Public Health
International Harm Reduction Association Conference
These conferences have been held around the world for two decades and, for 2010, we are returning to the city which hosted the first conference in 1990 – Liverpool, England.
Training: Treating Substance Using Patients in Your Practice - An Introduction to Harm Reduction Psychotherapy
This workshop will introduce Tatarsky’s Integrative Harm Reduction Psychotherapy a new approach to effective treatment of substance using patients.
Training: Treating Drug and Alcohol Users in Your Practice
Treating Drug and Alcohol Users in Your Practice: Rationale, Theory and Technique of Integrative Harm Reduction Psychotherapy
Feature: Fired Up in Albuquerque -- The 2009 International Drug Policy Reform Conference
Feature: The State of Play -- Federal Drug Reform Legislation in the Congress
Ten months into the Obama administration, drug policy reform in the US Congress is moving along on a number of tracks.
Feature: 2009 International Drug Policy Reform Conferences Opens Amid Optimism in Albuquerque
Hundreds, possibly more than a thousand, people poured into the Convention Center in downtown Albuquerque, New Mexico, as the Drug Policy Alliance's
Feature: Veterans Incarcerated and Ignored When They Could Be Getting Help, Report Finds
Roughly 200,000 US veterans are in prison or jail, many of them there because of substance abuse or mental health issues, according to a new report released Wednesday.
Europe: British Science vs. Politics Battle Explodes As Top Drug Advisor Fired for Heresy
The British Labor government has created a firestorm of controversy with its firing of Professor David Nutt
British Science vs. Politics Battle Explodes As Top Drug Advisor Fired for Heresy
Posted in Chronicle Blog by Phillip Smith on Mon, 11/02/2009 - 6:14pmThe British Labor government has created a firestorm of controversy with its firing of Professor David Nutt, head of the Advisory Committee on the Misuse of Drugs (ACMD) last Friday. Nutt was canned by Home Secretary Alan Johnson after the psychopharmacologist again went public with his criticism of the government for refusing to follow a science- and evidence-based drug policy.
As of today, after a weekend of furious back and forth in dozens of newspaper articles, two more members of the ACMD have resigned in protest over the firing, and a mass resignation of the 31-member body may come after a meeting next Monday. Johnson told parliament Monday that he had agreed to a request from the ACMD for an urgent meeting, but he also told parliament he had ordered a review of the ACMD to satisfy ministers that the panel is "discharging its functions" and that it still represents a value to the public.
The ACMD's charge is to "make recommendations to government on the control of dangerous or otherwise harmful drugs, including classification and scheduling under the Misuse of Drugs Act 1971 and its regulations," its web page explains. "It considers any substance which is being or appears to be misused and of which is having or appears to be capable of having harmful effects sufficient to cause a social problem. It also carries out in-depth inquiries into aspects of drug use that are causing particular concern in the UK, with the aim of producing considered reports that will be helpful to policy makers and practitioners."
Tensions between the ACMD and the Labor government began rising after the government up-scheduled marijuana from a Class C drug (least harmful) back to Class B, where it had been prior to being down-scheduled in 2004. The Labor government ignored the ACMD's recommendation that marijuana remain Class C. Things only got worse when the ACMD recommended that Ecstasy be down-scheduled from Class A (most harmful) to Class B, and the government promptly ignored that advice.
At that point, Nutt went public with his criticisms of then Home Secretary Jacqui Smith. He also famously compared the dangers of Ecstasy to those of horse-riding, deeply offending both the horsey set and the Labor government. Smith told Nutt to shut up, and he managed to do so until last week.
Last week, in a lecture and briefing paper at the Center for Crime and Justice Studies at King's College London, Nutt accused Smith of "distorting and devaluing" scientific evidence when she decided to reclassify marijuana. He also said that Ecstasy and LSD are less dangerous than alcohol and tobacco.
"We have to accept young people like to experiment – with drugs and other potentially harmful activities – and what we should be doing in all of this is to protect them from harm at this stage of their lives," he said. "We therefore have to provide more accurate and credible information. If you think that scaring kids will stop them using, you are probably wrong.”
Nutt's briefing paper included a ranking of various licit and illicit drugs by comparative harm. Heroin and cocaine were ranked the most harmful in Nutt's scheme, with alcohol fifth, marijuana ninth, LSD fourteenth, and Ecstasy eighteenth.
"We need a full and open discussion of the evidence and a mature debate about what the drug laws are for — and whether they are doing their job," Nutt said.
That was too much for Home Minister Alan Johnson. He told parliament Monday that Smith had warned Nutt not to publicly disagree with ministry decisions again. "Well, it has happened again," said Johnson. "On Thursday October 29 Professor Nutt chose, without prior notification to my department, to initiate a debate on drug policy in the national media, returning to the February decisions, and accusing my predecessor or distorting and devaluing scientific research. As a result, I have lost confidence in Professor Nutt's ability to be my principal adviser on drugs."
