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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.

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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)

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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.

NAACP Calls for End to War on Drugs

The National Association for the Advancement of Colored People (NAACP) has now officially broken with the war on drugs. At its 102nd annual convention in Los Angeles Tuesday, the nation's oldest and largest black advocacy group passed an historic resolution calling for an end to the drug war.

screening of "10 Rules for Dealing with Police," NAACP national conference, July 2010
The title of the resolution pretty much says it all: "A Call to End the War on Drugs, Allocate Funding to Investigate Substance Abuse Treatment, Education, and Opportunities in Communities of Color for A Better Tomorrow."

"Today the NAACP has taken a major step towards equity, justice and effective law enforcement," said Benjamin Todd Jealous, president and CEO of the NAACP.  "These flawed drug policies that have been mostly enforced in African American communities must be stopped and replaced with evidenced-based practices that address the root causes of drug use and abuse in America."

The resolution noted that the US spends over $40 billion a year to battle against drugs and locks up hundreds of thousands of low-level drug offenders, mostly from communities of color. Blacks are 13 times as likely to be imprisoned for low-level drug offenses as whites, despite using drugs at roughly the same rate as whites, the group noted.

"Studies show that all racial groups abuse drugs at similar rates, but the numbers also show that African Americans, Hispanics and other people of color are stopped, searched, arrested, charged, convicted, and sent to prison for drug-related charges at a much higher rate," said Alice Huffman, President of the California State Conference of the NAACP, which last year endorsed California's Prop 19 marijuana legalization initiative. "This dual system of drug law enforcement that serves to keep African-Americans and other minorities under lock and key and in prison must be exposed and eradicated."

Instead of choking the US criminal justice system with drug offenders, the resolution called for an investment in treatment and prevention programs, including methadone clinics and treatment programs proven effective.

"We know that the war on drugs has been a complete failure because in the forty years that we’ve been waging this war, drug use and abuse has not gone down," said Robert Rooks, director of the NAACP Criminal Justice Program. "The only thing we've accomplished is becoming the world's largest incarcerator, sending people with mental health and addiction issues to prison, and creating a system of racial disparities that rivals Jim Crow policies of the 1960's."

Neill Franklin, an African American former narcotics cop from Baltimore and executive director of Law Enforcement Against Prohibition, made a presentation about ending the war on drugs to the conference Monday, and had more to say Tuesday.   

"The NAACP has been on the forefront of the struggle for civil rights and social justice in this country for over a century. The fact that these leaders are joining others like the National Black Police Association in calling for an end to the 'war on drugs' should be a wake up call to those politicians - including and especially President Obama - who still have not come to terms with the devastation that the 'drug war' causes in our society and especially in communities of color."

Although passed by delegates to the convention, the resolution must be ratified by the NAACP board of directors in October. Once that happens, the NAACP's 1,200 active units across the country will mobilize to conduct campaigns advocating for the end of the war on drugs.

The African-American community has long suffered the brunt of drug law enforcement in this country, but has proven remarkably resistant to calls to reform our drug policies, in part because it has also suffered the effects of drug abuse. That the nation's leading African-American organization has taken a stand against the drug war is a big deal.

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Chronicle Book Review: The Power of the Poppy

The Power of the Poppy: Harnessing Nature's Most Dangerous Plant Ally, by Kenaz Filan (2011, Park Street Press, 312 pp, $18.95 PB)

Kenaz Filan thinks that Poppy (always capitalized in the book) is a sentient being. Before you roll your eyes as you recall the fervent mushroom cultists who say the same sort of thing, recall also that more mainstream authors, such as foodie Michael Pollan, have been known to talk like that, too, posing similar questions about what plants want. I'm not personally convinced about the sentience of plants, but I find that adherents of such a position definitely bring something of value to the table: respect for their subjects.

The opium poppy certainly deserves our respect. It can bring miraculous surcease from suffering through the pain-relieving alkaloids within, but those same alkaloids can also bring addiction, oblivion, and death. Our "most dangerous plant ally" can be both kindness and curse, boon and bane. Only by respecting Poppy, writes Filan, can we learn how best to manage our relationship with her.

The Power of the Poppy is part historical treatment, part cultural essay, part pharmacopeia, part practical guide. As such, positions on plant consciousness notwithstanding, it's a fascinating and illuminating treatment of the poppy and its derivatives. Filan traces the history of man's relationship with poppy from 6,000-year-old archeological digs in Europe, through early uses in the Roman empire and the Islamic world, and on to the current era of the war on drugs.

While Filan addresses the war on drugs and finds it stupid, this is not mainly a book about drug policy, and he dismisses the issue in short order. "Our war on drugs has been a one-sided rout," he writes in the introduction. "We keep saying 'no' to drugs, but they refuse to listen."

