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Latin America: Bloody Easter Weekend in Mexico's Drug Wars

Prohibition-related violence in Mexico took no break for the Easter holiday, with 59 people killed in the three-day period between Holy Thursday and Easter Sunday, according to Mexican press reports compiled by New Mexico State University's Frontera NorteSur (FNS) news service. The victims included former and current policemen, four soldiers, street-level drug dealers, used car salesmen, and an American citizen, Cuban-born Humberto Flores, who was gunned down in Cancun.

The violence ran the length and breadth of the country, with killings occurring in the northern border states (Baja California, Sonora, Chihuahua, Coahuila, Nuevo León, Tamaulipas), the center (Guanajuato, Mexico state), the Yucatan peninsula (Quintana Roo), the east coast (Veracruz), and the Pacific Coast (Oaxaca, Guerrero, Sinaloa). As FNS noted: "Once again, the geographical pattern of killings demonstrates how organized crime has extended its violent reach to virtually every nook and cranny of the country."

But there are hotspots, and one of them is Ciudad Juárez, across the Rio Grande River from El Paso. Nearly two dozen killings took place there over Easter weekend, including four people found burned to death at Los Lamentos ("The Regrets"), Chihuahua, on the New Mexico border. The police chief there crossed the US border into New Mexico seeking asylum after his deputies quit, saying he feared drug traffickers.

Further down the river in Reynosa, Tamaulipas, the body of Araceli de la Cruz, a 47-year-old woman kidnapped March 13, was dumped in front of an army post blindfolded and with a mutilated hand stuffed in her mouth. Accompanying the body was a note addressed to a Mexican army general warning of the fate that befalls informers.

In the past two years, as the Mexican government has undertaken massive offensives against the drug trafficking organizations, and the cartels have fought among themselves for control of lucrative franchises, the death toll has been around 2,000 a year. It looks as if 2008 is on, if not ahead of, the pace. And the killing continues: Nine more murders were reported in Ciudad Juárez by mid-week this week.

Search and Seizure: US Supreme Court to Decide Warrantless Search Case

The US Supreme Court agreed Monday to hear a case that could clarify limits on when police using an informant may enter a residence. The case is Pearson v. Callahan (07-751), in which five members of the Central Utah Narcotics Task Force are being sued by a man whose home was searched without a warrant after an informant bought methamphetamine inside.

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US Supreme Court
In 2002, a snitch working with the task force bought $100 worth of meth from Afton Callahan inside Callahan's trailer in Fillmore, Utah. Once the officers waiting outside received the snitch's signal via wire that the deal had gone down, they entered and searched the trailer and arrested Callahan for sale and possession of meth.

Callahan moved to have the evidence suppressed because a warrantless search is unconstitutional, but a state court trial judge rejected that motion. Callahan then agreed to a conditional guilty plea while appealing the Fourth Amendment issue. A state appeals court later agreed with him and overturned his conviction.

Callahan then turned around and sued the task force members for violating his Fourth Amendment rights. The officers then argued that they were immune under the doctrine of "qualified immunity," which holds that government officials cannot be held liable for violating a law that was not clear at the time. A federal district judge, Paul Cassell, ruled in 2006 that the police were entitled to immunity, even if the search was unconstitutional, but the US 10th Circuit Court of Appeals in Denver overruled Cassell, holding that the Constitution was so clear on the need for a warrant that no reasonable police officer would have proceeded without one.

Lawyers for the police officers then appealed to the US Supreme Court, which will have to decide both the search and the immunity questions. But despite what the 10th Circuit held, the federal courts are divided on whether a warrant is necessary in those circumstances. Some federal circuits -- but not the 10th -- have created the strange notion of a "consent-once-removed" exception to the Fourth Amendment. Under that theory, someone who consents to the entry of an undercover police informant is also consenting to the entry of police as well -- even if he doesn't know it. Because the resident gives permission to the snitch to enter, he has also given permission for the police to enter, this novel doctrine holds.

Now, the US Supreme Court will decide if there will be yet one more addition to the holes in the Fourth Amendment created by the drug war. And whether police who conduct unconstitutional searches will have to pay for them.

No Evidence Needed? War on Salvia Divinorum Heating Up -- YouTube Videos Play Role

Nearly a year ago, we reported on mounting efforts to ban salvia divinorum in states and localities around the country. Since then, the war on the hallucinogenic plant has only intensified, despite the lack of any evidence that its use is widespread or that it has any harmful physical effects on its users.

