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Feature: Historic Hearing on Marijuana Legalization in the California Legislature

In an historic hearing Wednesday, the California legislature examined the pros and cons of marijuana legalization. The hearing marked the first time legalization has been discussed in the legislature since California banned marijuana in 1913.

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Ammiano press conference for hearing
Onlookers and media packed the hearing room for the three-hour session. Capitol employees had to hook up remote monitors in the hallway for the overflowing crowd of supporters and opponents of marijuana legalization.

The hearing before the legislature's Public Safety Committee was called for and chaired by Assemblyman Tom Ammiano (D-SF), who earlier this year introduced AB 390, a bill that would legalize, regulate, and tax marijuana in the state. While Ammiano has made clear that he supports legalization, the witness list for the hearing was well-balanced, with legislative analysts and representatives of law enforcement as well as reform advocates in the mix.

The hearing began with testimony from legislative analysts, who estimated that the state could realize tax revenues ranging from hundreds of millions to nearly $1.4 billion a year from legalization. The latter figure was from the state Board of Equalization, while the lower estimates came from the Legislative Analyst's Office.

But tax revenues wouldn't be the only fiscal impact of legalization. "If California were to legalize, we would no longer have offenders in state prison or on parole for marijuana offenses," noted Golaszewski. "We estimate the savings there at several tens of millions of dollars a year. There would also be a substantial reduction in the number of arrests and criminal cases law enforcement makes. To the extent they no longer have to arrest people for marijuana, they could shift resources elsewhere."

Golaszewski said there are roughly 1,500 people imprisoned on marijuana charges in California, 850 of them for possession offenses.

The analysts were followed by a panel of attorneys who debated the legality of state legalization. "If California decides to legalize, nothing in the Constitution stands in its way," said Tamar Todd, a staff attorney for the Drug Policy Alliance Network.

But while Marty Mayer, attorney for the California Peace Officers Association (CPOA), generally agreed with that assessment, he also argued that the state could not unilaterally legalize. "The state of California cannot unequivocally legalize marijuana," he said, noting that marijuana is prohibited under federal law.

Next up were the cops, and there were no surprises there. "Marijuana radically diminishes our society," said CPOA president John Standish. "Marijuana is a mind-altering addictive drug that robs you of memory, motivation, and concentration," he said before Ammiano cut him short, noting that the purpose of the hearing was to discuss public safety and economic impacts of legalization, not to debate marijuana's effects on health.

"Alcohol and cigarettes are taxed to the hilt, but the taxes don't cover the cost of medical treatment, let alone DUIs," Standish continued. "This would lead to an increase in crime rates, social costs, medical costs, and environmental concerns. There is also a very real concern that Mexican drug cartels are behind most of the imported marijuana coming into the US," he added, without explaining what that had to do with legalizing marijuana production in California.

And, pulling out yet another woolly chestnut, Standish resorted to the old and discredited "gateway theory" that marijuana use is a stepping stone to hard drug use. "Marijuana is a gateway drug," he said. "Every incident in 30 years of law enforcement I have been in where marijuana has been involved has not been good. Both marijuana and methamphetamine are equally critical problems," he said.

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overflow room
After reciting a short list of violent incidents around large-scale illegal grows allegedly operated by Mexican drug cartels, Sara Simpson, acting assisting chief of the Attorney General's Bureau of Narcotics Enforcement, warned that the cartels were likely to try to maintain their market share. "That could lead to more violence," she warned.

"Legalizing marijuana is bad public policy," said Simpson. "A significant number of marijuana users are incapacitated," she claimed. "When a recreational drug user backs over your four-year-old, you consider yourself a victim of violent crime. Legalization would increase death and injury totals."

"Why would we want to legalize a substance known to cause cancer?" asked Scott Kirkland, chief of police in El Cerrito and chairman of the California Police Chiefs' Medical Marijuana Task Force. "Legalization will only result in increased use of marijuana with a corresponding increase in drugged driving," he warned.

But later witnesses said that California was simply wasting resources by arresting marijuana offenders. Dan Macallair, executive director of the Center on Juvenile and Criminal Justice, said that arrest statistics from the past 20 years show that California law enforcement is more focused on prosecuting simple possession cases than cultivation and sales.

"California's drug war, particularly on marijuana, is focused on drug users," he said. "Virtually every category of crime has declined since 1990, except for a dramatic increase in arrests for marijuana possession. In 1990, there were 20,834 arrests for possession. Last year, there were 61,388 arrests. "

This was going on while arrests for all other drug offenses declined, Macallair said. For all other drugs, arrests were down 29%. Even marijuana manufacture and sales arrests had declined by 21%. More people went to prison in California in 2008 for marijuana possession than for manufacture or sales, he added.

"Our courtrooms are full every day with marijuana cases," said Terence Hallinan, the former San Francisco City and County District Attorney. "It's still against the law to sell even a gram. There are a lot of people in court and jail for marijuana offenses."

