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The 2014 National Drug Control Strategy: Baby Steps in the Right Direction [FEATURE]

The White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) released its 2014 National Drug Control Strategy Wednesday. While in general, it is remarkable for its similarities to drug control strategies going back more than a decade, it does include some signals suggesting that the Obama administration is ready for a shift in emphasis in the drug war -- from a criminal justice approach to a more public health-oriented approach.

But even that rhetorical positioning is somewhat undercut by the strategy's continuing commitment to the criminalization of drug users and the people who supply them, as well as particular policy prescriptions, such as its support for expansion of drug courts -- the use of the criminal justice system to enforce therapeutic health goals like abstinence from drug use, as opposed to measures that don't involve criminal justice intervention.

The 2014 strategy also continues the roughly 3:2 funding ratio between law enforcement and treatment and prevention spending that has marked federal anti-drug spending since at least the Clinton administration in the 1990s. And it does so somewhat deceptively.

"In support of this Strategy," ONDCP wrote in a press release, "the President has requested $25.5 billion in Fiscal Year 2015. Federal funding for public health programs that address substance use has increased every year, and the portion of the Nation's drug budget spent on drug treatment and prevention efforts -- 43% -- has grown to its highest level in over 12 years. The $10.9 billion request for treatment and prevention is now nearly 20% higher than the $9.2 billion requested for Federally-funded domestic drug law enforcement and incarceration."

What the press release doesn't mention when claiming that treatment and prevention spending now exceeds spending on law enforcement is that it did not include figures for drug interdiction and international spending on the law enforcement side of the ledger. The White House's proposed federal drug budget for 2015, however, shows that those drug prohibition-enforcement costs add up to another $5.4 billion, or $14.6 billion for enforcing drug prohibition versus $10.9 billion for treatment and prevention.

The strategy does, however, provide a sharper focus than in the past on reducing the harms associated with drug use, such as overdoses and the spread of HIV/AIDS, hepatitis C, and other blood-borne diseases. It calls for greater access to the opiate overdose reversal drug naloxone and supports needle exchange and state laws that provide limited immunity from prosecution for people suffering overdoses and the people who seek help for them -- the so-called 911 Good Samaritan laws. The strategy also sets a five-year goal for reducing overdose deaths, something drug reform advocates had been seeking.

The strategy also acknowledges the need to reduce mandatory minimum drug sentencing and recognizes that the US has the world's largest prison population, but in absolute terms and per capita. And, implicitly acknowledging that Americans increasingly see the war on drugs as a failed policy, the 2014 strategy has adjusted its rhetoric to emphasize public health over the drug war.

Acting ONDCP head or "drug czar" Michael Botticelli (ONDCP)
But, despite polls now consistently showing majority support for marijuana legalization, and despite the reality of legal marijuana in two states, with two more and the District of Columbia likely to embrace it later this year, the 2014 strategy appears not only wedded to marijuana prohibition, but even disturbed that Americans now think pot is safer than booze.

That puts ONDCP at odds not only with the American public, but with the president. In an interview published in January by the New Yorker, Obama said marijuana is less dangerous than alcohol "in terms of its impact on the individual consumer."

Noting that about three-quarters of a million people are arrested on marijuana charges each year, and nearly nine out of ten of those for simple possession, the Marijuana Policy Project (MPP) pronounced itself unimpressed with the new national drug strategy.

The drug czar's office is still tone deaf when it comes to marijuana policy. It appears to be addicted to marijuana prohibition. Why stay the course when the current policy has utterly failed to accomplish its goals?" asked MPP communications director Mason Tvert.

"The strategy even goes so far as to lament the public's growing recognition that marijuana is not as harmful as we were once led to believe. President Obama finally acknowledged the fact that marijuana is less harmful than alcohol, yet his administration is going to maintain a policy of punishing adults who make the safer choice," Tvert continued. "Most Americans think marijuana should be made legal, and even the Justice Department has acknowledged that regulating marijuana could be a better approach than prohibition. Legalizing and regulating marijuana is not a panacea, but it is sound policy."

The Drug Policy Alliance (DPA), with a wider policy remit than MPP, had a nuanced response to the release of the drug strategy. It was critical of some aspects of the strategy, but had kind words for others.

"The administration says drug use is a health issue but then advocates for policies that put people in the criminal justice system," said Bill Piper, DPA national affairs director. "Until the drug czar says it is time to stop arresting people for drug use, he is not treating drug use as a health issue no matter what he says. I know of no other health issue in which people are thrown in jail if they don't get better."

Still, said Piper, the drug czar's office deserves some credit for addressing serious issues associated with drug use under prohibition.

"Director Botticelli should be applauded for taking strong steps to reduce drug overdose fatalities and the spread of HIV/AIDS, hepatitis C and other infectious diseases," he said. "His leadership on these issues, and his work overall to reduce the stigma associated with substance misuse, are encouraging."

But when it comes to marijuana policy, DPA found itself pretty much on the same page as MPP.

"The Administration continues to keep its head in the sand when it comes to marijuana law reform," said Piper. "Hundreds of thousands of Americans are being arrested each year for nothing more than possessing small amounts of marijuana for personal use. Once arrested they can be discriminated against in employment and housing for life. The administration can't ignore the destructive impact of mass arrests forever."

