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.
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.
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.
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 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.
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.
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."
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.
"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.
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.
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.
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.)
The XIX International AIDS Conference took place in Washington, DC, last week, bringing more than 20,000 scientists, activists, government officials, and journalists to assess the science and determine best practices for reducing the spread of the HIV virus. The US was able to host the conference for the first time in 22 years after it finally repealed a law denying people with HIV admission to the country.
Drug users and sex workers who wanted to attend the conference were thus faced with a dilemma: Tell the truth and be barred or lie on the visa application, which in itself is a violation of US immigration law. As a result, representatives of some of the groups most affected -- and most likely to be affected in the future -- were unable to attend.
"People do not want to run the risk of attending the conference in a country where they are told they are not wanted or desired," said Allan Clear, the executive director of the Harm Reduction Coalition. "It sends the message that people who have a history of drug use or sex work are not actually included in the dialog at all, and is a serious setback in the fight against AIDS. I don't think the US government has any particular interest in actually involving sex workers or drug users in policy or programming."
The exclusion of drug users and sex workers hasn't gone down well with activists. As far back as two years ago at the Vienna AIDS conference, Indian activist Meena Seshu called for a boycott of AIDS 2012, pointing out that it was unethical three decades into the AIDS epidemic to discuss AIDS policy without including those most affected. Some have boycotted the conference, opting instead to attend a Kiev conference that began July 9 for drug users and people living with HIV from Eastern Europe. Sex workers and their allies followed with a side meeting in Kolkata this week. While those two events are officially considered "hubs" of the International AIDS Conference, many attended them as a means of protesting the exclusion of drug users and sex workers in Washington.
Unhappiness broke into the open in Washington Monday when dozens of drug user and sex workers activists disrupted the conference's opening press event. They leapt from their seats unexpectedly and marched through the room, waving banners and shouting slogans such as "No drug users? No sex workers? No International AIDS conference!"
Discontent with AIDS policies that marginalize drug users and sex workers escaped from the conference rooms and onto the streets again on Tuesday, as hundreds marched to the White House chanting "No More Drug War" in a rally timed to coincide with the conference. The march broadened the scope of protest, linking the battle against AIDS with the war on drugs and corporate domination of US political life.
On the way to the White House, protestors stopped at UPS and Wells Fargo facilities to chide those corporations for unhelpful practices. UPS took heat for donating to politicians who voted to restore the federal ban on needle exchange funding, and Wells Fargo for investing in private prisons.
"Wells Fargo is literally invested in locking more people up," said Laura Thomas of Drug Policy Alliance (DPA).
Activism around drug users and AIDS also took place in the conference's Global Village, including the installation of a model of Vancouver's Insite supervised injection site and tours of a local needle exchange outreach van courtesy of DC's Family and Medical Counseling Services. The Harm Reduction and Global Drug Policy Zone in the village also featured special events and presentations put on by groups including the Harm Reduction Coalition, Harm Reduction International, the Hungarian Civil Liberties Union, the Eurasian Harm Reduction Network, and the International Network of People Who Use Drugs.
Advocates also took advantage of the AIDS conference to unleash a campaign on the theme of "You Can't End AIDS Unless You End the Drug War." Articles to that effect appeared on Alternet and the Huffington Post (and were picked up elsewhere), while Global Commission on Drug Policy member Richard Branson penned a USA Today op-ed piece on how drug prohibition contributes to the spread of HIV. As part of the same campaign, Politico ran a full-page ad signed by Global Commission members and other notables, repeating the message and directly challenging both President Obama and Gov. Romney to "do the right thing." Giants in AIDS advocacy like Michael Kazatchkine and Stephen Lewis joined the calls in speeches given during the conference.
In an unexpected cap to things, former President Bill Clinton called for drug use to be treated as a public health issue, not a criminal justice one, in remarks at the closing plenary. Clinton cited The Huffington Post and Alternet op-eds, coauthored by the Drug Policy Alliance's Ethan Nadelmann and American Foundation for AIDS Research founder Matthilde Krim.
