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Harm Reduction 2013

Our friends at the Hungarian Civil Liberties Union attended the international harm reduction conference in Vilnius, Lithuania, this week, and have brought some of it to the rest of us through a new video:

 
Among the highlights are the former presidents of Switzerland and Poland.
Location: 
Vilnius
Lithuania

Drug Prohibitions Hurt Science, Researchers Charge

In a paper published Wednesday in the journal Nature Reviews Neuroscience, a group of leading scientists argue that global drug prohibition has not only compounded the harms of drug use, but also produced the worst censorship of research in centuries. They likened the banning of psychoactive drugs and the subsequent hampering of research on them to the Catholic Church banning the works of Copernicus and Galileo.

Prof. David Nutt (gov.uk)
The paper, Effects of Schedule I Drug Laws on Neuroscience Research and Treatment Innovation (abstract only), was written by Professor David Nutt of Imperial College London and Leslie King, both former government advisors, and Professor David Nichols of the University of North Carolina-Chapel Hill.

The possession of marijuana, MDMA (ecstasy) and psychedelics are stringently regulated under national laws and international conventions dating back to the 1960s, but those laws are not based on science, and the global prohibition regime is rigid and resistant to change, they argued.

"The decision to outlaw these drugs was based on their perceived dangers, but in many cases the harms have been overstated and are actually less than many legal drugs such as alcohol," said Nutt, professor of neuropsychopharmacology at Imperial College London. "The laws have never been updated despite scientific advances and growing evidence that many of these drugs are relatively safe. And there appears to be no way for the international community to make such changes."

In the paper, Nutt and his colleagues argue that the scheduling of psychoactive drugs impedes research into their methods of action and therapeutic potentials and sometimes makes it impossible.

"This hindering of research and therapy is motivated by politics, not science," said Nutt. "It's one of the most scandalous examples of scientific censorship in modern times. The ban on embryonic stem cell research by the Bush administration is the only possible contender, but that only affected the USA, not the whole world."

Research in psychoactive drugs should be free of severe restrictions, the scientists argued.

"If we adopted a more rational approach to drug regulation, it would empower researchers to make advances in the study of consciousness and brain mechanisms of psychosis, and could lead to major treatment innovations in areas such as depression and PTSD," Nutt said.

Nutt headed Britain's Advisory Committee on the Misuse of Drugs until 2009, when he was forced out by the Labor government of Prime Minister Gordon Brown. Nutt was sacked after publicly criticizing the government for ignoring the committee's scientific advice on marijuana on ecstasy. He then became chair of the Independent Scientific Committee on Drugs, which aims to review and investigate the harms and benefits of drugs free from political interference.

London
United Kingdom

Vermont Governor Signs Overdose Prevention Bills

Vermont Gov. Peter Shumlin (D) Wednesday signed into law two bills aimed at reducing the toll of drug overdose deaths in the state. House Bill 65 provides limited legal protection for those who witness or experience a drug or alcohol overdose and summon medical assistance, while House Bill 522 permits prescription of the opiate-antagonist drug Naloxone to third parties and provides limited immunity for such prescription as well as administration of the drug.

"We cannot break our focus on this critical issue, because drug addiction harms not just the individuals ensnared in it but also our families and communities," Shumlin said. "I pledge to continue to work with mayors, law enforcement, medical and mental health experts and legislators to fight this problem, and will be focusing between now and January on the next steps in this battle."

HB 65, the "Good Samaritan" bill is the broadest of its kind. While 13 states and the District of Columbia have enacted such bills, Vermont's is the first to provide protection from arrest or all drug offenses -- not just possession -- as well as protections against asset forfeiture. It also provides protection against the revocation of parole or probation or the violation of restraining orders for people who seek help for overdose victims.

"Criminalization should not be a barrier to calling 911," said Lindsay LaSalle, an attorney with the Drug Policy Alliance. "The Vermont legislature has aptly recognized that saving a life is of paramount importance to the prosecution of any nonviolent drug crime."

HB 522 is the bill that expands access to Naloxone, which is credited with reversing more than 10,000 overdoses nationwide since 1996. The bill also provides immunity from civil or criminal liability for Naloxone providers.

"Implementation of these new laws by public health and law enforcement officials is critical to improving public willingness to immediately seek medical assistance for overdoses involving illegal drugs and alcohol use as well as to administer Naloxone to opioid overdose victims," said LaSalle.

