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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The White House: Obama on Drug Policy

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

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

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

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

Under Civil Rights:

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

Under Foreign Policy:

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

Under Rural Issues:

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

Under Urban Issues:

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

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

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

Canada: BC Local Elections Bring Another Drug Reform Mayor to Vancouver, A Drug Reform Mayor Back to Grand Forks, and a Drug Reformer to Victoria's City Council

Municipal elections in British Columbia Saturday saw Vancouver get another in a string of pro-drug reform mayors, while a marijuana reformer was returned to the mayor's office in Grand Forks in the interior, and another prominent reform advocate was elected to the city council in Victoria.

In Vancouver, the civic electoral coalition Vision Vancouver succeeded in placing its candidate, Gregor Robertson in the mayor's seat as well as sweeping eight of 11 council seats. Robertson and Vision Vancouver are strong supporters of the city's pioneering Four Pillars drug policy.

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Philippe Lucas (from vicgreens.com)
As Vision Vancouver notes in its platform, it will: "Focus on the Four Pillars to deal with drugs in our communities. Prevention, treatment, harm reduction, and enforcement are the most effective tools to make our communities safer. This includes support for InSite, a focus on access to treatment, and expanding prevention education programs."

Meanwhile, in the small interior border town of Grand Forks (pop. 5,000), former mayor and leader in Marc Emery's BC Marijuana Party Bryan Taylor was reelected. Taylor came to drug reform initially around industrial hemp but soon emerged as a leading BC Marijuana Party campaigner in the 2001 elections. He is barred from entering the US, which he can see from his hillside home outside Grand Forks, originally because he was arrested for hemp cultivation ("drug trafficking," in official US-speak). But even after the Canadian government dropped charges against him, US border control authorities continue to deny him entry, accusing him of "fraud and misrepresentation" if he fails to admit he smokes marijuana and deeming him ineligible to enter the country if he does admit it.

And on Vancouver Island, one of the Canadian drug reformers most familiar to his American counterparts, Philippe Lucas, won a seat on the Victoria city council running as a Green Party candidate. Lucas will be joined by Mayor-elect Dean Fortin, who also supports harm reduction and has vowed to find a permanent location for the city's needle exchange program.

In a Victoria radio interview after the election, Fortin said Lucas "is going to challenge the council a lot" and "will be pushing the harm reduction model."

That's no surprise. In addition to running the Vancouver Island Compassion Society, Lucas also authored the BC Green Party drug policy and substance abuse platform planks, which include calls for a legal, regulated market in marijuana. The soft-spoken but keenly focused Lucas will no doubt be a strong force for reform in Victoria.

All in all, a good day for drug reform and its advocates in British Columbia. It looks like BC will retain its position in the vanguard of drug reform in the Western hemisphere.

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

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

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

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

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

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

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

Harm Reduction: Funds Begin to Flow to DC Needle Exchange Programs

Eight months after Congress voted to end a decade-long ban on the use of federal funds for needle exchange programs (NEPs) in the District of Columbia, money is starting to flow to the programs in the city with the nation's highest rate of HIV. District officials had announced almost immediately after the congressional vote that they would fund NEPs in an effort to control the spread of the disease among injection drug users.

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PreventionWorks! at work (screen shot from nytimes.com '''slide show,'' June '07)
Now, according to the Washington Times, funding is finally reaching the city's NEPs. The city will spend $700,000 a year on NEPs, with the city's largest program, PreventionWorks!, getting $300,000 a year.

According to a DC HIV/AIDS Administration 2007 report, injection drug use is the second most common mode of acquiring the HIV virus after unprotected sex, and the District has some 10,000 injection drug users.

DC NEP advocates have long argued that the federal funding ban left them starved for funds and unable to adequately address the injection drug using population. PreventionWorks!, for example, has had to scrape by on private contributions, limiting the work it has been able to do.

The need is obvious and so is the response, Ken Vail, the group's executive director, told the Times. "If you want to reduce the spread of HIV... you put more syringes out there," he said.

A Life and Death Issue

You Can Make a Difference

Dear friends,

Several months ago my colleague Naomi Long and I had an op-ed in The Washington Post calling for a repeal of the federal prohibition that blocks states from using their share of HIV/AIDS prevention money on syringe exchange programs. We had a hard-hitting conclusion: “As many as 300,000 Americans could contract HIV/AIDS or hepatitis C over the next decade because of a lack of access to sterile syringes. This essentially makes the national syringe ban a death sentence for drug users, their partners and children.”

Take action now to support a bill in Congress that would repeal the ban.

Last year my colleague Jasmine Tyler lost her father to HIV/AIDS that he contracted from injection drug use and it really hit our D.C. office hard. She had this to share: “From the time he found out he was HIV-positive until the day he died in April of 2007, he suffered greatly and so did our family.  Every day I know that the hell he lived through could have been avoided if only he had had access to sterile needles all the time.  It’s too late to bring him back, but every other life that can be saved should be.”