Washington, DC
United States

What To Do About the Drug Trade in West Africa? [FEATURE]

Over the past decade, West Africa has emerged as an increasingly important player in the global illicit drug trade. Although the region has historically not been a drug producing one -- with the important exception of marijuana -- it has become a platform for predominantly Latin American drug traffickers moving their illicit commodities toward lucrative European and Middle Eastern markets. The cocaine traffic alone is worth more than a billion dollars a year, according to a 2013 report from the UN Office on Drugs and Crime (UNODC).

children walking from home to school in Bamako, Mali (JoeyTranchinaPhotography©2014 Sète, France)
And the trade is becoming more complex. Now, it's not only cocaine flowing through the region, but heroin destined mainly for Western Europe and methamphetamines being manufactured there and exported to Asia and South Africa, that same UNODC report found.

The region -- stretching along the African coast from Nigeria to the east to Senegal on the west, and extending deep into the Sahara Desert in countries such as Mali and Niger -- is plagued by weak states and corrupt governments, making it attractive to criminals of all sorts, who thrive in lawless lands. And it's not just criminals. The region is also home to various bands of Islamist militants, some of whom are involved in the drug trade.

Now, a commission of prominent West Africans is calling for fundamental changes in drug policies in the region. Last week, the West Africa Commission on Drugs, issued a report, Not Just in Transit: Drugs, the State and Society in West Africa, calling for the decriminalization of drug use, treating drug use primarily as a public health issue, and for the region to avoid becoming the next front line in the failed war on drugs.

The commission is impressive. It was initiated by former UN Secretary-General Kofi Annan of Nigeria and headed by former Nigerian President Olusegun Obasanjo, and includes other former heads of state as well as a distinguished group of West Africans from the worlds of politics, civil society, health, security and the judiciary.

And so is its very existence. It marks the entrance of West African civil society into the international debate on drug policy in which calls for fundamental drug reform have gained increasing momentum in recent years. In 2008, former Latin American heads of state and other luminaries formed the Latin American Commission on Drugs and Democracy, and in 2011, Annan and other world luminaries and former heads of state came together to form the Global Commission on Drug Policy. Now, West Africa adds its voice to the chorus calling for change.

"We call on West African governments to reform drug laws and policies and decriminalize low-level and non-violent drug offenses," said Obasanjo upon the report's release last week. "West Africa is no longer just a transit zone for drugs arriving from South America and ending up in Europe but has become a significant zone of consumption and production. The glaring absence of treatment facilities for drug users fuels the spread of disease and exposes an entire generation, users and non-users alike, to growing public health risks."

"Most governments' reaction to simply criminalize drug use without thinking about prevention or access to treatment has not just led to overcrowded jails, but also worsened health and social problems," added Kofi Annan.

West Africa
"We need the active support and involvement of civil society and of the international community," said commission member Edem Kodjo. "South America, where most of the drugs smuggled to West Africa come from, and Europe, which is the main consumer market, must take the lead to deal with both production and consumption at home. We cannot solve this problem alone; governments and civil society have to come together in West Africa to help prevent the drug problem from getting completely out of hand."

The report won kudos from American drug reformer Ethan Nadelmann, head of the Drug Policy Alliance.

"First Europe, then the Americas, now Africa," he said. "Drug policy reform is truly becoming a global movement, with Kofi Annan and Olusegun Obasango providing the sort of bold leadership that we've also seen in Latin America. Maybe, just maybe, West Africa will be spared the fate of other parts of the world where prohibition-related crime, violence and corruption spiraled out of control."

But some analysts, while welcoming the report, suggested that it did not get at the heart of the problem in West Africa.

"The report focuses on public health, and that's great, but I'm not sure that's the issue," said Vanda Felbab-Brown, a senior fellow with the Center for 21st Century Security and Intelligence in the Foreign Policy program at the Brookings Institution who has published extensively on West Africa. "Nor are there generally large prison populations due to the arrests of low-level drug offenders. There is increasing drug use, and many addicts don't have access to public health. That, however is not because they were arrested, but because Africa in general doesn't have access to public health," she pointed out.

"In some senses, the commission report is preventative -- it warns of policies that would be counterproductive -- but it is not going to solve West Africa's problems," Felbab-Brown continued. "And the harm reduction approaches that dominate the discourse in Europe and the US are not really apropos for West African public health issues. The increasing focus of the international community is interdiction, but that accounts for only a small fraction of the total traffic, and the report doesn't deal with what kind of alternate law enforcement there should be, or who should be targeted."

But others thought the criminal justice and public health emphasis in the report were a step down the right path.

"The report's message about alternatives to criminalization for use and minor offenses is important in criminal justice terms -- to discourage the horrible over-representation of minor drug offenders in prisons in the region -- but also as a reminder that there are no such alternatives unless the health and social sectors develop those alternatives," said Joan Csete, deputy director of the Open Society Foundation's Global Drug Policy Program.

"Health ministries need to be as important around the drug policymaking table as the police, which is far from the case in most of Africa today," she added. "Services for treatment of drug dependence in the region are absent or of appalling quality. Improving health and social support for people with drug dependence is a key to drug policy reform in West Africa."

And Felbab-Brown agreed that while measures like drug prevention and treatment wouldn't solve the region's problems, they would still be helpful.