Montpelier, VT
United States

Paris to Get Supervised Drug Injection Site

France's first supervised injection site (SIJ) for hard drug users will open in Paris by this fall, local officials announced Thursday. It will be located near the Gare du Nord train station, an area of open hard drug use and sales and petty crime.

injecting at a supervised injection site in Vancouver (vch.ca)
The SIJ will be ready "by the autumn," Remi Feraud, mayor of the 10th arrondissement, where it will be located, told reporters. The site is "sufficiently far from residential areas, schools and shops to not pose a serious risk of public disorder," he said.

The project is "aimed at reducing the number of people taking drugs in the street, in common areas of apartment buildings and other areas such as car parks," added deputy mayor Myriam El Khomri. The area would be given a boosted police presence, she added, to prevent dealers from selling their wares in the proximity.

While supervised injection sites are a proven harm reduction measure, local officials were downplaying that aspect and instead highlighting the public order and safety effects. That could be a bid to blunt opposition and hostility from local residents' associations, who have said they fear the SIJ would further degrade the area, described as "an open air drug market."

While this will be the first SIJ in the City of Light, Paris already has a needle exchange program. It handed out more than 300,000 syringes last year, half of them in the Gare du Nord.

SIJs already operate in a number of European countries, include Germany and Switzerland, as well as Australia and Canada.

Paris
France

China, Southeast Asia Vow More Better Drug War

At a meeting in Myanmar Thursday, China and five Southeast Asian nations vowed to redouble their efforts and boost cooperation in an effort to get a grip on illegal drug use and trafficking, which they called "a significant threat" to the region.

opium poppy (UNODC)
China was joined by Cambodia, Laos, Myanmar, Thailand, and Vietnam), along with the UN Office on Drugs and Crime (UNODC), for the Ministerial Meeting of the Signatory Countries to the 1993 Memorandum of Understanding on Drug Control in the Greater Mekong Sub-Region.

"Consumption and production of narcotic drugs continues to grow rapidly within the region and worldwide, constituting a significant threat to the East Asian region," according to a joint statement adopted at the meeting.

The countries and the UNODC pledged to heighten cross-border cooperation, examine alternative development programs, and share experiences in drug treatment, prevention, and public awareness.

"This agreement marks the continued commitment of the six MOU countries in supporting drug control in the region, and the celebration of 20 years of partnership and collaboration," said Myanmar representative Home Affairs Minister Lt. Gen. Ko Ko at the signing ceremony. "The MOU Member States re-affirm our commitment and assure the international community of our efforts to eliminate the drug problem in our region."

Southeast Asia has been a hotbed of methamphetamine production in recent years, and Myanmar is now the world's second largest producer of opium -- although its production is only about one-tenth that of world leader Afghanistan.

"Major challenges persist," said John Sandage, UNODC director of treaty affairs. "The resurgence of opium poppy cultivation, the dramatic spread of amphetamine-type stimulants (ATS), the influx of drugs new to the region and increased levels of addiction. UNODC looks forward to working with the MOU states to implement plans that help us better understand the threat and challenges, build technical capacity and lead to greater cooperation across borders and among agencies."

Nay Pyi Taw
Myanmar

Colorado Legislature Passes Sentencing Reform

In the final week of Colorado's legislative sessions, while all the attention was focused on passing marijuana commerce regulations, the state legislature quietly passed a measure designed to reduce the number of drug offenders sent to prison and save the state money. Senate Bill 250 had passed the Senate in April, the House passed it with amendments last Friday, and the Senate concurred with the House version Monday.

The bill creates a separate sentencing system for drug offenders and allows people convicted of some felony drug charges to be sentenced to probation and community-based sentencing and see that felony charge changed to a misdemeanor conviction upon completion of probation.

It also creates an "exhaustion of remedies" requirement for some drug offenders. That means they must have already participated in several other forms of treatment and sentencing before being sentenced to prison.

Those and other reform provisions in the bill will save the state of Colorado $5 million a year, according to the Colorado Commission on Criminal and Juvenile Justice. Some 550 offenders a year will be able to avoid prison sentences for their drug offenses under the new law, according to a legislative analysis.

