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Europe: Heroin Maintenance Comes to Denmark

On Monday, Denmark opened its first heroin distribution clinic, two years after the Danish parliament passed a law legalizing the distribution of medicinal heroin. The opening was delayed until after the city of Copenhagen agreed to house the program.

Denmark thus joins Germany, the Netherland, and Switzerland, and to a lesser extent, Great Britain, as countries that allow for the provision of heroin to hard-core users who have proven unamenable to the traditional treatments, such as methadone maintenance. A pilot heroin maintenance program is also underway in Vancouver, Canada.

The Copenhagen clinic will serve about 120 of Denmark's 300 or so identified hard-core users. Only addicts who have been referred from a methadone treatment center will be accepted. While subjects will be prescribed heroin, they will have to consume it at the clinic.

"Our objective is not to cure heroin addicts, but to help those who are not satisfied by methadone by providing them with clean heroin, allowing them to avoid disease and the temptation of criminal acts to obtain the drug," a doctor and head of the clinic Inger Nielsen told Agence-France Presse. People in the program will get methadone for the first two weeks "so we can determine how much heroin to prescribe," she added.

The Danish User Association, a group that represents drug users, while supportive of heroin maintenance, criticized the program for requiring users to go to the clinic twice a day, seven days a week, to get their fixes. "This means living like a zombie, without being able to hold down a job or study or have hobbies," said head of the association Joergen Kjaer.

DrugSense FOCUS ALERT: #433 Black Tar Heroin

DrugSense FOCUS Alert #433 - Tuesday, 16 February 2010 For newspapers to print a series of articles about heroin is rare. The Los Angeles Times printed, starting on the newspaper's front page each day, an in depth series Sunday through today. The sidebar, below, appeared at the end of each article. Here are the links to each article: Sunday: http://www.mapinc.org/drugnews/v10/n111/a09.html Monday: http://www.mapinc.org/drugnews/v10/n114/a01.html Tuesday: http://www.mapinc.org/drugnews/v10/n117/a03.html Your letters to the editor may be sent by using the webform at http://mapinc.org/url/bc7El3Yo - which recommends letters of about 150 words or less - or by email to letters@latimes.com. Sustaining all the activities of DrugSense in support of the reform community is difficult in these hard economic times. Please consider giving what you can. Details are at http://www.drugsense.org/donate.htm. ********************************************************************** ABOUT THIS SERIES Times staff writer Sam Quinones is the author of two books about Mexico, where he lived for 10 years. For this series, he traveled to Colorado, Idaho, Ohio, West Virginia and Xalisco, Mexico, to track the spread of black-tar heroin. He interviewed police narcotics officers, federal drug agents, prosecutors, public health officials, addiction experts and imprisoned former dealers and addicts across the U.S. Sunday: Pushing heroin into the heartland. Monday: Black tar packs a deadly punch. Tuesday: Drug money transforms a backwater. latimes.com/blacktar An audio slide show and other resources are available online. ********************************************************************** Suggestions for Writing LTEs Are at Our Media Activism Center http://www.mapinc.org/resource/#guides ********************************************************************** Prepared by: Richard Lake, Senior Editor www.mapinc.org === DrugSense provides many services at no charge, but they are not free to produce. Your contributions make DrugSense and its Media Awareness Project (MAP) happen. Please donate today. Our secure Web server at http://www.drugsense.org/donate.htm accepts credit cards and Paypal. Or, mail your check or money order to: DrugSense 14252 Culver Drive #328 Irvine, CA 92604-0326. (800) 266 5759 DrugSense is a 501c(3) non-profit organization dedicated to raising awareness about the expensive, ineffective, and destructive "War on Drugs." Donations are tax deductible to the extent provided by law.

Europe: Anthrax Heroin Toll Rises as England Marks First Death

English authorities announced Wednesday that a Blackpool heroin user died of anthrax, making him the first fatality in England from what is apparently a batch of heroin contaminated with anthrax. The bad dope has been blamed for nine deaths in Scotland and one in Germany since the outbreak began in December.

http://stopthedrugwar.com/files/anthraxspores.jpg
anthrax spores
The anthrax fatality announcement from the National Health Service (NHS) in Blackpool came just five days after the Health Protection Agency issued a statement warning that a female heroin user in London had been hospitalized with anthrax.

