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Second National Conference on Methamphetamine, HIV, and Hepatitis Underway in Salt Lake City

Around a thousand people, including some of the nation's foremost experts in treating, researching and developing responses to methamphetamine use, gathered at the Hilton Hotel in downtown Salt Lake City as Science and Response: The 2nd Annual Conference on Methamphetamine, HIV and Hepatitis got underway Thursday. Sponsored by the Salt Lake City-based Harm Reduction Project, the conference aimed at developing evidence-based "best practices" for responding to meth and emphasized prevention and treatment instead of prison for
meth offenders.

This year's conference was uncontroversial -- a marked change from the first one, also held in Salt Lake City, which was attacked by congressional arch-drug warrior Rep. Mark Souder (R-IN) because presenters openly discussed the impact of meth on the gay community. Souder was also incensed that the US Department of Health and Human Services provided limited financial support for the conference, and authored a successful amendment to the appropriations bill funding the White House Office of National Drug Control Policy calling for an investigation of the conference and HHS policy.

"The fact that there is absolutely no controversy this year indicates more than just a leadership change in Congress. It shows that our approach -- bringing together all the stakeholders and families affected by meth -- is the right one," said Harm Reduction Project executive director Luciano Colonna in a statement on the eve of the conference.

While Colonna sounded sanguine in the statement above, he was less so as he opened the conference Thursday morning. Visibly choking up at times as he sounded the theme of this year's conference, "500 Days Later," he noted that since the first conference in August 2005, "thousands have died or been incarcerated." And Colonna could not resist a reference to Souder and ideological allies in Congress. "There's no need to mention the names of cheap mudslingers because their party lost," he said to loud applause.

"I'm tired of seeing meth users incarcerated because of failed theories and practices followed by many treatment providers, faith-based groups and other organizations," Colonna said. "We look to the criminal justice system to solve our problems, and its participation has been a result of our failure. Just as with the homeless, veterans, and the mentally ill, we have failed as a system of care and as a country. We have the audacity to attack the criminal justice system as if the strands of this mess can be separated out, but we are all culpable."

If Colonna wasn't going to name names, Salt Lake City Mayor Rocky Anderson had no such compunctions. As he welcomed attendees to his city, Anderson hit back. "I will say Souder's name," Anderson proclaimed. "We shouldn't ever forget the people who caused so much damage. They don't care that needle exchange programs help injection drug users avoid HIV; they have the attitude that if people use drugs, they deserve what they get. People like Mark Souder would rather make political hay out of tragedy rather than having the integrity to deal with issues based on facts and research."

Citing drug use surveys that put the number of people who used meth within the last year at 1.3 million and the number who used within the last month at 500,000, Anderson pointed out that, "If it were up to Souder, they would all be in prison."

Mayor Anderson, a strong drug reform proponent, had a better idea. "Those numbers are the purest case for harm reduction," he argued. "We know there are people who will use drugs and we can reduce the harm, not only for them and their families, but for all of us. The current approach is so wasteful and cost ineffective. And thanks to you, treatment programs are much more available, but in too many areas, you have to get busted to get affordable treatment. It is time to make treatment on demand available for everybody," he said to sustained cheering and applause.

Given the topic of the conference, it is not surprising that attendees are a different mix than what one would expect at a strictly drug reform conference. While drug reformers were present in respectable numbers -- the Drug Policy Alliance in particular had a large contingent -- they are outnumbered by harm reductionists, treatment providers and social service agency workers. Similarly, with the event's emphasis on "Science and Reason," the panels were heavy with research results and presentations bearing names like "Adapting Gay-Affirmative, Evidence-Based Interventions for Use in a Community-Based Drug Treatment Clinic," "Stimulant Injectors From Three Ukraine Cities," and "The Impact of Meth Use on Inpatient Substance Abuse Treatment Facilities for Youth in Canada."

The mix of interests and orientations led to some fireworks at the first conference, especially around the issue of stimulant maintenance therapy, or providing meth users with a substitute stimulant, such as dextroamphetamine, much as heroin users are prescribed methadone. Such issues may excite controversy again this year, but an opening day panel on the topic caused only a few raised eyebrows -- not any outbursts of indignation. The controversy is likely to come in Vancouver, where Mayor Sam Sullivan recently announced he wanted to implement an amphetamine maintenance pilot program with some 700 subjects.

With three full days of plenaries, panels, breakout session, and workshops, last weekend's conference not only provided information on best practices for educators, prevention workers, and treatment providers, but also helped broaden the rising chorus of voices calling for more enlightened methamphetamine policies. In addition, the conference pointed the Chronicle to a number of meth-related issues that bear further reporting, from the spread of repressive legislation in the states to the effort to expand drug maintenance therapies to stimulant drugs like meth and the resort of some states to criminalizing pregnant drug-using mothers. Look for reports on these topics in the Chronicle in coming weeks.

Lecture: Entheogens, Enlightenment, and Experimental Humanities

Entheogens, Enlightenment, and Experimental Humanities with Thomas B. Roberts, Ph.D., Professor Emeritus at Northern Illinois University and Author of Psychoactive Sacramentals. Presented by the Templeton Research Lectureship Program on the Constructive Engagement Between Science and Religion (2005-2008) in Association with the Spirituality, Religion, and Health Interest Group. For questions, please contact 215-614-0332 or go to www.mindreligion.com. Pizza will be provided after the lecture.
Date: 
Wed, 02/07/2007 - 10:00am - 12:00pm
Location: 
3400 Spruce Street 1st Floor Maloney
Philadelphia, PA 19104
United States

