United Nations

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

Ah, the Clockwork Orange brainwashing day. (For my preamble, click here. For coverage of day 1, click here.) There's nothing in my cranium. I've blocked it all out. A windowless auditorium and a set of presentations where the direction from the organizers to the presenters was "keep it tedious and repeat the information from the day before."

Allan Clear, after the nine hours took its toll

I sat for 9 hours or so waiting for some kind of stimulation that was not arriving. Supplied with powerpoint presentations of the most unimaginative kind, graphs and pie charts and tables, presenters made a great show of their learning and authority, but speakers had a complete inability to talk in either a compelling or dynamic fashion. Did no one on the organizing committee check to see if presentations would overlap? John Strang, National Addiction Center, United Kingdom, talked about methadone as Herb Kleber, Columbia University, USA, did the day before; a panel on brief interventions on which presenters both used the same WHO tool as a discussion point. You can't blame the presenters. The organizers clearly had a concept in mind and that's where it stayed – in someone's mind or in a folder in a cabinet hidden behind cleaning supplies that had been pilfered from the commissary. The conference is presenters from university settings and addiction centers from the USA, Canada and the UK who have failed to adapt their presentations for their audience. I cannot imagine that Herb Kleber actually put any thought into what he presented. His secretary pulled a canned presentation from his presentation file in 'My Documents' and handed it to him at 4:00 pm on Friday afternoon. How does science on methadone translate into practice for someone who is dealing with an emerged heroin epidemic in Dar es Salaam? Yes methadone and buprenorphine is very effective but how do you deliver it to drug users in a country that has no history of addiction medicine, where methadone is not currently in the country, where users are not going to pay for medication and where the government is going to be looking over their shoulders for a reaction from the International Narcotics Control Board if they deviate from a clinic based system? I might be the only person who really cared. Three quarters of the audience didn't show up today. After all, there is Christmas shopping to be gathered up and taken home. "From research to practice" is the tag after the colon in the description of the conference. The absent audience didn't get that on day 2 and maybe they knew it wasn't going to be delivered anyway. Perhaps, however, none of this is the point. As Gilberto Gerra, Chief of Health and Human Development Section of UNODC indicated on the first day, UNODC is gathering steam to launch a big demand reduction initiative. However, to make it work, UNODC needs US buy-in. Therefore a US dominated event is a perfect sop to butter them up. It's a solid way of branding drug treatment as the demand reduction approach. The estimable John Strang choked nervously during his presentation when he mentioned 'harm reduction', lamely explaining that it's not a controversial term in Europe. European governments do see harm reduction as part of a health care continuum for drug users and hopefully can ensure that not only can they continue to fight for it through the UNGASS process but can see it assimilated into the new UNODC demand reduction initiative. Thomas Barbor from the University of Connecticut School of Medicine delivered a fairly decent albeit guarded presentation on brief interventions. It would have been nice if he could have stretched out a little and talked in more detail about applications. Screening, Brief Intervention and Referral to Treatment (SBIRT) fits snugly into the harm reduction fold. It's aimed at non-problematic users in settings that are generally not used to discuss alcohol and drug use. Essentially, workers at needle exchange programs deliver brief interventions everyday but SBIRT takes it to emergency rooms and other venues and approaches a different audience. It's not a technique aimed at cessation of drug use and it's not necessarily targeted at people with problematic use although if those individuals are ferreted out, then they get the treatment referral. It was interesting watching Herb Kleber grapple with the concept (although it can't be new to him). He wanted to know what the sustained effect was on keeping use down after the intervention. However that's not the point. If use remains down, that's cool. But if the user can be more conscious of their use and not drink and drive for instance, then that's great. Kleber wasn't the only one confused. I had dinner with a confused David Joranson from the University of Wisconsin. He's working with Scott Burris from Temple University and Dave Burrows from aidsprojects.com from the Land of Oz on providing access to pain medication to people in need. "So why are we lumped in with harm reduction?" was his plaintive cry. No reason that makes any sense, David, except when you get involved with providing pain medication to people who are suffering you come up against control mechanisms and fear. And when you provoke those feelings in authorities you get lumped in with all the other transgressors – the queers and the junkies and the sex workers – and life becomes a series of negotiations and compromises. Good people get hurt and great projects get unreasonably scrutinized because ideologues cannot get over their dogma and paranoia. Methadone and buprenorphine are essential medicines according to the WHO. However, some funding for the pain medication issue has been applied to a short film that covers the health-oriented side (as opposed to the deviant side!) of opiate use. Called "The Two Faces of Opium" it shows the need for pain medicine and shows methadone as an addiction medicine. Unfortunately only about 25 people got to see this film as it was shown as an evening side event. I think the daytime audience would have benefited a great deal more from the film than the anything else on view today. Allan Clear is executive director of the Harm Reduction Coalition.

