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Feature: Battle Over California's Nonviolent Offender Recovery Act Initiative Begins to Heat Up

With election day less than two months away, the battle over California's groundbreaking "treatment not jail" initiative is heating up. Known as the Nonviolent Offender Rehabilitation Act (NORA) and appearing on the ballot as Proposition 5, the initiative would divert thousands of drug users and drug-using lawbreakers into drug treatment and away from the state's bulging and budget-draining prisons. In doing so, it would build upon and greatly expand the effort begun with the passage of the "treatment not jail" Proposition 36 by voters in 2002.

According to NORA supporters, the initiative:

  • Requires the state to expand and increase funding and oversight for individualized treatment and rehabilitation programs for nonviolent drug offenders and parolees.
  • Reduces criminal consequences of nonviolent drug offenses by mandating three-tiered probation with treatment and by providing for case dismissal and/or sealing of records after probation. Limits court's authority to incarcerate offenders who violate probation or parole.
  • Shortens parole for most drug offenses, including sales, and for nonviolent property crimes.
  • Creates numerous divisions, boards, commissions, and reporting requirements regarding drug treatment and rehabilitation.
  • Decriminalizes possession of less than an once of marijuana.

The complex, ambitious proposal would not be cheap -- estimated annual costs to the state to implement it would be about $1 billion per year. But according to a July 1 analysis by the nonpartisan Legislative Analyst's Office, that spending would be more than offset by savings to the state of more than $1 billion annually in reduced prison and parole costs and a net savings of $2.5 billion in prison construction that would no longer be necessary.

NORA has broad support from a long list of California groups and individuals, including not only the entire treatment and recovery community, but also the League of Women Voters, labor unions, the former warden of San Quentin, and former US Secretary of State George Schultz.

"The treatment community gave Prop. 36 only mixed support at the time," said Al Senella, chief operating officer of the Tarzana Treatment Center and president of the California Association of Alcohol and Drug Treatment Program Executives, both of which have endorsed Prop 5. "But as far as I can tell now, there is total support for the initiative in the treatment community. I don't know any treatment organizations opposing it."

"When you look at the Yes on 5 coalition, you find a wide array of addiction and public health advocates, youth advocates, the League of Women Voters, consumer federations, and on and on," said Margaret Dooley-Sammuli, Southern California deputy state director for the Drug Policy Alliance, which has spearheaded the Prop. 5 effort. "It really shows the breadth and diversity of Yes on 5; it really gives you a sense of what California has to gain and from how many perspectives," she said. "When you look at the 'no' side, it is dominated by law enforcement. That's very revealing."

While NORA has broad support from the treatment and recovery community and beyond, it is opposed by a formidable array of law enforcement and drug court interests. It has drawn the ire of the National Association of Drug Court Professionals, which slammed it in a position paper earlier this year, as well as the opposition of virtually all of California's sheriffs, district attorneys, police chiefs, prison guards, and probation officers.

Although the opposition had been relatively quiet until this month, last Friday it fired a broadside over NORA's bow when noted actor Martin Sheen penned a "no on NORA"
op-ed
in the Sacramento Bee. Sheen wrote that he opposes Prop 5. because "it will do so much harm to so many people" because it lacks the teeth to punish offenders who fall off the wagon. "Successful rehabilitation needs accountability and so often demands direct intervention in the life of someone who is addicted to drugs, rather than waiting for them to seek treatment 'when they are ready,'" he wrote.

Prop. 5 is the product of "harm reduction theory" and would shift resources from programs that meet his approval, such as Narcotics Anonymous, Sheen complained. "The real problem with Proposition 5 is that it is not about stopping drug use," he wrote. "If it were, it would mandate funding for ongoing drug testing instead of prohibiting that funding, and it would not give drug sellers a reward for the harm they do to so many." The initiative is "poorly designed and dangerous," Sheen warned.

"I certainly respect Martin Sheen's feelings and experiences, but to generalize and universalize them to public policy is the wrong approach," responded Dooley-Sammuli. "We don't want to decide what's best for 36 million Californians based on one man's perspective. He's concerned that Prop. 5 won't work, just like he was concerned that Prop. 36 wouldn't work, but we know now that it did work. I'm not so sure Martin Sheen is up to speed on the research in these areas, and he's wrong again. I'm disappointed he isn't any closer to achieving understanding."

"Martin Sheen is a celebrity, and perhaps that will sway some folks, but he did the same thing with Prop. 36, and he didn't sway enough folks," said Senella. "I respect the fact that he and his son had issues and overcame them, but his position is driven by his personal views, not by the data and expert opinion. And while he wrote an op-ed, I don't see him putting up millions for an effective opposition campaign. He is just giving the opposition a voice, not financial muscle."

Sheen isn't alone. While the powerful state prison guards' union, the California Correctional Peace Officers Association, hasn't taken an official position on Prop 5 -- mainly because it is busy trying to recall Gov. Arnold Schwarzenegger (R) over budget issues -- it will do so soon, said union spokesman Lance Corcoran.

"We haven't taken an official position, but we have done an analysis, and we see this as basically a get out of jail free act," he said. "We think Prop. 36 has arguably not been successful, and we think Prop. 5 will be a failure, too. This is not something that will be good for California," he warned.

Susan Blacksher is executive director of the California Association of Addiction Recovery Resources, the largest residential treatment care provider organization in the state. For Blacksher, NORA is a necessary deepening and broadening of Prop. 36, whose success was limited by lack of resources, she argued.

"Prop. 36 didn't anticipate the sheer volume of need, and similarly, many counties did not fully recognize the magnitude of their addiction problems," she explained. "They assumed they would be picking up people who were early in their drug-taking careers, but almost from the beginning we began to see that the people coming through the program had more severe problems than anticipated. There were just not enough resources for the volume of people and the severity of their problems."