"We're already seeing quite a bit of heroin in the region, and we are seeing increasing use," she said. "These are cheap and prevalent commodities, the traffickers partake in kind, and user communities are being established. In a sense, developing strategies to prevent use, get treatment, and prevent the spread of HIV and Hepatitis C is useful because there are more and more users."

drug, security, and insurgency analyst Vanda Felbab-Brown (brookings.edu)
But for Felbab-Brown, the key problem for West Africa is its weak and corrupt states.

"The big trafficking issues are around the intersection of very poor, very weak, very corrupt, and often very fragile states with state participation in various forms of criminality," she said. "Drugs are just another commodity to be exploited by elites for personal enrichment. Elites are already stealing money from oil, timber, and diamonds, and now there is another resource to exploit for personal enrichment and advancement," she argued.

"One narrative has it that drug trafficking has caused fragility and instability, but I think trafficking compounded the problems; it didn't create them," Felbab-Brown continued. "There is a systematic deficiency of good governance. Many of these states have functioned for decades like mafia bazaars, and the trafficking just augments other rents. There are rotten governments, miserable institutions, and poor leadership around all commodities, not just drugs."

"The states are not monolithic," Csete noted. "Some have high-level corruption, some are aggressive in trying to fight money-laundering and other elements of organized criminal networks, some rely heavily on traditional interdiction methods. Some of these countries have relatively strong democratic systems and relatively strong economic growth; some have governance institutions that are less strong."

The state of the states in West Africa influenced the commission and its recommendations, Csete said.

"Legalization of drugs -- production, sale, consumption -- was not judged to be politically feasible or necessarily desirable by the commission," she explained. "I think the commissioners generally perceive that generally these countries do not yet have a political climate favorable to debate on progressive changes in drug policy. The whole idea of the commission and its report is to open those debates -- high-profile people from the region saying things that sitting officials do not find it politically easy to say."

"These are newer post-colonial states," Felbab-Brown noted. "Are we having unreasonable expectations? Is this like Europe in the 13th Century, or is that some of these countries are doomed to exist in perpetual misgovernance?"

While there may be concern in Western capitals about the specter of West African drug trafficking, many West Africans have other, more pressing, drug policy concerns.

In its 2013 report, the UNODC noted that the importation of fake pharmaceutical drugs from South and Southeast Asia into the region was a problem. Joey Tranchina, a longtime drug policy observer who has recently spent time in Mali, agrees.

"Having traversed Mali from Bamako to Mopti, except for the usual oblique indigenous references to smoking weed, the only personal experience I have with drug crime is counterfeit pharmaceuticals from India, China, and Russia," he said. "They're sold cheap in the streets to people who can't afford regular meds and they take the place of real pharmaceuticals, especially malaria and HIV drugs. These drug scams are killing people in Mali," he said.

"Most people in West Africa don't see drug trafficking as that much of a problem," said Felbab-Brown. "If it's mostly going to Westerners, they say so what? For them it is a mechanism to make money, and those drug traffickers frequently become politicians. They are able to create and reconstitute patronage networks around drug trafficking, just as they were once able to get elected with money from blood diamonds."

It seems that, to the degree that drug use and drug trafficking are West African problems, they are problems inextricably interwoven with the broader issues of weak, fragile, and corrupt states that are unable or unwilling to deliver the goods for their citizens. The West Africa Commission on Drugs has pointed a way toward some solutions and avoiding some failed policies already discredited elsewhere, but it seems clear that that is just the beginning.

Chronicle AM -- June 10, 2014

New York City residents are still getting arrested for marijuana at the rate of 80 a day, New York state residents face another year without medical marijuana passing, Philly heads for decriminalization of a sort, the Justice Department supports retroactivity for recent sentencing reforms, the Sinaloa cartel has apparently lost another key leader, and more. Let's get to it:

NYC marijuana arrests just keep on coming. (www.nyc.gov)
Marijuana Policy

Colorado Lawsuit Claims Marijuana Taxes Violate Fifth Amendment. Denver attorney Robert Corry Jr. has filed a lawsuit on behalf of an unnamed marijuana retailer arguing that paying pot taxes violates a citizen's Fifth Amendment right against self-incrimination since marijuana remains illegal under federal law. The lawsuit seeks a permanent injunction to stop the state from collecting taxes and the return of all taxes collected. A similar lawsuit has been filed in Washington state by attorney Douglas Hiatt.

New York City Marijuana Arrests So Far This Year at Same Pace as Last Year. New Yorkers are still being arrested for small-time pot possession in high numbers under new Mayor Bill DeBlasio (D). According to the Marijuana Arrest Project, so far this year, NYPD is arresting an average of 80 people a day for pot possession, compared to 78 a day throughout 2013 under then-Mayor Michael Bloomberg (R). Another constant is that blacks and Latinos continue to make up the vast majority of marijuana possession busts. They accounted for 87% of pot arrests last year and 86% so far this year. Click on the title link for more details.

Philadelphia City Council Committee Approves Decriminalization Measure. A city council committee yesterday approved a bill that would make possession of up to 30 grams of marijuana a code violation punishable by a $25 fine -- but would still give police officers the discretion to arrest. But Mayor Michael Nutter opposes the bill. His Public Safety Director, Mike Resnick, said the opposition stems the discretional arrest provision, which he said could create unfair situations. A final vote is likely next week.