The Rev. Canon Mary Moreno Richardson of St. Paul's Episcopal Cathedral in San Diego told the committee marijuana law enforcement has especially pernicious effects on the young. "When they find a group of kids with a joint, they take them all in to juvie. When they're incarcerated, they join gangs for safety. Jails have become the boot camps for the gangs," she said. "We need to think about and protect our youth."

"I speak on behalf of California's millions of marijuana users who are tired of being criminals and would like to be taxpaying, law-abiding citizens," said Dale Gieringer, executive director of California NORML. "We think it makes no sense for taxpayers to pay for criminalizing marijuana users and their suppliers when we could be raising revenues in a legal market."

"Today, our marijuana laws are putting our children in harm's way," said retired Orange County Superior Court Judge James P. Gray. "We want to reduce the exposure of a lifestyle of marijuana use and selling to our children, but prohibition's illegal dealers don't ask for ID," he said.

At the end of the hearing, Ammiano opened the floor to public comment. While most speakers supported legalization, a contingent of conservative African-American religious leaders vigorously denounced it. "I know from personal experience the devastation that occurs in one's life and community as a result of drug abuse that began with marijuana," said Bishop Ron Allen, founder and president of the International Faith Based Coalition.

Also in opposition was Californians for Drug Free Youth. John Redman, the group's director, said legalizing marijuana to raise revenues was reprehensible. "This is blood money, pure and simple," Redman said.

The battle lines are shaping up. On one side are law enforcement, conservative clerics, and anti-drug zealots. On the other are researchers, activists, and, evidently, the majority of Californians. Ammiano gave as a handout at the hearing a sheet listing at least six recent polls showing majority support for marijuana legalization in the state.

The bill isn't going anywhere for awhile. Ammiano said he will hold more hearings later and may revise it based on the hearings. But marijuana legalization is now before the legislature in California.

Feature: Busted for Handing Out Clean Needles -- The Mono Park 2 Fight Back in California's Central Valley

Hit hard by a double whammy of drought and economic slowdown, California's Central Valley has become a hotbed of methamphetamine and other injection drug use. Now, the dusty town of Modesto, in Stanislaus County, has become a focal point in the statewide and nationwide battle over how to help injection drug users. Last week, two volunteers at an unsanctioned needle exchange were in court in Modesto hoping to reach a plea bargain after they were arrested in April for handing out syringes. Now known as the Mono Park 2, they're looking at serious jail time for trying to save lives.

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mobile needle exchange/clinic site in nearby Fresno
The deal was supposed to be that Stanislaus County District Attorney Birgit Fladager would drop drug paraphernalia possession charges against exchange volunteers Kristy Tribuzio and Brian Robinson if they agreed to quit handing out needles until there was a legal program in place. But that didn't happen. Instead, at the last minute, the DA rejected the plea deal. Another hearing is set for November 9. If the DA and defense attorneys cannot reach agreement then, the case will go to trial.

The case has its genesis in longstanding efforts to win official approval for a needle exchange in Modesto. California law allows for needle exchanges, but only as a local option. The county board of supervisors must declare a health emergency in order for needle exchanges to operate legally.

In a 2008 report, Containing the Emerging Threat of Hepatitis through a Syringe Exchange Program (begins on page 22), the Stanislaus County Civil Grand Jury recommended the county authorize syringe exchanges and implement them either directly or through a community based contractor. The effort also had the support of county public health officials, including Public Health Department, the Advisory Board for Substance Abuse Programs, the Local AIDS Advisory Implementation Group, and the Hepatitis C Task Force, who cited a high incidence of Hepatitis C. They cited research indicating that needle exchanges reduced the spread of blood-borne diseases, brought injection drug users into contact with public health workers, and did not result in increases in drug use.

But despite the input from the public health community and the grand jury report, the Stanislaus County Board of Supervisors a year ago voted unanimously against allowing needle exchanges. In so doing, they heeded their own prejudices and those of law enforcement over science-based policies and the advice of the public health community.

County Sheriff Adam Christianson and DA Fladager both spoke out against needle exchanges, saying they would enable drug users to continue their addiction. Fladager said needle exchanges sent the wrong message to young people and encouraged them to think the county would take care of them if they become addicted.

"All of the challenges we are faced with in Stanislaus County, the gangs, methamphetamine, crimes, all have elements of drug addiction," Christianson said. "A syringe exchange program enables people to continue with their drug addiction."

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used syringes collected by exchange -- they might otherwise have been discarded in public places
Noting that Hep C was not a big issue for the county because most patients are covered by insurance, Supervisor Bill O'Brien also objected on bizarre moral grounds. "Then there's the human issue. Giving a drug user a clean needle is not the best thing for him. Illegal drug use has a risk, and making it safer promotes it," he said.

Supervisor Jim DeMartini thanked the grand jury for the report, but then dismissively added, "Like many well-intentioned programs that don't work out, this will never work out and deliver the benefits promised."

Too bad the sheriff, the DA, and the county board don't agree with the nation's drug czar. "Needle exchange programs have been proven to reduce the transmission of blood-borne diseases," Gil Kerlikowske told Congress during confirmation hearings earlier this year. "A number of studies conducted in the US have shown needle exchange programs do not increase drug use. I understand that research has shown these programs, when implemented in the context of a comprehensive program that offers other services such as referral to counseling, healthcare, drug treatment, HIV/AIDS prevention, counseling and testing, are effective at connecting addicted users to drug treatment."

