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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mexico Marijuana and Drug Reform Bills Filed [FEATURE]

Late last week, lawmakers in Mexico City filed two bills that would begin to radically transform the country's approach to drugs. One was introduced in the Mexico City legislative assembly and one in the federal legislature.

http://stopthedrugwar.com/files/mexico-seal-231px.jpg
The moves come as the debate over drug policy in general and marijuana in particular heats up in the region. The legalization of marijuana in Uruguay and the US states of Colorado and Washington has enlivened ongoing efforts at drug reform in Mexico, and the country continues to bleed from the violence associated with criminal organizations that rose to power on the back of drug prohibition.

They also come just days after four former Latin American presidents -- Ernesto Zedillo of Mexico, Ricardo Lago of Chile, Fernando Enrique Cardoso of Brazil, and Cesar Gaviria of Colombia -- penned an open letter in support to Mexico City Mayor Miguel Angel Mancera, himself a proponent of legalization.

"This is a necessary debate to have for Mexico City, Mexico and the entire region," the four ex-presidents said. "Something needs to change as 40 years of immense efforts and funds have failed to reduce both the production and consumption of illicit drugs."

"We believe we're making a very important contribution to a global debate that has to do with rethinking the issue of drugs," Vidal Llerenas, a member of the Mexico City Legislative Assembly and sponsor of the local legislation, said at Thursday news conference announcing the bills.

"The aim of this legislation is not to change the drug sphere in the city, but rather to simply avoid criminalizing those who consume marijuana," said Deputy Eduardo Santillan Perez, another sponsor of the bill.

The Legislative Assembly in Mexico City
The Mexico City bill would de-emphasize small-time marijuana prosecutions. It would instruct police and judges to deprioritize prosecution of marijuana violations in some circumstances, and it would create a Portugal-style "dissuasion commission" which could impose administrative sanctions on offenders instead of subjecting them to the criminal process.

The bill would also allow for the limited retail sales of marijuana in the Federal District. Such sales could only take place under certain criteria, including posting warnings to consumers about potential health risks. Retailers would not be allowed to sell to minors or be located near schools, and they would not be allowed to sell adulterated marijuana. Retailers who complied with these criteria would be issued permits to sell marijuana by the district government's Institute for the Attention and Prevention of Addictions.

The federal bill would raise possession limits for the amount of drugs decriminalized under a 2009 law. Under that law, the possession of up to five grams of pot was decriminalized; the new bill would increase that to 30 grams (slightly more than an ounce). It would similar increase the decriminalized possession limits for drugs such as cocaine, heroin, and methamphetamine.

The federal bill would also allow for the use of medical marijuana. And it would devolve some decision making power on drug policy issues from the federal government to states and cities.

There are clear medicinal benefits to using marijuana, said PRD Deputy Fernando Belaunzaran Mendez, and denying these benefits "is like when the clergy denied Galileo's claim that the Earth moves."

The prospects of passage are much better for the Mexico City bill than the federal bill, because the Party of the Democratic Revolution (PRD), whose members introduced both the local and the federal bills, dominates the Mexico City assembly, but not the federal one. Mexico City, which has moved to allow abortion, divorce, and same-sex marriage, is also more socially liberal than the country as a whole. The Mexico City bill is likely to be debated early next month.

Both bills had their genesis in discussions that began last summer, when the Mexico City legislature organized public hearings to explore alternative solutions to the city's drug problems. Civil society groups, including México Unido Contra la Delincuencia (MUCD), the Colectivo por Una Politica Integral Hacia las Drogas (CUPIHD), and Britain's Transform Drug Policy Foundation were deeply involved in the drafting process, along with lawyers, medical professionals, security professionals and drug policy experts.

"Of the four specialists that helped draft the bill, two were from CUPIHD," said Alejandro Madrazo Larous, a constitutional law expert, law professor and CUPIHD member who helped draft the bill.

He told the Chronicle that international reform currents were indeed percolating in Mexico.

"As other countries move forward with reforms, it just seems more and more absurd that we are killing each other in Mexico to ban something that is becoming a regulated business," he said.

Reefer Bender in Mexico City wants to legalize it. (Phillip Smith, Drug War Chronicle)
"We welcome this attempt to replace stringent cannabis law enforcement with humane, just and effective alternatives," said MUCD's Lisa Sanchez. "Decades of punitive responses have failed to reduce levels of use and have effectively left the market in the hands of criminal entrepreneurs whose watchwords are violence and greed. This is a great opportunity for the government to adopt a new approach to drugs and improve the health and safety of its citizens. Let's not waste it."

"On the heels of historic marijuana legalization victories in Washington, Colorado and Uruguay, it's promising to see other countries and jurisdictions following suit. The innovative nature of the marijuana bill -- which combines elements of marijuana regulation models from around the world -- demonstrates that reforms can be tailored to fit the local context," said Hannah Hetzer, policy manager for the Americas at the Drug Policy Alliance.

"Mexico has suffered immensely from the war on drugs," Hetzer continued. "Amidst extreme levels of violence and crime, it is encouraging to see Mexico's capital city attempt to refocus its efforts away from marijuana possession and low-level drug offenses and to invest in reducing violent crime instead."

Madrazo Larous said passage of the bills would smartly reprioritize law enforcement, but that it would take work.

"I think they have a chance," he said. "We are reaching out for more support. If we can pass this at the national level, it would free up resources at the local level which would allow for better criminal investigation and prosecution of violent crimes. Today, we waste too many resources running after consumers and petty dealers."