More than 200 people from around the globe have shown up for the first day of this drug treatment meeting at the United Nations Office on Drugs and Crime (UNODC) in Vienna. (If you're just tuning it, it may be helpful to read my first post, from yesterday, where I set the stage for what's to come.) Tantalizingly titled "Technical Seminar on Drug Addiction Prevention and Treatment: from Research to Practice," the tag line at the bottom of the conference program awkwardly hawks "NOTHING LESS than a qualified, systematic, science-based approach such as that used to treat other health conditions" — a fair enough goal. I tell you, the crowd was on tenterhooks for the event to begin. In truth it was the most subdued, dead crowd ever gathered. Perhaps the most exciting event of the day was kangaroo hotpot on the canteen menu. To be clear, I have less interest in the science on show than on the subtexts of the dialogue and what is said and not said — all with an eye on the Commission on Narcotic Drugs (CND) meeting occurring next March. At that convening, countries will gather to review the last decade of UN-approved international drug policy, set forth at the first United Nations General Assembly Special Session (UNGASS) on Drugs in 1998, and issue a new UN Political Declaration. I suspect that the goings on at this prior conference may offer hints of what's to come. Antonio Maria Costa, the Executive Director of the UNODC, was in fine fettle opening the event. True to his pompous, unapologetic manner he was disrespectfully late, but his opening remarks were good. He wants the CND/UNGASS process to put increased money into demand reduction in order to put health at the center of the equation and reduce drug related crime. Consequently, Costa called for the rebalancing of drug control (by putting a greater emphasis on health), expressed concern that too little is spent on treating drug addiction, and acknowledged that law enforcement should not be used as an alternative to treatment. Costa also rejects the over-incarceration of drug users (he's been consistent about this). I'd like to think that Costa's comment re: over incarceration was an unsubtle dig at the US, where 1 in 31 US citizens live under the auspices of the criminal justice system. However, I suspect he's directing his remarks at the world below the equator or at Central Asia. In so many words, he admonished member states for not protecting their drug users and respecting their human rights. The day went downhill from then on in, as the conference morphed into a showcase for the disconnect between the science around drugs and addiction and the current reality re: which research-based policy recommendations are ever actually applied or funded or prioritized by governmental bodies. Consider the presentation of the keynote speaker, Dr. Nora Volkow, who heads the United States' National Institutes on Drug Abuse. I like Volkow. She cares about people who use drugs, and exudes compassion and even fire when she defends them. Before her presentation, we had a conversation about the federal ban on the funding of syringe exchange, and she expressed real excitement about working for Barack Obama.