Given the knowledge base about the effectiveness of exchanges and the evident human need for them in Modesto, needle exchange advocates were not content to simply roll over and die. Instead, they created an unauthorized needle exchange in the city's Mono Park, also known as needle park by residents because of the used needles littering the ground there. The program was publicized and went along on a low-level basis without a hitch until April, when, after an elaborate undercover sting, police swooped down and arrested the exchange volunteers.

Kristi Tribuzio just happened to be volunteering with the needle exchange the day the bust went down. Now, she's one of the defendants. "There was a direct need for this, and when I found out there was an existing exchange -- I saw a flyer on a telephone pole -- I asked how is this happening?" she said. "I got involved; I was just going out there for the people. An undercover cop came up and did an exchange, and then, a little later eight to 10 undercover officers drove up with a drug dog and arrested us. It was pretty harsh and crazy," she recalled.

"Looking back, Brian and I think it was maybe naive of us to just go out there and do something that was helping people in line with other syringe exchange programs," said Tribuzio. "We didn't understand what the consequences could be."

Now, she and Robinson face up to a year in jail for violating the paraphernalia law. For Tribuzio, there were other consequences, including the loss of her contract position with the Stanislaus County drug and alcohol education and prevention program. "I was laid off two days after I was arrested. Because I was a contract worker, they didn't need a reason to fire me, and no official reason was given. Ironically, my employer supports needle exchange," she said. "Maybe that's why they laid me off instead of firing me for cause. Now, at least, I can get unemployment."

Tribuzio had previously worked as a substitute teacher, but she can't do that now, either. "I'm getting an MA in education, and I have a teaching credential, but my credential is now suspended," she said. "Imagine, a teacher in San Francisco could be doing just what I did, and there would be no problem."

That's because needle exchanges have been authorized by the San Francisco County Board of Supervisors, just as they have in most large California cities. But in more conservative locales, like the Central Valley, the fight is more difficult, and therein lies the problem -- and the solution -- said one prominent harm reductionist.

"What we need is to get legislation authorizing syringe exchanges on a statewide level rather than our current system, which requires that they be authorized by local authorities," said Hilary McQuie, Oakland-based Western director of the Harm Reduction Coalition. "Requiring local authorization means we have to deal with 54 jurisdictions instead of just one, and the politics makes it really difficult in conservative places like Fresno or Modesto. It will be really difficult to get syringe exchange approved in Modesto without a statewide mandate," she said.

Short of that, needle exchange advocates need to carefully lay the groundwork beforehand, she said. In that respect, the Modesto needle exchange perhaps suffered from political naivete. "The effort with the grand jury in Modesto was done in good faith, but the grand jury finding required a response from the Board of Supervisors within three months," she noted. "They hadn't really lined up their support with the Board, and the Board ended up voting against it. That was problematic."

While personally difficult for Tribuzio and Robinson, the battle over needle exchanges in Modesto has moved the issue forward locally and stirred support from around the country and the world. A Mono Park 2 Defense Committee has formed to back them. At last week's hearing, more than a dozen supporters were present in court, and the pair had letters of support from some 35 public health and harm reduction organizations here and abroad.

"We've gotten a ton of support from the harm reduction community," said Tribuzio. "This whole thing has been stressful and overwhelming for us, but they've given us a wealth of training, knowledge, and support, more than we ever expected. We've gotten support from people in other exchanges, and letters of support from around the world. We've also been building alliances with people in the community. Things in the Central Valley are crazy, and we can't turn our heads away in the face of disease. Now, at least, people are paying attention."

While Robinson and Tribuzio wait for their legal problems to be resolved, they continue to work with at-risk communities. "After the bust, we started Off The Streets, and that does everything except for needle exchange," said Tribuzio. "We're doing needs assessments, trying to get our fingers on the pulse of the community, trying to help where we can."

For McQuie, the trials and tribulations of the Mono Park 2 are, sadly, par for the course. "This is how most of the programs got started, doing them illegally, so they're in good company," she said.

