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Privacy: Kansas House Passes Bill Mandating Drug Tests for Public Assistance

The Kansas House Wednesday gave final approval to a bill that requires Kansans who seek public assistance to undergo drug testing. The bill, HB 2275, passed by a margin of 99-26. It now heads to the state Senate.

Sponsored by Sen. Kasha Kelly (R-Arkansas City), the bill targets the 14,000 Kansans who receive cash assistance from the state Department of Social Rehabilitation Services. Recipients of financial support in temporary aid for families, general assistance, child care support, and grandparents as caregivers programs would all be subjected to drug testing. It would not apply to non-cash benefits, such as food stamps and medical care.

The bill envisions testing one-third of the target population each year. A positive drug test would result in an evaluation and possible drug treatment. Failure to complete evaluation and/or treatment would result in the termination of benefits, as would a third positive drug test.

As the Chronicle reported last week Kansas is only one of a number of states where legislatoes are pushing similar bills. Drug testing public assistance recipients was okayed, but not required, under the 1996 federal welfare reform bill. But the only state to actually implement such a plan, Michigan, was shot down by the federal courts, which held that it violated the Fourth Amendment's proscription against unreasonable searches and seizures.

Kelly, unconcerned about constitutional niceties, said the state should work to keep parents off drugs and advance the interests of children. "Shouldn't you be fearful if you're using?" she said on the House floor.

Social Rehabilitation Services Secretary Don Jordan testified that only 3% to 8% of clients would likely test positive for marijuana, cocaine, or other illegal drugs. That figure is slightly below overall nationwide drug use levels. The program would cost $800,000 a year, he said. The bill will not be implemented unless the legislature makes a specific appropriation to cover the cost, but in a fiscal note, legislative analysts suggested the possibility of using asset forfeiture proceeds to fund the program.

The bill was opposed by the Kansas Public Health Authority, but legislators proved receptive to arguments like those of Rep. Brenda Landwehr (R-Wichita), head of the House Health and Human Services Committee, who said if the bill failed to pass it is as if the legislature would be declaring: "Mr. and Mrs. Taxpayer, we don't really care if someone buys drugs with your hard-earned money."

Rep. Marti Crow (D-Leavenworth) wasn't buying it. "Testing someone because they're poor? Where does that make any sense?" he asked. "This is crazy and mean."

But Crow was in the minority. The bill now goes to the state Senate.

Feature: Meeting in Vienna, UN Commission on Narcotics Drugs Prepares to Head Further Down Same Prohibitionist Path, But Dissenting Voices Grow Louder

The United Nations Commission on Narcotic Drugs (CND) met this week in Vienna to draft a political statement and plan of action to guide international drug policy for the next decade. The statement largely affirms existing prohibitionist policies and ignores harm reduction, as the CND has done it the past. [Editor's note: The draft statement had not been formally approved as of press time, but is likely to be approved as is.]

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Vienna International Center, home of the UN Office on Drugs and Crime
The political statement is supposed to evaluate the implementation of the previous political declaration and action plan approved by the UN General Assembly Special Session (UNGASS) in 1998. At the 1998 session, UNGASS adopted the slogan "A Drug-Free World -- We Can Do It" and launched a "campaign" to wipe out all drug crops -- from marijuana to opium to coca -- by 2008.

But while the international community continues to slide down its century-old prohibitionist path regarding non-medicinal drug use and sales, it is encountering an increasing amount of friction. The United States, as leader of the hard-liners, continues to dominate the debates and set the agenda, but an emerging bloc of mainly Latin American and European countries is expressing deep reservations about continuing the same policies for another decade.

The atmosphere in Vienna this week was circus like, complete with street protests, as national delegations, non-governmental organizations (NGOs), and other interested parties heatedly debated what an increasingly vociferous minority called a "failed" approach to the issue. Debate was particularly intense about the inclusion of harm reduction in the political statement -- a position rejected by the US delegation, led by outgoing acting drug czar Edward Jurith.

The drug summit came as the UN, the CND, and the countries pushing the prohibitionist hard-line have come under repeated attack for essentially maintaining the status quo. On Tuesday, the European Commission issued a report that found while in the past decade policies to help drug users and go after drug traffickers have matured, there was little evidence to suggest that the global drug situation had improved.

"Broadly speaking the situation has improved a little in some of the richer countries, while for others it worsened, and for some of those it worsened sharply and substantially, among which are a few large developing or transitional countries," an EC media statement on the report said. "In other words, the world drugs problem seems to be more or less in the same state as in 1998: if anything, the situation has become more complex: prices for drugs in most Western countries have fallen since 1998 by as much as 10% to 30%, despite tougher sentencing of the sellers of e.g. cocaine and heroin in some of these markets."

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SSDP's Kris Krane, caged as part of HCLU demonstration at UN (drogriporter.hu/en/demonstration)
Current anti-drug policies also came under attack from a growing coalition of NGOs, including Human Rights Watch, the International Harm Reduction Association, the European NGO Coalition for Just and Effective Drug Policies (ENCOD), and the International Drug Policy Consortium, as well as various NGOs from the US, Brazil, Canada, and England, among others, all of whom were in Vienna for the meeting. Human Rights Watch urged the CND to undo a decade of neglect, while the English group Transform Drug Policy Foundation called for a moratorium on global strategic drug policy setting, a review of the consequences of prohibitionist policies, and a commission to explore alternatives to the failed war on drugs.

"Every state that signs up to the political declaration at this commission recommits the UN to complicity in fighting a catastrophic war on drugs," said Danny Kushlick, policy director for Transform. "It is a tragic irony that the UN, so often renowned for peacekeeping, is being used to fight a war that brings untold misery to some of the most marginalized people on earth. 8,000 deaths in Mexico in recent years, the destabilization of Colombia and Afghanistan, continued corruption and instability in the Caribbean and West Africa are testament to the catastrophic impact of a drug control system based upon global prohibition. It is no surprise that the declaration is unlikely even to mention harm reduction, as it runs counter to the primary impact of the prevailing drug control system which, as the past ten years demonstrate, increases harm."

Not all the action took place in the conference hall. Wednesday saw a lively demonstration by NGO groups including Students for Sensible Drug Policy, the drug user group INPUD, ENCOD, and the Hungarian Civil Liberties Union, among others. Protestors spoke to reporters from jail-like cages, waved signs and passed out pamphlets to delegates forced to run their gauntlet, and decried the harms of drug prohibition. One particularly effective protestor was dressed as a sun-glass wearing, cigar-puffing Mafioso, celebrating that business was good thanks to prohibition.

Even UN Office on Drugs and Crime (UNODC) head Antonio Maria Costa, while whistling past the graveyard to insist that progress had been made in the past decade, acknowledged that current global policies have backfired in some ways. Giving the opening address Wednesday, Costa said "the world drug problem has been contained, but not solved" thanks to international anti-drug efforts.

