Overdoses

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California Drug Overdose Prevention Bill Passes

A bill aimed at saving the lives of drug overdose victims by protecting those who would come to their assistance from prosecution on drug charges passed the California legislature Monday on a bipartisan vote of 54-22 in the Assembly. It had already passed the Senate. The vote came days before International Overdose Awareness Day.

fatal drug overdose (wikimedia.org)
In recent years, Californians have been dying of drug or alcohol overdoses at a rate of ten a day, with the number of fatal overdoses increasing by 24% between 2000 and 2006, according to supporting documentation within the bill.

Introduced by Assemblyman Tom Ammiano (D-San Francisco), the bill, Assembly Bill 472, provides that neither the overdose victim nor a person who seeks emergency treatment for him shall be charged with the crime of drug possession or being under the influence of drugs, provided the drugs are for personal use.

Such bills are known as "Good Samaritan" bills and have already been passed nine other states.

In asking his colleagues to vote for the measure, Ammiano noted that more people die from drug overdoses than in car crashes. Fewer would die, he said, if witnesses sought prompt emergency help, but some hesitate for fear of being arrested for their drug use or possession. That argument got through to members of both parties.

"This is not going soft on crime," said Assemblyman Donald Wagner (R-Irvine). While he added that he does not condone drug use, he said it was necessary to "overlook some indiscretions for the greater good."

"It's critically important to save lives," said Assemblywoman Kristen Olsen (R-Modesto). "This bill doesn't condone drug behavior."

"It's not going to encourage underage use," noted Assemblyman Mike Feuer (D-Los Angeles). On the contrary, he said, the knowledge that overdose is so life-threatening should encourage users to reevaluate their behaviors.

"It's time we started saving lives in California," said Ammiano.

The bill was lobbied for by the Drug Policy Alliance, and supported by a range of organizations including California Society of Addiction Medicine, California Attorneys for Criminal Justice; California Professional Firefighters, California Association of Alcohol and Drug Program Executives County Alcohol and Drug Program Administrators Association of California, National Council of Alcohol and Drug Dependence of the San Fernando Valley, National Association of Social Workers, Asian Pacific AIDS Intervention Team, Bay Area Addiction Research and Treatment, Families ACT!, Grief Recovery After a Substance Passing and Parents for Addiction Treatment and Healing.

The only group to officially oppose it was the California Sheriff's Association.

The bill now goes to the desk of Gov. Jerry Brown (D).

Sacramento, CA
United States

New Jersey Good Samaritan Overdose Bill Passes

A bill designed to reduce drug overdose deaths by providing some legal protection to people who witness them and summon medical assistance has been approved by the state legislature and now awaits the signature of Gov. Chris Christie (R). The bill passed the Senate Monday on a 21-10 vote; it had cleared the Assembly back in May.

fatal drug overdose (wikimedia.org)
The bill, Assembly Bill 578, also known as the Good Samaritan Emergency Response Act, would provide limited legal protection against drug possession charges for people who witness an overdose and call 911. It is aimed at reducing drug overdose deaths by reducing the fear of arrest for those might call for assistance.

According to the Centers for Disease Control and Prevention, drug overdoses are now the leading cause of accidental death, replacing automobile accidents. More than 27,000 people died from drug overdoses in 2007, most of them from prescription opiates, either by themselves or in combination with other drugs, including alcohol.

Many drug overdose deaths occur in the presence of others and take hours to occur, meaning that there is time and opportunity to call for help. But strict enforcement of drug possession laws against would-be Samaritans discourages some from making that call.

Advocates are applauding the passage of the life-saving bill.

"Calling 911 should never be a crime. Our current policies focus on punishment and drive people into the shadows and away from help," said Roseanne Scotti, New Jersey State Director of the Drug Policy Alliance. "Saving lives should always take priority over punishing behavior.  A Good Samaritan law will encourage people to get help."

"When a life is on the line we can ill afford to waste time weighing the consequences of calling 911 or deciding whether or not to be truthful about what substance was used to overdose," said Senate bill sponsor Sen. Joseph Vitale (D-Middlesex). "By narrowly eliminating the criminal consequences one might face after calling 911 to report an overdose, I hope to diminish any hesitation one might have about doing the right thing."