The spate of anthrax cases among heroin users is baffling police and health experts, who have yet to actually come up with any heroin samples containing anthrax spores. There is speculation that the heroin could have been contaminated at its likely source in Afghanistan, perhaps from contaminated soils or animal skins, or that it was present in a cutting agent added there or at some other point on its transcontinental trek to northern Europe.

The cases in Germany and England have no known link to those in Scotland, leading to fears that tainted dope could be widespread. On the other hand, the numbers so far reported as being infected remain relatively small.

Although harm reductionists and drug user advocates have called for measures including public information campaigns among users, swift access to drug treatment, and making prescription heroin more widely available, British health officials continue to do little more than tell users to quit. Dr. Arif Rajpura, director of public health at NHS Blackpool, was singing from the same official hymnal this week.

He repeated warnings for users to stop using and advised them to be on the lookout for symptoms of anthrax, including rashes, swelling, severe headaches, and high fevers. "Heroin users are strongly advised to cease taking heroin by any route, if at all possible, and to seek help from their local drug treatment services. This is a very serious infection for drug users and prompt treatment is crucial," he said.

Europe: Anthrax Heroin Toll Rises as England Marks First Death

English authorities announced Wednesday that a Blackpool heroin user died of anthrax, making him the first fatality in England from what is apparently a batch of heroin contaminated with anthrax. The bad dope has been blamed for nine deaths in Scotland and one in Germany since the outbreak began in December. The anthrax fatality announcement from the National Health Service (NHS) in Blackpool came just five days after the Health Protection Agency issued a statement warning that a female heroin user in London had been hospitalized with anthrax. The spate of anthrax cases among heroin users is baffling police and health experts, who have yet to actually come up with any heroin samples containing anthrax spores. There is speculation that the heroin could have been contaminated at its likely source in Afghanistan, perhaps from contaminated soils or animal skins, or that it was present in a cutting agent added there or at some other point on its transcontinental trek to northern Europe. The cases in Germany and England have no known link to those in Scotland, leading to fears that tainted dope could be widespread. On the other hand, the numbers infected remain relatively small. Although harm reductionists and drug user advocates have called for measures including public information campaigns among users, swift access to drug treatment, and making prescription heroin more widely available, British health officials continue to do little more than tell users to quit. Dr. Arif Rajpura, director of public health at NHS Blackpool, was singing from the same official hymnal this week. He repeated warnings for users to stop using and advised them to be on the lookout for symptoms of anthrax, including rashes, swelling, severe headaches, and high fevers. "Heroin users are strongly advised to cease taking heroin by any route, if at all possible, and to seek help from their local drug treatment services. This is a very serious infection for drug users and prompt treatment is crucial," he said.
Location: 
Blackpool
United Kingdom

Europe: Anthrax-Tainted Heroin Death Toll Up to Ten

The death toll from anthrax-tainted heroin in Europe has risen to 10 as Health Protection Scotland confirmed that a heroin user who died in the Glasgow area on December 12 was infected with anthrax. Nine of the 10 deaths occurred in Scotland; the other occurred in Germany.

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anthrax spores
The latest announced death is actually the earliest. Prior to the announcement of this death, the earliest known death took place December 16.

At least 19 drug users -- 18 of them Scottish -- have been diagnosed with anthrax since the outbreak began. A pair of heroin deaths in Sweden turned out to be unrelated, and a cluster of deaths in Portugal has not been confirmed as being linked to anthrax.

While Scottish authorities have yet to find any anthrax-tainted heroin, they believe either the heroin itself or cutting agents have been contaminated with anthrax spores. They said there is no evidence of person-to-person infection.