But global drug control efforts have had "a dramatic unintended consequence," he added, "a criminal black market of staggering proportions." The international drug trade is "undermining security and development and causing some to make a dangerous wager in favor of legalization. Drugs are not harmful because they are controlled; they are controlled because they are harmful." Drug legalization would be "a historic mistake," he said.

Even so, Costa painted a dire picture of what prohibition had wrought: "When mafias can buy elections, candidates, political parties, in a word, power, the consequences can only be highly destabilizing" he said. "While ghettoes burn, West Africa is under attack, drug cartels threaten Central America and drug money penetrates bankrupt financial institutions".

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activists from International Network of People Who Use Drugs (INPUD) at demo (drogriporter.hu/en/demonstration)
Not everybody was buying into the UNODC-CND-US position of more of the same. Bolivian President Evo Morales brandished a coca leaf, then chewed it during his address to the delegates to underline his demand that coca be removed from the list of proscribed substances.

"This is coca leaf, this is not cocaine; this is part and parcel of a culture," Morales said. The ban on coca was a "major historical mistake," he added. "It has no harmful impact, no harmful impact at all in its natural state. It causes no mental disturbances, it does not make people run mad, as some would have us believe, and it does not cause addiction."

Neighboring Brazil was also critical. "We ought to recognize the important progress achieved over the last decade," said Brazilian delegate Jorge Armando Felix. "But the achievements have not been accomplished. The aim of a world free of drugs has proven to be unobtainable and in fact has led to unintended consequences such as the increase of the prison population, increase in violence related to an illegal drug market, increase in homicide and violence among the young population with a dramatic impact on mortality and life expectancy -- social exclusion due to drug use and the emergence of synthetic drugs."

Felix also had some prescriptions for UNGASS and the CND. "At this historic moment with the opportunity to reassess the past 10 years and more importantly to think about the challenges to come, Brazil enforces the need for recognition of and moving towards: harm reduction strategies; assessing drug dependence, and HIV AIDS populations; securing the human rights of drug users; correcting the imbalance between investments in supply and demand reduction areas; increasing actions and programs of prevention based on scientific evidence with an emphasis towards vulnerable populations and towards increase of access to and care for problematic or vulnerable drug users; and to the acknowledgment of different models of treatment for the need for increased funding of these efforts."

Brazilian Luiz Paulo Guanabara, head of the NGO Psicotropicus, observed it all with mixed feelings. "Early on, I thought the NGO strategy for harm reduction would not result in anything and that we should aim for drug regulation instead," he said. "And in the end, the term harm reduction is not in the political declaration, but the Beyond 2008 document is very strong and has not gone unnoticed."

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Mafioso-looking activist distributing ''United Nations of Prohibition'' 1,000 note bills with UNODC chief Costa's face on one side, and a thank you from the In Memoriam Al Capone Trust on the other (drogriporter.hu/en/demonstration)
Guanabara had harsh words for both the Americans and the UN. "It seems like the American delegates believe harm reduction is a sin -- or they favor harm increase, so they can lock up more people and have more HIV patients, increase crime, sell more weapons and make money out of the disgrace of others and families' destruction. Their prohibitionist stance is obscene," he declared. "And these guys at the CND understand nothing of drugs and drug use, they are just bureaucrats. To put drugs in the hands of bureaucrats is as dangerous as putting them in the hands of criminals."

But despite the lack of results this time around, Guanabara was thrilled by the participation of civil society. "The civil society mobilization is enormous and intense," he said. "The NGO events around the meeting were the real high-level meetings, not the low-level ones with the bureaucrats at the CND."

While the sentiments from Brazil and Bolivia were echoed by various national delegations, mainly European, and while even the UNODC and the US are willing to give nods to an increased emphasis on treatment and prevention, with the US delegation even going so far as to approve of needle exchanges, at the end of the day, the CND political declaration and action plan represents a stubborn adherence to the prohibitionist status quo.

"Government delegations could have used this process to take stock of what has failed in the last decade in drug-control efforts, and to craft a new international drug policy that reflects current realities and challenges," said Prof. Gerry Stimson, executive director of the International Harm Reduction Association. "Instead, they produced a declaration that is not only weak -- it actually undermines fundamental health and human rights obligations."

American attendee and long-time drug reform activist Michael Krawitz also had mixed feelings. "The slow train wreck that Harry Anslinger started with the 1961 Single Convention is finally grinding to a halt," he said. "The argument here has been a semantic one over harm reduction, but the subtext is much more important, and the subtext is that the treaties were set up to protect public health and are currently being interpreted in such a way as to do the opposite. The declaration wound up being watered down and piled high with reservations. The next five years should prove interesting."

The IHRA and other NGOs called on governments with reservations about the political declaration to refuse to endorse it. That probably will not happen, but some governments have indicated they will add reservations to their approval of the declaration. After a century of prohibition, the first formal cracks are beginning to appear at the center of the legal backbone of global drug prohibition. Given that the dissent has largely appeared only since the last UNGASS in 1998, perhaps this isn't such a bad start.

Feature: Prisons Under Pressure -- Corrections Budgets in the Age of Austerity

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Arizona State Prison Complex at Douglas
If there are any silver linings in the current economic, fiscal, and budgetary disaster that afflicts the US, one of them could be that the budget crunch at statehouses around the country means that even formerly sacrosanct programs are on the chopping block. With drug offenders filling approximately 20-25% of prison cells in any given state, prison budgets are now under intense scrutiny, creating opportunities to advance sentencing, prison, and drug law reform in one fell swoop.

Nationwide, corrections spending ranks fourth in eating up state budget dollars, trailing only health care, education, and transportation. According to the National Association of State Budget Officers, five states -- Connecticut, Delaware, Michigan, Oregon and Vermont -- spend more on prisons they than do on schools.

The US currently spends about $68 billion a year on corrections, mostly at the state level. Even at a time when people are talking about trillion dollar bail-outs, that's a lot of money. And with states from California to the Carolinas facing severe budget squeezes, even "law and order" legislators and executive branch officials are eyeing their expensive state prison systems in an increasingly desperate search to cut costs.

"If you look at the amount of money spent on corrections in the states, it's an enormous amount," said Lawanda Johnson of the Justice Policy Institute. "If they could reduce prison spending, that would definitely have an impact on their state budgets. Now, a few states are starting to look at their jail and prison populations," she said.

Among them:

Alabama: The state Department of Corrections is facing a 20% budget cut in 2009. Alabama Corrections Commissioner Richard Allen is telling legislators he will try to "dampen down" the number of new inmates by working on sentencing reform, community corrections, new pardon and parole rules, and a supervised reentry program. The number of Alabama prisoners jumped from nearly 28,000 in March 2006 to more than 30,000 in December 2008, an increase Allen said was caused in part because the legislature had created 67 new felony crimes since 2001.