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salvia leaves (courtesy erowid.org)
Salvia is a member of the mint family from Mexico, where it has been used by Mazatec curanderos (medicine men) for centuries. Within the past decade, awareness of its powerful hallucinogenic properties has begun to seep into the popular consciousness. Now, it is widely available at head shops and via the Internet, where it can be purchased in a smokeable form that produces almost instantaneous intoxication and a freight train of a trip lasting a handful of minutes.

Fueled largely by the appearance of salvia-intoxicated youths on YouTube (there were some 3,500 such videos at last count), law enforcement's reflexive desire to prohibit any mind-altering substances, and legislators' wishes to "do something" about youth drug use, efforts to ban the plant are spreading. While some states have stopped at limiting salvia's use to adults, most recently Maine, more have banned it outright. Legislative measures affecting salvia have been filed in 16 more states too, as well as a number of towns and cities.

In 2005, Louisiana became the first state to ban salvia, making it a proscribed Schedule I controlled substance. Since then, Delaware, Michigan, Missouri, North Dakota, and Tennessee have joined the list. (Tennessee bans ingestion -- it's a Class A misdemeanor -- but not possession. All the others excepting North Dakota have placed it in Schedule I.) In Oklahoma, only concentrated salvia is banned. Salvia is also a controlled substance in Australia, Belgium, Denmark, Estonia, Finland, Italy, Spain and Sweden.

The press has also played a role in stoking fears of salvia and misstating its popularity. "Salvia: The Next Marijuana?," asked the Associated Press in a widely-reprinted story earlier this month.

Chris Bennett, proprietor of Urban Shaman Ethnobotanicals in downtown Vancouver, just laughed at the "salvia is the next marijuana" meme. "Anyone who says that is demonstrating their complete lack of knowledge of either salvia or marijuana," he said. "There is just no comparison. Cannabis is a mild relaxant and euphoric, while salvia is a very fast-acting visionary substance where some people report out of body experiences."

Researchers say that while salvia's effects on consciousness may be disquieting, the plant has not been shown to be toxic to humans, its effects are so potent is unlikely to be used repeatedly, and its active property, salvinorin A, could assist in the development of medicines for mood disorders. While action at the state level would unlikely affect research, a move by the DEA to put it on the controlled substances list could.

There are hazards to messing with hallucinogens, one expert was quick to point out. "It's an hallucinogen, and while its hallucinogenic actions are different from those induced by LSD and other hallucinogens, it has the liabilities that hallucinogens do," said Bryan Roth, a professor of pharmacology at University of North Carolina's School of Medicine, the man who isolated salvinorin A. "When people take it, they are disoriented. If you don't know where you are and you're driving a car, that would be a bad experience."

Still, said Roth, while it may make you freak out, it isn't going to kill you. "There is no evidence of any overt toxicity, there are no reports in the medical literature that anyone has died from it. The caveat is that there have been no formal studies done on humans, but the animal data suggests that it doesn't kill animals given massive doses, and that's usually -- but not always -- predictive for human pharmacology."

The DEA has been evaluating salvia for several years now, but there is no sign that it is ready to take action. "Salvia is a drug we are currently looking at to see if it should or should not be scheduled," said Rogene Waite, a spokesperson for the DEA, which is tasked with evaluating potential drug "threats." The agency has initiated the process of evaluating the eight factors listed in the Controlled Substances Act in determining whether or not to schedule a drug, she said. "There is no time frame or limit on this process," she said, providing no further hint on when or if ever the DEA would move to add salvia onto the federal list of controlled substances.

But legislators across the land are not waiting for the DEA. In California, Assemblyman Anthony Adams (R-Hesperia) introduced a bill that would ban salvia for minors at the urging of the San Bernardino County Sheriff's Department, he told the Riverside Press-Enquirer. "If you have the opportunity to get in front of an emerging drug, I think, geez, you should do that," said Adams, whose district includes San Bernardino and Redlands.

On the other side of the country, Massachusetts state Rep. Vinny deMacedo (R-Plymouth) is cosponsoring legislation that would criminalize salvia possession. "I believe by not making this drug illegal we are sending a message to our youth that it is okay, and there is no way that a drug that causes such mind altering effects on an individual should be considered legal," deMacedo told the Plymouth News.

Again, legislators took action after being alerted by law enforcement. DeMacedo said he agreed to sponsor the bill after hearing from Plymouth County Sheriff Joseph MacDonald. "I'd never heard of it before," deMacedo said. "It creates this psychedelic-type, mind-altering high, similar to LSD. I thought, 'You've got to be kidding. Something like this is legal?'"