"While public health investigations are continuing to attempt to identify the source of the contamination, no drug samples tested to date have shown anthrax contamination, although a number of other types of potentially harmful bacteria have been found," said Colin Ramsay, an agency epidemiologist. "It must therefore be assumed that all heroin in Scotland carries the risk of anthrax contamination and users are advised to cease taking heroin by any route. While we appreciate that this may be extremely difficult advice for users to follow, it remains the only public health protection advice possible based on current evidence."

As noted in our earlier story linked to above, harm reductionists have called for other measures, ranging from informational campaigns to liberalized prescribing of pharmaceutical heroin.

Infected patients typically developed inflammation or abscesses around the injection site within one or two days and were hospitalized about four days after that. In some severe cases, the lesions developed necrotizing fasciitis, a flesh-eating disease.

Feature: Anthrax-Tainted Heroin Takes Toll in Europe, Prompts Calls for Emergency Public Health Response

European heroin users are on high alert as the death toll rises from heroin tainted with anthrax. At least eight people have died -- seven in Scotland and one in Germany -- since early December, and another 14 Scottish heroin users have been hospitalized after being diagnosed with anthrax. Meanwhile, drug reform and drug user activists are reporting a cluster of nine suspicious heroin-related deaths in Coimbra, Portugal, although it is unclear at this point whether they are linked to anthrax-tainted heroin.

http://www.stopthedrugwar.org/files/anthraxspores.jpg
anthrax spores
The Scottish government has responded by urging heroin users to stop using and to seek drug treatment. That advice has not gone over well with drug users and public health and harm reduction advocates, who are demanding an emergency public health response.

The first four Scottish deaths were in Glasgow, but after one person died in Tayside and one in the Forth Valley earlier this month, Health Protection Scotland epidemiologist Dr. Colin Ramsay said: "The death of this patient in NHS Forth Valley indicates further geographical spread of the cases, meaning that heroin users all across Scotland need to be aware of the risks of a potentially contaminated supply. I would urge all users to stop using heroin immediately and contact local drug support services for help in stopping. If any heroin users do notice signs of infection, for example marked redness and swelling around an injection site or other signs of serious infection such as a high fever, they should seek urgent medical advice."

The French government has also reacted, with the General Directorate for Health issuing a statement Tuesday warning that contaminated heroin may be circulating in France and other European countries. Noting the rising death toll, the statement said "the likeliest source is heroin contaminated by anthrax spores."

Heroin users should be alert, the French statement said, because heroin contaminated with anthrax is indistinguishable from other heroin. "There is no outward sign or color enabling the user to tell whether the heroin has been contaminated by anthrax, and contaminated heroin dissolves or is used in the same way as uncontaminated heroin," it said.

Anthrax is a potentially lethal bacterium that exists naturally in the soil and can also occur among cattle. It is also a potential bio-terror weapon.

The vast majority of heroin consumed in Europe comes from Afghanistan, and while so far evidence is lacking, speculation is that anthrax spores may have been present in bone meal, an animal product sometimes used as a cutting agent. Another possibility is that containers used in the heroin production process were contaminated with anthrax spores. And, given fears that Al Qaeda and its Taliban allies could resort to biological warfare against the West and given the Taliban's role in the Afghan opium and heroin trade, a bio-attack cannot be completely ruled out.

"The anthrax-infected heroin hasn't decreased use, whether people are injecting it or chasing [smoking] it," said Tam Miller, chair of Chemical Reaction, an Edinburgh drug user group, and a member of INPUD (the International Network of People who Use Drugs). "People are scared -- you can be sure of that -- but I think they're more afraid of withdrawing. The Scottish government's advice was for people to stop using heroin, but that won't happen."

Instead, Miller said, heroin users are doing what they can to protect themselves. "Users feel there's not much they can do personally and, as usual, they feel isolated," he said. "A lot are looking up the effects on anthrax on the net and passing on information to people with no internet access. We think the powers that be should put out information on how to spot signs if someone has been in contact with access. Basically, mate, the Scottish government wants little to do with it."

