The Week Online with DRCNet, Issue #31, 2/27/98

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1. SPECIAL REPORT: American Public Health Association Holds Congressional Briefing on Syringe Exchange

-Adam J. Smith

On Tuesday, 2/24, the APHA held a very well-attended briefing for congressional staffers on the topic of syringe exchange. At a moment in history when the mere mention of drugs or drug policy reform sends shivers through the very halls of Congress, the prestige of the 125 year-old APHA was an important factor in cutting through the politics of the debate and drawing a crowd of over 100 staffers to the luncheon.

Three speakers, Harry Simpson, Executive Director of the Community Health Awareness Project in Detroit, Dr. Peter Beilenson, Health Commissioner for the City of Baltimore, and Dr. Don Des Jarlais, prominent AIDS researcher, currently on staff at the Beth Israel Medical Center in New York, made a compelling case in favor of syringe exchange from the practical, political and public health perspectives. Although all three speakers spoke of the imperative, both medical and moral, for lifting the current ban on the use of federal AIDS funding for these programs, the event also provided a broad-based education on the issue of harm reduction to staffers, who seemed eager both to learn more about syringe exchange and to gather rhetorical ammunition to take back to hesitant legislators.

Harry Simpson spoke first and told the standing room only crowd of his 16 years as an injection drug user. Clean and sober today and the Executive Director of a full-service harm-reduction and public health center with an annual budget of over $1 million, Simpson eloquently made the case for helping, rather than discarding, our fellow citizens who find themselves mired in addiction and abuse. "As a recovering addict, when I first heard about syringe-exchange, my initial reaction was, 'you gonna give these folks free needles? That's the most ridiculous thing I've ever heard.'" Simpson went on to say, however, that today, as a practitioner of harm reduction and syringe exchange, he believed that the service was not only an effective AIDS-prevention strategy, but also provided a bridge for substance abusers which led to healthier lives and quite often to successful recovery.

Dr. Beilenson spoke of the experience of the city of Baltimore, where AIDS is the #1 killer of persons 25-44 years-old. Baltimore, he said, had the largest city-run syringe exchange/harm reduction program in the country, with two mobile units, six separate sites and two pharmacies where syringes could be exchanged. Dr. Beilenson emphasized the superiority of exchanges, where dirty needles are taken back off the street and properly disposed of, over simple over-the-counter availability, which relied upon consumers to dispose of the potentially hazardous waste themselves.

One staffer asked about reports that some sites around the country had given syringes to people who had not brought used syringes to exchange, to which Dr. Beilenson replied that while an exchange is formally required, and that the vast majority of clients did in fact come to the sites with used syringes, if staff believed that a person asking for syringes was, in fact, an IV drug user, it would not be in anyone's interest to turn them away. In Baltimore, where each syringe is computer coded, the city-run exchange gets back over 90% of the syringes that it gives out. Dr. Beilenson also noted that while the typical taxpayer cost for a single indigent AIDS patient easily surpassed $100,000, the cost of running Baltimore's entire exchange program was just $300,000, making the program an enormous cost-saving measure for the city.

Dr. Beilenson also listed for the staffers four things that syringe exchange does NOT do: 1) increase the number of dirty needles on the streets (Baltimore has seen a decrease); 2) increase crime in their areas of operation (here again Baltimore has seen a decrease); 3) increase the use of drugs by clients (Baltimore's large-scale study found a 22% overall reduction in use by clients); 4) condone injection drug use, especially with regard to adolescents (Baltimore's program, which serves over 7,000 clients and which has exchanged 1.7 million syringes, has exactly two clients under 18 years of age).

Dr. Don Des Jarlais spoke of the public health imperative for implementing programs which have now been common-practice for years in nearly every western society. He told the gathered staffers that more than one half of all new AIDS cases in the US came directly from infected needles, and that overall, more than 70% of new cases were injection-related. He said that IV drug users have multiple incentives to use the programs where they are available, as in addition to the health benefits, new needles worked and felt better than old, dull needles. In fact, 70-90% of users who had access to programs used them regularly. In addition, he stressed, syringe exchange programs were the single largest source of treatment referrals in areas in which they operated.

In a nod to the partisan nature of the debate over the programs in the US, Des Jarlais addded that in the late 1980's "that noted British liberal Margaret Thatcher instituted nation-wide syringe exchange" as part of her country's AIDS prevention strategy, and that in contrast to the startling situation in the States, there is today in the UK almost no correlation between IV drug use and the AIDS virus.