"I and my family are so grateful to the senate for passing this life-saving legislation," said Patty DiRenzo, whose son Salvatore died of an overdose at age 27. "We, and the other families who have lost loved ones to overdose, will be advocating with Gov. Christie to urge him to sign this bill. It's extremely important that we prevent future overdose deaths and spare other families the grief that mine has endured."

If Gov. Christie signs the bill into law, New Jersey will become the ninth state to enact a Good Samaritan law. The others are Colorado, Connecticut, Florida, Illinois, New Mexico, New York, Rhode Island, and Washington. Similar legislation is pending in several other states.

Trenton, NJ
United States

UN Anti-Drug Body Supports Overdose Prevention Measures

Delegates to the 55th session of the UN Commission on Narcotics Drugs (CND) in Vienna unanimously approved a resolution to promote measures to prevent drug overdose deaths last Friday. The resolution calls on the UN Office on Drugs and Crime (UNODC), the World Health Organization (WHO), and other international organizations to work with individual countries to address and reduce drug overdoses. Crucially, the resolution included mention of naloxone, an opioid antagonist that can effectively reverse opiate overdoses and which does not carry any danger of abuse.

Naloxone can save lives, the CND recognized Friday (wikimedia.org)
The resolution was introduced by the Czech Republic and cosponsored by Israel and Denmark (the latter on behalf of the European Union). Earlier in the week, Gil Kerlikowske, head of the US Office on National Drug Control Policy (ONDCP -- the drug czar's office) affirmed US support for overdose prevention. In his opening statement at the week-long session, Kerlikowske endorsed training public health and medical personnel in overdose recognition and response, as well as the use of naloxone and other overdose reversal medications.

"Every life is worth saving," said Dasha Ocheret, policy and advocacy program manager for the Eurasian Harm Reduction Network. "Everyone knows someone who has died from an overdose. It's thrilling that the United Nations recognizes this is a problem to be taken seriously and something can be done."

"This represents a critical step towards improving global public health," said Donald McPherson, director of the Canadian Drug Policy Coalition and former drug policy coordinator for the city of Vancouver. "The global overdose epidemic can be addressed with meaningful, evidence-based interventions to reduce the immediate potential harms associated with opioid use, and prevent unnecessary death. It is heartening to witness CND member countries take this step together to save lives."

The biggest risk of fatal overdose is around opiates and opioid pain medications. According to the UNODC, "the ingestion of opioids accounts for nearly half of the global drug-related deaths, and the majority of deaths could have been prevented." The UNODC puts the number of user of opium derivatives, both medical and non-medical, at around 21 million worldwide.

Opioid overdose deaths are generally preventable for three reasons: The deaths occur gradually after drug use, there are typically other people present, and the effects of overdose can be reversed with naloxone, also known under its brand name, Narcan.

In some countries, including some states in the US, there are ongoing programs to offer naloxone to drug users, their friends, and family members. Last fall, Massachusetts announced its 1,000th overdose reversal using naloxone. New Mexico has also been a pioneer in expanding the use of naloxone.

"Naloxone is a safe and effective medication that has been available for more than forty years," said Sharon Stancliff of the New York City-based Harm Reduction Coalition. "It's exciting that the UN has officially recognized the importance of making this life-saving medication more widely available. It is vital that it is made accessible to people who need it, both inside the hospital setting and outside, through emergency services and to family members of opioid users."

Vienna
Austria

Tainted Ecstasy Linked to Western Canada Deaths

A cluster of recent fatalities among ecstasy (MDMA) users in western Canada has been linked to tainted drugs. At least five people in Alberta and three in British Columbia have died in the past few weeks. In six of those cases so far, paramethoxymethamphetamine (PMMA) has been found in toxicology reports.

Ecstasy -- or is it? (wikimedia.org)
The outbreak of deaths began last month in Calgary, and by December 29, Alberta Health Services sent out an alert warning that "Ecstasy or a combination of toxic substances sold on the street as Ecstasy is the likely cause of three recent Calgary-area deaths."

