Drug-Related AIDS/HIV or Hepatitis C

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Top British Doctor and Lawyer Join Drug Decrim Chorus

The former head of Britain's Royal College of Physicians has joined the growing chorus calling for radical reforms of the country's drug laws. Sir Ian Gilmore, who left his post just weeks ago, told the Guardian Monday the government should consider decriminalizing drugs because prohibition neither reduced crime nor improved health.

Prof. Ian Gilmore
"I'm not saying we should make heroin available to everyone, but we should be treating it as a health issue rather than criminalizing people," said Gilmore. "This could drastically reduce crime and improve health."

Just over three weeks ago, Nicholas Green, chairman of the Bar Council (the British equivalent of the ABA), called for decriminalization, saying it was "rational" to consider "decriminalizing personal drug use." "Crime was costing Britain $20 billion a year, he pointed out.

"[Decriminalization] can free up huge amounts of police resources, reduce crime and recidivism and improve public health. All this can be achieved without any overall increase in drug usage," Green said. "If this is so, then it would be rational to follow suit."

Gilmore, for his part, went out of his way to draw attention to yet another recent call for radical reform. He praised a recently published article in the British Medical Journal by Stephen Rolles, senior policy analyst at the Transform Drug Policy Foundation, which, he said, clearly made the argument for decriminalization.

In that article, Rolles noted that not only had prohibition worsened health problems such as HIV, it had also created numerous secondary harms, including "vast networks of organized crime, endemic violence related to the drug market, corruption of law enforcement and governments, militarized crop eradication programs (environmental damage, food insecurity, and human displacement), and funding of terrorism and insurgency."

Rolles' call for decriminalization also won the support of Dr. Fiona Godlee, editor of the British Medical Journal. "He says, and I agree, that we must regulate drug use, not criminalize it," she wrote in the journal.

"Sir Ian's statement is yet another nail in prohibition's coffin," Transform's Danny Kushlick told the Guardian. "The Hippocratic oath says: 'First, do no harm.' Physicians are duty bound to speak out if the outcomes show that prohibition causes more harm than it reduces."

Kushlick also prodded the government to act. "With a prime minister and deputy prime minister both longstanding supporters of alternatives to the war on drugs, at the very least the government must initiate an impact assessment comparing prohibition with decriminalization and strict legal regulation."

Drip, drip, drip. And so the prohibitionist consensus erodes even further.

United Kingdom

Press Release: 3 Georgian leaders sign Vienna Declaration, strengthen call for science-based drug policy