Throughout the program, attendees could be seen nodding in agreement and furiously taking notes. One staffer asked the panel how to broach the subject with a legislator for whom the moral imperative of helping drug addicted persons, or even the public health benefits of the programs, fell on deaf ears. Beilenson urged the staffer to argue dollars and cents. He reiterated his earlier assertion that Baltimore's $300,000 program was saving the city untold millions of dollars in health care costs each year. A warm round of applause closed the program, and a buzzing crowd of congressional aides spilled out into the hall and back to work.

[AJS: Having witnessed this event with the knowledge that the House Republican leadership is in the process of crafting a comprehensive Drug War legislative package, one could not escape the feeling that a fight over drug policy, a real fight with real philosophical distinctions, is set to emerge in the House and to be played out over the next 3-4 years. That fight will pit war vs. peace, marginalization vs. integration, and punitive measures vs. public and individual health imperatives. At stake will be nothing less than the future direction of the democracy, and the type and the character of the nation that we will hand to our children in the new millennium.]

2. It's "Certification" Time Again: Mexico Makes the Grade, Colombia Doesn't -- But Sanctions Will Be Lifted

In the annual, controversial ritual in which the President, with the consent of Congress, certifies those nations which have been appropriately cooperative in the global Drug War, Mexico has maintained its status as an ally, while Colombia, which has been decertified for the past two years, will remain off the list but will see US sanctions lifted.

None of this is final, of course, as Congress may well attempt to overturn President Clinton's decisions, as they attempted unsuccessfully to do last year with regard to Mexico. The Associated Press (2/26) reports that there is already a move on in Congress to decertify Mexico legislatively. Nations which have been denied certification face economic sanctions including an automatic "no" vote by the U.S. on any loan requests to the World Bank.

That is exactly the position in which Colombia has found itself over the past two years; the Clinton Administration has cited its belief that President Ernesto Samper received over $6 million in campaign contributions from drug traffickers during his 1994 campaign. Clinton's recommendation this year, that Colombia remain decertified but have economic sanctions waived, apparently reflects the belief of the administration that Colombia's police force and new attorney general are relatively free of corruption and are making a good-faith effort to combat the multi-billion dollar trade. The AP notes that US officials acknowledge the massive eradication efforts in Colombia but also know that increased planting of coca has more than made up the difference.

to admit is that it doesn't make a difference how hard a source country "fights" the drug trade -- demand for drugs in the US and other countries assures that someone will provide the supply. Study after study, many of them by the government's own General Accounting Office, have found that source country efforts have had negligible long-term impact on the price and availability of drugs in the US.]

3. Colorado State Senate Okays Needle Exchange: Republican State Chair Explicitly Threatens Reps Who Vote in Favor

In an emotional and hotly contested 20-15 vote, Colorado's senate approved SB-99, which would legalize syringe exchange in the state. The measure goes next to the house. The city of Denver would like to institute a needle exchange program, while Boulder already has one in operation, albeit illegally. Authorities in Boulder have thus far declined to shut the program down in the belief that it is providing a valuable service to the community.

Denver's Mayor Wellington Webb, a supporter of syringe exchange, told the Denver Post, "I'm pleased that we're halfway there, and I certainly want to congratulate those legislators who were able to give another tool to be used in the fight against the spread of AIDS.

But sources told The Week Online that Colorado State Republican Chair Steve Curtis has issued an explicit threat to any house member who votes in favor of the bill. Curtis promised that any house Republican who strays from the party line on this vote can be assured of facing party-financed opposition in their next primary. Insiders say that Curtis' threat may in fact work against his party, with the potential existing for a backlash against such an overt act of coercion. The bill is now in the 11-member Health, Environment, Welfare and Institutions committee, where it is thought that one or two swing votes are still needed to send the bill to the floor.

Paul Simons, Executive Director of People Engaged in Education and Reduction Strategies (PEERS), a proponent of the bill, told The Week Online, "There is obviously a lot of support within the city governments of both Denver and Boulder for these programs. We're facing a situation here where legislators from districts which are not facing these types of problems are trying to hold syringe exchange hostage, and are essentially condemning people to death, for purely political reasons. It's vital that people of Colorado contact their legislators and express their concern."

ALERT: Colorado residents are STRONGLY URGED to contact their state reps by phone THIS WEEK as the bill will be acted upon quickly.

