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The Year on Drugs 2009: The Top Ten US Domestic Drug Policy Stories

As 2009 prepares to become history, we look back at the past year's domestic drug policy developments. With the arrival of a highly popular (at least at first) new president, Barack Obama, and Democratic Party control of the levers of power in Congress, the drug reform gridlock that characterized the Bush years is giving way to real change in Washington, albeit not nearly quickly enough. A number of this year's Top 10 domestic drug stories have to do with the new atmospherics in Washington, where they have led, and where they might lead.

But not all of them. Drug reform isn't made just in Washington. Under our federal system, the 50 states and the District of Columbia have at least some ability to set their own courses on drug policy reforms. In some areas, actions in the state legislatures have reflected trends -- for better or worse -- broad enough to earn Top 10 status.

And Washington and the various statehouses notwithstanding, movement on drug reform is not limited to the political class. Legions of activists now in at least their second decade of serious reform work, a mass media that seems to have awakened from its dogmatic slumber about marijuana, a crumbling economy, and a bloody drug war within earshot of the southwestern border have all impacted the national conversation about drug reform and are all pushing politicians from city councilmen to state legislators to US senators to rethink drug prohibition.

For drug reformers, these are interesting times, indeed. Herewith, the Top 10 domestic drug policy stories of 2009:

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marijuana plants (photo from US Fish and Wildlife Service via Wikimedia)
Marijuana Goes Mainstream

Wow. This year has seen the US enter the beginnings of a sea change on policies and attitudes toward the recreational use of marijuana. The first hint that something had changed was the Michael Phelps bong photo non-scandal. When the multiple Olympic gold medal winner got outed for partying like a college student, only one corporate sponsor, fuddy-duddy Kellogg, dumped him, and was hit by a consumer boycott -- and arguably by falling stock prices -- in return. Otherwise, except for a deranged local sheriff who tried fruitlessly to concoct a criminal case against somebody -- anybody! -- over the bong photo, America's collective response basically amounted to "So what?"

Post-Phelps it was as if the flood gates had opened. Where once Drug War Chronicle and a handful of other publications pretty much had the field to ourselves, early this year, the mass media began paying attention. Countless commentaries, editorials and op-eds have graced the pages of newspaper and those short-attention-span segments on the cable news networks, an increasing number of them calling for legalization. The conversation about freeing the weed has gone mainstream.

The sea change is also reflected in poll numbers that, for the first time, this year showed national majorities in favor of legalization. In February, a Zogby poll showed 44% support nationwide -- and 58% in California. By late spring, the figures were generally creeping ever higher. An April Rasmussen poll had support for "taxation and regulation" at 41%, while an ABC News/Washington Post poll found 46% supported "legalizing the possession of small amounts of marijuana for personal use." Also in April, for the first time, a national poll showed majority support for legalization when Zogby showed 52% saying marijuana should be "legal, taxed, and regulated." In July, a CBS News poll had support for legalization at 41%.

In October, a Gallup poll had support for legalization at 44%, the highest ever in a Gallup survey. And a few weeks ago an Angus-Reid poll reported 53% nationwide supported legalization. Legalizing pot may not have clear majority support just yet, but it is on the cusp.

Marijuana law reform was also a topic at statehouses around the country this year, although successes were few and far between. At least six states saw decriminalization bills, but only one passed -- in Maine, which had already decriminalized possession of up to 1.25 ounces. This year's legislation doubled that amount. And then there were legalization bills. Two were introduced in the 2009 session, in California and Massachusetts, and two more have been pre-filed for next year, in New Hampshire and Washington. Both the California and Massachusetts bills got hearings this year, and the California bill is set for another hearing and a first committee vote in the Assembly in two weeks. In Rhode Island, meanwhile, the legislature voted this year to create a commission to study marijuana law reform; it will report at the end of January.

And then, finally, there is the excitement and discussion being generated by at least three separate marijuana legalization initiative campaigns underway in California. Oaksterdam medical marijuana entrepreneur Richard Lee's Tax Cannabis 2010 initiative has already announced it has sufficient signatures to make the ballot. Time will tell if the others make it, but at this point it is almost certain that voters in California will have a chance to say "legalize it" in November.

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medical marijuana dispensary, Ventura Blvd., LA (courtesy wikimedia.org)
Medical Marijuana: The Feds Butt Out and the Floodgates Begin to Swing Open

During his election campaign, President Obama promised to quit siccing the DEA on medical marijuana patients and providers. In February, new Attorney General Eric Holder announced there would be no more federal raids if providers were in compliance with state law, and pretty much held to that promise since then. In October, the Justice Department made it official policy when it issued a policy memo reiterating the administration's stance.

The new "hands off" policy from Washington has not been universally adhered to, nor has it addressed the issue of people currently serving sentences or facing prosecution under Bush administration anti-medical marijuana initiatives, but it has removed a huge looming threat to growers and dispensary operators and it has disarmed a favored (if intensely hypocritical) argument of medical marijuana foes that such laws should not be passed out of fear of what the feds would do.

Meanwhile, California rolls right along as medical marijuana's Wild West. Like countless other localities in the Golden State, the city of Los Angeles is grappling with what to do with its nearly one thousand dispensaries. The issue is being fought city by city and county by county, in the state courts and in the federal courts. And while the politicians argue, dispensary operators are creating political facts on the ground as their tax revenues go into hungry state and local coffers.

This year also marked the emergence of a medical marijuana industry infrastructure -- growers, grow shops, dispensaries, educational facilities, pot docs -- beyond California's borders, most notably in Colorado, where the dispensary scene exploded in the wake of the removal of the federal threat, and in Michigan, where last year's passage of a medical marijuana law has seen the creation of the Midwest's first medical marijuana industry.

While medical marijuana is legal in 13 states (and now, the District of Columbia), it remains difficult to win victories in state legislatures. There were medical marijuana bills in at least 18 states, but only two -- Minnesota and New Hampshire -- were approved by legislatures, and they were vetoed by prohibitionist governors. Bills are, however, still alive in six states -- Delaware, Illinois, New Jersey, New York, Pennsylvania, and Wisconsin -- with New Jersey and Wisconsin apparently best positioned to become the next medical marijuana state. In Rhode Island, which already approved a medical marijuana law in 2007, the legislature this year amended it to include a dispensary system.

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salvia leaves (photo courtesy Erowid.org)
The Reflexive Prohibitionist Impulse Remains Alive -- Just Ask Sally D

Despite evident progress on some drug reform fronts, a substantial number of Americans continue to hold to prohibitionist values, including a number of state legislators. The legislative response to the popularity of the fast-acting, short-lived hallucinogen salvia divinorum is the best indicator of that.

The DEA has been reviewing salvia for five years, and has yet to determine that it needs to become a controlled substance, but that hasn't stopped some legislators from trying to ban it. Appalled by YouTube videos that show young people getting very high, legislators in 13 states have banned or limited sales of the herb.

This year, four more states joined the list. The good news is that legislators in seven other states where salvia ban bills were introduced had better things to do with their time than worry about passing them.

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drug testing lab
"We Must Drug Test Welfare and Unemployment Recipients!"

In another indication that the drug warrior impulse is still alive and well -- as are its class war elements -- legislators in various states this year continued to introduce bills that would mandate suspicionless drug testing of people seeking unemployment, public assistance, or other public benefits. Never mind that Michigan, the only state to pass such a law, saw its efforts thrown out as an unconstitutional search by a federal appeals court several years back.

Such efforts exposed not only public resentment of benefits recipients, but also a certain level of ignorance about the way our society works. A common refrain from supporters was along the lines of "I have to get drug tested for my job, so why shouldn't they have to get drug tested?" Such questioners fail to understand that our system protects us from our government, but not from private employers.

