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Will Oregon Have Three Marijuana Initiatives This Year? [FEATURE]

Oregonians going to the polls this November could have the chance to vote twice to legalize marijuana, or maybe even three times. Two separate legalization initiative campaigns are underway there, and both have a good shot at actually making it onto the ballot. And one of those campaigns also includes a constitutional amendment that could also make the ballot.

Oregon very nearly joined Colorado and Washington in legalizing it in 2012, when the underfunded Oregon Cannabis Tax Act (OCTA) got more than 47% of the vote. Prospects have only gotten brighter since then. A recent poll showed solid majorities for a specific tax and regulate question (58%) and for a generic legalization question (64%).

And even sectors of the state's political establishment have suggested that legalization is an idea whose time has come. Gov. John Kitzhaber (D) urged the legislature to pass a bill that would put its version of a legalization initiative before the voters. That bill died when the session ran out, but it garnered some support in Salem.

This year, one initiative campaign, the Oregon Cannabis Tax Act campaign, a double-pronged effort led by the controversial but persevering medical marijuana entrepreneur Paul Stanford, who put OCTA on the ballot in 2012, is already well into the signature-gathering process, while the other, led by New Approach Oregon, is awaiting resolution of a legal challenge to its ballot language and chomping at the bit for petitioners to hit the streets.

The clock is ticking. Initiative petitioners have until July 3 to hand in the 87,213 valid voter signatures to qualify for the November ballot. The bar for the constitutional amendment is set higher, at 116,284 valid voter signatures.

The Oregon Cannabis Tax Act (OCTA) and the Oregon Cannabis Amendment (OCA) are both Stanford creations. OCTA would create a commission to regulate marijuana cultivation, processing, and sales, while the OCA would amend the state constitution to remove both criminal and civil sanctions for "the private personal use, possession or production of cannabis." The OCA would allow the state to reasonably regulate and tax marijuana commerce if it decided to.

OCTA proponent Paul Stanford (Facebook)
"We started gathering in early September, and we're well on the way now," said Stanford. "It's all a matter of money, and we've got some. And we've got time -- until July 3. We can easily get the rest of the way by then. We will be on the ballot."

The 2014 version of OCTA has some changes from the 2012 version. Gone is the historical preamble, which took up a quarter of the original OCTA, and which was derided by opponents. The new OCTA also adds limits for personal cultivation and possession, but generous ones: 24 ounces and 24 plants.

"We got 47% allowing people to grow and possess unlimited amounts for personal use, but people want limits," said Stanford. "Our limits are the same as those the legislature passed for medical patients in 2005."

The new OCTA retains the idea of marijuana commission to oversee legal commerce, but it has given authority over all appointments to that commission to the governor. The 2012 version had a majority of commission members elected by license marijuana business owners, a feature that left it open to charges it was creating a regulatory body captive to the industry it was supposed to regulate.

"The media portrayed this as akin to putting Philip Morris in charge of regulating the tobacco industry," Stanford explained. "So we put back to all appointed by the governor."

OCTA can win this year, and OCTA could have won in 2012 if it could have attracted sufficient funding, Stanford argued.

"In Washington, they spent $7 million; in Colorado, they spent $4 million; here in Oregon, we spent also half a million, and we only lost by 112,000 votes," he said. "Another $200,000 probably would have done it. It's the inverse law of cannabis reform funding -- the better an initiative is for the people and the planet, the less funding it gets from major funders."

While OCTA is getting some outside financial help this year -- Texas head shop owner Michael Kleinman's Foundation for Constitutional Protection has kicked in $97,000 so far, and Stanford said he hoped to announce a new funder this week -- it's gotten no support from big money groups like the Drug Policy Alliance, the Marijuana Policy Project, or Graham Boyd, the man with access to the funds of the late Peter Lewis.

New Approach Oregon's Control, Regulation, and Taxation of Marijuana and Industrial Hemp Act and its near-identical placeholder companion, the Control, Regulation and Taxation of Marijuana and Hemp Act of 2014 has, the group says, access to funding to get on the ballot, but it faces an obstacle of a different sort -- a legal challenge to its ballot language that has delayed signature gathering. That's largely the reason for the second version of the initiative; it is so far unchallenged, and if the first one is blocked by the state Supreme Court, signature gathering can then begin on the second.

"We're just waiting for our ballot title to get finalized, then we gather signatures," said Anthony Johnson, campaign manager for New Approach Oregon. "We expect the challenge to be done by the first of May, and our signature-gathering firm has assured us that if we are collecting by the first of May, we will have plenty of time to get on the ballot," he said.

"We've received pledges of a million dollars to get us on the ballot, and we expect to have time to gather the necessary signatures," he continued. While Johnson declined to get more specific about funding sources, he did say that "our funding team has always included the Drug Policy Alliance, as well as other national funders."

The New Approach initiative would legalize the personal possession of up to eight ounces and allow for the cultivation of four plants. And instead of a marijuana commission, it would rely on the Oregon Liquor Control Commission to regulate marijuana commerce, with a tax set at $35 an ounce.

Both Oregon initiative campaigns appear to be well-positioned to make the ballot this year, and that makes it one of the most likely to join the ranks of the legalization states this year. Alaska should get there first -- voters there go to the polls on their legalization initiative in August -- and Washington, DC, where signature-gathering for a legalization initiative should get underway shortly, is the other locale likely to go in 2014. That looks like it for this year, but at least in Oregon, they could do it twice, or even thrice on one ballot. And both campaigns say they will vote for any initiative that legalizes marijuana.

"If he makes the ballot, we will support any measure that improves the status quo," said Johnson.

"Or course I'll be voting for New Approach Oregon, and I encourage everyone else to," said Stanford.

That's the spirit.

OR
United States

Growing Demands for UN Drug Policy Reform [FEATURE]

The United Nations' Commission on Narcotic Drugs (CND) has wrapped up the High-Level Segment portion of its annual meeting in Vienna. The session revealed schisms among countries about future steps on global drug control even as the global drug bureaucrats gave signs of softening in some policy areas, especially around emphasizing public health as opposed to criminalization.

An indication of relaxation came when a key working group of the United Nations Office on Drugs and Crime (UNODC) announced the release of groundbreaking recommendations discouraging criminal sanctions for drug use. The Scientific Consultation Working Group on Drug Policy, Health and Human Rights of the UNODC -- which includes Nora Volkow, head of the US National Institute on Drug Abuse (NIDA) -- released the recommendations as the session got underway. The working group recommendations say 'criminal sanctions are not beneficial' in addressing the spectrum of drug use and misuse.

Getting down to business at the CND in Vienna (unodc.org)
The meeting ended with a formal joint ministerial statement agreed to at the last minute after months of contentious wrangling, but one where countries failed to agree on a common approach and where certain fractious issues -- such as the use of the death penalty for drug offenses or even the mention of the term "harm reduction" -- were omitted entirely.

Countries critical of the global drug policy status quo, particularly from Europe and Latin America, were joined by an ever-stronger civil society presence at the CND. The message of reform grows ever louder and presages an especially contentious next step, the UN General Assembly Special Session (UNGASS) on Drugs, set for 2016.

It's not just change in the halls of the UN drug bureaucracies, but changes on the ground that are helping to drive the debate. Uruguay and two US state, Colorado and Washington, have legalized marijuana in apparent contravention of the global drug treaties, and Latin American countries in particular have for several years now expressed growing dismay at the drug war status quo.

Uruguay's decision to legalize marijuana commerce was "not a solution to dealing with the world's drug problem," UN Office on Drugs and Crime (UNODC) head Yuri Fedotov said just days ago, and the International Narcotics Control Board (INCB) called the Uruguayan government "pirates" for going up against the UN drug conventions. But the UN drug bureaucrats were singing a slightly softer tune last week in Vienna.

Taking in the discussions in Vienna (idpc.net)
"My impression from the debates so far is that the prevailing mood is to say no to dismantling the provisions of the conventions, but yes to returning to the original spirit of the conventions: protection of health, welfare, and safety of people," Fedotov said in anodyne remarks at the release of the ministerial statement.

"The provisions of the conventions indeed are flexible, human rights based, and founded on the protection of health. I would like particularly to stress the need of strengthening the public health in a comprehensive, balanced, scientific evidence-based approach, that is very important, and fully consistent with human rights standards," Fedotov continued. "There is also a growing need for every country to move away from compulsory treatments and punitive measures and towards embracing these approaches, including protection against HIV/AIDS, as envisaged by the Conventions."

The ministerial statement itself, a compromise document, for the most part blandly supported the existing international drug control regime, although it, too, signaled a shift toward a more public health-oriented approach, and it obliquely referenced ongoing dissent by noting "the ongoing discussions in some regions on how to address the world drug problem, in light of the current situation and policies, and emphasize the importance of a broad, transparent, inclusive and scientific evidence-based discussion among Member States, with inputs from other relevant stakeholders, as appropriate, in multilateral settings, on the most effective ways to counter the world drug problem consistent with the three international drug control conventions…"

But behind the smooth language of the official statements, there was real anger and dismay at the toll of more than a half-century of global drug prohibition.