Medical Marijuana

North Carolina "March Against Fear" Aims to Generate Support for Medical Marijuana. North Carolinian Todd Stimson is leading a 259-mile "March Against Fear" from Asheville to Raleigh to help bring attention to a pending medical marijuana bill, House Bill 1161. The bill was filed last month and is now languishing in the House Judiciary Committee. Click on the title link to join up or get more info.

Key New York GOP Legislator Says He Will Not Allow Vote on Medical Marijuana. Senate Finance Committee Chairman John DeFrancisco (R) said today he would not allow a vote on the Compassionate Care Act, sponsored by Sen. Diane Savino (D). "The Savino bill will not come out of my committee, the Finance Committee," he said. "You don't have any kind of reasonable research on the effects. You have people coming in here every day trying to ban e-cigarettes and use of tobacco in other ways." He said he and other Senate Republicans may be open to legislation that would not allow marijuana to be smoked. The session ends next Thursday.

Clark County, Nevada, Commissioners Approve 18 Dispensary Licenses. There will soon be 18 medical marijuana dispensaries operating in unincorporated parts of Clark County, the home of Las Vegas. County commissioners approved the licenses yesterday. Nevada approved medical marijuana in 2000, but only approved dispensaries last year.

Drug Testing

Repeated School Drug Tests of Pennsylvania 10-Year-Old Provoke Scorching Editorial. The editorial board at the Pennsylvania news website PennLive has penned a strong editorial condemning the drug testing policy at the Susquenita Middle School, which has resulted in a 10-year-old girl be tested three times so far. The editorial notes that state law requires that school districts actually show there is problem and show that drug testing helps, but that Susquenita has failed to do either. "Repeatedly drug testing a trouble-free 10-year-old student like Natalie Cassell shows how ridiculous this kind of random snooping is. Innocent students are treated like criminals, while drug-using students can dodge the tests simply by deciding not to join after-school activities," PennLive noted. "At a time when school districts across the state are pleading for more state funding, surely Susquenita schools can find a better uses of money than an unproven, highly invasive program that randomly tests innocent 10-year olds.

Sentencing

Justice Department Supports Making Drug Sentence Cuts Retroactive. Attorney General Eric Holder announced Tuesday that the Justice Department is formally supporting a US Sentencing Commission proposal to allow some nonviolent drug offenders currently doing time in federal prisons to seek sentence reductions. The proposal would extend sentencing reforms already approved by the commission by making them retroactive.

Smarter Sentencing Act Gains Four More Sponsors. The Smarter Sentencing Act of 2013 picked up four more cosponsors Monday, three Democrats and one Republican. They are Del. Eleanor Holmes Norton (D-DC), Rep. Kathy Castor (D-FL), Rep. Tony Cardenas (D), and Rep. Paul Ryan (R-WI). The measure now has 37 cosponsors, 24 Democrats and 13 Republicans. It has been sitting in the House Judiciary Committee's Subcommittee on Crime, Terrorism, Homeland Security and Investigations since January.

Prescription Opiates

Massachusetts Governor Unveils Plan to Fight Opiate Use. Gov. Deval Patrick (D) today released a $20 package of proposals to deal with "the opioid addiction epidemic" in his state. He is calling for a summit of regional governors, as well as streamlined access to treatment, better prevention measures, and "strengthening safe prescribing and dispensing practices" to "minimize diversion and misuse." That last bit is likely to raise concerns among people worried about adequate access to prescription opiates. But unlike some other state-level responses to rising levels of opiate use, Patrick's did not contain a law enforcement component. The link leads to the full press release.

International

Key Sinaloa Cartel Figure Reported Dead. Reports are emerging from Mexico that Juan Jose "El Azul" Esparragoza, a key figure in the Sinaloa cartel, has died of natural causes. After the capture of cartel head Joaquin "El Chapo" Guzman by Mexican authorities earlier this year, Esparragoza and Ismael "El Mayo" Zambada were viewed as the effective leaders of the cartel.

Spanish Authorities Close Down Barcelona Cannabis Club for Selling… Cannabis. A Barcelona cannabis club has been closed after police spotted a man approaching tourists and taking them to the club to score. Under Spanish law, one can grow marijuana for personal use, but not sell it. The cannabis clubs have sprung up as a way for consumers to pool their growing resources. Members pay an annual membership fee for a chance to share in the proceeds of the collectively cultivated cannabis, but they're not supposed to sell it.

Responding to Holder on Heroin, Reformers Call for a Health Direction [FEATURE]

US Attorney General Eric Holder had heroin on his mind Monday, using his weekly video message and an accompanying press release to draw attention to rising heroin overdose deaths and vowing to combat the problem with a combination of law enforcement, treatment, prevention, and harm reduction measures. Drug reformers generally responded positively, but called on the Obama administration to seek comprehensive, science- and health-based solutions instead of engaging in more drug war.