Some of the key legislators in this process include Kay Alexander (58-R) 866-2955, Chuck Berry (21-R) 866-2346, Jeanne Faatz (1-R) 866-2966, Dorothy Gotlieb (10-R) 866-2910, William Kaufman (51-R) 866-2947, Martha Kreutz (37-R) 866-5510, Joyce Lawrence (45-R) 866-2922, Paul Schauer (39-R) 866-2935, Bryan Sullivant (62-R) 866-2916, Bill Swenson (12-R) 866-2920, Jack Taylor (56-R) 866-2949, and Tambor Williams (50-R) 866-2929. (All numbers are in area code 303.)

Please call one or more of the legislators on this list plus your own; and whether or not you live in Colorado, please get your friends and family in Colorado to call theirs. You can contact PEERS at (303) 455-2472.

For more information about syringe exchange and injection-related AIDS, go to DRCNet's Topics in Depth site at http://www.drcnet.org/AIDS/, the North American Syringe Exchange Network home page at http://www.nasen.org/, or the Safe Works AIDS Project web site at http://www.safeworks.org/.

4. House Republicans Declare: Damn the Science, Full Speed Ahead! Approve Resolution Opposing any Use of Marijuana as Medicine

(Reprinted with permission of the NORML Foundation, http://www.norml.org.)

February 26, 1998, Washington, DC: A coalition of Republicans on the House Judiciary Committee, Subcommittee on Crime, approved a "sense of the House of Representatives" resolution stating that "marijuana is a dangerous and addictive drug and should not be legalized for medical use." The resolution -- introduced by subcommittee chair Bill McCollum (R-FL) -- won the approval of all seven Republicans present, while being opposed by the two Democrats at the mark-up, Reps. John Conyers (D-MI) and Sheila Jackson Lee (D-TX). Ironically, the subcommittee's action came just one day after the National Academy of Sciences Institute of Medicine (IOM) held its third and final symposium on the merits of marijuana therapy. The IOM organized the conferences as part of a federally funded 18-month review of the scientific evidence demonstrating marijuana's therapeutic value. Before passing the resolution, the Republicans rejected an amendment offered by Rep. Conyers, ranking Democrat on the House Judiciary Committee, stating that the "States have the primary responsibility for protecting the health and safety of their citizens, and the Federal Government should not interfere with any state's policy (as expressed in a legislative enactment or referendum) which authorizes persons with AIDS or cancer to pursue, upon the recommendation of a licensed physician, a course of treatment for such illness that includes the use of marijuana." Republicans argued that any lifting of the legal ban prohibiting marijuana, even for medical purposes, would send mixed and potentially dangerous messages to the American public about drug use. Conyers said that the federal government has no right to interfere in the relationship between a doctor and a patient.

"We are talking about patients with the most serious illnesses a person can have -- people who may very well die," Conyers said. "And for these patients, there is substantial medical literature suggesting that marijuana can reduce their suffering." "The Republicans on the Judiciary Committee refuse to recognize that this is a public health question, not part of the war on drugs," said NORML Executive Director R. Keith Stroup, Esq. "They are willing to ignore the science and deny an effective medication to the sick and dying in order to advance their political agenda. It is especially disappointing that Chairman McCollum, who twice sponsored legislation to permit the legal use of medical marijuana in the 1980's, would lead this misguided effort." The resolution now goes for consideration before the full Judiciary Committee. A separate federal bill to allow for the legal use and distribution of medical marijuana in states that approve such efforts is pending in the House Commerce Committee, Subcommittee on Health and Environment. House Bill 1782 -- introduced by Rep. Barney Frank (D-MA) -- currently has ten co-sponsors. For more information or a copy of the February 23 House Resolution, please contact either Keith Stroup or Paul Armentano of NORML @ (202) 483-5500. Information on upcoming state medical marijuana initiatives and legislation is also available upon request.

5. Hollywood Group Promises More Anti-Drug Themes

A Hollywood organization known as the Caucus of Producers, Writers and Directors met with Drug Czar Barry McCaffrey last week (2/18) and announced their intention to incorporate more anti-drug themes into their work. Jerry Isenberg, chair of the caucus, told the Los Angeles Times that they would have to get creative becauses "simplistic 'drugs are bad' messages (are) old and ineffective." Asked about the groups apparent adherence to the administration's party line, Isenberg told the Times, "There is no party line, everybody hates drugs."

PLEASE SEE THIS WEEK'S EDITORIAL (at bottom) FOR REACTION TO THIS TREND.