Activists demanding a larger role for drug users and sex workers in setting the policies that are supposed to help them fight AIDS came armed with powerful ammunition. Two recent reports clearly lay out how criminalizing drug use helps spread the disease and how many countries are failing to adequately deal with the spread of HIV among injection drug users.
The first report, from the Global Commission on Drug Policy, makes its findings clear in its title: "The War on Drugs and HIV/AIDS: How Criminalization of Drug Use Fuels the Global Pandemic." In the report, the commission noted that injection drug use now accounts for one-third of new HIV infections outside of sub-Saharan Africa, including some 354,000 people in the US.
"Throughout the world, research has consistently shown that repressive drug law enforcement practices force drug users away from public health services and into hidden environments where HIV risk becomes markedly elevated," the commission said. "Mass incarceration of nonviolent drug offenders also plays a major role in spreading the pandemic."
The commission also remarked on "the remarkable failure" of drug prohibition in reducing the global drug supply. The worldwide supply of illicit opiates, such as heroin, has increased almost four-fold in recent decades, the commissioners noted. They also noted the drug war's contribution to the growth of organized crime and violence.
The commission identified proven addiction treatment and evidence-based public health measures that countries should put in place to reduce the spread of HIV and protect community health and safety. They include needle exchange programs, safer injecting facilities, and prescription heroin programs.
"Failure to take these steps is criminal," the commission said.
In the second report, "The Global State of Harm Reduction 2012: Towards an Integrated Response," from the London-based Harm Reduction International (formerly the International Harm Reduction Association), researchers found that while injection drug use has been identified in 158 countries, only half of them have any programs aimed at preventing the spread of HIV among injectors, and the situation internationally is not improving. Even in countries that are addressing the problem, programs suffer from lack of funding and donor support is decreasing. That is undermining the global response to AIDS, the report concluded.
"In the last two years, we have seen a significant scale-down of services in countries with some of the highest HIV burdens among people who inject drugs," said Rick Lines, the group's executive director. "As tens of thousands gather in Washington this week to call for an end to AIDS, it is becoming increasingly clear that governments have neither the will nor the intention of ending the spread of HIV among people who use drugs."
"We have seen the number of needle exchange programs in Russia drop for 70 in 2010 to only six in 2012. This is made worse by a retreat of many bilateral and multilateral donors to funding effective harm reduction interventions in many countries," said Claudia Stoicescu, public health analyst at Harm Reduction International and author of the report. "Such developments significantly limit progress toward global commitments to halve HIV transmission related to unsafe injecting by 2015, let alone any hope of achieving universal access to HIV prevention, treatment, care and support for people who inject drugs."
"The reluctance of governments to fund an adequate response to HIV and injecting drug use stands in stark contrast to the seemingly limitless budgets for ineffective and punitive law enforcement responses," said Lines. "Governments care more about fighting a losing war on drugs than they do about winning the fight against HIV."
As the world enters its fourth decade of living -- and dying -- with HIV/AIDS, this week's conference and its barriers to participation by and concern for some of those most directly affected by the crisis -- drug users and sex workers -- demonstrate how far we still have to go. They also make achingly clear the destructive role that drug prohibition and the criminalization of marginalized populations play in perpetuating the epidemic.
Maybe next time the International AIDS Society will hold its conference someplace where drug users and other marginalized groups can attend and be heard. Or maybe the United States will alter its harsh visa requirements aimed at drug users and sex workers. Either one would be good. Ending drug prohibition, the stigma it generates, and the obstacles to fighting disease it engenders would be better.
On Tuesday, as the UN's global drug prohibition bureaucracy marked its annual International Day Against Drug Abuse and Illicit Trafficking and UN Office on Drugs and Crime head Yuri Fedotov blamed hard drug use for "bringing misery to thousands of people, insecurity, and the spread of HIV," a group of leading international voices offered a starkly contrasting perspective, arguing instead that is the failures and consequences of global drug prohibition that are driving the spread of HIV/AIDS and other blood-borne diseases among drug users.
