Drug-Related AIDS/HIV or Hepatitis C

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Battle for Restored Needle Exchange Funding Heats Up [FEATURE]

After 20 years of walking in the political wilderness, public health and harm reduction advocates for federal funding for needle exchange programs made it to the Promised Land in December 2009, when the Democratic-controlled Congress overturned the longstanding funding ban. But just two years later, led by the Republican-controlled House and with the acquiescence of the Democratic-controlled Senate, Congress reinstated the ban in its 2012 federal omnibus spending bill.

Needle exchange advocates arrested on Capitol Hill Wednesday (Stephanie Simpson, Housing Works)
Advocates were outraged and dismayed by the congressional action, but are determined to fight back to restore funding for a harm reduction practice repeatedly proven to save lives and reduce the spread of infectious blood-borne diseases, such as HIV/AIDS and hepatitis C. This week, they came out swinging with a national day of action Wednesday that saw organized call-ins to members of Congress and civil disobedience actions leading to dozens of arrests at the offices of four of them, as well as actions in a dozen others cities across the county.

Although the funding ban's main proponents are Republicans, repealing the ban is actually the states' rights, deregulation position. Each year the federal government authorizes funding for grants to states to be used for AIDS prevention and treatment. When the ban was temporarily lifted, it neither increased nor decreased the amount of AIDS funding, but it meant that states could choose for themselves whether or not to use some of those funds to support needle exchange programs.

The activists have science and the evidence on their side. 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. Eight federal reports have found that increasing access to sterile syringes saves lives without increasing drug use.

More than 200 needle exchange programs operate across the country in cooperation with local law enforcement officials and health departments, but many are in danger of closing their doors or cutting back services without access to federal funds. That puts lives and the public health at risk.

Needle exchange supporters said the restored the ban will result in thousands of Americans contracting HIV/AIDS, hepatitis C or other infectious diseases next year alone. According to the Harm Reduction Coalition (HRC), needle sharing by injection drug users accounts for 8,000 new cases of HIV and 15,000 new cases of hepatitis C each year. In New York City, there has been a 75% reduction in new HIV cases as a result of instituting such programs, according to a 2005 study cited by HRC.

"We need Congress to stand behind public health and science, and declare a cease-fire on syringe exchange," said HRC executive director Allan Clear. "All of the research tells the same story: Syringe exchange prevents infections, promotes drug treatment, and reduces drug use. Congress must stop treating syringe exchange as an ideological pawn in partisan politics."

"The federal syringe funding ban was costly in both human and fiscal terms -- it is outrageous that Congress has restored it given how overwhelming and clear the science is in support of making sterile syringes widely available," said Bill Piper, director of national affairs for the Drug Policy Alliance. "Make no mistake about it -- members of Congress who supported this ban have put the lives of their constituents in jeopardy."

Cherry blossoms bloom in DC as arrestee is detained (Stephanie Simpson, Housing Works)
The renewed ban on federal funding for needle exchanges couldn't come at a more inopportune time. With a wave of drug users who began their careers with opioid pain pills finding succor in the needle, making access to clean needles more difficult is likely to make matters worse.

"We need to support syringe exchange programs now more than ever," said HRC policy director Daniel Raymond. "Health officials in many states report a disturbing new trend of hepatitis C outbreaks in young people, driven by a new wave of injection drug use linked to the prescription painkiller epidemic. We're in danger of starving programs of federal funds, just when the demand for syringe exchange is increasing."

In Washington, while a coordinated campaign of phone calling kept the congressional switchboard humming, dozens of AIDS and harm reduction activists went to Capitol Hill and held sit-ins at the offices of four House Republicans, including Speaker John Boehner (R-OH), Rep. Denny Rehberg (R-MT), Mike Rogers (R-MI) and Eric Cantor (R-VA) for their role in reinstating the ban on federal funding for syringe exchange programs last December.

Carrying signs reading "Syringe Exchange: A Fix for AIDS," the activists chanted and blocked doorways before being arrested by Capitol Police. They were expected to be booked and released later Wednesday.

At least 32 people were arrested at Congress, according to Housing Works, a New York City-based group that provides services for AIDS sufferers. Housing Works participated in the action as part of the We Can End AIDS Coalition, an umbrella group coordinating a July 24 mass protest in Washington around economic justice and human rights for AIDS patients.

"Our government should be embarrassed as this year's host of the International AIDS Conference to have sneaked this into an unrelated bill under the cloak of night last December," said Housing Works CEO Charles King. "The US cannot be any shining example to the rest of the world on how to end the AIDS epidemic when we’re still fighting foolish policies that reject what we know works."

Wednesday's action was only an opening skirmish in what will be a determined battle to restore the federal funds. The AIDS, public health, and harm reduction communities are not going to just roll over and play dead while Congress makes decisions that will result in real people becoming really dead.

"We refuse to let the close-mindedness of anti-science conservatives dictate public health policy," said Clear. "We can't afford these political games, and we can't afford any more new infections. Our communities are struggling; Congress needs to listen and show leadership by rescinding the funding ban."

Greece to Hand out Needles, Condoms in AIDS Fight

The Greek government announced Tuesday that it will begin harm reduction measures, including handing out condoms and needles to heroin addicts, in an effort to slow an alarming rise in new HIV cases, Agence-France Presse reported. The government anti-drug organization Okana and volunteer organizations will hand out 30,000 condoms and 10,000 needles as part of the effort, which will be initially launched in Athens.

view of the Acropolis at sunset (wikimedia.org)
"There is an imperative need for immediate action to limit the spread of infection," deputy health minister Michalis Timosidis said in a parliamentary document.

Greek health officials had reported in November that new HIV cases were up by 52.7% last year over 2010. The government center for disease control and prevention said over 800 new cases had been recorded through October 2011.

A third of the new cases were reported among gay men, but officials said most new cases were linked to prostitution and intravenous drug use. The number of new HIV infections among heroin users increased a whopping 1,250% in a year, the disease control center said.

Because of the economic crisis, Greece has been forced to radically cut social spending to eliminate budget deficits in order to receive loans from the International Monetary Fund and the European Union. Those spending cuts have seen staff layoffs and mergers in the health sector, which doctors said are weakening the effectiveness of the Greek health care system.