With marijuana legalization also on both the legislative and the popular agenda in Washington, DC, it appears that Mexico City and Washington are in a race to see which North American capital city becomes the first to allow legal marijuana sales. Sorry, Ottawa.

Mexico City
Mexico

Chronicle AM -- February 13, 2014

A bill has been filed to stop forcing the drug czar to oppose drug legalization, CBD medical marijuana bills continue to get attention, and there are big doings south of the border, and more. Let's get to it:

Russell Brand helped push British petition over the top. (flickr.com/photos/evarinaldiphotography/)
Drug Legalization

Congressman Steven Cohen Files Bill to Let Drug Czar Deal Honestly with Drug Legalization. The Office of National Drug Control Policy (ONDCP, the drug czar's office) is required by law to oppose legalization of any Schedule I substance and prohibited from studying it. Now, Rep. Steven Cohen (D-TN) has filed a bill, the Unmuzzle the Drug Czar Act (H.R. 4046), that would strip that language from the drug czar's enabling legislation, the ONDCP Reauthorization Act of 1998.

Marijuana Policy

High Times, Westword Sue Colorado Over Marijuana Advertising Restrictions. Marijuana magazine High Times and Denver alternative weekly Westword filed a lawsuit in federal court Monday challenging Colorado's restrictions on advertising for legal marijuana. The state's rules allow pot businesses to advertise only in adult-oriented publications for which "no more than 30% of the publication's readership is reasonably expected to be under 21." The lawsuit argues that the restrictions are an unconstitutional contravention of free speech.

Rhode Island Legalization Bill Coming. House Judiciary Committee Chair Edith Ajello and Senate Health and Human Services Committee Chair Josh Miller announced Wednesday they will file a bill to legalize marijuana for adults and set up a system of taxation and regulation for marijuana commerce. The effort is backed by Regulate Rhode Island and the Marijuana Policy Project.

Hawaii Decriminalization, Medical Marijuana Bills Get Hearing Today. Three Senate committees are holding a joint hearing today on two decriminalization bills, Senate Bill 2358 and Senate Bill 2733, and one bill, Senate Bill 2402, a bill that would take away protections for patients who possess and use marijuana concentrates.

Medical Marijuana

Medical Marijuana Rally Set for Friday in Topeka. Supporters of a long-stalled medical marijuana bill, Senate Bill 9, will rally at the Kansas State Capitol Rotunda Friday morning and lobby legislators after that. The effort is organized by Kansas for Change. Click on the title link for more details.

Hundreds Pack Oklahoma Capitol for CBD Medical Marijuana Hearing. Demonstrators called for marijuana legalization outside as hundreds of people jammed into the state capitol for a hearing on CBD medical marijuana. Dramatic and moving testimony was heard from family members of children suffering seizure disorders who might be helped by access to CBD cannabis oils.

Wisconsin Lawmakers Hold Hearing on CBD Medical Marijuana. Wisconsin legislators Wednesday heard from families of children with seizure disorders, who pleaded with them to pass a pending CBD medical marijuana bill.

Harm Reduction

Cincinnati Gets Its First Needle Exchange Program. The first needle exchange program in the Southwest Ohio/Northern Kentucky region is open for business. The Cincinnati Exchange Program becomes the third in Ohio, with others already operating in Cleveland and Portsmouth. The needle exchanges have been proven to reduce the spread of HIV, Hep C, and other blood-borne infectious diseases.

Prescription Drugs

Prescription Drug Database Bill Wins Missouri House Vote. A bill that would establish a prescription drug database has won a vote in the House, but senators, citing privacy concerns, said there is little chance of it moving forward in their chamber. The bill would create an electronic database managed by the state health department that would share information about prescriptions, patients, and doctors. The bill is House Bill 1133.

International

Mexico City Decriminalization, Regulation Bill and Mexican National Drug Reform Bill Introduced Today. In Mexico City, legislators for the federal district introduced a bill to decriminalize the possession of up to five grams of marijuana and remove the option of incarceration for possession of small amounts of other drugs. The bill would also allow for limited regulated marijuana sales. The second, national, bill would reschedule marijuana and allow for its medical use. Look for a Chronicle feature article on this soon.

Dark Web Drug Sales Site Busted. German and Dutch authorities have arrested five men in a sting directed at an internet drug sales portal. The men were connected to Black Market Reloaded and its successor web site, Utopia. Undercover police purchased drugs and weapons through the web sites, they said, and seized computers, hard drives, USB sticks, and a Bitcoin wallet containing $680,000 worth of the electronic currency.

More Than 100,000 Sign British Petition for Review of Drug Laws. Green Party MP Caroline Lucas set up an online petition urging the British government to order a cost-benefit analysis and impact assessment of British drug laws within the next year. It has now achieved the benchmark of 100,000 signatures, which means it must be addressed by the Backbench Business Committee. Sign-ons accelerated after actor and comedian Russell Brand joined with the online campaign group Avaaz to encourage its 1.1 million members to sign up.

Chronicle AM -- February 12, 2014

Overdose prevention is big news today as the drug czar chimes in in favor, more than a dozen congressmen call on Obama to re- or de-schedule marijuana, the Italian Supreme Court undoes a bad drug law, and more. Let's get to it:

Eighteen Congressmen Call for Marijuana Rescheduling or Descheduling. In a Wednesday letter to the White House, 18 congressmen urged President Obama to tell Attorney General Holder to ease up on marijuana. "We request that you instruct Attorney General Holder to delist or classify marijuana in a more appropriate way, at the very least eliminating it from Schedule I or II. Furthermore, one would hope that your Administration officials publicly reflect your views on this matter," said the letter signed by 17 Democrats and one Republican. The letter's lead author is Rep. Earl Blumenauer (D-OR).

