue is not a new one, having been raised by Human Rights Watch in September 2011. HRW detailed forced labor, worker pay getting taken by the centers or staffs, inmates getting beaten, even bones broken, if they didn't comply with instructions.

Nevertheless, in its 2011 annual report, published five months after HRW's, the International Narcotics Control Board had only this to say in relation to Vietnam's treatment centers:

In September 2010, the Government of Viet Nam issued a decree on the strengthening of family-based and community-based drug treatment and rehabilitation services. In March 2011, the Ministry of Public Security of Viet Nam adopted measures to improve the collection and analysis of drug-related data. In June 2011, the Government of Viet Nam adopted the national strategy on drug control and prevention for the period ending in 2020. Based on that strategic document, the national target programme for the period 2011-2015 was developed to address drug-related issues in the country.
 

and

The Board welcomes the steps taken in Viet Nam to improve the treatment and rehabilitation of drug abusers and the efforts made in participating in different projects sponsored by [the UN Office on Drugs and Crime, UNODC] in that area. The Board encourages the Government to reinforce and support existing facilities as well as to undertake capacity-building in the field of treatment for drug abusers.
 

The 2012 INCB report, released last week -- more than a month after the special rapporteur's report was released -- offers just this:

The Government of Viet Nam launched its new national drug control and crime prevention strategies in July 2012. The strategies highlight the need for a comprehensive national response that combines effective law enforcement, drug abuse treatment and rehabilitation measures that allow for better integration of former drug dependent persons into society and the active participation of communities in crime prevention.
 

I understand that any system involving confinement has the potential for abuse, in the best of times and places, and that any one report on a subject can miss the mark. But we have allegations from a respected organization, and now from the UN itself, of systemic abuses, of a degree of seriousness that would seem to invalidate the entire project. Presumably international funding is in the mix at well. So why not even a word about it, from the self-described "quasi-judicial body" overseeing the international drug control regime?

Open Society Foundation's Joanne Csete noted comments by the late Hamid Ghodse, then INCB chairman, at the Commission on Narcotic Drugs last year, disclaiming any role for human rights concerns in the drug treaties or his agency. But that is not the stated position of the other main UN drug agency, UNODC.

So do we have a scandal in the making -- or better yet, an opportunity to reform the international drug control regime?

[By the way, Csete's afore-linked essay is part of the LSE IDEAS report included in our current membership offers.]

UN Report Slams Cruel Drug Treatment as "Torture"

Compulsory "treatment" for drug addiction in some parts of the world is "tantamount to torture or cruel, inhuman or degrading treatment," according to report last month from the UN's special rapporteur on torture and other degrading treatments and punishments. The report was delivered to the Office of the UN High Commissioner for Human Rights in Vienna.

drug "rehabilitation center," Vietnam (ohchr.org)
Authored by Special Rapporteur Juan Mendez, the report takes special aim at forced "rehabilitation centers" for drug users. Such centers are typically found in Southeast Asian states, such as Vietnam and Thailand, as well as in some countries in the former Soviet Union. But the report also decries the lack of opiate substitution therapies in confinement setting and bemoans the lack of access to effective opioid pain treatment in large swathes of the world.

"Compulsory detention for drug users is common in so-called rehabilitation centers," Mendez wrote. "Sometimes referred to as drug treatment centers or 'reeducation through labor' centers or camps, these are institutions commonly run by military or paramilitary, police or security forces, or private companies. Persons who use, or are suspected of using, drugs and who do not voluntarily opt for drug treatment and rehabilitation are confined in such centers and compelled to undergo diverse interventions."

The victims of such interventions face not only drug withdrawal without medical assistance, but also "state-sanctioned beatings, caning or whipping, forced labor, sexual abuse, and intentional humiliation," as well as "flogging therapy," "bread and water therapy," and forced electroshock treatments, all in the name of rehabilitation.

As Mendez notes, both the World Health Organization (WHO) and the UN Office on Drug Control (UNODC) have determined that "neither detention nor forced labor have been recognized by science as treatment for drug use disorders." Such forced detentions, often with no legal or medical evaluation or recourse, thus "violate international human rights law and are illegitimate substitutes for evidence-based measures, such as substitution therapy, psychological interventions and other forms of treatment given with full, informed consent."