Asia: Drug Users Form Regional Drug User Organization

In a meeting in Bangkok last weekend, more than two dozen drug users from nine different countries came together to put the finishing touches on the creation of a new drug user advocacy organization, the Asian Network of People who Use Drugs (ANPUD). The Bangkok meeting was the culmination of a two-year process began at a meeting of the International Congress on AIDS in Asia and the Pacific in Colombo, Sri Lanka, in 2007, and resulted in creating a constitution and selecting a steering committee for the new group. ANPUD adopts the principles of MIPUD (Meaningful Involvement of People who Use Drugs), and in doing so, aligns itself with other drug user advocacy groups, including the International Network of People who Use Drugs (INPUD), of which ANPUD is an independent affiliate, the Australian Injection and Illicit Drug Users League (AIVL),the Vancouver Area Network of Drug Users, and the Nothing About Us Without Us movement. ANPUD currently has more than 150 members and sees its mission to advocate for the rights of drug users and communities before national governments and the international community. There is plenty to do. Asia has the largest number of drug users in the world, but is, for the most part, woefully retrograde on drug policy issues. Not only do drug users face harsh criminal sanctions—up to and including the death penalty—but Asian has the lowest coverage of harm reduction services in the world. Access to harm reduction programs, such as needle exchanges and opioid maintenance therapy, is extremely limited. "People who use drugs are stigmatized, criminalized and abused in every country in Asia," said Jimmy Dorabjee, a key figure in the formation of ANPUD. "Our human rights are violated and we have little in the way of health services to stay alive. If governments do not see people who use drugs, hear us and talk to us, they will continue to ignore us." The Director of the UNAIDS Regional Support Team, Dr. Prasada Rao, spoke of the urgent need to engage with drug user networks and offered his support to ANPUD, saying that "For UNAIDS, HIV prevention among drug users is a key priority at the global level," said Dr. Prasada Rao, director of the UNAIDS Regional Support Team. "I am very pleased today to be here to see ANPUD being shaped into an organization that will play a key role in Asia's HIV response. It is critical that we are able to more effectively involve the voices of Asian people who use drugs in the scaling up of HIV prevention services across Asia." "When I go back home, I am now responsible for sharing the experiences with the 250 or so drug users who are actively advocating for better services at the national level," said Nepalese drug user and newly elected steering committee member Ekta Thapa Mahat. "It will be a great way for us to work together and help build the capacity of people who use drugs in Asia." "The results of the meeting exceeded my expectations," said Ele Morrison, program manager for AVIL's Regional Partnership Project. "The participants set ambitious goals for themselves and they have achieved a lot in just two days to set up this new organization. The building blocks for genuine ownership by people who use drugs is definitely there." While the meetings leading to the formation were organized and managed by drug users, the process received financial support from the World Health Organization, the UNAIDS Regional Task Force, and AIVL.
Location: 
Bangkok
Thailand

Feature: Federal Needle Exchange Funding Ban Battle Continues

Years of effort by harm reductionists, public health authorities, HIV/AIDS researchers and activists, and drug law reformers to undo the more than 20-year-old ban on federal funding for needle exchange programs (NEPs) may come to fruition this year, but there are significant obstacles to overcome. Still, advocates of the reform are cautiously optimistic.

Since 1988, the US government has prevented local and state public health authorities from using federal funds for NEPs, which studies have shown to be effective in reducing HIV infection rates among injection drug users (IDUs) and their sexual partners, promoting public health and safety by taking syringes off the streets, and protecting law enforcement personnel from injuries. NEPS have been endorsed by the World Health Organization, the American Medical Association, Centers for Disease Control and Prevention Director Thomas Frieden, and former Surgeons General Everett Koop and David Satcher, among many others.


Chicago map demonstrating the impact of the
1000-foot rule -- click for larger copies and more
maps of Chicago and San Francisco (courtesy
Dr.Russell Barbour, Center for Interdisciplinary
Research on AIDS, Yale School of Medicine)

Injection drug use accounts for up to 16% of the 56,000 new HIV infections in the US every year -- or nearly 9,000 people. IDUs represent 20% of the more than 1 million people living with HIV/AIDS in the US and the majority of the 3.2 million Americans living with hepatitis C infection.

Still, those numbers could have been higher. In a 2008 study, the CDC concluded that the incidence of HIV among injection drug users had decreased by 80% in the past 20 years, in part due to needle exchange programs. There are today an estimated 185 NEPs operating in 36 states, the District of Columbia, and Puerto Rico. But they rely on local or private funds, and many of them are failing to meet demand because of lack of funding. While the CDC says that its public health policy goal is 100% needle exchange, current estimates are that only 3.2% of needles used by drug users in urban areas are exchanged for clean ones.

The federal funding ban was first removed in a July 10 vote of the House Subcommittee on Labor, Health and Human Services, Education, and Related Agencies. A week later, the full Appropriations Committee approved the bill after voting down an amendment proposed by US Rep. Chet Edwards (D-TX) that would have reinstated the funding ban.

But the Appropriations Committee did approve an amendment dictating that federally funded NEPs could not operate "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, or university, or any public swimming pool, park, playground, video arcade, or youth center, or an event sponsored by any such entity."

A floor amendment by Rep. Mark Souder (R-IN) to reinstate the funding ban also was defeated, clearing the way for repeal of the ban to pass the House. But the thousand-foot language remains in the appropriations bill approved by the House, and it's extremely objectionable to reform advocates. The Senate committee working on the issue did not include ending the funding ban, but reform advocates are pinning their hopes on both ending the ban and killing the thousand-foot restriction on the end-game House-Senate appropriations conference committee.

"The Senate has taken up their version of the bill in committee, but hasn't had a full vote," explained Daniel Raymond, policy director for the Harm Reduction Coalition. "At the committee level, the Senate chose not to take any action on the ban. At this point, there is a conflict between the House and the Senate." HRC is lobbying the Senate to repeal the ban, without the restrictions.