"People have been sacrificed in our actions to tackle the drug problem," Colombian Justice Minister Gomez Mendez told delegates. "We call for more effective ways to achieve the objectives stated in international agreements. Alternatives are needed. Drug policies cannot travel at the speed of a telegraph while drug problems develop at the speed of broadband Internet."

ENCOD's Coffee Sniffer Brigade reenacted prohibitions of yore, to the bemusement of CND security. (encod.org)
"We should not be driven by ideologies and wishful thinking. We unfortunately know today that the idea of a drug-free world based on the belief that, if we eradicate supply, we will reduce demand, is not achievable. We should look to and evaluate alternative regimes appearing in North and South America and in Europe rather than just be silent about it", said the Czech Republic delegate, echoing the calls for drug policy reform made by not only Colombia, but also Guatemala, Ecuador, Mexico and Uruguay.

"Since 1961, due to a rigid and narrow interpretation of the UN drug conventions, there has been one single means to control the use of cannabis -- criminalization has been imposed, "said Diego Canepa, representative of the delegation of Uruguay. "We have don't have a magic recipe, but we are trying to find a way out and snatch the market away from traffickers. We have a responsibility to represent our citizens, and not to take the challenge and act accordingly would be an unforgivable error."

The Mexican delegation said that health policies should be encouraged instead of the criminalization of drug use and that a thorough review of the international drug strategies is required. The delegation of Guatemala highlighted that "the revision of the UN drug conventions is needed and that the Latin American hemispheric debate is ongoing."

"The failure of present drug policies has generated questions from governments, policy-makers, intellectuals and civil society organizations from across the region," said the Ecuadorian delegation. "Many voices are calling for a change in paradigm in the understanding and approach to the drug phenomenon."

Even the US delegation was sounding eerily reformist. Acting Office of National Drug Control Policy (ONDCP -- the drug czar's office) head Michael Botticelli called for continuing down "the path of criminal justice reform" and cited recent Obama administration moves to minimize mandatory minimum drug sentences.

But the call for reform came most loudly in the person of Eliot Ross, representing the International Network of People Who Use Drugs, who noted that human rights law and drug control law continued to be inconsistent, and called for a comprehensive overhaul of the treaties and amnesty for drug prisoners.

Changing the global drug control system for the better is agonizingly slow work -- it's been 16 years since hundreds of global intellectuals signed an open letter in The New York Times calling on the last UNGASS on Drugs to begin to adopt fundamental reforms. But, under the weight of rising pressure, the creaky machine is starting to move.

"We derive hope from the fact that, contrary to earlier CND meetings, there are now countries openly condemning prohibition as the basic answer to drug problems," said ENCOD (the European NGO Council for Just and Effective Drug Policies). "More than ever, not just governmental but UNODC officials see the writing on the wall. Instead of insisting on the need to create 'a drug free world', they refer to the need to protect people and societies from the damages of drugs and drug trafficking. We continue to urge governments to put these words into action and steadily direct their policy towards legal regulation as the only way to reduce harms and increase public safety. We hope for and expect major change at the 2016 UNODC meetings in New York. Prohibitionary drug laws are the problem. Removing them is the solution."

In a theatrical jab at prohibitions gone by, ENCOD activists reprised the strange saga of the Coffee Sniffer Brigade, a group of disabled soldiers who had to enforce the ban on coffee roasting and brewing that was imposed by the Prussian King Frederick the Great in the second half of the 18th Century. Delegates reacted first with reservation, then with support, the activists reported.

"The remaking of the system is happening before our eyes. For decades governments used the United Nations to push a one-size-fits-all approach," said Joanne Csete, deputy director of the Open Society Global Drug Policy Program. "The dissent we're seeing today is the deconstruction of the international drug war."

"This is the beginning of a serious re-think on drug control," said Ann Fordham, executive director of the International Drug Policy Consortium. "Billions of dollars have been wasted, millions of people have been criminalized, thousands of lives have been lost and the drug cartels carry on getting richer. Given this reality, the charade of a global consensus on drugs is now unacceptable, and some governments have found the courage to speak out."

Responding to Holder on Heroin, Reformers Call for a Health Direction [FEATURE]

US Attorney General Eric Holder had heroin on his mind Monday, using his weekly video message and an accompanying press release to draw attention to rising heroin overdose deaths and vowing to combat the problem with a combination of law enforcement, treatment, prevention, and harm reduction measures. Drug reformers generally responded positively, but called on the Obama administration to seek comprehensive, science- and health-based solutions instead of engaging in more drug war.

Attorney General Holder takes on heroin (usdoj.gov)
"Addiction to heroin and other opiates -- including certain prescription pain-killers -- is impacting the lives of Americans in every state, in every region, and from every background and walk of life -- and all too often, with deadly results. Between 2006 and 2010, heroin overdose deaths increased by 45%," Holder said. "Scientific studies, federal, state and local investigations, addiction treatment providers, and victims reveal that the cycle of heroin abuse commonly begins with prescription opiate abuse. The transition to -- and increase in -- heroin abuse is a sad but not unpredictable symptom of the significant increase in prescription drug abuse we've seen over the past decade."

What Holder didn't mention is that the rise in prescription pain pill misuse is tied to a massive increase in prescribing opioids for pain in the past decade. A study published last fall found that between 2000 and 2010, the amount of opioids prescribed for non-cancer pain had nearly doubled, and that during the same period, the percentage of people complaining of pain who received prescriptions for opioids jumped from 11% to nearly 20%. But reining in prescriptions generally isn't the answer either.

But at the same time, a 2011 Institute of Medicine report found that while "opioid prescriptions for chronic non-cancer pain [in the US] have increased sharply… 29% of primary care physicians and 16% of pain specialists report they prescribe opioids less often than they think appropriate because of concerns about regulatory repercussions."

As the IOM report noted, having more opioid prescriptions doesn't necessarily mean that "patients who really need opioids [are] able to get them." Opioid misuse and under-use of opioids for pain treatment when they are needed are problems that coexist in society. Pain pill crackdowns have also been found to result in increased use of street heroin, as a Washington Post article last week reports -- two additional reasons advocates prefer public health approaches to heroin more than law enforcement -- and why great care should be taken with the law enforcement measures.

"It's clear that opiate addiction is an urgent -- and growing -- public health crisis. And that's why Justice Department officials, including the DEA, and other key federal, state, and local leaders, are fighting back aggressively," Holder continued. "Confronting this crisis will require a combination of enforcement and treatment. The Justice Department is committed to both."

Holder pointed to DEA efforts to prevent diversion of pharmaceutical pain-relievers to non-medical users, mentioning investigations of doctors, pharmacists, and distributors.

"With DEA as our lead agency, we have adopted a strategy to attack all levels of the supply chain to prevent pharmaceutical controlled substances from getting into the hands of non-medical users," Holder said.

Cooking heroin (wikimedia.org)
Holder also pointed out that DEA had opened some 4,500 heroin investigations since 2011 and promising more to come.

But, as Holder noted, "enforcement alone won't solve the problem," so the administration is working with civil society and law enforcement "to increase our support for education, prevention, and treatment."

And although he didn't use the words "harm reduction," Holder is also calling for some harm reduction measures. He urged law enforcement and medical first responders to carry the overdose reversal drug naloxone (Narcan) and signaled support for "911 Good Samaritan" laws, which grant immunity from criminal prosecution to those seeking medical help for someone experiencing an overdose.

Holder got restrained plaudits from drug reformers for his small steps toward harm reduction measures, but they called for a more comprehensive approach.

"Preventing fatal overdose requires a comprehensive solution," said Meghan Ralston, harm reduction manager for the Drug Policy Alliance. "While naloxone is an absolutely critical component, we need a scientific, health-based approach to truly address the roots of the problem. This includes improving access to effective, non-coercive drug treatment for everyone who wants it, as well as improving access to medication-assisted treatments such as methadone and buprenorphine."

Naloxone (Narcan) can reverse opiate overdoses (wikimedia.org)
Ralston also added that just making naloxone available to cops and EMTs wasn't good enough. Friends and family members, not "first responders," are most often the people who encounter others in the throes of life-threatening overdoses.

"While we applaud Attorney General Holder's clear support for expanding access to naloxone, particularly among law enforcement and 'first responders,' we urge him to clarify that he supports naloxone access for anyone who may be the first person to discover an opiate overdose in progress," she said.