In his few pages devoted to the past century of opium prohibition, he reiterates the futility of trying to stamp out poppy even as its cultivation spreads. "Poppy is happy to fulfill our needs as long as we propagate her species," he writes. "To her, our 'war' is like locust invasions and droughts -- an annoyance, but hardly something that will endanger the continued existence of her children."

From there, Filan turns to the chemistry and pharmacology of opium and its derivatives and synthetics. He traces the isolation of morphine, codeine, heroin, thebaine (from which is derived hydromorphone [Dilaudid], oxymorphone [Opana], hydrocodone [Vicodin], and oxycodone [Oxycontin]), kompot (East European homebrew heroin), methadone, and fentanyl. Along the way, Filan touches on such topics as the lack of pain-relieving poppy products in the developing world, the development of Oxycontin and the rapid spread of "hillbilly heroin," and controversies over needle exchanges, safe injection sites, and methadone maintenance therapies.

In nearly every case of the development of a new opiate or opioid drug, researchers were hoping to find a substance that maintains poppy's analgesic qualities while eliminating or at least reducing its addictive ones. No such luck. "Despite the best efforts of our chemical minds," Filan writes, "Poppy still demands her bargain…Even as we go to war with Poppy, we are forced to do business with her."

In his next section, demonstrates the bargain poppy extracts as he profiles 11 famous users, including Confessions of an Opium Eater author Thomas de Quincy, Samuel Taylor Coleridge, William Burroughs, Lou Reed (whose Velvet Underground-era Heroin and Waiting for My Man put the 1960s New York junkie experience to music), and DJ Screw, whom I must confess I never heard of until reading The Power of the Poppy. Mr. Screw, whose real name, it turns out, was Robert Earl Davis, was a Houston DJ who rose to hip-hop fame after smoking Mexican weed and accidentally hitting the pitch button as he mixed tapes. The ensuing distorted vocals and slowed down beats became known as "screwed down" and Davis picked up the moniker DJ Screw.

Among the favorite topics of Screw and his crew was "purple drank," a concoction of soda pop, codeine cough syrup, and Jolly Ranchers candy, that created a warm, relaxed high. Screwed down music was the perfect accompaniment for a drank-fueled evening. While DJ Screw died young, in part because of his fondness for drank, he was also an overweight, fried-food loving smoker. While drank may have helped make DJ Screw, as always, poppy exacted her part of the bargain.

In the final segment of the book, Filan gets practical. He describes how to grow your own (from papaver somniferum seeds widely available at gardening stores) and how to extract the raw opium. He describes poppy tea brewing recipes, as well as how to use poppy in pill, tablet, or capsule form; as well as eating smoking, snorting, and shooting it. And he doesn't stint on explaining the dangerous path one is on when one embraces the poppy. Although I don't recall Filan ever using the words harm reduction, he is all about it as he cautions about overdose, dependency, and addiction.

The Power of the Poppy elucidates the many ways the histories of man and poppy are intertwined, and it's full of interesting tidbits along the way. Who knew that the use of "dope" to mean drugs came from Dutch sailors mixing opium and tobacco off China in the 17th Century? They called the mixture "doep," like a greasy stew they ate. Or that calling seedy establishments "dives" derived from scandalized descriptions of California opium dens, with the patrons reclining on divans? Or that the scientific name for snorting is "insufflation"?

If you have an interest in opium and its role in human affairs, The Power of the Poppy will be both entertaining and enlightening. And -- who knows? -- maybe you'll start treating that plant and its derivatives with the respect they deserve.

Drug Courts Poor Public Policy, Reports Charge [FEATURE]

With a pair of separate reports released Tuesday, the Drug Policy Alliance (DPA) and the Justice Policy Institute (JPI) have issued a damning indictment of drug courts as a policy response to drug use. Instead of relying on criminal justice approaches like drug courts, policymakers would be better served by moving toward evidence-based public health approaches, including harm reduction and drug treatment, as well as by decriminalizing drug use, the reports conclude.

Since then-Dade County District Attorney Janet Reno created the first drug court in Miami in 1989, drug courts have appeared all over the country and now number around 2,000. In drug courts, drug offenders are given the option of avoiding prison by instead pleading guilty and being put under the scrutiny of the drug court judge. Drug courts enforce abstinence by imposing sanctions on offenders who relapse, including jail or prison time and being thrown out of the program and imprisoned on the original charge. The Obama administration wants to provide $57 million in federal funding for them in its FY 2012 budget.