IACM: Call for papers for the 2007 Conference in Cologne

[Courtesy of our friends at the International Association for Cannabis as Medicine] CALL FOR PAPERS: The program committee would like to invite you to present your research at the International Association for Cannabis as Medicine (IACM) 4th Conference on Cannabinoids in Medicine in Cologne, Germany, on 5-6 October. You may submit your abstract electronically until April 15, 2007 for oral presentations and until June 15, 2007 for poster presentations to info@cannabis-med.org. If your abstract is accepted you will have free access to the meeting. In addition, speakers will have one night of free accommodation at the conference hotel Holiday Inn. Speakers may ask the IACM for a subsidy of their travel expenses. IACM AWARD: During the Meeting the IACM will honour four persons for special achievements regarding the re-introduction of cannabis and cannabinoids as medicine. We would like you to propose candidates and send your proposal by e-mail to award2007@cannabis-med.org until June 15, 2007. The IACM Award Committee consisting of Vincenzo Di Marzo, Franjo Grotenhermen, Ester Fride, and Kirsten Müller-Vahl will elect the Awardees. Each award is associated with a price money of 500 Euros (about 650 US Dollars). IACM GENERAL MEETING: During the meeting the IACM will held its annual General Meeting. Regular members will elect the new Board of Directors (a maximum of 10 members) including the chairman. Associate members will elect the patient representatives (a maximum of 2 members). Members of the IACM are invited to make suggestions for candidates by e-mail to info@cannabis-med.org. Suggestions can also be made during the General Meeting. IACM members will get a written invitation to the General Meeting together with the printed IACM-News in July. More information on IACM Award and Call for Papers at http://www.iacm-conference2007.org
Location: 
Cologne
Germany

The Drug War's "Unacceptable Losses"

[This post comes courtesy of Ken Wolski, RN, MPA. He is the executive director of the Coalition for Medical Marijuana -- New Jersey, www.cmmnj.org, ohamkrw@aol.com] "Unacceptable Losses" opened Friday, 1/12/07, at the Woodrow Wilson School's Bernstein Gallery on the Princeton University Campus. This photo-documentary by photgrapher and med student Arthur Robinson Williams examines U.S. drug policy and victims of it. At the exhibit, there are large color and black and white prints that accompany text of interviews that Mr. Williams conducted. The photos Mr. Williams took seemed designed to capture the essential humanity of the subject. (Some of this photographic detail is missing in the web site.) The web site is divided into sections on Treatment on Demand, Sentencing Reform, Syringe Access, Harm Reduction and Medical Marijuana. The stories are very compelling. Though the web site is still a work-in-progess, I highly recommend a look. I was reminded of CMM-NJ member Roberta M., when I read the story of the man with RSD whose pain was so severe he contemplated suicide until he tried marijuana. I consider the War on Drugs the worst policy this country imagined. It combines the worst features of Prohibition and the Vietnam War, in its domestic and foreign components. Lack of medical access to marijuana for legitimate patients is an atrocity in this war. I was one of the first people who was photographed and interviewed by Mr. Williams during his one-year project, though he eventually found more compelling stories for the exhibit and the website. Mr. Williams is looking for additional stories to tell, and he invites submissions via his web site. His web site states: "Although law enforcement is an integral part of the War on Drugs, it is unnecessarily taking resources from effective and complimentary public health strategies. Your stories will form the foundation for that argument." The "Unacceptable Losses" exhibit hopes to tour the country's major universities the way the photo-journalist toured the country collecting subjects for the exhibit. For more, see http://unacceptablelosses.org/.
Location: 
Princeton, NJ
United States

Mexican cartels settling into Peru

Location: 
Lima
Peru
Publication/Source: 
The Herald (Mexico)
URL: 
http://www.eluniversal.com.mx/miami/22944.html

Feature: Afghan Opium Dilemma Sparks New Calls for Alternative Development, "Normalizing" the Poppy Crop

With Afghanistan's opium crop reaching record levels last year and seemingly destined for a repeat performance this year, lawmakers and officials on both sides of the Atlantic are looking for innovative solutions. Or at least some of them are. Seemingly bereft of new ideas, the US government's official line is that the solution is eradicating as much of the crop as possible with herbicides, as drug czar John Walters announced in Kabul two weeks ago.

http://stopthedrugwar.org/files/poppy2.jpg
incised papaver specimens (opium poppies)
While the Afghan government of President Hamid Karzai has endorsed the notion -- though not yet put it into effect -- it has done so reluctantly, knowing that eradication will infuriate the hundreds of thousands of poor farmers who depend on the poppy harvest to feed their families. As the Karzai government knows full well, angry poppy farmers mean bad times for the government and good times for the resurgent Taliban, which awaits the aggrieved growers with open arms.

But while the US government and a grudging Afghan government are embracing standard drug war tactics, the situation in Afghanistan has created the political space for the consideration of other solutions. Some, such as alternative development proposals, are almost as shop-worn a response as eradication, while others, including various schemes to legitimize the poppy crop, represent a break with the global prohibitionist consensus.

Alternative development -- the substitution of other cash crops for opium poppies and the creation of new economic activities -- is the preferred solution of a number of scholars and non-governmental organizations, as well as the international community as represented by the United Nations and the World Bank. In a highly detailed report on the Afghan opium economy released at the end of November, the World Bank called for a "smart" counter-narcotics strategy featuring both alternative development and law enforcement action against the trade, but even as it did so, it underscored that alternative development would be a long-term -- not a short-term -- solution.

"A 'smart' counter-narcotics strategy will be essential for the effectiveness and sustainability of the fight against drugs," the report noted. "The diversity, flexibility, and dynamic character of the drug industry have been amply demonstrated in recent years. It must be recognized that counter-narcotics efforts -- whether enforcement actions or development of alternative livelihoods -- inevitably cannot be anywhere nearly as nimble or quick as the activities they are targeted against, and they inevitably take time, measured in decades rather than years in the case of alternative livelihoods programs."

But evidence of a "smart" counter-narcotics strategy being implemented is severely lacking. As Afghanistan scholar Barnett Rubin noted in a recent article in Foreign Affairs, the US government failed to consolidate gains it made with a small reduction in the area cultivated in 2005. "Although the decrease was due almost entirely to the political persuasion of farmers by the government, the United States failed to deliver the alternative livelihoods the farmers expected and continued to pressure the Afghan government to engage in counterproductive crop eradication," Rubin wrote. "The Taliban exploited the eradication policy to gain the support of poppy growers."

