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Greece to Hand out Needles, Condoms in AIDS Fight

The Greek government announced Tuesday that it will begin harm reduction measures, including handing out condoms and needles to heroin addicts, in an effort to slow an alarming rise in new HIV cases, Agence-France Presse reported. The government anti-drug organization Okana and volunteer organizations will hand out 30,000 condoms and 10,000 needles as part of the effort, which will be initially launched in Athens.

view of the Acropolis at sunset (wikimedia.org)
"There is an imperative need for immediate action to limit the spread of infection," deputy health minister Michalis Timosidis said in a parliamentary document.

Greek health officials had reported in November that new HIV cases were up by 52.7% last year over 2010. The government center for disease control and prevention said over 800 new cases had been recorded through October 2011.

A third of the new cases were reported among gay men, but officials said most new cases were linked to prostitution and intravenous drug use. The number of new HIV infections among heroin users increased a whopping 1,250% in a year, the disease control center said.

Because of the economic crisis, Greece has been forced to radically cut social spending to eliminate budget deficits in order to receive loans from the International Monetary Fund and the European Union. Those spending cuts have seen staff layoffs and mergers in the health sector, which doctors said are weakening the effectiveness of the Greek health care system.


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

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.

Copenhagen Safe Injection Site Set to Open

A private safe injection site for heroin users is set to open in Copenhagen this week despite warnings from police and over the objections of neighbors. The harm reduction operation will be located in the city's Vesterbro district near Central Station. It will be the first in Denmark.

Copenhagen's Vesterbro district (Image via Wikimedia)
Police said they did not oppose the site's opening, but would shut it down if they find people using drugs there. "The room is not illegal per se, but possession of narcotics is illegal," Copenhagen Police spokesman Arne Wissing told the Copenhagen Post.  "We have no intention to sit passively and witness criminal acts, so if we see people in possession of illegal drugs, we will certainly act."

But safe injection site organizer Michael Lodberg Olsen said there was nothing illegal about it. "If that's the case, then they could just as well have shut down all of Vesterbro 30 years ago," he said, referring to needle exchange programs that have operated there for decades. "A report from the UN states that handing out clean needles to drug abusers is the same as establishing an injection room," he said.

Safe injection sites are already operating in Australia, Canada, Germany, Luxembourg, the Netherlands, Norway, and Spain. There are no safe injection sites in the US, although there has been talk about establishing one in San Francisco.


California Governor Vetoes Needle Access Bill

Gov. Arnold Schwarzenegger (R) last Thursday vetoed a bill that would have allowed pharmacies all over California sell syringes to adults without a prescription. The bill was touted by health experts as a key step in reducing the transmission of HIV/AIDS, hepatitis, and other blood-borne diseases.

mobile needle exchange/clinic site, Fresno
The state Department of Public Health estimates that approximately 3,000 California residents contract hepatitis C through syringe sharing every year and another 750 cases of HIV are caused by syringe sharing. Sharing dirty needles is the leading cause of new hepatitis C infections in the state and the second leading cause of new HIV infections.

"When I signed legislation my first year in office allowing for a pilot program to allow the sale of syringes through participating counties and registered pharmacies, I was seeking to balance the competing public health, law enforcement and local control issues that this issue requires," the governor wrote in his veto message. "I believe this balance was achieved and SB 1029 would remove the ability of local officials to best determine policies in their jurisdiction. Some counties have not sought to implement this pilot program, citing competing priorities, lack of pharmacy interest and law enforcement opposition. I respect these local decisions and while I appreciate the author’s hard work and dedication to this issue, I cannot sign this bill," Schwarzenegger wrote.

Instead, Schwarzenegger signed AB 1701, which extends the existing Disease Prevention Demonstration Project for another eight years. That gives cities and counties the option of opting out of the program and not allowing syringe sales without a prescription.

The veto angered SB 1029 author Sen. Leland Yee (D-San Francisco), who in a statement last Friday said Schwarzenegger apparently "was not interested in an effective public health measure that would reduce health care costs to taxpayers. Not only did he ignore the recommendation of doctors and other health experts, but he ignored the fact that HIV-AIDS and hepatitis do not recognize county borders. Such epidemics are certain to continue without implementing these comprehensive strategies."

SB 1029's approach "has been evaluated extensively throughout the world and has been found to significantly reduce rates of HIV and hepatitis without contributing to any increase in drug use, drug injection, crime or unsafe discard of syringes," Yee continued. "In fact, there is not one credible study that refutes these findings. The governor’s veto is a moral and fiscal dilemma."

The veto was "tragic and infuriating," said Laura Thomas of the Drug Policy Alliance, which supported Yee's bill. "It is an irrational attachment to drug war hysteria, at the expense of human life and fiscal responsibility to the California taxpayer," she said. "Nothing would have worked better and cost less in reducing the spread of HIV and hepatitis C than SB 1029."