Attorney General Holder takes on heroin (usdoj.gov)
"Addiction to heroin and other opiates -- including certain prescription pain-killers -- is impacting the lives of Americans in every state, in every region, and from every background and walk of life -- and all too often, with deadly results. Between 2006 and 2010, heroin overdose deaths increased by 45%," Holder said. "Scientific studies, federal, state and local investigations, addiction treatment providers, and victims reveal that the cycle of heroin abuse commonly begins with prescription opiate abuse. The transition to -- and increase in -- heroin abuse is a sad but not unpredictable symptom of the significant increase in prescription drug abuse we've seen over the past decade."

What Holder didn't mention is that the rise in prescription pain pill misuse is tied to a massive increase in prescribing opioids for pain in the past decade. A study published last fall found that between 2000 and 2010, the amount of opioids prescribed for non-cancer pain had nearly doubled, and that during the same period, the percentage of people complaining of pain who received prescriptions for opioids jumped from 11% to nearly 20%. But reining in prescriptions generally isn't the answer either.

But at the same time, a 2011 Institute of Medicine report found that while "opioid prescriptions for chronic non-cancer pain [in the US] have increased sharply… 29% of primary care physicians and 16% of pain specialists report they prescribe opioids less often than they think appropriate because of concerns about regulatory repercussions."

As the IOM report noted, having more opioid prescriptions doesn't necessarily mean that "patients who really need opioids [are] able to get them." Opioid misuse and under-use of opioids for pain treatment when they are needed are problems that coexist in society. Pain pill crackdowns have also been found to result in increased use of street heroin, as a Washington Post article last week reports -- two additional reasons advocates prefer public health approaches to heroin more than law enforcement -- and why great care should be taken with the law enforcement measures.

"It's clear that opiate addiction is an urgent -- and growing -- public health crisis. And that's why Justice Department officials, including the DEA, and other key federal, state, and local leaders, are fighting back aggressively," Holder continued. "Confronting this crisis will require a combination of enforcement and treatment. The Justice Department is committed to both."

Holder pointed to DEA efforts to prevent diversion of pharmaceutical pain-relievers to non-medical users, mentioning investigations of doctors, pharmacists, and distributors.

"With DEA as our lead agency, we have adopted a strategy to attack all levels of the supply chain to prevent pharmaceutical controlled substances from getting into the hands of non-medical users," Holder said.

Cooking heroin (wikimedia.org)
Holder also pointed out that DEA had opened some 4,500 heroin investigations since 2011 and promising more to come.

But, as Holder noted, "enforcement alone won't solve the problem," so the administration is working with civil society and law enforcement "to increase our support for education, prevention, and treatment."

And although he didn't use the words "harm reduction," Holder is also calling for some harm reduction measures. He urged law enforcement and medical first responders to carry the overdose reversal drug naloxone (Narcan) and signaled support for "911 Good Samaritan" laws, which grant immunity from criminal prosecution to those seeking medical help for someone experiencing an overdose.

Holder got restrained plaudits from drug reformers for his small steps toward harm reduction measures, but they called for a more comprehensive approach.

"Preventing fatal overdose requires a comprehensive solution," said Meghan Ralston, harm reduction manager for the Drug Policy Alliance. "While naloxone is an absolutely critical component, we need a scientific, health-based approach to truly address the roots of the problem. This includes improving access to effective, non-coercive drug treatment for everyone who wants it, as well as improving access to medication-assisted treatments such as methadone and buprenorphine."

Naloxone (Narcan) can reverse opiate overdoses (wikimedia.org)
Ralston also added that just making naloxone available to cops and EMTs wasn't good enough. Friends and family members, not "first responders," are most often the people who encounter others in the throes of life-threatening overdoses.

"While we applaud Attorney General Holder's clear support for expanding access to naloxone, particularly among law enforcement and 'first responders,' we urge him to clarify that he supports naloxone access for anyone who may be the first person to discover an opiate overdose in progress," she said.

But Law Enforcement Against Prohibition (LEAP), a group of law enforcement officials opposed to the war on drugs, applauded the move, which could help soften reflexive law enforcement opposition to carrying the overdose antidote, an attitude reflected in the the International Association of Chiefs of Police's opposition to all harm reduction measures.

"Police may not be the first to embrace change, but we are slowly evolving," said Lieutenant Commander Diane Goldstein (Ret.). "We cannot arrest our way out of a public health problem, and it's clear that the Attorney General is beginning to understand that and to embrace the role of harm reduction in reducing death, disease and addiction in our communities. We still have a long way to go, but this is a good sign."

The idea is "a no-brainer," according to executive director Major Neill Franklin (Ret.). "It is simply immoral not to support something proven to save lives for political reasons," Franklin added. "Yes, police send a message when they choose not to carry naloxone. But that message is not 'don't do drugs,' it's 'if you make the wrong decisions in your life, we don't care about you.' That offends me both as a former cop and as a human being."

The nuanced pushback to Holder's law enforcement/prevention/treatment/hint of harm reduction approach is good as far as it goes, but it doesn't go far enough. Decriminalizing and destigmatizing now illicit drug use, as has been the case in Portugal, is an obvious next step, and removing the question of drugs from the purview of the criminal justice system altogether would be even better. Still, that a sitting attorney general is calling for treatment and harm reduction as well as law enforcement is a good thing, and for reformers to be calling him on not going far enough is a good thing, too.

