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Psychedelics Could Treat Addiction, Says Vancouver Official

Vancouver, BC
The Tyee

No Honor for Last Holdout State Against Needle Exchange

A few weeks we reported in Drug War Chronicle that New Jersey had become the only state in the nation not allowing needle exchange programs in some form or at least syringe purchase without a prescription -- the second to last state, Delaware, passed a needle exchange law last month. The Times of New Jersey opined on the matter this morning in an opinion piece titled, "The Last One Standing." The Times writes:
After 13 years of debate without action, New Jersey is now the only state without a needle-exchange program -- a title the state should be embarrassed to hold, especially since its accompanying titles include fifth highest rate of adult HIV/AIDS cases in the nation and double the national percentage of cases caused by injection.
Having observed the issue in New Jersey for most of those years -- I well remember the days when Diana McCague and New Brunswick's The Chai Project mounted their open challenge to New Jersey's needle exchange prohibition -- and being originally from New Jersey myself, I am glad to see a major paper speak up again. According to the editorial there are "only a few loud legislators who are fundamentally opposed" to two state senate bills that would legalize needle exchange and permit prescriptionless syringe sales. In my view, those "loud legislators" have committed a monstrous crime against humanity -- really -- and so did the attorney general who squelched the newer programs opened by city emergency order through the courts. Former governor Whitman was maybe the worst villain in this. Large numbers of New Jerseyans are contracting AIDS and Hepatitis C through needle sharing, are dying from those diseases and spreading them to others. The scientific evidence supporting needle exchange programs is absolutely overwhelming. Talk about moral confusion! There should be new Chai Projects, in all the cities around the state, law or now law. Then let the legislators catch up and the opponents fall behind into history's dustbin where they belong.
United States

Editorial: Sometimes They Tell the Truth

David Borden, Executive Director
David Borden
It's alternately refreshing or appalling to hear public officials who deal with drug policy occasionally tell the truth about it. This week reformers got to bring home some of both.

The refreshing truth-telling came from Great Britain, where a Parliamentary Committee harshly tore into the official drug classification scheme used in the Misuse of Drugs Act, and the agency that is responsible for maintaining it. Many of the rankings seemed to have resulted from "knee-jerk responses to media storms," the committee charged, with no consistency and "no solid evidence to back-up the view that classification had a deterrent effect." "The current classification system is riddled with anomalies and clearly not fit for its purpose," the chairman said. "From what we have seen, the Home Office and ACMD approach to classification seems to have been based on ad hockery and conservatism." (See two articles below in this issue to read all about it.)

Gotta like that! But now for one that I don't like -- not at all. In Philadelphia, one of the cities suffering under the crisis of fentanyl-laced heroin and the resulting wave of often fatal overdoses, the harm reduction program Prevention Point Philadelphia, partnering with a local physician, has begun to help distribute naloxone, a medication that if used soon enough during an overdose can save the victim's life.

Naloxone distribution is a type of program known as "harm reduction," the idea of which is that since we know some people are going to use drugs regardless of how we fight them, there are things that can be done to help them save their lives and the lives of others -- even before they stop using drugs, for that matter even if they never stop using drugs. Needle exchange programs are another example of harm reduction at work.

The drug czar's office reacted to the PPP venture with criticism. If heroin users have a chance of surviving an overdose, the reasoning went, it is "disinhibiting" to the objective of getting addicts to just stop using the stuff. "We don't want to send the message out that there is a safe way to use heroin," an ONDCP spokesperson said. But "dead addicts don't recover," as the common mantra in the harm reduction field goes.

While the drug czar's position is dead wrong about this -- deadly wrong, in fact -- the comment seems a fairly truthful explanation of the horrible way that many drug warriors think. It is a direct corollary of the spokesperson's comment that it is better to have people who could be saved instead die, in order to dissuade others from using drugs -- better to make sure that drugs kill -- so that everyone will be sure that drugs do kill. But the dead from overdoses are definitely (and permanently) dead, whereas those who, through the withholding of livesaving assistance to some, are thereby saved from death through their own choices, may or may not exist.

