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Chronicle Book Review: "The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture," by Richard De Grandpre (2007, Duke University Press, 294 pp., $24.95 HB)

Phillip S. Smith, Writer Editor
Phil Smith
Ritalin is a popular stimulant used to control the behavior of hyperactive children. It is legal, widely prescribed, and much adored by many parents and educators. Cocaine is an illegal stimulant, harshly penalized, and is reviled by the guardians of the common good. Yet Ritalin and cocaine act on the brain in a very similar fashion. In laboratory experiments, subjects -- human and animal -- do not differentiate between the two. So why is one legal and accepted and the other illegal and proscribed?

In other lab experiments, heroin users falsely told that their doses were being reduced reported withdrawal symptoms. Conversely, heroin users told their doses were being maintained when they were really being reduced showed no withdrawal symptoms. What's up with that?

In "The Cult of Pharmacology," drug researcher, former fellow at the National Institute on Drug Abuse, and author of "Ritalin Nation" Richard De Grandpre takes a serious crack at answering those questions. In a fascinating and provocative read, De Grandpre provides an illuminating social history of drug use in America, an eye-opening window into the legal drug industry, and a harsh, Szaszian critique of the increasingly popular disease model of addiction.

With American politicians poised to make the disease model of addiction official dogma by congressional fiat -- Sen. Joe Biden's (D-DE) bill that would define addiction as a brain disease is moving on Capitol Hill -- De Grandpre's intervention into the never-ending drug debate in America couldn't be more timely. Biden, along with a large portion of the biopharmacological research community and the American public in general are what De Grandpre would call victims of "the cult of pharmacology."
What is that? While in days of yore, drug actions were considered the work of spirits or demons, we have advanced beyond such silliness through science, right? We know that psychoactive drugs affect the brain in certain ways, right? Well, maybe not. In De Grandpre's own words:

"As a drug ideology derived from the eternal notion that psychoactive compounds contain a unique spirit or essence, the cult of pharmacology legitimized the belief that these spirits bypassed all social conditioning of the mind and by themselves transform human thought and action. Unlike other worldly modes of influence on mind and human experience, and despite many advances in the pharmacological sciences in the twentieth century, psychoactive substances continue to be treated in the main as spirits that could enter into a body and take possession of it. Yes, soul was transformed into mind and spirit into biochemistry, giving the appearance that science and medicine had done away with the myths surrounding what had come to be called 'drugs.' Drugs were not demythologized, however, but rather remythologized. Psychobabble and biobabble replaced magical explanations of drug action, creating what had become by the end of the century a new, molecular pharmacologism."

As De Grandpre illustrates with the heroin experiments, among many others, neither people nor lab animals necessarily respond to drugs in the predictable manner expected by the disease model. One of the most striking and well-known lab animal experiments gave monkeys unfettered access to cocaine, which some used until they killed themselves. But a much lesser known and remarked upon follow-up found that when the animals were given a chance to select another stimulus -- sugared water -- their cocaine use dropped dramatically.

I can't help thinking of the current wave of methamphetamine use and its destructive consequences in this context. As De Grandpre points out, Americans gobbled down billions of amphetamine tablets from the 1940s through the 1970s (when they were restricted, only to be replaced a few years later by Ritalin) without the horrid consequences that seem to obtain among tweakers these days. It's not the drugs that have changed -- amphetamines are amphetamines, and methamphetamine is an amphetamine -- but the social context and what De Grandpre calls the "placebo text" -- the set of beliefs one carries about how the drug is supposed to affect you -- that have changed.

Like lab rats in a sterile environment with no stimulus except cocaine, today's tweakers, and I'm speaking of the stereotypical Western and Midwestern poor, rural, white users (who as a South Dakotan I know well), may be so tweaked out not because of the pharmacological properties of the demon drug meth, but because of their sterile social environment and dim prospects… and because that's how meth's placebo text tells them to respond to the drug.

My mother and millions of women like her, on the other hand, took methamphetamines in the 1960s as a diet aid -- not a recreational drug -- and responded quite differently. Yes, she cleaned house like crazy and got pretty chatty, but she did not become "addicted" to the drug, nor did she engage in the kind of pathological behaviors associated with tweakers. Instead, she quit using it because she didn't like the fact that it kept her up at night.