The problem of support for alternative development is not limited to isolated opium growing communities, as Barnett noted. "As numerous studies have documented over the years, Afghanistan has not received the resources needed to stabilize it. International military commanders, who confront the results of this poverty every day, estimate that Washington must double the resources it devotes to Afghanistan. Major needs include accelerated road building, the purchase of diesel for immediate power production, the expansion of cross-border electricity purchases, investment in water projects to improve the productivity of agriculture, the development of infrastructure for mineral exploitation, and a massive program of skill building for the public and private sectors."

And that is the Catch-22 of eliminating the poppy crop through alternative development. While the lack of roads, electric power, and other infrastructure for development make it difficult to get off the ground, let alone sustain alternative development, the opium economy, with its hostility toward interference from the central government and the West and its de facto alliance with insurgents and freelance gun men, makes the creation of such crucial developmental infrastructure almost impossible. In fact, in the face of a revitalized Taliban, some of the non-governmental organizations working on alternative development have fled the opium growing regions.

Rubin is harshly critical of US counter-narcotics policy in Afghanistan, noting that the US at first ignored trafficking by warlords it wanted as allies, then, as the uproar over increasing opium production grew louder, called for crop eradication. "To Afghans," he wrote, "this policy has looked like a way of rewarding rich drug dealers while punishing poor farmers."

After noting that the current global prohibition regime does not reduce drug use, but does produce huge profits for criminals, armed insurrectionists, and corrupt government officials, Rubin recommends treating the opium problem as a security and development issue. But then we are back to Catch-22. Still, he makes certain concrete recommendations: "[R]ural development in both poppy-growing and non-poppy-growing areas, including the construction of roads and cold-storage facilities to make other products marketable; employment creation through the development of new rural industries; and reform of the Ministry of the Interior and other government bodies to root out major figures involved with narcotics, regardless of political or family connections."

But the continuing expansion of the Afghan opium economy, combined with the reemergence of the Taliban and its Al Qaeda allies and the need for US and NATO soldiers to fight and die to try to stop them, has led to increasing calls for an approach that transcends both repression and alternative development. Most recently, in the past few days, a US congressman and British Member of Parliament (MP) have called separately for diverting the poppy crop into the legitimate medicinal market for opioid pain relievers.

The European defense and drug policy think tank Senlis Council was first out of the gate with that notion, unveiling a comprehensive proposal to do just that. But that proposal has so far gained little traction, garnering the support of only a handful of Western politicians. Still, rising fears in the West that attempts to eradicate the crop will lead to increased political instability and violence by driving Afghan farmers into the waiting arms of the Taliban appear to be leading to a new receptivity to the notion -- or something similar.

Here in the US, Rep. Russ Carnahan (D-MO) said last week that he would use his newly acquired seat on the House International Relations Committee to raise the issue this month. "You can't just cut off the poppies because that's the livelihood of the people who live there," Carnahan said. "But providing them with alternative legal markets for pain-relief medication is a way to help cut back on that heroin supply."

Carnahan cited the successful experiences of Turkey and India in the early 1970s, when US officials were worried about a rising tide of heroin from poppy crops in those two countries. Officials in the Nixon administration drafted a treaty that blunted the threat by allowing Turkey and India to sell their crops to make pain medications as part of their legitimate economies. Carnahan is also exploring the idea of using altered, morphine-free poppies containing thebaine, which can be turned into a number of therapeutic compounds, including oxycodone, oxymorphon, naltrexone, and buprenorphine. The altered poppies that produce thebaine are the strain that is used in Australia, where they are grown under license for the medicinal market.

"The idea of creating a trade for morphine-free opium is very worthwhile and needs to be thought through carefully," said Toni Kutchan, a biochemist at the Donald Danforth Plant Science Center in St. Louis. "It should not be pushed off the table by a knee-jerk reaction against it."

"I'd certainly like to see a study on how feasible that is," said James Dobbins, director at the International Security and Defense Policy Center at the RAND Corp. "I do think that the current US and international effort is at best a kind of a band aid that can't have more than a marginal impact."

"I think the government should give serious consideration to attempting to implement that type of program," said Dr. Charles Schuster, former head of the National Institute on Drug Abuse. Current US policies alone "are never going to be the solution for this," he added.

But the senior State Department official heading US efforts to fight the Afghan drug trade scoffed. Tom Schweich said the idea was "not realistic." Instead, he counseled more of the same. "You really need to keep it illegal and eradicate it," Schweich said.

Meanwhile, a British MP last week was calling on the British government to just buy up the Afghan opium crop and use it around the world for pain relief. South West Beds MP Andrew Selous asked the House of Commons why not? "Why, given that heroin can have legitimate medical uses, cannot we buy up the Afghan heroin crop and use it around the world for pain relief? That would stop it flooding into this country illegally. We need much serious thought on that issue."

Selous cited the murders of five addicted prostitutes in Ipswich last month. "I read the biographies of the women who were so brutally and horrifically murdered and I cannot have been the only one to be struck by the fact that they were all heroin addicts," he said. "It is a problem that affects all our constituencies -- there will not be a single Member of Parliament who does not have a heroin problem in their constituency. Given that we know that 90% of the heroin on UK streets comes from Afghanistan and that we have a major military presence there, it is extraordinary that we cannot do more to stop the poppy crop ending up here."

While the Bush administration is pushing for tougher measures and chemical eradication of the crops, and the UN, World Bank, and some academics are advocating intensified development and state-building strategies as an adjunct or alternative, the chorus of critics looking for a better way is growing, and they are implicitly -- if not explicitly -- challenging the global prohibition regime itself.