"It's been a long time coming," said Sen. Steve King (R), sponsor of the bill. "It starts to deal with addiction issues and getting them off drugs."

The governor is expected to sign the bill shortly.

Denver, CO
United States

Colorado Harm Reduction Bills Pass

Colorado legislators approved not one, but two measures aimed at reducing the harms of drug use this week. Both a syringe exchange bill and a naloxone provision bill passed the legislature and now head for the governor's desk.

syringe exchange supplies (wikimedia.org)
The first measure, Senate Bill 208, expands on the Clean Syringe Exchange bill passed in 2010, which exempted staff and volunteers -- but not exchange participants -- from drug paraphernalia possession charges. That left actual injection drug users making use of the exchange at risk for being arrested for carrying clean or used syringes.

This year's bill adds participants to the categories of the protected. Now, participants in the state's six syringe exchange programs -- in Denver, Boulder, Grand Junction, and Fort Collins -- will be able to carry clean syringes and return used ones for proper disposal without fear of arrest.

The second bill, Senate Bill 14, authorizes anyone who might witness an opiate overdose to be prescribed and administer the opioid overdose reversal drug Naloxone. Naloxone has been shown repeatedly to safe lives by reducing the number of opioid drug overdose deaths.

Both bills were supported by the Denver-based Harm Reduction Action Center, the state Department of Public Health and Environment, and the Drug Policy Alliance. The syringe exchange bill was also supported by the, Denver Colorado AIDS Project, Boulder County Public Health, and the Colorado Criminal Justice Reform Coalition, while the Naloxone bill was also supported by the Colorado Medical Society, the Colorado Psychiatric Society, the Colorado Provider's Association, the Colorado Behavioral Health Council, and Mental Health America of Colorado.

Denver, CO
United States

Overdose Prevention Deal in New Jersey

Last fall, New Jersey Gov. Chris Christie (R) vetoed the Good Samaritan Emergency Response Act (Assembly Bill 578), which would have provided limited legal protection to people who witness a drug overdose and summon help. But on Tuesday, Christie changed his tune, reaching an agreement with legislative leaders to include Good Samaritan language in another overdose prevention bill that is sitting on his desk.

The legislature had meanwhile passed Assembly Bill 3095 to expand access to the opioid overdose antidote naloxone. Under the agreement with legislators, Christie conditionally vetoed that bill and agreed to add the Good Samaritan language. The legislature then reconvened, passing the amended measure by votes of 24-1 in the Senate and 68-2 in the House.

The Good Samaritan language Christie agreed to is less broad than envisioned in AB 578, but advocates said it still contains the most important protections for an effective Good Samaritan bill -- it would protect individuals from arrest and prosecution for drug possession charges as well as protection from revocation of parole and probation.

"My family and I are so thankful for this compromise," said Patty DiRenzo of Blackwood, whose son Salvatore died of an overdose at age 27. "We, and the other families who have lost loved ones to overdose, look forward to the day that Governor Christie signs this life-saving bill. It's extremely important that we prevent future overdose deaths and spare other families the grief that mine has endured."

 "We are incredibly grateful to the governor and legislative leadership and sponsors of these bills for working so hard to reach an agreement on this life-saving legislation,” said Roseanne Scotti, New Jersey state director for Drug Policy Alliance.

As prescription drug overdose numbers have mounted in the past decade, an increasing number of states have adopted measures such as Good Samaritan laws and widening the availability of naloxone in a bid to reduce the death toll. California, Connecticut, the District of Columbia, Illinois, Massachusetts, New Mexico, New York, North Carolina, Rhode Island, and Washington have all passed both kinds of law, while Colorado and Florida have passed Good Samaritan laws and Virginia has passed a naloxone law.

Trenton, NJ
United States

GAO Says ONCDP Not Achieving Drug Goals So Far

Just a day after the Office of National Drug Control Policy (ONDCP -- the drug czar's office) released its latest annual national drug control strategy, the Government Accountability Office (GAO) has issued a report finding that ONDCP has fallen well short of goals enunciated in its 2010 national drug strategy.

In the report, Office of National Drug Control Policy: Office Could Better Identify Opportunities to Increase Program Coordination, GAO noted that ONDCP and the federal government "have not made progress toward achieving most of the goals articulated in the 2010 National Drug Control Strategy." In some areas, including reducing teen drug use, reducing drug overdose deaths, and reducing HIV infections from injection drug use, GAO found, ONDCP was not only not making progress, but sometimes the numbers were moving in the opposite direction.