Those who oppose harm reduction are in effect supporting "harm intensification" instead -- a deliberate attempt through policy to increase the dangers of drugs -- at a cost of lives, and in my view of morality too.

But that is what prohibition is truly about, harm intensification on a global scale. Hence the need for legalization instead -- so morally defunct ideas like those expressed this week by the drug czar's office can be laid to rest and their ghastly consequences finally be made to cease.

Harm Reduction: Drug Czar's Office Opposes Letting Heroin Users Have Easy Access to Overdose Antidote

When heroin users around Philadelphia started overdosing on junk laced with fentanyl, a powerful synthetic opiate, a local harm reduction group began working with a sympathetic physician to provide addicts prescriptions to naloxone (brand name Narcan). The Office of National Drug Control Policy thinks that's a bad idea.

In many cities, paramedics carry Narcan with them, but by the time they arrive on the scene, it can be too late, explained Casey Cook, executive director of Prevention Point Philadelphia, the group that runs the city's needle exchange program. "If people have to rely on paramedics, more often than not, the overdose is going to be fatal, just because of the amount of time for people to get there," she told the Associated Press in an interview last Friday.

But the drug czar's office is worried that providing addicts with the means to survive an overdose would prove "disinhibiting," much the same way social conservatives argue that providing teenagers with condoms to prevent pregnancy and disease "disinhibits" them from remaining abstinent. ONDCP doesn't want to appear to condone drug use. "We don't want to send the message out that there is a safe way to use heroin," said Jennifer DeVallance, an ONDCP spokesperson told the AP.

There were some 16,000 drug-related deaths reported in 2002, the vast majority of them involving either heroin or prescription opiates, and at least 400 people have died in the wave of fentanyl-related heroin ODs in the past few months. Better they should die than people think heroin is safe, huh?

Rising Violent Crime in US Sparks a Search For Answers

United States
Voice of America

Feature: British Parliamentary Committee Slams Drug Classification Scheme, Calls for Evidence-Based System

The British Parliament's Science and Technology Committee released a report Monday that rips into Britain's current drug classification scheme as "opaque" and urges that it be replaced with a system that is based on scientific evidence and accurately reflects actual harm to drug users and society. The current system is "not fit for its purpose," the scorching report found.

Under the current system, drugs are classified as Class A (heroin, cocaine), B (methamphetamine), or C (marijuana, anabolic steroids), with the Class A drugs considered most harmful and Class C drugs considered least harmful. Class A drugs carry a seven-year prison sentence for possession, Class B five years, and Class C two years. Sales of Class A drugs can earn up to a life sentence, while sales of Class B and C drugs can earn up to 14 years. The British Home Secretary is charged with deciding which drug goes where in the classification scheme based on evidence provided by advisors, who are supposed to weigh the problems caused by various drugs and classify them accordingly.
ecstasy pills
It hasn’t worked out that way, the committee concluded in its report, aptly titled "Drug Classification: Making a Hash Of It? "There was a lack of consistency in the way some drugs were classified in the A,B,C system and no solid evidence to back-up the view that classification had a deterrent effect," the committee noted dryly as it released its findings. "The Committee was also critical of the Advisory Council on the Misuse of Drugs, the key scientific advisory body on drugs policy, calling its failure to alert the Home Secretary to the serious flaws in the classification system a 'dereliction of its duty.'"

Pointing to the recent review of the 2004 down-classification of marijuana from Class B to Class C against a steady drumbeat of tabloid hyperventilation over its alleged dangers, the committee complained that such reviews gave the impression they were “knee-jerk responses to media storms." The committee also scored the Home Office and ACMD for failing to demonstrate that the current classification system is effective and for failing to invest in research on addiction.