Perhaps, as De Grandpre concedes, it is not only set and setting that make the difference. While he doesn’t directly discuss the pharmacodynamics of meth, in his discussion of Ritalin and cocaine, he notes studies suggesting that the manner of ingestion of the drug (oral, say, versus injected or smoked) can have an effect on the drug user's experience. My mother wasn't shooting up or smoking speed, she was popping little yellow pills.

Was it the placebo context that kept my mother from tweekerdom? Was it the fact that she swallowed pills instead of injecting powders? Or that she took small doses instead of large ones? We don't know. What De Grandpre convincingly argues is that we do (or should) know that it is not something deterministically inherent in the methamphetamine molecule that caused her (and millions of other slightly overweight women in the 1960s and 1970s) to walk away from it, but made poor, rural, white people into tweakers in the 1990s and 2000s.

My mother was fortunate. Her drug use was sanctioned. If she had been taking the same drugs illegally, she would have faced prison. As De Grandpre notes, that's because the last century saw a bifurcation in dealing with drugs: Some drugs -- notably heroin, cocaine, and marijuana -- are "demon drugs," full of pharmaceutical malice, ready to enslave the unwary user, while others, notably the prescription pharmaceuticals, are "angel drugs," here to save us from the troubles of the day with their molecular magic.

We can thank the American Medical Association and the pharmaceutical industry for that, according to De Grandpre. Rather than being rivals for market share, as was the case in the era of patent medicines before the Food and Drug Act of 1906, the two groups decided to split the booty. The pharmaceutical companies would develop and market psychoactive drugs and the doctors would sanction and prescribe them as "ethical medicines" as opposed to dangerous drugs.

This historical process gave rise to "differential prohibition," or the demonizing of some drugs and the sanctifying of others -- even if, like Ritalin and cocaine, they are essentially the same thing -- as well as to the two faces of an authoritarian state: the therapeutic state that classifies drug taking as a disease and wants to treat it, often with other drugs and the prohibitionist state that sees drug use as immoral and wishes to punish it.

There is much, much more to "The Cult of Pharmacology." Even as a wizened veteran of the drug scene, there is much that challenges my beliefs and preconceptions about drugs and their interactions with humans. De Grandpre's theses may be controversial and even unpopular in this period when much of the mainstream political discourse seems to consist of calling for treatment instead of prison and for dealing with drug "addicts" as victims instead of miscreants. But he should definitely be read by anyone concerned with drug policy in America and why it's gone so terribly awry.

Feature: Is Addiction a Brain Disease? Biden Bill to Define It as Such is Moving on Capitol Hill

A bill introduced by Sen. Joe Biden (D-DE) that would define addiction as a brain disease is moving in the Senate. Treatment professionals, mainstream scientists, and recovery advocates see it as a good thing. There are some skeptics, though.
NIDA book cover, with brain scan image
The bill, the Recognizing Addiction as a Disease Act of 2007 (S. 1011), would also change the name of the National Institute on Drug Abuse (NIDA) to the National Institute on Diseases of Addiction, and change the name of the National Institute on Alcohol Abuse and Alcoholism to the National Institute on Alcohol Disorders and Health.

"Addiction is a neurobiological disease -- not a lifestyle choice -- and it's about time we start treating it as such," said Sen. Biden in a statement when he introduced this bill this spring. "We must lead by example and change the names of our federal research institutes to accurately reflect this reality. By changing the way we talk about addiction, we change the way people think about addiction, both of which are critical steps in getting past the social stigma too often associated with the disease. This bill is a small but important step towards stripping away the social stigma surrounding the treatment of diseases of addiction," said Sen. Biden.

The measure is garnering bipartisan support. It passed out of the Senate Health, Education, Labor and Pensions (HELP) committee in June with the backing of Sen. Mike Enzi (R-WY), the ranking minority committee member. "Science shows us the addiction to alcohol or any other drug is a disease," Enzi said in a statement marking the vote. "While the initial decision to use drugs is a choice, there comes a time when continued use turns on the addiction switch in the brain. That time can vary depending on factors ranging from genetics to environment to type of drug and frequency of use. Because of that and the continued stereotypes and challenges that are often barriers to people with addiction issues seeking treatment I am proud to support this legislation. Although the names of the Institutes will change, their mission -- preventing and treating drug and alcohol addiction -- will remain the same."

The politicians are taking their cue from neurological researchers led by NIDA scientists who have been working for years to find the magic link between the brain and compulsive drug use. Dr. Nora Volkow, current head of NIDA, has been leading the charge, and Biden and Enzi could have been reading from her briefing book.