Such centers continue to operate despite calls to close them from organizations including the WHO, the UNODC, and the UN Commission on Narcotic Drugs. And they are often operating with "direct or indirect support and assistance from international donors without adequate human rights oversight."

Drug users are "a highly stigmatized and criminalized population" who suffer numerous abuses, including denial of treatment for HIV, deprivation of child custody, and inclusion in drug registries where their civil rights are curtailed. One form of ill-treatment and "possibly torture of drug users" is the denial of opiate substitute therapy, "including as a way of eliciting criminal confessions through inducing painful withdrawal symptoms."

The denial of such treatments in jails and prisons is "a violation of the right to be free from torture and ill-treatment," Mendez noted, and should be considered a violation in non-custodial settings as well. "By denying effective drug treatment, state drug policies intentionally subject a large group of people to severe physical pain, suffering and humiliation, effectively punishing them for using drugs and trying to coerce them into abstinence, in complete disregard of the chronic nature of dependency and of the scientific evidence pointing to the ineffectiveness of punitive measures."

The rapporteur also noted with chagrin that 5.5 billion people, or 83% of the planet's population, live in areas "with low or no access to controlled medicines and have no access to treatment for moderate to severe pain." While most of Mendez' concern is directed at the developing world, he also notes that "in the United States, over a third of patients are not adequately treated for pain."

Mendez identified obstacles to the availability of opioid pain medications as "overly restrictive drug control regulations," as well as misinterpretation of those regulations, deficiencies in supply management, lack of concern about palliative care, and "ingrained prejudices" about using such medications.

New York City, NY
United States

Did You Know? "Ranking 20 Drugs and Alcohol Based on Overall Harm," on ProCon.org

Did you know that the harmfulness of a drug can be rated with at least 16 different criteria? Read the details in "Ranking 20 Drugs and Alcohol by Overall Harm," on the web site medicalmarijuana.procon.org, part of the ProCon.org family.

This is the second in a six-part series of ProCon.org teasers being published in Drug War Chronicle. Keep tuning in to the Chronicle for more important facts from ProCon.org the next several weeks, or sign up for ProCon.org's email list or RSS feed. Read last week's Chronicle ProCon.org piece here.

ProCon.org is a web site promoting critical thinking, education, and informed citizenship by presenting controversial issues in a straightforward, nonpartisan primarily pro-con format.

New Group Seeks to Stop Marijuana Legalization [FEATURE]

The passage of marijuana legalization measures by voters in Colorado and Washington in November has sparked interest in marijuana policy like never before, and now it has sparked the formation of a new group dedicated to fighting a rearguard action to stop legalization from spreading further.

http://www.stopthedrugwar.org/files/patrick-kennedy.jpg
Patrick Kennedy (bioguide.congress.gov)
The group, Smart Approaches to Marijuana (SAM or Project SAM) has among its "leadership team" liberal former Rhode Island Democratic congressman and self-admitted oxycodone and alcohol addict Patrick Kennedy and conservative commentator David Frum. It also includes professional neo-prohibitionist Dr. Kevin Sabet and a handful of medical researchers. It describes itself as a project of the Policy Solutions Lab, a Cambridge, Massachusetts, a drug policy consulting firm headed by Sabet.

SAM emphasizes a public health approach to marijuana, but when it comes to marijuana and the law, its prescriptions are a mix of the near-reasonable and the around-the-bend. Rational marijuana policy, SAM says, precludes relying "only on the criminal justice system to address people whose only crime is smoking or possessing a small amount of marijuana" and the group calls for small-time possession to be decriminalized, but "subject to a mandatory health screening an marijuana-education program." The SAM version of decrim also includes referrals to treatment "if needed" and probation for up to a year "to prevent further drug use."

But it also calls for an end to NYPD-style "stop and frisk" busts and the expungement of arrest records for marijuana possession. SAM calls for an end to mandatory minimum sentences for marijuana cultivation or distribution, but wants those offenses to remain "misdemeanors or felonies based on the amount possessed."

For now, SAM advocates a zero-tolerance approach to marijuana and driving, saying "driving with any amount of marijuana in one's system should be at least a misdemeanor" and should result in a "mandatory health assessment, marijuana education program, and referral to treatment or social services." If a scientifically-based impairment level is established, SAM calls for driving at or above that level to be at least a misdemeanor.