Then, in a new joint warning on January 11, the city of Calgary and Alberta Health Services announced that the province's chief medical examiner had confirmed that "paramethoxymethamphetamine (PMMA) and methamphetamine -- not previously associated with street drugs sold in Calgary as 'ecstasy' -- was present in toxicology results for each of five recent Calgary-area street-drug deaths."

On Thursday, British Columbia Provincial Health Officer Dr. Perry Kendall confirmed that PMMA had shown up in one of the BC deaths, while toxicology reports were still outstanding in the two other cases.

PMMA is thought to be a less expensive compound to produce than ecstasy, similar in appearance, and produces similar, though stronger, psychoactive and physical effects. Its use as an adulterant has been linked to earlier clusters of deaths in Norway and the Netherlands.

"There are some important differences in the toxicity of PMMA compared to MDMA" said Dr. Mark Yarema, Medical Director of the Poison and Drug Information Service (PADIS). "Although all have toxic effects, PMMA is considered more toxic than MDMA, with a higher incidence of seizures and elevated body temperature. Also, the onset of action of PMMA is delayed and its initial effect may be milder. This is dangerous as it may result in users ingesting several tablets to achieve a desired effect, with potentially fatal consequences."

If Canada is going to continue to subject recreational drug users to the Russian roulette of buying drugs without quality controls or ingredients labeling in the black market, it behooves drug users to do what they can to protect themselves. They could start by checking in with organizations such as DanceSafe or checking into ecstasy testing kits.

Canada

Chronicle Film Review: Prohibition

Prohibition: A Film by Ken Burns and Lynn Novick (2011, Florentine Films/WETA, 3 discs, 5 ½ hrs., $41.99)

One of America's leading documentarians has done it again. Ken Burns, producer of the widely watched and hailed documentaries, Baseball and The Civil War, has now teamed up with Lynn Novick to examine the rise, fall, and repeal of the 18th Amendment banning alcohol sales and production. It is a worthy effort, and well-executed.

Prohibition "postcards" online at pbs.org/kenburns/prohibition/send-postcards/
The multi-hour must-see premiered over three nights this week on PBS, pulling in nearly four million viewers on its opening night -- very big numbers for public TV. It's also available online at the PBS Ken Burns Prohibition web site.

For most us of Prohibition is ancient history, skimmed over bloodlessly in dusty tomes in high school and undergraduate history courses. My 83-year-old mother, for instance, was still a toddler when revelers across the land tippled with delirious joy to mark repeal. For anyone younger than her -- and that's most of us -- Prohibition is no more than a school lesson, not a thing of living memory, except, perhaps, for an old story or two told by grandpa or grandma.

One of the successes of Prohibition is the way it brings that dry history to life. Through the skillful use of contemporary film, photographic stills, oral history, written remembrances narrated by actors, and a lively narration by Peter Coyote, Burns and Novick are able to recreate the living, breathing reality of second half 19th and early 20th Century America. Staring face to face at the glowering glare of a doughty battle-axe like Carrie Nation or the lizard-lidded, full-lipped gaze of Chicago gangster Al Capone, listening to Al Smith rail against the dries or Mabel Willibrand rally preachers against repeal, helps us put a human face on the  passions and frailties behind the march of the social revolution that was Prohibition and the mass rejection of it that was repeal.

Similarly, vivid scenes of saloon debauchery, with passed out drunks and giddy tipplers, of speakeasies filled with good-time guys and giddy flappers, of mass marches for and against, of political conventions and campaigns in which Prohibition was a burning issue of the day, help put living flesh on the dry bones of history.

The early 20th Century experiment in social control and legislating morality contains many lessons for contemporary activists seeking to undo the damage done by drug prohibition. Burns and Novick deserve our thanks for teasing out the varied strands that turned the 19th Century's temperance movement among mostly rural, Protestant, church-going women into a political powerhouse capable of blunting the power of big booze, shuttering the breweries and distilleries, and eliminating the saloons men saw as their last refuge from the demands of wife and children.

For me, the most important achievement of Prohibition is the way in situates the temperance movement within the broader social and political context of a tension-filled, rapidly evolving America. As Burns and Novick make abundantly clear, Prohibition did not happen in a vacuum. Among the forces propelling it were many of the same forces active today propelling reactionary social movements: racism (directed against newly arrived Irish, German, and Jewish immigrants), nativism (ditto), religious bigotry (aimed at those Catholic immigrants), nationalism (against mainly German-American beer brewers, especially during World War I), and rural vs. urban tensions.

