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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Pinellas County
FL
United States

"You Can't Stop AIDS Without Ending the Drug War" [FEATURE]

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.

http://stopthedrugwar.org/files/aids2012-protest-1.jpg
activists interrupt the conference opening session to protest the exclusion of drug users and sex workers (video at droginreporter.hu/en)
But other critical groups remained excluded -- drug users and sex workers. Although they make up a majority of people living with HIV in many countries, people who admit to ever using drugs or engaging in prostitution within the past 10 years are inadmissible under US immigration laws. The State Department could have issued a blanker waiver of inadmissibility for people attending the conference, but declined to do so.

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.

Washington, DC
United States

Making Sure Drugs Kill: Commission Blames Drug War for Spreading AIDS [FEATURE]

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.

Commission members Michel Kazatchkine, Ruth Dreifuss, and Ilana Szabo at London press conference
Those voices, gathered together as the Global Commission on Drug Policy, include six former presidents from around the world, public health experts, and socially conscious entrepreneurs such as Sir Richard Branson. They took the opportunity of global anti-drug day to issue a report, The War on Drugs and HIV/AIDS: How the Criminalization of Drug Use Fuels the Global Pandemic that directly condemns the drug war as a failure and calls for immediate, fundamental reforms of the global drug prohibition regime to slow the spread of HIV and reduce other drug war harms.

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."

Commission member Sir Richard Branson at "Atlantic Exchange" drug policy discussion, Washington, DC, March 2012
"I have long thought the war on drugs did more harm than good, and the commission's report put the data behind those beliefs," said Branson. "The war on drugs is not stopping drug use, and it also contributes significantly to the AIDS epidemic by driving users into the shadows. As an entrepreneur, if my business was failing for 40 years, I would close it down. Refusing to implement public health measures to reduce HIV and protect people with a drug problem is nothing short of criminal."

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.

London
United Kingdom

Historic Challenge to Drug War Looms at Cartagena Summit [FEATURE]

In just a couple of days, President Obama will fly to Cartagena, Colombia, to attend this weekend's Organization of American States (OAS) Sixth Summit of the Americas. He and the US delegation are going to get an earful of criticism of US drug policies from Latin American leaders, and that makes it an historic occasion. For the first time, alternatives to drug prohibition are going to be on the agenda at a gathering of hemispheric heads of state.

group photo at 2009 Summit of the Americas (whitehouse.gov)
It's been building for some time now. More than a decade ago, Uruguayan President Jorge Batlle became the first Latin American sitting head of state to call for a discussion of drug legalization. Former Mexican President Vicente Fox joined the call, albeit only briefly while still in office through some media quotes, much more frequently after leaving office in 2006. Honduran President Manuel Zelaya issued a similar call in 2008, but didn't move on it before being overthrown in a coup the following year.

Meanwhile, drug prohibition-related violence in Mexico exploded in the years since President Felipe Calderon called out the army after taking office in December 2006. As the savagery of the multi-sided Mexican drug wars intensified and the death toll accelerated, surpassing 50,000 by the end of last year, the call for another path grew ever louder and more insistent.

In 2009, a group of very prominent Latin American political leaders and public intellectuals led by former Brazilian President Henrique Cardoso, former Colombian President Cesar Gaviria, and former Mexican President Ernesto Zedillo formed the Latin American Commission on Drugs and Democracy, calling for a fundamental reexamination of drug policy in the hemisphere and a discussion of alternatives, including decriminalization and regulation of black markets. That was followed last year by the Global Commission on Drug Policy, which includes the Latin American ex-presidents, as well as former Switzerland President Ruth Dreiffus and other prominent citizens such as Richard Branson and former UN Secretary General Kofi Annan, echoing the Latin American Commission's call for reform.

As the commissions issued their reports, the violence in Mexico not only worsened, it spread south into Central America, where governments were weaker, poverty more endemic, and violent street gangs already well-entrenched. Guatemala, Honduras, and El Salvador, in particular, saw homicide rates soar in recent years, well beyond Mexico's, as the Mexican cartels moved into the region, a key transit point on the cocaine trail from South America to the insatiable consumers of the north.

Colombian President Juan Manuel Santos, the secretary of defense under his predecessor, Alvaro Uribe, and a man who knows well just what a sustained war on drugs can and cannot achieve, has been among the latest to pick up the torch of drug reform. Santos has made repeated statements in favor of putting alternatives to prohibition on the table, although he has been careful to say Colombia doesn't want to go it alone, and now he has been joined by another unlikely reformer, Guatemalan President Otto Perez Molina, a rightist former general who campaigned on a tough on crime agenda.