Public release date: 22-Jul-2010 Contact: Michael Kessler [email protected] 34-655-792-699 International AIDS Society 3 Georgian leaders sign Vienna Declaration, strengthen call for science-based drug policy First Lady Sandra Roelofs, Deputy Chairman of Parliament George Tsereteli and Vice Minister of Labor, Health and Social Affairs Irakli Giorgobiani show support for evidence-based drug policy 22 July 2010 [Vienna, Austria] – Sandra Roelofs, First Lady of Georgia; George Tsereteli, Georgia's Deputy Chairman of Parliament; and Irakli Giorgobiani, Georgia's Vice Minister of Labour, Health and Social Affairs, today signed the Vienna Declaration, the official declaration of the XVIII International AIDS conference (AIDS 2010) in Vienna, Austria. The Vienna Declaration (www.viennadeclaration.com) is a scientific statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies. More than 12,580 people – including Nobel laureates and leaders in science, medicine and public policy – have signed the declaration since it was launched three weeks ago. The Declaration was published in the Lancet medical journal to coincide with AIDS 2010. "Georgia supports evidence- based policy in our efforts to protect community health and safety," said Roelofs, the wife of Mikheil Saakashvili, President of Georgia. "Our signatures on the Vienna Declaration reinforce our recognition that harm reduction can provide numerous benefits and highlights the need to design policies that align with emerging science." Georgia is moving forward with activities that are intended to ensure safer and healthier communities across the country by taking action in three priority areas: prevention, treatment and enforcement. "The health of Georgians is paramount and therefore we are looking at many ways to improve the well-being of all of our citizens, including those facing challenges such as substance use and HIV," said Giorgobiani. Added Tsereteli: "We believe a scientific approach to drug policy is the way forward. We will move in support of evidence-based research and policy to optimize investments in public health, improve existing policies, and adopt much more effective and relevant legislation." In some areas of rapid HIV spread, such as Eastern Europe and Central Asia, injecting drug use is the primary cause of new HIV infections. In some countries, people who use drugs are threatened with arrest, incarceration and worse, and therefore are reluctant to access the necessary public health services. "Misguided drug policies fuel the AIDS epidemic and result in violence, increased crime rates and destabilization of entire states – yet there is no evidence that they have reduced rates of drug use or drug supply," said AIDS 2010 Chair Dr. Julio Montaner, President of the IAS and Director of the BC Centre for Excellence in HIV/AIDS. "I welcome the endorsement of the Vienna Declaration from these Georgian leaders; it provides great hope for the future in an area of the world being devastated by the HIV and AIDS epidemic." In much of the world, the current approach to drug policy is ineffective because it neglects proven and evidence-based interventions, while pouring a massive amount of public funds and human resources into expensive and futile enforcement measures. Legal barriers to scientifically proven prevention services such as needle programmes and opioid substitution therapy (OST) mean hundreds of thousands of people become infected with HIV and Hepatitis C (HCV) every year. In some areas of the world, the criminalization of people who inject drugs has also resulted in record incarceration rates placing a massive burden on taxpayers. An emphasis on criminalization produces a cycle of disease transmission, breaking homes and destroying livelihoods. "Georgia is at risk of rising HIV rates due to epidemics in neighboring countries and a high rate of injection drug use, so it is gratifying to see this type of leadership and deep support for evidence-based policy-making in this area," said Dr. Evan Wood, the chair of the Vienna Declaration writing committee and founder of the International Centre for Science in Drug Policy (ICSDP). The Vienna Declaration calls on governments and international organizations to take a number of steps, including: * undertake a transparent review the effectiveness of current drug policies; * implement and evaluate a science-based public health approach to address the harms stemming from illicit drug use; * scale up evidence-based drug dependence treatment options; * abolish ineffective compulsory drug treatment centres that violate the Universal Declaration of Human Rights; and * unequivocally endorse and scale up funding for the drug treatment and harm reduction measures endorsed by the World Health Organization (WHO) and the United Nations. The declaration also calls for the meaningful involvement of people who use drugs in developing, monitoring and implementing services and policies that affect their lives. The Vienna Declaration is one step in pushing for support of science-based approaches to dealing with illicit drugs. The signature-gathering process aims to galvanise scientists and others working in illicit drug policy and place real and sustained pressure on policymakers to meaningfully consider the scientific evidence regarding the limited beneficial impact and negative unintended consequences of conventional illicit drug policies. The impact of the Vienna Declaration will be measured over the coming years, and progress reports on the adoption of evidence-based policies will be presented at subsequent International AIDS Conferences. The adoption of the Vienna Declaration's recommendations among high-level policymakers at the local, national, and international levels will also be tracked by the International Centre for Science in Drug Policy. The Vienna Declaration was drafted by an international team of scientists and other experts. It was initiated by the IAS, the International Centre for Science in Drug Policy (ICSDP), and the BC Centre for Excellence in HIV/AIDS based in Vancouver, British Columbia. Those wishing to sign on may visit www.viennadeclaration.com, where the full text of the declaration, along with a list of authors, is available. The two-page declaration references 28 reports, describing the scientific evidence documenting the effectiveness of public health approaches to drug policy and the negative consequences of approaches that criminalize drug users. ### BC Centre for Excellence in HIV/AIDS The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada's largest HIV/AIDS research, treatment and education facility. The BC-CfE is based at St Paul's Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE is dedicated to improving the health of British Columbians with HIV through developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related diseases. International Centre for Science in Drug Policy ICSDP aims to be a primary source for rigorous scientific evidence on illicit drug policy in order to benefit policymakers, law enforcement, and affected communities. To this end, the ICSDP conducts original scientific research in the form of systematic reviews, evidence-based drug policy guidelines, and research collaborations with leading scientists and institutions across diverse continents and disciplines. MEDIA CONTACTS: Michael Kessler Media Consultant, AIDS 2010 Email: [email protected] Tel: +34 655 792 699 Mahafrine Petigara Edelman Email: [email protected] Tel: +1 604 623 3007, ext. 297
Location: 
Vienna
Austria

Latin American Ex-Presidents Sign Anti-Prohibitionist "Vienna Declaration"

Last week, the Chronicle did a feature story on the Vienna Declaration, a sign-on document from the international scientific community calling for the decriminalization of drug use and science-based drug policy reform. The declaration is an official declaration of the XVIII International AIDS Conference, set for Vienna next week.