OP-ED: This Is Your Brain on Drugs, Dad

Location: 
San Francisco, CA
United States
Publication/Source: 
The New York Times
URL: 
http://www.nytimes.com/2007/01/03/opinion/03males.html?pagewanted=1&_r=1

DRCNet Proudly Among Road to Vienna 2008 Conference Attendees to Issue a Declaration

On the final day of The Road to Vienna 2008 conference at the European Parliament in Brussels, a declaration was issued that will be sent to media and Members of European Parliament. Signers of the declaration include Members of the European Parliament from two political groups (GUE/NGL and GREENS) and representatives of more than 50 NGO´s, as well as local and regional authorities from around Europe and beyond. The Road to Vienna 2008, THE DECLARATION On November 7th, 2006, at the Conference "The Road to Vienna 2008" that took place in the European Parliament in Brussels, the following declaration has been agreed upon with the : Drug policies in Europe should be aimed at reducing, not at increasing harm. A system in which drugs are illegal generates armed conflicts, the spread of diseases, repression of populations and individual citizens, organised crime, money laundering, violations of basic human rights, and ecological destruction. In 1998, the UN General Assembly Special Session in New York called for a global strategy to obtain a drug free world by 2008. The failure of policies based on this assumption is proved every day by citizens, by the farmers living in coca and opium producing areas in South America and Asia, by people in jails, on dancefloors, in coffeeshops, in user rooms, but also in institutional corridors. Therefore, there is a need for a different drug policy. In the future drug policies in Europe should be based on a bottom-up approach. By taking evidence as a basis for drug policies, biased and counterproductive approaches can be challenged and avoided. Today, harm reduction is embraced by many local and regional authorities in Europe as an effective approach to the most urgent health problems related to drug use. However, it is not yet recognized as one of the basic elements of drug policy. Still many options to apply harm reduction measures are being jeopardized by national legislation and blocked by the international legislatory framework (i.e., the UN conventions on drugs and their narrow interpretation and inappropriate application). The European Union should promote the widest possible expansion of harm reduction programmes, which have proven their undeniable results throughout Europe. Particularly in the Eastern European countries, there is an urgent need for these programmes in order to reduce the spread of blood borne diseases. Millions of Europeans are forced to break the laws of their country on a daily basis, in order to provide themselves with cannabis. Today the possession of cannabis is depenalised or tolerated in most of the EU member states, as a consequence of the pragmatic attitude of most European citizens towards the use of cannabis. Nevertheless, cannabis remains an illegal drug, and the activities that are needed to provide cannabis consumers, even for therapeutic purposes, are still taking place in an illegal environment. Wherever governments try to control the cannabis market with repressive measures, this leads to a further increase of the role played by criminal organisations. Therefore, cannabis consumers in various European countries are offering an alternative option to control this market from both a public health and public safety point of view. In countries where the cultivation of cannabis for personal use is depenalised (such as Spain, Belgium, Switzerland and the Netherlands, cannabis consumers are establishing Cannabis Social Clubs, which are legal associations that organise a transparant, closed circuit of cultivation, distribution and consumption of cannabis by their adult members, as a way to escape from the illegal market. These clubs could become a useful experiment with a system which aims at regulating the market, facilitating environmentally and consumer friendly ways of production and consumption. We call on local and national authorities in the European Union to cooperate with these initiatives. The call for depenalising the coca leaf, as a tool to facilitate an alternative for the illegal market to the millions of people involved in coca production in South America, has recently been adopted by the current government of Bolivia under the presidence of Evo Morales. The international depenalisation of the coca leaf could allow the export of coca tea and other benefitial coca derivates and thus contribute to the worldwide recognition of the great nutritional, medicinal and cultural value of coca. This could help to reduce the dependence of coca farmers of the illegal economy and help to establish a sustainable economy based on renewable agricultural resources. We call on all national authorities in the European Union to cooperate with the Bolivian government and others on this issue. The efforts to reduce the cultivation of opium in Asia have not only failed, they have also had counterproductive results. Currently 40 times more opium is being produced in Afghanistan than before the US led invasion of the country in 2001. We call on the authorities of the European Union to start applying a different approach. Depenalising the cultivation of opium and allowing the use of this substance for benefitial purposes, among others as a pain killer, could become one of the options to increase the life standards of opium farmers in Afghanistan, Burma and other countries. The meeting of the United Nations Commission on Narcotic Drugs in Vienna in 2008 will be the next opportunity to evaluate the anti-drugs strategy that has been applied worldwide for the past 10 years. We call on the European Union to do whatever is possible to ensure that this evaluation process will be genuine, looking at the impact of anti-drug strategies on the lives of affected citizens as well as the financial and other consequences for the law enforcement apparatus. Vienna 2008 should mark the start of a different drug policy. A minimum standard of tolerance should be established within the international legislatory framework , which can facilitate the legal and political space for local, regional and national authorities to apply policies that are not based on prohibition. People who cultivate and consume drugs are not less respectable, nor less legitimate than people who don't. Together with other citizens who are directly affected by the drugs phenomenon they should be consulted in the design of drug policies in order to make these policies more just and effective. This Declaration is signed by: Members of European Parliament Mrs. Katalijne BUITENWEG, MEP, GREENS Mr. Giusto CATANIA, MEP, GUE/NGL Local/Regional Authorities Mrs. Belen BILBAO, Regional Government of Basque Country, Spain Civil Society Organisations European Coalition for Just and Effective Drug Policies (ENCOD) ARSECA, Spain HPPRY, Finland Livello 57, Italy Radio For Peace, Italy Hanfjournal, Germany Ganjazz, Spain Legalize, Netherlands PIC, Italy Trekt Uw Plant, Belgium CLCA, United Kingdom LCA, United Kingdom Ligne Blanche, France CIRC, France Checkpoint, Netherlands DEBED, Belgium AMOC, Netherlands FAUDAS, Spain VRCO, Netherlands Colosseum, Netherlands GROEN VRIJ, Netherlands DAK, Belgium STAD, Belgium SPLIF, Netherlands Common Sense for Drug Policy, USA Info Chanvre, Switzerland ASUD, France MDHG, Netherlands Pannagh, Spain FAC, Spain HOPE, Bulgaria Forum Droghe, Italy Drug Reform Coordination, USA PCN, Netherlands Students Against Prohibition, Slovenia DHV, Germany DROLEG, Switzerland SHK, Switzerland Liaisons Antiprohibitionnistes, Belgium
Location: 
United States

