Harm Reduction Project: HRPnews Digest February 12, 2007

News & Opinion This Week www.harmredux.org 1. Opening Address: The Second National Conference on Methamphetamine, HIV, Hepatitis and HIV: Science and Response: 2007 2. Some Alternative News Coverage from the Second National Conference on Methamphetamine, HIV, and Hepatitis in Salt Lake City 3. Must Read Report: Examination of the Association Between Syringe Exchange Programs (SEP) Dispensation Policy and SEP Client-level Syringe Coverage Among Injection Drug Users 4. Second National Conference on Methamphetamine, HIV, Hepatitis and HIV Presentations w/Audio to Be Posted On Line in Early March B Upcoming Conferences and Events C Quote D How To Help E About HRP F Subscription Information 1. Opening Address: The Second National Conference on Methamphetamine, HIV, Hepatitis and HIV: Science and Response: 2007 Salt Lake City, February 1, 2007 Luciano Colonna, Executive Director, Harm Reduction Project Approximately 500 days ago, during the opening of the First National Conference on Methamphetamine, HIV and Hepatitis, we promised to provide you with the latest developments in evidence-based scientific research and reports on responses to methamphetamine use emanating from the frontlines. I can assure you that both our speakers and the staff of the Harm Reduction Project wish to repeat these objectives at this year's conference. Much has happened in the past two years on the methamphetamine front, some of it representing progress, such as advances in research into replacement therapies; some representing tentative glimmers of hope that an altering political climate will afford providers and researchers more freedom to explore practical, evidence-based solutions to the complicated problem of meth use. By the same token, progress has lagged in certain areas. It's my hope that the next 3 days will be filled with frank, honest, lively, and creative discussion about all of this and more. As we head into the conference, I want to issue you, as participants, a disclaimer, or even a warning: Many of the thoughts, concepts, facts, and beliefs you witness and discuss this weekend may make you feel uncomfortable. They may challenge your belief systems, or call into question the therapeutic model you're committed to, or present evidence contrary to what you know. In fact, your comfort levels may be severely tested in this epicenter of colliding worlds of diversity, as treatment providers trade ideas with harm reductionists, and members of the ALCU share war stories with local law enforcement As your conference organizers, we think this is a good thing, and we hope you ultimately will, too. For it's not your belief systems that we wish to change. It's your ability to understand, and thus empathize with, your clients that is of the utmost importance to us. I'm making the assumption that for you to be here you must believe this too, at some level. We are all in the business of improving lives. And to do that, we have to have a realistic, unflinching understanding of what those lives are like, in all their diversity. So, while it is not my wish that you all return to your towns and cities embracing homosexuality or recreational drug use - I do hope that you will return to your jobs with a clearer understanding of what actually happens in these lives that you have given yourselves the responsibility of improving - the daily struggles, challenges, success, failures, feelings, frustrations, questions, hopes, fears. With that said, I will offer some simple advice. 1. Try to stick with it. Raise your hand, challenge the speakers, button hole him or her at the end of the presentation and see what develops. 2. Leave a session if you just can't handle it. There are myriad sessions to choose from - if you can't accept a particular challenge to your comfort level, find something that suits you better. I would like to acknowledge the many individuals who have influenced the content of my speech here this morning, Briefly, they include Stephanie Rosenfeld, Allan Clear, Mayor Rocky Anderson, Patrick Fleming, Jack Plumb, Caroline Millington, Utah Governor Huntsman, Salt Lake County Council Member Jenny Wilson, Reverend Ed Sanders, Doug LeCheminant, of LDS Social Services, Ethan Nadelmann, Louis Borgenicht, Daniel Abrahamson, Helena Huang, Dr. Marsha Rosenbaum, William McCall, Bill Piper, Suzanne Plumb, Dr. Mark Bigler, Corrine Carrey, and the Salt Lake, Denver, and Washington DC offices of the Harm Reduction Project. In addition, there are also the voices of hundred’s of thousands of drugs users, those who have died from AIDS, are living with AIDS, and the ever growing population of people suffering with viral Hepatitis whom our government just can’t seem to find the resources to help. In addition, I must acknowledge Margaret Chase Smith of Maine, who in 1950 spoke on the Senate floor on behalf of the Declaration of Conscience, opposing McCarthyism. I would like to share some of her words: I will speak as briefly as possible because too much harm has already been done with irresponsible words of bitterness and selfish political opportunism. I will speak as simply as possible because the issue is too great to be obscured by eloquence. I will speak simply and briefly in the hope that my words will be taken to heart. The United States Senate has long enjoyed worldwide respect as the greatest deliberative body in the world. But recently that deliberative character has too often been debased to the level of a forum of hate and character assassination sheltered by the shield of congressional immunity. I think that it is high time for the United States Senate and its members to do some soul-searching---for it to weigh its consciences---on the manner in which