Aimed at national governments, international organizations, and the United Nations' global drug control bureaucracy seated at Vienna, the declaration went public June 28. Tuesday, the declaration picked up a trio of big-time endorsements, as three former Latin American presidents signed on.

Former Brazilian President Henrique Cardoso, former Mexican President Ernesto Zedillo, and former Colombian President Cesar Gaviria were also joined in signing the declaration by Peruvian author and journalist Mario Vargas Llosa, Brazilian writer Paulo Coehlo, and author and former Nicaraguan Vice-President Sergio Ramirez Mercado. All six have already made waves in international drug reform circles as members of the Latin American Commission on Drugs and Democracy, which in 2008 issued a final report criticizing drug prohibition along lines similar to this year's Vienna Declaration.

"The war on drugs has failed," said Cardoso. "In Latin America, the only outcome of prohibition is to shift areas of cultivation and drug cartels from one country to another, with no reduction in the violence and corruption generated by the drug trade."

"The war on drugs has had such an incredibly negative impact on Latin America, and the fact that the Vienna Declaration is receiving this level of endorsement from former heads of state should serve as an example to those currently in power," said AIDS 2010 Chair Dr. Julio Montaner, President of the International AIDS Society and director of the BC Center for Excellence in HIV/AIDS, two of the organizations tasked with writing the declaration. "I hope that the Vienna Declaration will inspire many more political leaders to cast aside the drug war rhetoric and embrace evidence-based policies that can meaningfully improve community health and safety."

The Vienna Declaration calls on governments and international organizations, including the United Nations, to take a number of steps, including:

  • undertaking a transparent review of the effectiveness of current drug policies;
  • implementing and evaluating a science-based public health approach to address the harms stemming from illicit drug use;
  • scaling up evidence-based drug dependence treatment options;
  • abolishing ineffective compulsory drug treatment centers that violate the Universal Declaration of Human Rights; and
  • endorsing and scaling up funding for the drug treatment and harm reduction measures endorsed by the World Health Organization (WHO) and the United Nations.

"Instead of sticking to failed policies with disastrous consequences, we must direct our efforts to the reduction of consumption and the reduction of the harm caused by drugs to people and society," said Cardoso. "Repressive policies are firmly rooted in prejudices, fears and ideological visions. The way forward to safeguard human rights, security and health is a strategy of peace not war."

"We welcome the support of Presidents Cardoso, Zedillo and Gaviria, as well as the many doctors, scientists, researchers and public figures who have already put their support and endorsement behind the Vienna Declaration," said Dr. Evan Wood, founder of the International Centre for Science in Drug Policy and the chair of the Vienna Declaration writing committee. "This level of support, especially before the conference has started, demonstrates the urgency that global leaders in many disciplines believe we must move towards reforming drug policies."

"The approach to drug policy proposed in the Vienna Declaration will prevent new HIV infections and ensure that people who struggle with addiction have access to the medical and support services they need," said Dr. Brigitte Schmied, AIDS 2010 Local Co-Chair and President of the Austrian AIDS Society. "Access to proven interventions and to the highest standard of health care are rights that each of us values, including those living with addiction."

With an estimated 20,000 people expected to attend next week's sessions, the international AIDS conference is one of the largest public health conferences on the planet. Declaration authors and signatories hope to use it as a springboard in garnering public, scientific, and political support for regime change when it comes to global drug prohibition.

Feature: Drug War a Devastating Failure, Scientists and Researchers Say in Vienna Declaration

A decade ago, scientists, researchers, and AIDS activists confronted a sitting president in South Africa who denied that AIDS was caused by HIV. They responded by declaring at the 2000 Durbin AIDS conference that the evidence was in and the matter was settled. Now, with the Vienna AIDS conference coming up later this month, they are at it again -- only this time the target is the war on drugs.

https://stopthedrugwar.org/files/vienna2009demo1.jpg
HCLU-organized demonstration outside UN anti-drug agency, former SSDP executive director Kris Krane inside cage (drogriporter.hu/en/demonstration)
Their weapon is the Vienna Declaration, an official conference statement authored by experts from the International AIDS Society, the International Center for Science in Drug Policy, and the British Columbia Center for Excellence in HIV/AIDS. The document is a harsh indictment of the global drug war that calls for evidence-based policymaking. It demands that laws which criminalize drug users and help fuel the spread of AIDS be reformed.