Sacramento, CA
United States

Canadian Medical Association Journal Article Sides with Drug Injection Site

Vancouver, BC
An article in the Canadian Medical Association Journal slams the federal government for its efforts to shut down Insite in downtown Vancouver, Canada's only safe injection site for drug addicts.
CBC Radio-Canda (Canada)

On the street, you can see the harm caused by drug laws (Opinion)

Former British Columbia police officer David Bratzer discusses drug prohibition's role in increasing the rate of HIV infections, and how the Vienna Declaration is trying to bring positive change.
The Ottawa Citizen (Canada)

UNODC: The Russians Are Coming

[Update, 6:20pm EST: Peter Sarosi at HCLU just told me Ban Ki-moon has indeed picked Fedotov. Hence I have removed the question mark from the end of the title of this article. :( - DB]

Current head of the UN Office on Drugs and Crime (UNODC) Antonio Maria Costa is set to end his 10-year term at the end of this month, and according to at least one published report, a Russian diplomat has emerged as the frontrunner in the race to replace him. That is causing shivers in some sectors of the drug reform community because the Russians are viewed as quite retrograde in their drug policy positions.

The report names Russia's current ambassador to the United Kingdom, Yuri Fedotov, as the top candidate to oversee UNODC and its $250 million annual budget. Other short-listed candidates include Spanish lawyer Carlos Castresana, who headed a UN anti-crime commission in Guatemala, Colombian Ambassador to the European Union Carlos Holmes Trujillo, and Brazilian attorney Pedro Abramovay. The final decision is up to UN Secretary General Ban Ki-moon.

If Fedotov wins the position, Russia would be in a far more influential position to influence international drug policy, and that is raising concerns because of Russia's increasingly shrill demands that the US and NATO return to opium eradication in Afghanistan, its refusal to allow methadone maintenance and its refusal to fund needle exchange programs even as it confronts fast-growing heroin addiction and HIV infection rates.

The concerns have crystallized in a campaign to block his appointment, including a Facebook group called We Don't Want A Russian UN Drug Czar!, which is urging people to send an email message to that effect to Secretary General Ki-moon. Group organizers the Hungarian Civil Liberties Union have also produced a video on the subject:

Harm Reduction: Colorado Bill Would Legalize Needle Exchanges

Colorado is one of just 17 US states that do not allow needle exchanges, but that could change under a bill before the Colorado Senate. The bill, SB 189, would allow local health departments to exchange dirty needles for clean ones in a bid to slow the spread of blood-borne diseases, such as HIV/AIDS and Hepatitis C among injection drug users.

widely-used needle exchange graphic
The bill passed its first legislative hurdle Wednesday, passing out of the Senate Health and Human Services Committee with only two no votes. It now goes before the Senate for a floor vote.

"This is intended to be a public health measure to stop the spread of infectious diseases," lead sponsor Sen. Pat Steadman (D-Denver) told ABC 7 News.

But the bill is generating opposition from solons who fear it will enable drug use. "It does give kind of a wink and a nod towards the use of illegal drugs," said Sen. Kevin Lundberg (R-Berthoud), who opposes the measure. "My common sense says a needle exchange program is a de facto drug legalization and I'm not going to go there. We've got a problem with illegal drugs," he said. "Let's not make it worse by saying maybe, sort of, kind of, you can do it."

"No one's condoning illegal drug use," Steadman retorted. "No one's saying, 'Go have a good time.' What we're saying is, 'Please be safe.'"

Under current Colorado law, groups are allowed to collect used syringes, but not exchange them for clean ones. The only city in the state that allows for needle exchanges is Boulder, which passed a 1989 law exempting some groups from prosecution for doing exchanges.

That doesn't mean there is no needle exchange in Denver, the state's largest city. The Underground Syringe Exchange of Denver (USED) has been doing exchanges since 2008 and has handed out more than 11,000 needles to drug users.

"We remove syringes off the streets of Denver," said USED member Chris Conner. "They wind up in our dumpsters. They wind up thrown away in public bathrooms or discarded in parks," he said. "So this is a public health issue for all of us."

Drug War Chronicle Book Review: "In the Realm of Hungry Ghosts: Close Encounters With Addiction," by Dr. Gabor Maté (2010, North Atlantic Books, 468 pp., $17.95 PB)

Phillip S. Smith, Writer/Editor

In the revised edition of his prize-winning Canadian best-seller, Vancouver's Dr. Gabor Maté has made an important contribution to the literature on drug use and addiction. For more than a dozen years, Maté has been a staff physician for the Portland Hotel Society in Vancouver's infamous Downtown Eastside, home to one of the hemispheric largest, most concentrated populations of drug addicts. The Portland is unique -- once just another shoddy Skid Row SRO, under the management of the Society it is now both a residence for the hardest of the hard-core and a harm reduction facility.