But while it may be easy to ridicule the reactionaries of the last century, the roots of Prohibition also come uncomfortably close for present-day progressives. The temperance movement -- in all its intemperance -- was closely tied to "what about the children!" sentiment and women's suffrage, a cry for healthy living,  as well as the sort of "do-gooderism" conducted by "busybodies" that still informs much of the discourse when it comes to drug policy reform today.

As Prohibition shows most excellently, the politics of morality and social control are deep and twisted, and unraveling them reveals some unflattering facets of progressivism, as well as the more easily derided absolutists of what could fairly be called the Christian Right.

Where Prohibition is perhaps most useful to modern day drug reformers is in its depiction of the social ills it generated. Much as the Drug Policy Alliance likes to say "drug abuse is bad, drug prohibition is worse," viewers of Prohibition could fairly draw the conclusion that "mass drunkenness is bad, mass drunkenness under Prohibition is worse." Burns and Novick sketch the rapid expansion of organized crime under Prohibition, the gang wars of Chicago and New York, the corruption of cops and public officials -- all the side-effects of prohibition so familiar to present day reformers.

Prohibition "postcards" online at pbs.org/kenburns/prohibition/send-postcards/
But they also look at its public health consequences, which -- like current drug prohibition -- were also in many ways disastrous. There were mass deaths from bad bathtub gin, deaths from drinking wood alcohol, outbreaks of "Jake Leg," a neurological disorder caused by contaminated whiskey that crippled hundreds, if not thousands, and while alcohol consumption initially declined, that decline was soon reversed, and with even more unhealthy drinking patterns.

In the end, Prohibition died of neglect, ridicule, and changing social attitudes, forged at least in part by the experience of Prohibition itself. And at the end, it revealed itself to be hollow, crumpling with amazing rapidity after the Great Depression hit and the big city, immigrant-friendly Democrats under FDR took power. Before the end of FDR's first year in office, Prohibition was history.

There are many lessons and parallels for contemporary drug reformers in Prohibition, but they are not exact and may not apply across the board. Alcohol prohibition lasted barely a decade, but drug prohibition is now in its second century. Why one was a flash in the pan and the other remains a painful, enduring legacy are questions that need to be answered if we are ever to leave drug prohibition in the dustbin of history along with Prohibition. Prohibition can help us start to ask the questions that will give us the right answers.

Disappointingly, Ken Burns doesn't appear interested in pursuing the parallels, nor even the dissimilarities, between Prohibition then and prohibition now. He does not reference the prohibition of other drugs in Prohibition (although heroin and cocaine were already criminalized federally and marijuana was being banned in a number of states), nor, as he has made clear in interviews, does he see a useful comparison between the two.

But that disagreement or lack of boldness notwithstanding, Prohibition is still a great viewing experience that brings alive a critical episode in US social and political history, an episode who reverberations still linger and whose contours are still echoed in drug prohibition. This is your history, America -- watch, enjoy, learn, and ponder.

Canada Supreme Court Okays Safe Injection Site [FEATURE]

Rebuffing the Conservative government of Prime Minister, the Canadian Supreme Court Friday ruled unanimously that Vancouver's safe injection site for heroin addicts can stay open. Known as Insite, the Downtown Eastside facility is the only safe injection site in North America.

Vancouver's safe injection site wins a reprieve. (Image: Vancouver Coastal Health)
The Downtown Eastside, centered on the intersection of Main and Hasting, streets, has one of the highest concentrations of injection drug users in the world. An overgrown Skid Row flush with prostitution and destitution, most of its residents live in decaying SRO hotels lining Main Street. Out of 12,000 residents in the area, some 5,000 are estimated to be drug addicts.

At Insite, drug users are provided clean needles and sterilized water with which to mix their drug. Insite does not provide the drugs; users must bring their own. The users inject under medical supervision at one of 12 injecting alcoves.

