Harm Intensification

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California Good Samaritan Drug Overdose Bill Signed Into Law

California Gov. Jerry Brown Monday signed into law Assembly Bill 472, the "911 Good Samaritan Bill," aimed at reducing fatal drug overdoses by removing the threat of criminal prosecution for people who seek assistance for people suffering from them. California becomes the 10th state to enact such a law since New Mexico led the way back in 2007.

fatal drug overdose (wikimedia.org)
Sponsored by Rep. Tom Ammiano (D-San Francisco), the bill received bipartisan support in the legislature and was cosponsored by the Drug Policy Alliance, the ACLU of California, and the Health Officers Association of California.

"This is a great victory for parents. None of us want our kids overdosing on drugs, but as I told the legislature, I'd rather have my kid around to yell at than attend a funeral," said Ammiano. "The young friends of those who overdose shouldn’t hesitate to seek help because they fear arrest. With the Governor's signature, they won't have to."

"This is an incredibly special day for the thousands of California family members who worked so hard and for so long to pass this life-saving bill," said Meghan Ralston, harm reduction manager of the Drug Policy Alliance. "This is just a small first step in reducing the number of fatal overdoses in California, but it's a deeply important one."

Drug overdose deaths are the number one cause of accidental death in California, as in many other states. The new law encourages people to seek emergency health services when they witness an overdose by providing limited protections from charge and prosecution for low-level drug law violations, including possession of small amounts of drugs. Those who sell drugs are not protected under the new law.

"I never go a day without thinking of my son Jeff and I never will," said Denise Cullen, cofounder of GRASP (Grief Recovery After a Substance Passing). "Losing a child to a drug overdose is a tragedy in ways I can't explain, but fighting so hard for him and for all the parents just like me, to get this law passed is really the best possible way I can honor him."

"After forty years of the war on drugs, California is finally righting its priorities by putting saving lives ahead of making petty arrests. The message is loud and clear: call for help in case of an overdose. This is an important step toward better drug and public health policies and it will save lives," said Margaret Dooley-Sammuli, senior policy advocate for the ACLU of California.

"The physician Health Officers who provide leadership for public health programs in every county are grateful to Governor Brown for partnering with us on this common sense, no-cost approach to saving lives," said Bruce Pomer, executive director of Health Officers Association of California. "It's urgently needed."

Now the task is to get the word out to those populations where it will do the most good. Advocates from dozens of state and local organizations will be working to do just that, both before the new law goes into effect on January 1, and throughout the following year.

Sacramento, CA
United States

Danes Want Heroin Pills for Addicts

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

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

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

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

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

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

Copenhagen
Denmark

California Drug Overdose Prevention Bill Passes

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

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

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

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

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

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

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

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

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

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

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

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

Sacramento, CA
United States

New Jersey Good Samaritan Overdose Bill Passes

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

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

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

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

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

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

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

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

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

Trenton, NJ
United States

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

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

http://stopthedrugwar.org/files/aids2012-protest-1.jpg
activists interrupt the conference opening session to protest the exclusion of drug users and sex workers (video at droginreporter.hu/en)
But other critical groups remained excluded -- drug users and sex workers. Although they make up a majority of people living with HIV in many countries, people who admit to ever using drugs or engaging in prostitution within the past 10 years are inadmissible under US immigration laws. The State Department could have issued a blanker waiver of inadmissibility for people attending the conference, but declined to do so.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Washington, DC
United States

Obama Signs Synthetic Drug Ban Bill

President Barack Obama Monday signed into law a bill banning the synthetic drugs known popularly as "bath salts" and "fake weed." The language barring the substances was inserted into the Food and Drug Administration safety bill passed last month by the Congress.

Bye-bye Spice, hello...? (wikimedia.org)
The bill targets 31 specific synthetic stimulant, cannabinoid, and hallucinogenic compounds. Marketed under brand names like K2 and Spice for synthetic cannabinoids and under names like Ivory Wave, among others, for synthetic stimulants, the drugs have become increasingly popular in recent years.

With their rising popularity came rising reports of emergency room visits and poison control center calls attributed to the drugs. Synthetic cannabinoids have been linked to symptoms similar to those suffered by people who sought medical help after smoking marijuana, while the adverse reactions reported by "bath salts" users have been more serious.