It is Perez Molina who has been most active in recent weeks, calling for a Central American summit last month to discuss alternatives to drug prohibition ranging from decriminalization to regulated drug transit corridors to charging the US a "tax" on seized drugs. That summit saw two of his regional colleagues attend, Costa Rican President Laura Chinchilla and Panamian President Ricardo Martinelli, but no consensus was achieved, no declaration was issued, and three other regional leaders declined to show up. But that summit, too, was a first -- the first time Latin American leaders met specifically to discuss regional drug law reform.

All of this has not gone unnoticed by policymakers in Washington. Vice-President Biden, Homeland Security Secretary Napolitano, State Department functionaries and US military brass have all been flying south this year, reluctantly conceding that drug legalization may be a legitimate topic of debate, but that the US is having none of it.

"It's worth discussing," Biden told reporters in Mexico City last month. "But there's no possibility the Obama-Biden administration will change its policy on legalization. There are more problems with legalization than non-legalization."

But along with discussing an end to prohibition, the Latin Americans have also offered up proposals between the polar opposites of prohibition and legalization. Options discussed have included decriminalization of drug possession and marijuana legalization to different approaches to combating the drug trade to maintaining addicts with a regulated drug supply. In Colombia, Santos has sponsored legislation to decriminalize possession of "personal dose" quantities of drugs, restoring a policy mandated by the country's Constitutional Court but undone by a constitutional amendment under President Uribe.

And it's not just Latin American political leaders. The calls for change at the top are reflected in a civil society movement for drug reform that has been quietly percolating for years. In fact, an international, but mainly Latin American, group of non-governmental organizations this week issued an Open Letter to the Presidents of the Americas calling for decriminalizing drug use and possession, alternatives to incarceration for non-serious drug offenses, a regulated market for marijuana, a public health approach to problematic drug use, alternative development, respect for traditional uses, and a more focused war on organized crime that is less broadly repressive than current models. In Mexico, a social movement led by poet Javier Sicilia, whose son fell victim to cartel violence, has called for an end to the violence and pressed Preident Calderon on drug reform.

After decades of US-imposed drug war, from US military operations in Bolivia in the 1980s to the multi-billion dollar Plan Colombia, with its counterinsurgency and aerial herbicide spraying, to the blood-stained Mexican border towns and the drug gang-ridden slums of Rio de Janeiro, Latin America is growing increasingly ready to strike out on a different path.

That's what awaits President Obama and the US delegation in Cartagena. The most vibrant discussions may well take place in hallways or behind closed doors, but the US is now faced with yawning cracks in its decades-long drug war consensus.

Joe Biden with Mexican Pres. Calderon last month (whitehouse.gov)
"It's very clear that we may be reaching a point of critical mass where a sufficient number of people are raising the questions of why not dialog on this issue, why not discuss it, why peremptorily dismiss it, why does the president laugh when the subject of drugs is brought up, is he so archly political that it becomes a sort of diabolical act to seriously discuss it, why isn't some new direction being ventured forth?" said Larry Birns, executive director of the Council on Hemispheric Affairs.

"It seems the public is approaching the point where it has become credible to say quite frankly that the drug war hasn't worked. The real menace to society is not so much legalization but the failure to confront the hard fact that after decades of effort and hundreds of billions of dollars, a successful prohibition strategy has not been created, nor is there any likelihood of it being created," he said.

"This is the first major gathering of heads of state at which alternatives to prohibitionist drug control policies, including decriminalization and legal regulation of currently illegal drugs, will be on the agenda," said Ethan Nadelmann, head of the Drug Policy Alliance. "Arguments that were articulated just five years ago primarily by intellectuals and activists, and three years ago by former presidents, are now being advanced, with growing sophistication and nuance, by current presidents. There is now, for the first time, a critical mass of support in the Americas that ensures that this burgeoning debate will no longer be suppressed."

"A lot of countries don't want to do the US's dirty work anymore -- enforcing the prohibitionist policies that are unenforceable and hypocritical," said Laura Carlson, director for Latin America rights and security in the Americas program at the Center for International Policy. "Everybody knows that it's impossible to wipe out the illicit drug business without making it legal, and most people know that the efforts aimed at ostensibly doing that are not 100% honest and certainly not effective. Many Latin American countries don't want the degree of US intervention in their national security that the drug war entails either," she noted.

"Having said that, the US government is determined to put down any talk of alternatives and particularly alternatives that begin with regulation rather than prohibition. The recent visits of Napolitano, Biden, [US State Department Assistant Secretary for the Bureau of International Narcotics and Law Enforcement Affairs William] Brownfield and the military leaders all carried that message," the Mexico City-based analyst continued. "Small and dependent countries -- El Salvador is the example here, after reversing its position on legalization -- are afraid to stand up to the US on this, and progressive countries don't seem to want to get involved, both because they find the issue a political hot potato and because they are focusing efforts on strengthening alternative organizations to the OAS."