Arguments made by law enforcement and the drug court organizations that NORA should be opposed because it did not offer sufficient sanctions for relapses was "like throwing out the baby with the bathwater," Blacksher said. "NORA has been brilliantly crafted taking into account all the issues we've been discussing over the past six years, and there was a lot of discussion about sanctions. Some of us in the recovery movement think short term sanctions like flash incarceration can make sense if used as part of treatment, and not just punishment," she said, "but why are we making such a big deal about this when the rest of it makes so much sense?"

Blacksher said she understood the frustration of law enforcement and drug courts over the issue of sanctions, but it was not enough to invalidate NORA. And, as she noted, "Their jails and prisons are so full, something has to happen."

"You would think the judges and prosecutors who led the way on drug courts would support what will be the nation's largest expansion of drug courts," said Dooley-Sammuli. "I'm disappointed there as well. What I think we're really seeing is a turf battle, where folks would rather protect their turf than support what will be an expansion of drug courts. Unfortunately, the folks who run those courts are resisting what have been proven to be the best practices."

"The drug court people believe strongly in accountability, and so does the treatment community," said Senella, "but the drug court people believe they should have full authority. Prop. 36 didn't give them that, and neither does NORA. NORA does give them a great deal, it gives them additional authority, but not as much as they want. And although drug courts will get substantially more funding under NORA, they oppose it because it imposes some criteria on them about when they can impose their sanctions."

"I was alive in the 1960s when we went through this drill before," said Michael Rushford of the conservative, victims' rights-oriented Criminal Justice Legal Foundation. "Crime rates tripled while we were diverting felons to the streets. Not everyone remembers that and, unfortunately, if you don't learn from history, you're doomed to repeat it," he said.

"Sure, I could see some diversion for juveniles, but when you're talking about felony offenders, there need to be consequences," Rushford continued. "Prop 5. would let somebody with $50,000 worth of meth avoid prison; it would let a repeat car thief avoid prison. It's a bad deal."

"These kinds of arguments are simply not based on facts or an accurate reading of the initiative," said Senella. "You can't have $50,000 worth of meth and just walk away; you can't go around stealing cars and just walk away. For these kinds of cases, judges will have complete discretion. If the judge decides this guy is stealing cars because he's strung out on something, he may be a good candidate for diversion, but it is in no way a free ticket out of trouble."

Despite five years of evaluations and annual reports on the efficacy of Prop. 36, neither the legislature nor Gov. Schwarzenegger have taken the initiative to implement the recommendations of the various reports. That's why it's up to the public, said reform advocates.

"People say California needs this, but something this big should go through Sacramento," said Dooley-Sammuli. "We say yes it should, but it hasn't. The federal courts have already taken over medical care in our prisons and there is a November 17 hearing to see if they should put the entire California Department of Corrections under receivership as well. The state government has proven incapable of action on this."

"The legislature and the governor can't or won't acknowledge what the public believes is important and what the science has demonstrated," said Senella. "In approving Prop. 36, the public showed that it was important to voters and their loved ones that treatment was a priority instead of prison as a method of dealing with addiction," he said.

"The only way to move forward on this is through the initiative process," he said. "That's why we need and support NORA. What has gone on in California corrections is clearly not working -- we have the second highest recidivism rate in the nation. Our current approach is not what the science indicates is necessary. It's absolutely clear that if you treat the addiction, you do a great deal for the recidivism rate."

"One way or another, the future of prison overcrowding in California will be decided in November," said Dooley-Sammuli. "Either by the voters on election day or by three federal judges later in the month. Rehabilitation and treatment has a lot of support among California voters. So far, we have let addiction drive our record-setting incarceration rates. The voters understand that."

Australia: Strong Support for Medical Marijuana, Needle Exchange Programs, National Survey Finds

Australia's 2007 National Drug Strategy Household Survey, in which more than 23,000 people over the age of 12 were quizzed by the Australian Institute of Health and Welfare about their drug use and attitudes toward various drug policy positions, has demonstrated broad support for medical marijuana and harm reduction measures aimed at hard drug users.

Regarding heroin use, the survey found that 67% supported needle exchange programs, 68% supported methadone maintenance, 75% supported the use of naltrexone for overdose avoidance, and 79% supported the use of rapid detox therapy. On the other hand, only 50% supported heroin injection sites, and only 33% supported heroin maintenance therapy.

Medical marijuana also won strong support. Some 69% supported legal medical marijuana, while an even larger number, 75%, supported clinical trials for medical marijuana. In all the policy choices cited here, support was at higher levels than the most recent national survey in 2004.

Marijuana legalization for personal use did not fare so well. Only 21% supported legalization, down from 27% in 2004. The intervening period has been one of Reefer Madness Down Under, with Australian authorities and a complicit media waxing hysterical about the alleged dangers of the weed.

When it comes to legalizing other drugs, support was in the single digits, and relatively unchanged from 2004.

Frighteningly, large majorities of Australians favored increased criminal penalties for drug sales offenses. More than 80% favored harsher sentences for hard drug sales, while even for marijuana, nearly two-thirds (63%) wanted stiffer penalties.

Feature: Amsterdam, Connecticut? Drug Reformer With Bold Vision Seeks State Office, Radical Change

Like the rest of inner city America, Bridgeport, Connecticut's 130th District has for decades been ground zero in the war on drugs. Mostly black and Latino, like other majority minority neighborhoods across the land, it has suffered the twin ravages of drug abuse and drug prohibition. Now, a former drug-fighting Navy officer turned drug reformer is seeking to change all that with a bold vision and an upstart bid for the state House of Representatives.

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Sylvester Salcedo (2nd from right)
In late May, Bridgeport attorney Sylvester Salcedo announced he was seeking the Democratic Party nomination for November's House race in the 130th. Salcedo is best known in drug reform circles for being the first and only former military officer to protest the drug war by sending back his Navy and Marine Corps Achievement medal to then President Bill Clinton.

"Narcotics use and abuse is our problem here at home," he wrote at the time in a letter sent to Clinton. "The solutions should be applied here and not in Colombia or elsewhere. To spend this additional amount of money overseas is wasteful and counterproductive."

