Harm Intensification

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Harm Reduction: Colorado Bill Would Legalize Needle Exchanges

Colorado is one of just 17 US states that do not allow needle exchanges, but that could change under a bill before the Colorado Senate. The bill, SB 189, would allow local health departments to exchange dirty needles for clean ones in a bid to slow the spread of blood-borne diseases, such as HIV/AIDS and Hepatitis C among injection drug users.

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widely-used needle exchange graphic
The bill passed its first legislative hurdle Wednesday, passing out of the Senate Health and Human Services Committee with only two no votes. It now goes before the Senate for a floor vote.

"This is intended to be a public health measure to stop the spread of infectious diseases," lead sponsor Sen. Pat Steadman (D-Denver) told ABC 7 News.

But the bill is generating opposition from solons who fear it will enable drug use. "It does give kind of a wink and a nod towards the use of illegal drugs," said Sen. Kevin Lundberg (R-Berthoud), who opposes the measure. "My common sense says a needle exchange program is a de facto drug legalization and I'm not going to go there. We've got a problem with illegal drugs," he said. "Let's not make it worse by saying maybe, sort of, kind of, you can do it."

"No one's condoning illegal drug use," Steadman retorted. "No one's saying, 'Go have a good time.' What we're saying is, 'Please be safe.'"

Under current Colorado law, groups are allowed to collect used syringes, but not exchange them for clean ones. The only city in the state that allows for needle exchanges is Boulder, which passed a 1989 law exempting some groups from prosecution for doing exchanges.

That doesn't mean there is no needle exchange in Denver, the state's largest city. The Underground Syringe Exchange of Denver (USED) has been doing exchanges since 2008 and has handed out more than 11,000 needles to drug users.

"We remove syringes off the streets of Denver," said USED member Chris Conner. "They wind up in our dumpsters. They wind up thrown away in public bathrooms or discarded in parks," he said. "So this is a public health issue for all of us."

Press Release: Sarah Palin Offered $25,000 by Marijuana Policy Reform Advocates

MEDIA ADVISORY – For event on Tuesday, April 6, 2010, at 11 a.m. PDT                                                        

APRIL 5, 2010

Sarah Palin Offered $25,000 by Marijuana Policy Reform Advocates

Palin Addresses Alcohol Industry Gathering; MPP-Backed Campaign Offers Her $25,000 to Make Similar Speech to its Supporters

CONTACT: In Nevada: Dave Schwartz, campaign manager, Nevadans for Sensible Marijuana Laws (702-727-1081 or dschwartz@mpp.org). In Washington: Steve Fox, director of state campaigns, Marijuana Policy Project (202-905-2042 or sfox@mpp.org).

LAS VEGAS, NEVADA — Tomorrow, at Caesar’s Palace, former Alaska governor Sarah Palin will deliver the keynote address at the Wine & Spirits Wholesalers of America’s national convention. Immediately following that speech, Dave Schwartz, the campaign manager for Nevadans for Sensible Marijuana Laws (NSML), will offer Palin $25,000 to deliver a similar address to supporters of a regulated marijuana market in this country.

         In exchange for the $25,000, Palin will be asked to speak at one of NSML’s upcoming events, acknowledge the fact that marijuana is just as legitimate a recreational substance as the substance she is talking about at the WSWA convention (in fact, it is objectively much safer), and endorse taxing and regulating marijuana in Nevada and throughout the U.S.

         “There’s no reason why former governor Palin should reject our offer,” Schwartz said. “The health effects of the substance she is talking about at the WSWA convention cause 33,000 deaths in the U.S. annually. The comparable number for marijuana is zero. Alcohol is also associated with violent crime and other destructive acts, while marijuana is not. If Gov. Palin is comfortable endorsing that product, we are certain she will endorse ours. We look forward to negotiating with her team to find a time that works in her schedule.

