Harm Intensification

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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

Billboard Goes Up for Colorado Marijuana Initiative

In the opening move of its election season effort to pass Amendment 64, a marijuana legalization and regulation initiative, the Colorado Campaign to Regulate Marijuana Like Alcohol has put up a billboard in the heart of Denver featuring a nice, middle aged woman who says, "For many reasons, I prefer marijuana over alcohol" and asks "Does that make me a bad person?"

the first billboard in the Colorado campaign (CRMLA)
The billboard near Mile High Stadium sits above a liquor store. It went up last Thursday.

The initiative, which takes the form of a constitutional amendment, legalizes the possession of up to an ounce of marijuana by adults 21 and over. Adults would also be able to possess up to six plants -- three mature -- and the fruits of their harvest.

It also calls for the licensing of marijuana cultivation facilities, product manufacturing facilities, testing facilities, and retail stores. It would require the legislature to pass an excise tax on the wholesale sale of marijuana and that the first $40 million in tax revenues each year be dedicated to the state's public school capital construction assistance fund. It would give local governments the ability to regulate such facilities or prohibit them.

In the most recent polling on the issue, a December Public Policy Polling survey found that 49% supported the general notion of legalizing marijuana -- the poll did not ask specifically about Amendment 64 -- while 40% opposed it and 10% were undecided.

That shows that victory is within reach, but by no means assured. One of the key demographic groups needed to win is mothers and middle-aged women, like that nice lady on the billboard.

Colorado isn't the only state where marijuana legalization will be on the ballot. A similar effort in Washington has qualified for the ballot, while signature-gathering for initiatives continues in a number of states. Of those, efforts in Oregon and Montana now appear to have the best shot of actually qualifying for the ballot.

Greece to Hand out Needles, Condoms in AIDS Fight

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

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

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

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

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

Athens
Greece

UN Anti-Drug Body Supports Overdose Prevention Measures

Delegates to the 55th session of the UN Commission on Narcotics Drugs (CND) in Vienna unanimously approved a resolution to promote measures to prevent drug overdose deaths last Friday. The resolution calls on the UN Office on Drugs and Crime (UNODC), the World Health Organization (WHO), and other international organizations to work with individual countries to address and reduce drug overdoses. Crucially, the resolution included mention of naloxone, an opioid antagonist that can effectively reverse opiate overdoses and which does not carry any danger of abuse.

Naloxone can save lives, the CND recognized Friday (wikimedia.org)
The resolution was introduced by the Czech Republic and cosponsored by Israel and Denmark (the latter on behalf of the European Union). Earlier in the week, Gil Kerlikowske, head of the US Office on National Drug Control Policy (ONDCP -- the drug czar's office) affirmed US support for overdose prevention. In his opening statement at the week-long session, Kerlikowske endorsed training public health and medical personnel in overdose recognition and response, as well as the use of naloxone and other overdose reversal medications.

"Every life is worth saving," said Dasha Ocheret, policy and advocacy program manager for the Eurasian Harm Reduction Network. "Everyone knows someone who has died from an overdose. It's thrilling that the United Nations recognizes this is a problem to be taken seriously and something can be done."

"This represents a critical step towards improving global public health," said Donald McPherson, director of the Canadian Drug Policy Coalition and former drug policy coordinator for the city of Vancouver. "The global overdose epidemic can be addressed with meaningful, evidence-based interventions to reduce the immediate potential harms associated with opioid use, and prevent unnecessary death. It is heartening to witness CND member countries take this step together to save lives."

The biggest risk of fatal overdose is around opiates and opioid pain medications. According to the UNODC, "the ingestion of opioids accounts for nearly half of the global drug-related deaths, and the majority of deaths could have been prevented." The UNODC puts the number of user of opium derivatives, both medical and non-medical, at around 21 million worldwide.

Opioid overdose deaths are generally preventable for three reasons: The deaths occur gradually after drug use, there are typically other people present, and the effects of overdose can be reversed with naloxone, also known under its brand name, Narcan.

In some countries, including some states in the US, there are ongoing programs to offer naloxone to drug users, their friends, and family members. Last fall, Massachusetts announced its 1,000th overdose reversal using naloxone. New Mexico has also been a pioneer in expanding the use of naloxone.