In Florida, Rep. Mary Brandenburg wants to save the kids by sending anyone possessing salvia to prison for up to five years. "As soon as we make one drug illegal, kids start looking around for other drugs they can buy legally. This is just the next one," she explained.

While legislators attempt to stay ahead of the curve by banning any new, potentially mind-altering substances at the drop of hat, their efforts are misdirected, said Urban Shaman's Bennett. The YouTube kids may be the public face of salvia, but they are only a minority of users, he said. "It's all ages," he said, adding that his store does not sell to people under 18. "Every time there is some media attention, I get a bunch of middle-aged people coming in and asking for it."

Salvia is not a party drug, said Bennett. "The most serious users are people seeking a classic shamanic experience, seeking a visionary experience as part of their spiritual path. They feel they're accessing a higher level of consciousness," he explained. "And even they don't seem to use it more than once a month or so."

For all the commotion surrounding salvia, there is very little evidence of actual harm to anyone, said Bennett. "You'll notice you don't hear anybody talking about organic damage to the human organism," he said. "This is all purely fear and loathing of people having a visionary experience."

What little data there is on salvia use and its effects tends to bear him out. There are no reported deaths from salvia use, with the exception of a Delaware teenager who committed suicide in 2006 at some point after using it. (That unfortunate young man is widely cited by the proponents of banning salvia, even though there is no concomitant wave of salvia-linked suicides. Also, he was reportedly taking an acne medication linked to depression and had been using alcohol.) Users are not showing up with any frequency in mental hospitals or hospital emergency rooms.

While the YouTube kids may present a problematic public face of salvia use, there's not much to be done about that, said Bennett. "You can't control that," he shrugged. "And so what? Some kids are having a powerful visionary experience for five minutes on YouTube. Why is that somehow more threatening than watching someone in the jungle take ayahuasca or something on National Geographic?"

Bennett, for one, has no use for a ban on salvia -- or any other plant, for that matter. "We have a fundamental natural right to have access to all plants, and I don't care if it's salvia or marijuana or poppy or coca. That's just as clear-cut as our right to air and water," he said.

But Bennett's perspective is not one widely shared by legislators in the US. Instead, they reflexively reach to prohibit that which they do not understand. And the very "kids" they claim to be saving will be the ones going to prison.

Medical Marijuana: California Dr. Molly Fry Sentenced to Five Years

A federal judge in Sacramento sentenced Dr. Marion "Mollie" Fry and her companion, attorney Dale Schafer, to five years in federal prison for conspiring to grow and distribute marijuana on March 19. Fry, who used marijuana herself in connection with radical breast cancer surgery, and Schafer, who used it for back pain and a dangerous form of hemophilia, also provided marijuana to patients under California's Compassionate Use Act.

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Fry, Schafer and family at August 2007 demonstration (courtesy indybay.org)
But the Justice Department prosecuted the couple under the federal marijuana laws, leaving US District Judge Frank Damrell Jr. no choice but to impose the mandatory minimum five-year prison sentenced required under the law because they had more than 100 plants.

"It is a sad day, a terrible day," Damrell said during sentencing, adding that if it were up to him, the punishment would have been less. But he also criticized Fry and Schafer for refusing to accept a plea bargain that could have left them free. "You had the opportunity to resolve this case, but you wanted to soldier on, knowing that your kid would be left behind," he told the couple.

In a departure from normal practice on the federal bench and to the delight of supporters who packed the courtroom, Judge Damrell granted the pair bail, so they will remain free while their case is appealed. Damrell, who is also presiding over the Bryan Epis case and has granted him bail too, said the exceptional circumstances of the case create "serious issues that need to be decided by an appellate court." Among those, he noted, are Fry and Schafer's claim they were entrapped.

Marijuana: Barney Frank to Introduce Federal Decriminalization Bill

Rep. Barney Frank (D-MA) used a Friday night appearance on the HBO program "Real Time," hosted by Bill Maher, to announce that he planned to file a federal bill decriminalizing small amounts of marijuana this week. Frank, who has long been a supporter of marijuana law reform, said that federal law unfairly targets medical marijuana patients in states where it is legal. He also argued that decisions about whether to make marijuana illegal should be left up to the states.