         “Let me make one thing clear. In making this offer, we are not intending to attack the alcohol industry or alcohol users,” Schwartz continued. “Rather, we’re highlighting the fact that marijuana is objectively less harmful than alcohol. It makes no sense to keep marijuana in the criminal market while a former vice-presidential candidate celebrates the alcohol industry. We want legitimate businesspeople in Nevada to benefit from the sales of marijuana, and we want adults to be free to choose whichever substance they prefer —marijuana or alcohol — when they relax after work.”          

         With more than 124,000 members and supporters nationwide, the Marijuana Policy Project is the largest marijuana policy reform organization in the United States. MPP believes that the best way to minimize the harm associated with marijuana is to regulate marijuana in a manner similar to alcohol. For more information, please visit www.mpp.org.

         Nevadans for Sensible Marijuana Laws is a ballot advocacy group formed in Nevada to support a 2012 ballot initiative to tax and regulate marijuana like alcohol in the state. It receives significant funding and support from the Marijuana Policy Project.

####

Location: 
Las Vegas, NV
United States

Europe: England to Ban Methedrone? Nutt Says Not So Fast

Pressure to ban the "legal high" mephedrone is rising in the United Kingdom, especially since it was linked to the deaths of two teenagers on Sunday. But the former head of the Advisory Council on the Misuse of Drugs (ACMD) is urging the government to move with caution, and perhaps to create a new drug classification for new drugs whose effects and dangers are not well understood.

Mephedrone is an amphetamine-type stimulant derived from cathinone, the active ingredient found in khat. When chewed, as is the custom in the Arabian Peninsula and the Horn of Africa, khat delivers a mild stimulant buzz that has been likened to drinking a cup of coffee or strong tea. But mephedrone, which has exploded in popularity in the last year or so in Great Britain, delivers a high that users liken to ecstasy or cocaine.

Known as M-Cat and meow-meow, among other nicknames, mephedrone is reportedly becoming a favorite alternative to ecstasy on the British club scene. It is available online and in head shops in tablet, powder, or liquid form, with a dose running between $20 and $30. It has been linked to three deaths, including the two on Sunday, but it is not clear that any of those deaths were directly caused by mephedrone.

The 18- and 19-year-old men who died on Sunday, for instance, ingested alcohol and methadone, as well as mephedrone, during a night of clubbing. And the cause of death for a 14-year-old girl who died last year after taking mephedrone was listed as bronchial pneumonia, not mephedrone overdose.

According to the British newspaper The Guardian, Home Office drugs minister Alan Campbell has said he will move to take "immediate action" after receiving advice from the ACMD at the end of the month. The ACMD already has mephedrone on its radar, having held an evidence-gathering meeting on the drug on February 22.

Campbell spoke amidst a rising clamor for an immediate ban from anti-drug campaigners and school head teachers. Campbell insisted that the Home Office was ready to "act swiftly," but not too swiftly. "It is important we consider independent expert advice to stop organized criminals exploiting loopholes by simply switching to a different but similar compound."

But former ACMD head David Nutt, who was sacked last year after repeatedly criticizing the government for valuing politics over science and evidence in its drug scheduling decisions, said mephedrone should stay legal for now and that Britain should consider adding a new category to its drug scheduling scheme.

"To make it illegal without proper evidence of harm would be wrong and might have unwanted consequences, such as a switch to more dangerous drugs or alcohol," Nutt said. There is an alternative, he added. "One approach would be a new class in the Misuse of Drugs Act -- the class D model, adopted in New Zealand to deal with BZP. This is a holding category where drugs can be put in place before they are well understood: sales are limited to over-18s; the product is quality-controlled so users know what they are getting; and it comes with health education messages."

Knowing the Labor government and its record when it comes to drug scheduling, however, chances are that mephedrone will be banned by summer.