"I think the US strategy of Brownfield and the State Department will be to say that legalization was brought up and rejected by the Latin American leaders," offered Sanho Tree, director of the Drug Policy Project at the Institute for Policy Studies. "They will use dichotomous rhetoric, they will try to maneuver the discussion into either prohibition or heroin in vending machines, but this is about the whole spectrum of regulatory possibilities. That's what we need to be talking about instead of that false dichotomy."

Still, to even deign to discuss policy alternatives to prohibition is a notable step forward for the US, even if it is only to dismiss them, Nadelmann argued.

"The shift in the public posture of the US government -- from rejecting any discussion of legalization to acknowledging that 'it is a legitimate subject of debate' -- is significant, notwithstanding the clear caveat by the Obama administration that it remains firmly opposed to the notion," he noted. "That said, it is safe to assume that the US government will do all it can to suppress, ignore, distort and otherwise derail the emerging dialog.  US officials are handicapped, however, by the remarkable failure of government agencies over the past thirty years to contemplate, much less evaluate, alternative drug control strategies. They also must contend with the fact that the United States has rapidly emerged -- at the level of civil society, public opinion and state government -- as a global leader in reform of marijuana policies."

The discussion on drug policy at Cartagena isn't taking place in a vacuum, and there is at least one other issue where the US finds itself at odds with its host and most of the region: Cuba. The US has once again insisted that Cuba not be allowed to attend the summit, and President Santos reluctantly acceded, but the whole affair leaves a sour taste in the mouth of Latin Americans. Ecuadorian President Correa is not coming because of the snub, and the issue only plays into hemispheric discontent with Washington's war on drugs.

"The US won the day in persuading Santos not to invite Cuba," said Birns, "but the political cost of that action is high, and the whole drug issue is twinned to it, not because Castro has an enlightened position on drugs, but because of anti-Americanism in the region. This means Cartagena is the city where a lethal blow against the status quo will be achieved."

"The United States is not going to listen," said Birns, "but this era of non-discussion of drug legalization and refusal to countenance the possibility of dialog on the issue may be coming to an end. More and more people who aren't known as drug reform crusaders are coming forth and saying it's not working, that we need another approach, and that's probably decriminalization and legalization. We're very much closer to liberation on this issue than we've ever been before."

"Liberation" may now be within sight, but diplomatic dissent is not yet close to being translated into paradigmatic policy shifts. Whatever discussion does take place in Cartagena this weekend, don't expect any official breakthroughs or even declarations, said Carlson.

"I am not optimistic about there being any formal commitment, or perhaps even mention, of legalization per se," she said. "The implementation group for the Sixth Summit is already working on the final declaration and it contains a section on 'Citizen Security and Transnational Organized Crime.' I think that as far as it will go is to state that transnational organized crime is a growing problem and that the nations of the Americas agree to work together, blah, blah, blah," she predicted.

"The United States will reiterate its 'shared responsibility' and commitment, but will not mention the need to change a failed model," Carlson said. "There will be more rhetorical emphasis on social programs for 'resilient communities' and especially on police and judicial reform, although the former will not be reflected in what are largely military and police budgets. I think the best we can hope would be a mandate for a policy review and a commitment to continue to discuss alternatives. The specific proposals to legalize transit, to create a regional court for organized crime cases and US payment for interdictions will not likely be resolved."

"This is a long process, not an immediate objective," said Tree. "In Central America, it's going to take a year or two of thoughtful -- not sensational -- media coverage. When people see anarchy, they want order. With a more thoughtful dialog, we can begin to get traction."

"It is too soon to predict that this Summit of the Americas represents any sort of tipping point in global or even regional drug control policy," Nadelmann summed up. "But the odds are good that this gathering will one day be viewed as a pivotal moment in the transformation from the failed global drug prohibition regime of the twentieth century to a new 21st century global drug control regime better grounded in science, health, fiscal prudence and human rights."

We'll see what happens this weekend, but at the very least, the taboo on serious discussion of reforming the drug prohibition regime at the highest levels has been shattered. Look for a report on the summit itself next week.

Cartagena
Colombia

Giving Addicts Heroin More Effective Than Methadone, Study Finds

Treating intractable heroin addicts with a pharmaceutical version of their drug is more cost-effective than providing them with methadone, a common opioid substitute, a study published Monday in the Canadian Medical Association Journal suggests.

Diacetylmorphine AKA pharmaceutical grade heroin (wikimedia.org)
The study analyzed data from the North American Opiate Medication Initiative (NAOMI ), a 2005-2008 study that compared the use of diacetylmorphine (heroin) and methadone in street addicts. In the NAOMI study, researchers selected 250 subjects in Vancouver and Montreal who had been strung out for at least five years and had twice previously failed on methadone maintenance. Participants were randomly chosen to take either heroin or methadone.