California: With a prison population of more than 170,000 and the state facing budget deficits of gargantuan proportions, Gov. Arnold Schwarzenegger (R) has suggested eliminating parole time for all non-serious, nonviolent, and non-sex offenders. His plan would cut the parole population by 65,000 people, more than half the 123,000 currently on parole. It would also reduce by tens of thousands the number of people behind bars in the Golden State by increasing good-time credits for inmates who obey the rules and complete rehabilitation. That move could cut the prison population by 15,000 by June 2010. Schwarzenegger's proposal is opposed by -- you guessed it -- the California Correctional Peace Officers Association, for which mass imprisonment is a job security issue.

Colorado: Gov. Bill Ritter (D) has proposed extensive cuts in the state corrections system, including closing two state prisons, delay the construction or expansion of two other prisons, and selling a department-owned 1,000-acre ranch. Those cuts would eliminate at least 71 jobs and save $13.6 million in the coming fiscal year.

Kentucky: Gov. Steve Beshear (D) and state legislators last year granted early release to some 1,800 prisoners, including some violent offenders, in a bid to take a bite out of the state's $1 billion budget deficit. Although Beshear and the legislature have protected the Corrections Department from budget cuts afflicting nearly all other state agencies and programs, the state's dire financial straits are making passage of a treatment-not-jail bill for drug offenders more likely this year. That could save the state $1.47 million.

Michigan: Gov. Jennifer Granholm (D) will propose keeping prison spending near the $2 billion mark in 2010, 57% higher than a decade ago, but legislators are about to chew on proposals for reform from the Council of State Governments Justice Center to cut the number of state prison inmates by 5,000. That would save about $262 million by 2015, far short of the $500 million annual savings now being called for by the Detroit Chamber of Commerce, among others. The Justice Center proposals include cutting the average time above the minimum sentences inmates serve from 27% to 20%. Some 12,000 inmates have already served more than their minimum sentences. Deputy Corrections Director Dennis Schrantz said those proposals were only the beginning, noting that the state had closed nine prisons since 2003 and will close three more this year.

Mississippi: Faced with an emergency $6.5 million (2%) budget cut for the current fiscal year, the state Department of Corrections is moving to reduce the number of inmates in county and regional jails and private prisons. The state pays counties $20 per inmate per day to house them and pays private prison companies at least $31.70 per inmate per day. The state will remove 300 inmates from county jails and 50 from private prisons. Corrections Commissioner Chris Epps also has sent a list of 2,900 nonviolent inmates to the parole board for possible early release. The department may also grant early release to prisoners with severe medical problems, allowing the state to cut costs by not having to provide medical care for them.

New York: With a $15 billion budget deficit and a Department of Correctional Services eating up $2.5 billion a year -- more than any other state agency -- Gov. David Paterson (D) is seeking to release 1,600 offenders early and reform or repeal the state's draconian Rockefeller drug laws. The prison budget has continued to increase despite a whopping 35% drop in crime in the last decade and a prison population at the lowest levels since the 1980s. Now Correctional Services Director Brian Fischer wants to close prison camps and correctional annexes sitting empty with a thousand beds, saving the state $100 million and cutting the 31,000 corrections department employees by about 1,400 through attrition. It's a start.

South Carolina: After running in the red for the last two years, the state's prison director, Jon Ozmint, told legislators he needed $36 million for the current fiscal year, leaving the solons with three choices: cut spending for health, education, or other services; finance corrections through the reserve, or close prisons. Legislators last year rejected Ozmint's suggestion that they save money by releasing prisoners early and closing prisons. This year, Ozmint is suggesting that the state reduce the requirement that serious felons serve 85% of their sentence to 70%. The prison crisis in South Carolina has prompted the normally pro-prison Charleston Post & Courier to call for "alternative sentencing that could keep nonviolent offenders out of prison" and "revising mandatory minimum sentences."

Virginia: Telling legislators "we want to lock up people we're afraid of and not ones we're mad at," Virginia corrections director Gene Johnson said this week Gov. Tim Kaine (D) wants to release some nonviolent offenders 90 days early to save the state $5 million a year. Nearly 1,200 inmates would qualify for early release, he said. Virginia has already closed five prisons employing 702 people, and may resort to limited lay-offs, Johnson told legislators.

This is by no means a list of all the states grappling with prison spending in the current crisis. Correctional costs are on the agenda at statehouses across the country, but as the list above suggests, the economic squeeze is providing openings for reform.

"In the handful of states that have already opened legislative sessions this year, the corrections budget is frequently raised in budget conversations," said Ryan King, an analyst for The Sentencing Project. "A number of governors have raised the issue. It will definitely be on the table. With the recession really taking hold this year, it will be a major, major issue," he said.

"With each passing year, there is a little greater acknowledgement that we are in a position where states are spending far too much money to incarcerate and can't build their way out of it, but the prison population is still increasing each year," said King. "If we want to talk about a sustainable reduction in the prison population, we need to revisit who is going and for how long, as well as a critical evaluation of sentencing laws, repealing mandatory minimums, and expanding parole eligibility. Those are the big steps that need to be taken."

There is still resistance to reform, King said, but things are changing. "There is now much broader consideration of amending parole and probation policies, along with diversion of drug offenders," he said. "Those are probably the two most widely achieved reforms in the last few years. We will probably see more of that, but if we're going to move this from diverting a few thousand people to really addressing the 1.5 million in prison, we are going to have to start asking whether people belong in prison for decades, whether life without parole is really necessary. The real engines of growth for the prison population are admissions and sentence lengths, and a lot of policymakers are still uncomfortable having that conversation."

After decades of seemingly endless sentence increases and prison-building, perhaps the wheel is beginning to turn. Politicians immune to "bleeding heart" pleas for humanity are not immune to pocket-book issues. But while change is starting to come, the US remains a long way from losing its crown as the world's leading jailer.

Feature: Narcs Cheer -- House Economic Stimulus Bill Would Give Byrne Grant Program $3 Billion Over Three Years

As part of the $825 billion economic stimulus bill passed by the House last week, the Democratic Party leadership and the Obama administration included $3 billion for the controversial Byrne Justice Assistance Grant program, which funds multi-agency drug task forces across the country, and $1 billion for the Community Oriented Policing (COPS) program, which will pay for thousands of additional police officers to hit the streets. Drug enforcement lobby groups are pleased, particularly about the Byrne funding, but others predict that any "stimulus" more Byrne grants might provide will be followed long-term drag on state budgets in ways going beyond the federal dollars.

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Sen. Harkin and Iowa law enforcement officials at 2004 press conference
In one of the few drug policy-related decisions made by the Bush administration that reformers could cheer, the Bush administration tried throughout its second term to reduce or eliminate funding for the Byrne grants. In so doing, it was heeding the concerns of conservative and taxpayer groups, who called the program "an ineffective and inefficient use of resources." But while the Bush administration tried to gut the program, Congress, still tied to the "tough on drugs" mentality, kept trying to restore funding, albeit at reduced levels.

The Byrne grant program, and especially its funding of the scandal-ridden multi-jurisdictional anti-drug task forces, also came in for harsh criticism from drug reform, civil rights and criminal justice groups. For these critics, the program was in dire need of reform because of incidents like the Tulia, Texas, scandal, where a Byrne-funded task force police officer managed to get 10% of the black population of the town locked up on bogus cocaine distribution charges. Scandals like Tulia showed the Byrne grant program "did more harm than good," the critics wrote in a 2006 letter demanding reform.