	Ingo Michels, representative of Germany's Ministry of Health

Certainly Dr. Volkow's presentation on the science of addiction was well done, and it affirmed much of what has been said for years by those of us who are involved in harm reduction. She ran through her Positron Emission Tomography (PET) Scan studies (they show the effect of drugs on the brain) and noted that there is hope of our someday being able to know in advance who is vulnerable to problematic drug use. In stating that abstinence is 'magical thinking' and addiction has a smorgasbord of serious medical consequences, including hiv/hcv, cancer, and mental illness, associated with it, she laid out a fine argument for embracing harm reduction without connecting the dots of course. She noted that people are people are at risk due to environmental factors. But looking at the blues, reds and yellows in the dissected brains on show, one would be hard pressed not to consider the color of the person who possessed this brain to begin with and then the hard, cold facts re: the skin color of who actually gets locked up for long periods of time in the US for having what Dr. Volkow was describes as a brain disease. The drug war in the US has disproportionately affected people and communities of color. Looking at the science of addiction doesn't dispel the effects of institutionalized racism. Nor does it reunite families, deliver education, or prevent HIV transmission. Scientific discovery is only the first step; it won't do us much good unless and until it's translated into real world policies and services. Hopefully that's Dr. Nora Volkow's dream under Obama (and Obama's dream as President): to put the theories that come out of what she and her colleagues are learning in the lab into practice. Most of the rest of the presentations were equally predictable. Drug treatment works. Drug prevention is cost effective. Drug treatment is cost effective. Addiction is a brain disease. Methadone works. Buprenorphine works. And that's all to the good. But will any of the policy recommendations that come out of this research ever actually be applied or funded or prioritized by governmental bodies? Anywhere? Vladimir Poznyak, from the Department of Mental Health and Substance Abuse at the World Health Organization (WHO), was the first person to bring up harm reduction. Clearly there is some tension between WHO and this UNODC meeting. Given the consistent commitment WHO has expressed for harm reduction, Poznyak pointedly highlighted needle exchange and harm reduction as HIV prevention in a WHO technical manual during his talk. But for my money the Man of the Day was Ingo Michels from the Ministry of Health in Germany. Michels' presentation, which detailed Germany's comprehensive drug treatment system and included information on safer injection sites, heroin prescription, and drug user organizations, clearly rejected the extent to which harm reduction had remained hidden and unspoken during the first day. It was also the first indication that harm reduction is more than just a means of HIV prevention. Your intrepid reporter then got the first question in. Prattling on in my usual fashion that is never succinct and always more about making a point rather than asking a simple question, and bearing in mind what I said in yesterday's post about the way in which US governmental representatives at these UN meetings always suppress the extent of harm reduction and needle exchange programs in the US and their success, I went at it. I detailed out the number of needle exchange programs in the US; noted out that the larger programs are federally funded (except for needles); and pointed out that they represent a continuum of care for drug users, act as a safety net for drug users who are "out of treatment," and make referrals to drug treatment. In short, I argued that the UN is cornering itself by limiting harm reduction programs as just an HIV intervention. Well, that set Michels off. He slammed the US representatives for blocking the UNGASS process and said he hoped the Obama Presidency would mean that there would be a new UNGASS delegation at this March's meeting. (Being fairly new to this process, I think he probably overstepped his bounds. Excellent stuff.) Surprisingly, the conservative panel facilitator, Gilberto Gerra, Chief of Health and Human Development Section of UNODC, also animatedly joined the discussion by saying that UNODC believes that harm reduction should be part of the "comprehensive package." I'll be damned. More battle to be joined tomorrow. Allan Clear is executive director of the Harm Reduction Coalition.