"We commend the full House for recognizing that NEPs are essential, effective tools that work in our fight against HIV and hepatitis transmission," said Kevin Robert Frost, chief executive of the Foundation for AIDS Research. "And while the compromise in the bill isn't perfect, we are hopeful that a final bill will reach President Obama's desk without limitations."

"We urge Congress to recognize both the benefit and cost-savings of syringe exchange programs, and the research that NEPs do not have detrimental impact on communities," said Marjorie Hill of Gay Men's Health Crisis, which has just released yet another study demonstrating NEPs' effectiveness in decreasing the transmission of blood-borne diseases. "For too long, we have allowed ideology to drive public health policy. It is time to remove the federal funds ban for syringe exchange and remove the harmful 1,000 feet restriction," added Hill.

"The House bill, as it stands, still puts ideology before science by limiting how federal funds can be used for NEPs," Frost said. "But we have time to fix the legislation, and I'm hopeful that the full US Congress will realize the importance of allowing local elected and public health officials to make their own decisions about how to address their HIV and hepatitis epidemics."

"I believe that the president, the Senate, and the House all want to do the right thing and they're trying to figure out how to do it," said Bill McColl of AIDS Action. "If they follow their own rhetoric about science- and evidence-based HIV/AIDS prevention policy, then they will remove the thousand-foot restriction," he said.

"The thousand-foot provision is a backdoor means of reinstating the funding ban," McColl continued. "There is almost no urban environment in which it would allow needle exchanges to operate. There are no currently existing needle exchanges that would be able to get federal funding, so it just doesn't make sense to change the policy that way. Drug policy groups have gone and literally shown Congress maps of what would be excluded. They've got letters from mayors and police saying this is not a workable provision. Again, Congress and the president know what the science is."

In addition to eliminating federally-funded needle exchanges in vast swathes of the urban landscape, the thousand-foot rule would have other insidious effects, said McColl. "Having that rule would have undesirable side effects, in that it would separate needle exchange from other public health services. Our AIDS program does testing in areas with lots of drug use -- that's where we need to be testing, and that's where we want the population to have clean syringes. With federal funding available and with the thousand-foot rule, prevention services will be driven away from needle exchanges."

Alice Bell, prevention project coordinator for Prevention Point Pittsburgh, already lives with geographical restrictions. "We have a local regulation that specifies 1,500 feet from schools only, not all the other restrictions in the current language of the federal bill. We have to move our main needle exchange site because the building we're in is being sold, and we're having trouble finding a good place. Any federal restrictions would make it even tougher," she said.

Bell wants the federal funding ban ended, but worries that the thousand-foot rule would put a crimp in her efforts. "We still want it. We need the federal funding. Our program is expanding, but we can't really expand our exchange service because we don't have money for needles. The toughest thing is always getting money for needles. Ending the federal funding ban would make a huge difference to us."

Federal funding becomes even more significant when coupled with economic hard times and budget problems at the state and local level, Bell noted. "We're mostly funded through foundations and private donations, and we've begun getting some state and county money for overdose prevention and HIV prevention, but the needle exchange -- the core of what we do -- is the toughest to get funded."

"The Senate will most likely go along with the House in conference committee," said Drug Policy Alliance director of national affairs Bill Piper. "They will probably take a bunch of appropriations bills and put them in a massive omnibus spending bill. It is far from clear that there will be a ban in what comes out of the Congress."

But the thousand-foot rule has to go, he said. "A lot of groups have been lobbying really hard on the thousand-foot issue," Piper noted. "It would be an effective ban is many cities. Here in DC, for example, the only place you could do a needle exchange program would be down at the docks on the Potomac. The strategy is to convince the conference committee to either take that out or come up with something better."

Advocates are lobbying hard right now, said the Harm Reduction Coalition's Raymond. "Right now, we're doing a push to make sure the Senate is educated about the issue and ask the leadership to get on board with House's action to address the ban," he said. "The House version has the thousand-foot restriction, so we're also making the arguments about why that's not workable and needs to be redone. We've been circulating maps showing its impact to House members who are focused on the issue. This restriction goes far beyond any reasonable desire to balance public health with other interests. When that provision was thrown in at the last minute, its effects hadn't really been thought out," he argued.

"We keep up the work in reaching out to Congress on both House and Senate side," said Raymond, "and we're also asking the White House to show some leadership and urge the Senate to address the federal ban. We don't want this issue to get lost in the shuffle, we're calling on everyone in the community to make our voices heard and reaching out to our elected officials."

It may take awhile to get settled, said Piper. "The entire appropriations process is messed up, and a lot of will depend on if, when, and how the Senate deals with health care," he explained. "Supposedly, they will get the appropriations bills done by the end of October, but I think that's a fantasy. Last year, they didn't even do this year's appropriations bills until March."

Still, AIDS Action's McColl maintains a positive outlook. "I think the members who will be called on to vote on this understand the issues," he said. "I have a pretty good feeling about this. I'm hopeful this is the year."