Looking at the UN, smelling a rat---A comment on ‘Sweden’s succesful drug policy: a review of the evidence’ UNODC september 2006

http://www.cedro-uva.org/lib/cohen.looking.html Peter Cohen (2006), Looking at the UN, smelling a rat. Amsterdam: CEDRO. © Copyright 2006 Peter Cohen. All rights reserved. Looking at the UN, smelling a rat A comment on ‘Sweden’s succesful drug policy: a review of the evidence’ UNODC september 2006 [1] Peter Cohen Introduction [i] The year 2009 will mark the centennial of the Shanghai Opium Conference, the first world-wide agreement on the reduction of opium use and production. China, then still an extremely poor feudal nation, was spending most of its foreign exchange on opium it imported through British traders. The British sold their cheap Indian Opium for pure silver to the Chinese, and had almost two centuries of opium fortune-making behind them. The fledgling United States of America tried to conquer a share of the profits in this lavish market, at a time when prohibitionist ideas about alcohol and opium control were expanding all over the globe. It was time for the American Disease to be born. [2] In later analyses of the history of drug and alcohol controls other names for the American Disease have been coined. The most appropriate one, not tied to any nationality per se, is the ‘Temperance Movement’. It was comprised of a collective of local movements prevalent in a group of nations. Later these nine nations would be identified as a special group, the nations where the temperance culture would endorse far reaching control policies in the attempt to regulate medical and recreational drugs. [3] The global impact of these temperance cultures has varied from almost nothing to considerable. It is this variance we will address in this comment because it is at the heart of the report that will be discussed. Sweden represents the most fundamentalist and extreme pole of this variance. Swedish policy makers and popular ideologues developed their own logic , policy language and version of Swedish drug history in order to convince themselves that no other policy could be possible. [4] The UNODC in 2006 After years of mismanagement, the UNODC not only has the difficult task of regaining some status for itself. It also has the task of reinstalling faith into its core business, the business of drug control. As its director aptly remarks in the opening phrases of the report on Sweden : “More people experiment with drugs and more people become regular users… There are thus suggestions, at the European level, that drug policies have failed to contain a widespread problem.” (page 5) The report we will be discussing here has to be seen against the background of diminishing support for present prohibitionist drug control policies world wide. It does not have, according to me, a purely empirical nor scientific ambition. It is too clumsy and too primitive for that to be the case. But as a helping hand for doubting drug control functionaries, struggling with the obvious increase in drug use and drug production all over the world and the astounding inadequacy of global policies, the report must be perceived as a genuine attempt to stand behind them. The report about Sweden is “a rapid assessment, based on open-source documents, supplemented by Government documents and information obtained from government officials” (page 7) Why did UNODC choose Sweden as an example? “….in the case of Sweden, the clear association between a restrictive drug policy and low levels of drug use, is striking.” “Swedish drug policy is highly effective in preventing drug use…” “….a review of fluctuations in abuse rates shows that periods of low drug abuse in the country are associated with times when the drug problem was regarded as a priority.” (page7) According to this report, then, if ever you had doubts that drug control has effects on levels of drug use, you should study the example of Sweden. Or, that if your drug control is not working, nor effective enough, you will have problems with drugs! UNODC director Costa said at the launch of World Drug Report 2006 that countries have the drug problems they deserve. He repeats this remark in the Sweden report, saying that “each government is responsible for the size of the drug problem in its country. Societies often have the drug problem they deserve” (page 5) So, we have to see the present work of UNODC to be tailor made to arrive at the conclusion that drug control works, and that a deficit in drug control will translate into an increased ‘drug problem’. Let us see how this precious work is done, and if it can stand the test of simple questions asked about it. I will proceed by selecting just a few examples of how this is done, because if the reader wants the full works, she had better read the full report. But since the method behind the work is the same throughout, it does not matter much which examples are chosen. First, a clear definition of the ‘drug problem’ is not supplied. It can be anything UNODC deems it to be. Thus, the drug problem is defined as the level of drug use in the population, or in certain age cohorts. This material is supported by levels of ‘heavy use’ or drug abuse, a category that is not defined either. Drug use and drug abuse are freely interchanged in the language of the report, thereby repeating a source of confusion that has become standard in most writing about ‘the drug problem’. The first problem clearly is with the data that are chosen. I do not mean the reliability of the data, for that is a huge problem on its own (not discussed in the report). I mean that the choice of data that are presented for supporting the case of Sweden’s success, is left to the authors. Since there is no clear theory about what data are needed to create a standard description of the drug situation in a country, we can not blame UNODC for this. They simply use the lack of scientific or standardised clarity to legitimise their agenda. [5] So, by showing many tables of use of (cannabis) drugs, mostly with 15 year old school children or of 18 year old army conscripts, they define drug use levels in Sweden. In a few other places prevalence data are given for the Swedish population between 15 and 75 years old. All these data are then compared, sometimes to other individual countries, but most frequently to the European average, as reported by EMCDDA in Lisbon. The Sweden report then shows that on most of these variables Sweden shows scores below EU average. However, if one studies the tables that EMCDA provides for drug use, such as the last year use of cannabis for the drug use age cohort of 15-34 year olds, one can not escape the fact that 14 countries out of 19 produce prevalence figures below the EU average [6]. So in theory it would be possible to produce a UNODC report with the title “The successful drug policy of the Netherlands,” because on many indicators of drug and alcohol use and of the number of ‘heavy users’ seen in treatment, the Netherlands produces indicators that are (well) below the European average, and far below the USA or Australia. Just like Sweden. In the same vein UNODC could produce a series of reports called “The catastrophic drug policy of” France, the UK, or the Czech Republic, or the USA because these UN members show indicators of (some) drug use that are higher or far higher than the EU average. We invite UNODC to write such reports, as soon as possible! Sweden is also lauded because of the vast resources it spends on drug use prevention and drug policy in general. But Greece, (a culture profoundly different from those of the Netherlands or Sweden) spending almost nothing, the least of all EU countries on drug policies, has even LOWER drug use figures than Sweden (if one chooses to believe the Greek data). Looking at other figures from Sweden, ones that are not mentioned in the UNODC report, one sees that Sweden has relatively low levels of alcohol use, and low levels of tobacco use. (Liters of consumed pure alcohol per year in Sweden is 7, versus 10 in Holland