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Barney Frank
Asked by Maher as to why he would push a pot decriminalization bill now, Frank said the American public has already decided that personal use of marijuana is not a problem. "I now think it's time for the politicians to catch up to the public," Frank said. "The notion that you lock people up for smoking marijuana is pretty silly. I'm going to call it the 'Make Room for Serious Criminals' bill."

Elaborating on his TV remarks in a Sunday interview with the Associated Press, the Massachusetts congressman said elected officials are lagging behind public opinion on the issue. "Do you really think people should be prosecuted for smoking marijuana? I don't think most people agree with that. It's one area where the public is ahead of the elected officials," Frank said. "It does not appear to me to be a law that society is serious about."

He seemed particularly irked by DEA raids and federal prosecution of medical marijuana patients and providers in California. "I don't think smoking marijuana should be a federal case," he said. "There's no federal law against mugging."

A dozen states have already decriminalized marijuana possession, with the New Hampshire House voting to approve such a measure last week. But the Granite State bill is opposed by state Senate leaders and the governor.

Rep. Frank's bill had not appeared on the Congressional web site as of Thursday afternoon.

Latin America: First Coca Plantations, Cocaine Lab Found in Brazil

In an ominous sign for US coca eradication efforts in South America, the Brazilian military said Sunday it had for the first time discovered coca plantations and a cocaine laboratory on its national territory. Coca has been grown by indigenous people in the Andes for thousands of years, and in recent years, three countries -- Colombia, Peru, and Bolivia -- have accounted for all the world's coca leaf.

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coca seedlings
The Brazilian army used helicopters and small boats to reach the coca fields and lab in a remote area near the northwestern city of Tabatinga, close to the borders with Peru and Colombia. The fields were discovered when satellite photos showed large clearings hacked out of the jungle.

Lt. Col. Antônio Elcio Franco Filho told reporters Sunday finding coca plants was a surprise. "It is the first time these plantations have been found in Brazil," he said, adding that the find had prompted authorities to look for more fields in the region.

"This is new in Brazil and it's a concern," Walter Maierovitch, an organized crime expert who once headed Brazil's anti-drug efforts, told the government's Agência Brasil news service. "It could mean a change in the geo-strategy of some Colombian cartels."

While coca grows well in the Andean-Amazon highlands, the climate in the Amazon basin is not believed to be favorable to coca cultivation. But according to Franco Filho, the leaf growing in Brazil could be adapted to that climate.

"We believe they are using a transgenic or an adaptation of the leaf used in the Andean region," Franco Filho said. "They are probably trying to find new locations to grow this, so we need to stay alert. Authorities need to crack down on them immediately. If we don't do anything it might even become a source of deforestation."

By Monday, US anti-drug officials were raising alarms. "Brazilian law enforcement is going to have to be vigilant on this front, so it doesn't become a major producer," DEA spokesman Garrison Courtney told the Associated Press. If coca can be successful grown there, said Courtney, "the Amazon would be a perfect area, with all the brush and uninhabited areas. It almost creates a perfect opportunity. Drug traffickers and organizations are always moving to new areas."

No one was arrested in the raid. Brazil, whose status as the world's number two cocaine consumer nation may be threatened by the rising popularity of the drug in Europe, may now be about to join the elite ranks of the coca producing nations.

Law Enforcement: Senate Votes to Restore Byrne Drug Task Force Funding Program

The US Senate voted last Friday to restore funding to the federal grant program that pays for the multi-jurisdictional state and local anti-drug task forces that roam the land enforcing the drug laws. The Bush administration's Fiscal Year 2009 budget had zeroed out appropriations for the program, the Byrne Justice Assistance Grant Program.

Funded at $520 million in Fiscal Year 2007, the two-decade old program that allows states to supplement their anti-drug spending with federal tax dollars was already down substantially from previous funding levels. For the past three years, as a cost-cutting move, the Bush administration has tried to zero it out completely, but that has proven extremely unpopular with Congress. In December, as it sought to pass the FY 2008 budget, the House voted to fund the block grant portion of the program at $600 million and the Senate at $660 million, but in last-minute budget negotiations, the White House insisted the funding be cut.

For FY 2009, the Bush administration again zeroed out appropriations for the JAG program, instead allocating $200 million for a combined federal grants program. But it is up against a powerful law enforcement lobby that has mobilized to restore funding. Democrat politicians eager to appear "tough on crime" have been especially vulnerable to such appeals.