War of Words: The International Narcotics Control Board vs. A Changing World [FEATURE]

The global drug prohibition bureaucracy's watchdog group, the International Drug Control Board (INCB) released its Annual Report 2013 today, voicing its concerns with and wagging its finger at drug reform efforts that deviate from its interpretation of the international drug control treaties that birthed it. The INCB is "concerned" about moves toward marijuana legalization and warns about "the importance of universal implementation of international drug control treaties by all states."

"We deeply regret the developments at the state level in Colorado and Washington, in the United States, regarding the legalization of the recreational use of cannabis," INCB head Raymond Yans said in introducing the report. "INCB reiterates that these developments contravene the provisions of the drug control conventions, which limit the use of cannabis to medical and scientific use only. INCB urges the Government of the United States to ensure that the treaties are fully implemented on the entirety of its territory."

For some years now, some European and Latin American countries have been expressing a desire to see change in the international system, and "soft defections," such as the Dutch cannabis coffee shop system and Spain's cannabis cultivation clubs, have stretched the prohibitionist treaties to their legal limits. But legal marijuana in Uruguay is a clear breach of the treaties, as Colorado and Washington may be. That is bringing matters to an unavoidable head.

After surveying the state of drug affairs around the globe, the 96-page INCB report ends with a number of concerns and recommendations, ranging from non-controversial items such as calling for adequate prevention and treatment efforts to urging greater attention to prescription drug abuse and more attention paid to new synthetic drugs. [Ed: There is some controversy over how to best approach prescription drug abuse and synthetic drugs. e.g. the type of attention to pay to them.]

But the INCB is clearly perturbed by the erosion of the international drug prohibition consensus, and especially by its concrete manifestations in legalization in Uruguay, Colorado, and Washington and the spreading acceptance of medical marijuana.

"The Board is concerned that a number of States that are parties to the 1961 Convention are considering legislative proposals intended to regulate the use of cannabis for purposes other than medical and scientific ones" and "urges all Governments and the international community to carefully consider the negative impact of such developments. In the Board's opinion, the likely increase in the abuse of cannabis will lead to increased public health costs," the report said.

Similarly, the INCB "noted with concern" Uruguay's marijuana legalization law, which "would not be in conformity with the international drug control treaties, particularly the 1961 Convention" and urged the government there "to ensure the country remains fully compliant with international law, which limits the use of narcotic drugs, including cannabis, exclusively to medical and scientific purposes."

Ditto for Colorado and Washington, where the board was "concerned" about the marijuana legalization initiatives and underlined that "such legislation is not in conformity with the international drug control treaties." The US government should "continue to ensure the full implementation of the international drug control treaties on its entire territory," INCB chided.

But even as INCB struggles to maintain the legal backbone of global prohibition, it is not only seeing marijuana prohibition crumble in Uruguay and the two American states, it is also itself coming under increasing attack as a symbol of a crumbling ancien regime that creates more harm than good with its adherence to prohibitionist, law enforcement-oriented approaches to the use and commerce in psychoactive substances.

"We are at a tipping point now as increasing numbers of nations realize that cannabis prohibition has failed to reduce its use, filled prisons with young people, increased violence and fueled the rise of organized crime," said Martin Jelsma of the Transnational Institute. "As nations like Uruguay pioneer new approaches, we need the UN to open up an honest dialogue on the strengths and weaknesses of the treaty system rather than close their eyes and indulge in blame games."

"For many years, countries have stretched the UN drug control conventions to their legal limits, particularly around the use of cannabis," agreed Dave Bewley-Taylor of the Global Drug Policy Observatory. "Now that the cracks have reached the point of treaty breach, we need a serious discussion about how to reform international drug conventions to better protect people's health, safety and human rights. Reform won't be easy, but the question facing the international community today is no longer whether there is a need to reassess and modernize the UN drug control system, but rather when and how."

"This is very much the same old stuff," said John Collins, coordinator of the London School of Economics IDEAS International Drug Policy Project and a PhD candidate studying mid-20th Century international drug control policy. "The INCB views its role as advocating a strict prohibitionist oriented set of policies at the international level and interpreting the international treaties as mandating this one-size-fits-all approach. It highlights that INCB, which was created as a technical body to monitor international flows of narcotics and report back to the UN Commission on Narcotic Drugs, has carved out and maintains a highly politicized role, far removed from its original treaty functions. This should be a cause for concern for all states interested in having a functioning, public health oriented and cooperative international framework for coordinating the global response to drug issues," Collins told the Chronicle.

"The INCB and its current president, Raymond Yans, take a very ideological view of this issue," Collins continued. "Yans attributes all the negative and unintended consequences of bad drug policies solely to drugs and suggests the way to lessen these problems is more of the same. Many of the policies the board advocates fly in the face of best-practice public health policy -- for example the board demanding that states close 'drug consumption rooms, facilities where addicts can abuse drugs,'" he noted.

"If the board was really concerned about the 'health and welfare' of global populations it would be advocating for these scientifically proven public health interventions. Instead it chooses the road of unscientific and ideological based policies," Collins argued.

The INCB's reliance on ideology-driven policy sometimes leads to grotesque results. There are more than 30 countries that apply the death penalty for drugs in violation of international law. Virtually every international human rights and drug control body opposes the death penalty for drugs including the United Nations Office on Drugs and Crime, the UN Human Rights Committee, the UN's human rights experts on extrajudicial killings, torture and health, among many others.