"Drug addiction is a brain disease," said Volkow in a typical NIDA news release. "Although initial drug use might be voluntary, once addiction develops this control is markedly disrupted. Imaging studies have shown specific abnormalities in the brains of some, but not all, addicted individuals. While scientific advancements in the understanding of addiction have occurred at unprecedented speed in recent years, unanswered questions remain that highlight the need for further research to better define the neurobiological processes involved in addiction."

Not surprisingly, the treatment and recovery communities, anxious to see the social climate shift to one of more support and less punishment for the addicted, support the legislation. "Recognizing addiction is the next step forward," said Daniel Guarnera, government relations liaison for the NAADAC -- The Association for Addiction Professionals. "NIDA and its scientists have demonstrated overwhelmingly that addiction is not a behavioral trait, but rather is caused by physiological changes to the body that make people want to use addictive substances. This bill allows the terminology to catch up with the science."

Although the bill does little more than make a congressional pronouncement and rename a couple of institutes, it is still an important step, said Guarnera. "Yes, it's symbolic, but that symbolism is hugely important, because language should reflect medical knowledge, and medical knowledge has demonstrated that drug abuse is a physical phenomenon."

"We utterly endorse this bill," said Pat Taylor, executive director of Faces and Voices of Recovery, a treatment and recovery advocacy umbrella organization. "I think it's a great idea to rename the agencies. People with drug and alcohol problems can and do recover from addiction. Calling them 'abusers' just stigmatizes them."

Taylor and her organization are actively supporting the bill, she said. "We've sent letters of endorsement for the bill," she said. "People blame people for their drug and alcohol problems, so this is an important issue for the recovery community. We need to rethink how we talk about this."

Is addiction in fact a brain disease? Some researchers think that's too simple. Scott Lilienfeld, a professor of psychology at Emory University told ABC News last week: "What I find troubling with the brain disease rhetoric is that it's grossly oversimplified, it boils down an incredibly complex problem to not necessarily the most important explanation. You can view a psychological problem on many levels. Low level explanation refers to molecules in the brain. There are other levels including people's personality traits and moods, people's parents, environment. Higher level than this is community."

"Every level tells you something useful," Lilienfeld continued. "Brain disease is only one level among many and not even the most helpful. Implying it's the only level of explanation, that's counterproductive."

Some mavericks go even further. "No, addiction is not a brain disease," said Dr. Jeffrey Schaler, a psychologist and professor in the Department of Justice, Law and Society at American University in Washington, DC, and author of "The Myth of Addiction." "Diseases are physical wounds, cellular abnormalities. Addiction is a behavior, something that a person does. Diseases are things a person has," he argued.

"You can't will away a real disease," Schaler continued. "But people will away behaviors they don't like all the time."

Others feel that the concept of addiction itself is too imprecise. "There is no clear conception of what people mean by the word 'addiction,' and there are numerous papers on this unsatisfactory concept," said Professor John Davies, head of the Center for Applied Social Psychology at the University of Strathclyde in Scotland, another prominent critic of the "addiction is a brain disease" model. Using drugs and 'addiction' are not synonymous," Davies continued, noting that many "fun drug users" become "addicts" as soon as they end up in court.

"Of course, people can and do get into an awful mess when they fail to manage their habit effectively," Davies concedes. "But look at the data. Harmful damaging drug use is heavily social-class related whereas drug use per se is less so. People give up the so-called 'disease' when their lives change, they get a new partner, a new job, a move of house."

"Sen. Biden's crusade is part of a decades-long, political struggle to isolate drug habits in users and to obscure the social and historical factors that ultimately underline so-called drug problems," said Richard De Grandpre, author of "The Cult of Pharmacology: How America Became The World's Most Troubled Drug Culture" (see review here next week), citing the case of the Vietnam war veterans who picked up opiate habits, but who, for the most part, rapidly shed them upon returning home.

"These vets used chronically and were said to be addicted. What happened to their addictions?" De Grandpre asked. "The feared epidemic did not materialize because the social factors that sustained heroin use in Vietnam had all but disappeared upon returning."

Davies sees the addiction label as having pernicious consequences for problem users as well. "It makes things far worse," he said. It makes people believe that the roots of their behavior are beyond their capacity to control, which is the last thing you need when you're trying to get someone to change their behavior."

