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Making Sure Drugs Kill: Commission Blames Drug War for Spreading AIDS [FEATURE]

On Tuesday, as the UN's global drug prohibition bureaucracy marked its annual International Day Against Drug Abuse and Illicit Trafficking and UN Office on Drugs and Crime head Yuri Fedotov blamed hard drug use for "bringing misery to thousands of people, insecurity, and the spread of HIV," a group of leading international voices offered a starkly contrasting perspective, arguing instead that is the failures and consequences of global drug prohibition that are driving the spread of HIV/AIDS and other blood-borne diseases among drug users.

Commission members Michel Kazatchkine, Ruth Dreifuss, and Ilana Szabo at London press conference
Those voices, gathered together as the Global Commission on Drug Policy, include six former presidents from around the world, public health experts, and socially conscious entrepreneurs such as Sir Richard Branson. They took the opportunity of global anti-drug day to issue a report, The War on Drugs and HIV/AIDS: How the Criminalization of Drug Use Fuels the Global Pandemic that directly condemns the drug war as a failure and calls for immediate, fundamental reforms of the global drug prohibition regime to slow the spread of HIV and reduce other drug war harms.

There are an estimated 33 million people worldwide infected with HIV, and outside sub-Saharan Africa, injection drug use accounts for one-third of new infections. The situation is particularly bad in Russia and other countries in the former Soviet Union and East Bloc that continue to take harsh drug war approaches to drug use despite the evidence before their own eyes. In Russia, nearly one in a hundred adults is now infected with HIV.

But it's not just the Russian sphere where policymakers ignore the evidence. The report also cites China, Thailand, and the US, where Congress recently reinstated a longstanding ban on the use of federal funds for syringe exchange programs. In countries that have adopted evidence-based HIV prevention programs, such as Switzerland and Portugal, injection drug use-related HIV infections have nearly been eliminated.

According to the report, drug prohibition and the criminalization of drug users spurs the spread of HIV through the following means:

  • Fear of arrest drives persons who use drugs underground, away from HIV testing and HIV prevention services and into high-risk environments.
  • Restrictions on provision of sterile syringes to drug users result in increased syringe sharing.
  • Prohibitions or restrictions on opioid substitution therapy and other evidence-based treatment result in untreated addiction and avoidable HIV risk behavior.
  • Deficient conditions and lack of HIV prevention measures in prison lead to HIV outbreaks among incarcerated drug users.
  • Disruptions of HIV antiretroviral therapy result in elevated HIV viral load and subsequent HIV transmission and increased antiretroviral resistance.
  • Limited public funds are wasted on harmful and ineffective drug law enforcement efforts instead of being invested in proven HIV prevention strategies.

"The Global Commission is calling on all entities to acknowledge and address the causal links between the war on drugs' criminalization of drug use and drug users and the spread of HIV/AIDS," commission member Michel Kazatchkine, the former executive director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria told a London press conference. "For people who inject drugs and their sex partners, the AIDS epidemic continues to be a public health emergency."

"It is so clear now that there is a relation between repressive drug policies and the spread of HIV/AIDS," said former Colombian President Cesar Gaviria. "If we don't get people into the health system without fear, it will be very difficult to do treatment and prevention."

Commission member Sir Richard Branson at "Atlantic Exchange" drug policy discussion, Washington, DC, March 2012
"I have long thought the war on drugs did more harm than good, and the commission's report put the data behind those beliefs," said Branson. "The war on drugs is not stopping drug use, and it also contributes significantly to the AIDS epidemic by driving users into the shadows. As an entrepreneur, if my business was failing for 40 years, I would close it down. Refusing to implement public health measures to reduce HIV and protect people with a drug problem is nothing short of criminal."

Branson and the other commissioners made some concrete recommendations for action in the report. Those include:

  • Push national governments to halt the practice of arresting and imprisoning people who use drugs but do no harm to others.
  • Measure drug policy success by indicators that have real meaning in communities, such as reduced rates of transmission of HIV and other infectious diseases, fewer overdose deaths, reduced drug market violence, fewer individuals incarcerated and lowered rates of problematic substance use.
  • Respond to the fact that HIV risk behavior resulting from repressive drug control policies and under-funding of evidence-based approaches is the main issue driving the HIV epidemic in many regions of the world.
  • Act urgently: The war on drugs has failed, and millions of new HIV infections and AIDS deaths can be averted if action is taken now.

"The AIDS epidemic is a harsh and brutal teacher that obliges us to take a scientific approach to deal with sex workers and drug addicts," said former Swiss President and commission member Ruth Dreifuss. "Politicians have to inform citizens of the benefits, risks, and failures of drug policy, and politics has to take responsibility for policy change. Public health has to be at least as important as criminalizing the drug traffic," she told the press conference.