"Naloxone is a safe and effective medication that has been available for more than forty years," said Sharon Stancliff of the New York City-based Harm Reduction Coalition. "It's exciting that the UN has officially recognized the importance of making this life-saving medication more widely available. It is vital that it is made accessible to people who need it, both inside the hospital setting and outside, through emergency services and to family members of opioid users."

Vienna
Austria

DEA Extends Ban on Fake Marijuana Chemicals

The DEA has extended for another six months its emergency ban on five synthetic cannabinoids used to manufacture "fake weed" products. The chemicals are sprayed on herbal mixtures and the resulting product is sold under names including Spice and K2.

The agency first enacted the ban a year ago, but that emergency ban was set to expire last Thursday. The DEA published the extension in the federal register that same day.

The extension continues the ban on five synthetic cannabinoids: JWH-018, JWH-073, JWH-200, CP-47,497 (that's all one chemical CP-47,497) and cannabicyclohexanol. The ban means those substances are treated as Schedule I drugs under federal law.

"Schedule 1 substances are reserved for those substances with a high potential for abuse, no currently accepted medical use in treatment in the United States and a lack of accepted safety for use of the drug under medical supervision," the DEA reminded in a press release last Wednesday.

The American Association of Poison Control Centers reported last month that after synthetic marijuana products first appeared on their radar in 2009, generating several hundred calls, the number jumped to 2,906 calls in 2010 and 6,956 last year. Their data also showed that the number of calls peaked in July 2011 at 705 and have declined since then, with 551 calls reported in December.

The poison centers and emergency room doctors have reported such symptoms as disorientation, elevated heart rates, and vomiting, similar to those reported from adverse reactions to marijuana. There are no confirmed reports of overdose deaths, and only a handful of deaths potentially linked to synthetic marijuana, including a trio of suicides after use, a young man killed in a traffic accident while driving after use, and a 13-year-old Pennsylvania boy who smoked synthetic weed out of a plastic Pez dispenser and later died of complications from a lung transplant.

"We continue to address the problems of synthetic drug manufacturing, trafficking, and abuse. Our efforts have clearly shown that these chemicals present an imminent threat to public safety," said DEA Administrator Michele M. Leonhart. "This six month extension is critical and gives us the time necessary to conduct the administrative scheduling process for permanent control.

A number of states have and localities have already banned synthetic marijuana, and more are moving to do so this year. Federal legislation that would ban both synthetic marijuana and new synthetic stimulants ("bath salts") has passed the House, but is being blocked in the Senate by a hold placed on it by Sen. Rand Paul (R-KY).

This week, the Drug Policy Alliance (DPA) joined the American Civil Liberties Union, NAACP and nearly 40 other organizations on a letter to members of the Senate urging them to oppose the legislation. In a separate press release, DPA urged Congress to not just reject the synthetic drug legislation but also overhaul US drug policy, pointing out that last year marked the 40th Anniversary of President Nixon declaring a war on drugs, and despite the government arresting tens of millions of nonviolent Americans and spending more than a trillion dollars, drugs are cheap, potent, and readily available in every community.

"Senator Rand Paul is standing up to both political parties and doing what it takes to protect Kentucky taxpayers from the career politicians in Washington who want to waste more money on failed drug policies," said Bill Piper, DPA director of national affairs. "He should be applauded for opposing government waste and supporting public safety. The failed war on drugs costs too much and achieves too little; it is time for a new approach."

Washington, DC
United States

Police Refuse to Release Description of Toxic Ecstasy Pills, Increasing the Danger of More Deaths

A string of recent overdose deaths in British Columbia has a lot of people deeply concerned. But this reaction by law enforcement is certain to make the problem worse.

VANCOUVER — Police in B.C. are reluctant to tell the public what unique markings are on ecstasy pills suspected to contain a lethal additive linked to five deaths in the province.

That's because they don't want users thinking they're sanctioning the rest of the pills. [CTV]

That is some sick logic right there. Listen, if you don't want people to think you're sanctioning the other pills, then say something like, "we're not sanctioning the other pills." What's so hard about that? But for the sake of saving human lives, at least tell people what the poison pills look like. 