and Greece, 14 in France. The percentage of daily smokers in Sweden is 16, versus 30 in the Netherlands and almost 40 in Greece) And the Swedes use relatively few pharmaceutical drugs as well, spending on them less than most countries in the EU (7% of health expenditures - the only country spending less than that is Norway, with 6%. The Dutch spend 12%!! The champion pharma client is Spain, with 23%) [7] So, in order not to fall into the trap of a detailed discussion of the hand picked data used in the UNODC report on Sweden, I would like to stress that the basic assumption of that report does not have any scientific legitimacy. The basic assumption is that the low figures that Sweden shows on a series of indicators on recreational drug use are due to Sweden’s drug policy. Maybe! And let us for the convenience of the argument ignore the quality of the data. But to propose this association, as the UNODC report clearly does, it should at least show some evidence the two are causally related, and why. This evidence is so completely lacking that one may ask if the report should not be seen as a religious document that is intended to prop up faith in drug control rather than an attempt at scientific rigour and clarification. The other thesis: drug control is irrelevant for levels of drug use. Maybe Sweden’s drug policy is just another phenomenon on its own, next to low levels of alcohol and drug use, that EXPRESSES a temperance culture, but does not cause it. In other words, even if Swedes were to choose a less extreme policy, their temperance culture would still produce low levels of intoxicant use, lower than some but not all countries. The Greeks, using little alcohol and drugs as well, will produce their own low figures from a series of completely different cultural or demographic characteristics and determinants, as do the Dutch. Nothing contradicts the thesis that drug policies, whatever they may be, have little to do with the production of the drug and alcohol situation that is found. For UNODC to even contemplate this ‘cultural construction’ notion would be disaster, because it opens the road to a scientific analysis of drug situations, separating it from the ideological analysis that suits UNODC. And this notion would completely invalidate Mr. Costa’s conviction that countries have the drug problem they ‘deserve’ if they fail in drug control orthodoxy. Another way of looking at the situation would be to correlate demographic and cultural variables to a local drug situation. For instance, in the Netherlands epidemiological research has shown that levels of cannabis use in the densely populated urban regions of the country is almost four times as high as in the open spaces of the rural regions. In other words, within a nation with a highly homogeneous drug policy, differences in use levels can be higher than between nations with markedly different drug policies. Also, in Amsterdam life time prevalence of cannabis use is about twice as high as in Rotterdam in spite of the identical drug policies reigning. [8] In the Netherlands the growth of the urban population has been high from 1975 until 2005, with levels varying from 0,5% to over 1% per year. In Sweden during this period urban growth has been less than 0,1 % per year (with the exception of the period 1990-1995, with 0,17% urban growth, exactly when drug use experienced an increase in Sweden) [9] It would be relevant to develop a line of reasoning in which proportions of urban/rural populations, and the change thereof, could be seen as a demographic variable that influences levels of drug use and the emergence of drug use fashions, irrespective of the drug ‘policies’ that are undertaken. Another demographic variable might be the proportion of the elderly in the population. In Greece — where cannabis use is lowest of all Europe — 44% of the population (compared to work force) are aged 65 or older. In Sweden, with 33% of the population older than 65, we observe slightly higher cannabis use. Slightly higher still cannabis use in the Netherlands corresponds with 24% of the population older than 65 (compared to work force)! But such simple eye catching associations will not create serious possibilities for understanding variation of drug use level in the populations of the world. Combinations with other variables will have to be developed. Important aspects of working life may be candidate variables. In Greece, with a relatively old population and a relatively high rate of unemployment (10% in 2004), people have to work a lot of hours for their income (1925 hours per year). Compare this with the Netherlands, with a relatively young population and low unemployment rate (4,6% in 2004): people work a far shorter time for their income (1357 hours). Couple this to continuous increases of urbanization and urban life styles in the Netherlands and we have a background for recreational behaviour that is different, perhaps far different, than other countries may exhibit. Countless local variations in these variables may exist as well, presenting nearly ideal conditions to test theories using these combinations of variables in relation to well measured (standardized!!) prevalence data and their development over time. The possibilities of examining reasonable hypotheses that relate drug use levels with combinations of economic, demographic or cultural variables has, however, not even begun. Rather, the dominance of ideological analysis is striking. But such studies would clearly help answer questions about why levels of drug use vary so vastly within Europe, and within countries. [10] Drug policy costs, are there any? The UNODC report on Sweden is not completely silent on the costs of Swedish drug control but gives them relatively little place. It mentions the funding it requires, and it mentions the high proportion of heavy (and severely marginalised) drug users who are subject to coerced and non-coerced treatment. It also shows that the proportion of high intensity/high frequency drug users is not markedly different in Sweden than in most other EU countries! The report also mentions the large number of drug deaths that is part of the Swedish drug situation but notes that it decreased “from 403 cases in 2001 to 385 cases in 2003” (page 33) to underscore the positive tone about the Swedish drug control. Unfortunately the topic of drug related deaths is not further elaborated, which led Ted Goldberg to note the following: “The figures UNODC uses for drug related deaths are misleading. Peter Krantz, a postmortem examiner, has been studying statistics for drug related deaths as revealed in autopsies. He found 296 in 2000 and 425 in 2002. To give you an idea how high 425 is in a country the size of Sweden, it means 1.2 per day in a country where 1.5 per day die in traffic accidents. And of course it’s not recreational consumers who are dying. Contemporary drug policy is in fact an important reason why so many problematic consumers die. Drug policy accomplishes this by driving users further out of society, by coercing them into meaningless and repressive treatment, by making them afraid to contact the authorities when, for instance someone has overdosed, by not providing injection facilities where people don’t have to be in a hurry and can take a part of an injection and wait and see what happens so they don’t overdose, and where there is qualified help on the premises, etc. Drug policy as it is today is actually killing people — not saving lives.” [11] The topic of drug related deaths is treated in the UNODC report without comparing the Swedish rate to DRD rates in other countries (in dark contrast to the overdose of such comparisons of drug use in 15 year olds). We know that the variable ‘drug related death’ is not the gold standard of precision and that in spite of feeble EMCDDA efforts serious unsolved registration, definition and calculation issues are at stake here, as much as with all other non-standardised variables in the epidemiology of the drug arena. But if we trust the bookkeeping talents