Harm Reduction: Drug-Related Deaths Rose Dramatically in Recent Years, CDC Says

In a report released Wednesday, the Centers for Disease Control (CDC) has found that drug-related deaths -- the vast majority of them overdoses -- increased dramatically between 1999 and 2006, and that drug-related deaths now outpace deaths from motor vehicle accidents in 16 states. That's up from 12 states the previous year and double the eight states in 2003.

More people died from drug-related causes than traffic accidents in the following states: Massachusetts, New Hampshire, Rhode Island, Connecticut, New York, New Jersey, Maryland, Pennsylvania, Ohio, Michigan, Illinois, Colorado, Utah, Nevada, Oregon and Washington.

The news comes even as harm reductionists and public health advocates seek to gain support on Capitol Hill for passage of H.R. 2855, the Drug Overdose Reduction Act, sponsored by Rep. Donna Edwards (D-MD). The bill would create a federal grant program to support both existing and new overdose prevention programs across the country.

"Patients and their families could receive written instructions on how to recognize and respond to an overdose. In addition, college campuses could utilize overdose prevention money to educate students on how to recognize and respond to an alcohol overdose," advocates for H.R. 2855 wrote in a letter to Reps. Henry Waxman (D-CA) and Frank Pallone (D-NJ), chairmen of the House Energy and Commerce Committee and the committee's Health subcommittee, respectively.

Something like H.R. 2855 is desperately needed. According to CDC researchers, who examined death certificate data from around the country, some 45,000 died in traffic accidents in 2006, while 39,000 people suffered drug-related deaths. About 90% of the drug deaths were classified as overdoses, but researchers also included in that figure people who died of organ damage from long-term drug use.

Researchers reported a sharp increase in deaths tied to cocaine and to the opioid analgesics, a class of powerful drugs, used medically for pain treatment (as well as for non-prescription drug-taking via the black market), that includes fentanyl, methadone, morphine, and popular pain relievers like Vicodin and Oxycontin. Cocaine-related deaths jumped from about 4,000 in 1999 to more than 7,000 in 2006, but methadone-related deaths increased seven-fold to about 5,000, and other opioid deaths more than doubled from less than 3,000 to more than 6,000. Interestingly, heroin-related deaths actually declined slightly, hovering just below 2,000 a year throughout the period in question.

And despite all the alarms about young people dying of drug overdoses, the 15-24 age group had the lowest drug-related death rate of any group except those over 65. Only about three per 100,000 young people died of drug-related causes in 2006, compared to six per 100,000 among the 25-34 age group, eight per 100,000 in the 35-44 age group, and 10 per 100,000 in the 45-54 age group.

CDC researchers did not discuss causes for the increase in overall drug-related deaths or the rate of drug-related deaths.

Public Health: Feds Finally Issue Warning on Tainted Cocaine

Three weeks ago, Drug War Chronicle reported on cocaine cut with the veterinary agent levamisole and asked what the federal government was doing about it. Ten days later, the feds responded to the situation, with the Substance Abuse and Mental Health Services Administration (SAMSHA) issuing a public health alert on September 21.

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The alert, sent out to medical professionals, substance abuse treatment centers, and other public health authorities, warned of the "life-threatening risk" that much of the US cocaine supply may be adulterated with the veterinary anti-parasitic drug. It has been linked to a serious, sometimes fatal, blood disorder called agranulocytosis, with SAMHSA saying there are at least 20 confirmed or suspected cases and two deaths in the US associated with the tainted cocaine.

Despite being first noticed by forensic scientists at least three years ago and by the DEA late last year, there has been little public awareness of the public health threat. SAMHSA expects the number of cases to rise as public and professional awareness spreads.

"SAMHSA and other public health authorities are working together to inform everyone of this serious potential public health risk and what measures are being taken to address it," said SAMHSA Acting Administrator Eric Broderick, DDS, MPH.

The addition of levamisole to cocaine is believed to be done by Colombian drug traffickers. Ingesting the tainted drug can seriously reduce a person's white blood cells, suppressing immune function and the body's ability to fight off even minor infections. People who snort, smoke, or inject crack or powder cocaine contaminated by levamisole can experience overwhelming, rapidly-developing, life threatening infections, SAMHSA warned. Other serious side effects can also occur.

The DEA is reporting that levamisole is showed up in over 70% of cocaine analyzed in July, and authorities in Seattle are reporting that 80% of persons testing positive for cocaine are also testing positive for levamisole.

In its alert, SAMHSA warned that:

THIS IS A VERY SERIOUS ILLNESS THAT NEEDS TO BE TREATED AT A HOSPITAL. If you use cocaine, watch out for:

  • high fever, chills, or weakness
  • swollen glands
  • painful sores (mouth, anal)
  • any infection that won't go away or gets worse very fast, including sore throat or mouth sores; skin infections, abscesses; thrush (white coating of the mouth, tongue, or throat); pneumonia (fever, cough, shortness of breath).