Of course, Tulia wasn't the only Byrne-related scandal. A 2002 report from the ACLU of Texas found 16 more scandals involving Byrne grant-funded task forces in Texas, including cases of witness tampering, falsifying of government records, fabricating evidence, false imprisonment, racial profiling, and sexual harassment. Byrne-related scandals have also occurred in other states, including the misuse of millions of dollars of grant money in Kentucky and Massachusetts, false convictions because of police perjury in Missouri, and making deals with drug offenders to drop or lower charges in exchange for cash or vehicles in Alabama, Arkansas, Georgia, Massachusetts, New York, Ohio, and Wisconsin.

In accord with its own budget-cutting imperatives, and in response to critics on the right and left, the Bush administration again tried to zero out the Byrne grant program in FY 2008. While the program was indeed cut from $520 million in 2007, Congress still funded it at $170 million for 2008. Now, it has folded the Byrne program and the Clinton-era COPS program into the emergency economic stimulus bill, leading to loud cheers from the law enforcement community.

"Safe communities are the foundation of a growing economy, and increased Byrne JAG funding will help state and local governments hire officers, add prosecutors and fund critical treatment and crime prevention programs," said National Criminal Justice Association President David Steingraber, executive director of the Wisconsin Office of Justice Assistance. "I applaud the stimulus bill proposed by the House Democrats and press Congress for its quick approval."

"This is very encouraging," said Bob Bushman, vice-president of the National Narcotics Officers Associations Coalition and a 35-year veteran of drug law enforcement in Minnesota. "We think it's a very good sign that this was included in the House bill. The House side was where we struggled in past years. Maybe now the House has listened to us and is taking our concerns more seriously," he said. "We built a broad coalition of law enforcement and drug treatment and prevention people."

Byrne money doesn't just fund the task forces, Bushman pointed out, although he conceded that's where much of the money has gone. "Byrne money goes to all 50 states, and most of them used it for the multi-jurisdictional task forces. Here in Minnesota, we split it between task forces and offender reentry programs and drug courts."

While a answer to just how much Byrne money has gone to the task forces remains buried deep in the bowels of the Justice Department -- part of the problem is that the 50 states are awarded block grants and then decide at the state level how to allocate the funds, and some states are better than others at reporting back to Justice -- observers put a low-ball figure of at least 25% going to fund them, and possibly much higher.

The task forces are needed, said Bowman. "While we are never going to arrest our way out of this, I've seen too much of the damage done by drug abuse, and we need all the help we can get," he said. "Not just for policing, but also for treatment and prevention and drug courts. We need all three pillars, and the Byrne program helps with all three."

If law enforcement was pleased, that wasn't the case with civil rights, taxpayer, and drug reform groups. They said they were disappointed in the restoration of funding under the auspices of the economic stimulus bill, and vowed to continue to try to either cut or reform the program.

"We're working on a letter to Congress about the Byrne grants right now," said Lawanda Johnson, communications director for the Justice Policy Institute, one of the organizations that had signed on to the 2006 DPA letter. "The Byrne grant program is not an effective use of funds for preserving public safety or stimulating the economy. The only way you will get an economic boost from this is if you own stock in Corrections Corporation of America," she laughed, grimly.

"With so many smart people working on the budget and the stimulus package, you would think they would understand that the states are looking to reduce their prison populations and change those policies that have jailed so many people," said Johnson. "To then turn around and have the federal government invest $4 billion in more police and more grants seems paradoxical. It's just going to jack up the spending for states and localities, and they are already struggling."

"We oppose the wasteful economic stimulus bill and we oppose the inclusion of the Byrne grants in it," said Leslie Paige, spokesperson for Citizens Against Government Waste, one of the conservative taxpayer groups that has opposed the grants for the past several years. "If there is going to be government spending, the least you can do is make sure the money is going to have a long term positive impact on the economy."

"This is disappointing, but not surprising," said Bill Piper, national affairs director for the Drug Policy Alliance. "This reverses Bush's cuts in the program and restores funding at even higher levels. At the same time Congress and the Obama administration are expressing great concern about racial disparities and over-incarceration, they keep trying to fund this program, which will only stimulate more arrests of more nonviolent drug offenders," Piper noted.

"The Democrats are framing this as helping in these tough economic times, but the people who will be arrested will end up in state prison, and the states will have to pay for that," Piper pointed out. "The states may well end up paying more in the long run. It's far from clear that this will stimulate the economy, but what is clear is that it will stimulate the breaking up of families and decreasing productivity and tax revenues, especially in communities already devastated by the impact of over-incarceration."

Killing funding outright is unlikely, said Piper. "I don't think there's any way we can stop this from being included because the support for it is strong and bipartisan," he said. "No one wants to go up against the police. Our real hope is that later in the year we can put some restrictions on the program, which is what we've been working on. Instead of trying to cut it, we can try to use it to encourage state and local law enforcement to change how they operate. They're so addicted to federal funding that they may do just about anything, such as documenting arrests or having performance measures."

Bushman and the rest of law enforcement aren't resting easy just yet. "The funding has to survive hearings and make it into the final appropriation," he noted. "This is not a done deal yet."

But it looks like Congress is well on the way to funding three more years of Byrne grants at $1 billion a year, the highest level of funding in years. And don't forget the 13,000 new police officers to be funded for the next three years by the COPS program. If Congress and the cops have their way, we can look forward to more drug busts, more prosecutions, more people sentenced to prison, and a greater burden on already deficit-ridden state budgets.

The White House: Obama on Drug Policy

The incoming Obama administration has posted its agenda online at the White House web site Whitehouse.gov. While neither drug policy nor criminal justice merited its own category in the Obama agenda, several of the broad categories listed do contain references to drug and crime policy and provide a strong indication of the administration's proclivities.

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But before getting into what the agenda mentions, it's worth noting what the agenda does not mention: marijuana. There is not a word about the nation's most widely used illicit drug or the nearly 900,000 arrests a year generated by marijuana prohibition. Nor, despite Obama campaign pledges, is there a word about medical marijuana or ending the DEA raids on providers in California -- which doesn't necessarily mean he will go back on his word. It could well be that the issue is seen as too marginal to be included in the broad agenda for national change. With the first raid on a medical marijuana clinic during the Obama administration hitting this very week, reformers are anxiously hoping it is only the work of Bush holdovers and not a signal about the future.

Reformers may find themselves pleased with some Obama positions, but they will be less happy with others. The Obama administration wants to reduce inequities in the criminal justice system, but it also taking thoroughly conventional positions on other drug policy issues.