There are an estimated 33 million people worldwide infected with HIV, and outside sub-Saharan Africa, injection drug use accounts for one-third of new infections. The situation is particularly bad in Russia and other countries in the former Soviet Union and East Bloc that continue to take harsh drug war approaches to drug use despite the evidence before their own eyes. In Russia, nearly one in a hundred adults is now infected with HIV.
But it's not just the Russian sphere where policymakers ignore the evidence. The report also cites China, Thailand, and the US, where Congress recently reinstated a longstanding ban on the use of federal funds for syringe exchange programs. In countries that have adopted evidence-based HIV prevention programs, such as Switzerland and Portugal, injection drug use-related HIV infections have nearly been eliminated.
According to the report, drug prohibition and the criminalization of drug users spurs the spread of HIV through the following means:
- Fear of arrest drives persons who use drugs underground, away from HIV testing and HIV prevention services and into high-risk environments.
- Restrictions on provision of sterile syringes to drug users result in increased syringe sharing.
- Prohibitions or restrictions on opioid substitution therapy and other evidence-based treatment result in untreated addiction and avoidable HIV risk behavior.
- Deficient conditions and lack of HIV prevention measures in prison lead to HIV outbreaks among incarcerated drug users.
- Disruptions of HIV antiretroviral therapy result in elevated HIV viral load and subsequent HIV transmission and increased antiretroviral resistance.
- Limited public funds are wasted on harmful and ineffective drug law enforcement efforts instead of being invested in proven HIV prevention strategies.
"The Global Commission is calling on all entities to acknowledge and address the causal links between the war on drugs' criminalization of drug use and drug users and the spread of HIV/AIDS," commission member Michel Kazatchkine, the former executive director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria told a London press conference. "For people who inject drugs and their sex partners, the AIDS epidemic continues to be a public health emergency."
"It is so clear now that there is a relation between repressive drug policies and the spread of HIV/AIDS," said former Colombian President Cesar Gaviria. "If we don't get people into the health system without fear, it will be very difficult to do treatment and prevention."
Branson and the other commissioners made some concrete recommendations for action in the report. Those include:
- Push national governments to halt the practice of arresting and imprisoning people who use drugs but do no harm to others.
- Measure drug policy success by indicators that have real meaning in communities, such as reduced rates of transmission of HIV and other infectious diseases, fewer overdose deaths, reduced drug market violence, fewer individuals incarcerated and lowered rates of problematic substance use.
- Respond to the fact that HIV risk behavior resulting from repressive drug control policies and under-funding of evidence-based approaches is the main issue driving the HIV epidemic in many regions of the world.
- Act urgently: The war on drugs has failed, and millions of new HIV infections and AIDS deaths can be averted if action is taken now.
"The AIDS epidemic is a harsh and brutal teacher that obliges us to take a scientific approach to deal with sex workers and drug addicts," said former Swiss President and commission member Ruth Dreifuss. "Politicians have to inform citizens of the benefits, risks, and failures of drug policy, and politics has to take responsibility for policy change. Public health has to be at least as important as criminalizing the drug traffic," she told the press conference.
"Addicted injecting drug users is one of the main sources of the spread, and not all of them will achieve abstinence," said Dreifuss. "Substitution therapies can take people away from street drug dealers and violence. For some, the provision of medical heroin is necessary to allow them to abandon criminal activities and overcome marginalization. It's possible to implement these large scale programs at low costs with high benefits," she argued.
"For others, harm reduction measures are necessary in order to avoid the spread of HIV/AIDS and other bloodborne disease. Needle exchange programs, free condoms, safe consumption rooms all not only save the lives of drug users but protect the whole population," Dreifuss explained. "We need the full spectrum of these measures for those in prison, too, who are at more risk for HIV infections."
Dreifuss touted her own country's experience as a model. Faced with mounting injection drug use, Switzerland eventually went the route of supervised injection sites and opioid maintenance, including heroin maintenance.
"Our experience is that it works," she said. "The police protect the injection rooms from dealers. The four pillar policy [prevention, treatment, harm reduction, enforcement] has been broadly accepted by our citizens and the spread of HIV/AIDS is under control."
Even within the constraints imposed by the global drug prohibition regime, countries can still take action to mitigate the drug war's role in the spread of infectious disease, she said.