Fast forward eight years and little has changed. The war on drugs continues apace, drug arrests and drug war prisoners reach new highs every year. The violence associated with drug prohibition continues to plague cities like Bridgeport. And Salcedo has had enough.

"The war on drugs is one of our nation's longest wars, at home and abroad," he said as he announced his candidacy May 29. "It is senseless, wasteful and counterproductive. It is highly discriminatory on a racial and economic basis. I said so on the steps of the US Congress in Washington, DC flanked and supported by Minnesota Republican Congressman Jim Ramstad and California Republican Congressman Tom Campbell in the summer of 2000," he said.

"Eight years later, the conditions are the same, if not worse, especially for the isolated and abandoned residents of ethnic minority enclaves and neighborhoods like the 130th District," Salcedo continued. "I want to win this State Representative seat to be a leader of change. I want to lead the way to peace, understanding and cooperation, not through the politics of fear, and racial and ethnic discord and conflict. This senseless war on the poor and the voiceless must end."

Salcedo is not one for half-measures. He is proposing turning the 130th District into a sort of mini-Amsterdam, a zone of drug tolerance replete with safe injection sites, opiate maintenance facilities, and taxed and regulated marijuana sales. "I'm floating around this idea of the Covenant of the 130th District, which is to declare the district as a zone of tolerance," he said.

"I want to borrow from models like Amsterdam or Frankfort," he elaborated. "I'm not pushing legalization legislation, but acknowledging the fact that the 130th is a high drug trafficking and consumption area, from marijuana to heroin to cocaine. I want to try those approaches here. If you live in the district and are a heroin addict, we would work with you, whether it's a treatment and rehabilitation regime or a maintenance regime. If you select maintenance, you get the level of pharmaceutical grade heroin you need. In either case, you get medical, psychological, and social services, an intake exam, a social worker and a drug counselor to work with you. But this won't be a coercive or punitive program; instead it will be designed to develop the relationship with the addict."

Citing Bridgeport's chronically under-funded schools, libraries, and other services, Salcedo also called for regulated marijuana sales as a revenue raiser. "I want to open up a number of marijuana coffee shops in this district," he said. "They could be city sponsored, or they could be a joint private-public project. If people want to come here and imbibe, we will welcome them, let them pay the market price, and tax their purchases. The profits can go to the city general fund, or, if it's a joint venture, a share to the entrepreneurs," he said. "We will follow the experience of Amsterdam, with the police working collaboratively, so they're not arresting people coming from the coffee shops."

Salcedo's will undoubtedly be an uphill battle against the entrenched Bridgeport Democratic Party political establishment and to convince skeptical voters that more of the drug war same old same old is not the solution. But he has already passed the first hurdle by getting 290 district residents to sign his nominating petitions. Now he has to raise $5,000 by August to show he is a viable candidate and qualify for another $20,000 in primary funding from the state of Connecticut. At least 150 Bridgeport residents must donate to his campaign for him to qualify. (That doesn't mean people from outside Bridgeport or Connecticut cannot donate -- they can.)

He can do it, Salcedo said. "The primaries are eight weeks away, and nobody expected me to even get the required signatures, but I did. And I met every person who signed my nomination papers. I think I can meet this challenge, too."

He's going to need some help, from the drug reform community at large and from Connecticut activists in particular if he is to have a chance. One prominent Connecticut drug reformer, Efficacy founder and 2006 Green Party gubernatorial candidate Cliff Thornton is among the first to step up.

"I'll definitely be going down there and doing a few things for Sylvester," said Thornton. "I have to help the reformer."

One thing he will advise Salcedo to do is put his drug reform message in the background. "We'll try to sharpen his message," Thornton said. "He doesn't have to lead with drug policy. He's already known as the drug reformer, and he won't have to talk about it because people are going to ask him about it.

Another thing Salcedo can do is try to tie drug reform into other issues facing the community, Thornton said. "We're spending somewhere between $600 million and $800 million on prisons in Connecticut every year," he said. "If we took that and put it toward health care, we could take care of everyone in the state. That's the kind of connection we need to be drawing."

It would be a good thing if national drug reform organizations provided more than token support, Thornton said, looking back at his 2006 campaign. "When it came to actually supporting that run, everybody disappeared," he said. "The flagship organizations sent a few bucks here and there, but not enough to make a difference. And that's a shame. We are starting to elect good drug reform politicians, like Roger Goodman in Washington state and Chris Murphy here in Connecticut. Their opponents attack them as soft on drug policy, and they go up in the polls. We can elect people, if we support them," Thornton said.

Salcedo could use the help, he said. "Right now this is basically a one-man campaign, and I have a full-time job."

Still, he said, he may be able to pull off a surprise victory. "This is going to be a low turnout election, no other issues on the ballot here, and the only reason people are likely to go to the ballot box is to vote for me for change or because they're tied to one of the establishment candidates," he said. "In this district in this election, maybe 200 or 300 votes can win it. I'll be beating the bushes and talking face to face with people. I'll do everything I can, and then it's up to the voters.

(This blog post was published by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also shares the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Feature: US Drug Policies Flawed and Failed, Experts Tell Congressional Committee

The US Congress Joint Economic Committee yesterday held a historic hearing on the economic costs of US drug policy. The hearing, titled Illegal Drugs: Economic Impact, Societal Costs, Policy Responses, was called at the request of Sen. Jim Webb (D-VA), who in his opening remarks described the all-too-familiar failure of US drug policy to accomplish the goals it has set for itself. It was the second hearing related to incarceration that Webb has convened under the auspices of this committee.

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Jim Webb at 2007 incarceration hearing (photo from sentencingproject.org)
"Our insatiable demand for drugs" drives the drug trade, Webb pointed out. "We're spending enormous amounts of money to interdict drug shipments, but supplies remain consistent. Some 86% of high schoolers report easy access to marijuana. Cocaine prices have fallen by about 80% since the 1980s," the freshman senator continued. "Efforts to curb illegal drug use have relied heavily on enforcement. The number of people in custody on drug charges has increased 13-fold in the past 25 years, yet the flow of drugs remains undiminished. Drug convictions and collateral punishments are devastating our minority communities," Webb said.