As a medical resident at the Portland, Maté has seen it all. The first section of "Hungry Ghosts" is filled with descriptions of his patients and their lives. Much of this is quite literally horrendous: Coked-out women turning tricks in alleys for their next rock and contracting syphilis; suicidal, opiate-addicted women refusing HIV treatments; mentally ill and alcoholic men dying young of liver cancer from Hepatitis C infections; people strung out on crack scrabbling at pieces of gravel on the sidewalk in the hallucinatory hope it's another rock; multi-addicted men and women, blood oozing from festering sores as they search yet again for a vein to hit, people overdosing and then going right back at it, people overdosing and dying.

And yet, despite the misery they are in and the wrecks that are their lives, they keep on using. "Hungry Ghosts" is an extended meditation on why. The second chunk of the book is devoted in particular to addressing that question. Maté offers an extended tour of the latest research into the disease model of addiction, with succinct and understandable (to the layperson) explanations of reward circuits in the brain, dopamine and serotonin flows, and all that good neuro-bio-pharmacological stuff so beloved of NIDA grantees. Repeated use of a substance indeed "rewires" the brain, creating pleasure circuits demanding to be fulfilled and pleasure deficits demanding to be fixed... with that next fix.

But unlike the NIDA people, with what I consider to be their neuro-bio-pharmacological determinism and reductionism, Maté goes a step further. He points out, accurately enough, that no matter what substance we're talking about, only a fraction of users, typically between 10% and 20%, become addicts. The "chronic relapsing brain disease" model may have some utility, but it fails to explain why some people are susceptible to addiction in the first place and others are not.

Maté noticed something about his downtrodden, strung-out clientele in Vancouver. They were almost universally abused as children, and at best, neglected. And I mean abused: Not spanked too hard, but raped, beaten, raped again, exploited, sent into foster care, literally spit on by their parents. It's very ugly.

One story especially sticks with me. A First Nations woman whose mother lives on the Downtown Eastside was given up at birth by her addicted mother, and sent to live with relatives, several of whom repeatedly sexually molested her in especially disgusting ways. She grew up an angry, depressed kid who turned to drugs and drink early. Tired of her life, she saved up $500 when she was 14 and ran away to Vancouver to find her mother. She did find her mother -- too bad for her. Mommie dearest promptly shot her up with heroin, spent the $500 on drugs for herself, then turned her out to turn tricks on the street. And you wonder why this woman prefers a narcotized bliss?

Maté doesn't just rely on anthropology and anecdote. He takes the reader instead into an extended look at the research on early childhood development and identifies messed-up childhoods as the key indicator of future substance abuse (as well as many other) problems. It doesn't have to be as extreme as some of these cases, but Maté makes clear that a nurturing early up-bringing is absolutely vital to the development of mentally and emotionally stable human beings.

Maté also has a startling confession to make: He, too, is an addict. The good doctor has been fighting a lifelong battle with his addiction to... wait for it... buying classical music CDs. He has behaved just like a junkie, he admits, spending thousands of dollars on his habit, lying to his wife, neglecting his kids, even leaving in the middle of medical procedures to run and score the latest Vivaldi. He's suffered the same feelings of compulsion, guilt, disgust, and self-denigration as any other addict, even if he doesn't have the scars on his veins to show for it.

At first glance, Maté's claim almost seems ludicrous, but he's making an important point: Addiction is addiction, whether it's to heroin or gambling, cocaine or shopping, he argues. The process of changes in the brain is the same, the compulsion is the same, the negative self-feelings are the same. We don't blame playing cards for gambling addiction or shopping malls for shopaholism; similarly, drugs are not to blame for drug addiction -- our own messed up psyches are the root of the problem.

And that leads to another important point: Those hollow-eyed addicts are like the rest of us, they are a dark mirror on our own inner problems, and most of us have some. (I'm reminded of a cartoon I once saw of a man sitting by all alone in an empty auditorium under a hanging banner saying, "Welcome to the convention of children of non-dysfunctional families.")

This is important because it stops us from dehumanizing drug addicts. They are not "the other." They are us, different only in degree. They deserve caring and compassion even if it is tough and seemingly fruitless work. Maté chides himself for falling from that saintly pedestal on occasion, and good for him.

Not surprisingly, Maté is a strong advocate of harm reduction and a harsh critic of prohibitionist drug policies and the US war on drugs in particular. By grinding drug users down even further, prohibition serves only to make them more likely to seek solace in chemical nirvana. It's almost as if prohibition were designed to create and perpetuate drug addiction.

In the final chapters of "Hungry Ghosts," Maté offers a glimmer of hope for beating drug addiction (or gambling addiction or sex addiction or whatever your particular compulsion is). It is a tough path of self-awareness and spiritual practice. I don't know if it will work -- I haven't tried it myself -- but it is important to remind ourselves that addiction is not necessarily a hopeless trap with no escape.

This is good, strong, compassionate, highly informed reading. I heartily recommend this book to anyone with an interest in addiction, addiction treatment, early childhood development, or drug policy. Thanks, doc.

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