Less controversially, SAM advocates for increased emphasis on education and prevention. It also calls for early screening for marijuana use and limited intervention "for those who not progressed to full marijuana addiction."

For a taste of SAM's kinder, gentler, neo-prohibitionist rhetoric, David Frum's Monday CNN column is instructive. "We don't want to lock people up for casual marijuana use -- or even stigmatize them with an arrest record," he writes. "But what we do want to do is send a clear message: Marijuana use is a bad choice."

Marijuana use may be okay for some "less vulnerable" people, Frum writes, but we're not all as good at handling modern life as he is.

"But we need to recognize that modern life is becoming steadily more dangerous for people prone to make bad choices," he argues. "At a time when they need more help than ever to climb the ladder, marijuana legalization kicks them back down the ladder. The goal of public policy should not be to punish vulnerable kids for making life-wrecking mistakes. The goal of public policy should be to protect (to the extent we can) the vulnerable from making life-wrecking mistakes in the first place."

Marijuana legalization advocates are having none of it. And they level the charge of hypocrisy in particular at Kennedy, whose family made its fortune selling alcohol. The Marijuana Policy Project (MPP) has called on Kennedy to explain why he wants to keep "an objectively less harmful alternative to alcohol illegal" and has created an online petition calling on him to offer an explanation or resign as chairman of SAM.

"Former Congressman Kennedy's proposal is the definition of hypocrisy," said MPP communications director Mason Tvert. "He is living in part off of the fortune his family made by selling alcohol while leading a campaign that makes it seem like marijuana -- an objectively less harmful product -- is the greatest threat to public health. He personally should know better."

Nor did Tvert think much of SAM's insistence that marijuana users need treatment.

"The proposal is on par with forcing every alcohol user into treatment at their own cost or at a cost to the state. In fact, it would be less logical because the science is clear that marijuana is far less toxic, less addictive, and less likely to be associated with acts of violence," Tvert said.

"If this group truly cares about public health, it should be providing the public with facts regarding the relative harms of marijuana and discouraging the use of the more harmful product," Tvert said. "Why on earth would they want keep a less harmful alternative to alcohol illegal? Former Congressman Kennedy and his organization should answer this question before calling on our government to start forcing people into treatment programs and throwing them into marijuana re-education camps."

Project SAM is out of step with current public opinion, said NORML executive director Allen St. Pierre.

"There really aren’t that many people publicly opposing marijuana law reform these days," St. Pierre noted. "The fact that a liberal like Patrick Kennedy is joining with a conservative like David Frum speaks to a mainstream disconnect. Both these guys are seen as mainstream, but three-quarters of the population support medical marijuana and decriminalization, half the country supports legalization, and we know that in two states, 55% voted for legalization. I can't speak to why they're so politically tone deaf."

"Kevin Sabet recognizes the old approach is just done for -- just saying marijuana turns you into an addict is no longer working," MPP's Tvert told the Chronicle. "This is a thinly veiled attempt to maintain marijuana prohibition by appealing to the sensibilities of people who recognize it’s a failure. They are clutching at straws. If they truly think people shouldn’t have their lives ruined for marijuana, they shouldn’t be proposing it be kept illegal."

"We are well past the epoch of the A.M. Rosenthals and the Joe Califanos," said St. Pierre, referring to ardent drug warriors of yore. "The mainstream media has moved away from the type of Reefer Madness that Frum and Kennedy are trying to engage in," he said. "Their advocacy is based on Kevin Sabet's rhetoric, and it's an extension of a failed policy. They're trying to buy time and delay marijuana law reform."

The political terrain has undergone a seismic shift with the November election results, and the rhetorical terrain has been shifting (reality not so much) away from drug war talk under the Obama administration. Now, Project SAM can join drug czar Kerlikowske is hoping talking more gently can thwart the progress of marijuana legalization.

Did You Know? 105 Medical Studies Involving Cannabis and Cannabis Extracts, on ProCon.org

Did you know there were 105 peer-reviewed medical studies involving cannabis and cannabis extracts between 1990 and 2012? Read the details at 105 Peer-Reviewed Studies on Marijuana -- Medical Studies Involving Cannabis and Cannabis Extracts (1990 - 2012), on the web site medicalmarijuana.procon.org, part of the ProCon.org family.

This is the first in a six-part series of ProCon.org teasers being published in Drug War Chronicle. Keep tuning in to the Chronicle for more important facts from ProCon.org the next several weeks, or sign up for ProCon.org's email list or RSS feed.