For instance, under the broader goal of "curtailing illicit drug consumption in America," ONDCP had set use reduction goals to be achieved by 2015. It sought to reduce last month drug use by teens by 15%, but has achieved no movement. Similarly, it sought a 15% reduction in past month use by young adults, but has achieved no movement. It also sought to reduce lifetime use of drugs, alcohol, and tobacco by 8th graders by 15%, and was making progress toward its goal with alcohol and tobacco, but not with illegal drugs.

Likewise, under ONDCP's broad goal of "improving the public health and public safety of the American people by reducing the consequences of drug use," ONDCP identified goals of reducing overdose deaths, drug-related hospital emergency room visits, and drug-related HIV infections by 15% by 2015, but showed "movement away from goal" between 2010 and 2012.

Drug czar Gil Kerlikowske is talking up a "21st Century Approach" to drug use with a heavy emphasis on treatment and prevention, but the latest national drug budget still allocates 58% of funding to law enforcement and interdiction. And those remaining funds for treatment and prevention are "fragmented" across 15 federal agencies, with much overlapping. GAO reviewed 76 federal drug treatment and prevention programs and found 59 of them overlapped.

GAO did note that while ONDCP was not showing progress in most of its goals, it had implemented 107 of the 112 "action items" contemplated to meet those goals. The auditors noted that "ONDCP officials stated that implementing these action items is necessary, but may not be sufficient to achieve Strategy goals."

Washington, DC
United States

White House 2013 National Drug Strategy Released

The White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) released its 2013 National Drug Control Strategy Wednesday. The strategy is being billed as a "21st Century Approach" to drug use and trafficking, but despite some rhetorical softening maintains the US hard-line approach to the issue.

"The president has outlined his vision of an America built to last -- where an educated, skilled workforce has the knowledge, energy and expertise to compete in the global marketplace. Yet -- for far too many Americans -- that vision is limited by drug use, which not only diminishes the potential of the individual, but jeopardizes families, communities and neighborhoods," ONDCP wrote on a blog post announcing the strategy's release and touting reductions in cocaine and prescription drug abuse as progress made.

"Today we are releasing a science-driven plan for drug policy reform in America to build upon this progress," ONDCP continued. "This 21st century drug policy outlines a series of evidence-based reforms that treat our nation's drug problem as a public health issue, not just a criminal justice issue. This policy underscores what we all know to be true: we cannot arrest or incarcerate our way out of the drug problem."

The strategy emphasizes treatment and prevention, but despite the rhetoric, the Fiscal Year 2014 federal drug budget it accompanies continues to be imbalanced, with 58% of federal anti-drug spending directed at law enforcement and interdiction efforts. That figure does mark a decline from previous years, but only a marginal one.

And even its emphasis on treatment also includes punitive criminal justice elements, such as its embrace of the drug court system, where drug-addicted people are subjected to legal sanctions for such addiction-related behaviors as failing a drug test or missing an appointment. That has some drug reformers calling foul.

"The administration says drug use is a health issue but then advocates for policies that put people in the criminal justice system," said Bill Piper, director of national affairs for the Drug Policy Alliance. "Until the drug czar says it is time to stop arresting people for drug use, he is not treating drug use as a health issue no matter what he says. I know of no other health issue in which people are thrown in jail if they don't get better."

While much of the strategy is little more than the same old same old, the strategy does call for expanded access to naloxone, a low-cost antidote that can reverse the effects of opioid overdoses. That is in response to the rapid growth in prescription drug overdose deaths in recent years.

"Director Kerlikowske should be applauded for taking steps to reduce drug overdose fatalities, but he's not doing much to reduce drug arrests or the many other problems associated with treating drug use through the criminal justice system," said Piper.

But while the drug strategy shows flexibility in its efforts to deal with fatal drug overdoses, it maintains a staunch opposition to marijuana reform and includes attacking outdoor and indoor marijuana cultivation as one of its key goals.

"The administration's continued opposition to marijuana law reform shows they're not serious about reforming US drug policy," said Piper. "At the very least they should stop getting in the way of states that are trying to improve public health and safety by regulating marijuana like alcohol."

Washington, DC
United States

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