The authors of the Vienna Declaration want you to sign on, too. You can do so at the web site linked to above.

"The criminalization of illicit drug users is fueling the HIV epidemic and has resulted in overwhelmingly negative health and social consequences. A full policy reorientation is needed," they said in the declaration.

Arguing there is "overwhelming evidence that drug law enforcement has failed to meet its stated objectives," the declaration lays out the consequences of the drug war:

  • HIV epidemics fueled by the criminalization of people who use illicit drugs and by prohibitions on the provision of sterile needles and opioid substitution treatment.
  • HIV outbreaks among incarcerated and institutionalized drug users as a result of punitive laws and policies and a lack of HIV prevention services in these settings.
  • The undermining of public health systems when law enforcement drives drug users away from prevention and care services and into environments where the risk of infectious disease transmission (e.g., HIV, hepatitis C & B, and tuberculosis) and other harms is increased.
  • A crisis in criminal justice systems as a result of record incarceration rates in a number of nations. This has negatively affected the social functioning of entire communities. While racial disparities in incarceration rates for drug offenses are evident in countries all over the world, the impact has been particularly severe in the US, where approximately one in nine African-American males in the age group 20 to 34 is incarcerated on any given day, primarily as a result of drug law enforcement.
  • Stigma towards people who use illicit drugs, which reinforces the political popularity of criminalizing drug users and undermines HIV prevention and other health promotion efforts.
  • Severe human rights violations, including torture, forced labor, inhuman and degrading treatment, and execution of drug offenders in a number of countries.
  • A massive illicit market worth an estimated annual value of US $320 billion. These profits remain entirely outside the control of government. They fuel crime, violence and corruption in countless urban communities and have destabilized entire countries, such as Colombia, Mexico and Afghanistan.
  • Billions of tax dollars wasted on a "War on Drugs" approach to drug control that does not achieve its stated objectives and, instead, directly or indirectly contributes to the above harms.

"Many of us in AIDS research and care confront the devastating impacts of misguided drug policies every day," said Julio Montaner, president of the International AIDS Society and director of the BC Center for Excellence in HIV/AIDS. "As scientists, we are committed to raising our collective voice to promote evidence-based approaches to illicit drug policy that start by recognizing that addiction is a medical condition, not a crime," added Montaner, who will serve as chairman of the Vienna conference.

"There is no positive spin you can put on the war on drugs," said Dr. Evan Wood, founder of the International Center for Science in Drug Policy. "You have a $320 billion illegal market, the enrichment of organized crime, violence, the spread of infectious disease. This declaration coming from the scientific community is long overdue. The community has not been meeting its ethical obligations in terms of speaking up about the harms of the war on drugs."

Stating that governments and international organizations have "ethical and legal obligations to respond to this crisis," the declaration calls on governments and international organizations, including the UN to:

  • Undertake a transparent review of the effectiveness of current drug policies.
  • Implement and evaluate a science-based public health approach to address the individual and community harms stemming from illicit drug use.
  • Decriminalize drug users, scale up evidence-based drug dependence treatment options and abolish ineffective compulsory drug treatment centers that violate the Universal Declaration of Human Rights.
  • Unequivocally endorse and scale up funding for the implementation of the comprehensive package of HIV interventions spelled out in the WHO, UNODC and UNAIDS Target Setting Guide.
  • Meaningfully involve members of the affected community in developing, monitoring and implementing services and policies that affect their lives.
  • We further call upon the UN Secretary-General, Ban Ki-moon, to urgently implement measures to ensure that the United Nations system -- including the International Narcotics Control Board -- speaks with one voice to support the decriminalization of drug users and the implementation of evidence-based approaches to drug control.

"This is a great initiative," enthused Ethan Nadelmann, executive director of the Drug Policy Alliance. "It is the most significant effort to date by the sponsors of the global AIDS conference to highlight the destructive impact of the global drug war. It is nicely coordinated with The Lancet to demonstrate legitimacy in the medical community. And it is relatively far reaching given that the declaration was drafted as a consensus statement."

"This is aimed at politicians, leaders of governments, the UN system, and it's aimed at housewives. We are trying to do basic education around the facts on this. There are still politicians who get elected vowing to crack down on drugs," said Wood. "While the declaration has a global aim and scope, at the end of the day, the person who is going to end the drug war is your average voter, who may or may not have been affected by it," he said.