Texas Governor Candidate Wendy Davis Says She Would Consider Decriminalization, Supports Medical Marijuana. Democratic gubernatorial candidate Wendy Davis told the Dallas Morning News editorial board she would consider decriminalizing marijuana possession and she supports medical marijuana. "We as a state need to think about the cost of that incarceration and, obviously, the cost to the taxpayers as a consequence of it, and whether we're really solving any problem for the state by virtue of incarcerations for small amounts of marijuana possession," Davis said. "I personally believe that medical marijuana should be allowed for. Certainly as governor I think it's important to be deferential to whether the state of Texas feels that it's ready for that."

Pennsylvania Governor Candidate Allyson Schwartz Calls for Decriminalization, Supports Medical Marijuana. Leading contender for the Pennsylvania Democratic Party gubernatorial nomination US Rep. Allyson Schwartz told the Philadelphia Weekly Monday she favors decriminalization and medical marijuana. "I do believe that marijuana is over-criminalized. And what we should do is decriminalize possession," she said. She also said she would sign a pending medical marijuana bill. "If it came to my desk, I would be supportive," she said.

New Mexico Senate Rules Committee Stalls Marijuana Legalization Resolution. State Sen. Gerald Ortiz y Pino (D-Bernallillo) saw his Senate Joint Resolution 10 stalled on a tie vote in the Senate Rules Committee Tuesday. The bill would have legalized possession for those 21 and over and set up a regulated system of marijuana commerce.

New Mexico House Committee Approves Study of Legalization Effects. A measure that asks the Legislative Finance Committee to study the effects of marijuana legalization in other states passed the House Appropriations and Finance Committee Tuesday. House Memorial 38, filed by Rep. Bill McCamley (D-Las Cruces), should now be headed for a House floor vote.

Arizona Decriminalization Bill for Small-Time Possession With Intent Filed. Rep. Mark Cardenas (D-Phoenix) has introduced a bill that decriminalizes possession with intent to sell of less than an ounce of pot, make possession of less than two pounds with intent to sell a petty offense, and make possession of more than two pounds with intent to sell a misdemeanor. The measure would also decriminalize growing if the yield is less than two pounds. The bill is House Bill 2474; it has been assigned to the House Judiciary and Rules committees.

Medical Marijuana

Medical Marijuana Supporters Rally in Oklahoma City. Supporters of medical marijuana led by Oklahoma NORML rallied at Oklahoma State Capitol today, and also did lobbying and training.

Harm Reduction

Drug Czar Calls for Overdose Antidote Drug to Be More Widely Available. The Office of National Drug Control Policy (ONDCP, the drug czar's office) called Tuesday for making the overdose antidote drug naloxone (Narcan) more widely available. "The Obama Administration is encouraging first responders to carry the overdose-reversal drug naloxone," ONDCP said in a blog post. "When administered quickly and effectively, naloxone immediately restores breathing to a victim in the throes of an opioid overdose. Because police are often the first on the scene of an overdose, the administration strongly encourages local law enforcement agencies to train and equip their personnel with this lifesaving drug… Used in concert with "Good Samaritan" laws, which grant immunity from criminal prosecution to those seeking medical help for someone experiencing an overdose, it can and will save lives."

Boston Mayor Calls for All First Responders to Carry Overdose Antidote. Boston Mayor Martin Walsh Tuesday responded to a spike in drug overdoses in the city by calling on all first responders to carry naloxone (Narcan), a medication used to reverse opioid overdoses. Both heroin and prescription opioid overdoses have jumped since 2009. Walsh announced a series of community workshops on the issue.

Indianapolis Police to Carry Overdose Antidote. Beginning next month, the Indianapolis Metropolitan Police will begin a pilot program where police officers are trained in the use of and will carry with them naloxone (Narcan) to reverse overdoses. Heroin overdose deaths have doubled in the city since 2011.

Maine Governor Opposes Bill to Increase Access to Overdose Antidote. Maine Gov. Paul LePage (R) opposes a bill to make the opioid antagonist naloxone (Narcan) more widely available, saying it would encourage drug use. The sponsor of the bill, Legislative Document 1209, Rep. Sara Gideon (D), said the governor's health policy advisor told her he would oppose the bill. "His main objection is his belief -- and I have to emphasize 'his belief' because there is no evidence that supports this at all -- his belief that increasing the availability of Narcan or naloxone will lead the drug user or drug abuser to have this feeling of invincibility," Gideon said. The Tea Party Republican governor last year vetoed bills to increase naloxone availability and create a Good Samaritan 911 law. Fatal heroin overdoses in the state quadrupled between 2011 and 2012.

Drugged Driving

New Mexico Drugged Driving Bill Advances. A drugged driving bill passed out of the House Transportation and Public Works Committee Tuesday. House Bill 190, filed by Rep. Bill Rehm (R-Albuquerque), would make driving with any detectable level of controlled substances, including marijuana and prescribed drugs evidence of driving under the influence of drugs. Such evidence would not automatically guarantee a conviction, but could be used to shore up prosecutions. The bill ran into opposition from, among others, the Drug Policy Alliance, which said it was likely to entrap regular users of marijuana or medical marijuana. The bill now moves to the House Judiciary Committee.

Synthetic Drugs

Missouri Synthetic Drugs Bill Advances. A bill that adds several specific substances to the state's list of banned synthetic cannabinoids advanced on a voice vote in the House Tuesday. House Bill 1051 is designed "basically to stay ahead of or try to keep up with new chemicals as they come out," said bill sponsor Rep. Shawn Rhoads (R-West Plains). The bill needs one more House vote before moving to the Senate.