But Law Enforcement Against Prohibition (LEAP), a group of law enforcement officials opposed to the war on drugs, applauded the move, which could help soften reflexive law enforcement opposition to carrying the overdose antidote, an attitude reflected in the the International Association of Chiefs of Police's opposition to all harm reduction measures.

"Police may not be the first to embrace change, but we are slowly evolving," said Lieutenant Commander Diane Goldstein (Ret.). "We cannot arrest our way out of a public health problem, and it's clear that the Attorney General is beginning to understand that and to embrace the role of harm reduction in reducing death, disease and addiction in our communities. We still have a long way to go, but this is a good sign."

The idea is "a no-brainer," according to executive director Major Neill Franklin (Ret.). "It is simply immoral not to support something proven to save lives for political reasons," Franklin added. "Yes, police send a message when they choose not to carry naloxone. But that message is not 'don't do drugs,' it's 'if you make the wrong decisions in your life, we don't care about you.' That offends me both as a former cop and as a human being."

The nuanced pushback to Holder's law enforcement/prevention/treatment/hint of harm reduction approach is good as far as it goes, but it doesn't go far enough. Decriminalizing and destigmatizing now illicit drug use, as has been the case in Portugal, is an obvious next step, and removing the question of drugs from the purview of the criminal justice system altogether would be even better. Still, that a sitting attorney general is calling for treatment and harm reduction as well as law enforcement is a good thing, and for reformers to be calling him on not going far enough is a good thing, too.

"The New Jim Crow" Author Michelle Alexander Talks Race and Drug War [FEATURE]

On Thursday, Michelle Alexander, author of the best-selling and galvanizing The New Jim Crow: Mass Incarceration in the Age of Colorblindness sat down with poet/activist Asha Bandele of the Drug Policy Alliance to discuss the book's impact and where we go from here.

Michelle Alexander (wikimedia.org)
The New Jim Crow has been a phenomenon. Spending nearly 80 weeks on The New York Times bestseller list, it brought to the forefront a national conversation about why the United States had become the world's largest incarcerator, with 2.2 million in prison or jail and 7.7 million under control of the criminal justice system, and African American boys and men -- and now women -- making up a disproportionate number of those imprisoned. Alexander identified failed drug war policies as the primary driver of those numbers, and called for a greater challenge to them by key civil rights leaders.

It's now been nearly four years since The New Jim Crow first appeared. Some things have changed -- federal sentencing reforms, marijuana legalization in two states -- but many others haven't. Alexander and Bandele discuss what has changed, what hasn't, and what needs to, raising serious questions about the path we've been down and providing suggestions about new directions.

Audio of the conversation is online here, and a transcript follows here:

Asha Bandele: The US has 5% of the world's population, but has 25% of the world's incarcerated population, and the biggest policy cause is the failed drug war. How has the landscape changed in the last four years since The New Jim Crow came out?

Michelle Alexander: The landscape absolutely has changed in profound ways. When writing this book, I was feeling incredibly frustrated by the failure of many civil rights organizations and leaders to make the war on drugs a critical priority in their organization and also by the failure of many of my progressive friends and allies to awaken to the magnitude of the harm caused by the war on drugs and mass incarceration. At the same time, not so long ago, I didn't understand the horror of the drug war myself, I failed to connect the dots and understand the ways these systems of racial and social control are born and reborn.

But over last few years, I couldn't be more pleased with reception. Many people warned me that civil rights organizations could be defensive or angered by criticisms in the book, but they've done nothing but respond with enthusiasm and some real self-reflection.

There is absolutely an awakening taking place. It's important to understand that this didn't start with my book -- Angela Davis coined the term "prison industrial complex" years ago; Mumia Abu-Jamal was writing from prison about mass incarceration and our racialized prison state. Many, many advocates have been doing this work and connecting the dots for far longer than I have. I wanted to lend more credibility and support for the work that so many have been doing for some, but that has been marginalized.

I am optimistic, but at the same time, I see real reasons for concern. There are important victories in legalizing marijuana in Colorado and Washington, in Holder speaking out against mandatory minimums and felon disenfranchisement, in politicians across the country raising concerns about the size of the prison state for the first time in 40 years, but much of the dialog is still driven by fiscal concerns rather than genuine concern for the people and communities most impacted, the families destroyed. We haven't yet really had the kind of conversation we must have as a nation if we are going to do more than tinker with the machine and break our habit of creating mass incarceration in America.

Asha Bandele: Obama has his My Brother's Keeper initiative directed at black boys falling behind. A lot of this is driven by having families and communities disrupted by the drug war. Obama nodded at the structural racism that dismembers communities, but he said it was a moral failing. He's addressed race the least of any modern American president. Your thoughts?

Michelle Alexander: I'm glad that Obama is shining a spotlight on the real crisis facing black communities today, in particular black boys and young men, and he's right to draw attention to it and elevate it, but I worry that the initiative is based more in rhetoric than in a meaningful commitment to addressing the structures and institutions that have created these conditions in our communities. There is a commitment to studying the problem and identifying programs that work to keep black kids in school and out of jail, and there is an aspect that seeks to engage foundations and corporations, but there is nothing in the initiative that offers any kind of policy change from the government or any government funding of any kind to support these desperately needed programs.

There is an implicit assumption that we just need to find what works to lift people up by their bootstraps, without acknowledging that we're waging a war on these communities we claim to be so concerned about. The initiative itself reflects this common narrative that suggests the reasons why there are so many poor people of color trapped at the bottom -- bad schools, poverty, broken homes. And if we encourage people to stay in school and get and stay married, then the whole problem of mass incarceration will no longer be of any real concern.

But I've come to believe we have it backwards. These communities are poor and have failing schools and broken homes not because of their personal failings, but because we've declared war on them, spent billions building prisons while allowing schools to fail, targeted children in these communities, stopping, searching, frisking them -- and the first arrest is typically for some nonviolent minor drug offense, which occurs with equal frequency in middle class white neighborhoods but typically goes ignored. We saddle them with criminal records, jail them, then release them to a parallel universe where they are discriminated against for the rest of their lives, locked into permanent second-class status.

We've done this in the communities most in need our support and economic investment. Rather than providing meaningful support to these families and communities where the jobs have gone overseas and they are struggling to move from an industrial-based economy to a global one, we have declared war on them. We have stood back and said "What is wrong with them?" The more pressing question is "What is wrong with us?"

Asha Bandele: During the Great Depression, FDR had the New Deal, but now it seem like there is no social commitment at the highest levels of government. And we see things like Eric Holder and Rand Paul standing together to end mandatory minimums. Is this an unholy alliance?

Michelle Alexander: We have to be very clear that so much of the progress being made on drug policy reflects the fact that we are at a time when politicians are highly motivated to downsize prisons because we can't afford the massive prison state without raising taxes on the predominantly white middle class. This is the first time in 40 years we've been willing to have a serious conversation about prison downsizing.

But I'm deeply concerned about us doing the right things for the wrong reasons. This movement to end mass incarceration and the war on drugs is about breaking the habit of forming caste-like systems and creating a new ethic of care and concern for each of us, this idea that each of us has basic human rights. That is the ultimate goal of this movement. The real issue that lies at the core of every caste system ever created is the devaluing of human beings.

If we're going to do this just to save some cash, we haven't woken up to the magnitude of the harm. If we are not willing to have a searching conversation about how we got to this place, how we are able to lock up millions of people, we will find ourselves either still having a slightly downsized mass incarceration system or some new system of racial control because we will have not learned the core lesson our racial history is trying to teach us. We have to learn to care for them, the Other, the ghetto dwellers we demonize.

Temporary, fleeting political alliances with politicians who may have no real interest in communities of color is problematic. We need to stay focused on doing the right things for the right reasons, and not count as victories battles won when the real lessons have not been learned.

Asha Bandele: Portugal decriminalized all drugs and drug use has remained flat, overdoses been cut by a third, HIV cut by two-thirds. What can we learn from taking a public health approach and its fundamental rejection of stigma?

Michelle Alexander: Portugal is an excellent example of how it is possible to reduce addiction and abuse and drug related crime in a non-punitive manner without filling prisons and jails. Supposedly, we criminalize drugs because we are so concerned about the harm they cause people, but we wind up inflicting far more pain and suffering than the substances themselves. What are we doing really when we criminalize drugs is not criminalizing substances, but people.

I support a wholesale shift to a public health model for dealing with drug addiction and abuse. How would we treat people abusing if we really cared about them? Would we put them in a cage, saddle them with criminal records that will force them into legal discrimination the rest of their lives? I support the decriminalization of all drugs for personal use. If you possess a substance, we should help you get education and support, not demonize, shame, and punish you for the rest of your life.

I'm thrilled that Colorado and Washington have legalized marijuana and DC has decriminalized it -- these are critically important steps in shifting from a purely punitive approach. But there are warning flags. I flick on the news, and I see images of people using marijuana and trying to run legitimate businesses, and they're almost all white. When we thought of them as black or brown, we had a purely punitive approach. Also, it seems like its exclusively white men being interviewed as wanting to start marijuana businesses and make a lot of money selling marijuana.