"Addicted injecting drug users is one of the main sources of the spread, and not all of them will achieve abstinence," said Dreifuss. "Substitution therapies can take people away from street drug dealers and violence. For some, the provision of medical heroin is necessary to allow them to abandon criminal activities and overcome marginalization. It's possible to implement these large scale programs at low costs with high benefits," she argued.

"For others, harm reduction measures are necessary in order to avoid the spread of HIV/AIDS and other bloodborne disease. Needle exchange programs, free condoms, safe consumption rooms all not only save the lives of drug users but protect the whole population," Dreifuss explained. "We need the full spectrum of these measures for those in prison, too, who are at more risk for HIV infections."

Dreifuss touted her own country's experience as a model. Faced with mounting injection drug use, Switzerland eventually went the route of supervised injection sites and opioid maintenance, including heroin maintenance.

"Our experience is that it works," she said. "The police protect the injection rooms from dealers. The four pillar policy [prevention, treatment, harm reduction, enforcement] has been broadly accepted by our citizens and the spread of HIV/AIDS is under control."

Even within the constraints imposed by the global drug prohibition regime, countries can still take action to mitigate the drug war's role in the spread of infectious disease, she said.

"It is possible for countries to adopt effective harm reduction measures within existing drug laws," Dreifuss argued. "The decriminalization of drug use is the first step, and the second step is to determine what type of market can drive out dealers. The war on drugs has failed to reduce supply or demand; let us replace prohibition with regulation and avoid jeopardizing public health and harm reduction policies with inefficient measures."

"Our message is that prohibitionist law enforcement has failed in its goals of eradicating drugs and protecting people's health," said Kazatchkine. "Illegal drugs have become cheaper and more available and HIV and other health risks have increased. Prohibitionist policies have been shifting the market to stronger drugs and led to a war on users with numerous human rights abuses, police harassment, violence, extortion. The fear of police and stigma is driving users underground and away from access to information, care, and medical services," he warned.

"One cannot improve health through war," he concluded. "This is an epidemic among people who inject that we can actually control. If we are to have a chance at reducing the transmission of AIDS, we need to open up and change our ways."

The Global Commission on Drugs has laid out the problem and showed us the path to fix it. Now, it is up to our political leadership to act accordingly, and it is up to us to ensure that it does.

London
United Kingdom

Drug Prohibition's Cocaine Traffickers Have Proven Both Vicious and Resilient

Location: 
Since the beginning of the drug prohibition war, the drug trade has ballooned, spreading violence and corruption across large parts of the globe. Despite billions spent on combating them drug traffickers have for decades outwitted the authorities, keeping consumers in North America and Europe supplied at a price and purity that remains remarkably consistent despite law enforcement officials around the world frequently heralding the dismantling of trafficking networks.
Publication/Source: 
The Irish Times (Ireland)
URL: 
http://www.irishtimes.com/newspaper/world/2011/0127/1224288397713.html

Random Drug Testing Won’t Save the Children From Heroin

Here’s drug czar John Walters shamelessly using a young woman’s death as an opportunity to plug student drug testing:

Heroin killed 19-year-old Alicia Lannes, and her parents say she got the drug from a boyfriend.  Experts say that's how most young kids get introduced to drugs: by friends or relatives.

While teen drug use is declining, Walters says a Fairfax County heroin ring busted in connection with Lannes' death proves it's still a problem.  He supports a federal program used in more than 4,000 schools to randomly drug test students.

"There's no question in my mind had this young woman been in a school, middle school or high school with random testing," said Walters, "She would not be dead today." [FOX DC]

Walters sounds supremely confident, as usual, yet the reality is that random drug testing is often impotent when it comes to discovering heroin use. Student drug testing programs typically rely on urine tests, which can only detect heroin for 3-4 days after use. Only marijuana -- which stays in your system for up to a month – can be effectively detected this way. Thus, random testing actually incentivizes students to experiment with more dangerous drugs like heroin that increase your chances of passing a drug test.


And thanks to the complete failure of the drug war, heroin is stronger today than ever before:

The drug enforcement agency says the purity of heroin found in Virginia is typically higher than usual—making it more deadly.

"They tend not to know how to gauge the strength and they usually take more than they need to," said Patrick McConnel, who oversees Treatment for Youth Services Administration Alcohol and Drug Services.

There are no easy answers here, to be sure, and I don’t claim any monopoly on the solutions to youth drug abuse. But I guarantee you that the problem isn’t our failure to collect more urine from young people. As long as the most dangerous substances continue to be manufactured, distributed, and controlled by criminals, the face of our drug problem will remain the same.

Marijuana Evolves Faster Than Human Beings

Explaining the failure of marijuana prohibition is easy. Sociology, economics, history, and psychology can all help to explain why a safe and popular drug cannot be removed from the market by force. Still, there is another important reason why marijuana is here to stay: it evolves at an incredibly rapid pace, becoming stronger and more profitable every day.