way it is performing its duty to the people of America. I think that it is high time that they remember that they were sworn to uphold and defend the Constitution. I think that it is high time that they remember that the Constitution, as amended, speaks not only of the freedom of speech but also of trial by jury instead of trial by accusation. Whether it is a criminal prosecution in court or a character prosecution in the Senate, there is little practical distinction when the life of a person has been ruined. Those of us who shout the loudest about Americanism in making character assassinations are all too frequently those who, by our own words and acts, ignore some of the basic principles of Americanism: Margaret Chase Smith's words strike close to home, for me, as I reflect on both the progress and the frustrations of the last 500 days. As I think about the feeling of fear and frustration that afflicts myself and my colleagues - and, I would venture to say, a large number of Americans, as we see and feel and experience the effects of lack of effective leadership in either the Legislative Branch or the Executive Branch of our Government in regard to the issues surrounding drug use in America and abroad. That leadership is so lacking that thousands of Americans die and suffer every day because of lack of access to effective drug treatment, long term prevention, and needle exchange. Thousands are incarcerated because of the color of their skin, lack of insurance, lack of economic power. Thousands of family-members and friends sit by helplessly, waiting for their children or loved-one to get some kind of help, and, tragically, thousands of these family members will wake up one day to the death of a loved one due to preventable drug overdoses. Let me go back to Margaret Chase Smith for a minute. These are the “basic principles of Americanism” she accused McCarthy-ites, so-called/self-proclaimed patriots, of ignoring in 1950. The right to criticize; The right to hold unpopular beliefs The right to protest; The right of independent thought. Today, as I look at the lack of leadership in the Federal Government, as I try to see the shape of the future of drug use issues in America, as I plot the course of my own responses, both personally and on an organizational level; and as I try to hold out hope that shifts in the political climate, such as advances in reality based research that will be favorable to our cause, I find that Margaret Chase Smith's words still present a relevant challenge. A few points: Number 1: In regard to the scientific research community: the exercise of their pursuits should not cost one single American citizen their reputation or their right to a livelihood nor should a person be in danger of losing his or her reputation or livelihood merely because they happen to use words or phrases that right wing ideologues sitting down for dinner in the beltway find offensive. Number 2: In regard to needle exchange programs, Former President Clinton said on July 12 of 2006 that he was "wrong" not to lift a ban on federal funding of needle-exchange programs during his presidency. Clinton acknowledged that a government panel told him that needle-exchange programs were effective in slowing the spread of HIV among injection-drug users, and didn't promote drug abuse. But Clinton said he took the advice of his drug czar, Gen. Barry McCaffrey, who opposed the funding because of "the message it would send on the drug front." Does anyone in the audience know of an algorithm that could give us an estimate of how many have died or become infected because of that executive decision? Number 3: The issue surrounding treatment in this country is equally a national travesty. A comprehensive study of the effectiveness of substance-abuse treatment in Massachusetts found out years ago that treatment does work and does prevent crime. According to the study by the Massachusetts Department of Public Health's Bureau of Substance Abuse Services, nine out of 10 illicit drug and alcohol abusers who entered treatment programs stayed out of jail in 1999. Furthermore, a third of them found jobs. Even so, with all we know about treatment, why do our civil servants have to spend so much of their time and energy up at our state legislatures year after year advocating for more treatment beds and/or treatment instead of incarceration? Number 4: Drug Prevention: In regard to prevention, ONDCP has a comprehensive list of 15 Principles of Prevention. Too long to elaborate here, one bolded principle is written as follows - Use Approaches that Have Been Shown to be Effective. With that said, I challenge those states that are using or in the processing of adapting the Montana Meth Project as a tool in the reduction of methamphetamine use. I no longer wish to hear people say, as a rationale for the backing of programs that don’t work, “Well, we just can't sit around and do nothing!” While I agree wholeheartedly with the statement, real progress cannot be made while leaving out a crucial step: Drug prevention approaches have to been shown to be effective. NUMBER 5: A brief mention of replacement therapies. We received more negative evaluations from our 2005 conference on Dr. John Grabowski's report on his NIDA funded substitution therapy research as a treatment for Methamphetamine Addiction than on any other presentation. Some conference participants were outraged that Dr. Grabowski would even research this avenue of drug treatment. I would like to remind everyone in this room about what the US Office of National Drug Control Policy has said about another kind of substitution therapy: Methadone. According to the ONDCP, “Methadone is a rigorously well-tested medication that is safe and efficacious for the