But if welfare drug testing excited some popular support, it also excited opposition, not only on constitutional grounds, but on grounds of cost and elemental fairness. In the four states where drug testing bills were introduced -- Kansas, Louisiana, Missouri and West Virginia -- none of them went anywhere. But even in an era when drug reform is in the air, such bills are a clear sign that there will be many rear-guard battles to fight.

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unjust, but also unaffordable
Rockefeller Drug Law and Other State Sentencing Reforms

Reeling under the impact of economic downtowns and budget crises, more and more states this year took a second look at drug-related sentencing policies. Most notable of the reforms enacted at the state level this year were reforms in New York's draconian Rockefeller drug laws, which went into effect in October. Under this newest round of Rockefeller drug law reforms, some 1,500 low-level drug offenders will be able to seek sentence reductions, while judges gain some sentencing power from prosecutors, and treatment resources are being beefed up. But still, more than 12,000 will remain in Empire State prisons on Rockefeller drug charges.

New York wasn't the only state to enact sentencing reforms this year. This month, New Jersey legislators passed a bill giving judges the discretion to waive mandatory minimum sentences for some drug offenses. Last month, Rhode Island mandatory minimum reforms went into effect. Earlier this year, Louisiana finally acted to redress the cruel plight of the "heroin lifers," people who had been sentenced to life without parole for heroin possession under an old state law. A new state law cut heroin sentences, but did not address the lifers. As a result, some lifers remained in prison with no hope of parole while more recent heroin offenders came, did their time, and went. Now, under this year's law, the lifers are eligible for parole.

Sentencing reforms are also in the works in a number of other states, from Alabama to California and from Colorado to Michigan. In some cases, reform legislation is in progress; in others, legislators are waiting for commissions to report their findings. In nearly every case, it is bottom-line budget concerns rather than bleeding heart compassion for the incarcerated that is driving the reforms.

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PolitickerMD cartoon about the Berwyn Heights raid
Swatting SWAT

It was only one bill in one state, and all it required was reporting by SWAT teams of their activities, but the Maryland SWAT bill passed this year marked the first time a state legislature has moved to rein in aggressive paramilitary-style policing. More precisely, the bill requires all law enforcement agencies that operate SWAT teams to submit monthly reports on their activities, including when and where they are used, and whether the operations result in arrests, seizures or injuries.

In took an ugly incident involving the mayor of a Washington, DC, suburb to make it happen. Marijuana traffickers sent a load of pot to the mayor's address to avoid having police show up on their doorstep in the event something went wrong, but something did go wrong, and police tracked the package. When the mayor innocently carried the package inside on returning home, the SWAT team swooped, manhandling the mayor and his mother-in-law and killing the family's pet dogs. The cops were unapologetic, the mayor was apoplectic, and now Maryland has a SWAT law. A new bill just filed in Maryland would take it further, requiring police to secure a judge's warrant before deploying a SWAT team.

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shrine to San Malverde, Mexico's ''narco-saint,'' Culiacan, Sinaloa
America Finally Notices the Drug War Across the River

While Congress and the Bush administration got serious about Mexico's bloody drug wars in 2008, passing a three-year, $1.4 billion anti-drug aid package for Mexico and Central America, it was not until this year that the prohibition-related violence in Mexico really made the radar north of the border.

It only took about 11,000 deaths (now up to over 16,000) among Mexican drug traffickers, police, soldiers, and innocent bystanders to get the US to pay attention to the havoc being wreaked on the other side of the Rio Grande. But by the spring, Washington was paying attention, and for the first time, one could hear mea culpas coming from the American side. Mexico's drug violence is driven by demand in the US, Secretary of State Hillary Clinton admitted and Homeland Security Secretary Janet Napolitano echoed.

But just because Washington admitted some fault didn't mean it was prepared to try anything different. And while the Mexican drug wars brought talk of legalization -- especially of marijuana -- what they brought in terms of policy was the Southwest Border Counternarcotics Strategy, which is basically mo' better drug war.

Mexico's drug wars show no signs of abating, and the pace of killing has accelerated each year since President Felipe Calderon sent in the army three years ago this month. The success -- or failure -- of his drug war policies may determine Calderon's political future, but it has for the first time concentrated the minds of US policymakers on the consequences of prohibition south of the border.

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syringes -- better at the exchange than on the street
Congress Ends Ban on Needle Exchange Funding, Butts Out of DC Affairs

After a decade-long struggle, the ban on federal funding for needle exchange programs ended this month with President Obama's signature on an omnibus appropriations bill that included ending the federal ban, as well as a similar ban that applied to the District of Columbia. The bill also removed a ban on the District implementing a medical marijuana law passed by voters in 1998.

Removing the funding ban has been a major goal of harm reduction and public health coalitions, but they had gotten nowhere in the Republican-controlled Congresses of the past decade. What a difference a change of parties makes.

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Jim Webb at 2007 incarceration hearing (photo from sentencingproject.org)
Questioning the Drug War: Two Congressional Bills

The US Congress has been a solid redoubt of prohibitionist sentiment for decades, but this year saw the beginning of cracks in the wall. Two legislators, Rep. Elliot Engel (D-NY) and Sen. Jim Webb (D-VA) introduced and have had hearings on bills that could potentially challenge drug war orthodoxy.

Engel's bill, the Western Hemisphere Drug Policy Commission Act, which has already passed the House, would set up a commission to examine US eradication, interdiction, and other policies in the Western Hemisphere. While Engel is no anti-prohibitionist, any honest commission assessing US drug policy in the Americas is likely to come up with findings that subvert drug war orthodoxy.

Meanwhile, Sen. Webb's National Criminal Justice Commission Act of 2009 comes at the issue from a much more critical perspective. It calls for a top-to-bottom review of a broad range of criminal justice issues, ranging from sentencing to drug laws to gangs and beyond, with an emphasis and costs and efficacy. Webb's bill remains in the Senate Judiciary Committee, but has 35 cosponsors. Webb has already held hearings on the costs of mass incarceration and the economic costs of drug policy, and even more than Engel's bill, the Webb bill has the potential to get at the roots of our flawed national drug policy.

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Sen. Durbin at May hearing on crack sentencing
The Crack/Powder Cocaine Sentencing Disparity

The 100:1 disparity in the quantities of crack needed to earn a mandatory minimum federal prison sentence versus the quantities of powder cocaine needed to earn the same sentence has been egregiously racist in its application, with roughly 90% of all federal crack offenders being non-white, and pressure has been mounting for years to undo it. It hasn't happened yet, but 2009 finally saw some serious progress on the issue.

The move to reform the sentencing disparity got a boost in June, when Attorney General Holder said it had to go. The next month, a House Judiciary Committee subcommittee passed the Fairness in Cocaine Sentencing Act of 2009. The bill is now before the House Judiciary and Energy and Commerce Committees.

On the Senate side, Sen. Dick Durbin (D-IL) introduced a companion bill in October, the Fairness in Sentencing Act. It hasn't moved yet, but thanks to a decade-long effort by a broad range of advocates, all the pieces are now in place for something to happen in this Congress. By the time we get around to the Top 10 of 2010, the end of the crack/powder cocaine sentencing disparity better be one of the big stories.

Congress: Budget Deal Includes Series of Drug Reform Victories

US House and Senate negotiators in conference committee approved the finishing touches on the Fiscal Year 2010 budget Tuesday night, and they included a number of early Christmas presents for different drug reform constituencies. It isn't quite a done deal yet -- this negotiated version of the FY 2010 Consolidated Appropriations Act must now win final approval on both the House and Senate floors. But they are up-or-down, no-amendments-allowed votes -- if the bill passes, it will include the drug reforms.