Prime Minister Gordon Brown is standing behind Johnson. An official spokesman said the firing was based on the "important principle" that advisers should present advice to ministers but not speak out against their policy decisions. "It would be regrettable if there were other resignations, but this is an important point of principle," the spokesman added. "The government is absolutely committed to the importance of having independent advice and evidence presented by advisory bodies."
Nutt defended himself and attacked the government in a London Sunday times opinion piece. "My sacking has cast a huge shadow over the relationship of science to policy," he wrote. "Several of the science experts from the Advisory Council on the Misuse of Drugs (ACMD) have resigned in protest and it seems likely that many others will follow suit. This means the Home Office no longer has a functioning advisory group, which is very unfortunate given the ever-increasing problems of drugs and the emergence of new ones. Also it seems unlikely that any 'true' scientist — one who can only speak the truth — will be able to work for this, or future, Home Secretaries.
One of the ACMD members who resigned, chemist Les King, said ministers were putting inappropriate pressure on scientists to make drug policy decisions based on political—not scientific—reasons. "It's being asked to rubber stamp a predetermined position," he said, warning that others could leave the council over the brouhaha. "If sufficient members do resign, the committee will no longer be able to operate," King said.
Scientist and Labor MP Robert Winston said Nutt had a "very reasonable" point about the relative dangers of legal and illegal drugs, and that he was disappointed by the firing. "I think that if governments appoint expert advice they shouldn't dismiss it so lightly," he said. "I think it shows a rather poor understanding of the value of science."
Reuters reported Saturday that the firing is causing consternation in scientific circles. Scientists told the news agency the decision could undermine the integrity of science in policy-making, including critical areas like health, the environment, education, and defense.
"Scientific data and their independent interpretation underpin evidence-based policy making -- and nobody rational could possibly want a government based on any other type of policy making," said Chris Higgins, chair of an advisory committee on spongiform encephalopathy, or "mad cow" disease.
Maurice Elphick, a professor of animal physiology and neuroscience at Queen Mary, University of London, said politicians should look elsewhere if they wanted data to back social policies and allow science to maintain objectivity. "If, however, politicians really do want to have an objective assessment of the relative risks to health of different recreational drugs, then they should listen to what the medical scientist has to say, not sack him." he said.
The Labor government has picked a fight with science. It's unclear how this will all play out, but Labor doesn't seem to be doing itself any favors so far.
Southeast Asia: UN's Top Health Rights Officials Calls for Decriminalizing Drug Use, Ending Forced "Rehab Camps"
The UN's top official on health rights called Tuesday
Feature: Historic Hearing on Marijuana Legalization in the California Legislature
In an historic hearing Wednesday, the California legislature examined the pros and cons of marijuana legalization.
Drug War Chronicle Book Review: "Drug War Zone: Frontline Dispatches from the Streets of El Paso and Juarez," by Howard Campbell (2009, University of Texas Press, 310 pp., $24.95 PB)
Phillip S. Smith, Writer Editor
Heroin Maintenance Comes to Denmark
Posted in Chronicle Blog by David Borden on Fri, 10/23/2009 - 2:49pmHeroin maintenance is coming to Denmark. And it's about time -- how about here too? The evidence is in, and it's only ideology that stands in the way of saving lives that now are being needlessly lost.
In the meanwhile, watch the video from the Hungarian Civil Liberties Union and the Danish Street Lawyers about the new program:
Europe: In Opinion Poll, Romanians Reject Marijuana Legalization
Last month, a Romanian presidential committee recommended decriminalizing the possession of "soft" drugs, implementing n
Feature: Busted for Handing Out Clean Needles -- The Mono Park 2 Fight Back in California's Central Valley
Hit hard by a double whammy of drought and economic slowdown, California's Central Valley has become a hotbed of methamphetamine and other injection drug use.
Southwest Asia: Afghan Opium Trade Wreaking Global Havoc, UNODC Warns
The UN Office on Drugs and Crime (UNODC) warned Wednesday that the traffic in Afghan opiates is spreading drug use and addiction along smuggling ro
Asia: Drug Users Form Regional Organization
In a meeting in Bangkok last weekend, more than two dozen drug users from nine different countries came together to put the finishing touches on the creation of a new drug user advocacy organizatio
Asia: Drug Users Form Regional Drug User Organization
Posted in Chronicle Blog by Phillip Smith on Wed, 10/21/2009 - 7:04pmIn a meeting in Bangkok last weekend, more than two dozen drug users from nine different countries came together to put the finishing touches on the creation of a new drug user advocacy organization, the Asian Network of People who Use Drugs (ANPUD). The Bangkok meeting was the culmination of a two-year process began at a meeting of the International Congress on AIDS in Asia and the Pacific in Colombo, Sri Lanka, in 2007, and resulted in creating a constitution and selecting a steering committee for the new group.
ANPUD adopts the principles of MIPUD (Meaningful Involvement of People who Use Drugs), and in doing so, aligns itself with other drug user advocacy groups, including the International Network of People who Use Drugs (INPUD), of which ANPUD is an independent affiliate, the Australian Injection and Illicit Drug Users League (AIVL),the Vancouver Area Network of Drug Users, and the Nothing About Us Without Us movement.