How should drug policy reformers (e.g., those concerned first and foremost with loosening prohibitionist drug policies) respond to the Biden bill? Rhetorically, both the "disease" and "choice" models have been used repeatedly to justify draconian policies -- the former at drug sellers, who mostly are not kingpins or monsters seeking to addict children to their goods, but get charged as such in the court of public opinion -- the latter at problem users, or even users in general, because they should just stop, because it's a choice.

"I tend to think that language changes that reduce the fuel in the drug discussion will help rather than hurt our cause," said David Borden, executive director of Stop the Drug War (DRCNet, publisher of this newsletter). "Terms like 'Diseases of Addiction' pack less verbal or rhetorical punch than shorter ones like 'Drug Abuse,' and are less useful for purposes of political propaganda. If the names of the agencies shift, the language coming out of the agencies will also have to shift, at least somewhat, and that will help -- it will be harder for politicians to focus their rhetoric on nonsense statements like 'all use is abuse,' if 'abuse' is no longer the government-endorsed term of choice in the discussion."

"Those are political concerns, however," Borden pointed out. "If 'disease' is a scientifically imprecise term for describing the set of conditions that are commonly known as 'addiction' -- and it seems to me that it probably is -- then Congress and NIDA probably shouldn't be using the term for that purpose. I'd be more comfortable with the bill if it used slightly different language." Still, he thinks it's probably a net positive. "I think the obvious message of the terminology shift would be to say that people with drug problems are not really criminals, and that's a good thing."

"Plus if addiction isn't a disease, there's still obviously some condition that some people have, physical for at least some of them, that makes it harder for them to make favorable choices," Borden added. "Otherwise I don't think there would be thousands of people risking arrest or overdose to inject themselves daily with heroin, or millions knowingly doing what they're doing to themselves with cigarette smoking. So I'm not sure that the imprecision in the term chosen for the discussion is such a big problem."

Schaler disagrees. "Drug policy reformers play into the hands of the therapeutic state when they support the idea that drug addiction is a treatable disease," he said. "It means doctors have more power over people instead of just drug agents."

In principle, neither Congressional fiat, nor therapists' concerns over what the right message is to send to patients, nor advocates' concerns over what will ultimately lead to better policies, should take a second seat in this debate -- the question is fundamentally a scientific one, and a philosophical one. With Congress holding the purse strings for the bulk of addictions research in this country, however, Congress' choices now may indeed affect the language being used in the future for some time to come. And language can indeed have an impact in ways going beyond its initial purposes.

Drug War Chronicle Book Review: "The Heroin Solution" by Arnold Trebach (2nd ed., 2006, Unlimited Publishing, 330 pp., $19.99 pb.)

Phillip S. Smith, Writer/Editor

(Click here to order "The Heroin Solution or other books by Arnold Trebach through DRCNet's latest book offer.)

When "The Heroin Solution" was first published by Yale University Press a quarter-century ago, it got rave reviews from the likes of the New York Times and Publishers Weekly. It was a mindblower. For the vast majority of readers, Arnold Trebach opened a window into an astonishing world they had never before imagined, one where -- gasp! -- doctors, not policemen, dealt with heroin and heroin users.
Trebach, who from his base at American University began influencing a generation of disciples and who founded the Drug Policy Foundation (the progenitor of the Drug Policy Alliance) in 1986, is now known as the grand old man of the American drug reform movement, and the success of "The Heroin Solution," along with his 1987 "The Great Drug War," played a big role in cementing that reputation.

What Trebach did in the "Heroin Solution" was tell three interwoven stories: the story of heroin, the story of the American approach to heroin, and the story of the British approach to heroin. For many, that book was an awakening, a realization that there was an alternative to what by 1982 was already being reviled as an atrocious and failing policy of prohibition and repression. Where the American system denied that heroin had any medical utility whatsoever and jailed physicians, junkies, and hapless pain patients alike, the British system was kinder and gentler, with doctors given considerable latitude to prescribe heroin even -- and especially -- in cases where they knew they were only allowing their patients to maintain their addiction.

Now, "The Heroin Solution" is out in a second edition, the last volume of the "Trebach Trilogy," which also includes the reprinted "The Great Drug War" and last year's "Fatal Distraction." But this edition of "The Heroin Solution" is not a substantive reworking of the material; the only addition to the original volume is a new preface.