Researchers in this study examined the cost-effectiveness of the two approaches in one-year, five-year, 10-year increments, as well over the lifetimes of the users. The study found that those using methadone generated an average lifetime social cost of $1.14 million, while those using heroin had a cost of $1.1 million, a difference of about $40,000 per user. An estimated 60,000 to 90,000 Canadians are addicted to heroin or other opioids.

"If you are on treatment, you're basically well-behaved," principal investigator Aslam Anis, a health economist at the University of British Columbia told the Canadian Press Monday. "When you're not taking treatment, for instance when you relapse, you're doing all kinds of bad things, criminal activity, getting into jail. The cost benefit is through an indirect effect," said Anis, through fewer robberies and other crimes, which have an adverse impact on victims and drive up criminal justice system costs.

"People who take (medical) heroin are retained on the treatment for longer periods of time and they have shorter periods of time when they relapse," Anis said. "And when you add it all up, you find that you've actually saved money."

"Methadone can be a very effective medication for some people, but it doesn't work for everybody with heroin addiction," said coauthor Dr. Martin Schechter, an epidemiologist at UBC's School of Population and Public Health. "And there is a subset of folks who go in and out of treatment and ultimately end up back using street heroin. They would be unlikely to be attracted into yet another methadone program," he said.

"But giving them injections of medically prescribed heroin in a clinic setting staffed by doctors, nurses and counselors gets them back into the health-care system. It also cuts the risk of infection with hepatitis C and HIV from needle-sharing. So diacetylmorphine is a medically prescribed heroin that we show in the study was more likely to keep people in treatment. And we know that keeping people in treatment is a very important predictor of success."

No matter what this or any other study finds, the Conservative Canadian government is opposed to harm reduction measures, such as safe injection sites and heroin maintenance therapies. Still, said Schecter, the government needs to face reality.

"The fact is that these people are taking heroin right now. They're in the back alleys in the Downtown Eastside, they're buying the heroin on the street, contributing to the black market and crime and violence," he said. "And they're not in any treatment and they're costing the system lots and lots of money. So our proposal says rather than having them do that in the back alley, why don't we attract them into a clinic where they will be in contact with doctors and nurses and counselors, we stabilize them by getting them out of a life of crime."

So, is anybody listening in Ottawa? Probably not, but the current government won't be in power forever.

Canada

New Canadian Drug Reform Coalition Emerges [FEATURE]

Even as Canada's Conservative federal government attempts to drag the country back into the last century with its drug and crime policies, a new drug reform umbrella group has emerged to fight for smart, sensible, evidence-based alternatives. The Canadian Drug Policy Coalition (CDPC) unveiled itself and its new web site late last month.

http://stopthedrugwar.org/files/cdpc-logo.jpg
Enlisting many of Canada's leading experts in drug policy, the coalition is headed by Donald Macpherson, the former head of Vancouver's ground-breaking Four Pillars approach to the drug problem. It also includes researchers, public health officials, front-line harm reduction and treatment providers, people who use drugs, HIV/AIDS service organizations, youth organizations, parents, and community members, all of whom are concerned with the health and safety outcomes of Canadian drug strategies. Its emergence couldn't be more timely. (See a complete list of member organizations here.)

Tuesday, the House of Commons approved a draconian omnibus anti-crime bill, C-10, that would, among other things, create mandatory minimum sentences for growing as few as six marijuana plants and for manufacturing small amounts of hashish or hash oil. The Tories were able to shove the bill through despite broad opposition from across Canada after winning an outright parliamentary majority in the last elections.

Reformers say they will be unable to stop the bill's passage, although they will likely challenge it in the courts, which have proven friendlier to innovative drug policy reforms. The Supreme Court of Canada earlier this year blocked the federal government from shutting down Insite, Vancouver's safe injection site. It is in this contested terrain of federal drug policy, as well at the provincial level, that the coalition seeks to intervene.

"We're letting the world know we're here and we're a coalition that wants to grow," said Macpherson. "We’re working toward trying to change the paradigm and the direction of the federal government and introducing a public health and human rights perspective on drug policy in Canada."

The coalition went public last week, marking its coming out with a press conference in Vancouver, a Macpherson op-ed in the Vancouver Sun, and joining with the British Columbia Health Officers' Council (HOC) in releasing an HOC report, Public Health Perspectives for Regulating Psychoactive Substances, which describes how public health oriented regulation of alcohol, tobacco, prescription and illegal substances can better reduce the harms that result both from substance use and substance regulation than current approaches.

"This paper highlights the large number of needless and preventable deaths, hospitalizations and human suffering consequent to our current approaches," said Dr. Richard Mathias of the HOC. "The Health Officers’ Council is inviting feedback on its ideas and requesting that organizations and individuals join with us in a call for immediate changes to put the public’s health first."