I have to say the image doesn't sit right. Here are white men poised to run big marijuana businesses after 40 years of impoverished black kids getting prison time for doing the same thing. As we talk about legalization, we have to also be willing to talk about reparations for the war on drugs, as in how do we repair the harm caused.

With regard to Iraq, Colin Powell said "If you break it, you own it," but we haven't learned that basic lesson from our own racial history. We set the slaves free with nothing, and after Reconstruction, a new caste system arose, Jim Crow. A movement arose and we stopped Jim Crow, but we got no reparations after the waging of a brutal war on poor communities of color that decimated families and fanned the violence it was supposed to address.

Do we simply say "We're done now, let's move on" and white men can make money? This time, we have to get it right; we have to tell the whole truth, we have to repair the harm done. It's not enough to just stop. Enormous harm had been done; we have to repair those communities.

War of Words: The International Narcotics Control Board vs. A Changing World [FEATURE]

The global drug prohibition bureaucracy's watchdog group, the International Drug Control Board (INCB) released its Annual Report 2013 today, voicing its concerns with and wagging its finger at drug reform efforts that deviate from its interpretation of the international drug control treaties that birthed it. The INCB is "concerned" about moves toward marijuana legalization and warns about "the importance of universal implementation of international drug control treaties by all states."

"We deeply regret the developments at the state level in Colorado and Washington, in the United States, regarding the legalization of the recreational use of cannabis," INCB head Raymond Yans said in introducing the report. "INCB reiterates that these developments contravene the provisions of the drug control conventions, which limit the use of cannabis to medical and scientific use only. INCB urges the Government of the United States to ensure that the treaties are fully implemented on the entirety of its territory."

For some years now, some European and Latin American countries have been expressing a desire to see change in the international system, and "soft defections," such as the Dutch cannabis coffee shop system and Spain's cannabis cultivation clubs, have stretched the prohibitionist treaties to their legal limits. But legal marijuana in Uruguay is a clear breach of the treaties, as Colorado and Washington may be. That is bringing matters to an unavoidable head.

After surveying the state of drug affairs around the globe, the 96-page INCB report ends with a number of concerns and recommendations, ranging from non-controversial items such as calling for adequate prevention and treatment efforts to urging greater attention to prescription drug abuse and more attention paid to new synthetic drugs. [Ed: There is some controversy over how to best approach prescription drug abuse and synthetic drugs. e.g. the type of attention to pay to them.]

But the INCB is clearly perturbed by the erosion of the international drug prohibition consensus, and especially by its concrete manifestations in legalization in Uruguay, Colorado, and Washington and the spreading acceptance of medical marijuana.

"The Board is concerned that a number of States that are parties to the 1961 Convention are considering legislative proposals intended to regulate the use of cannabis for purposes other than medical and scientific ones" and "urges all Governments and the international community to carefully consider the negative impact of such developments. In the Board's opinion, the likely increase in the abuse of cannabis will lead to increased public health costs," the report said.

Similarly, the INCB "noted with concern" Uruguay's marijuana legalization law, which "would not be in conformity with the international drug control treaties, particularly the 1961 Convention" and urged the government there "to ensure the country remains fully compliant with international law, which limits the use of narcotic drugs, including cannabis, exclusively to medical and scientific purposes."

Ditto for Colorado and Washington, where the board was "concerned" about the marijuana legalization initiatives and underlined that "such legislation is not in conformity with the international drug control treaties." The US government should "continue to ensure the full implementation of the international drug control treaties on its entire territory," INCB chided.

But even as INCB struggles to maintain the legal backbone of global prohibition, it is not only seeing marijuana prohibition crumble in Uruguay and the two American states, it is also itself coming under increasing attack as a symbol of a crumbling ancien regime that creates more harm than good with its adherence to prohibitionist, law enforcement-oriented approaches to the use and commerce in psychoactive substances.

"We are at a tipping point now as increasing numbers of nations realize that cannabis prohibition has failed to reduce its use, filled prisons with young people, increased violence and fueled the rise of organized crime," said Martin Jelsma of the Transnational Institute. "As nations like Uruguay pioneer new approaches, we need the UN to open up an honest dialogue on the strengths and weaknesses of the treaty system rather than close their eyes and indulge in blame games."

"For many years, countries have stretched the UN drug control conventions to their legal limits, particularly around the use of cannabis," agreed Dave Bewley-Taylor of the Global Drug Policy Observatory. "Now that the cracks have reached the point of treaty breach, we need a serious discussion about how to reform international drug conventions to better protect people's health, safety and human rights. Reform won't be easy, but the question facing the international community today is no longer whether there is a need to reassess and modernize the UN drug control system, but rather when and how."

"This is very much the same old stuff," said John Collins, coordinator of the London School of Economics IDEAS International Drug Policy Project and a PhD candidate studying mid-20th Century international drug control policy. "The INCB views its role as advocating a strict prohibitionist oriented set of policies at the international level and interpreting the international treaties as mandating this one-size-fits-all approach. It highlights that INCB, which was created as a technical body to monitor international flows of narcotics and report back to the UN Commission on Narcotic Drugs, has carved out and maintains a highly politicized role, far removed from its original treaty functions. This should be a cause for concern for all states interested in having a functioning, public health oriented and cooperative international framework for coordinating the global response to drug issues," Collins told the Chronicle.

"The INCB and its current president, Raymond Yans, take a very ideological view of this issue," Collins continued. "Yans attributes all the negative and unintended consequences of bad drug policies solely to drugs and suggests the way to lessen these problems is more of the same. Many of the policies the board advocates fly in the face of best-practice public health policy -- for example the board demanding that states close 'drug consumption rooms, facilities where addicts can abuse drugs,'" he noted.

"If the board was really concerned about the 'health and welfare' of global populations it would be advocating for these scientifically proven public health interventions. Instead it chooses the road of unscientific and ideological based policies," Collins argued.

The INCB's reliance on ideology-driven policy sometimes leads to grotesque results. There are more than 30 countries that apply the death penalty for drugs in violation of international law. Virtually every international human rights and drug control body opposes the death penalty for drugs including the United Nations Office on Drugs and Crime, the UN Human Rights Committee, the UN's human rights experts on extrajudicial killings, torture and health, among many others.

INCB head Raymond Yans (incb.org)
But when an INCB board member was asked in Thailand -- where 14 people have been executed for drugs since 2001 -- what its position on capital punishment was, he said, "the agency says it neither supports nor opposes the death penalty for drug-related offenses," according to the Bangkok Post.

Human rights experts were horrified and immediately wrote asking for clarification, to which the INCB responded, "The determination of sanctions applicable to drug-related offenses remains the exclusive prerogative of each State and therefore lie beyond the mandate and powers which have been conferred upon the Board by the international community," according to Human Rights Watch.

Another area where the board's concern about the health and welfare of global populations is being challenged is access to pain medications. A key part of the INCB's portfolio is regulating opioid pain medications, and this year again it said there is more than enough opium available to satisfy current demand, although it also noted that "consumption of narcotic drugs for pain relief is concentrated within a limited number of countries."

The World Health Organization (WHO) agrees about that latter point. A 2011 study estimated that around 5.5 billion people -- or 83% of the world population -- live in countries with 'low to non-existent' access to opioid pain relief for conditions such as cancer and HIV/AIDS. These substances are listed by the WHO as essential medicines, and the international drug control conventions recognise explicitly that they are 'indispensable' to the 'health and welfare of mankind.'

Adding to the paradox -- the global supply is sufficient, but four-fifths of the world doesn't have access -- the INCB calls on governments to "ensure that internationally controlled substances used for pain relief are accessible to people who need them."

What is going on?

"The INCB uses totals of requirements for opioid medicines compiled by the UN treaty signatory states," said Ann Fordham, executive director of the International Drug Policy Consortium, which keeps an eye on the agency with its INCB Watch. "Unfortunately there is often a huge gap between these administrative estimates and the actual medical needs of their populations."

The prohibitionist slant of global drug control also creates a climate conducive to understating the actual need for access to pain relief in other ways, Fordham told the Chronicle.

"Many governments interpret the international drug control conventions in a more restrictive manner than is necessary, and focus their efforts towards preventing access to the unauthorized use of opioids rather than to ensuring their medical and scientific availability," she said. "This is a grossly unbalanced reading of the conventions, underpinned by fear and prejudice regarding opioids and addiction."

Although the agency has cooperated somewhat with the WHO in attempting to enhance access to the medicines, said Fordham, it bears some blame for rendering the issue so fraught.