Athens
Greece

Giving Addicts Heroin More Effective Than Methadone, Study Finds

Treating intractable heroin addicts with a pharmaceutical version of their drug is more cost-effective than providing them with methadone, a common opioid substitute, a study published Monday in the Canadian Medical Association Journal suggests.

Diacetylmorphine AKA pharmaceutical grade heroin (wikimedia.org)
The study analyzed data from the North American Opiate Medication Initiative (NAOMI ), a 2005-2008 study that compared the use of diacetylmorphine (heroin) and methadone in street addicts. In the NAOMI study, researchers selected 250 subjects in Vancouver and Montreal who had been strung out for at least five years and had twice previously failed on methadone maintenance. Participants were randomly chosen to take either heroin or methadone.

Researchers in this study examined the cost-effectiveness of the two approaches in one-year, five-year, 10-year increments, as well over the lifetimes of the users. The study found that those using methadone generated an average lifetime social cost of $1.14 million, while those using heroin had a cost of $1.1 million, a difference of about $40,000 per user. An estimated 60,000 to 90,000 Canadians are addicted to heroin or other opioids.

"If you are on treatment, you're basically well-behaved," principal investigator Aslam Anis, a health economist at the University of British Columbia told the Canadian Press Monday. "When you're not taking treatment, for instance when you relapse, you're doing all kinds of bad things, criminal activity, getting into jail. The cost benefit is through an indirect effect," said Anis, through fewer robberies and other crimes, which have an adverse impact on victims and drive up criminal justice system costs.

"People who take (medical) heroin are retained on the treatment for longer periods of time and they have shorter periods of time when they relapse," Anis said. "And when you add it all up, you find that you've actually saved money."

"Methadone can be a very effective medication for some people, but it doesn't work for everybody with heroin addiction," said coauthor Dr. Martin Schechter, an epidemiologist at UBC's School of Population and Public Health. "And there is a subset of folks who go in and out of treatment and ultimately end up back using street heroin. They would be unlikely to be attracted into yet another methadone program," he said.

"But giving them injections of medically prescribed heroin in a clinic setting staffed by doctors, nurses and counselors gets them back into the health-care system. It also cuts the risk of infection with hepatitis C and HIV from needle-sharing. So diacetylmorphine is a medically prescribed heroin that we show in the study was more likely to keep people in treatment. And we know that keeping people in treatment is a very important predictor of success."

No matter what this or any other study finds, the Conservative Canadian government is opposed to harm reduction measures, such as safe injection sites and heroin maintenance therapies. Still, said Schecter, the government needs to face reality.

"The fact is that these people are taking heroin right now. They're in the back alleys in the Downtown Eastside, they're buying the heroin on the street, contributing to the black market and crime and violence," he said. "And they're not in any treatment and they're costing the system lots and lots of money. So our proposal says rather than having them do that in the back alley, why don't we attract them into a clinic where they will be in contact with doctors and nurses and counselors, we stabilize them by getting them out of a life of crime."

So, is anybody listening in Ottawa? Probably not, but the current government won't be in power forever.

Canada

New Mexico Legislature to Study Supervised Injection Sites [FEATURE]

In a groundbreaking move, the New Mexico legislature has approved a proposal to study how to enhance and expand the state's already cutting edge harm reduction programs, including a look a medically supervised injection sites (SIJs -- sometimes also known as safe injection sites) for hard drug users. That could clear the way for an eventual SIJ pilot program to operate in the state, although considerable political and legal hurdles remain.

The legislation, Senate Memorial 45, was sponsored by Sen. Richard Martinez, whose constituency includes Rio Arriba County, which has a drug overdose fatality rate five times the state's rate. The state's rate is double the national rate, making New Mexico the nation's leader in drug overdose-related deaths per capita.

"These deaths are preventable," said Martinez. "Overdose spares no one and affects everyone, especially families."

State health officials estimate the state has at least 24,000 injection drug users. Other estimates put that figure as high as 50,000.

The memorial, which was also endorsed by the New Mexico Public Health Association, passed the Senate on a 43-0 vote Monday night and does not need any further action to go into effect. It directs the University of New Mexico's Robert Wood Johnson Foundation Health Policy Center to undertake the study of emerging and evidence-based harm reduction approaches, including SIJs, and report back to the legislature by November 1.

"Sadly, our drug overdose epidemic has outgrown our current harm reduction approaches," said Emily Kaltenbach, director of the Drug Policy Alliance (DPA) New Mexico office. "On Monday, our state senators realized this and did not let politics trump science. They clearly stated their intent to go beyond the status quo and explore innovative strategies to help New Mexico’s families."

"Wow, getting something like that on the state level is huge," said Hilary McQuie, Western director for the Harm Reduction Coalition (HRC). "New Mexico once again takes the lead in state harm reduction efforts; it's one of the few states to take a statewide approach to these things."

"Heroin is still the number one cause of ODs here, but we're also seeing a high number of prescription drug overdose deaths," said Kaltenbach, "so I'm incredibly encouraged that the legislature is willing to look beyond the status quo and start studying proven programs like supervised injection sites. We're hoping to study the feasibility and legal and ethical implications, leading to a pilot site in New Mexico."

If that actually happens, it would be the first SIJ in the nation. Although SIJS are operating in at least 27 cities around the world, including Vancouver and Sydney, and have been proven to reduce the spread of HIV, Hep C, and other blood-borne diseases, as well as prevent overdoses, without increasing criminality or drug use, political and legal obstacles in the US have so far prevented them from spreading here. They face morality-based opposition as well as federal issues including a "crack house law," which bars anyone from knowingly allowing others to use controlled substances.

"These same sorts of issues came up when syringe exchange programs were first discussed," said Kaltenbach. "I think the legal issues can be overcome, but the states have to be willing to look at it as an extension of syringe exchange. This study will address those issues."

While New Mexico is the first state to order a study of SIJs, it isn't the only place in the country where they are on the agenda. In San Francisco, drug user groups, activists, and advocates are working toward winning approval for one there, while in New York City, a similar effort is going on.