"Our current policy mix is not working the way we want it to," Webb declared. "The ease with which drugs can be obtained, the price, the number of people using drugs, the violence on the border all show that. We need to rethink our responses to the health effects, the economic impacts, the effect on crime. We need to rethink our approach to the supply and demand of drugs."

Such sentiments coming from a sitting senator in the US in 2008 are bold if not remarkable, and it's not the first time that Webb has uttered such words:

In March of last year, he told George Stephanopoulos on the ABC News program This Week: "One of the issues which never comes up in campaigns but it's an issue that's tearing this country apart is this whole notion of our criminal justice system, how many people are in our criminal justice system more -- I think we have two million people incarcerated in this country right now and that's an issue that's going to take two or three years to try to get to the bottom of and that's where I want to put my energy."

In his recently-released book, A Time to Fight, Webb wrote: "The time has come to stop locking up people for mere possession and use of marijuana," "It makes far more sense to take the money that would be saved by such a policy and use it for enforcement of gang-related activities" and "Either we are home to the most evil population on earth, or we are locking up a lot of people who really don't need to be in jail, for actions that other countries seem to handle in more constructive ways."

Still, drug reformers may be impatient with the level of rethinking presented at the hearing. While witnesses including University of Maryland criminologist Peter Reuter, author of "Drug War Heresies," and John Walsh, director of the Washington Office on Latin America (WOLA) offered strong and familiar critiques of various aspects of US drug policy, neither of the words "prohibition" or "legalization" were ever uttered, nor were the words "tax and regulate," and radical alternatives to current policy were barely touched upon. Instead, the emphasis seemed to be on adjusting the "mix" of spending on law enforcement versus treatment and prevention.

The other two witnesses at the hearing, Kings County (Brooklyn), New York, Assistant District Attorney Anne Swern and community coordinator Norma Fernandes of the same office, were there to talk up the success of drug court-style programs in their community.

[The written testimony of all four witnesses is available at the hearing web site linked above.]

"US drug policy is comprehensive, but unbalanced," said Reuter. "As much as 75% of spending goes to enforcement, mainly to lock up low-level drug dealers. Treatment is not very available. The US has a larger drug problem than other Western countries, and the policy measures to confront it have met with little success," he told the committee.

Reuter said there were some indications policymakers and the electorate are tiring of the drug war approach, citing California's treatment-not-jail Proposition 36, but there was little indication Congress was interested in serious analysis of programs and policies.

"Congress has been content to accept rhetoric instead of research," Reuter said, citing its lack of reaction to the Office of National Drug Control Policy's refusal to release a now three-year-old report on drug use levels during the Bush administration. "It's hardly a secret that ONDCP has failed to publish that report, but Congress has not bothered to do anything," he complained. "We need more emphasis on the analytic base for policy."

But even with the paltry evidence available to work with, Reuter was able to summarize a bottom line: "The US imprisons too many people and provides too little treatment," he said. "We need more than marginal changes."

"US drug policies have been in place for some time without much change except for intensification," said WOLA's Walsh, noting that coca production levels are as high as they were 20 years ago. "Since 1981, we have spent about $800 billion on drug control, and $600 billion of that on supply reduction. We need a stiff dose of historical reality as we contemplate what to do now," he told the committee.

With the basic policies in place for so long, some conclusions can now be drawn, Walsh said. "First, the balloon effect is real and fully relevant today. We've seen it time and time again, not just with crops, but also with drug smuggling routes. If we want to talk about actually reducing illicit crops and we know eradication only leads to renewed planting, we need to be looking for alternatives," he said.

"Second, there is continuing strong availability of illicit drugs and a long-term trend toward falling prices," Walsh said, strongly suggesting that interdiction was a failed policy. "The perennial goal is to drive up prices, but prices have fallen sharply. There is evidence of disruptions in the US cocaine market last year, but whether that endures is an open question and quite doubtful given the historical record," he said.

"Third, finding drugs coming across the border is like finding a needle in a haystack, or more like finding lots of needles in lots of different moving haystacks," he said. "Our legal commerce with Mexico is so huge that to think we can seal the borders is delusional."

With respect to the anti-drug assistance package for Mexico currently being debated in Congress, Walsh had a warning: "Even with US assistance, any reduction in the flow of drugs from Mexico is unlikely." Instead, Walsh said, lawmakers should adjust their supply-control objectives and expectations to bring them in line with that reality.

Changes in drug producing countries will require sustained efforts to increase alternative livelihoods. That in turn will require patience and a turn away from "the quick fix mentality that hasn't fixed anything," Walsh said.

"We can't expect sudden improvements; there is no silver bullet," Walsh concluded. "We need to switch to harm reduction approaches and recognize drugs and drug use as perennial problems that can't be eliminated, but can be managed better. We need to minimize not only the harms associated with drug use, but also those related to policies meant to control drugs."

"It is important to be able to discuss the realities of the situation, it's not always a comfortable thing to talk about," Webb said after the oral testimony. "This is very much a demand problem. I've been skeptical bout drug eradication programs; they just don't work when you're supplying such an enormous thirst on this end. We have to find ways to address demand other than locking up more people. We have created an incredible underground economic apparatus and we have to think hard about how to address it."

"The way in which we focused attention on the supply side has been very much mistaken," agreed Rep. Maurice Hinchey (D-NY), who along with Rep. Bobby Scott (D-VA) and Sen. Amy Klobuchar (D-MN) were the only other solons attending the hearing. "All this focus on supply hasn't really done anything of any value. The real issue is demand, and prevention and dealing with people getting out of prison is the way to deal with this."

Reuter suggested part of the solution was in increase in what he called "coerced abstinence," or forced drug treatment. Citing the work of UCLA drug policy researcher Mark Kleiman, Reuter said that regimes of frequent testing with modest sanctions imposed immediately and with certainty can result "in a real decline in drug taking and criminal activity."