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US Capitol, Senate side
What the conference committee approved:

  • Ending the ban on federal funding for needle exchange programs -- without previous language that would have banned them from operating within 1,000 feet of schools, parks, and similar facilities. (Instead it seems to give local authorities the ability to overrule state or other officials on location choices.)
  • Ending the ban on the use of federal funds for needle exchanges in the District of Columbia.
  • Allowing the District of Columbia to implement the medical marijuana initiative passed by voters in 1998 but blocked by congressional diktat ever since.
  • Cutting funding for the Office of National Drug Control Policy's National Youth Anti-Drug Media Campaign from $70 million this year to $45 million next year.

In a news release after agreement was reached, this is how the committee described the language on needle exchange:

Modifies a prohibition on the use of funds in the Act for needle exchange programs; the revised provision prohibits the use of funds in this Act for needle exchange programs in any location that local public health or law enforcement agencies determine to be inappropriate.

Its description of the DC appropriations language:

Removing Special Restrictions on the District of Columbia: ...Also allows the District to implement a referendum on use of marijuana for medical purposes as has been done in other states, allows use of Federal funds for needle exchange programs except in locations considered inappropriate by District authorities.

And its language on the youth media campaign:

National Youth Anti-Drug Media Campaign: $45 million, $25 million below 2009 and the budget request, for a national ad campaign providing anti-drug messages directed at youth. Reductions were made in this program because of evaluations questioning its effectiveness. Part of the savings was redirected to other ONDCP drug-abuse-reduction programs.

Citing both reforms in the states -- from medical marijuana to sentencing reform -- as well as the conference committee's actions, Drug Policy Alliance executive director Ethan Nadelmann stopped just short of declaring victory Wednesday. "It's too soon to say that America's long national nightmare -- the war on drugs --is really over," Nadelmann. "But yesterday's action on Capitol Hill provides unprecedented evidence that Congress is at last coming to its senses when it comes to national drug control policy."

As noted above, there are still two votes to go, and reformers are applying the pressure until it is a done deal. "Hundreds of thousands of Americans will get HIV/AIDS or hepatitis C if Congress does not repeal the federal syringe funding ban," said Bill Piper, DPA national affairs director. "The science is overwhelming that syringe exchange programs reduce the spread of infectious diseases without increasing drug use. We will make sure the American people know which members of Congress stand in the way of repealing the ban and saving lives."

Washington, DC, residents got a two-fer from the committee when it approved ending the ban on the District funding needle exchanges and undoing the Barr Amendment, the work of erstwhile drug warrior turned reformer former Rep. Bob Barr (R-GA). Barr's amendment forbade the District from implementing the 1998 medical marijuana initiative, which won with 69% of the vote.

"Congress is close to making good on President Obama's promise to stop the federal government from undermining local efforts to provide relief to cancer, HIV/AIDS and other patients who need medical marijuana," said Naomi Long, the DC Metro director of the Drug Policy Alliance. "DC voters overwhelmingly voted to legalize marijuana for medical use and Congress should have never stood in the way of implementing the will of the people."

"The end of the Barr amendment is now in sight," said Aaron Houston, director of government relations for the Marijuana Policy Project. "This represents a huge victory not just for medical marijuana patients, but for all city residents who have every right to set their own policies in their own District without congressional meddling. DC residents overwhelmingly made the sensible, compassionate decision to pass a medical marijuana law, and now, more than 10 years later, suffering Washingtonians may finally be allowed to focus on treating their pain without fearing arrest."

Medical marijuana in the shadow of the Capitol? Federal dollars being spent on proven harm reduction techniques? Congress not micromanaging DC affairs? What is the world, or at least Washington, coming to?

Congressional Budget Deal Allows Federal Funding for Needle Exchange and Medical Marijuana in the Nation's Capital

US House and Senate negotiators in conference committee approved the finishing touches on the Fiscal Year 2010 budget Tuesday night, and they included a number of early Christmas presents for different drug reform constituencies. But it isn’t quite a done deal yet--this negotiated version of the FY 2010 Consolidated Appropriations Act must now win final approved in up-or-down, no-amendments-allowed floor votes in the House and the Senate. What the conference committee approved: * Ending the ban on federal funding for needle exchange programs--without previous language that would have banned them from operating within 1,000 feet of schools, parks, and similar facilities. * Ending the ban on the use of federal funds for needle exchanges in the District of Columbia. * Allowing the District of Columbia to implement the medical marijuana initiative passed by voters in 1998 and blocked by congressional diktat ever since. * Cutting funding for the Office of National Drug Control Policy’s National Youth Anti-Drug Media Campaign from $70 million this year to $45 million next year. In a news release after agreement was reached, this is how the committee described the language on needle exchange:
Modifies a prohibition on the use of funds in the Act for needle exchange programs; the revised provision prohibits the use of funds in this Act for needle exchange programs in any location that local public health or law enforcement agencies determine to be inappropriate
Its description of the DC appropriations language:
Removing Special Restrictions on the District of Columbia:...Also allows the District to implement a referendum on use of marijuana for medical purposes as has been done in other states, allows use of Federal funds for needle exchange programs except in locations considered inappropriate by District authorities.
And its language on the youth media campaign:
National Youth Anti-Drug Media Campaign: $45 million, $25 million below 2009 and the budget request, for a national ad campaign providing anti-drug messages directed at youth. Reductions were made in this program because of evaluations questioning its effectiveness. Part of the savings was redirected to other ONDCP drug-abuse-reduction programs.
Citing both reforms in the states--from medical marijuana to sentencing reform--as well as the conference committee’s actions, Drug Policy Alliance Executive Director Ethan Nadelmann stopped just short of declaring victory Wednesday. “It’s too soon to say that America’s long national nightmare – the war on drugs – is really over,” said Nadelmann. “But yesterday’s action on Capitol Hill provides unprecedented evidence that Congress is at last coming to its senses when it comes to national drug control policy.” But, as noted above, there are still two votes to go, and DPA is applying the pressure until it is a done deal. “Hundreds of thousands of Americans will get HIV/AIDS or hepatitis C if Congress does not repeal the federal syringe funding ban,” said Bill Piper, DPA national affairs director. “The science is overwhelming that syringe exchange programs reduce the spread of infectious diseases without increasing drug use. We will make sure the American people know which members of Congress stand in the way of repealing the ban and saving lives.” Washington, DC, residents got a two-fer from the committee when it approved ending the ban on the District funding needle exchanges and undoing the Barr Amendment, the work of erstwhile drug warrior turned reformer former Rep. Bob Barr (R-GA), which forbade the District from implementing the 1998 medical marijuana initiative, which won with 69% of the vote. “Congress is close to making good on President Obama’s promise to stop the federal government from undermining local efforts to provide relief to cancer, HIV/AIDS and other patients who need medical marijuana,” said Naomi Long, the DC Metro director of the Drug Policy Alliance. “DC voters overwhelmingly voted to legalize marijuana for medical use and Congress should have never stood in the way of implementing the will of the people.” "The end of the Barr amendment is now in sight,” said Aaron Houston, director of government relations for the Marijuana Policy Project. “This represents a huge victory not just for medical marijuana patients, but for all city residents who have every right to set their own policies in their own District without congressional meddling. DC residents overwhelmingly made the sensible, compassionate decision to pass a medical marijuana law, and now, more than 10 years later, suffering Washingtonians may finally be allowed to focus on treating their pain without fearing arrest." Medical marijuana in the shadow of the Capitol? Federal dollars being spent on proven harm reduction techniques? Congress not micromanaging DC affairs? What is the world, or at least Washington, coming to?
Location: 
Washington, DC
United States

Feature: Fired Up in Albuquerque -- The 2009 International Drug Policy Reform Conference

Jazzed by the sense that the tide is finally turning their way, more than a thousand people interested in changing drug policies flooded into Albuquerque, New Mexico, last weekend for the 2009 International Drug Policy Reform Conference, hosted by the Drug Policy Alliance. Police officers in suits mingled with aging hippies, politicians met with harm reductionists, research scientists chatted with attorneys, former prisoners huddled with state legislators, and marijuana legalizers mingled with drug treatment professionals -- all united by the belief that drug prohibition is a failed policy.