"The biggest obstacle is the perception of legal barriers," said DPA's Laura Thomas, who has been working on the San Francisco effort. "We have these crack house statutes, as well as state laws, that say it's illegal to knowingly allow people to use controlled substances. We have to figure out if there's room for a research project, like in Sydney, or create an exemption, like in Vancouver, or get a state law passed, like in New Mexico. We need a ruling that says 'yes,' this is not a violation."

http://stopthedrugwar.org/files/richard-martinez.jpg
Richard Martinez
In the meantime, the achingly slow process of building political support for an SIJ, or at least a feasibility study, goes forward. A year ago this week, a city Hep C task force recommended looking at SIJs. That followed on a similar recommendation from the city's HIV coalition.

"We continue to try to build support for a safe injection site," said Thomas. "During the mayoral campaign last year, at one of the candidate forums, they were all asked if they would support evaluating whether it would work for San Francisco, and most of them said they did, including our current city attorney, Dennis Herrera."

But despite the recommendations and expressions of support, nothing has happened yet. The San Francisco Drug Users' Union is trying to change that.

"We will be pressing the Board of Supervisors to study the possibilities," said the group's Isaac Jackson. "We're also doing a SIJ community design competition, a project in community imagineering. We'll give the winner a nominal prize and we'll present the winning design to the Board," he said.

"We think the city's Human Rights Commission will recommend safe injection sites in April," said HRC's McQuie. "But there have been other bodies and other recommendations. It's a matter of where the political will is and the priorities are."

For HRC, said McQuie, getting a safe injection site up and running in San Francisco is a back burner issue right now, but that could change.

"We have a lot of really great harm reduction projects going on, like the DOPE Project, that aren't getting financial support, and while there was a lot of enthusiasm for awhile about working toward a safe injection site, we kept planning meetings, but nobody would show up. It didn't feel like the energy was there. If the San Francisco Drug Users' Union wants to take some leadership, we would be happy to support it," said McQuie. "I think we will be going back to San Francisco and asking somebody to do something on this issue, but we're not sure who yet."

On the other side of the country, street-level activists are aiming for an SIJ in New York City. Citiwide Harm Reduction in the South Bronx, which is on the verge of opening the city's first fully staffed primary care clinic at a syringe exchange, is preparing to build a full-scale model of an SIJ at its 144th Street building. It may seem like performance act, but its purpose is educational.

"Our inspiration is the Smithsonian museums, where you can go inside the cockpit of the space shuttle," said Citiwide executive director Robert Cordero. "People have this grisly misconception of what a safe injection site would be like, and we want them to be able to have this Smithsonian experience here in the Bronx."

Such a model could be quite useful in educating elected officials and law enforcement, Cordero said.

"SIJs are a humane public health approach to reducing overdoses, HIV, Hep C, and crime, and can provide compassionate care for addicted people until they are ready to get into treatment," he said. "Do we want that, or do we want them just hanging out in front of the bodegas on 149th all day?"

Citiwide isn't going it alone on agitating for SIJs, and it isn't even taking the lead. Instead it is working with groups like HRC and the Vocals-NY Users' Union in a broader campaign.

"We're not trying to be the HRC or Vocals-NY," said Cordero. "We advocate through demonstrating what it would be like while partnering with others who are advocating every day. Our effort is to build the SIJ model, and when anyone comes to New York who is interested in these issues, there can be an educational moment."

Supervised injection sites are not a reality yet in the US, but pressure for them is mounting. Whether it's New Mexico, New York City, or San Francisco, one of these years someone is going to lead the US into the ranks of nations that understand their utility -- and their humanity. New Mexico has just taken a giant step, but let's hope it has to move fast to beat San Francisco and New York.

Santa Fe, NM
United States

Revised New Jersey Pharmacy Syringe Sales Bill Passes

The New Jersey legislature last week passed a revised S 958, bill allowing pharmacies to sell syringes without a prescription. Gov. Chris Christie (R) signed it into law Tuesday. The legislature had passed the bill in December, but last week, Christie conditionally vetoed the original version of the bill, saying it needed to be tightened.

In his veto statement, Christie said the bill should include "a requirement of purchasers to present a photo identification for proof of age" and should require the health department to provide information about syringe disposal and drug treatment programs to pharmacies.

The bill would allow for the purchase of up to 10 syringes without a prescription. It also decriminalizes the possession of needles bought from a pharmacy without a prescription.

New Jersey is one of only two states that still bans over-the-counter syringe sales. The other is neighboring Delaware.

The bill was sponsored by Assemblyman Reed Gusciora (D-Mercer), Assemblyman Gordon Johnson (D-Bergen), Assemblyman Craig Coughlin (D-Middlesex), Assemblywoman Joan Voss (D-Bergen), Assemblywoman Cleopatra Tucker (D-Essex), Assemblywoman Joan Quigley (D-Bergen and Hudson) and Assemblyman Thomas Giblin (D-Essex and Passaic).

Now that the governor has gotten the language he wanted, he has signed the bill.

Trenton, NJ
United States

The Top Ten Domestic US Drug Policy Stories of 2011 [FEATURE]

http://www.stopthedrugwar.org/files/usmap-small.jpg
We can put 2011 to bed now, but not before looking back one last time at the good, the bad, and the ugly. It was a year of rising hopes and crushing defeats, of gaining incremental victories and fending off old, failed policies. And it was a year in which the collapse of the prohibitionist consensus grew ever more pronounced. Let's look at some of the big stories:

Progress on Marijuana Legalization

Last year saw considerable progress in the fight for marijuana legalization, beginning in January, when Law Enforcement Against Prohibition (LEAP) got President Obama to say that legalization (in general) is "an entirely legitimate topic for debate," and that while he does not favor it, he does believe in "a public health-oriented approach" to illicit drugs. Before the LEAP intervention, which was made via a YouTube contest, legalization was "not in the president's vocabulary." While we're glad the president learned a new word, we would be more impressed if his actions matched his words. Later in the year, in response to "We the People" internet petitions, the Obama White House clarified that, yes, it still opposes marijuana legalization.

In June, Reps. Barney Frank (D-MA) and Ron Paul (R-TX) made history by introducing the first ever bill in Congress to end federal marijuana prohibition, H.R. 2306. It hasn't been scheduled for a hearing or otherwise advanced in the legislative process, but it has garnered 20 cosponsors so far. Sadly, its lead sponsors are both retiring after this term.