That got a nod of agreement from prosecutor Swern. "How long you stay in treatment is the best predictor of staying out of trouble or off drugs," she said. Swern is running a program with deferring sentencing, with some flexibility she said. "The beauty of our program is it allows us to give people many chances. If they fail in treatment and want to try again, we do that," she said.

As the hearing drew to an end, Webb had one last question: "Justice Department statistics show that of all drug arrests in 2005, 42.6% were for marijuana offenses. What about the energy expended arresting people for marijuana?" he asked, implicitly begging for someone to respond, "It's a waste of resources."

But no one connected directly with the floating softball. "The vast majority of those arrests are for simple possession," said Reuter. "In Maryland, essentially no one is sentenced to jail for marijuana possession, although about a third spend time in jail pre-trial. It's not as bad as it looks," he said sanguinely.

"There's violence around marijuana trafficking in Brooklyn," responded prosecutor Swern.

WOLA's Walsh came closest to a strong answer. "Your question goes to setting priorities," he said. "We need to discriminate among types of illicit drugs. Which do the most harm and deserve the most emphasis? Also, given the sheer number of marijuana users, what kind of dent can you make even with many more arrests?"

And so ended the first joint congressional hearing to challenge the dogmas of the drug war. For reformers that attended, there were generally thumbs up for Webb and the committee, mixed with a bit of disappointment that the hearings only went so far.

"It was extraordinary," said Sanho Tree, director of the Drug Policy Project at the DC-based Institute for Policy Studies. "They didn't cover some of the things I hoped they would, but I have to give them props for addressing the issue at all."

"Webb was looking for someone to say what he wanted to say with the marijuana question, that perhaps we should deemphasize law enforcement on that," said Doug McVay, policy analyst at Common Sense for Drug Policy, who also attended the hearing. "I don't think our witnesses quite caught what he was aiming for, an answer that arresting all those people for marijuana takes away resources that could be used to fight real crime."

Sen. Webb came in for special praise from Tree. "Perhaps because he's a possible vice presidential candidate, he had to tone things down a bit, but he is clearly not afraid to talk about over-incarceration, and using the Joint Economic Committee instead of Judiciary or Foreign Affairs is a brilliant use of that committee, because this is, after all, a policy with enormous economic consequences," Tree said. "Webb is clearly motivated by doing something about the high levels of incarceration. He held a hearing on it last year, and got the obvious answer that much of it is related to drug policy. Having heard that kind of answer, most politicians would walk away fast, but not Webb, so I have to give him credit."

Reversing the drug war juggernaut will not be easy. The Congressional Joint Economic Committee hearing Thursday was perhaps a small step toward that end, but it is a step in the right direction.

Europe: Scottish Parliament Think-Tank Calls for Prescription Heroin, Safe Injection Sites, Legalized Marijuana

A think-tank established by the Scottish parliament and tasked with looking at new approaches to drug policy has issued a report calling for radical changes in the way Scotland deals with the damage of drug and alcohol use. Parliament asked the think-tank, the Scottish Futures Forum, to determine how the country could cut the damage in half by 2025.

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Urquhart Castle on Loch Ness, Scotland (photo from Sam Fentress via Wikimedia)
The forum's report, Approaches to Drugs and Alcohol in Scotland: A Question of Architecture, landed like a stink-bomb in the middle of the ongoing Scottish debate over drug policy, which in recent months has been dominated by calls for a renewed "tough" approach to drug use and trafficking. It recommended that all substance use, including legal drugs like alcohol and tobacco, should be subsumed under a single policy dominated by a public health approach and was harshly critical of over-reliance on the criminal justice system to reduce the harms caused by substance use.

"Historically, we have seen, in particular, drug use mainly as a justice issue," the report noted. "This is mistaken and alcohol and drugs should be seen predominantly as a health, lifestyle and social issue to be considered along with smoking, obesity and other lifestyle challenges. The current level of enforcement activity tackling low level use of illegal drugs may not be the most effective deployment of enforcement resources and is likely to fail in reducing drug and alcohol related damage by half by 2025. It should be recognized that sending people to prison for low-level alcohol and drug-related crime is unproductive and probably unsustainable."

Instead of current policies, Scotland should shift to evidence-based policies emphasizing a public health approach, the forum said. Such policies would include consideration of safe injection sites to reduce the spread of infectious disease, prescribing of heroin to addicts, and the taxation and regulation of marijuana. More resources should go to prevention and treatment of substance abuse, as opposed to law enforcement, the forum said.

The Scottish government was not pleased, and a spokesman ruled out any quick establishment of safe injection sites. "There are complex legal and ethical issues around consumption rooms that cannot be easily resolved," the spokesman said. As for prescribing heroin, Scotland will "wait and see" how pilot programs in England are working out, he said.

Scottish Conservatives were appalled, with Tory leader Annabel Goldie calling safe injection sites "shooting galleries" and saying they and marijuana legalization were ideas out of the past.

But Liberal Democrats were more open. Their spokeswoman, Margaret Smith, said: "Drugs misuse is a global problem and if other countries have developed new and radical solutions, then it is sensible to consider them for use in Scotland."

Feature: Western Hemisphere's Only Heroin Maintenance Program Coming to an End

Every day for 15 months, Vancouver heroin addict Rob Scott Vincent, 36, went into a nondescript building on the city's Downtown Eastside where a nurse would hand him a syringe loaded with pharmaceutical grade heroin. Sitting at a sterile, stainless steel counter, Vincent would inject himself with the drug, then sit in an equally sterile waiting room for awhile as the drug took hold before heading out to do his daily business.