Insite operates under the auspices of the British Columbia Ministry of Health and the local public health authority, Vancouver Coastal Health. Numerous research reports on Insite have found that it has reduced fatal drug overdoses, reduced HIV and Hepatitis C transmission rates, reduced crime rates in the neighborhood, and increased the number of drug users entering treatment.

It has operated since 2003 under an exemption to Canada's drug laws, but since coming to power, the Harper government has attempted to shut it down, claiming it "enables" drug users. Friday's decision by the Canadian Supreme Court is the final chapter in that effort.

The Harper government argued that the federal drug law took precedence over British Columbia's public health policies. British Columbia and other Insite supporters argued that because Insite is providing a form of health care, its operation is a provincial matter. The federal government's concerns did not outweigh the benefits of Insite, the court said.

"The grave consequences that might result from a lapse in the current constitutional exemption for Insite cannot be ignored," the court said. "Insite has been proven to save lives with no discernible negative impact on the public safety and health objectives of Canada."

Hundreds of Insite supporters gathered at the facility at dawn and broke out in cheers after the decision was announced. As the news spread, harm reduction, public health, and drug reform groups in Canada and around the world lined up to applaud it.

"We are absolutely delighted that we finally have a clear decision on the legal framework for Insite," said Dr. Patricia Daly, Vancouver Coastal Health Chief Medical Health Officer. "Since 2003, Insite has made a positive impact on thousands of clients, saved lives by preventing overdoses, and provided vital health services to a vulnerable population. Today's ruling allows us to continue the outstanding work Insite, its doctors, nurses, staff and partners provide."

"This represents a victory for science," said Dr. Julio Montaner, Director of the BC Center for Excellence for HIV/AIDS. "Prior attempts from the federal government to stop the activities of Insite have been ruled unconstitutional. We are thankful for the continued and unwavering support from the provincial government that has allowed us to set an example in Canada and the world for how to deal with addiction which is, indeed, a medical condition."

"We applaud today's landmark decision by the Canadian Supreme Court to uphold the human rights of all Canadians by allowing Insite to remain open," said the Canadian HIV/AIDS Legal Network, CACTUS Montreal, and Harm Reduction International in a joint statement. "We are heartened the Supreme Court of Canada has recognized that criminal laws on drugs must give way to good public health practices and harm reduction."

"This is a victory for science, compassion and public health -- and, given the fiscal benefits of such programs, the Canadian taxpayer. The Supreme Court of Canada recognized that Insite saves lives, and that that should be a guiding principle in deciding drug policy," said Laura Thomas, California deputy director for the Drug Policy Alliance. "Congratulations to the advocates, drug users, researchers, nurses, and elected officials who have campaigned for Vancouver's supervised injection facility for so long. This is a complete validation of their work."

The Supreme Court of Canada's Insite ruling applies only to Insite. Other Canadian localities seeking to establish safe injection sites must win permission from the federal government. Canadian activists urged them to do so.

"In light of today's Supreme Court decision, jurisdictions Canada-wide should act fearlessly on evidence and make harm reduction services modeled on Insite available to those in need in their locales," said the Canadian groups. "The Minister of Health must respect the court's decision and grant similar exemptions to other sites so that people across Canada will be able to access the public health services they desperately need."

There are 67 safe injection sites operating today, with one in Australia, Insite in Vancouver, and the rest in Europe. There are no safe injection sites operating in the United States, although a move is afoot in San Francisco to get one underway there. The Drug Policy Alliance's Thomas said it is time to start pushing harder.

"For communities in the US which have been hard hit by drug use, it is time to look at the evidence from Canada and start opening supervised injection facilities here," she said. "We look forward to implementing the same desire to save lives in the US."

Vancouver, BC
Canada

Massachusetts Marks 1,000th Narcan Overdose Reversal

State officials in Massachusetts announced Tuesday that the state's pilot Narcon (naloxone) pilot program has marked the 1,000th overdose reversal since the program was introduced in 2007. The program is part of a broader effort undertaken by the Department of Public Health, its Bureau of Substance Abuse Services and its Bureau of Infectious Disease Control to reduce fatal and non-fatal opiate overdoses.