"This was needed a long time ago," said Wood. "The war on drugs does not achieve its stated objectives of reducing the availability and use of drugs and is incredibly wasteful of resources in locking people up, which does little more than turn people into hardened criminals," he said.

The authors are hoping that an official declaration broadly endorsed will help begin to sway policy makers. "It will be interesting to see what kind of support it receives," said Wood. "Former Seattle Police Chief Norm Stamper has endorsed it, and we have a 2008 Nobel prize winner for medicine on the web site. There are high level endorsements, and more are coming. Whether we touch a nerve with the news media remains to be seen. I am hoping it will have a big impact since this is the official conference declaration of one of the largest public health conferences on the planet."

"We have reached a tipping point in the conversation about drugs, drug policy, drug law enforcement, and the drug war," said Stamper, now a member of Law Enforcement Against Prohibition. "More and more, science has found its way into the conversation, and this is one step to advance that in some more dramatic fashion. I've heard much from the other side that is emotional and irrational. This is one effort to create even more impetus for infusing this dialogue on drug policy with evidence-driven, research-based findings."

That the AIDS conference is being held in Vienna adds a special fillip to the declaration, Wood said. "Vienna is symbolically important because it is where the infrastructure for maintaining the global war on drugs is located," said Woods, "and also because of the problems in Eastern Europe. In Russia, it's estimated that one out of every 100 adults is infected with the AIDS virus because Russia has not embraced evidence-based approaches. Methadone maintenance therapy is illegal there, needle exchanges are severely limited, the treatment programs are not evidence-based, and there are all sorts of human rights abuses around the drug war."

With the AIDS conference set to open July 18, Wood and the other authors are hoping the momentum will keep building up to and beyond. "It is my hope that now that the Vienna Declaration is online, large numbers of people will come forward and lend their names to this effort," he said.

The Vienna Declaration is one more indication of just how badly drug war orthodoxy has wilted under the harsh gaze of science. It's hard to win an argument when the facts are against you, but as the declaration notes, there are "those with vested interests in maintaining the status quo." The declaration should make their jobs that much more difficult and bring progressive approaches to drug policy that much closer.

UNODC: The Russians Are Coming

[Update, 6:20pm EST: Peter Sarosi at HCLU just told me Ban Ki-moon has indeed picked Fedotov. Hence I have removed the question mark from the end of the title of this article. :( - DB]

Current head of the UN Office on Drugs and Crime (UNODC) Antonio Maria Costa is set to end his 10-year term at the end of this month, and according to at least one published report, a Russian diplomat has emerged as the frontrunner in the race to replace him. That is causing shivers in some sectors of the drug reform community because the Russians are viewed as quite retrograde in their drug policy positions.

The report names Russia's current ambassador to the United Kingdom, Yuri Fedotov, as the top candidate to oversee UNODC and its $250 million annual budget. Other short-listed candidates include Spanish lawyer Carlos Castresana, who headed a UN anti-crime commission in Guatemala, Colombian Ambassador to the European Union Carlos Holmes Trujillo, and Brazilian attorney Pedro Abramovay. The final decision is up to UN Secretary General Ban Ki-moon.

If Fedotov wins the position, Russia would be in a far more influential position to influence international drug policy, and that is raising concerns because of Russia's increasingly shrill demands that the US and NATO return to opium eradication in Afghanistan, its refusal to allow methadone maintenance and its refusal to fund needle exchange programs even as it confronts fast-growing heroin addiction and HIV infection rates.

The concerns have crystallized in a campaign to block his appointment, including a Facebook group called We Don't Want A Russian UN Drug Czar!, which is urging people to send an email message to that effect to Secretary General Ki-moon. Group organizers the Hungarian Civil Liberties Union have also produced a video on the subject:

Feature: Schwarzenegger Trying to Gut California Methadone Funding in Budget Move

With California facing a $19 billion budget deficit, Gov. Arnold Schwarzenegger (R) last month proposed saving the state $53 million by cutting off Medi-Cal funding for methadone maintenance for most heroin addicts. That would cause the loss of more than $60 million in matching federal funds. The move was fiercely resisted by methadone advocates -- including a former drug czar -- and public policy analysts, and the proposal was defeated last week in committee votes in the state Senate and Assembly.

But California gives the governor the power to veto individual budget items, so advocates are not resting yet. Instead they are reaching out to the administration in hopes they can enlighten it and persuade the budget axe-wielding Schwarzenegger to aim elsewhere.