The Scottish government's response so far has drawn a harsh rebuke from the United Kingdom's harm reduction and public health community. In a Tuesday letter to the Scottish government, the International Harm Reduction Association, the drug think tank Release, the Transform Drug Policy Foundation, the UK Harm Reduction Alliance, and individual public health experts called on the government to put in place an emergency public health plan to deal with the crisis.

The letter said the government's advice to heroin users to stop using and enter treatment was "reckless in light of the fact that waiting times in Scotland for opiate substitute treatment (OST) are the longest in the UK. Many of those accessing services are informed that it is a condition of their treatment to engage with the service for a minimum period of time, before they will be entitled to a prescription offering an alternative substitute medication, usually methadone. In some areas of Scotland we have been informed that waiting times for OST can be up to 12 months."

[There is another potential issue with methadone, as well. The antibiotic drug Cipro, used to treat anthrax, interacts with methadone, leading to the possibility of methadone overdoses.]

Given the reality of treatment shortages and delays, it is "unacceptable" for the Scottish government to just tell users to stop or to go to treatment that isn't there, the letter said. "It is clear that this kind of approach can only lead to the death of more vulnerable people."

Instead, the Scottish government must immediately implement a public health plan that includes rapid access and low-threshold prescribing of alternatives to street heroin, the letter-writers advised. They recommended prescribing dihydrocodeine, a synthetic opiate approximately twice as strong as codeine. It is sold in the US under brand names including Panlor, Paracodin, and Synalgos.

"Such an approach will go some way to prevent any more loss of life and will provide greater protection to the public as a whole," the letter said. "Failure to adopt such a policy would mean that the Scottish state would be failing in its duty to its citizens."

Joep Oomen of the European Coalition for Just and Effective Drug Policies (ENCOD) had another suggestion. "The only decent reaction to this kind of episode is to immediately open facilities where people can test their heroin and where they can use in safe conditions, supervised by people who can help if anything goes wrong," he said.

"Hopefully, in the longer term, because of these incidents, authorities will start to see the need for introducing heroin maintenance programs, not as a trial for a limited group of people, but as a permanent service for all those who cannot abstain from heroin for a longer period of time," he added.

Ultimately, said Oomen, prohibition is the problem. "Adulteration is a practice that belongs to the illegal market," he said. "It happens because the people who control the heroin market have no interest at all in the health of their customers."

Dr. Sharon Stancliff of the US Harm Reduction Coalition agreed with her colleagues' assessment of the Scottish government's response. "Telling people to stop is not useful information," she said. "Maybe some occasional users will have a glass of wine instead, but if people are sick and treatment is limited, telling people that heroin is bad for them isn't going to have much impact," she explained.

"At this point, the European harm reduction people should be getting the word out, and the medical people over there need to be on the alert," she added.

Stancliff said she had seen no sign of heroin contaminated with anthrax on this side of the Atlantic, but she was worried. "I hope the DEA is out there buying heroin to see what's in it," she said. "If there is any hint of it here, physicians should be alerted by the Centers for Disease Control as they were with levamisole-tainted cocaine."

If the anthrax-contaminated heroin is coming from Afghanistan, as most heroin consumed in Europe does, US heroin users may catch a break. Most heroin consumed here is of Mexican or Colombian provenance.

But on the other side of the Atlantic, adulterated heroin is killing drug users.

Feature: New York Post's Attack on "Heroin How-to" Harm Reduction Pamphlet Fails to Get It Dropped

Harm reduction in New York City came under attack last weekend when the tabloid New York Post ran an article titled Heroin for Dummies, excoriating the city for spending $32,000 for a 2007 harm reduction pamphlet that, among other things, gave injection drug users advice on how to reduce the harm of injecting. Since then, the story has been picked up by the New York Times and national media, including CNN and Fox News.

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uncomfortable, but the right thing to do
But while the assault on evidence-based harm reduction practices is worrisome, it also sparked a vigorous defense of the pamphlet from Mayor Michael Bloomberg and city health officials and has provided an opportunity to broaden public awareness of harm reduction. By Thursday, despite demands that they be pulled, Health Commissioner Thomas Farley had decided that the pamphlets will continue to be distributed.