More than half the states and numerous localities have moved to ban some of these new synthetics, and the DEA placed both groups of substances under an emergency ban until Congress acted.

Congressional advocates of the prohibitionist approach to new synthetics were pleased.

"President Obama's swift approval of this federal ban is the final nail in the coffin for the legal sale of bath salts in smoke shops and convenient stores in New York State and throughout the rest of the country," said Schumer in a press release (which also includes a complete list of the 31 banned substances). "This law will close loopholes that have allowed manufacturers to circumvent local and state bans and ensure that you cannot simply cross state lines to find these deadly bath salts, and I'm pleased that after a great deal of effort, it has become law. We have seen bath salts catalyze some of the most heinous crimes in recent months across Upstate New York, and the President's signature ensures that the federal government can fight this scourge with a united front, across state lines and at our borders."

Schumer used the occasion to take a jab at Sen. Rand Paul (R-KY), who had placed a senatorial hold on the bill, blocking it for months over his concerns about mandatory minimum sentences before removing the hold after the bill's sentencing structure was modified. Schumer gloated that Congress passed the bill "over the strenuous objections" of Paul.

While Schumer and his colleagues claimed the bill will suppress the new synthetics, others were not so certain.

New York state anti-synthetic activist Deirdre Canaday, whose 26-year-old son Aaron Stinson died last year after smoking a form of fake weed called Mr. Nice Guy, told a local TV news station the ban addressed only a handful of potential new synthetic drugs.

"I think if the American public isn't careful, they'll think this issue has been addressed when this is really just the tip of the iceberg," she said. "By specifically labeling chemical compounds, they are creating an open door for these basement and garage chemists to create analogs, which is branching out from the original compound, and differing just slightly, and it still has the same effect," said Canaday.

Washington, DC
United States

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

London
United Kingdom

Kenya to Distribute Needles to Injection Drug Users

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

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

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

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

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

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

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

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

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

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

Mombasa
Kenya

US Senate Passes Synthetic Drug Ban, Without Mandatory Minimums [FEATURE]

The Senate has passed House Resolution 1254, the Synthetic Drug Control Act of 2011, which would federally criminalize the possession, distribution, and manufacture of synthetic cannabinoids ("fake marijuana") and synthetic stimulants ("bath salts"). The measure has already passed the House, and President Obama is expected to quickly sign it into law.

The synthetic cannabinoids are marketed as "herbal incense" and sold under brand names such as K2 and Spice, while the synthetic stimulants are marketed as "bath salts" and sold under a variety of names, including Ivory Wave and Vanilla Sky. Poison control centers and emergency rooms around the country have reported a sharp increase in synthetic drug incidents in the past two years, with Spice users reporting adverse effects similar to those sometimes reported with marijuana, while bath salts users have suffered more serious adverse effects, including hallucinations, psychotic breaks, and death.

Fake pot or bath salts or both are already banned in a number of states, and more states are considering criminalizing them. Both types of drugs have already been subject to emergency bans by the DEA while its legislatively mandated process for evaluating new drugs proceeds.

A widely publicized incident over the weekend in which a man chewed off parts of another man's face before being shot and killed by police has heightened concerns about the new synthetics, generating headlines like "Miami cannibal zombie-like attack linked to powerful 'bath salts' drug," but at this point, such claims are pure speculation. Police in the case have also posited "a new form of LSD" and "cocaine psychosis" to explain the attack, but any real information will have to await a toxicologist's report.

Sen. Rand Paul (R-KY) had single-handedly blocked passage of the bill for months by placing a senatorial hold on it. Paul objected to harsh mandatory minimum sentences in the bill, as well as to further broadening of the federal war on drugs.

But bill supporters, led by Sen. Charles Schumer (D-NY), resorted to a parliamentary maneuver to get it passed. They quietly attached it to an FDA regulatory bill, which the Senate passed last Wednesday.

Sen. Rand Paul got mandatory minimums removed
Still, Sen. Paul was able to insert language into the bill specifying that the Controlled Substance Act's mandatory minimum 20-year sentence for anyone supplying a drug that causes severe bodily harm or death to a user does not apply to the newly banned synthetics. That's because in order to get the FDA bill approved by Memorial Day, Sen. Rob Portman (R-OH), who actually sponsored the amendment adding the synthetics to the FDA bill, had to win unanimous consent for his amendment. Paul agreed not to object after Portman inserted the language about the mandatory minimums.