International

Italian Supreme Court Strikes Down Law Equating Marijuana With Heroin. The Italian Supreme Court Tuesday struck down a 2006 law that removed the distinction between "soft" and "hard" drugs, stiffening prison sentences for marijuana and hash offenders, and filling the country's prisons with low-level pot offenders. The expectation is that thousands of them will soon be freed.

Groups Call for UN to Freeze Vietnam Anti-Drug Aid Over Death Penalty. Harm Reduction International and the anti-death penalty groups Reprieve and the World Coalition Against the Death Penalty have called on the United Nations to freeze anti-drug aid for Vietnam after it sentencing 30 people to die for heroin trafficking. In a letter to the Vienna-based UN Office on Drugs and Crime (UNODC), they said they had raised concern for several years about UN support for countries that impose the death penalty for drug offenses and that UNODC had internal human rights guidance that required it "to cease support for a country if it is feared the support may facilitate executions." UNODC had not replied as of Wednesday afternoon.

Marijuana Seeds Dropped from Slovak Controlled Substances List, New Drugs Added. President Ivan Gasparovic Tuesday signed legislation that will drop marijuana seeds from the list of illegal drugs in Slovakia because they do not contain cannabinoids. But the updated list will now include eight new drugs, including buphedrone, desoxypipradrol and 4-methylamphetamine, and it down-schedules GHB to allow doctors to prescribe drugs containing it.

(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.)

Hoffman, Heroin, and What Is To Be Done [FEATURE]

The news last Sunday that acclaimed actor Phillip Seymour Hoffman had died of an apparent heroin overdose has turned a glaring media spotlight on the phenomenon, but heroin overdose deaths had been on the rise for several years before his premature demise. And while there has been much wailing and gnashing of teeth -- and quick arrests of low-level dealers and users -- too little has been said, either before or after his passing, about what could have been done to save him and what could be done to save others.

cooking heroin (wikimedia.org)
There are proven measures that can be taken to reduce overdose deaths -- and to enable heroin addicts to live safe and normal lives, whether they cease using heroin or not. All of the above face social and political obstacles and have only been implemented unevenly, if at all. If there is any good to come of Hoffmann's death it will be to the degree that it inspires broader discussion of what can be done to prevent the same thing happening to others in a similar position.

Hoffman, devoted family man and great actor that he was, died a criminal. And perhaps he died because his use of heroin was criminalized. Criminalized heroin -- heroin under drug prohibition -- is of uncertain provenance, of unknown strength and purity, adulterated with unknown substances. While we don't know what was in the heroin that Hoffman injected, we do know that he maintained his addiction and went to meet his maker with black market dope. That's what was found beside his lifeless body.

In a commentary published by The Guardian, actor Russell Brand, a recovered heroin addict, laid the blame for Hoffman's demise on the drug laws. "Addiction is a mental illness around which there is a great deal of confusion, which is hugely exacerbated by the laws that criminalise drug addicts," Brand wrote, calling prohibitionists' methods "so gallingly ineffective that it is difficult not to deduce that they are deliberately creating the worst imaginable circumstances to maximise the harm caused by substance misuse." As a result, "drug users, their families and society at large are all exposed to the worst conceivable version of this regrettably unavoidable problem."

We didn't always treat our addicts this way. Even after the passage of the Harrison Act in 1914, doctors continued for years to prescribe maintenance doses of opiates to addicts -- and hundreds of them went to jail for it as the medical profession fought, and ultimately lost, a battle with the nascent drug prohibition bureaucracy over whether giving addicts their medicine was part of the legitimate practice of medicine.

The idea of treating heroin addicts as patients instead of criminals was largely vanquished in the United States, but it never went away -- it lingers with methadone substitution, for example. But other countries have for decades been experimenting with providing maintenance doses of opioids to addicts, and to good result. It goes by various names -- opiate substitution therapy, heroin-assisted theatment, heroin maintenance -- and studies from Britain and other European countries, such as Germany, the Netherlands, and Switzerland, as well as the North American Opiate Medications Initiative (NAOMI) and the follow-up Study to Assess Long-Term Opiate Maintenance in Canada have touted its successes.

Those studies have found that providing pharmaceutical grade heroin to addicts in a clinical setting works. It reduces the likelihood of death or disease among clients, as well as allowing them to bring some stability and predictability to sometimes chaotic lives made even more chaotic by the demands of addiction under prohibition. Such treatment has also been found to have beneficial effects for society, with lowered criminality among participants and increased likelihood of their integration as productive members of society.

The dry, scientific language of the studies obscures the human realities around heroin addiction and opioid maintenance therapy. One NAOMI participant helps put a human face on it.

"I want to tell you what being a participant in this study did for me," one participant told researchers. "Initially it meant 'free heroin.' But over time it became more, much more. NAOMI took much of the stress out of my life and allowed me to think more clearly about my life and future. It exposed me to new ideas, people (staff and clients) that in my street life (read: stressful existence) there was no time for."

"After NAOMI, I was offered oral methadone, which I refused. After going quickly downhill, I ended up hopeless and homeless. I went into detox in April 2007, abstained from using for two months, then relapsed. In July 2008 I again went to detox and I am presently in a treatment center... I am definitely not "out of the woods" yet, but I feel I am on the right path. And this path started for me at the corner of Abbott and Hastings in Vancouver... Thank you and all who were involved in making NAOMI happen. Without NAOMI, I wouldn't be where I am today. I am sure I would be in a much worse place."