"The INCB has continually stressed the repressive aspect of the international drug control regime in its annual reports and other public statements, and in its direct dealings with member states," she said. "The INCB is therefore responsible for at least some of the very anxieties that drive governments toward overly restrictive approaches. This ambivalence considerably weakens the INCB's credibility and contradicts its health-related advocacy."

Fordham joined the call for a fundamental reform of global drug prohibition, and she didn't mince words about the INCB.

"The entire UN drug control system needs to be rebalanced further in the direction of health rather than criminalization, and it is changing; the shift in various parts of the system is apparent already," she said before leveling a blast at Yans and company. "But the INCB is notable as the most hard line, backward-looking element, regularly overstepping its mandate in the strident and hectoring manner its adopts with parties to the treaties, in its interference in functions that properly belong to the WHO and in its quasi-religious approach to a narrow interpretation of the drug control treaties."

The INCB should get out of the way on marijuana and concentrate on its pain relief function, said Collins.

"The INCB should stay out if it," he said bluntly. "It is a technocratic monitoring body. It should not be involving itself in national politics and national regulatory systems. So it doesn't need to be either a help or hindrance on issues regarding cannabis reform. It has no reason to be involved in this debate. It should be focusing on ensuring access to essential pain medicines. These debates are a distraction from that core function and I would argue one of the reasons it is failing to meet this core function."

Sorry, INCB. Welcome to the 21st Century.

Vienna
Austria

The Capture of El Chapo: A Capo Gone, But the Trade Goes On [FEATURE]

Special to the Chronicle by Bernd Debusmann, Jr., who is currently studying for an MA in International Journalism at City University London. Prior to that, he lived and worked in his native Mexico, most of it as a full-time freelancer for Reuters TV, also contributing to Fox Latino. Earlier he worked as a reporter in New York City and as a freelance producer for the Reuters Latin American Television Desk in Washington DC, during which time he dealt with many drug trafficking stories. During 2010 and 2011 he authored the weekly Mexico Drug War Update published by this newsletter, available in our Mexican Drug War archive section.

At around 06:40 on the morning of Saturday, February 22nd, Mexican marines and police officers arrested Sinaloa Cartel boss Joaquin "El Chapo" Guzman at a condominium in the Pacific resort town of Mazatlan. Without a doubt, Guzman is the most significant organized criminal captured or killed since the current Mexican drug war began in December 2006. But what effect will his capture have on the violence in Mexico and the flow of drugs to American consumers? Not much.

El Chapo in the custody of Mexican Marines Saturday (sedena.gob.mx)
Guzman was widely regarded as the world's most powerful drug trafficker, and his aggressive organization has been a significant contributor to the violence that has gripped Mexico in recent years. This is especially true in Tijuana and Ciudad Juarez, where the Sinaloa Cartel's bloody and drawn-out takeover of the access routes to the US drug market left thousands dead over the course of a three year orgy of violence.

Since his January 2001 escape from prison, Guzman turned into a mythic figure, Mexico's answer to Osama bin Laden. For much of his administration, former president Felipe Calderon was dogged by accusations that he was protecting Guzman, and ridiculed for not being able to find him. In February 2013, the Chicago Crime Commission named him "Public Enemy #1" for his role trafficking wholesale quantities of cocaine and heroin to the city.

Given his notoriety, Guzman's successful capture is a significant PR victory for the PRI administration of President Enrique Pena Nieto, as well as for the DEA and other American law enforcement agencies. But the victory may well prove much more symbolic than strategically meaningful.

Guzman's capture does not mean an end to the Sinaloa Cartel, a long-established and sophisticated organization whose tentacles spread across the world. The cartel is often referred to as "The Federation," of which Guzman was not the only leader. In his absence, much of the organization will likely come under the control of Ismael Zambada Garcia, aka "El Mayo," a capable and intelligent career drug trafficker considered by many to have been Guzman's equal. The organization can also count on the services of Juan Jose Esparragoza Moreno, aka "El Azul," a crafty former police officer well known for serving as a peacemaker between rival criminal organizations.

Another possibility is that Guzman may well be able to continue to exercise some control over the organization from inside prison, as he did the last time he was incarcerated. Mexico's prisons are notoriously corrupt, and many drug traffickers and criminals have been able to continue to direct the day-to-day operations of their organizations in relative comfort in posh cells.

Guzman's capture is very unlikely to have an effect on the overall level of violence in Mexico, and may actually lead to an increase in more bloodshed and mayhem if the Federation were to break up into rival factions fighting to fill the vacuum. Many Mexican narco-blogs are already theorizing that Guzman was given up by members of his own organization, perhaps even El Mayo himself.

This was the case after the 2009 killing of Arturo Beltran Leyva, which led violence to spike as his underlings fought amongst themselves to fill the void. It should also be noted that Beltran Leyva's organization was considered part of the Sinaloa Cartel until a violent split with Guzman in 2008, demonstrating the fickle and fluid nature of these organizations.

Another possibility is that -- sensing an opportunity -- Sinaloa Cartel rivals such as the notoriously violent Zetas will take advantage of the arrest and go on the offensive in Sinaloa's turf. This is not without precedent. In mid-2012, the Zetas, along with elements of the Beltran-Leyva organization and the Juarez Cartel, made a push into Sinaloa-controlled territory in mountains of the Sierra Madre.

By the American government's own admission, the Sinaloa Cartel has dozens -- if not hundreds -- of distribution cells across the US, as well as Europe. Additionally, the cartel is thought to have an organized logistical network across Central and South America. Guzman's arrest leaves these networks intact, and business will continue regardless of who is in charge.

That happened after the 1993 killing of Pablo Escobar in Colombia. Despite having eliminated the world's most wanted drug trafficker of the time and leaving the Medellin Cartel in tatters, the northbound flow of cocaine continued. His organization splintered into several smaller organizations, which, while being less capable of challenging the state, were more than up to the task of keeping business going at a steady pace.

Guzman was an immensely important drug trafficker with few equals and had the blood of thousands on his hands. His freedom had become an embarrassment to the Mexican government, and his eventual downfall was inevitable. But it is unlikely to have any significant impact on the flow of drugs from and through Mexico, or on the violence that continues to plague large swathes of the country.

As long as Mexican cartels can deliver the illegal commodities that American (and European) customers want, drug trafficking organizations will continue to exist. While there are very few drug traffickers currently of the same calibre as Guzman, as long as prohibition continues there will be ruthless, violent and intelligent individuals who want to profit from it. This means that there will always be a pool of people to replace men like Guzman. Only through sensible drug laws and demand reduction can these organizations be weakened and eventually driven out of business.

Mexico Marijuana and Drug Reform Bills Filed [FEATURE]

Late last week, lawmakers in Mexico City filed two bills that would begin to radically transform the country's approach to drugs. One was introduced in the Mexico City legislative assembly and one in the federal legislature.

http://stopthedrugwar.com/files/mexico-seal-231px.jpg
The moves come as the debate over drug policy in general and marijuana in particular heats up in the region. The legalization of marijuana in Uruguay and the US states of Colorado and Washington has enlivened ongoing efforts at drug reform in Mexico, and the country continues to bleed from the violence associated with criminal organizations that rose to power on the back of drug prohibition.

They also come just days after four former Latin American presidents -- Ernesto Zedillo of Mexico, Ricardo Lago of Chile, Fernando Enrique Cardoso of Brazil, and Cesar Gaviria of Colombia -- penned an open letter in support to Mexico City Mayor Miguel Angel Mancera, himself a proponent of legalization.

"This is a necessary debate to have for Mexico City, Mexico and the entire region," the four ex-presidents said. "Something needs to change as 40 years of immense efforts and funds have failed to reduce both the production and consumption of illicit drugs."

"We believe we're making a very important contribution to a global debate that has to do with rethinking the issue of drugs," Vidal Llerenas, a member of the Mexico City Legislative Assembly and sponsor of the local legislation, said at Thursday news conference announcing the bills.

"The aim of this legislation is not to change the drug sphere in the city, but rather to simply avoid criminalizing those who consume marijuana," said Deputy Eduardo Santillan Perez, another sponsor of the bill.

The Legislative Assembly in Mexico City
The Mexico City bill would de-emphasize small-time marijuana prosecutions. It would instruct police and judges to deprioritize prosecution of marijuana violations in some circumstances, and it would create a Portugal-style "dissuasion commission" which could impose administrative sanctions on offenders instead of subjecting them to the criminal process.

The bill would also allow for the limited retail sales of marijuana in the Federal District. Such sales could only take place under certain criteria, including posting warnings to consumers about potential health risks. Retailers would not be allowed to sell to minors or be located near schools, and they would not be allowed to sell adulterated marijuana. Retailers who complied with these criteria would be issued permits to sell marijuana by the district government's Institute for the Attention and Prevention of Addictions.