"The story about the emperor's new clothes is replayed time and again by governments unwilling to own up to realities," said Robert Holmes, head of the British Columbia Civil Liberties Association, as he saluted the report. "Public health professionals in B.C. are right to point out that our current chaotic and contradictory drug laws and policies need to be reviewed against scientific evidence of what works to reduce consumption, social harms, and costs," he said.

"People routinely get put in jail for conduct related to active drug addictions, but the criminal justice system is hardly a surrogate for medical care. It is plain that we have inadequate treatment and detox available for people with addictions to help them cope, recover or quit," noted Holmes. "By making cannabis taboo, our society both prohibits and makes more alluring its use. It is, of course, widely used. But instead of recognizing that and taxing it like tobacco and liquor products, with the tax revenue going to the cost of education and care, we leave the massive profits of this industry to organized crime and leave taxpayers with the bill for police efforts to contain it."

"This report is important because it's not about which drugs are legal and which are not," Macpherson said. "We need to look at all drugs through a public health lens. We're trying to get beyond 'good drug, bad drug' and move toward finding a regulatory system that minimizes the harm and maximizes the benefits of these substances."

The provincial health officers' report is also noteworthy because it actually addresses the benefits of drug use, Macpherson said.

"It takes courageous public health doctors to dare to talk about the benefits of drug use," he said. "We all know that drugs can be beneficial from our use of alcohol to relax or become more social or our use of pharmaceuticals to kill pain, but you're not allowed to talk about that in the drug policy arena. It's all about reducing harm, but we need to acknowledge that drug use has its benefits."

More broadly, the CDPC is working toward:

  • A health, social and human rights approach to substance use;
  • The important role harm reduction approaches play;
  • Removing the stigma of criminalization for people who use drugs;
  • Moving beyond the current approach to drug prohibition;
  • A national dialogue on drug policy for Canada.

"We'll advocate for a comprehensive public health and human rights approach," said Macpherson. "It's not just about health, but also looks at social and human rights issues. And it's not just about ending the drug war, but to start talking about alternatives to the failed war on drugs."

The CDPC sees itself as facilitating the dialog, Macpherson said. "A lot of change in drug policy requires political leadership, but politicians also need support in taking those courageous steps, so that when you bring people together to talk reasonably in an informed way and bring the evidence to bear, you can then move forward. They can see that despite their fears about safe injection sites or cannabis regulation, those are actually sound ways to go that make their communities safer in the long run than the way we're going now," he said. "We're trying to position ourselves as the organization than can help find the answers through our expertise and by looking at what's worked and what hasn't in other jurisdictions, and by convening people who care about these issues to look for solutions that actually work instead of the same old same old."

And despite Conservative domination at the federal level, there is still plenty that can be done, both in Ottawa and in the provinces, Macpherson said. "There is a lot that can be done around health and harm reduction because most of the health approaches emanate from provincial health ministries," he said. "Harm reduction can also be done locally by municipalities, for example, by making the criminalization of drug users a low priority for police."

While any decision to end Canada's drug war will have to come from Ottawa, Macpherson said, the provinces can still move forward themselves. "We can expand the number of safe injection sites and other harm reduction programs, and we can move toward a more comprehensive public health approach. They're doing that in some provinces," he said.

Given the obstinacy and recalcitrance of the government of Prime Minister Steven Harper, the CDPC certainly has its work cut out for it, but there couldn't be a group more suited for the task.

Vancouver, BC
Canada

Bay Area Pols Slam Feds' Medical Marijuana Crackdown

A pair of Northern California elected officials last week urged the federal government to back off on its "senseless assault" on medical marijuana dispensaries. At the same time, they said they want to meet with federal officials to see what's behind the crackdown.

Stalwart supporters of medical marijuana state Sen. Mark Leno (D-San Francisco) and Assemblyman Tom Ammiano (D-San Francisco) took to the microphones at a news conference at the State Building in San Francisco.

"I urge the federal government to stand down in its massive attack on medical marijuana dispensaries," Leno said in remarks reported by KTVU-TV. "California voters intended that patients should have safe and affordable access to medical marijuana," he said.

Leno and Ammiano said they are pondering new state legislation to regulate dispensaries, but added that such laws would be workable only if California legislators hear from the Justice Department that such regulations would have an impact on federal enforcement efforts. They said they hoped to speak with Justice Department officials in the next few days.

"To be successful legislatively, we would need some indication from the federal government that (the state legislation) would impact" the Justice Department offensive, Ammiano said. 

"Call the dogs off and let's sit down," Leno said.

The news conference came in response to the October 7 announcement by California's four US Attorneys that they are ramping up federal persecution of medical marijuana providers in the state. Even though California voters approved medical marijuana in 1996, the federal government refuses to recognize such laws.