Narcan is saving lives in Massachusetts. (image courtesy Cambridge OPEN)
Narcan is an opioid antagonist that blocks the effects of opioids, such as heroin, oxycodone, hydrocodone, fentanyl, codeine and methadone. The pilot programs teach people how to use Narcan, including opioid users and trusted people in their lives, such as family, friends and staff of human services programs. The Narcan pilot sites also provide education on overdose prevention and referrals to treatment. The Department of Public Health reported that more than 10,000 people are now enrolled in the pilot program, including drug users, friends, and family members.

"Too many families have been impacted by the rise in opiate abuse and overdoses in Massachusetts," said Lieutenant Governor Timothy Murray, Chair of the Interagency Council on Substance Abuse and Prevention. "As we continue to combat opiate abuse and provide resources for prevention and treatment services, Narcan has proven to be a powerful tool in saving lives, so that opiate abusers can receive treatment and begin to recover from their addiction."

"Massachusetts is a national leader in opioid overdose prevention," said Secretary of Health and Human Services JudyAnn Bigby, MD. "By using community-based programs to enroll participants and distribute Intra-nasal Narcan, this pilot has allowed us to reach opioid users and bystanders in communities across the state."

Intra-nasal Narcan is available at pilot sites located in 12 Massachusetts cities, including Boston, Brockton, Cambridge, Fall River, Gloucester, Hyannis, Lynn, New Bedford, Northampton, Provincetown, Quincy and Springfield. The pilot sites provide education on overdose prevention, recognition and response to opiate users and family and friends of opiate users, along with referrals to treatment. Click here to learn more.

Boston, MA
United States

Big Name Panel Calls Global Drug War a "Failure" [FEATURE]

The global war on drugs is a failure and governments worldwide should shift from repressive, law-enforcement centered policies to new ways of legalizing and regulating drugs, especially marijuana, as a means of reducing harm to individuals and society, a high-profile group of world leaders said in a report issued last Thursday.

Richard Branson blogs about being invited onto the global commission, on virgin.com.
The Global Commission on Drug Policy, whose members include former UN Secretary-General Kofi Annan and former presidents of Brazil, Colombia, and Mexico, said the global prohibitionist approach to drug policy, in place since the UN adopted the Single Convention on Narcotic Drugs a half-century ago, has failed to reduce either the drug supply or consumption.

Citing UN figures, the report said global marijuana consumption rose more than 8% and cocaine use 27% in the decade between 1998 and 2008. Again citing UN figures, the group estimated that there are some 250 million illegal drug consumers worldwide. "We simply cannot treat them all as criminals," the report concluded.

The report also argued that arresting "tens of millions" of low-level dealers, drug couriers, and drug-producing farmers not only failed to reduce production and consumption, but also failed to address the economic needs that pushed people into the trade in the first place.

Prohibitionist approaches also foster violence, most notably in the case of Mexico, the group argued, and impede efforts to stop the spread of diseases like HIV/AIDS and Hepatitis. Governments should instead turn to science- and evidence-based public health and harm reduction approaches, the group said. It cited studies of nations like Portugal and Australia, where the decriminalization of at least some drugs has not led to significantly greater use.

"Overwhelming evidence from Europe, Canada and Australia now demonstrates the human and social benefits both of treating drug addiction as a health rather than criminal justice problem and of reducing reliance on prohibitionist policies," said former Swiss president Ruth Dreifuss. "These policies need to be adopted worldwide, with requisite changes to the international drug control conventions."

The report offered a number of recommendations for global drug policy reform, including:

  • End the criminalization, marginalization and stigmatization of people who use drugs but who do no harm to others.
  • Encourage experimentation by governments with models of legal regulation of drugs (especially cannabis) to undermine the power of organized crime and safeguard the health and security of their citizens.
  • Ensure that a variety of treatment modalities are available -- including not just methadone and buprenorphine treatment but also the heroin-assisted treatment programs that have proven successful in many European countries and Canada.
  • Apply human rights and harm reduction principles and policies both to people who use drugs as well as those involved in the lower ends of illegal drug markets such as farmers, couriers and petty sellers.