The federal bill would raise possession limits for the amount of drugs decriminalized under a 2009 law. Under that law, the possession of up to five grams of pot was decriminalized; the new bill would increase that to 30 grams (slightly more than an ounce). It would similar increase the decriminalized possession limits for drugs such as cocaine, heroin, and methamphetamine.

The federal bill would also allow for the use of medical marijuana. And it would devolve some decision making power on drug policy issues from the federal government to states and cities.

There are clear medicinal benefits to using marijuana, said PRD Deputy Fernando Belaunzaran Mendez, and denying these benefits "is like when the clergy denied Galileo's claim that the Earth moves."

The prospects of passage are much better for the Mexico City bill than the federal bill, because the Party of the Democratic Revolution (PRD), whose members introduced both the local and the federal bills, dominates the Mexico City assembly, but not the federal one. Mexico City, which has moved to allow abortion, divorce, and same-sex marriage, is also more socially liberal than the country as a whole. The Mexico City bill is likely to be debated early next month.

Both bills had their genesis in discussions that began last summer, when the Mexico City legislature organized public hearings to explore alternative solutions to the city's drug problems. Civil society groups, including México Unido Contra la Delincuencia (MUCD), the Colectivo por Una Politica Integral Hacia las Drogas (CUPIHD), and Britain's Transform Drug Policy Foundation were deeply involved in the drafting process, along with lawyers, medical professionals, security professionals and drug policy experts.

"Of the four specialists that helped draft the bill, two were from CUPIHD," said Alejandro Madrazo Larous, a constitutional law expert, law professor and CUPIHD member who helped draft the bill.

He told the Chronicle that international reform currents were indeed percolating in Mexico.

"As other countries move forward with reforms, it just seems more and more absurd that we are killing each other in Mexico to ban something that is becoming a regulated business," he said.

Reefer Bender in Mexico City wants to legalize it. (Phillip Smith, Drug War Chronicle)
"We welcome this attempt to replace stringent cannabis law enforcement with humane, just and effective alternatives," said MUCD's Lisa Sanchez. "Decades of punitive responses have failed to reduce levels of use and have effectively left the market in the hands of criminal entrepreneurs whose watchwords are violence and greed. This is a great opportunity for the government to adopt a new approach to drugs and improve the health and safety of its citizens. Let's not waste it."

"On the heels of historic marijuana legalization victories in Washington, Colorado and Uruguay, it's promising to see other countries and jurisdictions following suit. The innovative nature of the marijuana bill -- which combines elements of marijuana regulation models from around the world -- demonstrates that reforms can be tailored to fit the local context," said Hannah Hetzer, policy manager for the Americas at the Drug Policy Alliance.

"Mexico has suffered immensely from the war on drugs," Hetzer continued. "Amidst extreme levels of violence and crime, it is encouraging to see Mexico's capital city attempt to refocus its efforts away from marijuana possession and low-level drug offenses and to invest in reducing violent crime instead."

Madrazo Larous said passage of the bills would smartly reprioritize law enforcement, but that it would take work.

"I think they have a chance," he said. "We are reaching out for more support. If we can pass this at the national level, it would free up resources at the local level which would allow for better criminal investigation and prosecution of violent crimes. Today, we waste too many resources running after consumers and petty dealers."

With marijuana legalization also on both the legislative and the popular agenda in Washington, DC, it appears that Mexico City and Washington are in a race to see which North American capital city becomes the first to allow legal marijuana sales. Sorry, Ottawa.

Mexico City
Mexico

Hoffman, Heroin, and What Is To Be Done [FEATURE]

The news last Sunday that acclaimed actor Phillip Seymour Hoffman had died of an apparent heroin overdose has turned a glaring media spotlight on the phenomenon, but heroin overdose deaths had been on the rise for several years before his premature demise. And while there has been much wailing and gnashing of teeth -- and quick arrests of low-level dealers and users -- too little has been said, either before or after his passing, about what could have been done to save him and what could be done to save others.

cooking heroin (wikimedia.org)
There are proven measures that can be taken to reduce overdose deaths -- and to enable heroin addicts to live safe and normal lives, whether they cease using heroin or not. All of the above face social and political obstacles and have only been implemented unevenly, if at all. If there is any good to come of Hoffmann's death it will be to the degree that it inspires broader discussion of what can be done to prevent the same thing happening to others in a similar position.

Hoffman, devoted family man and great actor that he was, died a criminal. And perhaps he died because his use of heroin was criminalized. Criminalized heroin -- heroin under drug prohibition -- is of uncertain provenance, of unknown strength and purity, adulterated with unknown substances. While we don't know what was in the heroin that Hoffman injected, we do know that he maintained his addiction and went to meet his maker with black market dope. That's what was found beside his lifeless body.

In a commentary published by The Guardian, actor Russell Brand, a recovered heroin addict, laid the blame for Hoffman's demise on the drug laws. "Addiction is a mental illness around which there is a great deal of confusion, which is hugely exacerbated by the laws that criminalise drug addicts," Brand wrote, calling prohibitionists' methods "so gallingly ineffective that it is difficult not to deduce that they are deliberately creating the worst imaginable circumstances to maximise the harm caused by substance misuse." As a result, "drug users, their families and society at large are all exposed to the worst conceivable version of this regrettably unavoidable problem."

We didn't always treat our addicts this way. Even after the passage of the Harrison Act in 1914, doctors continued for years to prescribe maintenance doses of opiates to addicts -- and hundreds of them went to jail for it as the medical profession fought, and ultimately lost, a battle with the nascent drug prohibition bureaucracy over whether giving addicts their medicine was part of the legitimate practice of medicine.

The idea of treating heroin addicts as patients instead of criminals was largely vanquished in the United States, but it never went away -- it lingers with methadone substitution, for example. But other countries have for decades been experimenting with providing maintenance doses of opioids to addicts, and to good result. It goes by various names -- opiate substitution therapy, heroin-assisted theatment, heroin maintenance -- and studies from Britain and other European countries, such as Germany, the Netherlands, and Switzerland, as well as the North American Opiate Medications Initiative (NAOMI) and the follow-up Study to Assess Long-Term Opiate Maintenance in Canada have touted its successes.

Those studies have found that providing pharmaceutical grade heroin to addicts in a clinical setting works. It reduces the likelihood of death or disease among clients, as well as allowing them to bring some stability and predictability to sometimes chaotic lives made even more chaotic by the demands of addiction under prohibition. Such treatment has also been found to have beneficial effects for society, with lowered criminality among participants and increased likelihood of their integration as productive members of society.

The dry, scientific language of the studies obscures the human realities around heroin addiction and opioid maintenance therapy. One NAOMI participant helps put a human face on it.

"I want to tell you what being a participant in this study did for me," one participant told researchers. "Initially it meant 'free heroin.' But over time it became more, much more. NAOMI took much of the stress out of my life and allowed me to think more clearly about my life and future. It exposed me to new ideas, people (staff and clients) that in my street life (read: stressful existence) there was no time for."

"After NAOMI, I was offered oral methadone, which I refused. After going quickly downhill, I ended up hopeless and homeless. I went into detox in April 2007, abstained from using for two months, then relapsed. In July 2008 I again went to detox and I am presently in a treatment center... I am definitely not "out of the woods" yet, but I feel I am on the right path. And this path started for me at the corner of Abbott and Hastings in Vancouver... Thank you and all who were involved in making NAOMI happen. Without NAOMI, I wouldn't be where I am today. I am sure I would be in a much worse place."

Arnold Trebach, one of the fathers of the drug reform in late 20th Century America, has been studying heroin since 1972, and is still at it. He examined the British system in the early 1970s, when doctors still prescribed heroin to thousands of addicts, and authored a book, The Heroin Solution, that compared and contrasted the US and UK approaches. Later this month, the octogenarian law professor will be appearing on a panel at the Vermont Law School to address what Gov. Peter Shumlin (D) has described as the heroin crisis there.

Phillip Seymour Hoffman (wikimedia.org)
"The death of Phillip Seymour Hoffman is a tragedy all the way around," Trebach told the Chronicle. "It's a bad idea to use heroin off the street, and he shouldn't have been doing that."

That said, Trebach continued, it didn't have to be that way.

"If we had had a sensible system of dealing with this, he would have been in treatment under medical care," he said. "If he was going to inject heroin, he should have been using pharmaceutically pure heroin in a medical setting where he could also have been exposed to efforts to straighten out his personal life, and he could have access to vitamins, weight control advice, and the whole spectrum of medical care. And if he had had access to opioid antagonists, he could still be alive," he added.

While Hoffman may have made bad personal choices, Trebach said, we as a society have made policy choices seemingly designed to amplify the prospects for disaster.

"This is a sad thing. He is just another one of the many victims of our barbaric drug policy," he said. "This was a totally unnecessary death at every level. He shouldn't have been using, but we should have been taking care of him."