Arnold Trebach, one of the fathers of the drug reform in late 20th Century America, has been studying heroin since 1972, and is still at it. He examined the British system in the early 1970s, when doctors still prescribed heroin to thousands of addicts, and authored a book, The Heroin Solution, that compared and contrasted the US and UK approaches. Later this month, the octogenarian law professor will be appearing on a panel at the Vermont Law School to address what Gov. Peter Shumlin (D) has described as the heroin crisis there.

Phillip Seymour Hoffman (wikimedia.org)
"The death of Phillip Seymour Hoffman is a tragedy all the way around," Trebach told the Chronicle. "It's a bad idea to use heroin off the street, and he shouldn't have been doing that."

That said, Trebach continued, it didn't have to be that way.

"If we had had a sensible system of dealing with this, he would have been in treatment under medical care," he said. "If he was going to inject heroin, he should have been using pharmaceutically pure heroin in a medical setting where he could also have been exposed to efforts to straighten out his personal life, and he could have access to vitamins, weight control advice, and the whole spectrum of medical care. And if he had had access to opioid antagonists, he could still be alive," he added.

While Hoffman may have made bad personal choices, Trebach said, we as a society have made policy choices seemingly designed to amplify the prospects for disaster.

"This is a sad thing. He is just another one of the many victims of our barbaric drug policy," he said. "This was a totally unnecessary death at every level. He shouldn't have been using, but we should have been taking care of him."

The stuff ought to be legalized, Trebach said.

"I'm an advocate of full legalization, but if we can't go that far, we need to at least provide social and psychological support for these people," he said. "And even if we were to decriminalize or legalize, I would still want to figure out ways to provide support and love and kindness to people using the stuff. I advise you not to do it, but if you're going to use it, I want to keep you alive. I remember talking to people from Liverpool [a famous heroin maintenance clinic covered in the '90s by Sixty Minutes, linked above] about harm reduction around heroin use back in the 1970s. One of the ladies said it is very hard to rehabilitate a dead addict."

"There are plenty of things we can be doing," said Hilary McQuie, Western director for the Harm Reduction Network, reeling off a list of harm reduction interventions that are by now well-known but inadequately implemented.

"We can make naloxone (Narcan) more available. We need better access to it. It should be offered to people like Hoffman when they are leaving treatment programs, especially if they've been using opiates, just as a safeguard," she said. "Having treatment programs as well as harm reduction programs distribute it is important. We can cut the overdose rate in half with naloxone, but there will still be people using alone and people using multiple substances."

There are other proven interventions that could be ramped up as well, McQuie said.

"Safe injection sites would be very helpful, so would more Good Samaritan overdose emergency laws, and more education, not to mention more access to methadone and buprenorphine and other opioid substitution therapies (OST)," she said, reeling off possible interventions.

Dr. Martin Schechter, director of the School of Population and Public Health at the University of British Columbia in Vancouver, knows a thing or two about OST. The principal study investigator for the NAOMI and the follow-up SALOME study, Schechter has overseen research into the effectiveness of treating intractable addicts with pharmaceutical heroin, as well as methadone. The results have been promising.

"What we're using is medically prescribed pharmaceutical diacetylmorphine, the active ingredient in heroin," he explained. "It's what you have when you strip away all the street additives. This is a stable, sterile medication from a pharmaceutical manufacturer. We know the precise dose tailored for each person. With street heroin, not only is it adulterated and injected in unsterile situations, but people really don't know how strong it is. That's probably what happened to Mr. Hoffman."

Naloxone (Narcan) can reverse opiate overdoses (wikimedia.org)
In NAOMI, 90,000 injections were administered to study participants, and only 11 people suffered overdoses requiring medical attention.

"Never did we have a fatal overdose," Schechter said. "Because it was in a clinic, nurses and doctors are right there. We administer Narcan (naloxone), and they wake up."

Heroin maintenance had even proven more effective than methadone in numerous studies, Schechter said.

"There have been seven randomized control trials across Europe and in Canada that have shown for people who have already tried treatments like methadone, that medically prescribed heroin is more effective and cost effective treatment than simply trying methadone one more time."

Those studies carry a lesson, he said.

"We have to start looking at heroin from a medicinal point of view and treat it like a medicine," he argued. "The more we drive its use underground, the more overdoses we get. We need to expand treatment programs, not only with methadone, but with medically prescribed heroin for people who don't respond to other treatments."

Safe injection sites are also a worthwhile intervention, Schechter said, although he also noted their limitations.

"Injecting under supervision is much safer; if there is an overdose, there is prompt attention, and they provide sterile equipment, reducing the risk of HIV and Hep C," he said. "But they are still injecting street heroin."

He would favor decriminalizing heroin possession, too, he said.

Harm reduction measures, opioid maintenance treatments, and the like are absolutely necessary interventions, said McQuie, but there is a larger issue at hand, as well.

"We still need to look at the overall issue of the stigmatization of drug users," she said. "People aren't open about their use, and that puts them in a more dangerous situation. It's really hard in a criminalized environment."

Stigmatization means to mark or brand someone or something as disgraceful and subject to strong disapproval. Defining an activity, such as heroin possession, as a crime is stigmatization crystallized into the legal structures of society itself.

"The ultimate harm reduction solution," McQuie argued, "is a regulated, decriminalized environment where it is available by prescription, so people know what they're getting, they know how much to use, and it's not cut with fentanyl or other deadly adulterants. People wouldn't have to deal with all the collateral damage that comes from being defined as criminals as well as dealing with the consequences of their drug use. They could deal with their addictions without having to worry about losing their homes, their families, and their freedoms."