Drug users are people, you know. They don't want to kill their friends. If everyone knows what the poisoned pills look like, they can help get them off the street. Everyone in the ecstasy scene will be on the lookout for the toxic doses and the people supplying that garbage will be strongly incentivized to toss it, or face serious consequences within their own social circle. This will work like 900% better than just telling everyone to stop taking ecstasy altogether.

We'll save for another day the conversation about why poisoned ecstasy exists in the first place (hint: the manufacturing process is dangerously unregulated).  

Tainted Ecstasy Linked to Western Canada Deaths

A cluster of recent fatalities among ecstasy (MDMA) users in western Canada has been linked to tainted drugs. At least five people in Alberta and three in British Columbia have died in the past few weeks. In six of those cases so far, paramethoxymethamphetamine (PMMA) has been found in toxicology reports.

Ecstasy -- or is it? (wikimedia.org)
The outbreak of deaths began last month in Calgary, and by December 29, Alberta Health Services sent out an alert warning that "Ecstasy or a combination of toxic substances sold on the street as Ecstasy is the likely cause of three recent Calgary-area deaths."

Then, in a new joint warning on January 11, the city of Calgary and Alberta Health Services announced that the province's chief medical examiner had confirmed that "paramethoxymethamphetamine (PMMA) and methamphetamine -- not previously associated with street drugs sold in Calgary as 'ecstasy' -- was present in toxicology results for each of five recent Calgary-area street-drug deaths."

On Thursday, British Columbia Provincial Health Officer Dr. Perry Kendall confirmed that PMMA had shown up in one of the BC deaths, while toxicology reports were still outstanding in the two other cases.

PMMA is thought to be a less expensive compound to produce than ecstasy, similar in appearance, and produces similar, though stronger, psychoactive and physical effects. Its use as an adulterant has been linked to earlier clusters of deaths in Norway and the Netherlands.

"There are some important differences in the toxicity of PMMA compared to MDMA" said Dr. Mark Yarema, Medical Director of the Poison and Drug Information Service (PADIS). "Although all have toxic effects, PMMA is considered more toxic than MDMA, with a higher incidence of seizures and elevated body temperature. Also, the onset of action of PMMA is delayed and its initial effect may be milder. This is dangerous as it may result in users ingesting several tablets to achieve a desired effect, with potentially fatal consequences."

If Canada is going to continue to subject recreational drug users to the Russian roulette of buying drugs without quality controls or ingredients labeling in the black market, it behooves drug users to do what they can to protect themselves. They could start by checking in with organizations such as DanceSafe or checking into ecstasy testing kits.

Canada

Chronicle Film Review: Prohibition

Prohibition: A Film by Ken Burns and Lynn Novick (2011, Florentine Films/WETA, 3 discs, 5 ½ hrs., $41.99)

One of America's leading documentarians has done it again. Ken Burns, producer of the widely watched and hailed documentaries, Baseball and The Civil War, has now teamed up with Lynn Novick to examine the rise, fall, and repeal of the 18th Amendment banning alcohol sales and production. It is a worthy effort, and well-executed.

Prohibition "postcards" online at pbs.org/kenburns/prohibition/send-postcards/
The multi-hour must-see premiered over three nights this week on PBS, pulling in nearly four million viewers on its opening night -- very big numbers for public TV. It's also available online at the PBS Ken Burns Prohibition web site.

For most us of Prohibition is ancient history, skimmed over bloodlessly in dusty tomes in high school and undergraduate history courses. My 83-year-old mother, for instance, was still a toddler when revelers across the land tippled with delirious joy to mark repeal. For anyone younger than her -- and that's most of us -- Prohibition is no more than a school lesson, not a thing of living memory, except, perhaps, for an old story or two told by grandpa or grandma.

One of the successes of Prohibition is the way it brings that dry history to life. Through the skillful use of contemporary film, photographic stills, oral history, written remembrances narrated by actors, and a lively narration by Peter Coyote, Burns and Novick are able to recreate the living, breathing reality of second half 19th and early 20th Century America. Staring face to face at the glowering glare of a doughty battle-axe like Carrie Nation or the lizard-lidded, full-lipped gaze of Chicago gangster Al Capone, listening to Al Smith rail against the dries or Mabel Willibrand rally preachers against repeal, helps us put a human face on the  passions and frailties behind the march of the social revolution that was Prohibition and the mass rejection of it that was repeal.