But let's let them speak for themselves. Here are the relevant sections of the Obama agenda:

Under Civil Rights:

  • End Racial Profiling: President Obama and Vice President Biden will ban racial profiling by federal law enforcement agencies and provide federal incentives to state and local police departments to prohibit the practice.
  • Reduce Crime Recidivism by Providing Ex-Offender Support: President Obama and Vice President Biden will provide job training, substance abuse and mental health counseling to ex-offenders, so that they are successfully re-integrated into society. Obama and Biden will also create a prison-to-work incentive program to improve ex-offender employment and job retention rates.
  • Eliminate Sentencing Disparities: President Obama and Vice President Biden believe the disparity between sentencing crack and powder-based cocaine is wrong and should be completely eliminated.
  • Expand Use of Drug Courts: President Obama and Vice President Biden will give first-time, non-violent offenders a chance to serve their sentence, where appropriate, in the type of drug rehabilitation programs that have proven to work better than a prison term in changing bad behavior.
  • Promote AIDS Prevention: In the first year of his presidency, President Obama will develop and begin to implement a comprehensive national HIV/AIDS strategy that includes all federal agencies. The strategy will be designed to reduce HIV infections, increase access to care and reduce HIV-related health disparities. The President will support common sense approaches including age-appropriate sex education that includes information about contraception, combating infection within our prison population through education and contraception, and distributing contraceptives through our public health system. The President also supports lifting the federal ban on needle exchange, which could dramatically reduce rates of infection among drug users. President Obama has also been willing to confront the stigma -- too often tied to homophobia -- that continues to surround HIV/AIDS.

Under Foreign Policy:

  • Afghanistan: Obama and Biden will refocus American resources on the greatest threat to our security -- the resurgence of al Qaeda and the Taliban in Afghanistan and Pakistan. They will increase our troop levels in Afghanistan, press our allies in NATO to do the same, and dedicate more resources to revitalize Afghanistan's economic development. Obama and Biden will demand the Afghan government do more, including cracking down on corruption and the illicit opium trade.

Under Rural Issues:

  • Combat Methamphetamine: Continue the fight to rid our communities of meth and offer support to help addicts heal.

Under Urban Issues:

  • Support Local Law Enforcement: President Obama and Vice President Biden are committed to fully funding the COPS program to put 50,000 police officers on the street and help address police brutality and accountability issues in local communities. Obama and Biden also support efforts to encourage young people to enter the law enforcement profession, so that our local police departments are not understaffed because of a dearth of qualified applicants.
  • Reduce Crime Recidivism by Providing Ex-Offender Supports: America is facing an incarceration and post-incarceration crisis in urban communities. Obama and Biden will create a prison-to-work incentive program, modeled on the successful Welfare-to-Work Partnership, and work to reform correctional systems to break down barriers for ex-offenders to find employment.

Think Tanks: Substance Abuse Center "Join Together" Merges With Califano's Controversial CASA

The Boston University-based drug treatment and prevention group Join Together is merging with the controversial National Center on Addiction and Substance Abuse, an outfit run for years by former Health, Education and Welfare Secretary Joseph Califano that reform groups have generally regarded as a propaganda mill. The two groups made the announcement Thursday.

"Merging Join Together into CASA will greatly strengthen CASA's ability to inform the American people of the economic and social costs of substance abuse and its impact on their lives, make CASA's research findings and recommendations widely available to those working on the front lines to prevent and treat substance abuse and addiction, and significantly expand our nationwide advocacy capacity," CASA said Thursday. "The combination of CASA and Join Together will produce a total far greater than the sum of the parts."

Join Together describes itself as "the nation's leading provider of information, strategic planning assistance, and leadership development for community-based efforts to advance effective alcohol and drug policy, prevention, and treatment." Among the organization's works is a 2003 report prepared in collaboration with the American Bar Association, lauded by drug policy reformers, in which the authoring panel called for a range of reforms to end discrimination against people in recovery from substance abuse, including repeal of the Higher Education Act's provision denying financial aid for college to would-be students because of drug convictions.

In an e-mail message to his list, Join Together director and founder David Rosenbloom, PhD said he was "thrilled about this new development." It would allow Join Together to expand its content making use of CASA staff and reports. "In fact, we have often looked to CASA research reports, conferences, demonstration projects and books as foundations for our own work." Rosenbloom will succeed Califano on the job as CASA's President and CEO.

Drug policy reformers will not be sorry to see Califano go into retirement. Reformers -- and others -- have criticized CASA's research on numerous occasions. For example, sociologist and drug researcher Craig Reinarman dissected Califano's anti-drug and anti-drug reform agenda in a 1997 article in the International Journal of Drug Policy. Califano had attacked Dutch cannabis policies, attempted to smear proponents as "legalizers," and countered them with what he called "facts" purporting to show that "legalization would be a disaster for European children and teenagers."

Califano is also a relentless purveyor of the widely discredited "gateway theory" that marijuana use leads to other drug use, and has resorted to such meaningless and debunked claims as "marijuana users are 85 times as likely to use cocaine as non-users."

In 2002, a Califano report on teen drinking came under fire from a different sort of critic: the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMSHA politely slapped down CASA's sensational -- and widely-reported -- claim that underage drinkers accounted for 25% of total alcohol consumption. The real figure was less than half of CASA's, SAMHSA reported.

Hopefully CASA under Rosenbloom will follow in Join Together's sober footsteps rather than CASA's sensationalistic ones. If so, the new CASA may well become a force for positive change.

The Drug Czar: Harm Reductionists, Treatment and Recovery Advocates Come Down on Different Sides of Rumored Ramstad Nomination

Former Minnesota congressman, self-acknowledged recovered alcoholic, and treatment and recovery advocate Jim Ramstad is widely rumored to be in the running for head of the Office of National Drug Control Policy (ONDCP -- the drug czar's office), and he is garnering both support and opposition from within the drug reform community, broadly defined.

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Jim Ramstad
It may all be for naught. Ramstad himself has asked the Obama transition team to consider him to head SAMHSA, the Substance Abuse and Mental Health Services Administration, a post where his appointment would arguably be less controversial. And President Bush's last-minute appointment Monday of current acting ONDCP deputy director Patrick Ward to replace outgoing drug czar John Walters only muddies the waters further.

While Ramstad has serious credentials on treatment and recovery, his opposition to needle exchange programs spurred drug policy analyst and author Maia Szalavitz to oppose his nomination in an article in the Huffington Post. "Ramstad may be a drug warrior in recovering person's clothing," she wrote, noting that he also opposes medical marijuana.

"While Ramstad has opposed some interdiction efforts and called for more treatment funding, someone who doesn't even believe that addicts have a right to life if they aren't in treatment is not the kind of recovering person that I want representing me as drug czar," Szalavitz, a former injection drug user herself, continued. "That's not change, President Obama -- that's more of the same. Don't make the mistake that Bill Clinton did and install a drug czar who will ignore science and push dogma. While it's great to have a recovering person as an example, just having a disease and talking with others who've recovered the same way you did does not make you an expert. We need someone who knows the science, recognizes that there are many paths to recovery -- and understands that dead addicts can't recover."