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candlelight vigil outside the Albuquerque Convention Center (courtesy Drug Policy Alliance)
As DPA's Ethan Nadelmann said before and repeated at the conference's opening session: "We are the people who love drugs, we are the people who hate drugs, we are the people that don't care about drugs," but who do care about the Constitution and social justice. "The wind is at our backs," Nadelmann chortled, echoing and amplifying the sense of progress and optimism that pervaded the conference like never before.

For three days, conference-goers attended a veritable plethora of panels and breakout sessions, with topics ranging from the drug war in Mexico and South America to research on psychedelics, from implementing harm reduction policies in rural areas to legalizing marijuana, from how to organize for drug reform to what sort of treatment works, and from medical marijuana to prescription heroin.

It was almost too much. At any given moment, several fascinating panels were going on, ensuring that at least some of them would be missed even by the most interested. The Thursday afternoon time bloc, for example, had six panels: "Medical Marijuana Production and Distribution Systems," "After Vienna: Prospects for UN and International Reform," "Innovative Approaches to Sentencing Reform," "Examining Gender in Drug Policy Reform," "Artistic Interventions for Gang Involved Youth," and "The Message is the Medium: Communications and Outreach Without Borders."

The choices weren't any easier at the Friday morning breakout session, with panels including "Marijuana Messaging that Works," "Fundraising in a Tough Economy," "Congress, President Obama, and the Drug Czar," "Zoned Out" (about "drug-free zones"), "Psychedelic Research: Neuroscience and Ethnobotanical Roots," "Opioid Overdose Prevention Workshop," and "Border Perspectives: Alternatives to the 40-Year-Old War on Drugs."

People came from all over the United States -- predominantly from the East Coast -- as well as South Africa, Australia, Canada, Europe (Denmark, England, France, Hungary, the Netherlands, Poland, Portugal, Scotland, and Switzerland), Latin America (Argentina, Brazil, Colombia, and Mexico), and Asia (Cambodia and Thailand).

Medical marijuana was one of the hot topics, and New Mexico, which has just authorized four dispensaries, was held up as a model by some panelists. "If we had a system as clear as New Mexico's, we'd be in great shape," said Alex Kreit, chair of a San Diego task force charged with developing regulations for dispensaries there.

"Our process has been deliberate, which you can also read as 'slow,'" responded Steve Jenison, medical director of the state Department of Health's Infectious Disease Bureau. "But our process will be a very sustainable one. We build a lot of consensus before we do anything."

Jenison added that the New Mexico, which relies on state-regulated dispensaries, was less likely to result in diversion than more open models, such as California's. "A not-for-profit being regulated by the state would be less likely to be a source of diversion to the illicit market," Jenison said.

For ACLU Drug Policy Law Project attorney Allen Hopper, such tight regulation has an added benefit: it is less likely to excite the ire of the feds. "The greater the degree of state involvement, the more the federal government is going to leave the state alone," Hopper said.

At Friday's plenary session, "Global Drug Prohibition: Costs, Consequences and Alternatives," Australia's Dr. Alex Wodak amused the audience by likening the drug war to "political Viagra" in that it "increases potency in elections." But he also made the more serious point that the US has exported its failed drug policy around the world, with deleterious consequences, especially for producer or transit states like Afghanistan, Bolivia, Colombia, Mexico, and Peru.

At that same session, former Mexican foreign minister Jorge Castaneda warned that Latin American countries feel constrained from making drug policy reforms because of the glowering presence of the US. Drug reform is a "radioactive" political issue, he said, in explaining why it is either elder statesmen, such as former Brazilian President Cardoso or people like himself, "with no political future," who raise the issue. At a panel the following day, Castaneda made news by bluntly accusing the Mexican army of executing drug traffickers without trial. (See related story here).

It wasn't all listening to panels. In the basement of the Albuquerque Convention Center, dozens of vendors showed off their wares, made their sales, and distributed their materials as attendees wandered through between sessions. And for many attendees, it was as much a reunion as a conference, with many informal small group huddles taking place at the center and in local bars and restaurants and nearby hotels so activists could swap experiences and strategies and just say hello again.

The conference also saw at least two premieres. On the first day of the conference, reporters and other interested parties repaired to a Convention Center conference room to see the US unveiling of the British Transform Drug Policy Foundation publication, After the War on Drugs: A Blueprint for Legalization, a how-to manual on how to get to drug reform's promised land. Transform executive director Danny Kushlick was joined by Jack Cole of Law Enforcement Against Prohibition, Sanho Tree of the Institute for Policy Studies, Deborah Small of Break the Chains, and DPA's Nadelmann as he laid out the case for moving beyond "what would it look like."

"There's never been a clear vision of a post-prohibition world," said Kushlick. "With this, we've tried to reclaim drug policy from the drug warriors. We want to make drug policy boring," he said. "We want not only harm reduction, but drama reduction," he added, envisioning debates about restrictions on sales hours, zoning, and other dreary topics instead of bloody drug wars and mass incarceration.

"As a movement, we have failed to articulate the alternative," said Tree. "And that leaves us vulnerable to the fear of the unknown. This report restores order to the anarchy. Prohibition means we have given up on regulating drugs; this report outlines some of the options for regulation."

That wasn't the only unveiling Thursday. Later in the evening, Flex Your Rights held the first public showing of a near-final version of its new video, 10 Rules for Dealing with Police. The screening of the self-explanatory successor to Flex Your Right's 2003 "Busted" -- which enjoyed a larger budget and consequently higher production level -- played to a packed and enthusiastic house. This highly useful examination of how not to get yourself busted is bound to equal if not exceed the break-out success of "Busted." "10 Rules" was one of a range of productions screened during a two-night conference film festival.

The conference ended Saturday evening with a plenary address by former New Mexico Gov. Gary Johnson, who came out as a legalizer back in 2001, and was welcomed with waves of applause before he ever opened his mouth. "It makes no sense to spend the kind of money we spend as a society locking up people for using drugs and using the criminal justice system to solve the problem," he said, throwing red meat to the crowd.

We'll do it all again two years from now in Los Angeles. See you there!

Feature: The State of Play -- Federal Drug Reform Legislation in the Congress

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US Capitol, Senate side
Ten months into the Obama administration, drug policy reform in the US Congress is moving along on a number of tracks. Here's an update on some of the more significant legislation moving (or not) on the Hill. With a few exceptions, this report does not deal with funding issues that are tied up in the tangled congressional appropriations process.

Next week Drug War Chronicle will publish a parallel report on the state of play for drug policy in the nation's statehouses.

The Crack/Powder Cocaine Sentencing Disparity

After years of inertia, efforts to undo the 100:1 sentencing disparity in federal crack and powder cocaine cases have picked up traction this year. In July, Rep. Bobby Scott (D-VA) and 83 cosponsors introduced the Fairness in Cocaine Sentencing Act, which would eliminate the disparity by treating all cocaine offenses as if they were powder cocaine offenses for sentencing purposes. That bill has passed the House Judiciary Committee and is now before the Energy and Commerce Committee. On the Senate side, Sen. Richard Durbin (D-IL) introduced companion legislation, the Fair Sentencing Act of 2009, last month. It is currently before the Senate Judiciary Committee.