"Fifty years after the initiation of the UN Single Convention on Narcotic Drugs, and 40 years after President Nixon launched the US government's global war on drugs, fundamental reforms in national and global drug control policies are urgently needed," said former president of Brazil Fernando Henrique Cardoso. "Let's start by treating drug addiction as a health issue, reducing drug demand through proven educational initiatives, and legally regulating rather than criminalizing cannabis."

"The war on drugs has failed to cut drug usage, but has filled our jails, cost millions in tax payer dollars, fuelled organized crime and caused thousands of deaths. We need a new approach, one that takes the power out of the hands of organized crime and treats people with addiction problems like patients, not criminals," said Richard Branson, founder of the Virgin Group and cofounder of The Elders, United Kingdom. "The good news is new approaches focused on regulation and decriminalization have worked. We need our leaders, including business people, looking at alternative, fact based approaches. We need more humane and effective ways to reduce the harm caused by drugs. The one thing we cannot afford to do is to go on pretending the war on drugs is working."

The Obama administration is having none of it. "Making drugs more available -- as this report suggests -- will make it harder to keep our communities healthy and safe," Rafael Lemaitre, spokesman for the Office of National Drug Control Policy told the Wall Street Journal the same day the report was released.

That sentiment is in line with earlier pronouncements from the administration that while it will emphasize a public health approach to drug policy, it stands firm against legalization. "Legalizing dangerous drugs would be a profound mistake, leading to more use, and more harmful consequences," drug czar Gil Kerlikowske said earlier this year.

But if the White House isn't listening, US drug reformers are -- and they're liking what they're hearing.

"It's no longer a question of whether legalizing drugs is a serious topic of debate for serious people," said Neill Franklin, executive director of Law Enforcement Against Prohibition (LEAP) and a 34-year veteran police officer from Baltimore, Maryland. "These former presidents and other international leaders have placed drug legalization squarely on the table as an important solution that policymakers need to consider. As a narcotics cop on the streets, I saw how the prohibition approach not only doesn't reduce drug abuse but how it causes violence and crime that affect all citizens and taxpayers, whether they use drugs or not."

"These prominent world leaders recognize an undeniable reality. The use of marijuana, which is objectively less harmful than alcohol, is widespread and will never be eliminated," said Rob Kampia, executive director of the Marijuana Policy Project. "They acknowledge that there are only two choices moving forward. We can maintain marijuana's status as a wholly illegal substance and steer billions of dollars toward drug cartels and other criminal actors. Or, we can encourage nations to make the adult use of marijuana legal and have it sold in regulated stores by legitimate, taxpaying business people. At long last, we have world leaders embracing the more rational choice and advocating for legal, regulated markets for marijuana. We praise these world leaders for their willingness to advocate for this sensible approach to marijuana policy."

"The long-term impact of the Global Commission's efforts will be defining," predicted David Borden, executive director of StoptheDrugWar.org (publisher of this newsletter). "Most people don't realize that there are leaders of this stature who believe prohibition causes much of the harm commonly seen as due to drugs. As more and more people hear these arguments, coming from some of the most credible people on the planet, legalization will come to be viewed as a credible and realistic option."

Other commission members include Louise Arbour, former UN High Commissioner for Human Rights, Canada; Fernando Henrique Cardoso, former President of Brazil (chair); Marion Caspers-Merk, former State Secretary at the German Federal Ministry of Health; Maria Cattaui former Secretary-General of the International Chamber of Commerce, Switzerland; Carlos Fuentes, writer and public intellectual, Mexico; Asma Jahangir, human rights activist, former UN Special Rapporteur on Arbitrary, Extrajudicial and Summary Executions, Pakistan; Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria , France; Mario Vargas Llosa, writer and public intellectual, Peru; George Papandreou, Prime Minister of Greece; George P. Shultz, former Secretary of State, United States (honorary chair); Javier Solana, former European Union High Representative for the Common Foreign and Security Policy , Spain; Thorvald Stoltenberg, former Minister of Foreign Affairs and UN High Commissioner for Refugees, Norway; Paul Volcker, former Chairman of the United States Federal Reserve and of the Economic Recovery Board; John Whitehead, banker and civil servant, chair of the World Trade Center Memorial Foundation, United States; and Ernesto Zedillo, former President of Mexico.