It still makes timely and compelling reading, but the reason why is hardly good news. "The Heroin Solution" is still relevant because we have progressed so little since it was written. The issues Trebach addressed in 1982 are, in many cases, the same issues we face today. Much has happened, but little has changed, and much of what has changed has changed for the worse.

In Britain, which Trebach described as a model of an enlightened (if not perfect) approach to heroin, the heavy hand of the state and governing medical bodies has slowly shrunk the space in which doctors may prescribe heroin. When Trebach wrote, probably a few thousand British addicts were being prescribed heroin; in his new preface, he estimates that perhaps 500 are. For all the talk of opiate maintenance in Britain, it seems like for the past quarter-century it seems like it's been one step forward, one step back.
Arnold Trebach at 2003 press conference on which DRCNet collaborated
Trebach decried the cruel and inhumane treatment of physicians and pain patients alike in "The Heroin Solution." If anything, the problem has gotten worse in the intervening quarter-century. One thing the book offers, though, is some perspective. The latest round of pain doctor persecutions smell remarkably similar to those of doctors Trebach mentioned operating back in the 1930s. It's a similarity Trebach notes himself in his preface to the new edition, where he cites the case of Dr. William Hurwitz, who just weeks ago was convicted again on federal drug charges for loose prescribing practices and faces possible decades in prison. (He's already been in for two years.)

Trebach asked in 1982 where America found itself nearly seven decades after passage of the Harrison Narcotics Act, and was not happy with the answer. It's much worse now. Back then, Trebach complained that the federal government spent $6 billion fighting the drug war in the 1970s; now $6 billion would fund the federal drug war for about three months. Since then, the prison population of the United States and the number of drug prisoners has gone through the roof. You know the drug war litany.

Trebach does, too, and that is part of the reason his thinking about drug prohibition has evolved over time. When he wrote "The Heroin Solution" in 1982, he called only for doctors to be allowed to prescribe heroin. Now, he is a full-blown anti-prohibitionist. Lack of progress on reforming US drug policy breeds more radical responses.

A revised and updated "The Heroin Solution" would be nice. There could be new chapters on the cutting-edge work on heroin maintenance going on in Switzerland and Germany, Spain and the Netherlands; the rise of safe injection sites; the trials in Vancouver; the spread of heroin addiction in Iran, Pakistan, and the Central Asian republics; and contemporary use patterns in the West, among others.

But 25 years after it was first published, "The Heroin Solution" is still relevant, still revelatory, and still a good read. Or, as Publishers Weekly said the first time around, "A blockbuster!"

(Click here to order "The Heroin Solution or other books by Arnold Trebach through DRCNet's latest book offer.)

Pregnancy: New Mexico Supreme Court Strikes Down Law Criminalizing Drug Use By Mothers-To-Be

In a case that pitted hard-nosed legislators and prosecutors against an array of women's rights, public health, medical, and drug reform groups, the New Mexico Supreme Court ruled May 11 that a state law expanding criminal child abuse laws to include drug use by pregnant women was unconstitutional. In a summary opinion, the state high court upheld a state Court of Appeals decision that reached the same conclusion.

The ruling came in the case of Cynthia Martinez, who was charged with felony child abuse in 2003 after her newborn child tested positive for cocaine. Under the law in question, she was charged with "permitting a child under 18 years of age to be placed in a situation that may endanger the child's life or health" by ingesting illicit drugs while pregnant.

While the state argued that a pregnant woman who is addicted to drugs should be sent to jail as a felony child abuser, both the appeals court and the state Supreme Court disagreed. During oral arguments, the justices appeared to be particularly concerned about issues raised in an amicus curiae brief submitted by the Drug Policy Alliance and National Advocates for Pregnant Women on behalf of nearly three dozen other leading medical and public health organizations, physicians, and scientific researchers. The justices repeatedly mentioned the DPA/NAPW brief and expressed grave concerns about the deterrent effect such prosecutions would have on women seeking prenatal care.

Such rulings are critical to avoid criminalizing poor women, said NAPW staff attorney Tiloma Jayasinghe. "Making child abuse laws applicable to pregnant women and fetuses would, by definition, make every woman who is low-income, uninsured, has health problems, and/or is battered who becomes pregnant a felony child abuser," she explained. "In oral argument, the state's attorney conceded that the law could potentially be applied to pregnant women who smoked."