What's on in Vienna this week? Oh it's the "The Technical Seminar on Drug Addiction Prevention and Treatment: From Research to Practice." What on earth can be the reason for holding a drug treatment meeting at the United Nations Office on Drugs and Crime (UNODC) in Vienna right before the holidays? Alas, I'm not familiar enough with local tradition to know whether it's as customary as a carol service or just another of the Bush Administration's dying groans — a last-ditch effort to spend down its budget or influence UN drug policy. There's plenty of reason to believe that it might be both. The US is the prime instigator of this conference, charmingly titled (in classic UN-speak) "The Technical Seminar on Drug Addiction Prevention and Treatment: From Research to Practice." Don't let the exciting title fool you. What happens here under the auspices of the US, in league with its dear friend Antonio Maria Costa, the Executive Director of UNODC — who is capable of saying very sensible things, but is also on record as having said that "One song, one picture, one quote that makes cocaine look cool can undo millions of pounds' worth of anti-drug education and prevention" — may well set the tone of future international drug policy. Although not directly connected to this conference, we'll know for sure in March. That's when the Commission on Narcotic Drugs (CND), which serves as the UN's governing body on these issues (the UNODC is the CND's administrative wing), will be having its 52nd Annual Meeting here in Vienna. The business at hand will include a Ministerial segment which will sign off on and release a new UN Political Declaration. This follows a year-long review and evaluation of the performance of the policies set forth during the 1998 United Nations General Assembly Special Session (UNGASS) on Drugs, which was the first of its kind. And why should you or anyone care about these meetings or UN Declarations? Because they have genuine implications in the national, international, and local level. The policies set during that first 1998 UNGASS on Drugs came down firmly on the side of the criminalization of illicit drugs and their users. Its goal was "eliminating or significantly reducing the illicit cultivation of coca bush, the cannabis plant and the opium poppy by the year 2008." Translation: it rubber stamped the ongoing War on Drugs. In the US, this disastrous, expensive, and ineffective strategy costs taxpayers a cool 12 billion in 2004 alone, and swelled the ranks of non-violent first-time drug offenders in US prisons, many of them low-income or working-class people of color. It has been equally disastrous internationally, from Mexico to Afghanistan. Now the future of international drug policy rests on what this new UNGASS Declaration will say. And at this very moment, out of your sight and away from the news media, there's a pitched battle being waged in the Demand Reduction Working Group — one of many working on that document. Representatives from the meetings' participating nations and from outside community-based organizations are arguing amongst and between themselves about the strategies for reducing illicit drug use. Are the collected nations going to sign on to yet another tour of duty with the War on Drugs? Or will this Declaration finally shift the focus of international drug policy towards a human rights, public health-based approach that will serve rather than merely criminalize and punish drug users? The answer to that question will be particularly important to countries that are in the process of developing their own drug plans. Certainly they should be able to turn to a science and public health-based document. Even 11 years ago, when the first UNGASS Political Declaration and action plans were being written, the science was clear re: the importance of harm reduction and syringe exchange as a mean of preventing HIV among people who use drugs. Even then, there was murmuring about the importance of developing drug policies that intersected with a human rights framework, and of "evidence based" solutions. Times have changed and our thinking has become more sophisticated. Drug treatment has to have a bigger role now; the interplay between drugs and infectious disease is more apparent. The world of drug policy has the opportunity to learn some towering lessons learned from the world of HIV, which long ago learned to include People Living with AIDS in policy discussions. In short, now is the moment for an evidence based, health oriented, human rights based international drug policy. But will the US stand aside and let that happen? Or will countries developing their own drug policies be denied access to evidence-based drug strategies? Will they be forced instead to rely on the existing official drug plans of countries like the US, which is notorious for exporting the same bad drug policy as it reserves for us at home and for acting out in a belligerent, bullying style at most international forums? At meetings held here in Vienna, the US delegation and the US mission are infamous for having apoplectic fits every time the term "harm reduction" is raised. They do so despite the considerable amount of harm reduction work that takes place in the States and its proven effectiveness in curbing HIV; despite the amount of federal funding that supports some of the larger programs around the country; despite the promotion of Safety Counts as an HIV prevention intervention; despite widely available methadone; and despite the great work that has curbed overdose and viral hepatitis, and made possible housing and mental health care for people who use drugs. Still, the State Department and the Office of National Drug Control Policy have happily and successfully ignored these vast accomplishments, and never breathed a word of them to fellow governments at these meetings. The rest of the international community believes that no harm reduction occurs in the States. And for so long as they believe that, they will be less well equipped to counter the resistance of their US counterparts. Which brings us to the issue of why I'm here and why we need to show up to meetings such this "technical seminar" — even in mid-December. Because back in July 2008, over 300 community-based organizations from around the world came together under the auspices of UNODC to prepare our own Political Declaration. And while not perfect, our Declaration is inclusive of people who use drugs, human rights, and harm reduction. http://www.harmreduction.org/article.php?id=782. Still, the work we put into that document will go unheeded and unused if countries like the US (and its allies in the War on Drugs, Russia and Japan) remain resolutely opposed to good policy reform. Someone has to challenge our government or we'll stay stuck in our rut and produce the same tired, regressive UN document no matter who has been elected to the White House. Anyway that's the scene setting for the next couple of days. There could be some cloak and dagger goings on — hints of the meeting to come in March. Or it's quite possible that this drug treatment conference is going to unfurl as, well, a very boring drug treatment conference in which case I'll report back on the hairstyles of the US Government delegation. Manana ……. Allan Clear is executive director of the Harm Reduction Coalition.

Last month I posted some video highlights, filmed by the Hungarian Civil Liberties Union, from a recent NGO session convened by the United Nations drug agency in Vienna where many of our friends participated. HCLU has released some more videos from the session, "Abstinence First?," discussing the flaws of the abstinence-only model; "Student Drug Testing"; and War on Drugs: The New Jim Crow." Follow the links to read introductory comments by HCLU's Peter Sarosi before watching the videos, or just watch them here:

The week before last NGOs from around the world concerned with drug policy gathered at the United Nations Vienna location. I wasn't there, but friends of mine played an important role, and they did a great job. Check out these video interviews put together by the Hungarian Civil Liberties Union: Find the HCLU web site here.

Graham Boyd at ACLU has a fascinating series of posts on the U.N. drug policy summit in Vienna. It is a remarkable event bringing together AIDS organizations, public health groups, human rights advocates, treatment specialists, police officers, substance abuse researchers, academics, drug policy reformers, and other experts from around the world to critique UN drug policy and make recommendations.