INCB head Raymond Yans (incb.org)
But when an INCB board member was asked in Thailand -- where 14 people have been executed for drugs since 2001 -- what its position on capital punishment was, he said, "the agency says it neither supports nor opposes the death penalty for drug-related offenses," according to the Bangkok Post.

Human rights experts were horrified and immediately wrote asking for clarification, to which the INCB responded, "The determination of sanctions applicable to drug-related offenses remains the exclusive prerogative of each State and therefore lie beyond the mandate and powers which have been conferred upon the Board by the international community," according to Human Rights Watch.

Another area where the board's concern about the health and welfare of global populations is being challenged is access to pain medications. A key part of the INCB's portfolio is regulating opioid pain medications, and this year again it said there is more than enough opium available to satisfy current demand, although it also noted that "consumption of narcotic drugs for pain relief is concentrated within a limited number of countries."

The World Health Organization (WHO) agrees about that latter point. A 2011 study estimated that around 5.5 billion people -- or 83% of the world population -- live in countries with 'low to non-existent' access to opioid pain relief for conditions such as cancer and HIV/AIDS. These substances are listed by the WHO as essential medicines, and the international drug control conventions recognise explicitly that they are 'indispensable' to the 'health and welfare of mankind.'

Adding to the paradox -- the global supply is sufficient, but four-fifths of the world doesn't have access -- the INCB calls on governments to "ensure that internationally controlled substances used for pain relief are accessible to people who need them."

What is going on?

"The INCB uses totals of requirements for opioid medicines compiled by the UN treaty signatory states," said Ann Fordham, executive director of the International Drug Policy Consortium, which keeps an eye on the agency with its INCB Watch. "Unfortunately there is often a huge gap between these administrative estimates and the actual medical needs of their populations."

The prohibitionist slant of global drug control also creates a climate conducive to understating the actual need for access to pain relief in other ways, Fordham told the Chronicle.

"Many governments interpret the international drug control conventions in a more restrictive manner than is necessary, and focus their efforts towards preventing access to the unauthorized use of opioids rather than to ensuring their medical and scientific availability," she said. "This is a grossly unbalanced reading of the conventions, underpinned by fear and prejudice regarding opioids and addiction."

Although the agency has cooperated somewhat with the WHO in attempting to enhance access to the medicines, said Fordham, it bears some blame for rendering the issue so fraught.

"The INCB has continually stressed the repressive aspect of the international drug control regime in its annual reports and other public statements, and in its direct dealings with member states," she said. "The INCB is therefore responsible for at least some of the very anxieties that drive governments toward overly restrictive approaches. This ambivalence considerably weakens the INCB's credibility and contradicts its health-related advocacy."

Fordham joined the call for a fundamental reform of global drug prohibition, and she didn't mince words about the INCB.

"The entire UN drug control system needs to be rebalanced further in the direction of health rather than criminalization, and it is changing; the shift in various parts of the system is apparent already," she said before leveling a blast at Yans and company. "But the INCB is notable as the most hard line, backward-looking element, regularly overstepping its mandate in the strident and hectoring manner its adopts with parties to the treaties, in its interference in functions that properly belong to the WHO and in its quasi-religious approach to a narrow interpretation of the drug control treaties."

The INCB should get out of the way on marijuana and concentrate on its pain relief function, said Collins.

"The INCB should stay out if it," he said bluntly. "It is a technocratic monitoring body. It should not be involving itself in national politics and national regulatory systems. So it doesn't need to be either a help or hindrance on issues regarding cannabis reform. It has no reason to be involved in this debate. It should be focusing on ensuring access to essential pain medicines. These debates are a distraction from that core function and I would argue one of the reasons it is failing to meet this core function."

Sorry, INCB. Welcome to the 21st Century.

Vienna
Austria

China, Southeast Asia Vow More Better Drug War

At a meeting in Myanmar Thursday, China and five Southeast Asian nations vowed to redouble their efforts and boost cooperation in an effort to get a grip on illegal drug use and trafficking, which they called "a significant threat" to the region.

opium poppy (UNODC)
China was joined by Cambodia, Laos, Myanmar, Thailand, and Vietnam), along with the UN Office on Drugs and Crime (UNODC), for the Ministerial Meeting of the Signatory Countries to the 1993 Memorandum of Understanding on Drug Control in the Greater Mekong Sub-Region.

"Consumption and production of narcotic drugs continues to grow rapidly within the region and worldwide, constituting a significant threat to the East Asian region," according to a joint statement adopted at the meeting.

The countries and the UNODC pledged to heighten cross-border cooperation, examine alternative development programs, and share experiences in drug treatment, prevention, and public awareness.

"This agreement marks the continued commitment of the six MOU countries in supporting drug control in the region, and the celebration of 20 years of partnership and collaboration," said Myanmar representative Home Affairs Minister Lt. Gen. Ko Ko at the signing ceremony. "The MOU Member States re-affirm our commitment and assure the international community of our efforts to eliminate the drug problem in our region."

Southeast Asia has been a hotbed of methamphetamine production in recent years, and Myanmar is now the world's second largest producer of opium -- although its production is only about one-tenth that of world leader Afghanistan.