Drug War Chronicle Book Review: "In the Realm of Hungry Ghosts: Close Encounters With Addiction," by Dr. Gabor Maté (2010, North Atlantic Books, 468 pp., $17.95 PB)

Phillip S. Smith, Writer/Editor

In the revised edition of his prize-winning Canadian best-seller, Vancouver's Dr. Gabor Maté has made an important contribution to the literature on drug use and addiction. For more than a dozen years, Maté has been a staff physician for the Portland Hotel Society in Vancouver's infamous Downtown Eastside, home to one of the hemispheric largest, most concentrated populations of drug addicts. The Portland is unique -- once just another shoddy Skid Row SRO, under the management of the Society it is now both a residence for the hardest of the hard-core and a harm reduction facility.

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As a medical resident at the Portland, Maté has seen it all. The first section of "Hungry Ghosts" is filled with descriptions of his patients and their lives. Much of this is quite literally horrendous: Coked-out women turning tricks in alleys for their next rock and contracting syphilis; suicidal, opiate-addicted women refusing HIV treatments; mentally ill and alcoholic men dying young of liver cancer from Hepatitis C infections; people strung out on crack scrabbling at pieces of gravel on the sidewalk in the hallucinatory hope it's another rock; multi-addicted men and women, blood oozing from festering sores as they search yet again for a vein to hit, people overdosing and then going right back at it, people overdosing and dying.

And yet, despite the misery they are in and the wrecks that are their lives, they keep on using. "Hungry Ghosts" is an extended meditation on why. The second chunk of the book is devoted in particular to addressing that question. Maté offers an extended tour of the latest research into the disease model of addiction, with succinct and understandable (to the layperson) explanations of reward circuits in the brain, dopamine and serotonin flows, and all that good neuro-bio-pharmacological stuff so beloved of NIDA grantees. Repeated use of a substance indeed "rewires" the brain, creating pleasure circuits demanding to be fulfilled and pleasure deficits demanding to be fixed... with that next fix.

But unlike the NIDA people, with what I consider to be their neuro-bio-pharmacological determinism and reductionism, Maté goes a step further. He points out, accurately enough, that no matter what substance we're talking about, only a fraction of users, typically between 10% and 20%, become addicts. The "chronic relapsing brain disease" model may have some utility, but it fails to explain why some people are susceptible to addiction in the first place and others are not.

Maté noticed something about his downtrodden, strung-out clientele in Vancouver. They were almost universally abused as children, and at best, neglected. And I mean abused: Not spanked too hard, but raped, beaten, raped again, exploited, sent into foster care, literally spit on by their parents. It's very ugly.

One story especially sticks with me. A First Nations woman whose mother lives on the Downtown Eastside was given up at birth by her addicted mother, and sent to live with relatives, several of whom repeatedly sexually molested her in especially disgusting ways. She grew up an angry, depressed kid who turned to drugs and drink early. Tired of her life, she saved up $500 when she was 14 and ran away to Vancouver to find her mother. She did find her mother -- too bad for her. Mommie dearest promptly shot her up with heroin, spent the $500 on drugs for herself, then turned her out to turn tricks on the street. And you wonder why this woman prefers a narcotized bliss?

Maté doesn't just rely on anthropology and anecdote. He takes the reader instead into an extended look at the research on early childhood development and identifies messed-up childhoods as the key indicator of future substance abuse (as well as many other) problems. It doesn't have to be as extreme as some of these cases, but Maté makes clear that a nurturing early up-bringing is absolutely vital to the development of mentally and emotionally stable human beings.

Maté also has a startling confession to make: He, too, is an addict. The good doctor has been fighting a lifelong battle with his addiction to... wait for it... buying classical music CDs. He has behaved just like a junkie, he admits, spending thousands of dollars on his habit, lying to his wife, neglecting his kids, even leaving in the middle of medical procedures to run and score the latest Vivaldi. He's suffered the same feelings of compulsion, guilt, disgust, and self-denigration as any other addict, even if he doesn't have the scars on his veins to show for it.