Throughout the year, there were indications that marijuana legalization is on the cusp of winning majority support among the electorate. An August Angus Reid poll had support at 55%, while an October Gallup poll had it at 50%, the first time support legalization has gone that high since Gallup started polling the issue. A November CBS News poll was the downside outlier, showing support at only 40%, down slightly from earlier CBS polls. But both the Angus Reid and the Gallup polls disagreed with CBS, showing support for legalization trending steadily upward in recent years.

Legalization is also polling reasonably -- if not comfortably -- well in Colorado and Washington, the two states almost certain to vote on initiatives in November. In December, Public Policy Polling had legalization leading 49% to 40% in Colorado, but that was down slightly from an August poll by the same group that had legalization leading 51% to 38%.

In Washington, a similar situation prevails. A January KING5/SurveyUSA poll had 56% saying legalization would be a good idea and 54% saying they supported marijuana being sold at state-run liquor stores (similar to what the I-502 initiative proposes), while a July Elway poll had 54% either definitely supporting legalization or inclined to support it. But by September, the Strategies 360 Washington Voter Survey had public opinion evenly split, with 46% supporting pot legalization and 46% opposed.

The polling numbers in Colorado and Washington demonstrate that victory at the polls in November is in reach, but that it will be a tough fight and is by no means a sure thing. "Stoners Against Proposition 19"-style opposition in both states isn't going to help matters, either.

Oh, and Connecticut became the 14th decriminalization state.

Medical Marijuana Advances…

In May, Delaware became the 16th state to enact a medical marijuana law. Under the law, patients with qualifying conditions can legally possess up to six ounces of marijuana, but they cannot grow their own. Instead, they must purchase it from a state-licensed compassion center. That law will go into effect this year.

Meanwhile, New Jersey and Washington, DC, continue their achingly slow progress toward actually implementing existing medical marijuana laws. In New Jersey, Gov. Chris Christie (R) finally got out of the way and okayed plans for up to six dispensaries, but early efforts to set them up are running into NIMBY-style opposition. In DC, a medical marijuana program approved by voters in 1998 (!) but thwarted by Congress until 2009 is nearly at the stage of selecting dispensary operators. One of these months or years, patients in New Jersey and DC may actually get their medicine.

And late in the year, after the federal government rejected a nine-year-old petition seeking to reschedule marijuana, the governors of Rhode Island, Vermont, and Washington formally asked the Obama administration to reschedule it so that states could regulate its medical use without fear of federal interference. As the year came to an end, Colorado joined in the request for rescheduling.

…But the Empire Strikes Back

Last year saw the Obama administration recalibrate its posture toward medical marijuana, and not for the better. Throughout the year, US Attorneys across the country sent ominous signals that states attempting to regulate medical marijuana dispensaries could face problems, including letters to state governors not quite stating that state employees involved in regulation of the medical marijuana industry could face prosecution. That intimidated public officials who were willing to be intimidated, leading, for example, to New Jersey Gov. Chris Christie (R) delaying his state's medical marijuana program, Rhode Island Gov. Lincoln Chafee (I) to kill plans for dispensaries there, and Washington Gov. Christine Gregoire (D) to veto key parts of a bill there that would have regulated dispensaries.

Then the feds hit hard at Montana, raiding dispensaries and growers there, even as the state law was under attack by conservative Republican legislators. Now, Montana medical marijuana providers are heading to federal prison, and the state law has been restricted. What was once a booming industry in Montana has been significantly stifled.

There have also been raids directed at providers in Colorado, Michigan, Oregon, and Washington, but California has been the primary target of federal attention in the latter half of the year. Since a joint offensive by federal prosecutors in the state got underway in October, with threat letters being sent to numerous dispensaries and their landlords, a great chill has settled over the land. Dispensary numbers are dropping by the day, the number of lost jobs number in the thousands, and the amount of tax revenues lost to local jurisdictions and the state is in the millions. That's not to mention the patients who are losing safe access to their medicine.

It's unclear whether the impetus for the crackdown originated in the Dept. of Justice headquarters in Washington or with individual US Attorneys in the states. Advocates hope it will stay limited mainly to states that are not effectively regulating the industry, and a coalition in California has filed a ballot initiative for 2012 that would do just that. Either way there is plenty of pain ahead, for patients and for providers who took the president's and attorney general's earlier words on the subject at face value.

Synthetic Panic

Last year, Congress and state and local governments across the land set their sights on new synthetic drugs, especially synthetic cannabinoids ("fake marijuana") and a number of methcathinone derivatives ("bath salts") marketed for their stimulating effects similar to amphetamines or cocaine. Confronted with these new substances, politicians resorted to reflex prohibitionism, banning them as fast as they could.

Some 40 states and countless cities and counties have imposed bans on fake weed or bath salts or both, most of them acting this year.

At the federal level, the DEA enacted emergency bans on fake weed -- after first being temporarily blocked by retailers -- and then bath salts until Congress could act. It did so at the end of the year, passing the Synthetic Drug Control Act of 2011. The bill makes both sets of substances Schedule I drugs under the Controlled Substances Act, which will pose substantial impediments to researching them. Under the bill, prison sentences of up to 20 years could be imposed for the distribution of even small quantities of the new synthetics.

But the prohibitionists have a problem: Synthetic drug makers are responding to the bans by bringing new, slightly different formulations of their products to market. Prosecutors are finding their cases evaporating when the find the drugs seized are not the ones already criminalized, and retailers are eager to continue to profit from the sales of the new drugs. As always, the drug law enforcers are playing catch-up and the new drug-producing chemists are way ahead of them.

The Drug War on Autopilot: Arrests Hold Steady, But Prisoners Decline Slightly

overcrowded Mule Creek State Prison, CA
Last year saw more evidence that drug law enforcement has hit a plateau, as 2010 drug arrests held steady, but the number of prisoners and people under correctional supervision declined slightly.

More than 1.6 million people were arrested for drug offenses in the US in 2010, according to the FBI's Uniform Crime Report 2010, and more than half of them were for marijuana. That's a drug arrest every 19 seconds, 24 hours a day, every day last year. The numbers suggest that despite "no more war on drugs" rhetoric emanating from Washington, the drug war juggernaut is rolling along on cruise control.