"It is possible for countries to adopt effective harm reduction measures within existing drug laws," Dreifuss argued. "The decriminalization of drug use is the first step, and the second step is to determine what type of market can drive out dealers. The war on drugs has failed to reduce supply or demand; let us replace prohibition with regulation and avoid jeopardizing public health and harm reduction policies with inefficient measures."
"Our message is that prohibitionist law enforcement has failed in its goals of eradicating drugs and protecting people's health," said Kazatchkine. "Illegal drugs have become cheaper and more available and HIV and other health risks have increased. Prohibitionist policies have been shifting the market to stronger drugs and led to a war on users with numerous human rights abuses, police harassment, violence, extortion. The fear of police and stigma is driving users underground and away from access to information, care, and medical services," he warned.
"One cannot improve health through war," he concluded. "This is an epidemic among people who inject that we can actually control. If we are to have a chance at reducing the transmission of AIDS, we need to open up and change our ways."
The Global Commission on Drugs has laid out the problem and showed us the path to fix it. Now, it is up to our political leadership to act accordingly, and it is up to us to ensure that it does.
Aghast and appalled at the bloody results of Mexican President Felipe Calderon's war on drugs, which has resulted in at least 50,000 deaths since he deployed the military against the so-called drug cartels in December 2006 and possibly as many as 70,000, dozens of organizations in Mexico and the US announced Monday that they will take part in a "Caravan for Peace" that will journey across the US late this summer in a bid to change failed drug war policies on both sides of the border.
The caravan will be underway in between presidential elections in the two countries. Mexico will choose a successor to Calderon on July 1, and whoever that successor is, will be re-tooling its fight against the drug cartels. By late summer, the US presidential campaign will be in full swing, and advocates hope to have at least some impact on that as well.
The caravan builds on similar efforts last year in Mexico. Led by Sicilia and other relatives of drug war victims, one caravan of more than 500 people left Cuernavaca and traveled north through 15 cities to Ciudad Juarez, one of the epicenters of prohibition-related violence in Mexico. A second caravan left Mexico City with 700 people traveling south through 21 cities. Those caravans helped turn what was an amorphous fear and dismay among Mexicans at the violence into a political movement that has put the issue of the drug wars and their victims squarely on the Mexican political agenda.
"The war on drugs has had painful consequences for our country, such as corruption and impunity," said Sicilia at a Mexico City press conference. "The proof of this is that Mexico has seen over 70,000 deaths and 10,000 disappearances, and this is closely linked to US regional security policies, which have sparked widespread areas of violence, human rights violations, and the loss of the rule of law. The drug war has failed," he said bluntly.
"On August 12, Mexicans will come to the US and cover a route of 25 cities in one month," Sicilia continued. "Our message is one of peace, and our journey will be peaceful with an open heart and the hope of speaking with each other. We believe the harm we live is linked to the failed policies we want to change."
"Regarding policies on the war on drugs, we propose the need to find a solution with a multidimensional and international approach that places the dignity of the individual at the center of drug policy," Sicilia said. "We call on both Mexican and US civil society to open and maintain a dialogue on evidence-based alternatives to prohibition and to consider various options for regulating drugs."
The broad range of interrelated issues is helping build a broad coalition around the caravan. Groups concerned with the border, immigrant rights, human rights, racial justice, and labor are all coming on board.
"Forty years ago, then President Nixon inaugurated the war on drugs, and we've not won the war on drugs -- the only thing we've achieved is being the world's leader in incarceration," said Dr. Niaz Kasravi, with the NAACP criminal justice program. "Through these policies, we've also promoted violence and death for those caught up in the drug war in the US and Mexico. In the US, those who have borne the brunt of it have been people of color. The war on drugs hasn't made our communities safer, healthier, or more stable, but has resulted in the mass incarceration of people of color, a de facto Jim Crow. We are in a violent state of emergency that must end, and we stand committed to ending the war on drugs."