At first glance, Maté's claim almost seems ludicrous, but he's making an important point: Addiction is addiction, whether it's to heroin or gambling, cocaine or shopping, he argues. The process of changes in the brain is the same, the compulsion is the same, the negative self-feelings are the same. We don't blame playing cards for gambling addiction or shopping malls for shopaholism; similarly, drugs are not to blame for drug addiction -- our own messed up psyches are the root of the problem.

And that leads to another important point: Those hollow-eyed addicts are like the rest of us, they are a dark mirror on our own inner problems, and most of us have some. (I'm reminded of a cartoon I once saw of a man sitting by all alone in an empty auditorium under a hanging banner saying, "Welcome to the convention of children of non-dysfunctional families.")

This is important because it stops us from dehumanizing drug addicts. They are not "the other." They are us, different only in degree. They deserve caring and compassion even if it is tough and seemingly fruitless work. Maté chides himself for falling from that saintly pedestal on occasion, and good for him.

Not surprisingly, Maté is a strong advocate of harm reduction and a harsh critic of prohibitionist drug policies and the US war on drugs in particular. By grinding drug users down even further, prohibition serves only to make them more likely to seek solace in chemical nirvana. It's almost as if prohibition were designed to create and perpetuate drug addiction.

In the final chapters of "Hungry Ghosts," Maté offers a glimmer of hope for beating drug addiction (or gambling addiction or sex addiction or whatever your particular compulsion is). It is a tough path of self-awareness and spiritual practice. I don't know if it will work -- I haven't tried it myself -- but it is important to remind ourselves that addiction is not necessarily a hopeless trap with no escape.

This is good, strong, compassionate, highly informed reading. I heartily recommend this book to anyone with an interest in addiction, addiction treatment, early childhood development, or drug policy. Thanks, doc.

Harm Reduction: Washington State "911 Good Samaritan Law" to Go Into Effect in June

Washington Gov. Christine Gregoire (D) Wednesday signed into law a measure that provides some legal immunity for people who report a drug overdose. That makes Washington the second state to enact a "911 Good Samaritan Law." New Mexico was the first in 2007.

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Washington State House, Olympia
Under the measure, if someone overdoses and someone else seeks assistance, that person cannot be prosecuted for drug possession, nor can the person overdosing. Good Samaritans could, however, be charged with manufacturing or selling drugs.

The measure is aimed at reducing drug overdoses by removing the fear of arrest as an impediment to seeking medical help. According to the state Department of Health, there were 820 fatal drug overdoses in the state in 2006, more than double the 403 in 1999.

The bill also allows people to use the opioid agonist naloxone, which counteracts the effects of opiate overdoses, if it is used to help prevent an overdose.

"We're going to save lives," Rep. Roger Goodman (D-Kirkland) told Senate sponsor Sen. Rosa Franklin (D-Tacoma) after the bill signing.

"It might take the fear out of calling for help," Franklin said.

Washington is the first state this year to pass a 911 Good Samaritan bill, but it may not be the last. According to the National Conference of State Legislatures, Hawaii, Massachusetts, Minnesota, and Rhode Island are considering similar measures.