ANPUD currently has more than 150 members and sees its mission to advocate for the rights of drug users and communities before national governments and the international community. There is plenty to do. Asia has the largest number of drug users in the world, but is, for the most part, woefully retrograde on drug policy issues. Not only do drug users face harsh criminal sanctions—up to and including the death penalty—but Asian has the lowest coverage of harm reduction services in the world. Access to harm reduction programs, such as needle exchanges and opioid maintenance therapy, is extremely limited.
"People who use drugs are stigmatized, criminalized and abused in every country in Asia," said Jimmy Dorabjee, a key figure in the formation of ANPUD. "Our human rights are violated and we have little in the way of health services to stay alive. If governments do not see people who use drugs, hear us and talk to us, they will continue to ignore us."
The Director of the UNAIDS Regional Support Team, Dr. Prasada Rao, spoke of the urgent need to engage with drug user networks and offered his support to ANPUD, saying that "For UNAIDS, HIV prevention among drug users is a key priority at the global level," said Dr. Prasada Rao, director of the UNAIDS Regional Support Team. "I am very pleased today to be here to see ANPUD being shaped into an organization that will play a key role in Asia's HIV response. It is critical that we are able to more effectively involve the voices of Asian people who use drugs in the scaling up of HIV prevention services across Asia."
"When I go back home, I am now responsible for sharing the experiences with the 250 or so drug users who are actively advocating for better services at the national level," said Nepalese drug user and newly elected steering committee member Ekta Thapa Mahat. "It will be a great way for us to work together and help build the capacity of people who use drugs in Asia."
"The results of the meeting exceeded my expectations," said Ele Morrison, program manager for AVIL's Regional Partnership Project. "The participants set ambitious goals for themselves and they have achieved a lot in just two days to set up this new organization. The building blocks for genuine ownership by people who use drugs is definitely there."
While the meetings leading to the formation were organized and managed by drug users, the process received financial support from the World Health Organization, the UNAIDS Regional Task Force, and AIVL.
Southwest Asia: Afghan Opium Trade Wreaking Global Havoc, UNODC Warns
Posted in Chronicle Blog by Phillip Smith on Wed, 10/21/2009 - 6:53pmSouthwest Asia: Afghan Opium Trade Wreaking Global Havoc, UNODC Warns
The UN Office on Drugs and Crime (UNODC) warned Wednesday that the traffic in Afghan opiates is spreading drug use and addiction along smuggling routes, spreading diseases, and funding insurgencies. The warning came in a new report, Addiction, Crime, and Insurgency: The Threat of Afghan Opium. "The Afghan opiate trade fuels consumption and addiction in countries along drug trafficking routes before reaching the main consumer markets in Europe (estimated at 3.1 million heroin users), contributing to the spread of HIV/AIDS and other blood-borne diseases," the report said.
Neighboring countries, especially Iran, Pakistan, and the Central Asian republics, are among the hardest hit, said UNODC. According to the report, Iran now has the highest opiate addiction rates in the world. "Iran faces the world's most serious opiate addiction problem, while injecting drug use in Central Asia is causing an HIV epidemic," UNODC said.
But the impact of the multi-billion flow of Afghan opiates could have an especially deleterious impact on Central Asia, UNODC chief Antonio Maria Costa warned in remarks accompanying the report. "The Silk Route, turned into a heroin route, is carving out a path of death and violence through one of the world's most strategic yet volatile regions," Costa said. "The perfect storm of drugs, crime and insurgency that has swirled around the Afghanistan/Pakistan border for years is heading for Central Asia."
In Pakistan and Afghanistan, the opium trade is funding violent radicals. "The funds generated from the drugs trade can pay for soldiers, weapons and protection, and are an important source of patronage," the report said. In Afghanistan, the Taliban generated between $90 million and $160 million annually in recent years, the UNODC estimated. In Pakistan, the UNODC estimated the trade at $1 billion annually, with "undetermined amounts going to insurgents."
Although Afghan opium production declined slightly last year, the country is producing—and has produced—more opium needed than to meet global supply. As a result, the UNODC estimates that there is an unaccounted for stockpile of 12,000 tons of opium—enough to satisfy every junkie on the planet for the next three to four years. "Thus, even if opiate production in Afghanistan were to cease immediately, there would still be ample supply," the report said.
Unsurprisingly, the UNODC report did not address the role that global drug prohibition plays in exacerbating problems related to opiate use and the opiate trade. Prohibitionist attitudes restrict the availability of harm reduction programs, such as needle exchanges, that could reduce the spread of blood-borne diseases. And it is global drug prohibition itself that creates the lucrative black market the UNODC says is financing insurgencies and spreading political instability.
New Zealand: New Anti-Meth Measures Set to Go Into Effect -- Tough Luck, Flu Sufferers
Under an anti-methamphetamine package announced last week by the government of New Zealand, popular cold and flu remedies containing pseudoephedrine will soon be available only by prescription afte