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Hastings Street, on Vancouver's East Side (courtesy VANDU)
Vincent was one of 251 participants -- 192 in Vancouver and the rest in Montreal -- in the only heroin maintenance program in the hemisphere, a pilot program known as the North American Opiate Maintenance Initiative (NAOMI). Originally intended to operate in both Canada and the US, the US component never got off the ground in the drug war atmosphere there. And now, NAOMI is winding down in Vancouver and Montreal. The last handful of participants in the program will get their last fixes at the end of this month.

In the program, which was limited to long-time addicts over 25 who had failed to kick the habit at least twice in previous treatment tries, participants used treatments of oral methadone or injected heroin. A small percentage received a pharmaceutical opiate called Dilaudid. Participants also received counseling and other support services. The Canadian federal government (then under control of the Liberals) funded the project with $1.8 million and agreed to allow the importation of pharmaceutical heroin for the project.

Similar pilot opiate maintenance projects in Switzerland, Germany and the Netherlands produced results showing reductions in criminality, drug use, and economic costs to society, and increases in health, stability, and employability among participants. NAOMI researchers and supporters are hoping it will produce similar results. While the final research report from NAOMI is not expected until the fall, preliminary results suggest the findings will be similar to those in Europe.

In a March briefing paper, NAOMI reported that 85% of participants taking injected heroin had stayed with the program for 12 months, that the treatment had proven to be "extremely safe," and that there had been no security issues or evidence that NAOMI had had a deleterious impact on the neighborhood. The paper also suggested that the program would show a positive economic impact.

Canada estimates that each heroin addict costs the country $45,000 a year. The studies of European opiate maintenance programs report that they save host countries $20,000 a year for each participant.

"What we know now is that we were able to recruit people with long-term dependence on heroin who repeatedly failed other treatments and who had many health and social problems when they entered," said Dr. David Marsh, one of the co-investigators and lead clinical physician for the study. "From a doctor's perspective, whether they were treated with methadone or heroin, many of them improved dramatically. We'll know from the formal research results how much and in what ways they improved."

The provision of methadone or heroin was only part of the treatment, Marsh said. "The medication is a component of a broader package of primary care, mental health care, addiction counseling, and case management to provide participants with access to a range of welfare and other benefits," said Marsh. "We work with people to try to manage the negative consequences of their drug use and help them improve their lives."

Vincent had been addicted to opiates for nearly 15 years when he decided to participate in NAOMI. "I wanted to see if it could better my life, and it did," he said. "It helped me slowly wean down. I'm still using, but not even one-third of what I was using."

Vincent's stint in NAOMI ended in March. Since then, he has had to return to the streets to find his drugs. "It's not too bad," he said. "I mostly use morphine pills, and I pick up a pill for $5 bucks every morning and I'm good for the day." Vincent pays for his fixes by collecting and recycling cans. But sometimes, he can't find what he wants and has to spend time searching for a substitute opiate -- heroin, dilaudid, whatever is around. "It's usually readily available," he said, "but sometimes I have to scrounge around."

Getting participants completely off opiates wasn't the be-all and end-all of the pilot program, said Marsh. "Patients benefit in a lot of ways," he said. "Some were able to stop taking illegal opiates, and in my view, if a patient is prescribed methadone and is using it properly, I consider that a success. Methadone treatment has been available for many years, and there are thousands of studies showing its benefits."

The Vancouver Area Network of Drug Users (VANDU) was one of the key supporters of NAOMI, despite its complaints about the restrictiveness of the standards for qualifying for the study. The program needs to continue, VANDU said.

"Regardless of the parameters they set that made it tough to qualify, this is a badly needed service and it's a shame it's just a pilot project and is not continuing," said VANDU president Richard Utendale. "I've talked to a lot of people who have been helped by it. They were able to improve their day-to-day lives by not having to struggle to feed their drug habits. NAOMI provided a safe place and support, and participants didn't have to worry about being jacked up by the police or ripped off or sold inferior products or dope with adulterants."

The Downtown Eastside, where both VANDU and NAOMI are located is the epicenter of one of the largest hard drug scenes in the hemisphere. The program had an impact on the area, said Utendale. "I think NAOMI also improved the neighborhood, with less street and property crime."

There was a downside to NAOMI, though, said Utendale. "The drawback is that when people are finished with the program, they have to go back on the street and resort to the same old means of getting their drugs. That's why this needs to be permanent."

Vincent said he wished the program could continue. "I would most definitely participate in a permanent program," he said. "It was very, very helpful. It's a lot easier to quit or reduce my intake with pharmaceutical grade heroin. Most of the stuff on the street is cut with other things -- that's why I like to use morphine. I can't see any reason for not keeping this open," he said. "NAOMI is a medical facility, just like Insite [the Vancouver safe injection site]. They should not shut it down."

But that is what is going to happen at the end of this month. Last November, doctors appealed on compassionate grounds to extend the program on behalf of five participants. So far there has been no agreement from either Health Canada or the regional health authority.

"Dreams are free," Utendale sighed, "but the way things are looking right now, this isn't going forward without some changes in Ottawa."

Marsh said it was "premature" to try to predict what would happen. "But I'm optimistic we'll find funding and get the regulatory approval at some point to apply the lessons we've learned from this study," he said.

But given the current Conservative federal government's ideological opposition to harm reduction, as evidenced by its losing battle to shut down Vancouver's safe injection site, it is going to take a new national election before there is any chance that Canada will follow the Europeans' lead and make heroin maintenance part of a broader public health policy.

Drug Treatment: Massachusetts Senate Ponders "Secure Treatment Centers"

Faced with rising drug overdose deaths and high rates of opiate addiction, Massachusetts lawmakers this week began discussing a $5 million plan to fund two "secure treatment centers" for arrested drug users. Under the initiative, drug users busted for small-time offenses who currently face jail would be given the option of seeking drug treatment for up to 90 days.

According to the state Department of Public Health, the number of opiate-related deaths in the Bay State increased from 363 in 2000 to 637 in 2006. The number of non-fatal drug overdoses has also increased dramatically, from 8,000 in 1996 to more than 18,000 in 2005.