Federal Needle Exchange Funding Ban

The longstanding ban on the use of federal AIDS grant funds to pay for needle exchange programs may soon be history. Although the Obama administration left the ban in its budget request, Obama pledged to eliminate it during his campaign, and his administration has signaled it wouldn't mind seeing it go. The House Appropriations Committee's Subcommittee on Labor, Health and Human Services, Education, and Related Agencies stripped out the ban language in a July 10 vote. A week later, the full Appropriations Committee approved the bill after voting down an amendment proposed by US Rep. Chet Edwards (D-TX) that would have reinstated the funding ban, but accepted a poison pill amendment that would ban federally-funded needle exchange from operating "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, or university, or any public swimming pool, park, playground, video arcade, or youth center, or an event sponsored by any such entity." The House later passed the appropriations bill with the 1000-foot ban intact, but defeated a floor amendment by Rep. Mark Souder (R-IN) to reinstate the funding ban.

On the Senate side, the appropriations bill has yet to be passed, but the Senate committee working on the issue did not include language ending the funding ban. Reform advocates are hoping that the Senate will come on board for ending the ban in conference committee, and that committee members also strip out the 1000-foot provision.

The National Criminal Justice Commission

Introduced in March by Sen. Jim Webb (D-VA), the National Criminal Justice Commission Act of 2009 would create a commission that would have 18 months to do a top-to-bottom review of the criminal justice system and come back with concrete, wide-ranging reforms to address the nation's sky-high incarceration rate, respond to international and domestic gang violence, and restructure the county's approach to drug policy. The bill is currently before the Senate Judiciary Committee, where this week it was set to hear a raft of hostile amendments from Republican members. It currently has 34 cosponsors, including Republicans Olympia Snowe of Maine and Orrin Hatch of Utah.

Restoring College Aid to Students with Drug Convictions

The infamous Higher Education Act (HEA) anti-drug provision, or "Aid Elimination Penalty," which bars students committing drug offenses from receiving financial aid for specified periods of time, is under fresh assault. In September, the US House of Representatives approved H.R. 3221, the Student Aid and Fiscal Responsibility Act (SAFRA), one of the provisions of which restricts the penalty to those convicted of drug sales, not mere drug possession. The bill will next go to a conference committee, whose job will be to produce a reconciled version of H.R. 3221 and a yet-to-be-passed Senate bill. The final version must then be reapproved by both the House and the Senate. If that final version contains the same or very similar language, it will mark the second significant reduction of the penalty, the decade-old handiwork of arch-drug warrior Rep. Mark Souder (R-IN). In 2006, the provision was scaled back to include only drug convictions that occurred while students were enrolled in college and receiving financial aid (a change supported by Souder himself). Souder opposed this year's possible change.

Medical Marijuana

Late last month, Rep. Sam Farr (D-CA) reintroduced H.R. 3939, the Truth in Trials Act, which would allow defendants in federal medical marijuana prosecutions to use medical evidence in their defense -- a right they do not have under current federal law. The bill currently has 28 cosponsors and has been endorsed by more than three dozen advocacy, health, and civil liberties organizations. It is before the House Judiciary Committee.

That isn't the only medical marijuana bill pending. In June, Rep. Barney Frank (D-MA) introduced the Medical Marijuana Protection Act, which would reclassify marijuana as a Schedule II drug and eliminate federal authority to prosecute medical marijuana patients and providers in states where it is legal. The measure has 29 cosponsors and has been sitting in the House Committee on Energy and Commerce ever since. Frank introduced similar legislation in the last two Congresses, but the bills never got a committee vote or even a hearing. Advocates hoped that with a Democratically-controlled Congress and a president who has at least given lip service to medical marijuana, Congress this year would prove to be friendlier ground, but that hasn't proven to be the case so far.

In July, the House passed the District of Columbia appropriations bill and in so doing removed an 11-year-old amendment barring the District from implementing the medical marijuana law approved by voters in 1998. Known as the Barr amendment after then Rep. Bob Barr (R-GA), the amendment has been attacked by both medical marijuana and DC home rule advocates for years as an unconscionable intrusion into District affairs. The Senate has yet to act. Among the proponents for removing the Barr amendment: Bob Barr.

Marijuana Decriminalization

In June, Reps. Ron Paul (R-TX) and Barney Frank (D-MA) introduced the Personal Use of Marijuana By Responsible Adults Act, which would remove federal criminal penalties for the possession of less than 100 grams (about 3.5 ounces) and for the not-for-profit transfer of up to one ounce. The bill would not change marijuana's status as a Schedule I controlled substance, would not change federal laws banning the growing, sale, and import and export of marijuana, and would not undo state laws prohibiting marijuana. It currently has nine cosponsors and has been referred to the House Judiciary Committee's Subcommittee on Crime, Terrorism, and Homeland Security.

And just so you don't get the mistaken idea that the era of drug war zealotry on the Hill is completely in the past, there is Rep. Mark Kirk (R-IL). In June, Kirk introduced the High Potency Marijuana Sentencing Enhancement Act, which would increase penalties for marijuana offenses if the THC level is above 15%. Taking a page from the British tabloids, Kirk complained that high-potency "Kush" was turning his suburban Chicago constituents into "zombies." Nearly six months later, Kirk's bill has exactly zero cosponsors and has been sent to die in the House Appropriations Committee's Subcommittee on Crime, Terrorism, and Homeland Security.

Industrial Hemp

Reps. Barney Frank (D-MA) and Ron Paul (R-TX) again introduced an industrial hemp bill this year. HR 1866, the Industrial Hemp Farming Act of 2009would remove restrictions on the cultivation of non-psychoactive industrial hemp. They were joined by a bipartisan group of nine cosponsors, a number which has since grown to 18. The bill was referred to the House Energy and Commerce and House Judiciary committees upon introduction. Six weeks later, Judiciary referred it to its Subcommittee on Crime, Terrorism, and Homeland Security, where it has languished ever since.

Safe and Drug-Free Schools Funding

In May, the Obama administration compiled a budgetary hit list of 121 programs it recommended by cut or completely eliminated, including $295 million for the Safe and Drug-Free Schools community grants program. (It left intact funding for the Safe and Drug-Free Schools National Program). Both the House and Senate Appropriations Committees agreed with the White House and zeroed out the program. The House education appropriations bill has already passed, but the Senate bill is still in process. Proponents of the program may still try to reinstate it in the Senate or during the conference committee to reconcile the House and Senate appropriations bills.

Next week, look for a report on drug policy-related doings in the various state legislatures.

Feature: 2009 International Drug Policy Reform Conferences Opens Amid Optimism in Albuquerque

Hundreds, possibly more than a thousand, people poured into the Convention Center in downtown Albuquerque, New Mexico, as the Drug Policy Alliance's 2009 International Drug Policy Reform Conference got underway yesterday. Set to go on through Saturday, the conference is drawing attendees from around the country and the world to discuss dozens of different drug reform topics. (See the link above for a look at the program.)

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screening of near-final version of the next Flex Your Rights film, 10 Rules for Dealing with Police
This is the second time DPA has brought the conference to the distant deserts of the Southwest. In 2001, DPA rewarded libertarian-leaning New Mexico Gov. Gary Johnson (R) for becoming the highest ranking elected official in the US to call for ending drug prohibition by bringing the conference to his home state. Since then, the ties between DPA and New Mexico have only deepened.