Similarly, vivid scenes of saloon debauchery, with passed out drunks and giddy tipplers, of speakeasies filled with good-time guys and giddy flappers, of mass marches for and against, of political conventions and campaigns in which Prohibition was a burning issue of the day, help put living flesh on the dry bones of history.

The early 20th Century experiment in social control and legislating morality contains many lessons for contemporary activists seeking to undo the damage done by drug prohibition. Burns and Novick deserve our thanks for teasing out the varied strands that turned the 19th Century's temperance movement among mostly rural, Protestant, church-going women into a political powerhouse capable of blunting the power of big booze, shuttering the breweries and distilleries, and eliminating the saloons men saw as their last refuge from the demands of wife and children.

For me, the most important achievement of Prohibition is the way in situates the temperance movement within the broader social and political context of a tension-filled, rapidly evolving America. As Burns and Novick make abundantly clear, Prohibition did not happen in a vacuum. Among the forces propelling it were many of the same forces active today propelling reactionary social movements: racism (directed against newly arrived Irish, German, and Jewish immigrants), nativism (ditto), religious bigotry (aimed at those Catholic immigrants), nationalism (against mainly German-American beer brewers, especially during World War I), and rural vs. urban tensions.

But while it may be easy to ridicule the reactionaries of the last century, the roots of Prohibition also come uncomfortably close for present-day progressives. The temperance movement -- in all its intemperance -- was closely tied to "what about the children!" sentiment and women's suffrage, a cry for healthy living,  as well as the sort of "do-gooderism" conducted by "busybodies" that still informs much of the discourse when it comes to drug policy reform today.

As Prohibition shows most excellently, the politics of morality and social control are deep and twisted, and unraveling them reveals some unflattering facets of progressivism, as well as the more easily derided absolutists of what could fairly be called the Christian Right.

Where Prohibition is perhaps most useful to modern day drug reformers is in its depiction of the social ills it generated. Much as the Drug Policy Alliance likes to say "drug abuse is bad, drug prohibition is worse," viewers of Prohibition could fairly draw the conclusion that "mass drunkenness is bad, mass drunkenness under Prohibition is worse." Burns and Novick sketch the rapid expansion of organized crime under Prohibition, the gang wars of Chicago and New York, the corruption of cops and public officials -- all the side-effects of prohibition so familiar to present day reformers.

Prohibition "postcards" online at pbs.org/kenburns/prohibition/send-postcards/
But they also look at its public health consequences, which -- like current drug prohibition -- were also in many ways disastrous. There were mass deaths from bad bathtub gin, deaths from drinking wood alcohol, outbreaks of "Jake Leg," a neurological disorder caused by contaminated whiskey that crippled hundreds, if not thousands, and while alcohol consumption initially declined, that decline was soon reversed, and with even more unhealthy drinking patterns.

In the end, Prohibition died of neglect, ridicule, and changing social attitudes, forged at least in part by the experience of Prohibition itself. And at the end, it revealed itself to be hollow, crumpling with amazing rapidity after the Great Depression hit and the big city, immigrant-friendly Democrats under FDR took power. Before the end of FDR's first year in office, Prohibition was history.

There are many lessons and parallels for contemporary drug reformers in Prohibition, but they are not exact and may not apply across the board. Alcohol prohibition lasted barely a decade, but drug prohibition is now in its second century. Why one was a flash in the pan and the other remains a painful, enduring legacy are questions that need to be answered if we are ever to leave drug prohibition in the dustbin of history along with Prohibition. Prohibition can help us start to ask the questions that will give us the right answers.

Disappointingly, Ken Burns doesn't appear interested in pursuing the parallels, nor even the dissimilarities, between Prohibition then and prohibition now. He does not reference the prohibition of other drugs in Prohibition (although heroin and cocaine were already criminalized federally and marijuana was being banned in a number of states), nor, as he has made clear in interviews, does he see a useful comparison between the two.

But that disagreement or lack of boldness notwithstanding, Prohibition is still a great viewing experience that brings alive a critical episode in US social and political history, an episode who reverberations still linger and whose contours are still echoed in drug prohibition. This is your history, America -- watch, enjoy, learn, and ponder.

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