The Centers for Disease Control and Prevention (CDC) is also getting in on the act. CDC will shortly publish a case report analysis in its Morbidity and Mortality Weekly Report and will be working with state public health authorities to collect information on the phenomenon. That information will be "used to guide treatment and prevention initiatives to address this public health concern."

One thing the feds are not doing is coming up with a test kit that would allow users to detect the presence of levamisole in cocaine. That's too bad, said Dr. Michael Clark, assistant professor in the Department of Psychiatry and Behavioral Science at the University of Washington Harborview Medical Center. "I thought to myself, why isn't there a test kit? It is easy to test for," he said. "It would be like testing your hot tub for its chemistry. Take a sample, mix some chemicals together, add a reagant, and see what turns what color."

Clark is working on developing just such a test kit. "It could be used at street level, and it could be used by a lot of public health and harm reduction groups. You want to identify levasimole before people ingest, very much like the Ecstasy testing. You could do the same thing with cocaine and levasimole," he said.

MPP of Nevada to Offer $10,000 Challenge: Marijuana is Safer Than Alcohol

MEDIA ADVISORY   
SEPTEMBER 21, 2009

 

MPP of Nevada to Offer $10,000 Challenge:
Marijuana is Safer Than Alcohol -- Prove Us Wrong and We'll Pay $10,000

Press Conference Sept. 23 to Reveal Details


PHOTO-OP: Large Mock Check For $10,000


CONTACT: Dave Schwartz,  MPP-NV Manager...................................................702-727-1081


LAS VEGAS -- At a Las Vegas news conference Sept. 23, the Marijuana Policy Project of Nevada will announce details of a $10,000 challenge to the people of Nevada. MPP-NV will pay $10,000 to anyone who can disprove three statements of fact that demonstrate that marijuana is objectively and unquestionably safer than alcohol.


     MPP-NV manager Dave Schwartz will unveil a large mock check for $10,000 as he announces specifics of the challenge, which kicks off a long-term public education campaign regarding the relative harms of marijuana and alcohol, and the harm caused by marijuana prohibition.


     WHAT: News conference to announce the Marijuana Policy Project of Nevada's $10,000 challenge


     WHO: MPP-NV manager Dave Schwartz


     WHEN: Wednesday, Sept. 23, 11:00 a.m.


     WHERE:  Near the emergency room entrance of University Medical Center Hospital (behind the hospital), corner of Goldring Avenue and Rose Street, Las Vegas.

     MPP of Nevada is a nonprofit organization dedicated to educating Nevadans about the true nature of marijuana and about the harms caused by marijuana prohibition in the state. For more information about MPP of Nevada, please visit http://www.mppnv.org.

####

Location: 
NV
United States

Overdose and Other Drug-Related Deaths Now Closing In on Car Wrecks as Leading Accidental Killer in US

In a report released Wednesday, the Centers for Disease Control (CDC) has found that drug-related deaths—the vast majority of them overdoses—increased dramatically between 1999 and 2006, and that drug-related deaths now outpace deaths from motor vehicle accidents in 16 states. That's up from 12 states the previous year and double the eight states in 2003. More people died from drug-related causes than traffic accidents in the following states: Massachusetts, New Hampshire, Rhode Island, Connecticut, New York, New Jersey, Maryland, Pennsylvania, Ohio, Michigan, Illinois, Colorado, Utah, Nevada, Oregon and Washington. According to CDC researchers, who examined death certificate data from around the country, some 45,000 died in traffic accidents in 2006, while 39,000 people suffered drug-related deaths. About 90% of the drug deaths were from overdoses, but researchers also included in that figure people who died of organ damage from long-term drug use. Researchers reported a sharp increase in deaths tied to cocaine and to the opioid analgesics, a class of powerful drug that includes fentanyl, methadone, morphine, and popular pain relievers like Vicodin and Oxycontin. Cocaine-related deaths jumped from about 4,000 in 1999 to more than 7,000 in 2006, but methadone-related deaths increased seven-fold to about 5,000, and other opioid deaths more than doubled from less than 3,000 to more than 6,000. Oddly enough, heroin-related deaths actually declined slightly, hovering just below 2,000 a year throughout the period in question. And despite all the alarums about young people dying of drug overdoses, the 15-24 age group had the lowest drug-related death rate of any group except those over 65. Only about three per 100,000 young people died of drug-related causes in 2006, compared to six per 100,000 among the 25-34 age group, eight per 100,000 in the 35-44 age group, and 10 per 100,000 in the 45-54 age group. CDC researchers did not discuss causes for the increase in overall drug-related deaths or the rate of drug-related deaths, but several plausible (and complementary) explanations come to mind: the introduction and widespread use of Oxycontin, the fentanyl-tainted heroin epidemic that appeared in 2006, the increasing non-medical use of prescription pain relievers, and the increasing use of methadone as a pain reliever.
Location: 
Atlanta, GA
United States

Harm Reduction: Pennsylvania Allows Syringe Sales Without Prescription, Effective Immediately

Responding to years of agitation by harm reductionists and public health advocates, the Pennsylvania Board of Pharmacy Saturday published new regulations that will allow pharmacies to sell syringes without a prescription. The change goes into effect immediately. The move was lauded by activists as a significant public health victory in the battle against the spread of HIV/AIDS and Hepatitis C via injection drug use.

http://stopthedrugwar.org/files/nline.gif
popular syringe exchange logo
Under previous regulations, pharmacies could sell syringes only to people who obtained a doctor's prescription. The new regulations carry no limit on the number of syringes that can be purchased at a time, nor do they have age limits.