treatment of narcotic withdrawal and dependence. For more than 30 years this synthetic narcotic has been used to treat opiod addiction” Shunning the idea of substitution therapy without clearly thinking about the complexities of treating serious drug issues is careless, if not reckless. Number 6; 500 days ago the organizers of this conference were harshly dealt with because a very small group in the Federal government didn't like the titles or the subject matter of many of our workshops or some of my public comments. There is no longer a reason to mention their chief mudslinger's name as his party's losses during the mid term elections took away his soapbox. A few examples of what inexplicably ruffled the feathers of these sensitive souls in Washington, DC were (1) “Do we need a War on Methamphetamine?” and (2) my explosive, drug war threatening comment, “For some, Meth is just a right of passage.” The panic that these comments sparked with in the US Department of Health and Human Services, the US Centers for Disease Control and Prevention, on the floor of the Capitol, and inside the White House, were both absurd and frightening. So frightening in fact, that I seriously considered censoring this year's presentations - an idea that I find morally at odds with everything the Harm Reduction Project stands for. Imagine my sense of vindication, not to mention satisfaction, when the very first abstract we received in 2006, from Dwight Hurst, of Davis Applied Technology College, in Layton, UT, population 62,400, was titled Everybody who is Anybody is Doing it: Drug Use as a Rite of Passage. Mr. Hurst, thank you very much for helping out a guy who was very much down on his luck that day. And finally, I'm tired of living in a world where drug users are incarcerated because of the failed theories and practices of many medical, social work, psychiatric, faith based, educational systems, and community based organizations. I believe that in spite of our best efforts, on many levels providers fail to deliver a top quality system of care, and to meet the needs of our constituents. As we continue to do a poor job at dealing with the intricacies of drug use, we look more and more to the criminal justice system to solve our problems. Of course, the criminal justice system has played a part in creating this mess, but a huge part of their participation has been driven by our own failure, in making them the fallback strategy. The system of criminal justice has become the fallback strategy for drug users, as well as the homeless, veterans, and mentally ill as we have failed as a system of care and as a country. And furthermore, we in the profession have the audacity to repeatedly attack Criminal Justice as if the strands of this mess are easily separable from each other. We are all culpable. So, what can we do? With that said, I offer some simple advice. 1. Try to stick with it. Raise your hand, challenge the speakers, button hole him or her at the end of the presentation and see what develops. 2. Leave the session if you just can't handle it. There are myriad sessions to choose from- if you can't accept a particular challenge to your comfort level, find something that suits you better. And to that end, we must stop sitting by and voting in the same members of the Legislative and Executive Branches of our Government over and over again and over again. If we keep doing so, the next 500 days will be very hard on those we hope to help. Thank you so very much for your attention. --- 2. Second National Conference on Methamphetamine, HIV, and Hepatitis Underway in Salt Lake City from Drug War Chronicle, Issue #471, 2/5/07 Around a thousand people, including some of the nation's foremost experts in treating, researching and developing responses to methamphetamine use, gathered at the Hilton Hotel in downtown Salt Lake City as Science and Response: The 2nd Annual Conference on Methamphetamine, HIV and Hepatitis got underway Thursday. Sponsored by the Salt Lake City-based Harm Reduction Project, the conference aimed at developing evidence-based "best practices" for responding to meth and emphasized prevention and treatment instead of prison for meth offenders. This year's conference was uncontroversial -- a marked change from the first one, also held in Salt Lake City, which was attacked by congressional arch-drug warrior Rep. Mark Souder (R-IN) because presenters openly discussed the impact of meth on the gay community. Souder was also incensed that the US Department of Health and Human Services provided limited financial support for the conference, and authored a successful amendment to the appropriations bill funding the White House Office of National Drug Control Policy calling for an investigation of the conference and HHS policy. "The fact that there is absolutely no controversy this year indicates more than just a leadership change in Congress. It shows that our approach -- bringing together all the stakeholders and families affected by meth -- is the right one," said Harm Reduction Project executive director Luciano Colonna in a statement on the eve of the conference. While Colonna sounded sanguine in the statement above, he was less so as he opened the conference Thursday morning. Visibly choking up at times as he sounded the theme of this year's conference, "500 Days Later," he noted that since the first conference in August 2005, "thousands have died or been incarcerated." And Colonna could not resist a reference to Souder and ideological allies in Congress. "There's no need to mention the names of cheap mudslingers because their party lost," he said to loud applause. "I'm tired of seeing meth users incarcerated because of failed theories and practices followed by many treatment providers, faith-based