The stuff ought to be legalized, Trebach said.

"I'm an advocate of full legalization, but if we can't go that far, we need to at least provide social and psychological support for these people," he said. "And even if we were to decriminalize or legalize, I would still want to figure out ways to provide support and love and kindness to people using the stuff. I advise you not to do it, but if you're going to use it, I want to keep you alive. I remember talking to people from Liverpool [a famous heroin maintenance clinic covered in the '90s by Sixty Minutes, linked above] about harm reduction around heroin use back in the 1970s. One of the ladies said it is very hard to rehabilitate a dead addict."

"There are plenty of things we can be doing," said Hilary McQuie, Western director for the Harm Reduction Network, reeling off a list of harm reduction interventions that are by now well-known but inadequately implemented.

"We can make naloxone (Narcan) more available. We need better access to it. It should be offered to people like Hoffman when they are leaving treatment programs, especially if they've been using opiates, just as a safeguard," she said. "Having treatment programs as well as harm reduction programs distribute it is important. We can cut the overdose rate in half with naloxone, but there will still be people using alone and people using multiple substances."

There are other proven interventions that could be ramped up as well, McQuie said.

"Safe injection sites would be very helpful, so would more Good Samaritan overdose emergency laws, and more education, not to mention more access to methadone and buprenorphine and other opioid substitution therapies (OST)," she said, reeling off possible interventions.

Dr. Martin Schechter, director of the School of Population and Public Health at the University of British Columbia in Vancouver, knows a thing or two about OST. The principal study investigator for the NAOMI and the follow-up SALOME study, Schechter has overseen research into the effectiveness of treating intractable addicts with pharmaceutical heroin, as well as methadone. The results have been promising.

"What we're using is medically prescribed pharmaceutical diacetylmorphine, the active ingredient in heroin," he explained. "It's what you have when you strip away all the street additives. This is a stable, sterile medication from a pharmaceutical manufacturer. We know the precise dose tailored for each person. With street heroin, not only is it adulterated and injected in unsterile situations, but people really don't know how strong it is. That's probably what happened to Mr. Hoffman."

Naloxone (Narcan) can reverse opiate overdoses (wikimedia.org)
In NAOMI, 90,000 injections were administered to study participants, and only 11 people suffered overdoses requiring medical attention.

"Never did we have a fatal overdose," Schechter said. "Because it was in a clinic, nurses and doctors are right there. We administer Narcan (naloxone), and they wake up."

Heroin maintenance had even proven more effective than methadone in numerous studies, Schechter said.

"There have been seven randomized control trials across Europe and in Canada that have shown for people who have already tried treatments like methadone, that medically prescribed heroin is more effective and cost effective treatment than simply trying methadone one more time."

Those studies carry a lesson, he said.

"We have to start looking at heroin from a medicinal point of view and treat it like a medicine," he argued. "The more we drive its use underground, the more overdoses we get. We need to expand treatment programs, not only with methadone, but with medically prescribed heroin for people who don't respond to other treatments."

Safe injection sites are also a worthwhile intervention, Schechter said, although he also noted their limitations.

"Injecting under supervision is much safer; if there is an overdose, there is prompt attention, and they provide sterile equipment, reducing the risk of HIV and Hep C," he said. "But they are still injecting street heroin."

He would favor decriminalizing heroin possession, too, he said.

Harm reduction measures, opioid maintenance treatments, and the like are absolutely necessary interventions, said McQuie, but there is a larger issue at hand, as well.

"We still need to look at the overall issue of the stigmatization of drug users," she said. "People aren't open about their use, and that puts them in a more dangerous situation. It's really hard in a criminalized environment."

Stigmatization means to mark or brand someone or something as disgraceful and subject to strong disapproval. Defining an activity, such as heroin possession, as a crime is stigmatization crystallized into the legal structures of society itself.

"The ultimate harm reduction solution," McQuie argued, "is a regulated, decriminalized environment where it is available by prescription, so people know what they're getting, they know how much to use, and it's not cut with fentanyl or other deadly adulterants. People wouldn't have to deal with all the collateral damage that comes from being defined as criminals as well as dealing with the consequences of their drug use. They could deal with their addictions without having to worry about losing their homes, their families, and their freedoms."

While such approaches have a long way to go before winning wide popular acceptance, policymakers should at least be held to account for the consequences of their decision-making, McQuie said, suggesting that the turn to heroin in recent years was a foreseeable result of the crackdown on prescription opioid pain medication beginning in the middle of the last decade.

"They started shutting down all those 'pill mills' and people should have anticipated what would happen and been ready for it," she said. "What we have seen is more and more people turning to injecting heroin, but nobody stopped to do an impact statement on what would be the likely result of restricting access to pain pills."

The impact can be seen in the numbers on heroin use, addiction, and overdoses. While talk of a "heroin epidemic" is overblown rhetoric, the number of heroin users has increased dramatically in the past decade. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the number of past year users grew by about 50% between 2002 and 2011, from roughly 400,000 to more than 600,000. At the same time, the number of addicted users increased from just under 200,000 to about 370,000, a slightly lesser increase.

If there is any good news, it is that, according to the latest (2012) National Household Survey of Drug Use and Health, the number of new heroin users has remained fairly steady at around 150,000 each year for the past decade. That suggests, however, that more first-time users are graduating to occasional and sometimes, dependent user status.

And some of them are dying of heroin overdoses, although not near the number dying from overdoses from prescription opioids. Between 1999 and 2007, heroin deaths hovered just under 2,000, even as prescription drug deaths skyrocketed, from around 2,500 in 1999 to more than 12,000 just eight years later. But, according to the Centers for Disease Control, by 2010, the latest year for which data are available, heroin overdose deaths had surpassed 3,000, a 50% increase in just three years.

While the number of heroin overdose deaths is still but a fraction of those attributed to prescription opioid overdoses and the numbers since 2010 are spotty, the increase that showed up in 2010 shows no signs of having gone away. Phillip Seymour Hoffman may be the most prominent recent victim, but in the week since his death, another 50 or 60 people have probably followed him to the morgue due to heroin overdoses.

There are ways to reduce the heroin overdose death toll. It's not a making of figuring out what they are. It's a matter of finding the political and social will to implement them, and that requires leaving the drug war paradigm behind.

New York City, NY
United States

DC City Council Approves Marijuana Decriminalization [FEATURE]

The District of Columbia city council moved another step closer to decriminalizing marijuana possession in the nation's capital Tuesday, approving a bill to do just that on an 11-1 vote. But it only acted after approving last-minute amendments that would make public pot-smoking a criminal offense and give police the right to conduct vehicle searches if they smell marijuana.

A final vote on the bill will come next month. It is expected to pass and already has the support of Mayor Vincent Gray.

While advocates greeted the council vote with praise, the accolades were tempered by concerns about the council's adoption of the late amendments. And looming over it all is the prospect of outright legalization in the District, either through a bill introduced by Councilmember David Grasso that is now before the council or through an initiative that is now awaiting language approval from District officials.

"This is a major victory for advancing the cause of racial justice in DC," said Grant Smith, policy manager with the Drug Policy Alliance. "The war on marijuana is largely a war on people of color and the DC council is saying enough is enough."

"As a former prosecuting attorney, I call this a step forward for the cause of promoting public safety," said Dan Riffle, director of federal policies for the Marijuana Policy Project (MPP). "Arresting and prosecuting adults for possessing a less harmful substance than alcohol is a waste of law enforcement and court resources. Police and prosecutors should focus their time and attention on addressing actual threats to public safety."

The "Marijuana Possession Decriminalization Amendment Act of 2014 (Council Bill 20-409)" would eliminate the threat of arrest for possessing marijuana impose a $25 civil fine for possession as well as forfeiture of the marijuana and any paraphernalia used to consume or carry it. But the amendments approved Tuesday criminalize public possession and allows those vehicle searches.

The bill was introduced after the publication of an ACLU report and a Washington Lawyers' Committee on Civil Rights and Urban Affairs report highlighting the disparate rate of arrests of blacks over whites for marijuana possession in the District. The reports found that blacks are arrested eight times as often as whites for the offense, even though rates of use among both races are thought to be relatively similar.

But advocates complained that the amendments adopted Tuesday would only serve to perpetuate racially biased marijuana law arrests, not end them. Some called for a solution to the problem by having the council pass the legalization bill.

"These last-minute amendments will simply expand stop-and-frisk policies in the District and will do nothing to fight the horrible racial disparities in marijuana enforcement," said MPP's Riffle. "We need to regulate and tax marijuana like alcohol, and take it out of the hands of criminals and drug cartels. Marijuana should be sold by legitimate businesses in licensed, regulated stores, not by criminals on our street corners. The sooner the council takes up Councilmember Grosso's bill, the better."