Through organizations like the National Association of Drug Court Professionals  (NADCP), the drug court movement has created a well-oiled public relations machine to justify its existence and expansion. NADCP maintains that the science shows that drug courts work and even maintains a convenient response to criticisms leveled by earlier critics.

The Chronicle contacted NADCP for comment this week, but representatives of the group said they were still digesting the reports and would issue a statement in a few days.

But in a Monday teleconference, DPA, JPI, and the National Association of Criminal Defense Lawyers (NACDL), which issued its own critical report on America's Problem-Solving Courts in 2009, slashed away at drug court claims of efficacy and scientific support. Drug courts are harsh on true addicts, don't benefit the public health or safety, and are an inefficient use of criminal justice system resources, they said.

"The drug court phenomenon is, in large part, a case of good intentions being mistaken for a good idea," said Margaret Dooley-Sammuli, DPA's Southern California state deputy director and co-author of the DPA report, Drug Courts are Not the Answer: Toward a Health-Centered Approach to Drug Use. "Drug courts have helped many people, but they have also failed many others, focused resources on people who could be better treated outside the criminal justice system and in some cases even led to increased incarceration. As long as they focus on people whose only crime is their health condition, drug courts will be part of the problem -- not the solution -- created by drug war policies," she said.

"Even if drug courts were able to take in all 1.4 million people arrested for just drug possession each year, over 500,000 to 1 million people would be kicked out and sentenced conventionally," Dooley-Sammuli added. "Drug courts just don't make sense as a response to low-level drug violations."

The DPA report found that drug courts have not demonstrated cost savings, reduced incarceration, or improved public safety. Previous "unscientific and poorly designed research" supporting drug courts has failed to acknowledge that drug courts often "cherry pick" people expected to do well, that many petty drug law violators choose drug courts because they are offered a choice of treatment or jail and drug courts thus are not diverting large numbers of people from long prison sentences, or that, given their focus on low-level drug violators, even positive results for individuals accrue few public safety benefits for the community.

Not only are drug courts' successes unproven, DPA said, they are often worse for the people participating in them. Their quick resort to incarceration for relapses means some defendants end up serving more time than if they had stayed out of drug court. And defendants who "fail" in drug court may face longer sentences because they lost the opportunity to plead to a lesser charge. In addition, the existence of drug courts is associated with increased arrests and imprisonment because law enforcement and others believe people will "get help" if arrested.

Worst, the DPA report found, drug courts are toughest on those who most need treatment for their addictions. Because of their use of quick sanctions against those who relapse, the seriously addicted are more likely to end up incarcerated for failing to stay clean, while those who don't have a drug problem are most likely to succeed. Drug courts typically don't allow what Dooley-Sammuli called the "gold standard" of treatment for opiate addiction, methadone or other maintenance therapies.

Drug courts should be reserved for cases involving offenses against persons and property committed by people who have substance abuse problems, while providing other options such as probation or treatment for people arrested for low-level drug law violations, the report recommended. It also called for bolstering public health systems, including harm reduction and drug treatment programs, to deal with drug use outside the criminal justice system, and for decriminalizing drug use to end the problem of mass arrests and incarceration.

"Drug courts are not a true alternative to incarceration," said Natassia Walsh, author of the JPI report, Addicted to Courts: How a Growing Dependency on Drug Courts Impacts People and Communities. "They are widening the net of criminal justice control. Even the mere existence of a drug court means more people are arrested for drug offenses, which brings more people into the criminal justice system, which means increased costs for states and localities, as well as for offenders and their families."

The JPI report found that providing people with alternatives like community-based drug treatment are more cost-effective and have more public safety benefits than treatment attached to the criminal justice system, with all its collateral consequences.

"It is shameful that for many people, involvement in the criminal justice system is the only way to access substance abuse treatment in this country," said Walsh. "We need to change the way we think about drug use and the drug policies that bring so many people into the justice system. The dramatic increase in drug courts over the past 20 years may provide talking points for so-called 'tough-on-crime' policymakers; however, there are other, better options that can save money and support people and communities. More effective, community-based programs and services that can have a positive, lasting impact on individuals, families and communities should be available."

"All three of our reports have some things in common, " said the NACDL's Elizabeth Kelly. "They recognize that substance abuse is a public health issue not appropriate for the criminal justice system to handle, they recognize that these problem-solving courts cherry pick their participants, allowing them to inflate success rates, and they recognize that drug courts exclude the people who are most problematic and who have the most profound addictions," she said.

"It is fundamentally bad public policy to make the only means to treatment through the criminal justice system that stigmatizes and burdens the individual with all the collateral consequences of a criminal conviction," Kelly concluded.

The fight to avoid the drug policy dead end that is drug courts is on.

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