"This is an epidemic," state Sen. Steven Tolman (D-Boston), who is pushing the plan, told the Associated Press. "We have all these kids and young adults who get hooked on the OxyContin and heroin, but the treatment infrastructure we have is mostly for alcohol."

Under Tolman's plan, which is included in the Senate version of the state budget, the $5 million would create two 60-bed secure treatment centers. The budget also includes language establishing a special commission to investigate and study the impact of OxyContin and heroin and make additional recommendations.

The plan was set to be discussed this week in the state Senate as part of the appropriations process.

Feature: Vancouver's Safe Injection Site Fights for Its Life -- Again

The only officially-sanctioned safe injection site in North America, Vancouver's InSite will have to close its doors June 30 if the Canadian federal government does not extend its exemption from Canada's Controlled Drugs and Substances Act. But while the Conservative government of Prime Minister Stephen Harper has made no secret of its distaste for the program, it has very strong community, local, provincial, and international support, and its supporters are now engaged in a strong campaign to ensure its continued existence.

https://stopthedrugwar.org/files/insite1.jpg
InSite (courtesy Vancouver Coastal Health)
Situated on Hastings Street in Vancouver's Downtown Eastside, home to one of the hemisphere's largest concentrations of hard drug users, InSite has operated since 2003, when it was granted a three-year exemption by the then Liberal government. With the advent of Conservative government, with its ideological opposition to programs that "encourage" or "facilitate" drug use, InSite's continued existence has been shaky. Twice, the Conservatives have granted the program temporary 18-month exemptions, saying that more research on its efficacy was needed.

But now, after five years of monitoring and evaluation, the results are in: According to peer-reviewed scientific studies, InSite increased the use of addiction treatment services, increased the use of detox services, reduced needle sharing, led to improvement in neighborhood public order and quality of life, resulted in no increase in drug-related crime, prevented overdose deaths, and helped reduce the spread of HIV/AIDS among drug injectors.

As if the nearly two-dozen studies of InSite were not enough, the Conservative government last year commissioned its own study, "Vancouver's INSITE service and other Supervised injection sites: What has been learned from research?," which was released in early April. According to Simon Fraser University criminologist Neil Boyd, who was hired by the government to advise the committee overseeing the study, the research shows that InSite has no apparent negative impacts, has resulted in "modest decreases" in drug use, and has not disturbed public order.

In fact, said Boyd at a press conference announcing his findings, InSite should not only be continued, but the program should be expanded to other locations. "I think our data suggests... the building of additional facilities of a similar kind in neighborhoods where they are needed would yield benefits much in excess of the costs required for such projects," he said.

That's unlikely under the Harper government, which is ideologically opposed to such harm reduction practices and in fact removed funding for them from its anti-drug budget. As Harper put it last October: "Because if you remain an addict, I don't care how much harm you reduce, you're going to have a short and miserable life."

Harper has also scoffed at empirical evidence when it conflicts with his agenda. In a January speech to party faithful, he mocked opponents who cited falling crime statistics in challenging his emphasis on law and order. "They try to pacify Canadians with statistics," said the prime minister. "Your personal experiences and impressions are wrong, they say; crime is really not a problem."

More recently, Health Minister Tony Clement and his underlings have sounded similar themes. Science would not be the only factor in determining whether to continue InSite's exemption, Clement's undersecretary, Winnipeg MP Steven Fletcher told The Canadian Press earlier this month. While the government would make a "rational and thoughtful decision based on science," it must also take into account "the realities of the situation," Fletcher explained. "There's multiple sides to this and they all have to be taken into consideration," said Fletcher.

When pressed in parliament by Vancouver East MP Libby Davies, a staunch InSite supporter, Clement vowed to make a decision before June 30 and responded to her criticism about rejecting the science supporting the program: "We are the government that actually wants more research, that actually commissioned more research because we want to make sure this decision is the right decision for Canada, for addicts and for the community in Vancouver," he said. "That is the decision we have made, more research and more consideration. That is because we are open-minded and we want to make the best decision for Canada and Canadians."

Now, as the June 30 deadline looms, InSite's supporters have mobilized. Already this month, the International Journal of Drug Policy published articles by scientists from around the world condemning the federal government for interfering politically with the site's research, Boyd held his Ottawa press conference, advocates held a rally in a Downtown Eastside park featuring 1,000 white crosses to symbolize the people who didn't die from drug overdoses while injecting at InSite, Vancouver street nurses picketed the office of the Vancouver Police Union, whose president is a leading critic of the site, BC Nurses Association president Debra MacPherson held a press conference to tout the health benefits of InSite, and all three BC civic parties have signaled their joint support of the program.

"We're fully behind the effort to keep InSite open," said David Hurford, director of communications for Vancouver Mayor Sam Sullivan. "It is part of the solution, not part of the problem, and it is a bottom-up solution from the grassroots. The federal government has said it supports grassroots decision-making, so why should bureaucrats from 3,000 miles away be making decisions for us here?" he asked.

The mayor's office is "working with local stakeholders to help communicate the benefits of InSite," said Hurford. "We wrote to the health minister last week asking him to keep the site open, and at a minimum, to extend the permits until all pending legal issues are heard."

Hurford is referring to a lawsuit pending in the BC courts that challenges Health Canada's jurisdiction over InSite. That suit argues that since under Canadian law, health care is the domain of the provinces, the federal government should not have control over InSite. But that lawsuit will not be settled by the end of next month.

Opposition politicians have also joined the fight. "This government chooses to view harm reduction as nothing more than dirty words, at the expense of protecting the safety and health of Canadians," said Liberal Party public health spokesperson Dr. Carolyn Bennett.

"The results from the InSite project show measurable evidence that it saves lives," said Liberal MP Dr. Hedy Fry, who played a key role in bringing the agreement that allowed InSite to open. "This has won it widespread support not only from experts in Canada but from the international scientific community, from the Vancouver police and from residents of the Downtown Eastside," said Dr. Fry. "It is simply irresponsible to ignore scientifically-based proof of the efficacy of harm reduction programs like this, and base public policy on ideology alone because real people suffer the consequences."