It was two Democrats, Sens. Russ Feingold of Wisconsin and Diane Feinstein of California, along with Georgia Republican Sen. Saxby Chambliss, who cosponsored an amendment to the 2009 budget that would fund the Byrne JAG program at $906 million, far above the levels of recent years.

"Day in and day out, communities depend on our law enforcement professionals to keep them safe and be fully prepared to respond in emergencies," Feingold said. "The dedicated service they provide cannot happen without support from the federal government. We must provide adequate funding for successful programs like the COPS program and the Byrne program in order to provide the tools, technology, and training our law enforcement professionals need to protect our communities," he said.

"Unfortunately, the president's proposal to cut funding for these successful crime-fighting programs is nothing new," Feingold said. "Congress has rightly rejected the President's cuts to these programs in the past, and I'm working with my colleagues to include this critical funding in the 2009 budget."

Despite the demagoguery and the Senate vote, a reinvigorated Byrne JAG grant program is not yet a done deal. The House must also vote to approve funding, and if the White House follows the direction it has taken in recent years, it will once again oppose any expansive new funding -- as it successfully did in December.

States Shifting to "Four Pillars" Approach, Instead of Mass Arrests and Scare Tactics, for Confronting Methamphetamine

Although the use of methamphetamine has remained fairly flat throughout this decade -- contrary to popular belief -- and its half-million semi-regular users are far fewer than regular users or heroin or cocaine, meth has been the demon drug du jour for the new millenium. The "meth epidemic" has aroused concerted law enforcement and propaganda efforts at the state and local levels, and belatedly aroused the attention of the Office of National Drug Control Policy (ONDCP), which turned away from its obsession with marijuana long enough to include a few anti-meth segments in its National Youth Anti-Drug Campaign.

But while the states and federal government fill their prisons with tens of thousands of meth offenders and crank out ever more draconian laws to try to suppress the popular stimulant, public health officials, harm reductionists, and drug reform activists say there is a better way. Instead of relying on punitive laws, scare tactics, and failed federal leadership in confronting methamphetamine abuse, states and the federal government would be better off adopting more enlightened alternative approaches.

Current, law enforcement-heavy approaches to meth are ineffective and counterproductive, said Bill Piper, national affairs director for the Drug Policy Alliance as he introduced a new report he authored, "A Four-Pillars Approach to Methamphetamine: Policies for Effective Drug Prevention, Treatment, Policing and Harm Reduction." "Meth is not a new drug," Piper told the Tuesday teleconference. "Its use has fluctuated for the past 40 years and has been relatively stable since 1999. But it has become more available, more potent, and more addictive over time, and federal policies have failed to reduce most of the problems associated with meth use."

Even when law enforcement can legitimately claim successes, as in the massive reduction in the number of home meth labs, it only breeds new problems, said Piper. "The law of unintended consequences brought us the increasing power of the Mexican meth cartels."

There is a better way, and that is to adopt the Four Pillars approach, Piper argued in the report. That approach, already in use in places like Geneva, Zurich, Frankfurt, Sydney, and most famously, Vancouver, "has resulted in a dramatic reduction in the number of users consuming drugs on the street, a significant drop in overdose deaths, and a reduction in the infection rates for HIV/AIDS and hepatitis," he said.

A Four Pillars approach to meth should include the following steps, the report said:

  • Eliminate barriers to successful meth treatment, such as the shortage of treatment programs for pregnant and parenting women;
  • Divert nonviolent methamphetamine offenders to treatment instead of jail;
  • Invest in research to develop the equivalent of methadone and buprenorphine for the treatment of methamphetamine abuse, and allow doctors to prescribe dextroamphetmaine, modafinil, Ritalin and other medications to treat stimulant addiction as part of counseling and drug treatment;
  • Eliminate failed, scare-based prevention programs like DARE and the National Youth Anti-Drug Media Campaign, and increase funding for after-school programs instead;
  • Re-prioritize local and federal law enforcement agencies to focus on violent criminals instead of nonviolent drug offenders, and set clear statutory goals and reporting requirements for the disruption of major methamphetamine operations; and
  • Make sterile syringes widely available to reduce the spread of HIV/AIDS and hepatitis C.

While New Mexico is the only state that has formally embraced a Four Pillars strategy including harm reduction as part of its approach to meth -- a program in which DPA played a key and continuing role -- promising developments are afoot in other places as well, including California and Utah.