While the Obama administration may be loathe to listen, the weight of world opinion, as reflected in the composition of the global commission that issued this report, is starting to create stress fractures in the wall of prohibition. A half-century of global drug prohibition has showed us what it can deliver, and the world is increasingly finding it wanting.

Scottish Liberal Democrats Back Prescription Heroin

Scottish Liberal Democrats at their party conference in Perth voted Saturday to make campaigning for heroin maintenance treatment part of their party platform. Heroin users should not be fined or imprisoned, but should be given the drug through the National Health Service, party members agreed.

Tavish Scott's Lib Dems want "heroin on the NHS." (Image via Wikimedia)
The Liberal Democrats are an opposition party in Scotland, holding 16 of 129 Scottish Parliament seats, 11 of 59 Scottish seats in the British Parliament, and one of six Scottish seats in the European Parliament. They are fourth of five major political parties, behind the National Party, Labor, and the Conservatives, but ahead of the Scottish Greens. They are led by Tavish Scott.

The Lib Dems argued that both society and heroin users would benefit from prescribing the drug. Overdose and tainted drug deaths would decline, and addicts would not have to turn to crime or prostitution to feed their habits, they said.

"For drug offenders, fines and jail time simply don't work. In fact a fine will make it much more likely for a drug user to turn to a life of crime to fuel their habit," said Callum Leslie, a candidate for Mid Fife and Glenrothes. "Instead, the Liberal Democrats want to see a much greater use of Drug Treatment and Testing Orders (DTTOs) and Community Service Orders (CSOs). The evidence shows that these methods work. Offenders are forced to pay back the community they harmed and have a chance to get drug free for good. Controlled diamorphine [heroin] treatment is a method that works where other methods have failed. It stops offenders getting street heroin, which can be fatal and turns offenders to further crime to fund their habit."

"There is a great cost to society, and the public purse, if offenders are just abandoned to a cycle of crime and prison," said Alex Cole-Hamilton, Liberal Democrat candidate for Edinburgh Central. "DTTOs and CSOs are measures that would save public money by keeping drug abusers out of jail. Drug offenders should not be treated the same as murderers. We should work to treat the problem of drug abuse, not lock addicts away and condemn them to a life of crime."

United Kingdom

Heroin Drought Causing Problems in England

A scarcity of heroin in England is leading to a growing number of drug overdoses and poisonings as users ingest dope cut with other substances by dealers trying to stretch supplies, The Guardian reported this week. Scene watchers there are calling it the worst drought in years.

Are you sure that's heroin? Be careful out there, especially in England
The drought is being blamed not on seizures by law enforcement agencies, but on a fungus that has blighted the Afghan opium poppy crop, reducing the size of this year's poppy crop by half. Afghanistan accounts for more than 90% of the world's opium production and likely 100% of the British heroin supply.

"There is a very significant heroin shortage across the UK at the moment," said Gary Cross, head of drug policy for the non-profit group Release.  "It has been going on for some time now, but the last two months have seen stockpiles exhausted."

"I've never known anything like it in 30 years," wrote one long-time heroin user on an on-line forum discussing the shortage.

As dealers and users scramble to grapple with the shortage, users are turning up at hospitals after ingesting adulterated heroin or, in some cases, fake heroin consisting of a powerful sedative, caffeine, and paracetamol, a bulking agent. Some have passed out after smoking or ingesting, while others have reported vomiting, amnesia, and flu-like symptoms.

"This 'heroin drought' appears to be serious and geographically widespread," said Neil Hunt, director of research at KCA, a nationwide community drug treatment service. "Street heroin is in a complete and utter muddle at the moment, and users are collapsing unexpectedly. We need to standardize information about what's out there.

"If people use this intravenously, perhaps on top of alcohol and methadone [the prescribed substitute drug for heroin], it is extremely risky," said Dr. John Ramsey, who runs a drug database at St. George's Medical School in London. "We have had many reports of people overdosing. It's really important that accident and emergency departments understand that they may not be dealing with a 'normal' heroin overdose when people are brought in," he said.

Harm reduction drug agencies are aware of the problem and working to address it. Several of them held an urgent meeting last week to discuss setting up an online warning system to give users notice about contaminated or adulterated drugs.

London
United Kingdom

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