While such approaches have a long way to go before winning wide popular acceptance, policymakers should at least be held to account for the consequences of their decision-making, McQuie said, suggesting that the turn to heroin in recent years was a foreseeable result of the crackdown on prescription opioid pain medication beginning in the middle of the last decade.

"They started shutting down all those 'pill mills' and people should have anticipated what would happen and been ready for it," she said. "What we have seen is more and more people turning to injecting heroin, but nobody stopped to do an impact statement on what would be the likely result of restricting access to pain pills."

The impact can be seen in the numbers on heroin use, addiction, and overdoses. While talk of a "heroin epidemic" is overblown rhetoric, the number of heroin users has increased dramatically in the past decade. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the number of past year users grew by about 50% between 2002 and 2011, from roughly 400,000 to more than 600,000. At the same time, the number of addicted users increased from just under 200,000 to about 370,000, a slightly lesser increase.

If there is any good news, it is that, according to the latest (2012) National Household Survey of Drug Use and Health, the number of new heroin users has remained fairly steady at around 150,000 each year for the past decade. That suggests, however, that more first-time users are graduating to occasional and sometimes, dependent user status.

And some of them are dying of heroin overdoses, although not near the number dying from overdoses from prescription opioids. Between 1999 and 2007, heroin deaths hovered just under 2,000, even as prescription drug deaths skyrocketed, from around 2,500 in 1999 to more than 12,000 just eight years later. But, according to the Centers for Disease Control, by 2010, the latest year for which data are available, heroin overdose deaths had surpassed 3,000, a 50% increase in just three years.

While the number of heroin overdose deaths is still but a fraction of those attributed to prescription opioid overdoses and the numbers since 2010 are spotty, the increase that showed up in 2010 shows no signs of having gone away. Phillip Seymour Hoffman may be the most prominent recent victim, but in the week since his death, another 50 or 60 people have probably followed him to the morgue due to heroin overdoses.

There are ways to reduce the heroin overdose death toll. It's not a making of figuring out what they are. It's a matter of finding the political and social will to implement them, and that requires leaving the drug war paradigm behind.

New York City, NY
United States

Chronicle AM -- January 9, 2014

Alaska appears poised to vote on marijuana legalization, New York's governor announces a half-step toward medical marijuana, the ACLU fights for our rights on a couple of fronts, and trouble could be coming to the coca fields of Peru. And more. Let's get to it:

Bolivian President Evo Morales has a new bully pulpit from which to crusade for coca. (wikimedia.org)
Alaska Marijuana Legalization Initiative Campaign Hands in Signatures. Supporters of an initiative to legalize marijuana in Alaska handed in 46,000 signatures Wednesday. The campaign only needs 30,000 valid signatures to qualify for the August ballot. State election officials have 60 days to verify the signatures.

Marijuana Decriminalization Bill Filed in Alabama. Rep. Patricia Todd (D-Birmingham) has filed a bill that would decriminalize the possession of up to an ounce of marijuana. An as yet unspecified fine would apply to offenders. The bill has been assigned to the House Judiciary Committee and will be scheduled for a hearing when the session gets underway next week.

Alabama Governor Rejects Legal and Medical Marijuana. Gov. Robert Bentley (R) said Wednesday he opposes legalizing marijuana for either recreational or medical purposes, although he suggested he would be open to FDA-approved medical marijuana products. "I do believe there are medications out there that will do the same thing," Bentley said. "Now if someone wants to use the medicine that is in marijuana, go through the testing when you do that through the FDA, go through all of that -- that's fine. I have no problem with that."

Medical Marijuana

New York Governor Announces Limited Medical Marijuana Program. Gov. Andrew Cuomo (D) used his State of the State address Wednesday to announce he will initiate a limited medical marijuana program through executive action. Advocates said the measure was not enough and that the state legislature needs to pass pending medical marijuana legislation.

Asset Forfeiture

Utah Moving to Undo Asset Forfeiture Reforms. The Utah legislature moved late last year to roll back asset forfeiture reforms approved by state voters in a 2000 referendum. In unanimous votes, legislators approved a bill that will kill the provision requiring reimbursement for property owners who win in court and to require prosecutors to file such cases in a timely manner. Read Radley Balko's lengthy report by clicking on the link.

Drugs and Pregnancy

Experts File Brief Challenging Use of Child Abuse Law against Pregnant Women Using Methadone. Some 76 groups and experts in maternal, fetal, and child health, addiction treatment, and health advocacy filed an amicus curiae (friend of the court) brief before the New Jersey Supreme Court, urging it to overturn a lower court ruling making the state's civil child abuse law applicable to women who received medically prescribed methadone treatment while pregnant.

Search and Seizure

Indiana ACLU Challenges Pain Medication Drug Test Rules. The ACLU of Indiana filed a lawsuit Wednesday in federal court challenging a new state rule that requires patients prescribed a certain level of pain medications to undergo annual drug tests. The rule concocted by the state Medical Licensing Board last month requires such patients to sign a treatment agreement that includes agreement to undergo the annual tests. The ACLU argues that the rule violates Fourth Amendment proscriptions against unreasonable searches and seizures.

Massachusetts ACLU Sues to Block Drug Dog Sniffs of Prison Visitors. The ACLU of Massachusetts and a prisoners' rights group have filed a lawsuit in Suffolk County Superior Court seeking to block the state Department of Corrections from using drug dogs to search prison visitors. The suit seeks a preliminary injunction to immediately stop the practice and allow for public comment on the policy, which the department instituted in November. A hearing is set for January 24.