Szczepanski said, "I hope that this case serves as a reminder that pregnant women who are struggling with drug use should be offered prenatal care and drug treatment, not prosecution. There are better ways to protect our children in New Mexico, and ensure that future generations will be safe and healthy."

Fighting Meth With Misinformation in Idaho

There is no question that methamphetamine is a potentially dangerous drug. Communities that take steps to prevent people from starting to use it in the first place are to be lauded. But if such efforts are to be credible with their target audiences, they need to include accurate information, not scary, demonizing distortions. Unfortunately, Blaine County, Idaho, is not doing that. In a new brochure from the Blaine County Sheriff's Office and the Community Drug Coalition written by a sheriff's office employee, comes the following amazing claim:
"One of the biggest dangers of meth is how quickly people can become addicted to it," the brochure says. "The National Methamphetamine Awareness Campaign says that 99 percent of people are hooked on meth after using it the first time."
Oh, come on. Yes, people can become dependent on meth. Yes, it is a drug whose biopharmacological effects make people want to binge on it. But no, 99% of people who try meth once are not hooked on it. And spewing such garbage—at taxpayer expense, no less!—is counterproductive at best. Here's what the federal government's meth resources web page has to say about methamphetamine addiction: "Long-term methamphetamine abuse results in many damaging effects, including addiction." Note that the site says long-term use, not one-time use. Neither do other federal government statistics back up the 99% claim. The 2005 National Survey on Drug Use and Health, the most recent available, notes that 10.4 million people over the age of 12 reported using meth at least once in their lives, but only 512,000 reported current (last month) use. Even if we assume that everyone who reported using within the last month is an addict (and that's not a very reasonable assumption), we find that only about 5% of people who ever used meth are currently addicted. It is possible, I suppose, that the remaining 93% of all meth users ever got strung out on their first line, but have since managed to beat the addiction. If that's the case, which I doubt, they didn't get the monkey off their backs through drug treatment. In 1992, 21,000 were admitted for meth treatment; by 2004, that number was up to 150,000. But the number of people reporting using meth that year was 1.3 million. Of past year meth users, a little more than 10% got treatment in 2004, whether they sought it themselves or were forced into it. If you want to discourage people from using meth, you need to be believable. Unfortunately for Blaine County, Idaho, it has produced an anti-meth brochure that is more laughable than believable. Next they'll be telling me meth will make hair grow on the palms of my hands.
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Supreme Court of New Mexico Strikes Down State’s Attempt to Convict Woman Struggling with Addiction During Pregnancy

For Immediate Release: May 11, 2007 CONTACT: Reena Szczepanski (DPA): 505-983-3277 or Nancy Goldstein (NAPW): 347-563-1647 Supreme Court of New Mexico Strikes Down State’s Attempt to Convict Woman Struggling with Addiction During Pregnancy Leading Physicians, Scientific Researchers, and Medical, Public Health, and Child Welfare Organizations Applaud Court’s Order On May 11, the Supreme Court of the State of New Mexico turned back the state's attempt to expand the criminal child abuse laws to apply to pregnant women and fetuses. In 2003, Ms. Cynthia Martinez was charged with felony child abuse “for permitting a child under 18 years of age to be placed in a situation that may endanger the child's life or health. . .” In bringing this prosecution, the state argued that a pregnant woman who cannot overcome a drug addiction before she gives birth should be sent to jail as a felony child abuser. Today the Supreme Court summarily affirmed the Court of Appeals decision, which overturned Ms. Martinez’s conviction. New Mexico joins more than 20 other states that have ruled on this issue and that have refused to judicially expand state criminal child abuse and related laws to reach the issues of pregnancy and addiction. The Drug Policy Alliance (“DPA”) and the National Advocates for Pregnant Women (“NAPW”) filed a friend-of-the-court brief on behalf of the New Mexico Public Health Association, the New Mexico Nurses Association, and nearly three dozen other leading medical and public health organizations, physicians, and scientific researchers. During oral argument, the Justices referenced the amicus brief filed by these organizations and expressed grave concerns about the deterrent effect such prosecutions would have on women seeking prenatal care. Tiloma Jayasinghe, NAPW staff attorney, explained, “Making child abuse laws applicable to pregnant women and fetuses would, by definition, make every woman who is low-income, uninsured, has health problems, and/or is battered who becomes pregnant a felony child abuser. In oral argument, the state’s attorney conceded that the law could potentially be applied to pregnant women who smoked.” Reena Szczepanski, Director of Drug Policy Alliance New Mexico, said, “I hope that this case serves as a reminder that pregnant women who are struggling with drug use should be offered prenatal care and drug treatment, not prosecution. There are better ways to protect our children in New Mexico, and ensure that future generations will be safe and healthy.” A complete list of the Amici appears below: New Mexico Section of the American College of Obstetricians and Gynecologists New Mexico Public Health Association New Mexico Nurses Association American College of Physicians, New Mexico National Association of Social Workers National Association of Social Workers, New Mexico National Coalition for Child Protection Reform Child Welfare Organizing Project American Academy of Addiction Psychiatry The Association for Medical Education and Research in Substance Abuse American Public Health Association Citizens for Midwifery Doctors of the World-USA Family Justice The Hygeia Foundation, Inc. National Perinatal Association National Asian Pacific American Women's Forum National Council on Alcoholism and Drug Dependence National Latina Institute for Reproductive Health National Women's Health Network Our Bodies Ourselves Pegasus Legal Services for Children Physicians and Lawyers for National Drug Policy Center for Gender and Justice Yolanda Briscoe, M.D. Bette Fleishman Norton Kalishman, M.D. Eve Espey, M.D. Gavriela DeBoer Dona Upson, M.D., M.A. Elizabeth M. Armstrong, Ph.D. Wendy Chavkin, M.D., M.P.H. Ellen Wright Clayton, M.D., J.D. Nancy Day, M.P.H. Leslie Hartley Gise, M.D. Stephanie S. Covington, Ph.D., L.C.S.W. Ms. Martinez was represented by Jane Wishner of the outhwest Women's Law Center and Joseph Goldberg of the law firm of Freedman Boyd Daniels Hollander Goldberg & Ives, P.A.
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Mouth Makeovers for Meth Moms