Schwarzenegger isn't the first top-tier elected official to go after methadone maintenance. Back in 1999, then New York City Mayor Rudy Giuliani vowed to wean all of the city's methadone patients off it in three months. While Giuliani acted for ideological rather than budgetary reasons -- he said he wanted "drug freedom," not drug dependence -- the pugnacious mayor later changed his tune, admitting the idea was "maybe somewhat unrealistic."

https://stopthedrugwar.org/files/harm-reduction-superheroes-vancouver.jpg
superheroes for harm reduction: ''Methadone Man'' public awareness campaign during last February's Olympics in Vancouver. You're needed everywhere, Methadone Man.
Currently, nearly 150 methadone clinics provide the heroin substitute to some 35,000 addicts, 55% of whom are on Medi-Cal. Advocates and treatment providers said that clinics would be forced to close if the proposal passed, affecting not only the Medi-Cal patients, but also patients who paid out of their own pockets or through private insurance to be able to get maintenance methadone.

"Methadone isn't a cure," said Roxanne Baker, president of the National Alliance of Methadone Advocates (NAMA), "but much like thyroid medication, as long as you keep taking it, it keeps your disease in check, and opiate addiction is a disease. When you mess with your brain with painkillers, it then doesn't produce the endorphins it should. It's not a matter of will power, it's a disease. You need something to replace those endorphins, whether its methadone, suboxone, or even prescription heroin, although I doubt we'll ever see that here."

Enacting the proposed cuts would be "a disaster," said Baker. "There would be no methadone programs left. More than half the patients statewide are on drug MediCal, and they wouldn't even have a place to go. A lot of these people have their lives in order. This is somebody's brother, somebody's aunt, somebody's mom. Please don't take this from us."

Last week, Clinton-era drug czar Gen. Barry McCaffrey flew into the state to hold a press conference denouncing the cut. "Dumping tens of thousands of opiate addicts back on the street would be an immediate disaster to law enforcement, and to the families of people who have become stable, functioning adults" thanks to methadone, said McCaffrey, who has a consulting firm and serves on the board of directors of an organization that treats chemical dependency.

Legislators were listening, not only to McCaffrey, but to the methadone treatment community. A Senate Budget Committee hearing last week proved tough going for Schwarzenegger's representatives.

"This measure would eliminate the drug MediCal program with the exception of the perinatal and youth funding," said John Wardlaw from the state Department of Finance. "This is not an easy reduction in any way. We are at the point where we are making very difficult reductions."

Committee Chair Denise Moreno Ducheny (D-San Diego) wasn't buying it. "How much federal funding are you giving up?" she asked.

"Sixty-six million dollars," Wardlaw said.

"We save $53 million and lose $66 million?" asked Ducheny.

"That is correct, ma'am."

Ducheny just stared at him for a few uncomfortable moments before moving on to the next witness.

"There would be cost shifts in the area of corrections and child welfare services," Greg Tallivant of the legislative analysts' office told the solons. "The day the clinic closes, those people have to do something. If they can't make it to the next methadone clinic, heroin would be the next choice. You would see people arrested. You would see prison costs and child welfare costs go up."

Assemblyman Mark Leno (D-San Francisco) was visibly irritated by the proposal. "There is a complete lack of interest in any cost-benefit analysis here," he said. "This is reckless and cavalier. It doesn't really make much sense. We have 171,000 people addicted to drugs. This will increase our crime rate; it's a recipe for disaster on our streets. Does the governor have no interest in this or does he not believe that this will impact the safety of our children and communities? We've already zero-funded the base Proposition 36 program. The outcome of this is to have drug offenders with no jail and no treatment."

"This is really a short-sighted proposal that shifts costs from funding treatment to funding law enforcement, jails, and prisons," said Jason Kletter, a member of the Bay Area Addiction Research Team (BAART), which is in turn a member of California Opioid Maintenance Providers (COMP), a nonprofit organization representing opioid maintenance treatment centers. "It is a public safety issue, to say nothing of the humanitarian crisis it would provoke," he said.

"We think if this happened many clinics would close, and the folks who lose access to care would likely relapse and cost the system much, much more in a short time," said Kletter. "We see relapse rates of 80% within a year when clinics close, so it wouldn't even be like we'd be kicking the can three or four years down the road."

"This would have the biggest impact on programs that have a high percentage of Medi-Cal beneficiaries in treatment and would be unable to stay open because more than half their patients, and thus, their revenues, are gone," said Kletter. "You would have a fundamental dismantling of the system."