“The current classification system is riddled with anomalies and clearly not fit for its purpose," committee chair MP Phil Willis said in a statement accompanying the report's release. "From what we have seen, the Home Office and ACMD approach to classification seems to have been based on ad hockery and conservatism. It’s obvious that there is an urgent need for a root and branch review of the classification system, as promised by the previous Home Secretary. We all know that the current Home Secretary has other things on his mind, but that’s not an excuse for trying to kick this issue into the long grass."

If Britain wants a rational drug classification system that works, said Willis, it should forget about using it to punish people for taking drugs the government doesn’t like. "The only way to get an accurate and up to date classification system is to remove the link with penalties and just focus on harm. That must be harm not only to the user but harm defined by the social consequences as well," the committee head explained. "It's time to bring in a more systematic and scientific approach to drug classification – how can we get the message across to young people if what we are saying is not based on evidence?"

The report also calls for including alcohol and tobacco in any new drug classification scheme, and suggests they should be classified as more dangerous than ecstasy. It also attacked the government's classification of several drugs. With psychedelic mushrooms, the government reclassified them administratively as dangerous Class A drugs, thus avoiding consultation with the ACMD. That move "contravened the spirit of the Misuse of Drugs Act and did not give the ACMD the chance to consider the evidence properly."

The committee report criticized the ACMD for not speaking out on the mushroom issue, saying its failure to do speak has "undermined its credibility." The report also scolded the ACMD for never getting around to reviewing ecstasy status, which currently mis-classifies it along with the most dangerous and harmful drugs.

Drugscope, a leading British drug policy thinktank, welcomed the committee's call for an overhaul of the classification system. "The Misuse of Drugs Act is over 30 years old and the drug scene in the UK has changed out of all recognition since then," said Drugscope head Marvin Barnes in a statement greeting the report's release. "It also true that some of the decisions about placing certain drugs within the Act, such as ecstasy and fresh magic mushrooms, do not bear much scientific scrutiny. It is important that the Act more accurately matches legal penalties to the overall risk of drugs to society. Such a review was promised by the Home Office in January, but we have heard nothing about it since," Barnes chided.

But Drugscope rejected some of the criticisms leveled against the ACMD in the report. "It may be that the ACMD could have been more proactive regarding drug classification, but their many reports have helped shape the drug treatment system in the UK," Barnes said. "In particular, their recommendation about supplying needles and syringes to heroin users in the 1980s may have saved the UK from a major HIV/AIDS epidemic."

A leading mental health nonprofit, Rethink, used the report's release to clamor for more information about the links between marijuana and mental illness. Rethink’s Director of Public Affairs Paul Corry said: "In any debate about the classification of cannabis, Rethink’s main concern is that the government delivers on its promise to educate the public about the mental health risks of cannabis use," said Rethink public affairs director Paul Corry in a statement Monday. "Rethink is concerned by the lack of progress concerning this critical public health issue. We know that early-age users, long-term users and people with a family history of mental illness are at a high risk of developing psychosis from smoking cannabis – the problem is that they don’t know it because the government has failed to act on its promise," Corry argued.

The British reform group the Transform Drug Policy Foundation also issued a statement welcoming the report. "Transform welcomes the fact that the committee has taken on board the broader critique of the classification system rather than getting bogged down in a pointless debate about why each drug is in a particular class," said Transform information officer Steve Rolles. "The bigger issue at stake here is that the entire classification system is based on drug war ideology, has no scientific basis whatsoever, and does the exact opposite of what it is intended to do. We would like to see this is a prelude to a more significant inquiry into the evidence base for the criminalization of drugs per se.”

Rollins also echoed calls for the Home Secretary to act. "We also hope that the Home Office will now resume the drug classification consultation announced by the then Home Secretary Charles Clarke earlier this year, as specifically recommended by the committee," he said. "The consultation document was ready to be published but seems to have been kicked into the long grass by the new Home Secretary. The Select Committee’s withering critique makes this promised Home Office consultation all the more urgent"

The Tories are using the report to hammer Labor's drug policy and take up the "dangerous marijuana" banner. Shadow Home Secretary Edward Garnier quickly released a statement seeking political advantage. "We will study the Select Committee Report in detail, but what is and has been apparent for some time is the lack of clarity in this government's policy on illegal drugs," Garnier charged. "The downgrading of cannabis sent out the message that it was pretty harmless and will have encouraged youngsters to take it up. It is vital that we have strong and effective measures warning children of the dangers of drugs devoid of any confusion."

