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Danes Want Heroin Pills for Addicts

In remarks reported by the Copenhagen Post Sunday, Danish Health Minister Astrid Krag announced that she is proposing that heroin in pill form be made available to addicts. Denmark is one of a handful of European countries that provide maintenance doses of heroin to addicts, but to this point, the drug was only available for injection.

Heroin safer in pill form? Danes thinks so. (wikimedia.org)
It is time to offer users a safer choice, Krag said, adding that the pills should be available next year. She said the Danish Board of Health had evidence to believe making heroin available in pill form would reduce the risks of disease and overdose.

"With tablets, we get a tool that lessens the risk of incorrect dosages, injuries and incidences of cancer," she explained. "This will be an improvement of the current system. It clearly needs to be in place by 2013."

The Danish government approved heroin maintenance in 2008, with the first clinic opening in 2010. There are now five of them. A supervised injection site is set to open in the Copenhagen neighborhood of Vesterbro later this year. In the meantime, a mobile injection site is zooming around the neighborhood.

Opposition conservative party spokespersons said they were open to the proposal, but wondered how it would be paid for. But spokespersons for the government Socialistisk Folkeparti said that was just politics.

"It is remarkable that [the conservative opposition] says that financing must be in place before you make a proposal," said Jonas Dahl, health spokesman for the Socialists. "The working procedure has always been that we first get a professional recommendation from the Board of Health and then find the money."


"You Can't Stop AIDS Without Ending the Drug War" [FEATURE]

The XIX International AIDS Conference took place in Washington, DC, last week, bringing more than 20,000 scientists, activists, government officials, and journalists to assess the science and determine best practices for reducing the spread of the HIV virus. The US was able to host the conference for the first time in 22 years after it finally repealed a law denying people with HIV admission to the country.

activists interrupt the conference opening session to protest the exclusion of drug users and sex workers (video at droginreporter.hu/en)
But other critical groups remained excluded -- drug users and sex workers. Although they make up a majority of people living with HIV in many countries, people who admit to ever using drugs or engaging in prostitution within the past 10 years are inadmissible under US immigration laws. The State Department could have issued a blanker waiver of inadmissibility for people attending the conference, but declined to do so.

Drug users and sex workers who wanted to attend the conference were thus faced with a dilemma: Tell the truth and be barred or lie on the visa application, which in itself is a violation of US immigration law. As a result, representatives of some of the groups most affected -- and most likely to be affected in the future -- were unable to attend.

"People do not want to run the risk of attending the conference in a country where they are told they are not wanted or desired," said Allan Clear, the executive director of the Harm Reduction Coalition. "It sends the message that people who have a history of drug use or sex work are not actually included in the dialog at all, and is a serious setback in the fight against AIDS. I don't think the US government has any particular interest in actually involving sex workers or drug users in policy or programming."

The exclusion of drug users and sex workers hasn't gone down well with activists. As far back as two years ago at the Vienna AIDS conference, Indian activist Meena Seshu called for a boycott of AIDS 2012, pointing out that it was unethical three decades into the AIDS epidemic to discuss AIDS policy without including those most affected. Some have boycotted the conference, opting instead to attend a Kiev conference that began July 9 for drug users and people living with HIV from Eastern Europe. Sex workers and their allies followed with a side meeting in Kolkata this week. While those two events are officially considered "hubs" of the International AIDS Conference, many attended them as a means of protesting the exclusion of drug users and sex workers in Washington.

Unhappiness broke into the open in Washington Monday when dozens of drug user and sex workers activists disrupted the conference's opening press event. They leapt from their seats unexpectedly and marched through the room, waving banners and shouting slogans such as "No drug users? No sex workers? No International AIDS conference!"

Discontent with AIDS policies that marginalize drug users and sex workers escaped from the conference rooms and onto the streets again on Tuesday, as hundreds marched to the White House chanting "No More Drug War" in a rally timed to coincide with the conference. The march broadened the scope of protest, linking the battle against AIDS with the war on drugs and corporate domination of US political life.

On the way to the White House, protestors stopped at UPS and Wells Fargo facilities to chide those corporations for unhelpful practices. UPS took heat for donating to politicians who voted to restore the federal ban on needle exchange funding, and Wells Fargo for investing in private prisons.

"Wells Fargo is literally invested in locking more people up," said Laura Thomas of Drug Policy Alliance (DPA).

Activism around drug users and AIDS also took place in the conference's Global Village, including the installation of a model of Vancouver's Insite supervised injection site and tours of a local needle exchange outreach van courtesy of DC's Family and Medical Counseling Services. The Harm Reduction and Global Drug Policy Zone in the village also featured special events and presentations put on by groups including the Harm Reduction Coalition, Harm Reduction International, the Hungarian Civil Liberties Union, the Eurasian Harm Reduction Network, and the International Network of People Who Use Drugs.