of EMCDDA we have at least some insight into the drug deaths data each government supplies to the international shareholders of the drug problem industry. EMCDDA reports a lower number of drug related deaths (DRD) than UNODC for the year in which comparisons are calculated, 2002 or thereabout. It reports that Sweden has 160 DRD in 2002 and the same proportion of DRD as Greece, 18 per million inhabitants (versus 7 for the Netherlands or 55 for the UK). UNODC, Goldberg, but also Lenke and Olson mention a much higher number than EMCDDA because they include other types of DRD than overdose only. UNODC mentions 391 for 2002, Goldberg mentions 425 for 2002 , Lenke and Olson [12] mention 350 for 1999. Accepting these numbers would considerably raise the present computations by EMCDDA of the DRD rate per million inhabitants in Sweden. It would topple that country from a relatively middle position versus other countries to a high position. A dramatic issue that is not dealt with at all in the report is the far reaching power of the special drug police. In Stockholm, police will chase drug users all through the night and collect them in their vans from the streets, and from the cafés. Trained special police can go into a bar, merely look one in the eye and arrest him or her, then drag them into police headquarters where blood is extracted from them against their will. Police violence on the drug using population is carefully nurtured in Sweden as a necessary element in the witch hunt against this alien evil, drugs. In an emotional appeal to the audience , the chairperson of the newly created Swedish Drug users Association asked in 2003 in Lisbon for a reform of Swedish drug policy because of the hardships it creates for all users, especially so called ‘heavy’ users. He asked for the creation of needle exchange and expansion of the availability of methadone for which there are far too few treatment opportunities. [13] Stahlenkrantz also mentions that heavy users “sometimes avoid calling for an ambulance because they are too scared of attracting the attention of social workers or the police.” (see ref 9). Discussion Harry Levine writes that Sweden uses far less alcohol than other countries “but they worry about it far more than almost anybody except other nordics and some English speaking countries” (personal communication), thereby illustrating his well known observation about the special character of the Protestant temperance cultures in relation to the use of alcohol and drugs. The same scholar writes in a personal communication: It is important to understand that shock waves have recently rolled over the Nordic alcohol model, forcing the Nordic societies to radically reconsider a hundred years of temperance-oriented alcohol policies. A group of Finnish and other drug researchers have written a smart, interesting book about this with the telling title: Broken Spirits. Power and Ideas in Nordic Alcohol Control. Stanton Peele writes about the temperance countries in his review of Broken Spirits: ”Broken Spirits describes the post-World War I creation of state alcohol monopolies in the Nordic countries, including Iceland, as ‘a spectacular historical experiment in social control.’” [14] The word ‘spectacular’ is fully applicable to the type of drug prohibition in these countries as well, being subordinated to the same control fundamentalism as has been shown toward alcohol, but in a higher gear, and of meaner disposition. These remarks by Levine and Peele invite us to think that the perceived decay of alcohol control policies in Sweden, as well as in other Nordic countries may be behind some of the brute tenacity that is shown in relation to conserving drug policies [15]. It is such tenacity that UNODC wants to see applauded, and we fear that UNODC will use the year 2009 to promote China to the status of hero of drug control, in spite of the disasters drug control is creating in relation to Chinese human rights (even more than in Sweden or the USA). We may not be surprised when UNODC presents us with a report that drug control in China is excellent, successful and that the number of public executions of drug sellers is actually declining from 1909 a year to 1896! Time for a good merry go round in Shanghai. Amsterdam october 2006 Notes [1] “Sweden’s succesful drug policy” UNODC June 2006 [2] David Musto The American disease. Origins of Narcotic Control 1973 Yale University Press [3] Harry Gene Levine "Temperance Cultures: Alcohol as a Problem in Nordic and English-Speaking Cultures" in Malcom Lader, Griffith Edwards, and D. Colin Drummon (ed) The Nature of Alcohol and Drug-Related Problems. New York: Oxford University Press, 1993, pp.16-36 [4] Boekhout van Solinge, Tim (1997), The Swedish drug control policy. An in-depth review and analysis. Amsterdam, Uitgeverij Jan Mets/CEDRO. [5] Until now we do not have for drugs what we do have for the economy, a standardised profile of economic indicators as provided by the World Bank or by OECD. Also the economic indicators themselves have been standardised. For instance, OECD provides comparison between ‘standardised’ calculations of a nation’s unemployment in order to circumvent the large variety of data that individual governments supply of ‘unemployment’. By dedicating institutions to the production of methodologically homogenised indicators , comparisons become possible. EMCDDA in Lisbon was assumed to supply this for drugs but has not the funding nor the management to do this. Maybe drug situation profiles should be produced by OECD, steeped into the difficulty of indicator driven profile production as they are. For pharmaceutical products and production OECD does a great job already. [6] http://annualreport.emcdda.europa.eu/en/elements/fig23-en.html [7] All these figures come from OECD Health Data 2006. [8] Abraham, Manja D. (1998), Drug use and lifestyle: Behind the superficiality of drug use prevalence rates. CEDRO Univ of Amsterdam. Abraham, Manja D., Hendrien L. Kaal, & Peter D.A. Cohen (2002), Licit and illicit drug use in the Netherlands 2001. Amsterdam: CEDRO/Mets en Schilt. [9] United Nations Urbanization Prospects:the 2005 revision population database http://esa.un.org/unup/p2k0data.asp [10] Political resistance against such notions can be understood as resistance to loosing a wonderful tool for political fire works.Drug policy is a tool that, lacking in definition or clarity, maybe used for all sorts of rallying the troops behind moral entrepreneurs who ‘will defend youth against drugs’ while sending them into wars or imprisoning them in their urban getto’s. [11] Ted Goldberg Ph.D,University of Stockholm, personal communication. See also Goldberg:”The evolution of Swedish Drug Policy” Jrnl of Drug Issues 2004 pages 551-576. [12] Leif Lenke and Borje Olsson,University of Stockhom: “The drug policy relevance of drug related deaths” in Henrik Thamm,ed: “Review of Swedish drug policy” Senlis Council 2003 [13] Berne Stahlenkranz,Stockholm: “ The tragic outcome of Sweden’s dream of a good drug free Society” Lisbon 2003 Senlis Council. Stahlenkranz speaks of the ‘extreme measures’ in Sweden from a point of view that is never mentioned in reviews of Swedens policy, the perspective of the drug user. I recommend organisers of conferences to invite him and ask for some of his descriptions of the police activity in Stockholm. [14] Whose Spirits Have Been Broken Anyway? Review of Broken Spirits: Power and Ideas in Nordic Alcohol Control. http://www.peele.net/lib/brokenspirits.html [15] Goldberg sees signs that the drug policies may show some relaxation, as the alcohol policies, and that voices pleading for expansion of needle exchange and methadone prescription are now gaining influence in Sweden (personal commincation). [i] Thanking Peter Webster for his editing, and clarifying where badly needed. Last update: October 20, 2006 Webmaster: Arjan Sas
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Southwest Asia: Leading Scholar Takes Senate Foreign Relations Committee to School on Afghan Drug Trade