The Drug Policy Alliance will be working to undo the amendments when the council takes a final vote on the bill next month, Smith told the Chronicle Tuesday night.

"There is one more opportunity to change the criminalization of public smoking when the council considers and votes one more time on the bill," he said. "We hope to work with Councilmember Tommy Wells and our community partners here in DC to pressure the council to reverse its decision to criminalize public consumption and treat public smoking as a civil offense instead."

Looming just behind the decriminalization fight is outright legalization. Public opinion in the District appears ready to make the leap. A Washington Post poll last year had support for legalization at a healthy 63%.

While some groups, like the Marijuana Policy Project, are working the council in an effort to move a bill, others favor the initiative process, especially if the council fails to act.

"As a DC resident, I'm proud the Council took an important step today to stop the expensive, time-consuming and racially discriminatory practice of putting people into handcuffs just for possessing marijuana," said Tom Angell of Marijuana Majority."But while this is clearly movement in the right direction, this legislation would unfortunately leave marijuana production and profits illegal and largely in the hands of street gangs and criminals. A clear majority of District voters supports legalizing marijuana, and that's why we're likely to approve a ballot initiative this November that would completely remove penalties for possession and allow residents to grow up to six plants. Hopefully such widespread voter support will spur the council to adopt more comprehensive legislation taxing and regulating the marijuana trade at some point soon."

Adam Eidinger of the DC Cannabis Campaign is the public face of the DC marijuana legalization initiative. The veteran District political gadfly had kind words for the decriminalization effort, but signaled it wouldn't make any difference to the initiative campaign.

"The compromise on the decrim bill wasn't that bad. The big deal is that it passed, and it passed with a veto-proof majority, and the mayor will sign it. We should be celebrating," he said, "But I'm on the war path. Decriminalization is a stepping stone toward ending the raging stream of marijuana arrests; it's a nice place to stand, but you don't want to live there, because you're going to fall in the water eventually. And I mean get arrested," he clarified.

"Look, decriminalization will get rid of a lot of arrests, but there will still be marijuana arrests and people engaging in illegal activity when they want to buy it," Eidinger continued. "And they're exposed to heroin and other hard drugs. You need to separate cannabis from all the hard drugs and create a legal cultivation and distribution system. That hurts the bulk hard drug dealers. If you care about reducing drug use and addiction, you create a massive harm reduction with marijuana legalization first. I don't have sympathy for the illicit market for heroin, but for the illicit cannabis market, it's not deadly."

The legalization initiative campaign continues to aim at the November ballot, Eidinger said, but still needs to secure funding if it's going to be successful. A key date for the initiative will be February 25, when the DC Board of Elections decides whether to approve the initiative language for signature-gathering.

"If the language is good, that's a big deal," Eidinger said. "I think some of the big money has been holding off until that happens. We're doing this on a shoe string and have raised $30,000 in six months, but we do have the money for signature-gathering locked in, thanks to Dr. Bronner's Magic Soaps. We will do paid and volunteer signature-gathering."

Marijuana law reform is coming to the District of Columbia. And the decriminalization bill is only the beginning.

Washington, DC
United States

In Breakthrough, Farm Bill Includes Hemp Amendment [FEATURE]

The omnibus federal farm bill approved by Congressional conference committee negotiators this week and destined to be quickly signed into law includes the hemp amendment that was approved by the House last year before the bill blew up over Republican efforts to cut food stamp spending. The final version of the farm bill passed the House Wednesday morning.

hemp field at sunrise (votehemp.com)
Originally introduced by Representatives Jared Polis (D-CO), Thomas Massie (R-KY) and Earl Blumenauer (D-OR), the hemp amendment doesn't legalize hemp production, but it does allow for research on industrial hemp by universities and state agriculture departments in the 10 states that have approved hemp production. There are two bills pending in Congress that would legalize hemp; they are House Resolution 525, the "Industrial Hemp Farming Act of 2013," and the companion legislation, Senate Bill 359.

The 10 states that have already passed laws allowing hemp production are California, Colorado, Kentucky, Maine, Montana, North Dakota, Oregon, Vermont, Washington, and West Virginia, and the vote comes as even more states are showing an interest in hemp. Hemp bills have been introduced in 11 states this year, including Hawaii, Indiana, Nebraska, New Jersey (carried over from 2013), New York, Oklahoma, South Carolina, Tennessee, Washington (two bills were carried over from 2013) West Virginia, and Wisconsin.

"Although I strongly opposed the Republican Farm Bill, I was pleased to see that the bipartisan amendment that I offered with Representatives Blumenauer and Massie was included in the final bill that passed the House of Representatives today," said Rep. Polis. "This common sense amendment will allow colleges and universities to grow and cultivate industrial hemp for academic and agricultural research purposes in states where industrial hemp cultivation is already legal. I look forward to working with my colleagues in the Senate to ensure that this language becomes law."

"This is an important victory for farmers, manufacturers, and consumers in Kentucky and across the country. Our amendment paves the way for production of industrial hemp by first allowing America's academic and research institutions to demonstrate that hemp and the products derived from hemp present a great economic opportunity for our country," said Rep. Massie. "The inclusion of our industrial hemp amendment in the farm bill reflects widespread support for cultivating industrial hemp and proves Congress can work together in a bipartisan fashion to help the American economy at a time when creating jobs is a national priority."

hemp supporter Rep. Jared Polis (D-CO) (house.gov)
"With the U.S. hemp industry estimated at over $500 million in annual retail sales and growing, a change in federal law to allow for colleges and universities to grow hemp for research would mean that we will finally begin to regain the knowledge that unfortunately has been lost over the past fifty years," says Vote Hemp President, Eric Steenstra. "The American Farm Bureau Federation announced their opposition to the controlled substance classification of hemp earlier this month, and now passage of this amendment means America can get on track to once again become the predominant producer and manufacturer of hemp -- one of the most versatile and ecological industrial crops on the planet."

The hemp amendment was among the few provisions in the farm bill that had not been previously approved by both houses of Congress. That it made it into the final version of the farm bill was a testament to the bill's support, and to some key supporters, Steenstra told the Chronicle Wednesday.

"Senator Wyden introduced an amendment to the Senate farm bill that was more expansive than the House version, but the leadership limited the votes severely and our provision never got a vote," Steenstra explained. "That, combined with the fact that Senator Leahy had basically cleared it through Judiciary, allowed it to go forward. But ultimately, Senator McConnell and other conferees spoke up for it."

Both McConnell and his fellow Kentucky US senator, Rand Paul, have been ardent hemp supporters, supporting legislation both at the state level and now, in Washington.

"This is an important victory for Kentucky's farmers, and I was pleased to be able to secure this language on behalf of our state," McConnell said in a statement issued Tuesday. "By giving states the go-ahead to cultivate hemp for pilot programs, we are laying the groundwork for a new commodity market for Kentucky farmers. By exploring innovative ways to use hemp to benefit a variety of Kentucky industries, while avoiding negative impact to Kentucky law enforcement's efforts at marijuana interdiction, the pilot programs authorized by this legislation could help boost our state's economy."

Senate Minority Leader Mitch McConnell (R-KY) played a key role. (senate.gov)
"We think this is pretty significant," Steenstra said. "It's an excellent first step to revitalize what was once a proud and significant industry in this country. A big part of our farming economy has been lost, and we have to work to recover it."

The bill not only allows universities to do hemp research, Steenstra noted, but it also allows state agriculture departments to do pilot studies.

"That's a little bit more expansive than just research," he said. "The can look into things like marketing and cultivation of hemp, and that's a significant opportunity for the 10 states where it is legal."

Steenstra didn't think inclusion of the hemp amendment in the farm bill would take the oomph out the pending hemp legalization bills.

"We've made it very clear, and all of our supporters in Congress understand this, that this is just a first step," he said. "There are a lot of people anxious to grow hemp, and this won't really solve that. We will be able to get some crops in the ground and show that hemp is not the boogie man we feared, but commercial farmers still won't be able to grow it until we get those bill passed."

Although hemp proponents are careful to draw a bright line between industrial hemp and psychoactive marijuana, the growing national debate over -- and acceptance of -- marijuana has been a help rather than a hindrance, Steenstra said.

"The reality is that hemp has been caught up in marijuana policy for 70-some years," he noted. "There is no way to deal with hemp policy without looking at overall marijuana policy. These are two separate tracks, but at the same time, having a lot of people looking at marijuana policy has been a good thing for hemp."

New leadership at the DEA would be a good thing, too, Steenstra said, moaning aloud as he recounted DEA Administrator Michele Leonhart's comment last week that the low point of her career was seeing a hemp flag fly over the US capitol.

"Of all the things she should be down about, she complains about a flag made out of non-drug hemp fiber," he said."We're hoping a more enlightened DEA head will come in and replace her and bring some sanity to policy over there."

Washington, DC
United States

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