Not surprisingly, the Drug Czar's office felt threatened by the event and sent an enforcer to intimidate everyone:

First, the intrigue. Throughout the first day, I kept noticing this one person who harrumphed, guffawed, and muttered every time someone spoke in ways critical of the drug policy status quo. By accent, she seemed to be from the United States. And she had a yellow badge, where everyone else had a red badge. Who was she? Why did she keep shuffling over to the U.S. groups like Drug Free America and other cheerleaders for U.S. hardline policy? She settled in right behind me, and gave instructions to her allies — tactics for blocking inclusion of harm reduction. She said "one of you needs to interject to stop the hand clapping in favor of their proposals." More and more, she seemed like some sort of puppet master. As the day concluded, she rushed up to the podium, accosted the chair, and, in the most agitated way, began lambasting the chair for various procedural points.

I had to find out about the American woman with the yellow badge. At a social gathering later that evening, I described my observations to some of the NGO delegates who regularly attend these U.N. events. Turns out that the yellow-badge woman is June Sivilli, an employee of the U.S. drug czar’s office and a regular fixture at Vienna drug meetings. Until now, she has been able to speak as an official voice of the U.S. government — and the U.S. is always the most important voice on U.N. drug policy issues. Now that non-governmental organizations (NGOs) are bringing the voices of ordinary people to the table for the first time ever, she was actively subverting the process, throwing every possible obstacle in the way of this quite benign process.

I’d always heard that the U.S. government played a bully role in international drug policy. But it’s really ugly to see it in practice.

It's really impossible to overstate the tyrannical role U.S. drug warriors have taken in attempting to subvert the U.N.'s deliberate effort to include diverse viewpoints in the NGO summit. I've discussed it before, and I'm not at all surprised to see the same tactics deployed in Vienna. I'd be surprised not to.

The mindset it requires to resist participation from such a vast group of experts is really an incredible thing to contemplate. One must really be in love with the drug war to struggle with such vigor to keep it just the way it is. What is it about the war on drugs that merits this devotion and loyalty? It is their deformed cannibal monster-child that must be sheltered and fed at any cost.

For decades, drug policy reformers have struggled to identify the perfect question, a point so simple and straightforward that no drug warrior can respond. It seems Frederick Polak of ENCOD and the Netherlands Drug Policy Foundation may have stumbled across it, nearly provoking a meltdown from UN Drug Czar Antonio-Maria Costa:


For the video-challenged, here's my rather loose approximation of how it went down:

Polak: How do you explain the fact that marijuana use in the Netherlands is lower than in surrounding countries despite the fact that it is sold freely to adults? Doesn't this fundamentally undermine the theory behind prohibition?

Costa: Thank you for your question. This is an issue I've considered at great length and which you misunderstand most profoundly. Allow me to begin by saying…oh for goodness' sake, I do believe I've left the oven on at my house. I must depart forthwith, but I'm grateful for your participation in this forum and my apologies for this most unfortunate oversight, which I must now attend to. Good day, my friends.

Indeed, remarkably low rates of marijuana use among the Dutch are a tremendously revealing phenomena. In fairness to Costa, it's certainly hard to imagine what he could say about such a thing, thus his rant about the controversy over Dutch coffeeshops was a good try despite its total irrelevance.

Next time, I recommend easing him into it by asking whether he even concedes that marijuana use in the Netherlands is lower than in surrounding nations. He'll respond by calling attention to a pretty bird perched outside the window. Attendees will turn their heads in unison to discover that the bird is not of notable prettiness.

Antonio Maria Costa, director of the United Nations Office on Drugs and Crime, lost his temper today at an NGO summit in Vienna. The event is intended to evaluate UN drug strategy from diverse perspectives, yet Costa began by insulting a huge number of professionals working to solve the drug problem:

"I attended the meeting of the drug alliance [DPA] in New Orleans last December, 1200 participants, 1000 lunatics, 200 good people to talk to. The other ones obviously on drugs." [Transform Drug Policy Foundation]

So I am a lunatic who was obviously on drugs when Costa maybe sort of saw part of my head from the stage as he spoke. Simply amazing. This is such a perfect depiction of the insulting and infantile tactics routinely employed by drug war supporters when their opposition gains momentum.

Believe me, the claim that attendees at the International Drug Policy Reform Conference 2007 were "obviously on drugs" is just a colossal lie. With this wildly disparaging characterization, Costa is attempting to attribute our values and beliefs to some drug-induced mania, thereby circumventing the need to take our arguments seriously. Yet anyone present at the conference knows precisely how dignified and impressive an event this truly was.

Witnessing this level of childishness from the world's top anti-drug official goes a long way towards explaining how the massive disaster of international drug prohibition is able to continue.