ProCon.org is a web site promoting critical thinking, education, and informed citizenship by presenting controversial issues in a straightforward, nonpartisan primarily pro-con format.

Decriminalize Drug Possession, UK Experts Say

In a report six years in the making, the United Kingdom Drug Policy Commission, a non-governmental advisory body chaired by Dame Edith Runciman, has called for a reboot of British drug policy and for decriminalizing the possession of small amounts of drugs for personal use.

The report, A Fresh Approach to Drugs, found that the UK is wasting much of the $4.8 billion a year it spends fighting illegal drugs, and that the annual cost to the country of hard drug use was about $20 billion. A smarter set of drug policies emphasizing prevention, diversion, and treatment would be a more effective use of public resources, the report found.

Some 42,000 people in the UK are convicted each year of drug possession offenses and another 160,000 given citations for marijuana possession. Arresting, citing, and jailing all those people "amounts to a lot of time and money for police, prosecution, and courts," the report said.

"To address these costs, there is evidence to suggest that the law on the possession of small amounts of controlled drugs, for personal use only, could be changed so that it is no longer a criminal offence. Criminal sanctions could be replaced with simple civil penalties, such as a fine, perhaps a referral to a drug awareness session run by a public health body, or if  there was a demonstrable need, to a drug treatment program. The evidence from other countries that have done this is that it would not necessarily lead to any significant increase in use, while providing opportunities to address some of the harms associated with existing drug laws," the report recommended.

"Given its relatively low level of harm, its wide usage, and international developments, the obvious drug to focus on as a first step is cannabis, which is already subject to lesser sanctions than previously with the use of cannabis warnings. If evaluations indicated that there were no substantial negative consequences, similar incremental measures could be considered, with caution and careful further evaluation, for other drugs," the report said.

But while the commission was ready to embrace decriminalization, it was not ready to go as far as legalizing drug sales.

"We do not believe that there is sufficient evidence at the moment to support the case for removing criminal penalties for the major production or supply offenses of most drugs," it said.

Still, policymakers might want to consider lowering the penalties for growing small numbers of marijuana plants to "undermine the commercialization of production, with the associated involvement of organized crime."

The report also called for a review of harsh sentences for drug offenses, a consistent framework for regulating all psychoactive substances -- from nicotine to heroin -- and for moving the policy prism through which drug policy is enacted from the criminal justice system to the public health system.

But the Home Office, which currently administers drug policy in Britain, wasn't having any of it. Things are going swimmingly already, a Home Office spokesperson said.

"While the government welcomes the UKDPC's contribution to the drugs debate, we remain confident that our ambitious approach to tackling drugs -- outlined in our drugs strategy -- is the right one," the spokesperson said. "Drug usage is at its lowest level since records began. Drug treatment completions are increasing and individuals are now significantly better placed to achieve recovery and live their lives free from drugs. "I want to take this opportunity to thank the UKDPC for its work in this area over the past six years."

United Kingdom

The GOP Platform on Crime and Drugs

With Republican delegates now gone home after their national convention in Tampa, this is as good a time as any to examine their official position on crime and drugs. The 2012 GOP Platform lays it out, and reformers may find a few things to be pleasantly surprised about, at least if elected Republicans actually adhere to their party's official positions.

What may be most significant is what isn't in the platform: Four years ago, the GOP platform had a whole section devoted to the war on drugs. That has vanished this time around.

But reformers still won't find too much to make them smile. In the platform section titled "Justice for All: Safe Neighborhoods and Prison Reform," after the boilerplate language about how "strong families and caring communities supported by excellent law enforcement" are the most effective forces in reducing crime, the Republicans get to it:

"Our national experience over the last several decades has shown that citizen vigilance, tough but fair prosecutors, meaningful sentences, protection of victims’ rights, and limits on judicial discretion can preserve public safety by keeping criminals off the streets," the platform reads. "Liberals do not understand this simple axiom: Criminals behind bars cannot harm the general public. To that end, we support mandatory prison sentencing for gang crimes, violent or sexual offenses against children, repeat drug dealers, rape, robbery and murder... We oppose parole for dangerous or repeat felons…"

But even the GOP, and, more broadly, conservatives are coming to understand that being "tough on crime" is not enough, as evidenced by the formation of the conservative Smart on Crime Coalition, some of whose positions appear to have been incorporated into the platform:

"While getting criminals off the street is essential, more attention must be paid to the process of restoring those individuals to the community. Prisons should do more than punish; they should attempt to rehabilitate and institute proven prisoner reentry systems to reduce recidivism and future victimization," the platform states.