In California, Proposition 36, the Substance Abuse and Crime Prevention Act, in effect since 2001, is making a significant contribution in drying up the flow of new drug prisoners into the state's swollen and budget-devouring prisons. Under Prop. 36, about 35,000 people a year have been diverted from prison to drug treatment through the criminal justice system, with slightly more than half of them reporting meth as their primary drug of abuse. With nearly 19,000 meth users a year entering treatment under Prop 36, the program is the largest meth treatment and prevention program in the nation.

"We are not only reducing the number of people locked up, but we have saved about $1.5 billion in the past seven years, with recidivism dropping and no negative impact on crime rates," said Margaret Dooley-Sammuli, Proposition 36 coordinator for DPA. "We can get treatment to people who need it with cost savings and a positive outcome."

Lou Martinez was one of those people. A chronic California meth user for a decade, he was arrested numerous times for possession of drugs or paraphernalia. "I was constantly getting picked up throughout the '90s, I could never comply with the probation conditions, I was in and out of jail all the time," he said.

Things changed after Prop. 36, Martinez said. "I got picked up again in 2002, but this time I was referred to Prop. 36 and was able to detox and get health and psych screenings. I spent 90 days in a transitional house, and when I graduated in 2004, for the first time in my adult life I wasn't under the control of the courts. Without Prop. 36, there is no way I could have broken that cycle of arrests and trying unsuccessfully to quit."

Martinez returned to college, got a bachelor's degree, and now works directly with Prop. 36 clients. "It saved my life," he said of the program.

In Utah, the Drug Offenders Rehabilitation Act (DORA), which provides substance abuse screening for anyone convicted of a felony is now taking an innovative Salt Lake County program statewide, while across the Four Corners in New Mexico, policymakers, state agencies and other stakeholders have developed a comprehensive meth strategy bringing together all four of the Four Pillars.

Harm reduction is a key element, said Reena Szczepanski, director of DPA New Mexico, and a key player in developing the New Mexico strategy. "What are we going to do for people before they are ready to go into treatment?" she said. "What other problems and conditions do they have? Since 1997, we've had a statewide system of needle exchanges, where drug users can get health education, access to testing, information on how to respond to overdoses. This is harm reduction. Before someone is ready to go into treatment, they are already engaging a system of services that will be there when they are ready," she said.

Methamphetamine may be over-hyped as a national drug problem, but it is a locus of concern among policymakers, health care professionals, law enforcement, and society at large. With meth such a high profile drug policy issue, the battles over how to approach it may set the tone for drug policy discussions for years to come. With its report calling for a Four Pillars approach, the Drug Policy Alliance is taking up the challenge.

Drug Overdose Deaths Are Going Through the Roof -- Is Anybody Watching?

According to a little noticed January report from the Centers for Disease Control (CDC), drug overdoses killed more than 33,000 people in 2005, the last year for which firm data are available. That makes drug overdose the second leading cause of accidental death, behind only motor vehicle accidents (43,667) and ahead of firearms deaths (30,694).

What's more disturbing is that the 2005 figures are only the latest in such a seemingly inexorable increase in overdose deaths that the eras of the 1970s heroin epidemic and the 1980s crack wave pale in comparison. According to the CDC, some 10,000 died of overdoses in 1990; by 1999, that number had hit 20,000; and in the six years between then and 2005, it increased by more than 60%.

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naloxone, the opiate overdose antidote
"The death toll is equivalent to a hundred 757s crashing and killing everybody on board every year, but this doesn't make the news," said Dan Bigg of the Chicago Recovery Alliance, a harm reduction organization providing needle exchange and other services to drug users. "So many people have died, and we just don't care."

Fortunately, some people care. Harm reductionists like Bigg, some public health officials, and a handful of epidemiologists, including those at the CDC, have been watching the up-trend with increasing concern, and some drug policy reform organizations are devoting some energy to measures that could bring those numbers down.

But as youth sociologist and long-time critic of the drug policy establishment's overweening fascination with teen drug use Mike Males noted back in February, the official and press response to the CDC report has been "utter silence." That's because the wrong people are dying, Males argued: "Erupting drug abuse centered in middle-aged America is killing tens of thousands and hospitalizing hundreds of thousands every year, destroying families and communities, subjecting hundreds of thousands of children to abuse and neglect and packing foster care systems to unmanageable peaks, fostering gun violence among inner-city drug dealers, inciting an epidemic of middle-aged crime and imprisonment costing Americans tens of billions of dollars annually, and now creating a spin-off drug abuse epidemic among teens and young adults. Yet, because today's drug epidemic is mainly white middle-aged adults -- a powerful population that is "not supposed to abuse drugs" -- the media and officials can't talk about it. The rigid media and official rule: Drugs can ONLY be discussed as crises of youth and minorities."