International

Peru Coca Eradication to Target VRAEM for First Time, DEVIDA Head Says. The Peruvian government for the first time will attempt to eradicate large amounts of coca crops in the Apurimac, Ene, and Mantaro river valleys (VRAEM), the head of the Peruvian anti-drug agency DEVIDA said Wednesday. The area is the most densely planted coca growing region in the world, accounting for more than half of all Peruvian production, and is the home of Shining Path guerilla remnants who got involved in the drug trade as their rebellion fizzled 20 years ago. DEVIDA wants to eradicate 37,000 acres of coca crops there, about 75% of total plantings in the region. Look for trouble when eradication efforts actually get underway, probably in August.

Bolivia to Use G-77 Post to Push for Legal Coca Leaf Internationally. Bolivian President Evo Morales has assumed chairmanship of the Group of 77 nations, and he said Wednesday that he would use his position to push for removing coca leaf from the 1961 UN Single Convention's list of internationally banned drugs. Bolivia briefly left the treaty in 2012 before returning last year with a reservation that it did not recognize the ban on coca leaf chewing. "Last year, we achieved recognition of traditional consumption of the coca leaf," he said. "Our next task will be to remove the coca leaf from the list of prohibited substances."

Germans Not Ready for Marijuana Legalization, Poll Finds. Only 29% of Germans said they favored legalizing marijuana in a new poll, while 65% were opposed. The only political party with a majority favoring legalization was the Greens, and just barely, with 51%. A Green politician, Monika Herrmann, is trying to open a Dutch-style cannabis coffee shop in Berlin's Friedrichshain-Kreuzberg district, but would need federal government approval. This poll isn't going to help.

France Approves Marijuana-Based Medicine for Multiple Sclerosis. France's health ministry announced Thursday it had approved the use of Sativex, a cannabinoid mouth spray, to treat patients suffering from multiple sclerosis (MS). The drug is the first marijuana-based medicine to be made available in the country. Sativex is already approved in more than 20 countries.

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

Greek Government Proposes Drug Decriminalization

The Greek government is proposing to decriminalize the possession of drugs under a bill sent to parliament by Justice Minister Miltadis Papioannou, the British web site Talking Drugs reported this week. Under the bill, drug possession would be decriminalized as long as the drug use does not affect others.

Athens Cycle Tour (cityofathens.gr)
The bill is a response to continuing high drug overdose numbers -- more than 300 deaths a year in recent years -- and high levels of imprisonment. Some 40% of Greek prisoners are doing time for drug or drug-related offenses.

Under the proposed bill, drug possession for personal use would qualify only as "misconduct" instead of a more serious criminal offense. The decriminalization provision would also apply to people growing marijuana for their personal use.

The bill would also guarantee the right to drug treatment, including for people currently imprisoned. People deemed "addict offenders" by the courts would be provided treatment instead of being jailed.

Under the "treatment not jail" approach, addicts would be admitted to an approved treatment program for detoxification, then granted deferred prosecution and conditional release under a drug monitoring program. It is unclear what would happen to addicts who relapse while in the program.

The bill does not legalize the sale of drugs, which would remain a felony offense. Like other decriminalization schemes, the measure would make life easier for drug users in some ways, but would do little to reduce the deleterious effects of the black market in proscribed substances.

Athens
Greece

Poland Approves Drug Decriminalization -- Sort Of [FEATURE]

With President Bronislaw Komorwski signing into law late last month an amendment to the country's harsh, decade-old drug laws, Poland has taken a step in the direction of the decriminalization of drug possession. But how much of a difference the new law will make is unclear at this point, and it won't go into effect for another six months. The new law also increases sentences for some drug distribution offenses.

21st Century Warsaw. Now, if Poland can just move its drug laws into the 21st Century. (Image via Wikimedia.org)
Under the old law, possession of even the smallest quantity of illegal drugs could lead to a three-year prison sentence. Under the amended drug law, people would still be arrested, but prosecutors will have the option of not charging people for personal drug possession if the quantity involved is small, if it is a first offense, or if the person is drug dependent.

It is one thing to have the law on the books, but whether prosecutors will take advantage of it remains to be seen. The experience in other European countries that have enacted similar laws suggests that they will have to be prodded.

Also unclear at this point is just what will constitute a "small" amount of drugs for personal use. That is an issue that is now being contested. In a sign of how volatile the issue is, demonstrators demanding a 30 gram figure for marijuana, the ability to grow at home, and amnesty for pot prisoners, clashed last weekend with police in Warsaw just days after the president signed the new law. Nearly 30 people were arrested on drug charges, and police were attacked with eggs and empty beer bottles.

The protest was called by the Free Hemp Initiative, and police estimated some 6,000 people attended. Demonstrators shouted slogans and waved banners with exhortations such as "Plant It, Smoke It, Legalize It!" on them. Organizers managed to cool down the crowd after the violence broke out by reminding people of their nonviolent stance.

Activists are planning to both push prosecutors to use the new law and to try to open up discussion around the personal use threshold in a bit to push further in the direction of real decriminalization.

Polish and international experts cautioned about making too much of the reform. "While this is only a small change, it is nevertheless a step in the right direction," said the International Drug Policy Consortium.

The reform "seems quite modest and even marginal," Dr Mateusz Klinowski, Chair of Legal Theory at the Jagiellonian University's Department of Law and Administration, told the Krakow Post. "Though the amendment doesn't seem to be a major breakthrough, at least it creates hope of future reforms," he added. "The first step has been taken and now it is public opinion and non-governmental organizations which have to advocate rational solutions and efficient law that will be aimed primarily at prevention and treatment, rather than at penalizing possession."