6. State Legislators Launch Counterattack on Prop 215 in California

- Lloyd Johnson for DRCNet

California State Sen. Richard Rainey (R-Walnut Creek) has introduced SB 2113, which would severely limit the reach and effectiveness of Prop 215. SB 2113 would make it illegal for a doctor to recommend marijuana to any patient under 18, limit the authority to California Licensed doctors only, disallow hospice personnel, nurses or other medical professionals from being designated as a patient's primary caregiver, and limit the law's application to cancer, HIV, glaucoma, and muscle spasms associated with a chronic illness (excluding depression, nausea, anorexia, arthritis, migraines and many other conditions for which relief has long been noted).

The bill also deletes the provision encouraging state and federal agencies to develop a means of distribution of the medicine, makes Buyers Clubs illegal, requires the doctor to administer a complete examination and written diagnosis prior to any recommendation, requires a new examination and written recommendation every six months, requires recommending physicians to have an ongoing relationship with a patient prior to recommendation, and would make an oral recommendation illegal. The complete content of SB 2113 at http://www.senate.ca.gov/. Even if passed by the legislature and signed by the Governor, SB 2113 will still require approval by the voters next November, as the California Constitution mandates that any law passed by the people can only be amended by the people.

ALERT: California residents, now is the time to let your State Reps know how you feel about SB 2113. If it gets on the ballot, it will consume precious resources to defeat.

7. California Supreme Court Deals a Blow to Buyers' Clubs

- Barrington Daltrey for DRCNet

The California Supreme Court dealt the medical marijuana clubs a setback this week (2/25), letting stand a lower court ruling prohibiting clubs from selling marijuana to patients, despite the 1996 Proposition 215 voter initiative. The appellants had argued that they qualified as "primary caregivers" even though they might be commercial enterprises. The appellate court's ruling held that Proposition 215 did not allow anyone the right to sell marijuana; nor did it allow commercial enterprises to act as "primary caregivers."

The spokesman for Cannabis Cultivator's Club of San Francisco, one of the appellants, is reported as having stated that he believes the club is now in compliance with the ruling, as it is not selling marijuana, but is only receiving reimbursement for cultivation costs.

The state's attorney has indicated he will seek to shut down CCC and various other clubs providing medical marijuana. Federal prosecutors are also seeking an order closing several clubs, based on federal law. Their action is pending in federal court.

8. No Federal Charges to be Filed Against Marine Who Shot Hernandez

The US Justice Department has decided not to pursue civil rights charges against Cpl. Clemente Banuelos, the marine who shot and killed Esequiel Hernandez, an 18 year-old Texas resident, near the Texas-Mexico border. Hernandez was out herding the family sheep when he was tracked and killed by a camouflaged, four-marine patrol on the lookout for smugglers and illegal aliens. Hernandez was carrying an old .22 rifle that he used to scare off snakes and other predators. The killing was the first of an American citizen by an active duty soldier.

9. EDITORIAL: Hollywood and the Drug War

Last week, a group calling itself the Caucus of Producers, Writers and Directors met with Drug Czar Barry McCaffrey and promised to work more anti-drug themes into their productions. "If anybody knows how to reach the adolescents of America, it is the people in this room" McCaffrey told the group. This is ironic, of course, because if there is anybody who doesn't know how to reach the adolescents of America, it is the people who are prosecuting the Drug War.

Over the past several years, the Hollywood community has been high on the list of allies that the Clinton administration has attempted to enlist in the War effort. Propaganda works of course, and if the information presented to kids through the entertainment industry is accurate (the Madison Avenue-issued Partnership For Drug Free America ads have been repeatedly attacked for employing more hyperbole than honesty), then surely no one could quibble with trying to warn kids about the dangers inherent in using drugs. But with the industry itself rife with illegal drug use, the apparent hypocrisy may well intrude on the effectiveness of the message.

And that hypocrisy goes well beyond the "do what I say, not what I do" variety. The General, while he talks a lot about treatment and prevention, is the front man for a policy that is directly responsible for making the US the world's #1 per capita incarcerator, with one out of every 144 Americans behind bars, and one in three young black males under criminal justice 'supervision". And while it is well known that drug use is common in the entertainment industry, trips to expensive rehab programs are still the rule, with arrests the notable exception. For unless a celebrity is caught doing something incredibly stupid or outrageous (such as smuggling drugs across a border, or being arrested for gross public displays of delirium), state and federal law enforcement agencies have shown little interest in intervening. When was the last time you read about a big Hollywood party being raided, resulting in arrests and asset forfeiture?