The numbers are there to back up Males' point. Not only are Americans dying of drug overdoses in numbers never seen before, it is the middle-aged -- not the young -- who are doing most of the dying. And they are not, for the most part, overdosing on heroin or cocaine, but on Oxycontin, Lorcet, and other opioids created for pain control but often diverted into the lucrative black market created by prohibition.

Back in October, CDC epidemiologist Leonard Paulozzi gave Congress a foretaste of what the January report held. Drug death "rates are currently more than twice what they were during the peak years of crack cocaine mortality in the early 1990s, and four to five times higher than the rates during the year of heroin mortality peak in 1975," he said in testimony before the House Oversight and Investigations Committee.

"Mortality statistics suggest that these deaths are largely due to the misuse and abuse of prescription drugs," Paulozzi continued. "Such statistics are backed up by studies of the records of state medical examiners. Such studies consistently report that a high percentage of people who die of prescription drug overdoses have a history of substance abuse."

But there is more to it than a mere correlation between increases in the prescribing and abuse of opioid pain relievers and a rising death rate, said Dr. Alex Kral, director of the Urban Health Program for RTI International, a large nonprofit health organization. Kral, who has been doing epidemiological research on opioid overdoses for 15 years, said there are a variety of factors at work.

"There hasn't been a big increase in heroin use," he said. "What's changed has been prescription opiate drug use. Oxycontin is probably a big part of the answer. The pharmaceutical companies have come up with good and highly useful versions of opioids, but they have also been diverted and used in illicit ways in epidemic fashion for the past 15 years."

But Kral also pointed the finger at the resort to mass imprisonment and forced treatment of drug offenders as a contributing factor. "What happens is that people who are opiate users go into prison or jail and they get off the drug, but when they come out and start using again, they use at the same levels as before, and they don't have the same kind of tolerance. We know that recent release from jail or prison is a big risk factor for overdose," he said.

"The last piece of the puzzle is drug treatment," Kral said. "Besides the tolerance problems for people who have been abstaining in treatment, there has been an increase in the use of methadone and buprenorphine, which is a good thing, but people are managing to overdose on those as well."

There are means of reducing the death toll, said a variety of harm reductionists, and the opioid antagonist naloxone (Narcan) was mentioned by all of them. Naloxone is a big part of the answer, said the Chicago Recovery Alliance's Bigg. "It's been around for 40 years, it's a pure antidote, and it has no side effects. It consistently reverses overdoses via intramuscular injection; it's very simple to administer. If people have naloxone, it becomes much, much easier to avoid overdose deaths."

"Naloxone should be made available over the counter without a prescription," said Bigg. "In the meantime, every time a physician prescribes opioids, he should also prescribe naloxone."

"For a couple of years now, we've been talking about trying to get naloxone reclassified so it's available over the counter or maybe prescribed by a pharmacist," said Hilary McQuie, Western director for the Harm Reduction Coalition. "The problem is that you don't just need congressional activity, you also need to deal with the FDA process, and it's hard to find anyone in the activist community who understands that process."

Harm reductionists also have to grapple with the changing face of drug overdoses. "We're used to dealing with injection drug users," McQuie admitted, "and nobody really has a good initiative for dealing with prescription drug users. In our lobbying meetings about the federal needle exchange funding ban, we've started to talk about this, specifically about getting naloxone out there."

But while the overdose epidemic weighs heavily on the movement, no one wants to spend money to bring the numbers down. "This is a very big issue, it's very present for harm reduction workers," said McQuie. "But we haven't done a lot of press on it because there is no funding for overdose prevention. We have a very good program in San Francisco to train residential hotel managers and drug users at needle exchanges. It's very cheap; it only cost $70,000, including naloxone. But we can't get funders interested in this. We write grants to do this sort of work around the state, and we never get any money."

Perversely, the Office of National Drug Control Policy also opposes making naloxone widely available -- on the grounds that it is a moral hazard. "First of all, I don't agree with giving an opioid antidote to non-medical professionals. That's No. 1," ONDCP's Deputy Director of Demand Reduction Bertha Madras said in January. "I just don't think that's good public health policy."

But even worse, Madras argued that availability of naloxone could encourage drug users to keep using because they would be less afraid of overdoses. And besides, Madras, continued, overdosing may be just what the doctor ordered for drug users. "Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services," Madras said.