Labor so far has been quiet, but Labor MP Paul Flynn told DRCNet he found the committee report a useful palliative for the politicization of drug policy. "Categorizing drugs in 1971 was to be the silver bullet to cut drug use. Then there were 1,000 addicts; now there are 280,000," he noted. "Yet all political parties still cling to this duff bullet by voting in 2005 for the insanity that classified magic mushrooms with heroin and left alcohol and nicotine unclassified. Thanks to the science committee for a whiff of sanity."

With the publication of the committee report, Britain is one step closer to rational, evidence-based drug classification system. The US drug classification system is similarly irrational, placing, for instance, marijuana and LSD in the same category as heroin, but there is no sign of any such scientifically-guided approach here.

In Memoriam: Methadone Pioneer Vincent P. Dole

(This memorial piece for a great pioneer in addiction treatment was written and distributed by his friend and colleague, Dr. Robert Newman.)

Dr. Vincent Dole (an internist) and his late wife, Marie Nyswander, MD (a psychiatrist), began their collaborative research with methadone with a handful of long-term heroin-dependent individuals in 1964. They did so in the face of overt threats of harsh criminal and civil action by federal narcotics agents. Their courageous, pioneering work demonstrated that methadone maintenance is a medical treatment of unparalleled effectiveness -- a superlative description that is as applicable today as it was four decades ago. As a result, well over three-quarters of a million people throughout the world are able to lead healthy, productive, self-fulfilling lives - over 200,000 in the United States, an estimated 530,000 in Western Europe, and many tens of thousands more in Eastern Europe, Middle East, Central Asia, Far East, Australia and New Zealand.

After the remarkable transformation they observed in their first few patients, Dr. Dole and Dr. Nyswander went on to provide direct supervision of the first methadone maintenance treatment program at Beth Israel Medical Center in New York. In so doing they demonstrated that it was possible to replicate on a large scale the therapeutic success they achieved in the small, controlled, research environment of the Rockefeller Institute (now Rockefeller University). Dr. Dole was also responsible in the early 1970s for convincing the New York City Department of Corrections (at the time headed by Commissioner Ben Malcolm) that detoxification of heroin-dependent inmates in the city's main detention facility at Rikers Island was imperative to save lives and lessen suffering (there had been a wave of suicides at the time that had been attributed to severe opiate withdrawal). The detoxification program continues to this day, and has become a model for enlightened corrections officials in other countries.

Dr. Dole and Dr. Nyswander's contributions, however, transcend the life-saving clinical impact on patients and the enormous associated benefits to the community as a whole. They had prescience to hypothesize, years before the discovery of the morphine-like endorphine system in the human body, that addiction is a metabolic disorder, a disease, and one that can and must be treated like any other chronic illness. What was at the time brilliant insight on their part is today almost universally accepted by scientists and clinicians alike, and remains the foundation upon which all rational policies and practices in the field rest.

In his mid-80s Dr. Dole traveled to Hamburg to be present at the naming ceremony of the Marie Nyswander Street; in less than ten years Germany moved from methadone being illegal to having over 60,000 patients in treatment! His efforts during recent years were devoted to fighting the stigma that, tragically, remains so widespread against the illness of addiction, the patients and the treatment.

Prosecutor Says Dangerous Heroin Now in Cape May County (New Jersey)

United States
Press of Atlantic City

Mayor Seeks Drug Maintenance for Drug Addicts

United States
Vancouver Sun

Safe Injecting Room Opponents Use "Stunt" to Try to Discredit It

Sydney, NSW
Sydney Morning Herald

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