Overall, 1,638,846 were arrested on drug charges in 2010, up very slightly from the 1,633,582 arrested in 2009. But while the number of drug arrests appears to be stabilizing, they are stabilizing at historically high levels. Overall drug arrests are up 8.3% from a decade ago.

Marijuana arrests last year stood at 853,838, down very slightly from 2009's 858,408. But for the second year in a row, pot busts accounted for more arrests than  all other drugs combined, constituting 52% of all drug arrests in 2010. Nearly eight million people have been arrested on pot charges since 2000.

The vast majority (88%) off marijuana arrests were for simple possession, with more than three-quarters of a million (750,591) busted in small-time arrests. Another 103,247 people were charged with sale or manufacture, a category that includes everything from massive marijuana smuggling operations to persons growing a single plant in their bedroom closets.

An analysis of the Uniform Crime Report data by the University of Maryland's Center for Substance Abuse Research added further substance to the notion that drug enforcement is flattening. The center found that the arrest rate for drug violations has decreased for the last four years, but still remains more than twice as high as rates in the early 1980s. The all-time peak was in 2006.

Meanwhile, the Bureau of Justice Statistics reported that for the first time since 1972, the US prison population in 2010 had fallen from the previous year and that for the second year in a row, the number of people under the supervision of adult correctional authorities had also declined.

In its report Prisoners in 2010, BJS reported that the overall US prison population at the end of 2010 was 1,605,127, a decrease of 9,228 prisoners or 0.6% from year end 2009. The number of state prisoners declined by 0.8% (10,881 prisoners), while the number of federal prisoners increased by 0.8% (1.653 prisoners). Drug offenders accounted for 18% of state prison populations in 2009, the last year for which that data is available. That's down from 22% in 2001. Violent offenders made up 53% of the state prison population, property offenders accounted for 19%, and public order or other offenders accounted for 9%.

In the federal prison population, drug offenders made up a whopping 51% of all prisoners, with public order offenders (mainly weapons and immigration violations) accounting for an additional 35%. Only about 10% of federal prisoners were doing time for violent offenses. Overall, somewhere between 350,000 and 400,000 people were doing prison time for drug offenses last year.

Similarly, in its report Correctional Population in the US 2010, BJS reported that the number of people under adult correctional supervision declined 1.3% last year, the second consecutive year of declines. The last two years are the only years to see this figure decline since 1980.

At the end of 2010, about 7.1 million people, or one in 33 adults, were either in prison or on probation or parole. About 1.4 million were in state prisons, 200,000 in federal prison, and 700,000 in jail, for a total imprisoned population of about 2.3 million. Nearly 4.9 million people were on probation or parole.

America's experiment with mass incarceration may have peaked, exhausted by its huge costs, but change is coming very slowly, and we are still the world's unchallenged leader in imprisoning our own citizens.

Federal Crack Prisoners Start Coming Home

Hundreds of federal crack cocaine prisoners began walking out prison in November, the first beneficiaries of a US Sentencing Commission decision to apply retroactive sentencing reductions to people already serving time on federal crack charges. As many as 1,800 federal crack prisoners were eligible for immediate release and up to 12,000 crack prisoners will be eligible for sentence reductions that will shorten their stays behind bars.

The releases come after Congress passed the Fair Sentencing Act in August 2010, which shrank the much criticized disparity between mandatory minimum sentences for crack and powder cocaine from 100:1 to 18:1. After Congress acted, the Sentencing Commission then moved to make those changes retroactive, resulting in the early releases beginning in November.

Despite the joyous reunions taking place across the country, the drug war juggernaut keeps on rolling, and there is much work remaining to be done. Not all prisoners who are eligible for sentence reductions are guaranteed to receive one, and retroactivity won't do anything to help people still beneath their mandatory minimum sentences. A bill with bipartisan support in Congress, H.R. 2316, the Fair Sentencing Clarification Act, would make Fair Sentencing Act changes to mandatory minimum sentences retroactive as well, so that crack offenders left behind by the act as is would gain its benefits.

And the Fair Sentencing Act itself, while an absolute advance from the 100:1 disparity embodied in the crack laws, still retains a scientifically unsupportable 18:1 disparity. For justice to obtain, legislation needs to advance that treats cocaine as cocaine, no matter the form it takes.

But even those sorts of reforms are reforms at the back end, after someone has already been investigated, arrested, prosecuted, and sentenced. Radical reform that will cut the air supply to the drug war incarceration complex requires changes on the front end.

Also in November, the US Supreme Court announced that it will decide whether the Fair Sentencing Act should be applied to those who were convicted, but not sentenced, before it came into effect -- the so-called "pipeline" cases. The decision to take up the issue came after lower courts split on the issue. The Supreme Court is expected to rule on the issue in June.

Drug Testing the Needy

drug testing lab
With state budgets strained by years of recession and slow recovery, lawmakers across the country are turning their sights on the poor and the needy. In at least 12 states, bills have been introduced that would require people seeking welfare or unemployment benefits to undergo drug testing and risk losing those benefits if they test positive. Some Republicans in the US Congress want to do the same thing. In a thirteenth state, Michigan, the state health department is leading the charge.

The race to drug test the needy appears to be based largely on anecdotal and apocryphal evidence. South Carolina Gov. Nikki Hailey (R), to take one example, cited reports that a nuclear installation there couldn't fill vacancies because half the applicants failed drug tests, but had to retract that statement because it was nowhere near to being true. In Florida, where welfare drug testing was briefly underway before being halted by a legal challenge, 96% of applicants passed drug tests, while in an Indiana unemployment drug testing program, only 2% failed.

While such legislation appeals to conservative values, it is having a tough time getting passed in most places, partly because of fears that such laws will be found unconstitutional. The federal courts have historically been reluctant to approve involuntary drug testing, allowing it only for certain law enforcement or public safety-related occupations and for some high school students. When Michigan tried to implement a welfare drug testing program more than a decade ago, a federal appeals court ruled that such a program violated welfare recipients' right to be free from unreasonable searches and seizures.