Szalavitz wasn't the only alarmed harm reductionist. Psychologist Andrew Tatarsky authored an open letter signed by more than 450 substance use and mental health treatment professionals warning that both SAMHSA and the drug czar's office need leadership that "supports evidence-based policies and that will make decisions based on science, not politics or ideology" and "we have reason to believe that Congressman Ramstad is not that person." In addition to Ramstad's opposition to harm reduction measures, Tatarsky noted that throughout his congressional tenure, Ramstad had failed to take any action on sentencing reform.

A Ramstad nomination also drew concern from the National Organization for the Reform of Marijuana Laws (NORML), which noted in a blog post that Ramstad had voted against medical marijuana at every opportunity, voted against needle exchange, and had been appointed to the board of directors of Joe Califano's anti-drug reform propaganda organization, the National Center for Addiction and Substance Abuse (CASA).

But while drug reformers and advocates of science-based policies raised concerns, parts of the treatment community are supporting Ramstad. In a January 11 letter to the Obama transition team, the treatment advocacy organization Faces and Voices of Recovery, a stalwart in many drug policy reform efforts, supported the Ramstad nomination.

"Clearly, the appointment of a person in long-term recovery from addiction to this important position would inspire the millions of Americans and their families who have battled addictions," wrote the group's executive director, Pat Taylor. "Even if Congressman Ramstad were not in recovery, he would be an excellent candidate for the Director of ONDCP. A Member of Congress for 18 years, he is a highly experienced and respected legislator who led the successful battle to require health insurers to cover addiction treatment at parity with other medical conditions. He founded and co-chaired the bi-partisan Addiction Treatment and Recovery Caucus and the Law Enforcement Caucus on Capitol Hill and has been influential in shaping drug policy in countries around the globe. He was a practicing criminal justice attorney for five years and has served on numerous non-profit boards; all of whom have the reduction of the global demand for drugs as part of their mission."

And Ramstad has picked up support from progressive groups like his home state Wellstone Action, the legacy of progressive Minnesota Sen. Paul Wellstone. In a January 9 letter, the group argued that despite Ramstad's misguided stands on needle exchange and medical marijuana, he still deserved the nomination. "Congressman Ramstad's leadership on policies and programs within the White House Office of National Drug Control Policy will serve President-elect Obama's administration and millions of Americans well," Wellstone Action said.

The reform movement is split on Ramstad, with treatment advocates coming down in favor and harm reductionists and drug law reformers opposed. As addiction skeptic Dr. Stanton Peele noted in the Huffington Post Tuesday: "For Wellstone, the Kennedy's, and many other progressives, the idea of treating substance abusers as disease sufferers is tremendously appealing -- indeed, one thrust of the drug policy reform movement is to shift from incarcerating addicts to treating them! But, for reformers, courting treatment advocates has come a cropper as addiction-as-disease proponents back a man who stands against drug policy reform's basic value of finding new, pragmatic approaches to drugs in America."

The drug reform movement is broad and encompasses many diverse actors. Where they come down on the Ramstad issue reflect philosophical differences as well as institutional interests. Just because we're part of a broader movement doesn't mean we're always going to agree.

Feature: Gazing Into the Crystal Ball -- What Can We Expect in 2009?

In the other feature article in this issue, we looked back at last year, examining the drug policy high and lows. Here, we look forward, and not surprisingly, see some of the same issues. With a prohibitionist drug policy firmly entrenched, many issues are perennial -- and will remain issues until they are resolved.

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gazing into the future of drug policy reform '09 (picture from wikimedia.org)
Of course, America's drug war does not end at our borders, so while there is much attention paid to domestic drug policy issues, our drug policies also have an important impact on our foreign policy. In fact, Afghanistan, which is arguably our most serious foreign policy crisis, is inextricably intertwined with our drug wars, while our drug policies in this hemisphere are also engendering crisis on our southern border and alienation and loss of influence in South America.

Medical Marijuana in the States

In November, Michigan voters made it the 13th medical marijuana state and the first in the Midwest. Now, nearly a quarter of the US population resides in medical marijuana states, and it is likely that number will increase this year. Legislative efforts are underway in Kansas, Illinois, Minnesota, New Jersey, and New York, among others, and chances are one or more of them will join the club this year. Interest in medical marijuana is also emerging in some unlikely places, such as Idaho, where one legislator has vowed to introduce a bill this year, and South Dakota, where activists who were defeated at the polls in 2006 are trying to get a bill in the legislature this month.

California's Grand Experiment with Medical Marijuana

As with so many other things, when it comes to medical marijuana, California is a different world. With its broadly written law allowing virtually anyone with $150 for a doctor's visit to seek certification as a a registered medical marijuana patient, and with its thriving system of co-ops, collectives, and dispensaries, the Golden State has created a situation of very low risk for consumers and significant protections even for growers and sellers.

With tax revenue streams from the dispensaries now pouring into the state's cash-starved coffers, medical marijuana is also creating political facts on the ground. The state of California is not going to move against a valuable revenue generator.

And if President-Elect Obama keeps his word, the DEA will soon butt out, too. But even if he doesn't, and the raids against dispensaries continue, it seems extremely unlikely that the feds can put the genie back in the bottle. The Bush administration tried for eight years and managed to shut down only a small fraction of operators, most of whom were replaced by competitors anyway.

The state's dispensary system, while currently a patch-work with some areas well-served with stores and other whole counties without any, is also a real world model of what regulated marijuana sales can look like. Despite the wailing and gnashing of teeth by pot foes, the dispensaries have, for the most part, operated non-problematically and as good commercial and community neighbors.

California's medical marijuana regime continues to evolve as the state comes to grips with the reality the voters created more than a decade ago. We will continue to watch and report as -- perhaps -- California leads the way to taxed and regulated marijuana sales, and not just for patients.

What Will Obama Do?

It will be a new era in Washington, DC, when President-Elect Obama becomes President Obama in less than three weeks. While the president cannot pass laws, he can provide leadership to the Congress and use his executive powers to make some changes, such as calling off the DEA in California, which he has promised to do.

The one thing we know he will not do is try to legalize marijuana. In response to publicly generated questions about marijuana legalization, his team has replied succinctly: No.

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What will President Obama do?
One early indicator of Obama's proclivities will be his selection of a replacement for John Walters, the head of the Office of National Drug Control Policy. While there has been speculation about some possible candidates, none of them very exciting for drug policy reformers, no candidate has yet been named.

President Obama will also submit budgets to Congress. Those documents will provide very clear indications of his priorities on matters of interest to the reform community, from the controversial program of grants to fund anti-drug law enforcement task forces to spending levels for drug prevention and treatment, as well as funding for America's foreign drug war adventures.

The conventional wisdom is that Obama is not going to expend political capital trying to undo decades of drug war policies, but perhaps the budget axe will do the talking. Goodness knows, we don't have any money to waste in the federal budget these days.

What Will the Congress Do?