It goes on to endorse state and local initiatives, such as "accountability courts," or the drug court model, and calls for government to work with faith-based institutions to try to divert first-time, nonviolent offenders -- although it doesn't say it wants to divert them from the criminal justice system, just from "criminal careers." The platform does, however, call for supporting state and local initiatives "trying new approaches to curbing drug abuse and diverting first-time offenders to rehabilitation."

The platform of the party of small government and states' rights also laments that federal law enforcement has "been strained by two unfortunate expansions: the over-criminalization of behavior and the over-federalization of offenses," noting that the number of federal offenses has increased by almost 50% since the 1980s.

"Federal criminal law should focus on acts by federal employees or acts committed on federal property -- and leave the rest to the states," the platform says. Then Congress should withdraw from federal departments and agencies the power to criminalize behavior, a practice which, according to the Congressional Research Service, has created 'tens of thousands' of criminal offenses... In the same way, Congress should reconsider the extent to which it has federalized offenses traditionally handled on the state or local level."

There it is, the official platform of the Republican Party this year. One mention of drug dealers, one mention of drug users, no mentions of medical marijuana or marijuana legalization, but some hints that the GOP could live with some experimentation in the states and a smaller federal enforcement arm.

Tampa, FL
United States

Now They're Trying to Ban... Kratom? [FEATURE]

The prohibitionist impulse is strong. When confronted with a newly encountered psychoactive substance, there are always special pleaders to sound the alarm and politicians willing to reflexively resort to the power of the ban. Whether it is something with serious potential dangers, like the "bath salts" drugs, or something much more innocuous, like khat, the mild stimulant from the Horn of Africa, doesn't seem to matter; the prohibitionist impulse is strong.

mitragyna speciosa (kratom) tree (photo by Gringobonk, courtesy Erowid.org)
Kratom is a substance that falls on the more innocuous side of the psychoactive spectrum. It is the leaves of the kratom tree, mitragyna speciosa, which is native to Thailand and Indonesia, where the leaves have been chewed or brewed into a tea and used for therapeutic and social purposes for years. According to the online repository of psychoactive knowledge, the Vaults of Erowid, kratom acts as both a mild stimulant and a mild sedative, creates feelings of empathy and euphoria, is useful for labor, and is relatively short-acting.

Of course, any psychoactive substance has its good and its bad sides, but kratom's downside doesn't seem very severe. Erowid lists its negatives as including a bitter taste, dizziness and nausea at higher doses, mild depression coming down, feeling hot and sweaty, and hangovers similar to alcohol. There is no mention of potential for addiction, and while fatal overdoses are theoretically possible, especially with its methanol and alkaloid extracts, in the real world, ODing on kratom doesn't appear to be an issue. No fatal overdoses are known to have actually occurred.

On the other hand, some of kratom's alkaloids bind to opioid receptors in the brain, making it an opioid agonist, and it is now being sold in the West and used to treat pain, depression, anxiety, and opiate withdrawal. Sold in smoke shops, herbal supplement emporia, and on the Internet, it is now apparently being lumped in with synthetic cannabinoids and the "bath salts" drugs by treatment professionals, law enforcement, and others who make a habit of searching for scary new drugs.

Kratom is not listed as a banned substance in the 1961 Single Convention on Narcotic Drugs or its successor treaty, and has been banned in only a handful of countries, most ironically in Thailand itself. It was banned there in 1943, when then Thai government was taxing the opium trade and opium users were switching to kratom to aid in withdrawals and as a substitute.

Arrests for kratom possession have jumped in recent years, from more than 1,200 in 2005 to more than 7,000 in 2009, even though the Thai Office of the Narcotics Control Board recommended to the Justice Department in 2010 that it be decriminalized because of the lack of any perceivable social harms.

In the US, the DEA added kratom to its list of drugs of concern in 2010, although that doesn't mean that a federal ban is necessarily imminent. Salvia divinorum, for example, has been a drug of concern for more than a decade now, with no action taken. But while the feds haven't acted, there were efforts to ban kratom in several states in the US this year, although only Indiana actually succeeding in outlawing it. In Louisiana, age restrictions were placed on its purchase.