In  commenting on the new law, Justice Minister Krysztof Kwiatkowski demonstrated that the old mentality or at least the old politics is still strong in the halls of power. While he confirmed that prosecutors must now investigate each drug possession case to see if it qualifies for dismissal, his rhetoric was that of prohibition.

"We have increased the criminal responsibility for those who sell death, in order to provide for more effective prosecution," he said. "Police should concentrate on the pursuit of drug dealers and not drug addicts. We should focus on providing treatment for such people."

Even this limited progress on reforming Poland's drug laws came only after years of delay. A team of experts appointed by the former justice minister had drawn up the amendments more than two years ago.

Polish politicians were also the object of a concerted civil society campaign to liberalize the drug laws. Celebrity chef Robert Maklowicz created a Facebook video, Cook Our Children a Better Future, arguing for reform, while at the same time, 71 Polish artists sent an open letter to the Sejm seeking a review of Polish drug policy.

Former Polish president Aleksander Kwaśniewski, sociologist Zygmunt Bauman, and renowned international human rights expert Wiktor Osiatyński also joined the fray, signing a January open letter coordinated by Krytyka Polityczna, an influential group of liberal thinkers. Over 100 organizations from Poland and worldwide recently signed a petition coordinated by the Polish Drug Policy Network. A video by the Hungarian Civil Liberties Union was viewed by nearly 50,000 people.

While for many advocates the reforms don't go far enough, they are at least a step in the right direction. Now it will be up to activists and civil society to continue prodding politicians to keep moving toward more civilized drug policies.

Warsaw
Poland

New Zealand Commission Urges Drug Law Reform

The New Zealand Law Commission Monday urged a broad overhaul of the island nation's drug laws to bring them into the 21st Century. The call came as the commission unveiled its review of the country's drug laws in a report, Controlling and Regulating Drugs: A Review of the Misuse of Drugs Act 1975.

Will Auckland become more like Oakland? It will if the Law Commission has its way. (Image via Wikimedia.org)
The Law Commission is an independent, but government-funded, body whose mission is to review areas of law that need developing or reforming and to make recommendations to parliament. It was asked by the then Labor government in 2007 to review the drug laws.

The commission called for steps toward legalizing medical marijuana, decriminalizing drug possession and small-time drug dealing, and doing away with drug paraphernalia laws. In response to the arrival of new synthetic drugs, it called for the reversal of current policy, which allows them until they are proven dangerous, and its replacement with a policy that bans them until they are proven safe.

The review calls for clinical trials on medical marijuana "as soon as practicable" and said medical marijuana patients should not be arrested in the meantime. "Given the strong belief of those who already use cannabis for medicinal purposes that it is an effective form of pain relief with fewer harmful side effects than other legally available drugs, we think that the proper moral position is to promote clinical trials as soon as practicable. We recommend that the government consider doing this."

People caught with drugs for personal use should be "cautioned" instead of arrested, the report said. "We recommend that a presumption against imprisonment should apply whenever the circumstances indicate that a drug offense was committed in a personal use context," the review said.

There should also be a statutory presumption against imprisonment for small-time drug dealing, the review said. ''We consider that the supply by drug users of small amounts of drugs with no significant element of commerciality ("social dealing") is entirely different from commercial dealing.''

Get rid of drug paraphernalia laws, the review said. ''We are not aware of any evidence that existence of the offense itself deters drug use."

The report highlights four key recommendations:

  • A mandatory cautioning scheme for all personal possession and use offences that come to the attention of the police, removing minor drug offenders from the criminal justice system and providing greater opportunities for those in need of treatment to access it.
  • A full scale review of the current drug classification system which is used to determine restrictiveness of controls and severity of penalties, addressing existing inconsistencies and focusing solely on assessing a drug's risk of harm, including social harm.
  • Making separate funding available for the treatment of offenders through the justice sector to support courts when they impose rehabilitative sentences to address alcohol and drug dependence problems.
  • Consideration of a pilot drug court, allowing the government to evaluate the cost-effectiveness of deferring sentencing of some offenders until they had undergone court-imposed alcohol and/or drug treatment.

"There are adverse social consequences from a distinctly punitive approach to lower level offending," Law Commission head Grant Hammond told the New Zealand Herald. "Quite large numbers of young New Zealanders receive criminal convictions -- which might subsist for life -- as a result of minor drug offenses. This is a disproportionate response to the harm those offenses cause. More can be done through the criminal justice system to achieve better outcomes for those individuals and for society at large."

The review won plaudits from Green Party leader Metiria Turei. "Current drug law is 35 years out-of-date and is hurting our families," she said. "Too many resources are directed into criminalizing people rather than providing them with the medical help they most need. The Law Commission's report recognizes this and seeks to redress it by adopting a harm reduction approach for dealing with personal drug use by adults. This new approach, if adopted, will actually save money enabling greater resources to be directed into health services for breaking the cycle of drug abuse and addiction. It will also free police to tackle more serious crime."

But Bob McCoskrie, director of the tough-on-drugs group Family First found little to like in the review. "A weak-kneed approach to drug use will simply send all the wrong messages that small amounts of drug use or dealing aren't that big a deal -- the completely wrong message, especially for younger people," he warned. "A cautioning scheme will simply be held in contempt by users, and fails to acknowledge the harm done by drug use which is undetected. The report is correct to call for better treatment facilities for addiction and mental illness, but a zero-tolerance approach to the use of drugs combined with treatment options is a far better solution."

A spokesman for the governing center-right National Party said the government welcomed the report, but needed time to study it.

Auckland
New Zealand

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