Tell MTV to "Get Real" on Marijuana

Since 1992, MTV has produced and aired programs like "The Real World," which feature young people consuming large quantities of alcohol and then engaging in reckless, violent, destructive, and oftentimes illegal behavior. Yet it has never once shown a cast member consuming marijuana, which the network almost surely prohibits and undoubtedly discourages. Please visit http://tinyurl.com/y8elkmn and take just a few seconds to sign SAFER's on-line petition calling on MTV to stop driving its cast members to drink and "start getting real." In the real world, millions of people use marijuana and every objective study on it has concluded it is far safer than alcohol for them and society. Yet in "The Real World" and other reality shows like "Jersey Shore," MTV makes sure alcohol is always available in abundance -- and that cast members never make the safer choice to use marijuana instead. Recently, things have gotten more out of control than ever. On this week's episode of "The Real World," an extremely drunken cast member shoved another off the tall ledge of the staircase outside their house, resulting in him being taken away on a backboard by paramedics. And just a couple a months ago MTV's new reality show, "Jersey Shore," received worldwide attention when a drunken young man at a bar punched one of the female cast members hard in the face after she accused him of stealing some drinks purchased by a fellow castmate.* You can help us draw much-needed attention to MTV's dangerous "alcohol only" reality programming by visiting http://tinyurl.com/ y8elkmn today and taking just a few seconds to sign: --- A petition in support of SAFER MTV programming --- Future cast members of "The Real World," "Jersey Shore," and other MTV reality shows should be allowed to use marijuana as a safer recreational alternative to alcohol. In the real world, millions of adults enjoy using marijuana responsibly, and every objective study on it has concluded it is far safer than alcohol both for them and society. Yet MTV embraces -- and often encourages -- the use of alcohol by its cast members, and it prohibits them from making the rational choice to use a less harmful substance instead. "The Real World," "Jersey Shore," and MTV's other reality shows should stop driving cast members to drink and "start getting real."

Tainted Supply: Cocaine Laced With Levamisole Keeps Turning Up

Back in September, we reported on the appearance of cocaine cut with levamisole, a veterinary de-worming agent, and its links to at least three deaths in the US and Canada from a disease caused by levamisole, agranulocytosis. At that time, the DEA reported that levamisole was turning up in about 30% of the cocaine it sampled.

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DEA levamisole findings
Now, the DEA says that figure is up to 70%. While the number of fatalities has remained unchanged since last fall, new cases of agranulocystosis continue to appear in North American drug users. Earlier this month, authorities in Winnipeg, Manitoba, reported that two cocaine users contracted the disease there and that additional cases had been reported in neighboring Alberta.

Levamisole suppresses immune function and the body's ability to fight off even minor infections, and people who ingest levamisole-tainted cocaine can be faced with quickly-developing, life-threatening infections. Agranulocytosis is a condition of suppressed immune systems. Its symptoms include chills or high fever, weakness, swollen glands, painful sores, sudden or lingering infections, skin infections, abscesses, thrush, and pneumonia.

Cocaine contaminated with levamisole, although not users with agranulocytosis, has also popped up in the last few days in Maine and Ohio. Samples of crack cocaine in Mansfield, Ohio, tested positive late last month. And public health officials reported Tuesday that 30% to 50% of Maine cocaine samples tested positive.

The Substance Abuse and Mental Health Services Administration (SAMHSA) put out an alert late in September warning of the tainted cocaine, but federal authorities have done little publicly since then.

Given the geographically widespread reports of cocaine contaminated with the veterinary drug, it is assumed that levamisole is being added as a cutting agent either in source countries or in transit countries, not by local dealers.

Europe: Anthrax Heroin Toll Rises as England Marks First Death

English authorities announced Wednesday that a Blackpool heroin user died of anthrax, making him the first fatality in England from what is apparently a batch of heroin contaminated with anthrax. The bad dope has been blamed for nine deaths in Scotland and one in Germany since the outbreak began in December.

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anthrax spores
The anthrax fatality announcement from the National Health Service (NHS) in Blackpool came just five days after the Health Protection Agency issued a statement warning that a female heroin user in London had been hospitalized with anthrax.

The spate of anthrax cases among heroin users is baffling police and health experts, who have yet to actually come up with any heroin samples containing anthrax spores. There is speculation that the heroin could have been contaminated at its likely source in Afghanistan, perhaps from contaminated soils or animal skins, or that it was present in a cutting agent added there or at some other point on its transcontinental trek to northern Europe.

The cases in Germany and England have no known link to those in Scotland, leading to fears that tainted dope could be widespread. On the other hand, the numbers so far reported as being infected remain relatively small.