Advocates also took advantage of the AIDS conference to unleash a campaign on the theme of "You Can't End AIDS Unless You End the Drug War." Articles to that effect appeared on Alternet and the Huffington Post (and were picked up elsewhere), while Global Commission on Drug Policy member Richard Branson penned a USA Today op-ed piece on how drug prohibition contributes to the spread of HIV. As part of the same campaign, Politico ran a full-page ad signed by Global Commission members and other notables, repeating the message and directly challenging both President Obama and Gov. Romney to "do the right thing." Giants in AIDS advocacy like Michael Kazatchkine and Stephen Lewis joined the calls in speeches given during the conference.

In an unexpected cap to things, former President Bill Clinton called for drug use to be treated as a public health issue, not a criminal justice one, in remarks at the closing plenary. Clinton cited The Huffington Post and Alternet op-eds, coauthored by the Drug Policy Alliance's Ethan Nadelmann and American Foundation for AIDS Research founder Matthilde Krim.

Activists demanding a larger role for drug users and sex workers in setting the policies that are supposed to help them fight AIDS came armed with powerful ammunition. Two recent reports clearly lay out how criminalizing drug use helps spread the disease and how many countries are failing to adequately deal with the spread of HIV among injection drug users.

The first report, from the Global Commission on Drug Policy, makes its findings clear in its title: "The War on Drugs and HIV/AIDS: How Criminalization of Drug Use Fuels the Global Pandemic." In the report, the commission noted that injection drug use now accounts for one-third of new HIV infections outside of sub-Saharan Africa, including some 354,000 people in the US.

"Throughout the world, research has consistently shown that repressive drug law enforcement practices force drug users away from public health services and into hidden environments where HIV risk becomes markedly elevated," the commission said. "Mass incarceration of nonviolent drug offenders also plays a major role in spreading the pandemic."

The commission also remarked on "the remarkable failure" of drug prohibition in reducing the global drug supply. The worldwide supply of illicit opiates, such as heroin, has increased almost four-fold in recent decades, the commissioners noted. They also noted the drug war's contribution to the growth of organized crime and violence.

The commission identified proven addiction treatment and evidence-based public health measures that countries should put in place to reduce the spread of HIV and protect community health and safety. They include needle exchange programs, safer injecting facilities, and prescription heroin programs.

"Failure to take these steps is criminal," the commission said.

In the second report, "The Global State of Harm Reduction 2012: Towards an Integrated Response," from the London-based Harm Reduction International (formerly the International Harm Reduction Association), researchers found that while injection drug use has been identified in 158 countries, only half of them have any programs aimed at preventing the spread of HIV among injectors, and the situation internationally is not improving. Even in countries that are addressing the problem, programs suffer from lack of funding and donor support is decreasing. That is undermining the global response to AIDS, the report concluded.

"In the last two years, we have seen a significant scale-down of services in countries with some of the highest HIV burdens among people who inject drugs," said Rick Lines, the group's executive director. "As tens of thousands gather in Washington this week to call for an end to AIDS, it is becoming increasingly clear that governments have neither the will nor the intention of ending the spread of HIV among people who use drugs."

"We have seen the number of needle exchange programs in Russia drop for 70 in 2010 to only six in 2012. This is made worse by a retreat of many bilateral and multilateral donors to funding effective harm reduction interventions in many countries," said Claudia Stoicescu, public health analyst at Harm Reduction International and author of the report. "Such developments significantly limit progress toward global commitments to halve HIV transmission related to unsafe injecting by 2015, let alone any hope of achieving universal access to HIV prevention, treatment, care and support for people who inject drugs."

"The reluctance of governments to fund an adequate response to HIV and injecting drug use stands in stark contrast to the seemingly limitless budgets for ineffective and punitive law enforcement responses," said Lines. "Governments care more about fighting a losing war on drugs than they do about winning the fight against HIV."

As the world enters its fourth decade of living -- and dying -- with HIV/AIDS, this week's conference and its barriers to participation by and concern for some of those most directly affected by the crisis -- drug users and sex workers -- demonstrate how far we still have to go. They also make achingly clear the destructive role that drug prohibition and the criminalization of marginalized populations play in perpetuating the epidemic.

Maybe next time the International AIDS Society will hold its conference someplace where drug users and other marginalized groups can attend and be heard. Or maybe the United States will alter its harsh visa requirements aimed at drug users and sex workers. Either one would be good. Ending drug prohibition, the stigma it generates, and the obstacles to fighting disease it engenders would be better.