"This change is particularly important in Pennsylvania because we have only two locations -- Pittsburgh and Philadelphia -- in which legally authorized syringe exchange programs operate," said David Webber, an attorney for the AIDS Law Project of Pennsylvania. "These two programs alone are simply not adequate to address this problem across the entire state, but syringe exchange programs continue to be crucial in providing sterile syringes as well as access to drug treatment and health care for injection drug users."

"This is a chance for every pharmacy to become part of HIV prevention in Pennsylvania," said Scott Burris, professor at Temple University's School of Law and a national authority on syringe regulation and HIV prevention. "The pharmacy board has taken an important step forward for evidence-based policy."

It didn't come swiftly or easily. Activist organizations including the Pennsylvania Aids Law Project, Prevention Point Pittsburgh, Prevention Point Philadelphia, as well as legislators, HIV workers, and others had lobbied for the change for a decade. An article in the Lancaster Intelligencer Journal cited several efforts:

  • In 2002, a group called the Pennsylvania Coalition for Responsible Syringe Policy asked the Pharmacy Board to consider deregulation.
  • In 2005, another group called Pennsylvanians for the Deregulation of Syringe Sales filed a formal petition to the Board, and met with legislators and officials in the Rendell Administration.
  • In 2007, the the Pennsylvania Pharmacists Association endorsed syringe deregulation and asked the Pharmacy Board to move swiftly on it.

Robert Field, organizer of Pennsylvanians for the Deregulation of Syringe Sales and co-chair of the Lancaster-based Common Sense for Drug Policy, told the Intelligencer Journal he looked at syringe deregulation after efforts to start a syringe exchange program in Reading met with opposition. The board responded in August 2007, proposing new regulations allowing for over-the-counter syringe sales and opening them up for public comment. Thanks to concerns expressed by harm reduction and public health groups during the comment period, the board removed age and quantity restrictions.

The board heard a number of concerns from the Pennsylvania Medical Society that the rule change would increase drug use. But research won the day. "Studies indicate that making syringes available will reduce the spread of HIV and will not lead to an increase of illicit drug use," said Field.

The board also rejected record-keeping requirements requested by the House Professional Licensure Committee, saying it "does not believe that maintaining a record and requiring individuals to provide a name or other identifying information would advance the public health and safety."

Now the number of states that do not allow syringe sales without a prescription is down to two: Delaware and New Jersey.

Harm Reduction: Pennsylvania Allows Syringe Sales Without Prescription, Effective Immediately

Responding to years of agitation by harm reductionists and public health advocates, the Pennsylvania Board of Pharmacy Saturday published new regulations that will allow pharmacies to sell syringes without a prescription. The change goes into effect immediately. The move was lauded by activists as a significant public health victory in the battle against the spread of HIV/AIDS and Hepatitis C via injection drug use. Under previous regulations, pharmacies could sell syringes only to people who obtained a doctor’s prescription. The new regulations carry no limit on the number of syringes that can be purchased at a time, nor do they have age limits. “This change is particularly important in Pennsylvania because we have only two locations--Pittsburgh and Philadelphia--in which legally authorized syringe exchange programs operate,” said David Webber, an attorney for the AIDS Law Project of Pennsylvania. “These two programs alone are simply not adequate to address this problem across the entire state, but syringe exchange programs continue to be crucial in providing sterile syringes as well as access to drug treatment and health care for injection drug users.” “This is a chance for every pharmacy to become part of HIV prevention in Pennsylvania,” said Scott Burris, professor at Temple University’s School of Law and a national authority on syringe regulation and HIV prevention. “The pharmacy board has taken an important step forward for evidence-based policy.” It didn’t come swiftly or easily. Activist organizations including the Pennsylvania Aids Law Project, Prevention Point Pittsburgh, Prevention Point Philadelphia, as well as legislators, HIV workers, and others had lobbied for the change for a decade. In August 2007, the pharmacy board proposed new regulations allowing for over-the-counter syringe sales and opened them up for public comment. Thanks to concerns expressed by harm reduction and public health groups during the comment period, the board removed age and quantity restrictions. The board rejected record-keeping requirements requested by the House Professional Licensure Committee, saying it “does not believe that maintaining a record and requiring individuals to provide a name or other identifying information would advance the public health and safety.” Similarly, it rejected a number of concerns from the Pennsylvania Medical Society that the rule change would increase drug use. The board’s action reflected well-established scientific evidence that access to clean syringes is a critical component of stemming the spread of blood-borne diseases such as HIV and Hep C among injection drug users. Now the number of states that do not allow syringe sales without a prescription is down to two: Delaware and New Jersey.
Location: 
PA
United States

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