Democrats now control not only the White House, but both houses of Congress. One area we will be watching closely is the progress, if any, of federal sentencing reform. There are now more than 100,000 federal drug war prisoners, too many of them low-level crack offenders serving draconian sentences thanks to the efforts of people like Vice President elect Joe Biden, a long-time congressional drug warrior. Several different crack-powder cocaine sentencing disparity bills have been introduced. The best was authored by Biden himself, a sign of changing times, if only slowly changing. It is past time for one of these bills, hopefully a good one, to pass into law.

Rep. Barney Frank (D-MA) introduced a federal marijuana decriminalization bill last year. The best prediction is that it will go nowhere, but we could always stand to be pleasantly surprised.

Rep. John Conyers (D-MI), head of the House Judiciary Committee, has emerged as a strong critic of federal interference in state medical marijuana programs. Conyers could use his position to highlight that issue, and possibly, to introduce legislation designed to address the problem of federal interference.

One area where the Congress, including the Democratic leadership, has proven vulnerable to the politics of tough on crime is the federal funding of those anti-drug task forces. In a rare fit of fiscal sanity, the Bush administration has been trying for years to zero out those grants, but the Congress keeps trying to get them back in the budget -- and then some. We will be watching those funding battles this year to see if anything has changed.

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Coca Museum, La Paz, Bolivia
Mexico

With the death toll from prohibition-related violence topping 5,000 last year, Mexico is in the midst of a multi-sided war that is not going to end in the foreseeable future, especially given America's insatiable appetite for the forbidden substances that are making Mexican drug trafficking organizations obscenely wealthy. With the $1.4 billion anti-drug military and police assistance known as Plan Merida approved last year by the Bush administration and the Congress, the US is now investing heavily in escalating the violence.

The National Drug Information Center has identified Mexican drug trafficking organizations as the nation's number one criminal threat, and chances are the violence south of the border will begin to ooze across the line. That will only add to the pressure among law enforcement and political figures to "do something." But given the current mindset among policymakers, just about anything they may be inclined to do to "help" is unlikely to be helpful.

The cartel wars in Mexico are also having an impact on Mexican domestic politics, with President Felipe Calderón's popularity suffering a significant decline. The angst over the escalating violence has already provided an opening for talk about drug policy reform in Mexico, with the opposition PRD saying that legalization has to be on the table, and Calderón himself announcing he wants to decriminalize drug possession (although how that would have any noticeable impact on the traffic or the violence remains unclear).

Look for the violence to continue, and watch to see if the resulting political pressure results in any actual policy changes. Drug War Chronicle will likely be heading down to Tijuana before too long for some on-scene reporting.

The Andean Drug War

... is not going well. Despite pouring billions of dollars into Plan Colombia, coca production there is at roughly the same level as a decade ago. Cocaine exports continue seemingly immune to all efforts to suppress them, although more appears to be heading for Europe these days. During the Bush administration, the US war on drugs in Colombia has morphed into openly supporting the Colombian government's counterinsurgency war against the leftist FARC rebels, who have been weakened, but, flush with dollars from the trade, are not going away. Neither are the rightist paramilitary organizations, who also benefit from the trade. Will an Obama administration try something new?

Meanwhile, Bolivia and Venezuela, the only countries singled out by the Bush administration as failing to comply with US drug policy objectives, have become allies in an emerging leftist bloc that seeks to challenge US hegemony in the region. Both countries have thrown out the DEA -- Venezuela in 2005, Bolivia last fall -- and are cooperating to expand markets for Bolivia's nascent coca industry. Bolivian President Evo Morales acknowledged this week that some coca production is being diverted to cocaine traffickers, but said that he does not need US help in dealing with it.

And in Peru, where President Alan García has sent out the army to eradicate coca crops in line with US policy, unrest is mounting in coca growing regions, coca farmers are pushing into indigenous territories, causing more problems, and the Shining Path insurgency, once thought decisively defeated, has reemerged, although apparently minus its Maoist ideology, as a criminal trafficking organization and protector of coca farmers. The Peruvian government blames the Shining Path for killing 25 soldiers, police, and anti-drug workers in ambushes last year. Look for that toll to increase this year.

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Afghan opium
Afghanistan

More than seven years after the US invaded to overthrow the Taliban and destroy Al Qaeda, Afghanistan is the world's largest opium producer, and has been each year since the Taliban were driven from power. While US drug war imperatives remain strong, they are in conflict with the broader objectives of the counterinsurgency there, and any efforts to suppress poppy planting or the opium trade will not only have a huge impact on the national economy, but are likely to drive Afghan farmers into the waiting arms of the resurgent Taliban, which is estimated to make hundreds of millions of dollars a year off taxing and protecting the trade. That buys a lot of guns to point at Afghan, American and NATO troops.

President elect Obama has vowed to reinvigorate the US war in Afghanistan by sending 20,000 additional troops, and NATO has reluctantly agreed to attack the drug trade by going after traffickers linked to the Taliban or various warlords -- but not those linked to the government in Kabul. Last year was the bloodiest year yet for coalition forces in Afghanistan; look for this year to top it.

Bush Endorses Harm Reduction Group…Sort Of

President Bush did a photo-op today in which he delivered used coats at the headquarters of Pathways to Housing and praised the organization’s efforts to help the homeless. Of course, there’s nothing surprising about the President doing charitable appearances during the Christmas season. What’s interesting is that Pathways to Housing offers a quite unique and forward-thinking approach to the problem of homelessness:

Founded in 1992, Pathways to Housing, a not-for-profit organization, works with individuals who have been turned away from other programs because of active substance use/abuse, refusal to participate in psychiatric treatment, histories of violence or incarceration, or other behavioral problems.

Pathways to Housing separates housing from treatment. It treats homelessness by providing people with individual apartments, and then treats mental illness by intensive and individualized programs that seek out and actively work with clients as long as they need, in order to address their emotional, psychiatric, medical, and human needs, on a twenty-four-hour, seven-day-a-week basis.

This is basically a harm reduction approach to homelessness, in that active drug users receive services (including an apartment) in order to stabilize their situation and connect them to opportunities for treatment and health care. It’s a fantastic program that is achieving remarkable success, which is exactly why I’m surprised to see the President associate himself with it.

Bush’s White House has vehemently pushed an abstinence-first approach to drug treatment, even going so far as to oppose overdose prevention kits on the theory that overdosing would teach users a lesson. Pathways to Housing’s approach to drug addiction is just the complete opposite of everything Bush’s drug policy has stood for. Thus today’s appearance illustrates once again the gaping disparity between what actually works and what his priorities have been for the last 8 years.