Tonight at 10:00, The Tyra Banks Show will be giving makeovers to disfigured recovering meth addicts in a thrilling episode titled "Makeovers for Life: Meth Faces."
Tyra wrote a letter to the ladies, explaining how proud she was of them for kicking their addictions. She revealed they would all receive a life-changing makeover to erase the physical scars of their past. Their first stop was The Ora Dentistry Spa to have their teeth examined and repaired by Dr. Sam Saleh. Next, they visited top skin specialist Dr. Ava Shamban at the Laser Institute for Dermatology and Skin Care to take care of their severe skin damage. Finally, they were sent to the Warren-Tricomi Salon, where they were treated to new hair color and cuts.
I know what you're thinking. Buying a shiny new grill for a meth addict re-enforces their destructive behavior. One might ask how people will learn to stop getting wasted on meth if Tyra Banks is going around getting them dental surgery.

Well according to the Tyra Banks Show, meth chooses you, not the other way around:
From CEO’s to soccer moms, meth has no preference.
I don't know about that, but in fairness to Tyra, her approach to the meth problem makes infinitely more sense than almost anything that's been tried so far.

Next week on Extreme Makeover: Home Edition, Ty Pennington and the gang will help victims of wrong address SWAT raids re-plaster their walls and replace their slain pets with cuddly new ones.
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Lou Dobbs Sucks Live

I don't have cable, so the only way to catch the latest edition of Lou Dobbs' appalling series "The War Within" was to attend a live filming at George Washington University. The value of actually being there was limited, although it was comforting knowing I could disrupt the live broadcast if I felt I had to.

To be fair, tonight's episode was a bit less offensive than previous installments. The focus was on addiction, and despite periodic outlandish Dobbsisms about "winning the drug war" and so forth, there were many valid concerns raised. Still, for a show that promises "News, Debate, Opinion," Lou Dobbs entirely failed to provide any debate. He brought out recovering addicts and school administrators, but his primary expert guests were Nora Volkow (NIDA), Joseph Califano (CASA), and Terry Klein (SAMHSA). As far as I can tell, these people completely agree on everything from public health policy to pizza toppings.

Having just discovered that the drug war isn't working, Dobbs would do well to consult some of the experts who've been predicting failure for decades. Califano offered the startling statistic that the U.S. has 4% of the world's population, but consumes 2/3 of the world's drugs. It is of course mind-boggling to contemplate how such an observation doesn’t lead to an immediate referendum on the policies that have gotten us here.