Washington, DC
United States

Making Sure Drugs Kill: Commission Blames Drug War for Spreading AIDS [FEATURE]

On Tuesday, as the UN's global drug prohibition bureaucracy marked its annual International Day Against Drug Abuse and Illicit Trafficking and UN Office on Drugs and Crime head Yuri Fedotov blamed hard drug use for "bringing misery to thousands of people, insecurity, and the spread of HIV," a group of leading international voices offered a starkly contrasting perspective, arguing instead that is the failures and consequences of global drug prohibition that are driving the spread of HIV/AIDS and other blood-borne diseases among drug users.

Commission members Michel Kazatchkine, Ruth Dreifuss, and Ilana Szabo at London press conference
Those voices, gathered together as the Global Commission on Drug Policy, include six former presidents from around the world, public health experts, and socially conscious entrepreneurs such as Sir Richard Branson. They took the opportunity of global anti-drug day to issue a report, The War on Drugs and HIV/AIDS: How the Criminalization of Drug Use Fuels the Global Pandemic that directly condemns the drug war as a failure and calls for immediate, fundamental reforms of the global drug prohibition regime to slow the spread of HIV and reduce other drug war harms.

There are an estimated 33 million people worldwide infected with HIV, and outside sub-Saharan Africa, injection drug use accounts for one-third of new infections. The situation is particularly bad in Russia and other countries in the former Soviet Union and East Bloc that continue to take harsh drug war approaches to drug use despite the evidence before their own eyes. In Russia, nearly one in a hundred adults is now infected with HIV.

But it's not just the Russian sphere where policymakers ignore the evidence. The report also cites China, Thailand, and the US, where Congress recently reinstated a longstanding ban on the use of federal funds for syringe exchange programs. In countries that have adopted evidence-based HIV prevention programs, such as Switzerland and Portugal, injection drug use-related HIV infections have nearly been eliminated.

According to the report, drug prohibition and the criminalization of drug users spurs the spread of HIV through the following means:

  • Fear of arrest drives persons who use drugs underground, away from HIV testing and HIV prevention services and into high-risk environments.
  • Restrictions on provision of sterile syringes to drug users result in increased syringe sharing.
  • Prohibitions or restrictions on opioid substitution therapy and other evidence-based treatment result in untreated addiction and avoidable HIV risk behavior.
  • Deficient conditions and lack of HIV prevention measures in prison lead to HIV outbreaks among incarcerated drug users.
  • Disruptions of HIV antiretroviral therapy result in elevated HIV viral load and subsequent HIV transmission and increased antiretroviral resistance.
  • Limited public funds are wasted on harmful and ineffective drug law enforcement efforts instead of being invested in proven HIV prevention strategies.

"The Global Commission is calling on all entities to acknowledge and address the causal links between the war on drugs' criminalization of drug use and drug users and the spread of HIV/AIDS," commission member Michel Kazatchkine, the former executive director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria told a London press conference. "For people who inject drugs and their sex partners, the AIDS epidemic continues to be a public health emergency."

"It is so clear now that there is a relation between repressive drug policies and the spread of HIV/AIDS," said former Colombian President Cesar Gaviria. "If we don't get people into the health system without fear, it will be very difficult to do treatment and prevention."

Commission member Sir Richard Branson at "Atlantic Exchange" drug policy discussion, Washington, DC, March 2012
"I have long thought the war on drugs did more harm than good, and the commission's report put the data behind those beliefs," said Branson. "The war on drugs is not stopping drug use, and it also contributes significantly to the AIDS epidemic by driving users into the shadows. As an entrepreneur, if my business was failing for 40 years, I would close it down. Refusing to implement public health measures to reduce HIV and protect people with a drug problem is nothing short of criminal."

Branson and the other commissioners made some concrete recommendations for action in the report. Those include:

  • Push national governments to halt the practice of arresting and imprisoning people who use drugs but do no harm to others.
  • Measure drug policy success by indicators that have real meaning in communities, such as reduced rates of transmission of HIV and other infectious diseases, fewer overdose deaths, reduced drug market violence, fewer individuals incarcerated and lowered rates of problematic substance use.
  • Respond to the fact that HIV risk behavior resulting from repressive drug control policies and under-funding of evidence-based approaches is the main issue driving the HIV epidemic in many regions of the world.
  • Act urgently: The war on drugs has failed, and millions of new HIV infections and AIDS deaths can be averted if action is taken now.

"The AIDS epidemic is a harsh and brutal teacher that obliges us to take a scientific approach to deal with sex workers and drug addicts," said former Swiss President and commission member Ruth Dreifuss. "Politicians have to inform citizens of the benefits, risks, and failures of drug policy, and politics has to take responsibility for policy change. Public health has to be at least as important as criminalizing the drug traffic," she told the press conference.