"We emphasize the dignity and humanity of immigrants in the US," said Oscar Chacon of the National Alliance of Latin American and Caribbean Communities (NALACC), "and when we were invited to consider joining the caravan, we identified with it as a cause of our own. We see our issues reflected throughout the caravan. Policies that emphasize militarization and authoritarianism and enforcement and punishment have human rights violations as their natural results. We see in the caravan an opportunity to write a new chapter in our initiatives to highlight the value of respect for all human life and we will use our participation to further educate Latino and immigrant communities about the relationship between policy decisions made in Washington and the sad effects they can have -- in this case, particularly for our Mexican brothers and sisters."
"Prior to coming here, I did not know the extent of the pain, sorrow, and suffering of the families here in Mexico," said Neill Franklin, head of Law Enforcement Against Prohibition. "There are so many orphans, so many families being attacked. Families and future generations are also under attack in my country, with drive-by shootings and running gun battles in the streets of our big cities. Most of those targeted by the drug war here are blacks and Latinos; we have many broken families and communities because of these policies. This caravan will unite our people, our pain, and our solutions in an effort to save our sons and daughters."
"This is a historic moment and one of great necessity," said Ted Lewis of Global Exchange. "The caravan arrives between two presidential elections, and that's intentional, not because we have electoral ends, but because we want the message to be heard on both sides of the border. This is a truly binational effort, and it is very important that leaders on both sides of the border take this message deeply into account as they organize in Mexico a new administration and as they campaign here in the US. This issue must be dealt with now."
Also on board is Border Angels, a San Diego-based group best known for leaving caches of water in the desert to help save the lives of undocumented immigrants heading north. The group has long been critical of increased border enforcement efforts such as Operation Gatekeeper, which have pushed those immigrants away from urban areas and into harsh and unforgiving environments as they seek to make their way to a better life.
"Operation Gatekeeper has led to more than 10,000 deaths since 1994," said the group's Enrique Morones. "Two people die crossing the border every day, but they are also dying south of the border. Now, we see a new wave of migration to escape the terrible violence in Mexico, the country of my parents, and that's why we are joining this movement for peace in this historic caravan. We have told both Obama and Calderon that human rights, love, and peace have no borders. We demand peace, justice, and dignity."
"I think this will really have a significant impact," said Ethan Nadelmann, executive director of the Drug Policy Alliance. "It's going to be a pivotal moment, just a month after the Mexican elections and just a few months before the US elections. I don't think drugs will be a major issue, but it will be bubbling up from time to time."
The caravan will seek to raise awareness on both sides of the border, Nadelmann said.
"Americans need to be aware of the devastation in Mexico from the combination of US demand and our failed prohibitionist policies," he said. "It's also important that Mexicans understand the devastating consequences of the war on drugs in the US -- the arrests and incarceration, the evisceration of civil rights. This mutual understanding is a pivotal part of what we're trying to accomplish."
"I hope the message will come through that change is needed on both sides of the border," Nadelmann continued. "We've seen the failures of prohibition on both sides, but the biggest impetus has to come from the US through legal regulation of marijuana and more innovative policies to reduce demand -- not from locking up more people, but by providing effective drug treatment and allowing people addicted to drugs to get them from legal sources. We need a fundmentally different approach, and this caravan will be a leap forward in understanding the consequences of failed prohibition."
A bill that would have decreased the penalties for simple drug possession from felonies to misdemeanors died last Thursday in the California Senate. The proposed measure, Senate Bill 1506, was defeated on a vote of 24-11.
"No data begins to suggest that putting felonies on these mostly young people and incarcerating them for longer periods of time in any way benefits their recovery from drug use," Leno told his colleagues before the vote.
But his Senate colleagues, including some Democrats, sided with law enforcement lobbyists, who opposed the bill.
"I don't understand how decriminalization will actually reduce crime in California," said Sen. Ted Gaines (R-Roseville).
Actually, by nearly any measure -- violent crimes, property crimes, murders -- the number of serious criminal offenses in California has dropped by about half in the past 20 years.
"With bills like this I can see Amsterdam from the capitol front porch," said Sen. Doug La Malfa (R-Richvale), who voted against the measure.
No word yet on whether Leno will try again next year.