As DPA New Mexico office head Reena Szczepanski explained at the opening plenary session, the Land of Enchantment is fertile ground for drug reform. "Back in 1997, when drug policy reform was little more than a twinkle in the eye, New Mexico passed a harm reduction act mandating the Department of Health to give out clean syringes for people with HIV/AIDS," she noted. "Then, when Gov. Johnson said it was time to end the war on drugs, DPA very wisely immediately opened an office here. In 2001, we passed the overdose prevention act, allowing for the distribution of naloxone. Then we passed opting out on the federal welfare ban, we passed asset forfeiture reform, we passed the 911 Good Samaritan Act -- saving somebody's life is more important than busting them for small amounts of drugs."

But wait, there's more. "Thanks to Gov. Bill Richardson, we became the 12th state to have legal access to medical marijuana for seriously ill people," Szczepanski continued. "We're working on treatment instead of incarceration, we're working to end the war on drugs in New Mexico and this country. This is a very special place for drug policy reform."

New Mexico is also right next store to one of the drug war's bloodiest battlegrounds: the mean streets of Ciudad Juarez, just across the Rio Grande River from El Paso, Texas, which in turn in borders New Mexico. More than 2,200 people have died in prohibition-related violence in Juarez this year alone.

That violence just across the river inspired El Paso City Councilman Beto O'Rourke to turn a motion expressing sympathy for El Paso's sister city into one that also asked for an open and honest debate on ending drug prohibition. The resolution passed the city council by a unanimous vote, only to be vetoed by the mayor. Then, as the council scheduled an override vote, the pressure came down.

"Each of us on the council got a call from Rep. Silvestre Reyes, our congressman and a very powerful figure," O'Rourke told the crowd Thursday. "He told us if we went forward with this, it will be very hard to get your district the federal funding you need. That's a powerful threat, since we rely on federal funding to deliver basic services. It was enough to get four members to change their votes."

While the resolution was defeated, the debacle opened the door for serious debate on drug policy in El Paso and generated support for ending prohibition as well, O'Rourke said. "Our local Students for Sensible Drug Policy chapter came out very strongly and helped organize a global policy forum in El Paso. I received hundreds of calls, letters, and emails of support from around the country and the world," O'Rourke related to sustained applause.

If Councilman O'Rourke was a new face, Ira Glasser is a familiar one. Former executive director of the ACLU and president of the DPA board of directors, Glasser told the crowd he was more optimistic about the prospects for change than ever before.

"Today we stand on the brink of transformative progress," he said. "I have never said that before. We can almost touch the goals we have sought, the unraveling of the so-called war on drugs, which is really a war on fundamental freedoms and constitutional rights, on personal autonomy, on our sovereignty over our minds and bodies, a war against people of darker skin color."

Just as Jim Crow laws were the successor to the system of slavery, said Glasser, so the drug war has been the successor to Jim Crow. "It's no accident that after the civil rights revolution ended with the passage of the last federal civil right law in 1968, Richard Nixon was elected on the southern strategy against progress on civil rights," he noted. "Within months of taking office, Nixon declared the modern war on drugs."

Glasser wasn't the only one feeling uplifted. "I am feeling good, better than ever before," said DPA executive director and plenary keynote speaker Ethan Nadelmann. "The wind is at our back. We are making progress like never before. We have to move hard and fast. Historically speaking, there are moments when everything comes together," drawing a pointed comparison with the successful temperance movement that managed to get alcohol banned during Prohibition. But Prohibition generated its own counter-movement, he said, again drawing a pointed parallel.

"Now, we're in another moment," Nadelmann said. "We're hurting with the recession, state budgets are hemorrhaging. More and more people are realizing we can't afford to pay for our prejudices, we can't continue to be the world's largest incarcerator."

But it's not just the economy that is opening the window, he continued. "What's happening in Mexico and Afghanistan, where illicit drugs are ready sources of revenues for criminals and political terrorists, that has people thinking. We have two major national security problems causing people to think afresh."

Nadelmann had a suggestion: "Ending marijuana prohibition is a highly effective way of undermining that violence," he said. "Until we end it, buy American."

Just after the opening plenary session ended, reporters and other interested parties repaired to a Convention Center conference room to see the US unveiling of the British Transform Drug Policy Foundation publication, After the War on Drugs: A Blueprint for Regulation, a how-to manual on how to get to drug reform's promised land. Transform executive director Danny Kushlick was joined by Jack Cole of Law Enforcement Against Prohibition, Sanho Tree of the Institute for Policy Studies, Deborah Small of Break the Chains, and DPA's Nadelmann as he laid out the case for moving beyond "what would it look like."

"There's never been a clear vision of a post-prohibition world," said Kushlick. "With this, we've tried to reclaim drug policy from the drug warriors. We want to make drug policy boring," he said. "We want not only harm reduction, but drama reduction," he added, envisioning debates about restrictions on sales hours, zoning, and other dreary topics instead of bloody drug wars and mass incarceration.

"As a movement, we have failed to articulate the alternative," said Tree. "And that leaves us vulnerable to the fear of the unknown. This report restores order to the anarchy. Prohibition means we have given up on regulating drugs; this report outlines some of the options for regulation."

That wasn't the only unveiling Thursday. Later in the evening, Flex Your Rights held the first public showing of its new video, 10 Rules for Dealing with Police. The screening of the self-explanatory successor to Flex Your Right's 2003 "Busted" played to a packed and enthusiastic house. This highly useful examination of how not to get yourself busted is bound to equal if not exceed the break-out success of "Busted."

The conference, of course, continued Thursday afternoon and will go through Saturday, but your reporter was busy getting this week's Drug War Chronicle ready to go. Come back next week for fuller reports on the 2009 International Drug Policy Reform Conference.

Europe: In Opinion Poll, Romanians Reject Marijuana Legalization

Last month, a Romanian presidential committee recommended decriminalizing the possession of "soft" drugs, implementing needle exchange programs, and legalizing prostitution. A poll this month suggests the committee and President Traian Băsescu have some work to do in winning over the Romanian public -- at least on the drugs issue.

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Traian Băsescu
According to a poll conducted by eResearch Corporation, an Angus-Reid affiliate, only 34% of Romanians agree with decriminalization, while 59% oppose it.

Băsescu came to power in 2004 as head of the Alliance for Truth and Justice, a coalition consisting of the Democratic and National Liberal parties, and vowed to institute reforms in the former communist satrapy. His Presidential Committee for the Analysis of Social and Demographic Risk was part of that pledge.

"Drug abuse needs to be discouraged, but with the adequate difference made between soft drugs and hard drugs, especially the ones injected such as heroin, which have devastating negative effects," the report said. But the report also called for "disincrimination (sic) of drug consumption -- but not of trafficking -- to bring consumers to the surface."

According to another eResearch poll, Romanians are going for bringing sex work in from the cold. That poll found that 56% supported legalizing prostitution, while only 37% opposed it.

Feature: Busted for Handing Out Clean Needles -- The Mono Park 2 Fight Back in California's Central Valley

Hit hard by a double whammy of drought and economic slowdown, California's Central Valley has become a hotbed of methamphetamine and other injection drug use. Now, the dusty town of Modesto, in Stanislaus County, has become a focal point in the statewide and nationwide battle over how to help injection drug users. Last week, two volunteers at an unsanctioned needle exchange were in court in Modesto hoping to reach a plea bargain after they were arrested in April for handing out syringes. Now known as the Mono Park 2, they're looking at serious jail time for trying to save lives.

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mobile needle exchange/clinic site in nearby Fresno
The deal was supposed to be that Stanislaus County District Attorney Birgit Fladager would drop drug paraphernalia possession charges against exchange volunteers Kristy Tribuzio and Brian Robinson if they agreed to quit handing out needles until there was a legal program in place. But that didn't happen. Instead, at the last minute, the DA rejected the plea deal. Another hearing is set for November 9. If the DA and defense attorneys cannot reach agreement then, the case will go to trial.