The experience of Iowa, where legislation to ban kratom is still pending, is illustrative of how bans are created. The Iowa effort happened after state Rep. Clel Baudler (R) heard about kratom on a radio program. Within two hours, he was moving to ban it.

"Kratom is a hallucinogen, addictive, and can be life threatening," he said at the time, in complete contradiction of all that is actually known about kratom.

It's not just states that are considering bans on kratom. Pinellas County, Florida, was about to enact one this week, but the prohibitionist bandwagon hit a bump in the road in the form of perennial drug war gadfly Randy Heine, owner of Rockin' Cards and Gifts in Pinellas Park, who told the Chronicle he had been selling kratom in his store since 1981.

Seeing what was coming down the pike, Heine alerted the Kratom Association, a group of users, producers, and vendors dedicated to keeping kratom legal, who flooded county commissioners with emails. He also addressed the commission itself.

http://stopthedrugwar.org/files/randy-heine-201px.jpg
Randy Heine
"I have been selling kratom for over 30 years out of my store on Park Blvd. I challenge anyone to find any problem originating from my store selling kratom," he wrote in a letter made available to the Chronicle. "Do not lump in synthetic chemicals with an organic plant material. This is like comparing apples to oranges. I would like to see kratom be sold only to persons over the age of 18, similar to the proposal being made in our sister state of Louisiana."

In the conservative county, Heine also appealed to the ghost of Ronald Reagan in his letter to commissioners. What riles up the Reagan in him, Heine wrote, is "growing the bureaucracy by creating another board to regulate what I and others do in privacy of our own homes."

"I got letters back from two of the commissioners," said Heine. "They read my Ronald Reagan letter out loud, and one of the GOP commissioners thanked me for sharing my thoughts. The commission has now deferred this item so we can take a closer look at the issues involved."

Many of his kratom customers are using it as an opiate substitute, he said.

"We have a drug rehab place here, and my feeling is that a lot of their clients are purchasing kratom instead of methadone. It's competition; I'm taking away money," he said. "Some of my customers say methadone is worse than heroin and keeps you addicted. Kratom weans them off heroin. A lot of them say they just do less and less kratom until the craving stops. I have a couple of senior women who say they're tired of taking prescription pills, that they make them nutty, and kratom works for them."

Chronicle readers may recall that Pinellas County is where a drug reform-minded upstart Democratic candidate for sheriff is taking on either the scandal-plagued Republican incumbent sheriff or his challenger and predecessor, former Sheriff Everett Rice (the GOP primary is next week), whose supporters on the council were pushing the kratom ban. That Democrat, Scott Swope, is so good on drug policy that his candidacy persuaded Heine to drop his own bid for the sheriff's office.

"This looks like another unconstitutional intrusion into the lives of Pinellas citizens who aren't harming anyone," Swope said. "I've researched kratom and although there doesn't seem to be as much research available as cannabis, it appears to me to be a plant product that should not be banned. I think the purchase or possession of any of these things (cannabis, kratom, bath salts) by minors should not be allowed. Adults, however, should be free to do what they want as long as they aren't harming anyone else."

While Heine is currently bedeviled by the effort to ban kratom, as well as an associated effort to force smoke shops to put large signs on their doors saying they sell drug paraphernalia, the Swope candidacy has him hoping for better times ahead. 

"Swope can win," he exulted. "We finally have a candidate who is talking about marijuana. Even the Republican candidates are now saying they wouldn't bust people for marijuana. When I was still a candidate, I went to many forums to talk about pot, and the media started asking these guys about it. Scott won't arrest people for personal use."

Whether it's relatively unknown substances like kratom or now familiar substances like marijuana, the battle lines are drawn in what is ultimately a culture war. On one hand, the forces of fear and authoritarianism; on the other, the forces of free inquiry and personal liberty. It's been a long war, and it isn't going to end anytime soon, but perhaps now there are hints that the correlation of forces is changing.

Stopping unnecessary prohibitions before they get started is part of the struggle; undoing entrenched prohibitions with powerful interests behind them is another part of the struggle, but even though the substances are different, it's the same struggle.

(This article was published by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also shares the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Pinellas County
FL
United States

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