The bill still contains draconian sentencing provisions, including sentences of up to 20 years for a first sale or manufacturing offense and up to 30 years for a subsequent offense.

The bill's sponsors said after the vote that its passage would strike a strong blow against the new synthetics, but industry advocates and the Congressional Budget Office (CBO) disagree.

"Let this be a warning to those who make a profit manufacturing and selling killer chemical components to our teens and children: the jig is up," Schumer said in a statement. "This bill closes loopholes that have allowed manufacturers to circumvent local and state bans and ensures that you cannot simply cross state lines to find these deadly synthetic drugs."

"These new designer drugs can kill, and if we don't take action, they are going to become more and more prevalent and put more and more people at risk," Sen. Amy Klobuchar (D-MN), another sponsor of the bill said in a statement. "Today's action is good news for this critical legislation to give law enforcement the tools they need to crack down on synthetic drugs before they put more lives in danger, and I will continue to work to ensure these provisions are signed into law."

But the Retail Compliance Association (RCA), which represents smoke shop and convenience store operators and which opposed the bill, pointed out that the bill only bans five chemical families and only names 15 synthetic cannabinoids. Many of those compounds are already off the market, the RCA said, adding that the bill does not include hundreds of additional compounds unrelated to the chemical families banned under it.

"This bill will be touted as banning what law enforcement has deemed 'fake pot,' but it does no such thing; it actually only bans a few of the potential ingredients of these products, by no means the products themselves," said RCA spokesman Dan Francis. "The bill's range of enforcement may well be limited to the specifically named compounds because labs cannot test for chemical families, nor can the police or retailers. The products are tested by many different levels of this industry, and no lab I have spoken with has a test to determine the chemical family," Francis added.

The CBO, for its part, published a cost analysis of the bill in November that found its impact would be minimal.

"Based on information from industry and law enforcement experts, CBO expects that, by the date of the legislation's enactment, most vendors will have largely replaced the banned substances with new products because many states have already passed legislation banning some or all of the compounds listed in the bill and because the DEA has already issued emergency rules temporarily banning five cannabimimetic agents and three synthetic stimulants," the analysis found.

Still, Congress can pat itself on the back for "doing something" about the new synthetic drugs -- whether or not it actually does anything good.

Washington, DC
United States

Australia Bans Synthetic Marijuana

As of Tuesday, synthetic cannabis ("fake weed") products are illegal in Australia. The ban came when the Therapeutic Goods Administration placed eight groups of synthetic cannabinoids and all synthetic cannabinomimetics on the National Medical and Poisons Schedule.

"spice" or K2 packet (wikimedia.org)
Fake weed is already banned in at least 16 countries and an ever-growing number of US states. The DEA issued an emergency ban on the substances last year, but a bill to make that ban permanent has been stalled in Congress by a hold placed on it by Sen. Rand Paul (R-KY).

Fake weed consists of powdered synthetic cannabinoids, which are then sprayed on herbal matter and marketed under brand names including Kronic, K-2, and Spice. They produce a high similar to marijuana and sometimes create undesired side effects in users similar to those sometimes experienced with marijuana. No deaths in the US have been directly linked to their use.

Possession, manufacture, or sale of fake weed is now a criminal offense in Australia with violators facing fines or jail, including up to 10 years in prison for manufacturing and distribution offenses.

The ban came after police last month called for urgent meetings with public health and drug authorities. The state of Western Australia last year requested consideration of a national ban and had banned fake weed in its territory last year after a spate of highly-publicized hospitalizations of users, but no other Australian state had enacted a ban.

"These products do not appear to have any legitimate therapeutic use and there is a developing international body of evidence and clinical experience that is showing harm related to use of these substances," said Western Australia Mental Health Minister Helen Morton, who had championed the ban there last year. "Removing synthetic cannabinoids from legal supply, sale and possession is expected to result in a significant decrease in consumption and the associated harm related to their use," she told Perth Now.

Ironically, the surge in fake weed use in Western Australia came as the state government there toughened its marijuana laws last year. Prior to the enactment of that law last August, possession of up to 30 grams of pot had been decriminalized, but under the new law, those possessing more than 10 grams face up to two years in prison. The cultivation of up to two plants had also been decriminalized, but is now punishable by up to two years in prison as well.

Canberra
Australia

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