While the Justice Department has said it is not targeting patients, it is clearly targeting dispensaries and medical marijuana grow operations, with DEA raids ongoing and threatening letters being sent to dispensary landlords in a bid to force them to evict their medical marijuana tenants.

At the press conference, Ammiano conceded that California has little recourse when it comes to federal interference in its medical marijuana program. "In the end, they'll probably do whatever they want," he said.

Now, the federal government needs to be convinced that raiding medical marijuana providers operating in compliance with state laws is not what it wants. President Obama had a chance to get that message when he visited California on a fundraising swing this week. He was met by organized protestors when he came to San Francisco Tuesday.

British Lib Dems Call for Sweeping Drug Reforms [FEATURE]

Members of Britain's Liberal Democratic Party overwhelmingly adopted a resolution Sunday supporting the decriminalization of drug possession and the regulated distribution of marijuana and calling for an "impact assessment" of the 1971 Misuse of Drugs Act that would provide a venue for considering decriminalization and controlled marijuana sales.

The resolution calls for an independent panel "to properly evaluate, economically and scientifically, the present legal framework for dealing with drugs in the United Kingdom." Citing the Portuguese decriminalization model, the resolution called for consideration of reforms so that "possession of any controlled drug for personal use would not be a criminal offense" or that "possession would be prohibited but should cause police officers to issue citations for individuals to appear before panels tasked with determining appropriate education, health or social interventions."

The resolution also calls for the review to consider "alternative, potential frameworks for a strictly controlled and regulated cannabis market and the potential impacts of such regulation on organized crime, and the health and safety of the public, especially children."

The resolution includes a call for "widespread provision of the highest quality evidence-based medical, psychological and social services for those affected by drugs problems," including the widespread use of heroin maintenance clinics for hard-core addicts.

The resolution also offers support for the Advisory Council on the Misuse of Drugs (ACMD), whose scientific integrity has been under attack first by the former Labor government, which resulted in a number of high profile resignations, and then by the Conservatives, who have put forth a plan to no longer require a certain number of scientists to sit on the council. The council should "retain a majority of independent scientific and social scientific experts in its membership," and no changes to the drug laws should take place without its advice, the resolution said.

The Liberal Democrats are the junior partner in Britain's coalition government, having brokered a deal with Conservatives after the last parliamentary elections. The resolution will put the party in conflict with the Conservatives, who are opposed to any liberalization of Britain's drug laws.

It also puts them at odds with Labor, which after a brief dalliance with downgrading marijuana offenses in 2004, overrode the advice of the ACMD to restore the old, harsher penalties the following year. The Liberal Democrats can continue to boast of having the most progressive drug policy position of any of Britain's major parties.

The resolution was introduced by Ewan Hoyle, delegate from Glasgow South and founder of Liberal Democrats for Drug Policy Reform. Politicians have tip-toed around drug policy reform because of "cowardice, pure cowardice," he said. Instead of panicking over what the tabloids might say, Hoyle added, "It's time politicians looked voters in the eye and attempted to explain complex concepts. I want [Liberal Democratic leader] Nick Clegg to walk into [Prime Minister] David Cameron's office and say: 'This is part of what is needed to get the country out of a hole.'"

While most party front-benchers stayed out of the debate, MP Tom Brake, co-chair of the Home Affairs Parliamentary Party Committee, congratulated delegates on passage of the resolution.

"Today, Liberal Democrats reaffirmed our support for an evidenced based drugs policy, calling for an independent panel to review current drug laws," Brake said after passage. "We want to ensure the Government has a clear focus on prevention and reducing harm by investing in education, treatment and rehabilitation, and moving away from criminalizing individuals and vulnerable drug users. We need proper regulation and investment if we are to get to the root of the battle with drugs. Liberal Democrats are the only party prepared to debate these issues."

The Conservatives were quick to go on the attack. The resolution "sends out the message that taking drugs is okay, but it is not," Tory MP Charles Walker told the tabloid Daily Mail. "If the Liberal Democrats think taking heroin, cocaine and smoking skunk is okay, then that is up to them, but the government and I think most people in Britain do not agree with them."

While Labor continues to back away from drug reform, at least one Labor MP congratulated the Liberal Democrats on the resolution.

"The resolution passed should be acceptable to all but the most prejudiced MPs," said MP Paul Flynn, a long-time supporter of drug law reform. "But what next? Will someone take the campaign forward in Parliament?" he asked. "I've tried several times with bills and debates. I still have the scars to prove it. But, contrary to popular belief, advocating the end of drug prohibition is not an electoral liability. If it was I would have been rejected by the voters twenty years ago. This is an era when there is respect for strongly held independent views that challenge accepted foolishness."

Flynn could not resist a chance to jab at Prime Minister Cameron -- who supported drug legalization before he opposed it -- and the Liberal Democrats as well.