Thus, Lou Dobbs has become a curious and increasingly common character in the drug policy discussion. He can see that nothing's changed. He wants to talk about "how to win," yet he insists on having that conversation with people who haven’t had an original idea about drug policy in their wildest dreams. Bizarrely, he interrupts the discussion of treatment to complain that our interdiction efforts are ineffective and under-funded, quickly snuffing out my faint hope that Dobbs' newfound interest in treatment would lead him to question the value of buying more helicopters to chase speedboats across the Gulf of Mexico.

Dobbs' insistence that the drug war is failing stands in stark contrast to recent ONDCP propaganda about how "America's drug problem is getting smaller," thus it's interesting to consider how a John Walters appearance on the "The War Within" would play out. If Walters could get over any potential objections to the premise of the program, he and Dobbs might have a blast plotting how to double our drug war losses.

Lou Dobbs, self-proclaimed champion of the middle-class, seems to think the solution to drug abuse is inside the wallets of American taxpayers. Guess he's got a "war within" going on right up there in his giant, ignorant head.

United States

Rokki's Education: HBO's ADDICTION Party

You're invited to my party to view HBO's groundbreaking series, ADDICTION. ADDICTION highlights recent advancements in research and effective new treatments. It highlights the experiences of individuals and their families - providing the hope of long-term recovery. Above all, it provides hope that treatment and long-term recovery is not only possible, it happens every day with the help and support of family, community, and dedicated health professionals. ADDICTION is a series of four programs that premieres from Thursday, March 15, to Sunday, March 18. In participating cable systems it will be free for the weekend. For more information, see
Fri, 03/16/2007 - 5:00pm - 7:00pm
3400 Portola Drive #A2
Santa Cruz, CA 95062
United States

'Heroin should be made legal'

United Kingdom
The Argus (UK)

Drug War Issues

Criminal JusticeAsset Forfeiture, Collateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Court Rulings, Drug Courts, Due Process, Felony Disenfranchisement, Incarceration, Policing (2011 Drug War Killings, 2012 Drug War Killings, 2013 Drug War Killings, 2014 Drug War Killings, 2015 Drug War Killings, 2016 Drug War Killings, 2017 Drug War Killings, Arrests, Eradication, Informants, Interdiction, Lowest Priority Policies, Police Corruption, Police Raids, Profiling, Search and Seizure, SWAT/Paramilitarization, Task Forces, Undercover Work), Probation or Parole, Prosecution, Reentry/Rehabilitation, Sentencing (Alternatives to Incarceration, Clemency and Pardon, Crack/Powder Cocaine Disparity, Death Penalty, Decriminalization, Defelonization, Drug Free Zones, Mandatory Minimums, Rockefeller Drug Laws, Sentencing Guidelines)CultureArt, Celebrities, Counter-Culture, Music, Poetry/Literature, Television, TheaterDrug UseParaphernalia, ViolenceIntersecting IssuesCollateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Violence, Border, Budgets/Taxes/Economics, Business, Civil Rights, Driving, Economics, Education (College Aid), Employment, Environment, Families, Free Speech, Gun Policy, Human Rights, Immigration, Militarization, Money Laundering, Pregnancy, Privacy (Search and Seizure, Drug Testing), Race, Religion, Science, Sports, Women's IssuesMarijuana PolicyGateway Theory, Hemp, Marijuana -- Personal Use, Marijuana Industry, Medical MarijuanaMedicineMedical Marijuana, Science of Drugs, Under-treatment of PainPublic HealthAddiction, Addiction Treatment (Science of Drugs), Drug Education, Drug Prevention, Drug-Related AIDS/HIV or Hepatitis C, Harm Reduction (Methadone & Other Opiate Maintenance, Needle Exchange, Overdose Prevention, Pill Testing, Safe Injection Sites)Source and Transit CountriesAndean Drug War, Coca, Hashish, Mexican Drug War, Opium ProductionSpecific DrugsAlcohol, Ayahuasca, Cocaine (Crack Cocaine), Ecstasy, Heroin, Ibogaine, ketamine, Khat, Kratom, Marijuana (Gateway Theory, Marijuana -- Personal Use, Medical Marijuana, Hashish), Methamphetamine, New Synthetic Drugs (Synthetic Cannabinoids, Synthetic Stimulants), Nicotine, Prescription Opiates (Fentanyl, Oxycontin), Psilocybin / Magic Mushrooms, Psychedelics (LSD, Mescaline, Peyote, Salvia Divinorum)YouthGrade School, Post-Secondary School, Raves, Secondary School