"Major challenges persist," said John Sandage, UNODC director of treaty affairs. "The resurgence of opium poppy cultivation, the dramatic spread of amphetamine-type stimulants (ATS), the influx of drugs new to the region and increased levels of addiction. UNODC looks forward to working with the MOU states to implement plans that help us better understand the threat and challenges, build technical capacity and lead to greater cooperation across borders and among agencies."

Nay Pyi Taw
Myanmar

GAO Says ONCDP Not Achieving Drug Goals So Far

Just a day after the Office of National Drug Control Policy (ONDCP -- the drug czar's office) released its latest annual national drug control strategy, the Government Accountability Office (GAO) has issued a report finding that ONDCP has fallen well short of goals enunciated in its 2010 national drug strategy.

In the report, Office of National Drug Control Policy: Office Could Better Identify Opportunities to Increase Program Coordination, GAO noted that ONDCP and the federal government "have not made progress toward achieving most of the goals articulated in the 2010 National Drug Control Strategy." In some areas, including reducing teen drug use, reducing drug overdose deaths, and reducing HIV infections from injection drug use, GAO found, ONDCP was not only not making progress, but sometimes the numbers were moving in the opposite direction.

For instance, under the broader goal of "curtailing illicit drug consumption in America," ONDCP had set use reduction goals to be achieved by 2015. It sought to reduce last month drug use by teens by 15%, but has achieved no movement. Similarly, it sought a 15% reduction in past month use by young adults, but has achieved no movement. It also sought to reduce lifetime use of drugs, alcohol, and tobacco by 8th graders by 15%, and was making progress toward its goal with alcohol and tobacco, but not with illegal drugs.

Likewise, under ONDCP's broad goal of "improving the public health and public safety of the American people by reducing the consequences of drug use," ONDCP identified goals of reducing overdose deaths, drug-related hospital emergency room visits, and drug-related HIV infections by 15% by 2015, but showed "movement away from goal" between 2010 and 2012.

Drug czar Gil Kerlikowske is talking up a "21st Century Approach" to drug use with a heavy emphasis on treatment and prevention, but the latest national drug budget still allocates 58% of funding to law enforcement and interdiction. And those remaining funds for treatment and prevention are "fragmented" across 15 federal agencies, with much overlapping. GAO reviewed 76 federal drug treatment and prevention programs and found 59 of them overlapped.

GAO did note that while ONDCP was not showing progress in most of its goals, it had implemented 107 of the 112 "action items" contemplated to meet those goals. The auditors noted that "ONDCP officials stated that implementing these action items is necessary, but may not be sufficient to achieve Strategy goals."

Washington, DC
United States

White House 2013 National Drug Strategy Released

The White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) released its 2013 National Drug Control Strategy Wednesday. The strategy is being billed as a "21st Century Approach" to drug use and trafficking, but despite some rhetorical softening maintains the US hard-line approach to the issue.

"The president has outlined his vision of an America built to last -- where an educated, skilled workforce has the knowledge, energy and expertise to compete in the global marketplace. Yet -- for far too many Americans -- that vision is limited by drug use, which not only diminishes the potential of the individual, but jeopardizes families, communities and neighborhoods," ONDCP wrote on a blog post announcing the strategy's release and touting reductions in cocaine and prescription drug abuse as progress made.

"Today we are releasing a science-driven plan for drug policy reform in America to build upon this progress," ONDCP continued. "This 21st century drug policy outlines a series of evidence-based reforms that treat our nation's drug problem as a public health issue, not just a criminal justice issue. This policy underscores what we all know to be true: we cannot arrest or incarcerate our way out of the drug problem."

The strategy emphasizes treatment and prevention, but despite the rhetoric, the Fiscal Year 2014 federal drug budget it accompanies continues to be imbalanced, with 58% of federal anti-drug spending directed at law enforcement and interdiction efforts. That figure does mark a decline from previous years, but only a marginal one.

And even its emphasis on treatment also includes punitive criminal justice elements, such as its embrace of the drug court system, where drug-addicted people are subjected to legal sanctions for such addiction-related behaviors as failing a drug test or missing an appointment. That has some drug reformers calling foul.

"The administration says drug use is a health issue but then advocates for policies that put people in the criminal justice system," said Bill Piper, director of national affairs for the Drug Policy Alliance. "Until the drug czar says it is time to stop arresting people for drug use, he is not treating drug use as a health issue no matter what he says. I know of no other health issue in which people are thrown in jail if they don't get better."

While much of the strategy is little more than the same old same old, the strategy does call for expanded access to naloxone, a low-cost antidote that can reverse the effects of opioid overdoses. That is in response to the rapid growth in prescription drug overdose deaths in recent years.

"Director Kerlikowske should be applauded for taking steps to reduce drug overdose fatalities, but he's not doing much to reduce drug arrests or the many other problems associated with treating drug use through the criminal justice system," said Piper.

But while the drug strategy shows flexibility in its efforts to deal with fatal drug overdoses, it maintains a staunch opposition to marijuana reform and includes attacking outdoor and indoor marijuana cultivation as one of its key goals.

"The administration's continued opposition to marijuana law reform shows they're not serious about reforming US drug policy," said Piper. "At the very least they should stop getting in the way of states that are trying to improve public health and safety by regulating marijuana like alcohol."

Washington, DC
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."

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://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.

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