Harm Reduction and Allan's Diplomatic Faux Pas, on the Final Day of the U.N. Drug Treatment Conference, Vienna

At last, my final day in Vienna attending the United Nations' "Technical Seminar on Drug Addiction Prevention and Treatment: From Research to Practice" conference. (To read my scene-setting preamble from earlier this week, click here. Day 1 is here and day 2 is here.) It's a wind-down day for a conference that never wound up — the day when harm reduction was finally allowed to rear its head — so often unwelcome at any conference dominated, as this one is, by the United States, whose official governmental representatives are highly and categorically opposed to harm reduction. Harm Reduction appeared in that very earnest fashion whereby presenters say, "Here is the science. We need no more evidence. However, I can tell that you're not listening, so I'm going to tell you again that this all works, folks." It was also the day that I made a diplomatic faux pas (as we say in the language of diplomacy). More about that later. I missed the first couple of presenters as I was grappling with the sudden disappearance of Internet connectivity and was hoping that the coffee would kick in. The Viennese make good coffee although it's more of a utility tool than anything pleasurable, kind of like putting socks on in the morning. As I arrived, Dr. Shanti Ranganathan from TTK Ranganathan Treatment Centre in India had just finished her talk. I gather that she covered home detoxification and a camp for drug injectors (it could be fun to speculate how that camp would work). Speaking to a colleague later in the day, I learned that due to the rural nature of India, the approach to drug treatment there is very different from the way it's done in the northern hemisphere. It's very community oriented, and villages have a say-so in the process. I wish I'd caught more of Ranganathan's presentation, which was more along the lines of what I'd been hoping to get information about. How do you deliver drug services in resource poor countries? A gentleman behind me asked, "Haven't we overspecialized drug addiction treatment and shouldn't it be mainstreamed to take advantage of existing resources?" At last, a cri de coeur from the audience! Drug services including treatment, harm reduction, and diversion programs have all sprouted like varieties of weeds. They're somehow related, but the root system and the genetic coding are different. So how could countries and governments differentiate and choose among them? Or figure out how to construct the best array of services based upon what was on show? They couldn't, to my mind. After all, how could anyone possibly make sense of the patchwork quilt of treatment systems and social services in the north given that they don't necessarily make sense — or work — for drug users in their country of origin to begin with? It's as if we're displaying the leaning tower of Pisa or parading the Venus de Milo as models that they should aspire to, and then wondering why the resource poor world makes buildings that lean and statues that have no arms. One place I would not want to live is Sweden, where a random study of the kids at the youth program being trumpeted revealed that each youth suffered from an average of four mental disorders; the majority of parents had one. It must be good to have sane parents. Nothing like pathologizing the young, is there? The Dutch rolled into town with their admirably well-developed harm reduction knowledge and advocacy models. Dr. Wim van den Brink from the Academic Medical Centre at the University of Amsterdam in the Netherlands ran through the continuum of the stages of a drug user's drug taking career and discussed where, when, and which type of a wide range of interventions can and should occur. He included heroin maintenance in this list. (It is widely accepted that heroin maintenance is the fallback option for users who seek treatment but for whom methadone or buprenorphine has not worked. It's not usually a first line option. Outcomes are comparable to all other maintenance programs.) In van den Brink's view, drug-using patients should be able to talk over what their expectations are with their doctors and then negotiate their options. Fancy that. He was pretty much the first speaker who identified drug users as having a role in their own treatment. And he identified abstinence, maintenance, a safe high, and chaotic use as markers on a scale. That may be the first time in 20 years I've heard a clinician identify pleasure as part of the range of options. The legendary Dr. Franz Trautmann from the Netherlands Institute on Mental Health and Addiction ran through the evidence supporting harm reduction interventions including outreach, drop-in centers, and "drug consumption rooms" — the Dutch term for what we in the United States call safer injection facilities or medically supervised injection centers. (The panel facilitator, Gilberto Gerra, Chief of Health and Human Development Section of UNODC, chimed in to reassure everyone that drug consumption rooms do not violate international conventions). It was kind of a relief to hear Dr. Evgeny Krupitsky, head of a laboratory that conducts research on drug addiction at St. Petersburg State Pavlov Medical University, give a convoluted and amusingly wrong-headed talk about the desperate need for the Russians to make naltrexone the first-line response to drug addiction in Russia. (US rejection of harm reduction has its parallel in Russia's refusal to allow methadone.) Naltrexone is an opioid antagonist, which means you can't get high after you've taken it. The opioid receptors in the brain get too blocked up to let any more opioid in. However, as a form of treatment, it's just not very effective. So the Russians keep adding medications to the basic naltrexone dose, unwittingly creating an out of control medication pharmacopoeia for their patients. Monica Beg of UNODC had the task of informing everyone again that syringe exchange is effective in stopping the spread of HIV. Her PowerPoint showed the global distribution of exchange programs (probably limited to the UN-influenced world, to be fair) and did not cover the United States. "The science is clear. Syringe exchange works. The debate is over." Within UNODC there is no debate on the science but as mentioned in my original preamble, UNODC acts as the secretariat for the Commission on Narcotic Drugs (CND) and so when the member States of CND produce Political Declaration, those member states can completely ignore the science as is the case with the US and Russia. In fact, the HIV Prevention Unit deserve a medal for its work in pushing for support from within UNODC. And that's when I just had to speak. I pointed out that despite all of the evidence that needle exchange has been effective in the US (there are 200+ programs, with some of the larger ones federally funded; needle exchange has reversed the HIV epidemic in NYC, once the global epicenter of injection drug use and HIV; scientists at NIDA, NIH, CDC, NIAID are all on record as saying syringe exchange works), an article still appeared on CNN.com just this last July with David Murray, a supposed scientist for the Office of National Drug Control Policy, saying needle-exchange programs "do not succeed in its effort to control the contagion of disease." My point being that while the scientific debate may be over, the political debate continues in the US — not least in the way the US government has been disrupting the process leading up to this March's United Nations General Assembly Special Session on drugs. (While representatives to the UNGASS, plus numerous non-governmental agencies around the world have been calling for harm reduction to be recognized as an important part of demand reduction, US representatives have continued their war against it.) The chair responded to me by saying that there couldn't be a response to my point as it was a political question and inappropriate for this forum. And that science would win out. Stymied at not having a planned end point, I emotionally said that I was glad that this administration was now out. (Apparently it's taken as bad form to name names.) The interaction was filmed by an Iranian television crew that's covering the Iranian involvement in this meeting, which included Azarahksh Mokri of the Iranian National Center for Addiction Studies, who gave a wonderful presentation on how to introduce a methadone program into a country like Iran. He is a brilliant, charismatic speaker who was succint and on point throughout his talk. Christian Kroll of the UNODC HIV Unit, the last speaker before the closing, had that second returned from a UNAIDS Prgramme Coordinating Board meeting and was fired up from saying farewell to Peter Piot, the UNAIDS Executive Director and Under Secretary-General of the United Nations. Kroll ran through the history of the AIDS movement (accidently conflating Gay Men's Health Crisis and ACT-UP) and the importance of civil society input into the UN process. I kept waiting and waiting for the punch line. "Are you asking for more civil society input into UNODC?", I asked. Kroll's response: "Yes I am." Being practically the only representative from "civil society" at the meeting and definitely the only person that spoke, I can see his point. We then sang the Internationale and Mr. Kroll and I caught the subway home together. Allan Clear is executive director of the Harm Reduction Coalition.

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