That ruling has served to restrain many lawmakers, but not Florida Gov. Rick Scott (R) and the Florida legislature. Scott issued an executive order to drug test state employees, but had to put that on hold in the face of threatened legal challenges. The state legislature passed and Scott signed a bill requiring welfare applicants and recipients to undergo drug testing or lose their benefits.

But the ACLU of Florida and the Florida Justice Institute filed suit in federal court to block that law on the grounds it violated the Fourth Amendment. In October, a federal judge granted a preliminary injunction preventing the state from implementing it. A final decision from that court and decisions about whether it will be appealed are eagerly awaited.

Marking 40 Years of Failed Drug War

Drug War 40th anniversary demo, San Francisco
June 17 marked forty years since President Richard Nixon, citing drug abuse as "public enemy No. 1," declared a "war on drugs." A trillion dollars and millions of ruined lives later, a political consensus is emerging that the war on drugs is a counterproductive failure. The Drug Policy Alliance led advocates all across the country in marking the auspicious date with a day of action to raise awareness about the catastrophic failure of drug prohibition and to call for an exit strategy from the failed war on drugs. More than 50 events on the anniversary generated hundreds of local and national stories.

In dozens of cities across the land, activists, drug war victims, and just plain folks gathered to commemorate the day of infamy and call for an end to that failed policy. Messages varied from city to city -- in California, demonstrators focused on prison spending during the budget crisis; in New Orleans, the emphasis was on racial injustice and harsh sentencing -- but the central overarching theme of the day, "No More Drug War!" was heard from sea to shining sea and all the way to Hawaii.

The crowds didn't compare to those who gather for massive marijuana legalization protests and festivals -- or protestivals -- such as the Seattle Hempfest, the Freedom Rally on Boston Commons, or the Ann Arbor Hash Bash, or even the crowds that gather for straightforward pot protests, such as 420 Day or the Global Marijuana March, but that's because the issues are tougher. People have to break a bit more profoundly with drug war orthodoxy to embrace completely ending the war on drugs than they do to support "soft" marijuana. That relatively small groups did so in cities across the land is just the beginning.

Congress Reinstates the Federal Ban on Funding Needle Exchanges

Two years ago, after years of advocacy by public health and harm reduction advocates, the longstanding ban on federal funding for needle exchanges was repealed. Last month, the ban was restored as the Senate took the final votes to approve the 2012 federal omnibus spending bill.

It was a Democratic-controlled House and Senate that rescinded the ban two years ago, and it was House Republicans who were responsible for reinstating it this year. Three separate appropriations bills contained language banning the use of federal funds, and House negotiators managed to get two of them into the omnibus bill passed Saturday.

A Labor-Health and Human Services appropriations bill including the ban on domestic use of federal funds for needle exchanges and a State Department bill including a ban on funding for needle exchange access in international programs both made it into the omnibus bill.

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. Eight federal reports have found that increasing access to sterile syringes saves lives without increasing drug use.

Needle exchange supporters said restoring the ban will result in thousands of Americans contracting HIV/AIDS, hepatitis C or other infectious diseases next year alone.

US Drug War Deaths

As far as we know, nobody has ever tried to count the number of people killed in the US because of the war on drugs. We took a crack at it last year, counting only those deaths directly attributable to drug law enforcement activities. The toll was 54, including three law enforcement officers.

Most of those killed were shot by police, many of them while in possession of firearms (some in their own homes) and some of them while shooting at police. Some were shot in vehicles after police said they tried to run them down (why is it they never were merely trying to get away?). But not all died at the hands of police -- several died of drug overdoses from eating drugs while trying to evade arrest, several more died from choking on bags of drugs they swallowed, one man drowned after jumping into a river to avoid a pot bust, and another died after stepping in front of a speeding semi-trailer while being busted for meth.

People were killed in "routine traffic stops," SWAT-style raids, and undercover operations. Hardly any of those cases made more than a blip in local media, the two exceptions being the case of Jose Guerena, an Iraq war vet gunned down by an Arizona SWAT team as he responded to his wife's cry of intruders in his own home, and the case of Eurie Stamps Sr., a 68-year-old Massachusetts man accidentally shot and killed by a SWAT team member executing a warrant for small-time crack sales.

Our criteria were highly restrictive and absolutely undercount the number of people who are killed by our drug laws. They don't include, for instance, people who overdosed unnecessarily because they didn't know what they were taking or medical marijuana patients who die after being refused organ transplants. Nor do they include cases where people embittered by the drug laws go out in a blaze of glory that wasn't directly drug law-related or cases, like the four men killed last year by Miami SWAT officers during an undercover operation directed at drug house robbers.

The toll of 54 dead, then, is an absolute minimum figure, but it's a start. We will keep track again this year, and look for a report on last year's numbers in the coming weeks.

In Conclusion...

Last year had its ups and downs, its victories and defeats, but leaves drug reformers and their allies better placed than ever before to whack away at drug prohibition. This year, it looks like voters in Colorado and Washington will have a chance to legalize marijuana, and who know what else the new year will bring. At the least, we can look forward to the continuing erosion of last century's prohibitionist consensus.


 

New Jersey Pharmacy Needle Sales Bill Passes

A bill that would allow for the sale of syringes in pharmacies without a prescription has cleared the New Jersey legislature with bipartisan support and awaits the governor's signature. The bill, Assembly Bill 1088, passed the Assembly Monday on a 54-24 vote; a companion measure passed the state Senate in February on a 28-12 vote.

The bill would allow for the purchase of 10 syringes without a prescription. (image via wikimedia.org)
An ever-growing body of evidence supports increased access to sterile syringes to reduce the spread of blood-borne diseases, such as HIV/AIDS and Hepatitis C. While New Jersey passed a law allowing for needle exchanges in 2006, the law capped their number at six.

The bill would allow for the purchase of up to 10 syringes without a prescription. It also decriminalizes the possession of needles bought from a pharmacy without a prescription.

New Jersey is one of only two states that still bans over-the-counter syringe sales. The other is neighboring Delaware.

The bill was sponsored by Assemblyman Reed Gusciora (D-Mercer), Assemblyman Gordon Johnson (D-Bergen), Assemblyman Craig Coughlin (D-Middlesex), Assemblywoman Joan Voss (D-Bergen), Assemblywoman Cleopatra Tucker (D-Essex), Assemblywoman Joan Quigley (D-Bergen and Hudson) and Assemblyman Thomas Giblin (D-Essex and Passaic).