"An additional reason why drugs reform may be successful is that we have a Prime Minister who understands the argument," Flynn noted. "He wrote a great column in 2002 setting out the alternatives. The vote was practically unanimous this afternoon. Will the Lib Dems have the cojones to implement their conference policy?"

It may not be just a matter of cojones, but also of numbers, said Steve Rolles of the Transform Drug Policy Institute.

"This is Liberal Democratic policy only, and they are the minority partner in the coalition government," he noted. "They have had a pretty strong drug policy position for years, but the problem has been that it has been a shield issue for them rather than a sword issue. They have not wanted to take the lead on it because the leadership sees it as a potential liability rather than a strength. They have made the intellectual journey, but are afraid to commit on the political side."

But now the Liberal Democrats have passed their resolution, even if party leader Nick Clegg has been noticeably silent on the issue, and that puts the issue squarely before the public again. That's a good thing, said Rolles.

"The Tories will certainly need to respond, and will be made to look trenchant, anti-evidence, and dogmatic as a result," the analyst said. "Labor may move slightly, but I think they are biding their time to see what the public reaction will be. All the parties know that drug policy reform must happen at some point, but none want to move on it until they are more confident it will play well politically," he said.

"This pushes the debate into the political mainstream, which is always helpful, not least because it provides cover for others to take a public position on reform," Rolles continued. "We know that exposure to informed debate on this issue tends to move opinion in a positive direction so that is also a positive.  This isn't a seismic moment but it is another step in the right direction. Undermining the creaking edifice of prohibition is an attritional process."

The Liberal Democratic Party has had its say on drug policy reform this past weekend. Now, the question is how the party leadership responds and whether Labor and the Conservatives can be moved on the issue. It looks like the drug debate is heating up again in Britain.

United Kingdom

British Lib Dems to Call for Drug Decriminalization

The British Liberal Democratic Party, junior partner in a coalition government with the Conservatives, is expected to pass a motion calling for an independent panel to study the decriminalization of the possession of all illicit drugs and for a regulated marijuana market, according to various British press reports. The motion is to be voted on at the party's annual conference next month.

The motion also calls for the inquiry to review the impact of the Misuse of Drugs Act and whether the government should seriously consider heroin maintenance programs. It cites the success of the Portuguese decriminalization model, as well as the call for reform from the Global Commission on Drug Policy, and the findings of Britain's own Advisory Council on the Misuse of Drugs, which called for the decriminalization of drug possession during the national review of drug strategy last year.

Aides to Deputy Prime Minister and Liberal Democratic Party head Nick Clegg told the Daily Mail they expected party members to approve the motion next month, making it official policy and putting the Lib Dems at odds with their Conservative partners.

But The Guardian reported that Lib Dems believe Prime Minister David Cameron and Home Secretary Theresa May can be persuaded to allow an open-minded inquiry into the controversial topic. Earlier in his political career Cameron called for drug legalization, but he has since retreated from that position.

"There is increasing evidence that the UK's drugs policy is not only ineffective and not cost effective, but actually harmful, impacting particularly severely on the poor and marginalized," the motion said, citing "the need for evidence-based policy making on drugs with a clear focus on prevention and harm reduction."

The motion also calls for the inquiry to "examine heroin maintenance clinics in Switzerland and the Netherlands which have delivered great health benefits for addicts and considerable reductions in drug-related crime."

Even if the motion is passed, it is unlikely to become law. Its proposals will be opposed not only by the Tories, but also by Labor, which briefly entertained a dalliance with lessening penalties for marijuana before doing a U-turn on the issue in the face of public and political pressure. But passage of the motion would mean that one of Britain's major political parties is now lining up behind serious drug reform efforts.

United Kingdom

Chronicle Book Review: Drugs and Drug Policy

Drugs and Drug Policy: What Everyone Needs to Know, by Mark Kleiman, Jonathan Caulkins, and Angela Hawken (2011, Oxford University Press, 234 pp., $16.95 PB)

http://www.stopthedrugwar.org/files/drugs_and_drug_policy.jpg
Mark Kleiman isn't real popular among the drug reform set. The UCLA professor of public policy is no legalizer, and even though he's too much of an evidence-minded academic to be a wild-eyed drug warrior, he still seems to have an unbecoming fondness for the coercive power of the state. Kleiman, who gets top-billing over coauthors Jonathan Caulkins of Carnegie Mellon and Angela Hawken at Pepperdine, also ruffles reformers' feathers with unnecessary snideness and snark.

But I watched Kleiman address Students for Sensible Drug Policy conventions a couple of times, and I thought it was a good thing, a very useful jolt to the group-think that can grip any gathering of congregants committed to a cause. I thought having the students have to hear the arguments of a leading academic thinker on drug policy who, while not "the enemy," was not especially saying what the average SSDPer wanted to hear, was salubrious for their critical thinking skills. I still think so.