"Addicted injecting drug users is one of the main sources of the spread, and not all of them will achieve abstinence," said Dreifuss. "Substitution therapies can take people away from street drug dealers and violence. For some, the provision of medical heroin is necessary to allow them to abandon criminal activities and overcome marginalization. It's possible to implement these large scale programs at low costs with high benefits," she argued.

"For others, harm reduction measures are necessary in order to avoid the spread of HIV/AIDS and other bloodborne disease. Needle exchange programs, free condoms, safe consumption rooms all not only save the lives of drug users but protect the whole population," Dreifuss explained. "We need the full spectrum of these measures for those in prison, too, who are at more risk for HIV infections."

Dreifuss touted her own country's experience as a model. Faced with mounting injection drug use, Switzerland eventually went the route of supervised injection sites and opioid maintenance, including heroin maintenance.

"Our experience is that it works," she said. "The police protect the injection rooms from dealers. The four pillar policy [prevention, treatment, harm reduction, enforcement] has been broadly accepted by our citizens and the spread of HIV/AIDS is under control."

Even within the constraints imposed by the global drug prohibition regime, countries can still take action to mitigate the drug war's role in the spread of infectious disease, she said.

"It is possible for countries to adopt effective harm reduction measures within existing drug laws," Dreifuss argued. "The decriminalization of drug use is the first step, and the second step is to determine what type of market can drive out dealers. The war on drugs has failed to reduce supply or demand; let us replace prohibition with regulation and avoid jeopardizing public health and harm reduction policies with inefficient measures."

"Our message is that prohibitionist law enforcement has failed in its goals of eradicating drugs and protecting people's health," said Kazatchkine. "Illegal drugs have become cheaper and more available and HIV and other health risks have increased. Prohibitionist policies have been shifting the market to stronger drugs and led to a war on users with numerous human rights abuses, police harassment, violence, extortion. The fear of police and stigma is driving users underground and away from access to information, care, and medical services," he warned.

"One cannot improve health through war," he concluded. "This is an epidemic among people who inject that we can actually control. If we are to have a chance at reducing the transmission of AIDS, we need to open up and change our ways."

The Global Commission on Drugs has laid out the problem and showed us the path to fix it. Now, it is up to our political leadership to act accordingly, and it is up to us to ensure that it does.

United Kingdom

Kenya to Distribute Needles to Injection Drug Users

The Kenyan government will begin distributing needles to the country's estimated 50,000 injection drug users next month in a bid to slow the spread of HIV and other blood-borne diseases. The plan was announced last week in Mombasa, where the first pilot program will begin.

Mombasa, a port city, is reportedly a transit route for international drug trafficking. It also has the country's highest number of injecting heroin users.

"We are trying our best to address the entire problem of drug abuse amongst the youths. We had to identify an alternative of stopping the youths from sharing needles, our attention having been drawn by the rate at which these young people were contracting HIV and other diseases, such as hepatitis," said Dr. Anisa Omar, the Coast Provincial Director of Public Health and Sanitation. "In Mombasa alone, we have over 26,000 youths who use injection drugs, with at least one out of every four being found to be HIV-positive. In Nairobi, we have 20,000 youths who are IDUs."

The Kenyan government estimates that injection drug use accounts for 4% of HIV infections and 17% of new HIV infections in Coast Province, where Mombasa is located. The government moved in 2010 to shift from addressing drug use as a criminal issue to addressing it as a public health issue.

The government plans to distribute some eight million needles to injection drug users as the plan is rolled out. It will also encourage people to be tested for HIV and will provide antiretroviral drugs, condoms, and medicines for tuberculosis, which commonly co-infects with HIV.

While the government has shifted to a public health and harm reduction approach, not everybody is on board. Anti-drug activists and some religious leaders have criticized the move.

"We will file a petition in court… these children of ours don't even have any veins remaining in their bodies," said Amina Abdalla, secretary of the Coast Community Anti-Drugs Coalition. "Where do they expect them to inject themselves? Their bodies are ruptured and rotten as a result of constant use of the needles. Besides, drug peddlers and barons will have a field day, for they'll know their products will be on demand, and that's not acceptable."

Coast religious leaders also objected, saying the government should instead spend its resources on drug treatment.

But Dr. Omar said that needle sharing significantly reduced the risk of coming down with HIV and hepatitis, and that justified the program.

"The program, which will see every addict given three needles and syringes per day, will be supplied to specified private rehabilitation centers and hospitals by NGOs and qualified medical practitioners, in collaboration with anti-drug campaigners, whom we soon plan to train on how they'll best handle the addicts."


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)

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