The cost incurred would be staggering, Kletter said."If 80% relapse in same year, we know that the state will incur $700 million to $1 billion in new costs in the criminal justice system," he said, citing a study from the 1990s that found each dollar invested in treatment produced a seven-dollar return. "The state wants to save $53 million by eliminating drug Medi-Cal and will also turn away more than $60 million in matching funds. That's $115 total program cost. A seven-to-one return on that is close to a billion dollars. "With 80% relapse, we could end up seeing $700 million in new criminal justice and prison costs."

"It's a terrible proposal," said Glenn Backes, a Sacramento-based public policy analyst who works with the Drug Policy Alliance at the Capitol. "California Democrats in both houses have said so. The Senate Republicans didn't do a cost-benefit analysis; they just said we can't afford to give out subsidized health care."

But in reality, the situation is even worse, said Backes. "They've killed Proposition 36 funding, drug courts are being slashed. According to the governor's finance director, that's 171,000 patients. The cost-benefit for this is worse than nil. If only one out of a thousand relapses and goes to prison, you've already lost money because prison is so much more expensive than treatment. If only one out of a thousand gets Hep C, the taxpayer loses. If only one out of a thousand gets HIV, the taxpayer loses."

It's easy to lose the human side in all the numbers, Backes said. "If only one out of a thousand ODs and dies, that's 170 California families who have lost a loved one."

And the battle continues. "While both the Senate and the Assembly budget committees have rejected the governor's proposal, in California, the governor has a line item veto," said Kletter. "We are continuing to try to work with the administration to explain the impact of this kind of proposal and get them to understand it is a public safety and cost-shifting issue. We haven't had any direct meeting with them yet, but that's next on our agenda. We want to educate them about them dire consequences of this sort of action."

Even if advocates many to salvage the drug Medi-Cal program, they would be well-advised to be searching for alternative funding sources, and how better than to take money from the drug war? Tough times call for creative solutions, and Backes has one: Use federal Byrne Justice Assistance Grants to fund treatment instead of drug task forces. Every dollar funding more drug war arrests costs $10 additional in spending for courts and prisons, he said.

"Historically, Byrne grant funds have been given to task forces to increase arrests," Backes noted. "The Drug Policy Alliance position is that Byrne funds would be better spent on almost anything other than doing low-level drug sweeps. We would rather see that money go into treatment for people in the system."

Feature: New York Post's Attack on "Heroin How-to" Harm Reduction Pamphlet Fails to Get It Dropped

Harm reduction in New York City came under attack last weekend when the tabloid New York Post ran an article titled Heroin for Dummies, excoriating the city for spending $32,000 for a 2007 harm reduction pamphlet that, among other things, gave injection drug users advice on how to reduce the harm of injecting. Since then, the story has been picked up by the New York Times and national media, including CNN and Fox News.

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uncomfortable, but the right thing to do
But while the assault on evidence-based harm reduction practices is worrisome, it also sparked a vigorous defense of the pamphlet from Mayor Michael Bloomberg and city health officials and has provided an opportunity to broaden public awareness of harm reduction. By Thursday, despite demands that they be pulled, Health Commissioner Thomas Farley had decided that the pamphlets will continue to be distributed.

The pamphlet, Take Charge, Take Care, was distributed by the city's Department of Health and Mental Hygiene and was aimed at injection drug users in the city. The harm reduction purpose behind it was to save lives and prevent overdoses and the spread of blood-borne disease. It counsels things like quitting, not sharing needles, and seeking treatment.

But also included in its advice were things like "Find the vein before you try to inject," "If you don't register [hit the vein], pull out and try again," and "Warm your body (jump up and down) to show your veins." Such common-sense harm reduction advice was like waving a red flag for Post and the drug warriors it interviewed.

"It's basically step-by- step instruction on how to inject a poison," said John Gilbride, head of the DEA's New York office. "It concerns me that the city would produce a how-to on using drugs," Gilbride said. "Heroin is extremely potent. You may only get the chance to use it once. To suggest there is a method of using that alleviates the dangers, that's very disturbing."

"It's sick," said City Council member Peter Vallone Jr. (D-Queens), chair of the council's public safety committee, who vowed to try to shut down distribution of the pamphlet. "This is a tremendous misuse of city funds, and I'm going to see what I can do to stop it. It sends a message to our youth: give it a try," he fumed.