In Drugs and Drug Policy, Kleiman and his coauthors continue with the occasional jibes aimed at the drug reform movement, at times reach conclusions at odds with my own, but also serve up a surprisingly chewy work of drug policy wonkery in delicious bite-size chunks. The innovative format, something like a series of FAQs organized within broader chapters -- "Why Have Drug Laws?" "How Does Drug Law Enforcement Work?" "What Treats Drug Abuse?" "Can Problem Drugs Be Dealt With at the Source?" -- allows us to unpack that all-encompassing monster called "drug policy" one subset at a time, and for that achievement alone, is worthy of praise. That it manages to cover so much ground in a paltry 234 pages is all the more laudable.

Overall, Drugs and Drug Policy is smart, reasonable, and thoughtful. It wants policies based on evidence and it advocates for some intelligent alternatives to current policies. It recognizes the utility of needle exchanges, safe injection sites, and opiate maintenance, even as it complains that "harm reduction" has been hijacked by legalizers. It explains that most people who use drugs -- even those diagnosable as suffering from substance abuse disorders -- will quit using drugs themselves without recourse to treatment. And it even allows that drug use can have beneficial effects, even if it doesn't do so until the seventh chapter.

But Kleiman et. al dismiss decriminalization as unlikely to have a big impact on the social fiscal burden of drug law enforcement because, even though it doesn't appear to have much impact on consumption, drug consumers are not, for the most part, filling our prisons -- drug dealers are. While they do concede that not criminalizing otherwise law-abiding citizens could have "significant benefits," they seem to underplay the negative, life-long impact of a criminal drug record on one's life prospects.

In fact, they seem all too comfortable with maintaining the pernicious role of the criminal justice system in drug policy even as they recognize that enforcing the drug laws is "unavoidably an ugly process," with its reliance on snitches, surveillance, and other "intrusive methods" of enforcement. To give them credit, they want smarter drug law enforcement -- concentrating police repression on violent drug dealers while turning a blind eye to discreet dealing, triaging coerced drug treatment spots so they are reserved for the people who could most benefit from them, giving up on interdiction and source country eradication as ineffective -- that might actually reduce the social and fiscal costs of both drug abuse and enforcement, and since drug prohibition isn't going away anytime soon, at least wasting less money on drug war tactics that don't work well should be on the table.

And they reject drug legalization as too scary to experiment with, but seem to imagine it as possible only within a corporate-controlled, heavily-advertised, low-priced scenario similar to that which has accreted around the alcohol industry. Yes, it's probably true that selling cocaine like Coors, would lead (at least initially) to a significant increase in use and problem use, but why does that have to be the only model? A government monopoly similar to the state liquor store model, with reasonable taxes and no corporate pressure to advertise could conceivably allow legalization without the increases in consumption that the authors predict, even though they concede they don't know how large they might be.

Still, when you get to what it is Kleiman et al. would do if they had their druthers, all but the most purist of legalization advocates will find a lot to like. They create three separate lists of recommendations -- a "consensus list" of reforms they think are politically doable now or in the near future, a "pragmatic list" of reforms that would appeal to dispassionate observers but could raise the hackles of moralists, and a "political bridge too far list" of reforms too radical for mainstream politicians to embrace.

The "consensus list" includes expanding opiate maintenance therapy, encouraging evidence-based treatment, early intervention by the health care system, encouraging people to quit on their own (as opposed to being "powerless"), relying less on interdiction, ending the charade that alternative development is drug control, and concentrating drug enforcement on reducing violence and disorder, as well as smarter, more effective coerced treatment in the legal system. If we saw the drug czar's office produce a National Drug Control Strategy with these recommendations, we would consider that a great victory. It ain't legalization, but its headed in a more intelligent, more humane direction.

The "pragmatic list" includes recommendations to lower the number of drug dealers behind bars, not reject harm reduction even if it's been "hijacked," stop punishing former dealers and addicts, reduce barriers to medical research on illegal substances, and be open-minded about less harmful forms of tobacco use.

The authors don't neglect alcohol and tobacco -- the two most widely-used drugs -- and that is really evident in their "political bridge too far" recommendations. The first three items there are aimed squarely at reducing alcohol consumption and its ill effects. They also argue for the legalization of individual or collective marijuana cultivation, a sort of legalization without the market, increased study of the non-medical benefits of drugs, and increasing cigarette taxes in low tax states.

I think Drugs and Drug Policy needs to be read by anyone seriously interested in drug policy reform. It hits almost all the bases, and it's well-informed, provocative, and challenging of dogmatic positions. You don't like the authors' conclusions? Refute them. It'll be good for you.

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