The pamphlet, Take Charge, Take Care, was distributed by the city's Department of Health and Mental Hygiene and was aimed at injection drug users in the city. The harm reduction purpose behind it was to save lives and prevent overdoses and the spread of blood-borne disease. It counsels things like quitting, not sharing needles, and seeking treatment.

But also included in its advice were things like "Find the vein before you try to inject," "If you don't register [hit the vein], pull out and try again," and "Warm your body (jump up and down) to show your veins." Such common-sense harm reduction advice was like waving a red flag for Post and the drug warriors it interviewed.

"It's basically step-by- step instruction on how to inject a poison," said John Gilbride, head of the DEA's New York office. "It concerns me that the city would produce a how-to on using drugs," Gilbride said. "Heroin is extremely potent. You may only get the chance to use it once. To suggest there is a method of using that alleviates the dangers, that's very disturbing."

"It's sick," said City Council member Peter Vallone Jr. (D-Queens), chair of the council's public safety committee, who vowed to try to shut down distribution of the pamphlet. "This is a tremendous misuse of city funds, and I'm going to see what I can do to stop it. It sends a message to our youth: give it a try," he fumed.

"What we do not want to do is suggest that there's anything safe about shooting up narcotics," said Bridget Brennan, the city's special narcotics prosecutor. "No matter how many times you wash your hands or how clean the needle is, it's still poison that you're putting in your veins."

Only at the very end of the Post article was any supporter of harm reduction or the pamphlet given a say. "Our goal is to promote health and save lives with this information," explained Daliah Heller, assistant commissioner for the Bureau of Alcohol and Drug Use Prevention, Care and Treatment. "From a health perspective, there is a less harmful way to inject yourself."

The New York Times article the following day was less one-sided than the Post's hit piece, but still gave Vallone and other critics top billing. "You're spending taxpayer money and getting a how-to guide for first-time users," Vallone claimed.

The pamphlet was "absolutely not" a how-to manual, Dr. Adam Karpati, executive deputy commissioner for the health department's division of mental hygiene, told the Times. "Our primary message, as it is in all our initiatives, is to help people stop using drugs and to provide them with information on how to quit," Karpati said, adding that health officials recognized that quitting was not a realistic expectation for all drug users.

While Karpati was playing defense, harm reduction supporters went on the offensive. "The Health Department's booklet is solidly grounded in science and public health," said Ethan Nadelmann, executive director of the Drug Policy Alliance. "But the same cannot be said of the irresponsible comments by John Gilbride, Bridget Brennan, and Peter Vallone, Jr. These sorts of reckless statements by top level city and federal law enforcement agents need to be repudiated by their superiors in city and federal government."

On Monday, Mayor Bloomberg defended the pamphlet. "I would certainly not recommend to anyone that they use hard drugs or soft drugs," Bloomberg said. "But our health department does have an interest in if you're going to do certain things to get you to do it as healthily as you possibly can."

Now that the flap is behind them, two leading harm reductionists are assessing what it all means. "There was a political agenda at work with this," said Allan Clear, head of the Harm Reduction Coalition. "The District Attorney's Office fed this to the Post. This is a deliberate attack, and it follows on the footsteps of Rockefeller drug law reform, where DAs had some of their power stripped away. This was a red rag for foes to wave to provoke people, when the amount spent on the brochure is relatively small."

"This was not a book for people who have never injected," said Robert Heimer, professor at the Yale School of Public Health. "We know that people use opiates for around three years before they start injecting, and they don't do it because of a pamphlet, but because they are following their friends' example. This pamphlet was distributed at needle exchanges, STD clinics, drug treatment centers, and to people leaving Rikers Island. That's who the audience is, not people who have never injected."

Neither Clear nor Heimer thought much of the press coverage, although Clear was more charitable to the Times than Heimer. "The brochure has been deceptively portrayed consistently in all the articles," said Clear. "This is a manual aimed at people who are using injection drugs. The first thing it says is if you want help, call this number. If you compare the articles in the Post and the Times, the anti-drug user invective in the Post was just horrendous and demonstrated a very biased position to begin with," said Clear. "The conversation in the Times was much more pro-public health and sympathetic."