http://stopthedrugwar.org/files/kabul2.jpg
war-torn Afghanistan (photo by Chronicle editor Phil Smith, 2005)
While Afghan President Hamid Karzai was in Washington this week for meetings with President Bush and other officials, and politicians of both parties were calling for increased anti-drug spending in Afghanistan to deal with that country's burgeoning opium crop, a little noticed Senate hearing last week provided a real crash course on a rational drug policy in Afghanistan. In a Senate Foreign Relations Committee hearing on September 21, New York University Professor Barnett Rubin, perhaps the country's leading Afghanistan expert, provided a strong critique of the obsessive focus on crop eradication and even suggested policymakers consider regulating the opium trade. Rubin is most recently the author of Aghanistan: Uncertain Transition from Turmoil to Normalcy, published by the Council on Foreign Relations in March.

Rubin addressed the issue both in his prepared remarks and in a brief question and answer session at the end of the hearing. His remarks are worth quoting extensively. Here is what he said in his prepared remarks (available only to paid subscribers):

"On narcotics, I would like -- sometimes when people call for a stronger counternarcotics policy, which I fully endorse, they focus on crop eradication, as if crop eradication were the central point of counternarcotics. I would submit that that is an error.

"First, we have to be clear about what is the goal of our counternarcotics policy in Afghanistan. Where does the harm come from? We are not trying to -- or we should not be trying to -- solve the world's problem of drug addiction in Afghanistan. If we, with all our capacity, cannot stop drug addiction in the United States, we are certainly not going to use law enforcement successfully to eliminate half the economy of the poorest and best armed country in the world.

"Therefore, we must focus on the real harm which comes from drug money. Now, 80% of the drug money inside Afghanistan, regardless of the 90% of the total income from drugs which goes outside of Afghanistan -- 80% of the drug money inside of Afghanistan is in the hands of traffickers and warlords, not farmers. When we eradicate crops, the price of poppy goes up, and the traffickers who have stocks become richer. Therefore, we should be focusing on the warlords and traffickers, on interdiction and so on, while we are helping the poor farmers. That is also consistent with our political interests of winning the farmers over and isolating those that are against us.

"Furthermore, it is a mistake to consider the drug problem in Afghanistan as something that is isolated in the major poppy growing areas. For instance, now there is fighting in Helmand province, which is the major poppy producing area in the world. Because there is fighting going on, it is not possible to implement a counternarcotics strategy in Helmand. We need to implement rural development throughout Afghanistan, especially in the areas where there is no poppy, in order to show people what is possible and build an alternative economy."

And here is an exchange between Rubin and Sens. George Voinovich (R-OH) and Frank Lugar (R-IN):

VOINOVICH:

"Mr. Chairman, could I just ask one last thing? You alluded to the issue of the drug problem in the United States. And I got the impression that some of these drugs are coming into the US. Is that...

RUBIN:

Well, I perhaps should have said the developed world. I believe actually the bulk of the narcotics produced in Afghanistan are consumed in Iran and Pakistan.

VOINOVICH:

OK. So that's why the Iranians are so interested in making sure it stops.

RUBIN:

Yes.

VOINOVICH:

The reason I bring it up is I just had our local FBI director visit with me from Cincinnati, and he said, "Senator, the issue of terrorism is one that we're gravely concerned about." But he said the biggest issue that we've got here in the United States that we're not paying attention to is the drug problem, and that our resources are being, you know, kind of spread out. And we really have got to look at that. It's still there, and we need to deal with it. And we're not directing our attention to it. And I think you remember the other hearing we had a year or so ago, we had the folks in here and they were talking about how active the Russian mafia is in the United States and seemed to be doing about whatever they want to do, because we don't have the resources to deal with that problem. So from my perspective, you're saying the biggest market is in those countries you just mentioned...

RUBIN:

That's in physical quantity. The biggest market in money is in Europe and of course in the United States. If I may add, if you don't mind my mentioning something that I heard in the other house yesterday, Dr. Paul, a Republican from Texas, mentioned at the hearing yesterday that in his view we had failed to learn the lessons of prohibition, which, of course, provided the start-up capital for organized crime in the United States, and that, in effect, by turning drug use into a crime, we are funding organized crime and insurgency around the world. And it may be that we need to look at other methods of regulation and treatment.

VOINOVICH:

Thank you.

LUGAR:

Thank you, Senator Voinovich. It's a fascinating thought that you just imparted, that although the bulk of the drugs may be utilized by Iran and Pakistan, that the greatest value for those that are not imbibed by these countries comes from Europe and the United States. Why? Because the people surely don't receive it for free, but what is the distribution? Why are Pakistan and Iran so afflicted by drugs from...

RUBIN:

Well, they're closer. Basically, the cost of production is a negligible portion of the price of narcotics.

LUGAR:

So it's transportation...

RUBIN:

No, no. It's risk because it's illegal.

LUGAR:

I see.

RUBIN:

If it were not illegal, it would be worth hardly anything. It's only its illegality that makes it so valuable.

LUGAR:

Another fascinating topic. (LAUGHTER) Well, we thank you again for your help (inaudible). The hearing is adjourned."

Another fascinating topic, indeed. At least someone is trying to educate our elected officials about the economic and political consequences of drug prohibition -- in Afghanistan, anyway.

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