So the Hollywood community is safe to go about its business, secure in the knowledge that the Drug War is a war against others, and that their friends in and around "the business" need only keep their use relatively private in order to avoid the consequences that the General and his War have in store for "regular people." One would imagine that few members of the entertainment industry believe that any of their drug-using colleagues would be better off doing a five or ten year mandatory sentence for possession or conspiracy. And of course, they would be right.

But while countless stars and starlets appear on the Oscars telecast sporting ribbons for AIDS research, or against cruelty to animals, or whatever undeniably worthy cause for which they wish to speak out, on the issue of the drug war, there is deafening silence -- even complicity. In the absence of dissent, a Czar calls forth their talents and their influence in service to a policy that is destroying the lives and communities of "regular people" while failing spectacularly to put a dent in either the availability or the abuse of drugs.

Public service announcements and anti-drug messages in entertainment are fine, but the fact is that an American child has a better chance of growing up in a community torn apart by the black market, or to lose a parent to the criminal justice system, or even to end up being sucked into the trade itself, than he or she has of ever becoming addicted to drugs. And this is true even though the current system virtually assures that kids have unfettered access to even the most dangerous substances.

Pardon the cynicism inherent in this question, but is there a quid pro quo here? Clearly, a few well-timed busts could put a very large and very public hole in the Hollywood community. The damages would extend far beyond the lives of the celebrities involved, what with contracts and ongoing projects and current work all dependent upon the viability of the "stars". Is Hollywood's latest bow to America's longest war some sort of insurance policy against such ugliness? Even if only implicitly?

One can almost hear, of course, the worried voices of agents and PR people warning the talent to stay far clear of this third-rail. Even those who support reform know that the majority of Americans is woefully misinformed about the issue. But in this case the image-makers are behind the curve. Europe is experiencing a virtual revolution of thought on the issue of drugs and policy, as is Australia and Canada. The Independent on Sunday, a British paper, is in fact in the midst of a very well-publicized campaign to legalize cannabis. They have garnered support from all segments of society, including the very public backing of Sir Paul McCartney. Of course, you won't read about the debate raging in the UK in the US media.

Here at home, polls indicate that over 50% of Americans know the Drug War has been a failure. That they often support even tougher measures, flawed though that strategy is, only underscores the fact that there are no other options being discussed by those with serious media access. A couple of Hollywood names could begin to remedy that in about a week. The fact is that the cutting edge of opinion on the issue is anti-war, which makes choosing propaganda over principle akin to taking the lead in "Big-Budget Part IV" instead of an artistically brilliant little piece, better for the soul than the bank account. But artists, in the end, must nourish their souls.

General McCaffrey is right about one thing--the power of celebrity is indeed awesome. That is why it would take just a few brave souls within the industry to stand up against this insane War to give the movement an enormous shot in the arm both in public awareness and in financial contributions to the badly outspent reform organizations. The Drug Warriors, McCaffrey included, like to answer questions about the War by reiterating that, well, drug abuse is bad, thereby implying that reformers think that drug abuse is somehow OK. That is not the reformer's point, of course, but the effect of such public implication is to chill the willingness of the non-believers to speak out. Thus far, the most notable recent example of bravery coming from Hollywood has been that radical Woody Harrelson, talking about industrial hemp. For a business that prides itself on independent thinking and progressive (on both the left and the right) politics, that is a pretty lame output.

If the professionals of the entertainment industry have not been threatened into cooperating, and remain silent simply for want of information, then it is certainly time for the voices of reform to access the industry and to educate it. But perhaps it is true. Perhaps the people of the entertainment industry, living in glass houses, er, mansions, are really afraid to throw stones lest the Feds show up at their next party with glass-cutters and warrants. If the entertainment industry has indeed been so cowed, it is a shame. It is also an indication of the absolute corruption of the war, both in its principles and in its execution.

Nearly fifty years ago the same industry was intimidated into silence during the red scare, and that silence destroyed careers and nearly destroyed a nation. It was not the industry's proudest moment. Today, only Hollywood knows why Hollywood has agreed to play a supporting role in the General's multi-billion dollar farce. But one thing is certain. Those who appear in the Drug War credits will have to live with that billing for the rest of their lives. Especially if they took the part for all the wrong reasons.

Adam J. Smith
Associate Director

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