"The Times article was incredibly negative," said Heimer. "The first eight or ten paragraphs were all the opposition, and only after that do you get to the health department and why it's a common sense public health approach. When you have 'liberal media' like the Times and rightwing Murdoch papers like the Post both condemning you, you are under a lot of pressure to change."

When all is said and done, did the pamphlet flap turn out to be a boon or a bane for harm reduction? Again, the two men differed.

"When you get this on Fox News or CNN and people are talking about it, even though the initial effort was to discredit the brochure, it actually brought harm reduction to public consciousness in a good way," said Clear. "While we feel attacked, there has been a lot of positive response, and this has raised the profile of harm reduction and the need to educate drug users. The public reaction hasn't been that bad; in fact, it's been quite good."

"Any time there is negative press, it's not good for harm reduction," said Heimer. "It's still fragile here. In places like Holland, Britain, Canada, and Australia, harm reduction is one of the four pillars -- prevention, treatment, law enforcement, harm reduction -- but in this country, very little is done about prevention, there is not enough drug treatment because there is not enough emphasis on demand reduction, and we spend all our money on supply reduction, and we know how that has worked."

Heroin Maintenance: SALOME Trials Set to Begin in Vancouver

In the Chronicle's review of the top international drug policy stories of the year last week, the slow spread of heroin maintenance was in the mix. This week, it's back in the news, with word that a new Canadian heroin maintenance study in Vancouver is about to get underway.

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Hastings St., on Vancouver's Downtown Eastside (courtesy vandu.org)
The Study to Assess Longer-term Opioid Medication Effectiveness (SALOME) will choose a Downtown Eastside location next month and begin taking applications from potential participants in February, according to a Tuesday press release from the Inner Change Foundation, which, along with the Canadian Institutes of Health Research, is funding the trial. With selection of participants supposed to last only three weeks, that means SALOME could be underway by March.

SALOME will enroll 322 hard-core heroin addicts -- they must have been using at least five years and failed other treatments, including methadone maintenance -- in a year-long, two-phase study. During the first phase, half will be given injectable heroin (diacetylmorphine) and half will be given injectable Dilaudid® (hydromorphone). In the second phase, half of the participants will be switched to oral versions of the drug they are using.

The comparison of heroin and Dilaudid® was inspired by unanticipated results from SALOME's forerunner, NAOMI (the North American Opiate Medication Study), which began in Vancouver in 2005 and produced positive results in research reviews last year. In NAOMI, researchers found that participants could not differentiate between heroin and Dilaudid®. The comparison of success rate among injection and oral administration users was inspired by hopes of reducing rates of injection heroin use.

SALOME was also supposed to take place in Montreal, but Quebec provincial authorities effectively killed it there by refusing to fund it. SALOME researchers have announced that it will now proceed in Vancouver alone.

With an estimated 5,000 heroin addicts in the Downtown Eastside and a municipal government that has officially embraced the progressive four pillars approach to problematic drug use -- prevention, treatment, harm reduction, and law enforcement -- Vancouver is most receptive to such ground-breaking research. It is also the home of Insite, North America's only safe injection site.

The NAOMI and SALOME projects are the only heroin maintenance programs to take place in North America. Ongoing or pilot heroin maintenance programs are underway in Britain, Denmark, Germany, the Netherlands, Spain, and Switzerland.

Afghanistan: US Anti-Drug Strategy Lacking, State Department Report Finds

The US counternarcotics mission in Afghanistan, a key element in Western efforts to defeat the Taliban, is short on long-term strategy, clear objectives, and a plan to hand over responsibility to Afghan authorities, the State Department said in a report released last Wednesday. The report was written by the State Department's Office of the Inspector General.