The case has its genesis in longstanding efforts to win official approval for a needle exchange in Modesto. California law allows for needle exchanges, but only as a local option. The county board of supervisors must declare a health emergency in order for needle exchanges to operate legally.

In a 2008 report, Containing the Emerging Threat of Hepatitis through a Syringe Exchange Program (begins on page 22), the Stanislaus County Civil Grand Jury recommended the county authorize syringe exchanges and implement them either directly or through a community based contractor. The effort also had the support of county public health officials, including Public Health Department, the Advisory Board for Substance Abuse Programs, the Local AIDS Advisory Implementation Group, and the Hepatitis C Task Force, who cited a high incidence of Hepatitis C. They cited research indicating that needle exchanges reduced the spread of blood-borne diseases, brought injection drug users into contact with public health workers, and did not result in increases in drug use.

But despite the input from the public health community and the grand jury report, the Stanislaus County Board of Supervisors a year ago voted unanimously against allowing needle exchanges. In so doing, they heeded their own prejudices and those of law enforcement over science-based policies and the advice of the public health community.

County Sheriff Adam Christianson and DA Fladager both spoke out against needle exchanges, saying they would enable drug users to continue their addiction. Fladager said needle exchanges sent the wrong message to young people and encouraged them to think the county would take care of them if they become addicted.

"All of the challenges we are faced with in Stanislaus County, the gangs, methamphetamine, crimes, all have elements of drug addiction," Christianson said. "A syringe exchange program enables people to continue with their drug addiction."

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used syringes collected by exchange -- they might otherwise have been discarded in public places
Noting that Hep C was not a big issue for the county because most patients are covered by insurance, Supervisor Bill O'Brien also objected on bizarre moral grounds. "Then there's the human issue. Giving a drug user a clean needle is not the best thing for him. Illegal drug use has a risk, and making it safer promotes it," he said.

Supervisor Jim DeMartini thanked the grand jury for the report, but then dismissively added, "Like many well-intentioned programs that don't work out, this will never work out and deliver the benefits promised."

Too bad the sheriff, the DA, and the county board don't agree with the nation's drug czar. "Needle exchange programs have been proven to reduce the transmission of blood-borne diseases," Gil Kerlikowske told Congress during confirmation hearings earlier this year. "A number of studies conducted in the US have shown needle exchange programs do not increase drug use. I understand that research has shown these programs, when implemented in the context of a comprehensive program that offers other services such as referral to counseling, healthcare, drug treatment, HIV/AIDS prevention, counseling and testing, are effective at connecting addicted users to drug treatment."

Given the knowledge base about the effectiveness of exchanges and the evident human need for them in Modesto, needle exchange advocates were not content to simply roll over and die. Instead, they created an unauthorized needle exchange in the city's Mono Park, also known as needle park by residents because of the used needles littering the ground there. The program was publicized and went along on a low-level basis without a hitch until April, when, after an elaborate undercover sting, police swooped down and arrested the exchange volunteers.

Kristi Tribuzio just happened to be volunteering with the needle exchange the day the bust went down. Now, she's one of the defendants. "There was a direct need for this, and when I found out there was an existing exchange -- I saw a flyer on a telephone pole -- I asked how is this happening?" she said. "I got involved; I was just going out there for the people. An undercover cop came up and did an exchange, and then, a little later eight to 10 undercover officers drove up with a drug dog and arrested us. It was pretty harsh and crazy," she recalled.

"Looking back, Brian and I think it was maybe naive of us to just go out there and do something that was helping people in line with other syringe exchange programs," said Tribuzio. "We didn't understand what the consequences could be."

Now, she and Robinson face up to a year in jail for violating the paraphernalia law. For Tribuzio, there were other consequences, including the loss of her contract position with the Stanislaus County drug and alcohol education and prevention program. "I was laid off two days after I was arrested. Because I was a contract worker, they didn't need a reason to fire me, and no official reason was given. Ironically, my employer supports needle exchange," she said. "Maybe that's why they laid me off instead of firing me for cause. Now, at least, I can get unemployment."

Tribuzio had previously worked as a substitute teacher, but she can't do that now, either. "I'm getting an MA in education, and I have a teaching credential, but my credential is now suspended," she said. "Imagine, a teacher in San Francisco could be doing just what I did, and there would be no problem."

That's because needle exchanges have been authorized by the San Francisco County Board of Supervisors, just as they have in most large California cities. But in more conservative locales, like the Central Valley, the fight is more difficult, and therein lies the problem -- and the solution -- said one prominent harm reductionist.

"What we need is to get legislation authorizing syringe exchanges on a statewide level rather than our current system, which requires that they be authorized by local authorities," said Hilary McQuie, Oakland-based Western director of the Harm Reduction Coalition. "Requiring local authorization means we have to deal with 54 jurisdictions instead of just one, and the politics makes it really difficult in conservative places like Fresno or Modesto. It will be really difficult to get syringe exchange approved in Modesto without a statewide mandate," she said.

Short of that, needle exchange advocates need to carefully lay the groundwork beforehand, she said. In that respect, the Modesto needle exchange perhaps suffered from political naivete. "The effort with the grand jury in Modesto was done in good faith, but the grand jury finding required a response from the Board of Supervisors within three months," she noted. "They hadn't really lined up their support with the Board, and the Board ended up voting against it. That was problematic."

While personally difficult for Tribuzio and Robinson, the battle over needle exchanges in Modesto has moved the issue forward locally and stirred support from around the country and the world. A Mono Park 2 Defense Committee has formed to back them. At last week's hearing, more than a dozen supporters were present in court, and the pair had letters of support from some 35 public health and harm reduction organizations here and abroad.

"We've gotten a ton of support from the harm reduction community," said Tribuzio. "This whole thing has been stressful and overwhelming for us, but they've given us a wealth of training, knowledge, and support, more than we ever expected. We've gotten support from people in other exchanges, and letters of support from around the world. We've also been building alliances with people in the community. Things in the Central Valley are crazy, and we can't turn our heads away in the face of disease. Now, at least, people are paying attention."

While Robinson and Tribuzio wait for their legal problems to be resolved, they continue to work with at-risk communities. "After the bust, we started Off The Streets, and that does everything except for needle exchange," said Tribuzio. "We're doing needs assessments, trying to get our fingers on the pulse of the community, trying to help where we can."

For McQuie, the trials and tribulations of the Mono Park 2 are, sadly, par for the course. "This is how most of the programs got started, doing them illegally, so they're in good company," she said.

Feature: Federal Needle Exchange Funding Ban Battle Continues

Years of effort by harm reductionists, public health authorities, HIV/AIDS researchers and activists, and drug law reformers to undo the more than 20-year-old ban on federal funding for needle exchange programs (NEPs) may come to fruition this year, but there are significant obstacles to overcome. Still, advocates of the reform are cautiously optimistic.

Since 1988, the US government has prevented local and state public health authorities from using federal funds for NEPs, which studies have shown to be effective in reducing HIV infection rates among injection drug users (IDUs) and their sexual partners, promoting public health and safety by taking syringes off the streets, and protecting law enforcement personnel from injuries. NEPS have been endorsed by the World Health Organization, the American Medical Association, Centers for Disease Control and Prevention Director Thomas Frieden, and former Surgeons General Everett Koop and David Satcher, among many others.


Chicago map demonstrating the impact of the
1000-foot rule -- click for larger copies and more
maps of Chicago and San Francisco (courtesy
Dr.Russell Barbour, Center for Interdisciplinary
Research on AIDS, Yale School of Medicine)

Injection drug use accounts for up to 16% of the 56,000 new HIV infections in the US every year -- or nearly 9,000 people. IDUs represent 20% of the more than 1 million people living with HIV/AIDS in the US and the majority of the 3.2 million Americans living with hepatitis C infection.