The vigorous growth and adaptability of the marijuana plant has long frustrated efforts by law-enforcement to thwart its production. Specific strains are easily cross-bred, producing offspring that emphasize certain qualities, thus growers in Oregon can develop a strain that grows well in Oregon's climate with minimal effort. Hybridization not only improves potency, but can also shorten flowering time and increase yield, thereby enabling growers to produce more in less time.

We're witnessing a situation in which the biological vigor of the plant itself has far outpaced law-enforcement efforts that were never effective to begin with. Indoor-grown strains can advance through 3-4 generations in a year's time, with the best specimens from each batch selected for cloning or crossbreeding. Each successive generation carries on the best traits of the former, which explains why growers can now accomplish in a basement what used to require an acre or more in the woods.

The great irony of all this is that drug warriors still think increased marijuana potency is an argument for their side. In reality, nothing could better illustrate the failure of their efforts to reduce the drug's production. Harsh marijuana laws have incentivized growers to produce a stronger product, which carries the same penalties by weight, while commanding higher prices on the street.

As the bitter debate over marijuana legalization rages on, the plants will grow ever faster, bigger, and stronger. Marijuana is one of nature's most remarkable creations, and it is unbelievable that so many people still haven't figured out that this plant is here to help us. From healthy foods to a promising cancer cure, we should be grateful that cannabis sativa grows and evolves as vigorously as it does.

With every forward step in marijuana's evolution, the war against this resilient plant becomes less and less effective.

Note: Thanks to court-qualified cannabis expert Chris Conrad for answering growing questions, and to pot-paparazzi Steve Bloom for turning me on to the government's awesome 2008 cultivation assessment, which got me thinking about this.
Location: 
United States

This is Not Your Parents' Cocaine

From The Baltimore Sun:
The United States and its Latin American allies are losing a major battle in the war on drugs, according to indicators showing that cocaine prices dipped for most of 2006 and American users were getting more bang for their buck.
We've already covered this story, but it's beginning to generate broader coverage. Of course, no amount of negative publicity will silence our brave drug warriors even momentarily. Here's Karen Tandy just yesterday:
"Plan Colombia is working. The amount of land used for the cultivation of coca is at an historic low in Colombia," the head of the US Drug Enforcement Administration, Karen Tandy, told a drug law enforcement conference in Madrid. [AFP]

So why does Washington cover up increased cocaine potency, while aggressively trumpeting increased marijuana potency? The answer is simple, although if you asked the drug czar, he'd turn purple and pretend not to understand what you mean.

In the case of cocaine, the federal government has long identified reducing purity and increasing price as the primary goals of our ridiculously expensive and ongoing South American drug war investments. Increased cocaine potency in 2007 raises serious doubts about the efficacy of the brutal jungle wars we've been bankrolling for 10 years.

In the case of marijuana, however, the government's primary interest is in convincing an experienced public that this isn’t the same drug that has so consistently failed to hurt anyone. Jacob Sullum puts it best:

These warnings have to be understood mainly as a rationalization for the hypocrisy of parents (and politicians) who smoked pot in their youth and thought it was no big deal then but feel a need to explain why it is a big deal now.
Of course, while drug war demagogues are fond of comparing today's more potent marijuana to cocaine, there's really nothing to which they can compare today's stronger cocaine. I dunno, anthrax maybe? When I start hearing reports about weaponized nose-candy, I'm totally moving to Jupiter.

Location: 
United States

U.S. will limit use of fentanyl ingredient

Location: 
Washington, DC
United States
Publication/Source: 
Detroit Free Press
URL: 
http://www.freep.com/apps/pbcs.dll/article?AID=/20070508/NEWS05/705080338/1007

More overdoses seen as heroin grows stronger

Location: 
Torrington, CT
United States
Publication/Source: 
The Register Citizen (CT)
URL: 
http://www.registercitizen.com/site/news.cfm?newsid=18308588&BRD=1652&PAG=461&dept_id=12530&rfi=6

Most meth now coming into state from outside

Location: 
IA
United States
Publication/Source: 
Radio Iowa
URL: 
http://www.radioiowa.com/gestalt/go.cfm?objectid=52439654-FC5B-FFCA-6B6016784DECEBD3

Legalizing drugs is better way to fight problem

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WV
United States
Publication/Source: 
The Herald-Dispatch (WV)
URL: 
http://www.herald-dispatch.com/apps/pbcs.dll/article?AID=/20070410/NEWS01/704100319/1001/NEWS10

Cherry picking data to prove a point about cannabis

Location: 
United Kingdom
Publication/Source: 
The Guardian (UK)
URL: 
http://www.guardian.co.uk/commentisfree/story/0,,2041750,00.html

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