While our country spends billions of dollars on efforts to prevent the spread of HIV/AIDS, hepatitis C and other infectious diseases, the U.S. prohibits the use of prevention funds to support syringe exchange programs. This robs cities, states and private organizations of the right to do what’s best for the people, and costs taxpayers a lot of money. It’s far cheaper to distribute syringes and prevent the spread of HIV/AIDS and hepatitis than it is to treat people who contract those infectious diseases after it's too late.

Last year, District of Columbia Congressional Delegate Eleanor Holmes Norton and New York Congressman Jose Serrano successfully repealed a federal ban that prohibited D.C. from spending its own budget money on syringe exchange programs. This week Rep. Serrano introduced a bill that would repeal the national syringe funding ban. If enacted, it could save hundreds of thousands of lives and millions in taxpayer dollars. Please urge your representative to support this urgent, life-saving bill.

Take action now.

Want to do more? Set up a meeting with your representative when he or she is in your district during Congress's August recess. Learn how.

Sincerely,

Bill Piper
Director of National Affairs
Drug Policy Alliance

More Information

--According to the Centers for Disease Control and Prevention (CDC), of the 415,193 people reported to be living with AIDS in the United States at the end of 2004, about 30 percent of cases are related to injection drug use, either directly (sharing contaminated syringes) or indirectly (having sex with someone who used a contaminated syringe or being born to a mother who used a contaminated syringe).

--Each year, approximately 12,000 Americans contract HIV/AIDS directly or indirectly from the sharing of dirty syringes. About 17,000 people contract hepatitis C.
 
--The Centers for Disease Control and Prevention (CDC), American Medical Association, National Academy of Sciences, American Public Health Association, and numerous other scientific bodies have found that syringe exchange programs are highly effective at preventing the spread of HIV/AIDS and other infectious diseases. Moreover, seven federal reports have found that increasing access to sterile syringes saves lives without increasing drug use.

--Increasing the availability of sterile syringes through exchange programs, pharmacies and other outlets reduces unsafe injection practices such as syringe sharing, curtails transmission of HIV/AIDS and hepatitis, increases safe disposal of used syringes, and helps injection drug users obtain drug education and treatment.

--The lifetime cost of treating just one person who contracts HIV/AIDS can be as high as $600,000. This cost is often borne by taxpayers. In contrast, syringe exchange programs can prevent thousands of new HIV/AIDS cases at very little cost. Funding syringe exchange programs saves both lives and taxpayer money.

--A federal appropriations rider in the annual Labor, Health and Human Services, Education, and Related Agencies spending bill prohibits states from spending their share of federal prevention money on syringe exchange programs. H.R. 6680 would repeal that provision.

Location: 
Washington, DC
United States

Harm Reduction: Bill to End Federal Needle Exchange Ban Filed

Rep. Jose Serrano (D-NY) and 25 cosponsors filed a bill Wednesday that would remove all restrictions on the use of federal funds for needle exchange programs (NEPs). The bill, the Community AIDS and Hepatitis Prevention (CAHP) Act of 2008 (H.R. 6680) is aimed at reducing the spread of blood-borne diseases that may be transmitted through infected syringes, such as HIV/AIDS and hepatitis C.

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widely-used syringe exchange graphic
NEPs have been proven to reduce the spread of blood-borne diseases, and there are now about 185 legal NEPs operating in the US. But since 1988, when the first legal NEP was approved, Congress has barred the use of any federal funds for such programs. While about half of NEPs receive some state or local funding, the federal ban means the cash-starved programs are blocked from accessing a major potential funding source.

The CAHP Act is endorsed by a more than a hundred HIV/AIDS, hep C, and other public policy groups. They have been pushing for more than a year to get the ban lifted. The Harm Reduction Coalition was one of the groups welcoming Serrano's bill.

"The Harm Reduction Coalition applauds Rep. Serrano's leadership in taking on the outdated and harmful federal funding ban", said Allan Clear, the group's executive director. "The federal funding ban has resulted in tens of thousands of needless HIV and hepatitis C infections. We know that syringe exchange works -- it's time for Congress to pave the way, and give communities the flexibility to use their federal HIV prevention dollars according to their own needs and priorities."