groups and other organizations," Colonna said. "We look to the criminal justice system to solve our problems, and its participation has been a result of our failure. Just as with the homeless, veterans, and the mentally ill, we have failed as a system of care and as a country. We have the audacity to attack the criminal justice system as if the strands of this mess can be separated out, but we are all culpable." If Colonna wasn't going to name names, Salt Lake City Mayor Rocky Anderson had no such compunctions. As he welcomed attendees to his city, Anderson hit back. "I will say Souder's name," Anderson proclaimed. "We shouldn't ever forget the people who caused so much damage. They don't care that needle exchange programs help injection drug users avoid HIV; they have the attitude that if people use drugs, they deserve what they get. People like Mark Souder would rather make political hay out of tragedy rather than having the integrity to deal with issues based on facts and research." Citing drug use surveys that put the number of people who used meth within the last year at 1.3 million and the number who used within the last month at 500,000, Anderson pointed out that, "If it were up to Souder, they would all be in prison." Mayor Anderson, a strong drug reform proponent, had a better idea. "Those numbers are the purest case for harm reduction," he argued. "We know there are people who will use drugs and we can reduce the harm, not only for them and their families, but for all of us. The current approach is so wasteful and cost ineffective. And thanks to you, treatment programs are much more available, but in too many areas, you have to get busted to get affordable treatment. It is time to make treatment on demand available for everybody," he said to sustained cheering and applause. Given the topic of the conference, it is not surprising that attendees are a different mix than what one would expect at a strictly drug reform conference. While drug reformers were present in respectable numbers -- the Drug Policy Alliance in particular had a large contingent -- they are outnumbered by harm reductionists, treatment providers and social service agency workers. Similarly, with the event's emphasis on "Science and Reason," the panels were heavy with research results and presentations bearing names like "Adapting Gay-Affirmative, Evidence-Based Interventions for Use in a Community-Based Drug Treatment Clinic," "Stimulant Injectors From Three Ukraine Cities," and "The Impact of Meth Use on Inpatient Substance Abuse Treatment Facilities for Youth in Canada." The mix of interests and orientations led to some fireworks at the first conference, especially around the issue of stimulant maintenance therapy, or providing meth users with a substitute stimulant, such as dextroamphetamine, much as heroin users are prescribed methadone. Such issues may excite controversy again this year, but an opening day panel on the topic caused only a few raised eyebrows -- not any outbursts of indignation. The controversy is likely to come in Vancouver, where Mayor Sam Sullivan recently announced he wanted to implement an amphetamine maintenance pilot program with some 700 subjects. With three full days of plenaries, panels, breakout session, and workshops, last weekend's conference not only provided information on best practices for educators, prevention workers, and treatment providers, but also helped broaden the rising chorus of voices calling for more enlightened methamphetamine policies. In addition, the conference pointed the Chronicle to a number of meth-related issues that bear further reporting, from the spread of repressive legislation in the states to the effort to expand drug maintenance therapies to stimulant drugs like meth and the resort of some states to criminalizing pregnant drug-using mothers. Look for reports on these topics in the Chronicle in coming weeks. --- 3. Examination of the Association Between Syringe Exchange Programs (SEP) Dispensation Policy and SEP Client-level Syringe Coverage Among Injection Drug Users The papers examine the role of syringe dispensing policy on syringe coverage (ratio of new syringes received to total injections) and how syringe coverage impacts HIV risk. Please contact Ricky Bluthenthal at [email protected] for a copy of the research and or more information. --- 4. Second National Conference on Methamphetamine, HIV, Hepatitis and HIV Presentations w/Audio to Be Posted On Line in Early March Stand by... --- B Upcoming Conferences and Events 18th International Conference on the Reduction of Drug Related Harm – "Harm Reduction: Coming of Age" Location: GROMADA Conference Centre, Warsaw, Poland Contact: +48 22 640 82 71, [email protected] May 13 - 18, 2007 For More Info: www.harmreduction2007.org ---- C Quote So reports of my madness, as they say, were greatly exaggerated. Not that I give a bugger either way. - David Icke ----- DHow To Help The Harm Reduction Project is able to provide services through the support of individuals such as yourself. Please help us make a difference and pledge your support today! PLEASE CLICK HERE TO DONATE or call 801-355-0234 for more information. ------- About HRP The Harm Reduction Project works for the enhancement of services available to marginalized populations. HARM REDUCTION PROJECT | SALT LAKE CITY | TEL (801) 355.0234 FAX (801) 355.0291 | 235 West 100 South, Salt Lake City, Utah 84101 HARM REDUCTION PROJECT | WASHINGTON, DC | TEL (202) 246-6391 FAX (202) 271.3363 | 3324 19th Street, NW, Washington, DC 20010 HARM REDUCTION PROJECT | DENVER | TEL (303) 572-7800 FAX (303) 572.7800 | 775 Lipan Street, Denver, Colorado 80204 Please visit us at www.harmredux.org & www.methconference.org for more information.