"This is a historic moment," said Roseanne Scotti, New Jersey state director for the Drug Policy Alliance.  "This is the first time the New Jersey legislature has voted to join the overwhelming majority of other states in allowing limited sales of syringes without a prescription. This legislation has overwhelming support from the medical and public health community. Governor Christie now has the opportunity to sign this legislation that will help end AIDS and save lives."

Trenton, NJ
United States

California Gov. Brown Signs Needle Access Bills

California Gov. Jerry Brown (D) has signed into law a pair of bills that will expand access to clean needles and help prevent the spread of HIV and Hepatitis C infections in the state. The move is winning him kudos from drug reformers and public health advocates.

Badly needed needle exchanges could be coming to more CA counties under a bill just signed by Gov Brown. (wikimedia.org)
The first bill, Senate Bill 41, sponsored by Sen. Leland Yee (D-San Francisco), makes legal the sale of syringes at pharmacies without a prescription. An earlier pilot program allowing such sales had been in effect in some counties and has proven effective at reducing needle-sharing, but most counties did not participate. Now, once the bill goes into effect on January 1, people will be able to buy syringes without a prescription at pharmacies statewide.

The second bill, AB 604, sponsored by Assemblywoman Nancy Skinner (D-Berkeley), allows the California Department of Public Health to authorize new needle exchange programs after consultation with local public health and law enforcement. Currently, needle exchange programs are only authorized after county officials declare a public health emergency, and the political will to do that has been lacking in some counties. This bill allows public health officials to take the initiative instead of waiting for elected officials. It, too, will go into effect on January 1.

"I am directing the department to administer AB 604 in a constrained way, working closely not only with local health officers and police chiefs, but with neighborhood associations as well," said Gov. Brown in his signing statement. "I believe that AB 604 can reduce the spread of communicable diseases and the suffering they cause and, at the same time, respect public safety and local preference."

"This is a huge victory for public health and common sense," said Laura Thomas, Deputy Director of California for the Drug Policy Alliance. "Now all Californians will have the same access to proven, effective HIV and hepatitis C prevention. This gives drug users the tools that they need to protect their health and that of their partners, children, and communities, as well as protecting the California taxpayer from the cost of HIV and hepatitis C infections."

Sacramento, CA
United States

Canada Supreme Court Okays Safe Injection Site [FEATURE]

Rebuffing the Conservative government of Prime Minister, the Canadian Supreme Court Friday ruled unanimously that Vancouver's safe injection site for heroin addicts can stay open. Known as Insite, the Downtown Eastside facility is the only safe injection site in North America.

Vancouver's safe injection site wins a reprieve. (Image: Vancouver Coastal Health)
The Downtown Eastside, centered on the intersection of Main and Hasting, streets, has one of the highest concentrations of injection drug users in the world. An overgrown Skid Row flush with prostitution and destitution, most of its residents live in decaying SRO hotels lining Main Street. Out of 12,000 residents in the area, some 5,000 are estimated to be drug addicts.

At Insite, drug users are provided clean needles and sterilized water with which to mix their drug. Insite does not provide the drugs; users must bring their own. The users inject under medical supervision at one of 12 injecting alcoves.

Insite operates under the auspices of the British Columbia Ministry of Health and the local public health authority, Vancouver Coastal Health. Numerous research reports on Insite have found that it has reduced fatal drug overdoses, reduced HIV and Hepatitis C transmission rates, reduced crime rates in the neighborhood, and increased the number of drug users entering treatment.

It has operated since 2003 under an exemption to Canada's drug laws, but since coming to power, the Harper government has attempted to shut it down, claiming it "enables" drug users. Friday's decision by the Canadian Supreme Court is the final chapter in that effort.

The Harper government argued that the federal drug law took precedence over British Columbia's public health policies. British Columbia and other Insite supporters argued that because Insite is providing a form of health care, its operation is a provincial matter. The federal government's concerns did not outweigh the benefits of Insite, the court said.

"The grave consequences that might result from a lapse in the current constitutional exemption for Insite cannot be ignored," the court said. "Insite has been proven to save lives with no discernible negative impact on the public safety and health objectives of Canada."

Hundreds of Insite supporters gathered at the facility at dawn and broke out in cheers after the decision was announced. As the news spread, harm reduction, public health, and drug reform groups in Canada and around the world lined up to applaud it.

"We are absolutely delighted that we finally have a clear decision on the legal framework for Insite," said Dr. Patricia Daly, Vancouver Coastal Health Chief Medical Health Officer. "Since 2003, Insite has made a positive impact on thousands of clients, saved lives by preventing overdoses, and provided vital health services to a vulnerable population. Today's ruling allows us to continue the outstanding work Insite, its doctors, nurses, staff and partners provide."

"This represents a victory for science," said Dr. Julio Montaner, Director of the BC Center for Excellence for HIV/AIDS. "Prior attempts from the federal government to stop the activities of Insite have been ruled unconstitutional. We are thankful for the continued and unwavering support from the provincial government that has allowed us to set an example in Canada and the world for how to deal with addiction which is, indeed, a medical condition."

"We applaud today's landmark decision by the Canadian Supreme Court to uphold the human rights of all Canadians by allowing Insite to remain open," said the Canadian HIV/AIDS Legal Network, CACTUS Montreal, and Harm Reduction International in a joint statement. "We are heartened the Supreme Court of Canada has recognized that criminal laws on drugs must give way to good public health practices and harm reduction."

"This is a victory for science, compassion and public health -- and, given the fiscal benefits of such programs, the Canadian taxpayer. The Supreme Court of Canada recognized that Insite saves lives, and that that should be a guiding principle in deciding drug policy," said Laura Thomas, California deputy director for the Drug Policy Alliance. "Congratulations to the advocates, drug users, researchers, nurses, and elected officials who have campaigned for Vancouver's supervised injection facility for so long. This is a complete validation of their work."

The Supreme Court of Canada's Insite ruling applies only to Insite. Other Canadian localities seeking to establish safe injection sites must win permission from the federal government. Canadian activists urged them to do so.