Although harm reductionists and drug user advocates have called for measures including public information campaigns among users, swift access to drug treatment, and making prescription heroin more widely available, British health officials continue to do little more than tell users to quit. Dr. Arif Rajpura, director of public health at NHS Blackpool, was singing from the same official hymnal this week.

He repeated warnings for users to stop using and advised them to be on the lookout for symptoms of anthrax, including rashes, swelling, severe headaches, and high fevers. "Heroin users are strongly advised to cease taking heroin by any route, if at all possible, and to seek help from their local drug treatment services. This is a very serious infection for drug users and prompt treatment is crucial," he said.

Europe: Anthrax Heroin Toll Rises as England Marks First Death

English authorities announced Wednesday that a Blackpool heroin user died of anthrax, making him the first fatality in England from what is apparently a batch of heroin contaminated with anthrax. The bad dope has been blamed for nine deaths in Scotland and one in Germany since the outbreak began in December. The anthrax fatality announcement from the National Health Service (NHS) in Blackpool came just five days after the Health Protection Agency issued a statement warning that a female heroin user in London had been hospitalized with anthrax. The spate of anthrax cases among heroin users is baffling police and health experts, who have yet to actually come up with any heroin samples containing anthrax spores. There is speculation that the heroin could have been contaminated at its likely source in Afghanistan, perhaps from contaminated soils or animal skins, or that it was present in a cutting agent added there or at some other point on its transcontinental trek to northern Europe. The cases in Germany and England have no known link to those in Scotland, leading to fears that tainted dope could be widespread. On the other hand, the numbers infected remain relatively small. Although harm reductionists and drug user advocates have called for measures including public information campaigns among users, swift access to drug treatment, and making prescription heroin more widely available, British health officials continue to do little more than tell users to quit. Dr. Arif Rajpura, director of public health at NHS Blackpool, was singing from the same official hymnal this week. He repeated warnings for users to stop using and advised them to be on the lookout for symptoms of anthrax, including rashes, swelling, severe headaches, and high fevers. "Heroin users are strongly advised to cease taking heroin by any route, if at all possible, and to seek help from their local drug treatment services. This is a very serious infection for drug users and prompt treatment is crucial," he said.
Location: 
Blackpool
United Kingdom

Europe: Anthrax-Tainted Heroin Death Toll Up to Ten

The death toll from anthrax-tainted heroin in Europe has risen to 10 as Health Protection Scotland confirmed that a heroin user who died in the Glasgow area on December 12 was infected with anthrax. Nine of the 10 deaths occurred in Scotland; the other occurred in Germany.

http://stopthedrugwar.org/files/anthraxspores.jpg
anthrax spores
The latest announced death is actually the earliest. Prior to the announcement of this death, the earliest known death took place December 16.

At least 19 drug users -- 18 of them Scottish -- have been diagnosed with anthrax since the outbreak began. A pair of heroin deaths in Sweden turned out to be unrelated, and a cluster of deaths in Portugal has not been confirmed as being linked to anthrax.

While Scottish authorities have yet to find any anthrax-tainted heroin, they believe either the heroin itself or cutting agents have been contaminated with anthrax spores. They said there is no evidence of person-to-person infection.

"While public health investigations are continuing to attempt to identify the source of the contamination, no drug samples tested to date have shown anthrax contamination, although a number of other types of potentially harmful bacteria have been found," said Colin Ramsay, an agency epidemiologist. "It must therefore be assumed that all heroin in Scotland carries the risk of anthrax contamination and users are advised to cease taking heroin by any route. While we appreciate that this may be extremely difficult advice for users to follow, it remains the only public health protection advice possible based on current evidence."

As noted in our earlier story linked to above, harm reductionists have called for other measures, ranging from informational campaigns to liberalized prescribing of pharmaceutical heroin.

Infected patients typically developed inflammation or abscesses around the injection site within one or two days and were hospitalized about four days after that. In some severe cases, the lesions developed necrotizing fasciitis, a flesh-eating disease.

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