"What we do not want to do is suggest that there's anything safe about shooting up narcotics," said Bridget Brennan, the city's special narcotics prosecutor. "No matter how many times you wash your hands or how clean the needle is, it's still poison that you're putting in your veins."

Only at the very end of the Post article was any supporter of harm reduction or the pamphlet given a say. "Our goal is to promote health and save lives with this information," explained Daliah Heller, assistant commissioner for the Bureau of Alcohol and Drug Use Prevention, Care and Treatment. "From a health perspective, there is a less harmful way to inject yourself."

The New York Times article the following day was less one-sided than the Post's hit piece, but still gave Vallone and other critics top billing. "You're spending taxpayer money and getting a how-to guide for first-time users," Vallone claimed.

The pamphlet was "absolutely not" a how-to manual, Dr. Adam Karpati, executive deputy commissioner for the health department's division of mental hygiene, told the Times. "Our primary message, as it is in all our initiatives, is to help people stop using drugs and to provide them with information on how to quit," Karpati said, adding that health officials recognized that quitting was not a realistic expectation for all drug users.

While Karpati was playing defense, harm reduction supporters went on the offensive. "The Health Department's booklet is solidly grounded in science and public health," said Ethan Nadelmann, executive director of the Drug Policy Alliance. "But the same cannot be said of the irresponsible comments by John Gilbride, Bridget Brennan, and Peter Vallone, Jr. These sorts of reckless statements by top level city and federal law enforcement agents need to be repudiated by their superiors in city and federal government."

On Monday, Mayor Bloomberg defended the pamphlet. "I would certainly not recommend to anyone that they use hard drugs or soft drugs," Bloomberg said. "But our health department does have an interest in if you're going to do certain things to get you to do it as healthily as you possibly can."

Now that the flap is behind them, two leading harm reductionists are assessing what it all means. "There was a political agenda at work with this," said Allan Clear, head of the Harm Reduction Coalition. "The District Attorney's Office fed this to the Post. This is a deliberate attack, and it follows on the footsteps of Rockefeller drug law reform, where DAs had some of their power stripped away. This was a red rag for foes to wave to provoke people, when the amount spent on the brochure is relatively small."

"This was not a book for people who have never injected," said Robert Heimer, professor at the Yale School of Public Health. "We know that people use opiates for around three years before they start injecting, and they don't do it because of a pamphlet, but because they are following their friends' example. This pamphlet was distributed at needle exchanges, STD clinics, drug treatment centers, and to people leaving Rikers Island. That's who the audience is, not people who have never injected."

Neither Clear nor Heimer thought much of the press coverage, although Clear was more charitable to the Times than Heimer. "The brochure has been deceptively portrayed consistently in all the articles," said Clear. "This is a manual aimed at people who are using injection drugs. The first thing it says is if you want help, call this number. If you compare the articles in the Post and the Times, the anti-drug user invective in the Post was just horrendous and demonstrated a very biased position to begin with," said Clear. "The conversation in the Times was much more pro-public health and sympathetic."

"The Times article was incredibly negative," said Heimer. "The first eight or ten paragraphs were all the opposition, and only after that do you get to the health department and why it's a common sense public health approach. When you have 'liberal media' like the Times and rightwing Murdoch papers like the Post both condemning you, you are under a lot of pressure to change."

When all is said and done, did the pamphlet flap turn out to be a boon or a bane for harm reduction? Again, the two men differed.

"When you get this on Fox News or CNN and people are talking about it, even though the initial effort was to discredit the brochure, it actually brought harm reduction to public consciousness in a good way," said Clear. "While we feel attacked, there has been a lot of positive response, and this has raised the profile of harm reduction and the need to educate drug users. The public reaction hasn't been that bad; in fact, it's been quite good."

"Any time there is negative press, it's not good for harm reduction," said Heimer. "It's still fragile here. In places like Holland, Britain, Canada, and Australia, harm reduction is one of the four pillars -- prevention, treatment, law enforcement, harm reduction -- but in this country, very little is done about prevention, there is not enough drug treatment because there is not enough emphasis on demand reduction, and we spend all our money on supply reduction, and we know how that has worked."

Congress: Budget Deal Includes Series of Drug Reform Victories

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

https://stopthedrugwar.org/files/capitolsenateside.jpg
US Capitol, Senate side
What the conference committee approved:

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

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

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

Its description of the DC appropriations language:

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

And its language on the youth media campaign:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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