"The drug czar's office argues that if you take away the potential consequences, in this case, a fatal overdose, you facilitate the use, but betting someone's life on that is just cruel and bizarre," snorted Bigg.

RTI's Kral noted that there are now 44 naloxone programs run by community groups across the country. "It would be wonderful if there were more of them, because they are staving off a lot of deaths, but they are controversial. The ONDCP says they condone drug use, but you can't rehabilitate a dead drug user."

While battles over naloxone access continue, said Bigg, there are other things that can be done. "We need to engage people, and that means overcoming shame," said Bigg. "Every couple of months, I get a call from a family that has lost a member to drugs and I ask them if they're willing to come forward and talk to reporters to stop it from happening again, and they say 'let me think about it,' and I never hear from them again.

Another means of reducing the death toll would be to start local organizations of people whose friends or family members have died or are still using and at risk. "We could call them 'First Things First,' as in first, let's keep our folks alive," he suggested.

"When people found out naloxone is out there, that it's this medicine that has no ill effects -- it has no effect at all unless you're using opioids -- and that it can't be abused, and that their family member could have had it and still be alive, that's a hard thing to realize," said Bigg. "Everyone who has lost a loved one wants him back, and to think he could still be alive today if there were naloxone is a bitter, bitter pill to swallow."

Despite the apparent low profile of drug policy reform groups, they, too, have been fighting on the overdose front. "We worked to pass groundbreaking overdose prevention bills in California and New Mexico," said Bill Piper, national affairs director for the Drug Policy Alliance. "We're working to advance overdose prevention bills in Maryland and New Jersey. We had a bill in 2006 in Congress that would have created a federal grant program for overdose prevention," he said, pointedly adding that not a single federal dollar goes to overdose prevention. "We've tried to introduce that in the new Congress but can't find someone to take a lead. To be frank, few politicians care about this issue. Their staff care even less."

A massive public education campaign is needed, said Piper, adding that DPA is working on a report on this very topic that should appear in a few weeks.

In the meantime, while politicians and drug war bureaucrats avert their gaze and deep-pocketed potential donors keep their purses tightly closed, while the nation worries about baseball players on steroids and teenagers smoking pot, the bodies pile up like cordwood.

Fry & Schafer Released on Bail Pending Appeal

[Courtesy of California NORML] SACRAMENTO, Mar. 19th - Dr. Mollie Fry and Dale Schafer walked out of US Court free on bail pending appeal after being sentenced to a five-year mandatory minimum by a US District Judge Frank Damrell, who deplored the sentence as a "tragedy" that should "never have happened." Supporters were elated by Damrell's decision to grant release on bail, which capped a tense and dramatic day that began with a succession of adverse rulings for the defense. Defense attorney Tony Serra called it "one of the saddest days I've confronted in a long career" after Damrell turned down all the defense's motions to avoid the mandatory minimums. Mollie Fry stirred the courtroom to tears as she related the story of her cancer and subsequent desire to help people with medical marijuana. "We caused no harm to anyone," she said, "There were no victims." Judge Damrell acknowledged the legitimacy of Fry's medical use of marijuana, but said that the couple had "spiraled out of control.' He concluded that he had "no choice" but to impose the mandatory minimum of 5 years, a sentence dictated by the jury's finding that the couple had grown a total of slightly more than 100 plants over a period of three years. On the final and crucial issue of the day, however, Damrell agreed that the couple had "substantial" grounds for appeal so as to justify their release on bail. Following expert testimony by attorneys J David Nick and Ephraim Margolin, Damrell found substantial appeals issues relating to entrapment, the defendants' state of mind, and the conflict between state and federal laws. He added that the couple's precarious state of health was further extraordinary grounds for keeping them out of prison. He reprimanded Dr.Fry for her loose standards in recommending marijuana, and stipulated as a strict condition for her release that she desist from further recommendations, to which she assented. To this observer, today's events felt like a momentous step forward towards the inevitable changing of federal marijuana laws. Judge Damrell effectively declared the bankruptcy of US laws regarding mandatory sentencing and medical marijuana, and rightly referred the matter to higher authorities to decide. There are good grounds to hope that Dale and Mollie will be vindicated by the Ninth Circuit and/or a change in administration. More later.... Dale Gieringer, Cal NORML -- California NORML, 2215-R Market St. #278, San Francisco CA 94114 -(415) 563- 5858 - www.canorml.org
Location: 
Sacramento, CA
United States

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