Still, those numbers could have been higher. In a 2008 study, the CDC concluded that the incidence of HIV among injection drug users had decreased by 80% in the past 20 years, in part due to needle exchange programs. There are today an estimated 185 NEPs operating in 36 states, the District of Columbia, and Puerto Rico. But they rely on local or private funds, and many of them are failing to meet demand because of lack of funding. While the CDC says that its public health policy goal is 100% needle exchange, current estimates are that only 3.2% of needles used by drug users in urban areas are exchanged for clean ones.

The federal funding ban was first removed in a July 10 vote of the House Subcommittee on Labor, Health and Human Services, Education, and Related Agencies. A week later, the full Appropriations Committee approved the bill after voting down an amendment proposed by US Rep. Chet Edwards (D-TX) that would have reinstated the funding ban.

But the Appropriations Committee did approve an amendment dictating that federally funded NEPs could not operate "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, or university, or any public swimming pool, park, playground, video arcade, or youth center, or an event sponsored by any such entity."

A floor amendment by Rep. Mark Souder (R-IN) to reinstate the funding ban also was defeated, clearing the way for repeal of the ban to pass the House. But the thousand-foot language remains in the appropriations bill approved by the House, and it's extremely objectionable to reform advocates. The Senate committee working on the issue did not include ending the funding ban, but reform advocates are pinning their hopes on both ending the ban and killing the thousand-foot restriction on the end-game House-Senate appropriations conference committee.

"The Senate has taken up their version of the bill in committee, but hasn't had a full vote," explained Daniel Raymond, policy director for the Harm Reduction Coalition. "At the committee level, the Senate chose not to take any action on the ban. At this point, there is a conflict between the House and the Senate." HRC is lobbying the Senate to repeal the ban, without the restrictions.

"We commend the full House for recognizing that NEPs are essential, effective tools that work in our fight against HIV and hepatitis transmission," said Kevin Robert Frost, chief executive of the Foundation for AIDS Research. "And while the compromise in the bill isn't perfect, we are hopeful that a final bill will reach President Obama's desk without limitations."

"We urge Congress to recognize both the benefit and cost-savings of syringe exchange programs, and the research that NEPs do not have detrimental impact on communities," said Marjorie Hill of Gay Men's Health Crisis, which has just released yet another study demonstrating NEPs' effectiveness in decreasing the transmission of blood-borne diseases. "For too long, we have allowed ideology to drive public health policy. It is time to remove the federal funds ban for syringe exchange and remove the harmful 1,000 feet restriction," added Hill.

"The House bill, as it stands, still puts ideology before science by limiting how federal funds can be used for NEPs," Frost said. "But we have time to fix the legislation, and I'm hopeful that the full US Congress will realize the importance of allowing local elected and public health officials to make their own decisions about how to address their HIV and hepatitis epidemics."

"I believe that the president, the Senate, and the House all want to do the right thing and they're trying to figure out how to do it," said Bill McColl of AIDS Action. "If they follow their own rhetoric about science- and evidence-based HIV/AIDS prevention policy, then they will remove the thousand-foot restriction," he said.

"The thousand-foot provision is a backdoor means of reinstating the funding ban," McColl continued. "There is almost no urban environment in which it would allow needle exchanges to operate. There are no currently existing needle exchanges that would be able to get federal funding, so it just doesn't make sense to change the policy that way. Drug policy groups have gone and literally shown Congress maps of what would be excluded. They've got letters from mayors and police saying this is not a workable provision. Again, Congress and the president know what the science is."

In addition to eliminating federally-funded needle exchanges in vast swathes of the urban landscape, the thousand-foot rule would have other insidious effects, said McColl. "Having that rule would have undesirable side effects, in that it would separate needle exchange from other public health services. Our AIDS program does testing in areas with lots of drug use -- that's where we need to be testing, and that's where we want the population to have clean syringes. With federal funding available and with the thousand-foot rule, prevention services will be driven away from needle exchanges."

Alice Bell, prevention project coordinator for Prevention Point Pittsburgh, already lives with geographical restrictions. "We have a local regulation that specifies 1,500 feet from schools only, not all the other restrictions in the current language of the federal bill. We have to move our main needle exchange site because the building we're in is being sold, and we're having trouble finding a good place. Any federal restrictions would make it even tougher," she said.

Bell wants the federal funding ban ended, but worries that the thousand-foot rule would put a crimp in her efforts. "We still want it. We need the federal funding. Our program is expanding, but we can't really expand our exchange service because we don't have money for needles. The toughest thing is always getting money for needles. Ending the federal funding ban would make a huge difference to us."

Federal funding becomes even more significant when coupled with economic hard times and budget problems at the state and local level, Bell noted. "We're mostly funded through foundations and private donations, and we've begun getting some state and county money for overdose prevention and HIV prevention, but the needle exchange -- the core of what we do -- is the toughest to get funded."

"The Senate will most likely go along with the House in conference committee," said Drug Policy Alliance director of national affairs Bill Piper. "They will probably take a bunch of appropriations bills and put them in a massive omnibus spending bill. It is far from clear that there will be a ban in what comes out of the Congress."

But the thousand-foot rule has to go, he said. "A lot of groups have been lobbying really hard on the thousand-foot issue," Piper noted. "It would be an effective ban is many cities. Here in DC, for example, the only place you could do a needle exchange program would be down at the docks on the Potomac. The strategy is to convince the conference committee to either take that out or come up with something better."

Advocates are lobbying hard right now, said the Harm Reduction Coalition's Raymond. "Right now, we're doing a push to make sure the Senate is educated about the issue and ask the leadership to get on board with House's action to address the ban," he said. "The House version has the thousand-foot restriction, so we're also making the arguments about why that's not workable and needs to be redone. We've been circulating maps showing its impact to House members who are focused on the issue. This restriction goes far beyond any reasonable desire to balance public health with other interests. When that provision was thrown in at the last minute, its effects hadn't really been thought out," he argued.

"We keep up the work in reaching out to Congress on both House and Senate side," said Raymond, "and we're also asking the White House to show some leadership and urge the Senate to address the federal ban. We don't want this issue to get lost in the shuffle, we're calling on everyone in the community to make our voices heard and reaching out to our elected officials."

It may take awhile to get settled, said Piper. "The entire appropriations process is messed up, and a lot of will depend on if, when, and how the Senate deals with health care," he explained. "Supposedly, they will get the appropriations bills done by the end of October, but I think that's a fantasy. Last year, they didn't even do this year's appropriations bills until March."

Still, AIDS Action's McColl maintains a positive outlook. "I think the members who will be called on to vote on this understand the issues," he said. "I have a pretty good feeling about this. I'm hopeful this is the year."

1000 Feet from Everywhere

One of the articles we are finalizing for publication in Drug War Chronicle tonight deals with needle exchange, and the state of legislation in Congress to end the ban on use by states of federal AIDS funds to support needle exchange programs. A bill has passed the House of Representatives -- good news -- but it includes a provision that would render it nearly useless. This provision would require that needle exchange programs receiving federal funds not operate "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, or university, or any public swimming pool, park, playground, video arcade, or youth center, or an event sponsored by any such entity." I'm not sure how any program could track where all the different such entities decide to hold events. More importantly, the rule would basically prevent needle exchanges from operating at all, because the area encompassed is pretty much everywhere inside any city. Dr. Russell Barbour, at Yale School of Medicine's Center for Interdisciplinary Research on AIDS, has produced several charts that advocates are using now on the Hill, illustrating the impact the provision would have on AIDS prevention efforts in Chicago and San Francisco. He graciously provided them to us. Check them out here: (more below the fold)

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