"The Conservative government must stop its unconscionable interference in scientific research on Vancouver's safe injection site," added New Democratic Party MP Libby Davies, who represents the Downtown Eastside. "Medical researchers from the University of British Columbia have revealed that Harper and his team have been suppressing evidence and denying funding to scientists who are looking objectively at the merits of Insite," she said.

"More than 20 medical and academic studies have been published showing the health and social benefits of InSite. We now have both scientific fact and evidence from users in our community that this facility is helping, not hurting the people of our city. The research record shows that Insite saves lives and increases public safety," Davies continued. "Harper doesn't understand that you can't just hide the facts whenever they don't suit your political agenda. We need a change in direction. It's time for this government to make decisions based on evidence instead of ideology -- InSite needs to be kept open."

"What we want is a 3 ½ year renewal of the exemption from the Controlled Substances Act," said Nathan Allen of InSite for Community Safety. "The fact that the Harper government has not granted this renewal shows they are very reluctant to support the community."

While the Harper government has previously said it needed more research to evaluate InSite's efficacy, that dog won't hunt anymore, said Allen. "They've already spent more than $1.5 million studying InSite, they've produced two dozen academic papers, and they've concluded that it has all kinds of positive impacts. We're wondering what questions the government has left to ask," he scoffed. "InSite has undergone the most thorough and well-funded scrutiny of any health clinic in the country."

In the event the government refuses to grant another exemption, Allen said he hoped it would respect provincial authority and local autonomy. "This has been a regional response to a local crisis here in Vancouver. We need to let the people here on the ground do what they need to do. If not, people will die," he predicted bluntly.

The clock is ticking for InSite, but the pressure is mounting on the Harper government. The next few weeks will determine if that pressure is sufficient to overcome the government's ideological opposition to the safe injection site.

Southeast Asia: Vietnam Ponders Drug Decriminalization

The Vietnamese National Assembly is considering legislation that would make drug use an administrative violation -- not a crime. Under current Vietnamese law, drug use is a criminal offense, a violation of Article 199 of the country's criminal code, and is punishable by up two years in prison.

But Truong Thi Mai, chair of the Assembly's Committee on Social Affairs, told a press conference last Friday the committee had recommended scrapping Article 199. "Being addicted to or using drugs should be considered a disease, and should only be subject to administrative fines," Mai said. "We cannot jail hundreds of thousands of drug users, can we?"

In actuality, Vietnam does not typically jail drug users; instead, it confines them in mandatory drug detoxification centers for up to two years, or in some centers, up to five years. Local governments maintain lists of drug addicts in their areas and send them to detox centers at their discretion. Few drug users are actually prosecuted under Article 199, so the impact of a decriminalization move would be mostly symbolic.

Still, that would be a good thing, said Le Minh Loan, a police chief and former director of counter-drug efforts in a province with one of the country's highest heroin addiction rates. "I think it makes sense to drop the article," Loan said. "Few countries in the world sentence drug addicts to prison terms."

Vietnamese drug rehabilitation efforts are not particularly effective, Loan said. "The rate of relapse into drug use is very high."

While Vietnam has harsh laws for drug dealing -- 85 people were sentenced to death last year for drug offenses and nine more so far this year -- those laws have had little impact on drug use in the Southeast Asian nation. Harsh enforcement is not working, said Mai. "Many people have been sentenced to death for trafficking heroin, but heroin trafficking is still rampant," Mai said. "The traffickers know that the laws are strict but they are still trafficking narcotics."

Drug Treatment: Idaho Senate Overrides Governor's Funding Increase Veto, Battle Continues

The Idaho Senate voted overwhelmingly Tuesday to override a gubernatorial veto of a bill that would have increased funding for drug treatment and prevention programs. Now, the House must vote to override by a similar "supermajority" to complete the restoration of funding against the wishes of Republican Gov. Butch Otter.

Last week, Otter vetoed line items in two bills that would have provided $16.8 million for Idaho substance abuse programs. The Senate override vote on SB 1458 restores $2.4 million in supplemental funding. But Otter also vetoed $14.4 million in treatment funding for the coming year in HB 608.

The twin vetoes would cut in half the funding for drug courts and treatment for probationers and parolees, as well as some community-based treatment programs. The tussle at the statehouse is the latest round in fighting over how best to continue a three-year, $21 million dollar anti-drug effort originally funded by a federal grant. The federal money ran out last year, and lawmakers replaced it with state funds. Otter complained that the programs were unproven and had been expanded beyond their original scope.

But the state Senate seemed determined to do something other than just pay for more prison cells, and for several senators, Idaho's drug war has hit close to home. "I don't believe there is a family represented in this body who has not been affected by drugs or alcohol or mental health problems at some point," said Sen. Chuck Coiner (R-Twin Falls) in remarks reported by The New West magazine.

Sen. Brent Hill (R-Rexburg), also speaking in support of the override, told of a family member "almost ruined" by methamphetamine. "Her teeth rotted right out of her head," he told his colleagues.

Sen. Lee Heinrich (R-Cascade) said his son had spent two and a half years in prison on drug-related charges. "He could have benefited from this program... I know what these drug-related things can do to families," he added, but then said he would vote against the override because he wasn't sure "we've looked at all the alternatives."

But it was Sen. Dean Cameron (R-Rupert) who was perhaps most perceptive, speaking of a "paradigm shift" among his conservative colleagues. "Doesn't it seem smart to get on the front end of these decisions? Doesn't it seem smart to try to affect them before they become incarcerated, so they don't offend in the first place?" he asked. "Cells alone are not the answer."

At mid-week, the governor was signaling he still sought compromise. "The governor has consistently indicated that he was willing to discuss this issue and reach a compromise as he has on other important issues," he said in a Wednesday statement. But the size of the increase in treatment spending "could not be justified in a year when we are asking so many others agencies, not to mention state workers, to do with less."

Now, the ball is in the House's court.

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