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opium poppies
The department's Bureau of International Narcotics and Law Enforcement Affairs (known colloquially as "drugs and thugs") is responsible for shaping and administering counternarcotics policy in Afghanistan, but it is not doing its job very well, the report said. "The department has not clarified an end state for counternarcotics efforts, engaged in long-term planning or established performance measures," it noted.

With the Taliban making hundreds of millions of dollars a year off the Afghan opium and heroin trade, a smart, effective counternarcotics strategy is critical to US plans to defeat the Taliban by sending in an additional 30,000 troops. There are already 68,000 US and NATO troops in the country, where they have suffered their worst losses so far this year. The number of US military dead in Afghanistan this year sits at 310, exactly double the number killed last year. Overall US and NATO fatalities topped 500 this year, up from 300 last year.

While an effective anti-drug policy may be critical to US plans, it may also be impossible to achieve. As analysts consulted by the Chronicle five years ago -- when opium production was just beginning to reemerge as a problem area -- noted, opium is deeply implicated in the Afghan economy, with more than a million families dependent on it for a living.

"In this case, even if you support drug prohibition in general, the war on drugs is not something we can pursue if we want a rational, effective policy in Afghanistan," said Ted Galen Carpenter, an international affairs analyst for the Cato Institute. "It will undermine everything else we're trying to achieve. The international supply side drug war is complete folly no matter where it is applied, but even if you don't accept that analysis, one ought to be aware that our top priority needs to be going after radical Islamic terrorists, not Afghan farmers," he said.

But heeding the views of the bureau's hard-line drug warriors, the report said that poppy eradication was "essential" to the success of the strategy. But Richard Holbrook, Obama's emissary to the region, abruptly ended the US role in eradication earlier this year, arguing that it served only to alienate poor poppy farmers and drive them into the arms of the Taliban. Instead, Western forces have concentrated on capturing or killing traffickers linked to the Taliban.

Even so, the report found, the bureau had "no clear strategy for transitioning and exiting from counternarcotics programs in Afghanistan." It added that while Afghan contractors working on poppy eradication were meeting agreed-upon goals, vague performance measures in their contracts made it difficult to tell how effective they were.

The report did cut the bureau some slack, noting that it faced tough challenges in Afghanistan, including "a weak justice system, corruption and the lack of political will" in the Afghan government. It also acknowledged the powerful economic incentives for poor Afghan farmers to grow opium poppies.

It recommended setting "a defined end state" for US anti-drug programs, in-country monitoring of contractors, and establishing benchmarks for measuring the Afghan takeover of anti-drug programs.

Europe: Czech Government Announces Decriminalization Quantities; Law Goes Into Effect on New Year’s Day

The Czech cabinet Monday approved a Justice Ministry proposal that sets personal use quantity limits for illicit drugs under a penal code revision that decriminalizes drug possession in the Czech Republic. The law and its quantity limits will take effect on January 1. The Czech government had approved the decriminalization law late last year, but failed to set precise quantities covered by it, instead leaving it to police and prosecutors to determine what constituted a “larger than small” amount of drugs. The resulting confusion--and the prosecution of some small-scale marijuana growers as drug traffickers--led the government to adopt more precise criteria. Under the new law, possession of less than the following amounts of illicit drugs will not be a criminal offense: Marijuana 15 grams (or five plants) Hashish 5 grams Magic mushrooms 40 pieces Peyote 5 plants LSD 5 tablets Ecstasy 4 tablets Amphetamine 2 grams Methamphetamine 2 grams Heroin 1.5 grams Coca 5 plants Cocaine 1 gram Possession of “larger than a small amount” of marijuana can result in a jail sentence of up to one year. For other illicit drugs, the sentence is two years. Trafficking offenses carry stiffer sentences. Justice Minister Daniela Kovarova said that the ministry had originally proposed decriminalizing the possession of up to two grams of hard drugs, but decided that limits being imposed by courts this year were appropriate. "The government finally decided that it would stick to the current court practice and drafted a table based on these limits," Kovarova said. The Czech Republic now joins Portugal as a European country that has decriminalized drug possession.
Location: 
Prague
Czech Republic

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