"In light of today's Supreme Court decision, jurisdictions Canada-wide should act fearlessly on evidence and make harm reduction services modeled on Insite available to those in need in their locales," said the Canadian groups. "The Minister of Health must respect the court's decision and grant similar exemptions to other sites so that people across Canada will be able to access the public health services they desperately need."

There are 67 safe injection sites operating today, with one in Australia, Insite in Vancouver, and the rest in Europe. There are no safe injection sites operating in the United States, although a move is afoot in San Francisco to get one underway there. The Drug Policy Alliance's Thomas said it is time to start pushing harder.

"For communities in the US which have been hard hit by drug use, it is time to look at the evidence from Canada and start opening supervised injection facilities here," she said. "We look forward to implementing the same desire to save lives in the US."

Vancouver, BC
Canada

Vietnam Using Drug Takers as Slave Labor [FEATURE]

Vietnamese drug users detained by the police are held for years without due process, subjected to torture and physical violence, and forced to work as low- or no-wage labor in camps that are supposed to be drug treatment centers, according to an explosive new report released Wednesday by Human Rights Watch, which called for the camps to be closed and the prisoners released.

The report, The Rehab Archipelago: Forced Labor and Other Abuses in Drug Detention Centers in Southern Vietnam, documents the experience of people confined in 14 detention centers controlled by the government of Ho Chi Minh City. It found that the camps, which are mandated to treat and rehabilitate drug users are instead little more than forced labor camps where prisoners work six days a week processing cashew nuts, sewing clothes, and manufacturing other items.

Those who refuse to work or who violate camp rules are subject to punishments that Human Rights Watch said in some cases amounts to torture. It cited the experience of Quynh Luu, a former detainee who was caught trying to escape.

"First they beat my legs so that I couldn't run off again," Quynh said. "Then they shocked me with an electric baton and kept me in the punishment room for a month."

Quynh's case is hardly an exception, said the human rights monitoring organization, which talked to numerous current and former prisoners.

"People did refuse to work but they were sent to the disciplinary room. There they worked longer hours with more strenuous work, and if they balked at that work then they were beaten. No one refused to work completely," said Ly Nhan, who was detained in Nhi Xuan center in Ho Chi Minh City for four years.

"Work was compulsory," said Luc Ngan, who was a minor when he began more than three years in detention at Youth Center No. 2 in Ho Chi Minh City. "We produced bamboo furniture, bamboo products, and plastic drinking straws. We were paid by the hour for work -- eight-hour days, six days a week."

While workers were paid, they never saw the money, said Quynh, who spent five years at Center No. 3 in Binh Duong province. "On paper I earned 120,000 Vietnamese dollars a month, but they took it. The center staff said it paid for our food and clothes."

"If we opposed the staff they beat us with a one-meter, six-sided wooden truncheon. Detainees had the bones in their arms and legs broken. This was normal life inside," said Dong Ban, who was imprisoned for more than four years in Center No. 5 in Dak Nong province.

"Tens of thousands of men, women and children are being held against their will in government-run forced labor centers in Vietnam," said Joe Amon, health and human rights director at Human Rights Watch. "This is not drug treatment, the centers should be closed, and these people should be released."

The Vietnamese embassy in Washington did not return a call for comment Wednesday.

The system of forced labor camps for drug users originated with "reeducation through labor" camps for drug users and prostitutes established after the North Vietnamese victory over the South in 1975. They received a renewed impetus in the mid-1990s as the government launched a campaign to eradicate "social evils," including drug use. Their numbers have grown as the Vietnamese economy has expanded, more than doubling from 56 in 2000 to 123 at the beginning of this year.

Perversely, international donations to support drug treatment centers and to the Ministry of Labor, Invalids and Social Affairs have enabled the regime to continue to hold HIV-positive drug users against their will, even though Vietnamese law says they have the right to be released if they are not receiving appropriate medical care. Since 1994, international donors have sought to "build capacity," including training staff in drug treatment and support for HIV interventions, but Human Rights Watch reported that most centers offer no antiretroviral treatment or even basic medical care. The group cites various reports putting the number of HIV-positive detainees at between 15% and 60% of the detainee population.

The report contains testimonies from numerous detainees and former detainees who said they were sent to the centers without a formal hearing and without ever seeing a lawyer or judge. Some were sent to the camps after being arrested by police, while others were turned in by family members who "volunteered" them, believing they would get effective drug treatment there.

"I was caught by police in a roundup of drug users," said Quy Hop, who spent four years in the Binh Duc camp in Binh Phuoc province. "They took me to the police station in the morning and by that evening I was in the drug center. I saw no lawyer, no judge."

A small number of detainees voluntarily placed themselves in the centers to get drug treatment, but even they were not free to leave. Some reported that their detention was capriciously extended by camp managers or by changes in government policy.

Human Rights Watch was unable to provide the names of any foreign companies benefiting from detainee labor, saying "the lack of transparency or any publicly accessible list of companies that have contracts with these government-run detention centers made corroborating the involvement of companies difficult." But it did cite Vietnamese media reports as saying two Vietnamese companies, Son Long JSC, a cashew processing firm, and Tran Boi Production, which manufactures plastic goods, both used detainee labor. Neither company has replied to inquiries from Human Rights Watch, the group said.

"Forced labor is not treatment, and profit-making is not rehabilitation," Amon said. "Donors should recognize that building the capacity of these centers perpetuates injustice, and companies should make sure their contractors and suppliers are not using goods from these centers."

Besides calling on the government of Vietnam to shut down the camps, Human Rights Watch is seeking "an immediate, thorough, and independent investigation into torture, ill treatment, arbitrary detention, and other abuses in the country's drug detention centers." In addition, it wants the government to make public a list of all companies with contracts for detainee labor.

Human Rights Watch also calls on international donors to review their aid to the detention centers to ensure that it is not supporting programs that violate international human rights standards and urges companies working with the detention centers to end all relationships immediately.

"People who are dependent on drugs in Vietnam need access to community-based, voluntary treatment," Amon said. "Instead, the government is locking them up, private companies are exploiting their labor, and international donors are turning a blind eye to the torture and abuses they face."

Ho Chi Minh City
Vietnam

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