TAKE ACTION: National Call-In to Repeal the Federal Ban on Syringe Exchange

[Courtesy of Harm Reduction Coalition] TAKE ACTION: National Call-In to Repeal the Federal Ban on Syringe Exchange In an important triumph for health advocates, Congress recently lifted the ban on the use of local tax dollars for syringe exchange in Washington DC. Now is the time to end the overall federal ban on funding syringe exchange, and we need everyone's help this week. Please join a national call-in to your Representative, asking them to demonstrate their support by signing onto a letter to House leadership. This is the first action in Congress in a decade to lift the ban, and we need to make a strong showing. One third of HIV infections in the United States are related to injection drug use. The 20-year federal funding ban curtails local communities from using their prevention dollars as they see fit to support this effective intervention. What you can do: Go to www.house.gov to find out who represents you. Find out how they voted on allowing Washington DC to lift the ban on using local tax dollars to support their syringe exchange programs. A 'nay' vote is good. It means they support the District using its own funds to conduct needle exchange. Now we need them to authorize the use of federal funding for all states. An 'aye' vote means they need extra education on the issue. http://www.govtrack.us/congress/vote.xpd?vote=h2007-589 Call up your US Representative's DC office (U.S. Congress switchboard at 1-800-828-0498, or 202-224-3121) and ask to speak to their Health staffer. Ask them to sign the bipartisan 'Dear Colleague' letter circulating by Reps Cummings (D-MD) and Castle (R-DE). If they already have, thank them! For a copy to send them go to www.harmreduction.org/article.php?id=766 Suggested message: Local communities should decide how best to fight the spread of HIV. Syringe exchanges are proven to help reduce HIV infection and also provide important links to drug treatment. It's time to lift the federal ban on syringe exchange funding. Will [xx member] sign the Cummings/Castle letter? Other key talking points: INJECTION-RELATED HIV One third of people with HIV in the United States were infected through injection drug use. Every year, another 8,000 people are newly infected with HIV through sharing contaminated syringes. THESE INFECTIONS ARE PREVENTABLE In communities where access to sterile syringes is supported, transmission of HIV in injecting drug users has declined as a proportion of all cases by mode of transmission. Decreases have also been documented among the sex partners and children of injection drug users. SYRINGE EXCHANGE PROGRAMS ARE HIGHLY COST-EFFECTIVE The lifetime cost of medical care for each new HIV infection is $385,200; the equivalent amount of money spent on syringe exchange programs would prevent at least 30 new HIV infections. SYRINGE EXCHANGE PROGRAMS INCREASE ACCESS TO DRUG TREATMENT & MEDICAL CARE In addition to the reduced risks for disease, sterile syringe access programs facilitate greater access to drug treatment. These programs also provide a crucial entry point into medical care, detox and rehabilitation, and mental health treatment. NEARLY 200 SYRINGE EXCHANGE PROGRAMS currently operate in 38 states, Puerto Rico, Washington DC, and Indian Lands. Most operate on a shoestring, surviving on dwindling private donations and severe restrictions of public funding. THE MEDICAL AND SCIENTIFIC COMMUNITY SUPPORT SYRINGE EXCHANGE Studies by the Centers for Disease Control and the National Academy of Sciences show that syringe exchange programs are effective. Programs have the support of the medical community, including the American Medical Association, the American Public Health Association and the American Nurses Association SYRINGE EXCHANGES GET DIRTY NEEDLES OFF THE STREETS Research demonstrates that the presence of a syringe exchange program results in fewer used syringes improperly discarded. . In Baltimore, after an SEP was implemented, the number of inappropriately discarded syringes decreased by almost 50%. . In Portland, the number of discarded syringes decreased by almost two-thirds after the NEP opened. . In 1992, Connecticut repealed a law forbidding the sale of syringes without a prescription. As a result, reports show a reduction in needle sharing by 50 percent and a decrease in HIV infections by over 30 percent. In addition, law enforcement officials experienced two-thirds fewer needle stick injuries. Email [email protected] and let us know what you hear back! Hilary McQuie Western Director Harm Reduction Coalition 1440 Broadway, Suite 510 Oakland, CA 94612 Tel: 510-444-6969 Fax: 510-444-6977 www.harmreduction.org [email protected]
Location: 
Washington, DC
United States

HRC Alert: Getting Congress Hip to Hep in May

[Courtesy of Harm Reduction Coalition] 

Dear Supporter,

Take Action to Repeal the Federal Ban on Syringe Exchange, Increase Hepatitis Prevention

Momentum is building to end the 20 year ban on the use of federal funds for syringe exchange programs, but now we need heat. HRC has initiated a campaign designed to build the pressure in Washington DC and provide an opportunity for syringe exchange advocates to work for what we believe in. Keep in mind Franklin D. Roosevelt's response to a reform delegation, "Okay, you've convinced me.  Now go on out and bring pressure on me!"  Action comes from keeping the heat on.

WHAT YOU CAN DO:

1. Organize a district-level meeting - Call up your US Representative's local office and arrange a meeting in May to talk to them about syringe exchange and the need to lift the federal ban. Download talking points, materials to leave behind, and ask them to take a stand and co-sign a 'Dear Colleague' letter from members of Congress to House leadership.

2. Send a Letter to the Editor - May 19 is World Hepatitis Awareness Day! Submit an op-ed or a letter to the editor this week to bring attention to the end for syringe exchange expansion through ending the federal ban. For addesses , please click here. Be sure to also send it to your Congressional representatives.

3. Demystify! Impress! Hold accountable! If you work at a syringe exchange program, consider inviting your US Congressperson &/or their staff to your site. Show 'em how much you do on how little funding.  Tell them what you would do with sufficient funding.

4. Let us know what you hear back - Email [email protected] and keep us in touch.

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