US Drug Policy focuses on prevention and healing

During his recent visit to Australia, the US Director of National Drug Control Policy Gil Kerlikowske held a series of high-level meetings with government, researchers and advocates, including Drug Free Australia. Director Kerlikowske is the chief adviser on Drug Policy in the Obama Administration.

In addressing a gathering of political and community leaders in the NSW Parliament, Director Kerlikowske outlined the following key elements of current initiatives in the US to help prevent and reduce drug use:

1)     moving away from outdated (and misleading) terminology such as the ‘War on Drugs’:

2)     countering legalisation lobby activities, including so called ‘medical’ marijuana

3)     high priority given to prevention initiatives such as:

  • the National Prevention Strategy, which aims to prevent harms in a diverse range of areas including domestic violence and alcohol and other drugs.
  • drug-free communities: a $370 billion program which funds 700 small community organisations to educate young people about the effects of drugs.
  • $31 billion in funding for drug education and treatment programs.
  • new drug-driving initiatives; he complimented Australian effort in being world leader in this initiative
  • more emphasis on children’s rights to be protected from the wide range of drug harms and exposure. This included support for the World Federation Against Drugs (WFAD) and their efforts to promote the UN Convention on the Rights of the Child

4)     moving towards a model combining health and law enforcement to prevent and reduce drug use. He gave the following examples:

  • the establishment of 2600 drug courts, which has encouraging data about reduced recidivism;
  • the HOPE project which works with former prisoners who fail the drug-testing conditions of their parole;
  • the May 2012 signing of the 5 nation Joint Statement (in Stockholm)  in support of  humane and balanced illicit drug policy http://www.wfad.se/images/articles/Final_statement_WFAD.pdf

DFA Members raised the following issues related to illicit drugs and drug policy in Australia:

1)     The need for and benefits of, mandatory rehabilitation

2)     Continued efforts to publicise the dangers of cannabis use, including becoming dependent and mental health and social problems, which are now indisputable

3)     The value of effective, specialised drug education for all sectors of the community

4)     The demonstrable success of the Howard government’s ‘Tough on Drugs’ strategy and the need to return to this more restrictive policy platform

5)     DFA conclusions from data in government-funded evaluations of the Sydney Medically Supervised Injecting Centre and commentary similar research on Vancouver’s Insight injecting facility, showing minimal, if any beneficial effect in terms of drug related morbidity or mortaility, or reduction in drug use or increase in numbers entering treatment in the vicinity of these two facilities;

6)     needle ‘exchanges’ that are no longer ‘exchanges’ and the flawed research related to their so-called success in reducing HIV and Hep C. (This was acknowledged by the Kerlikowske team).

7)     The use of naltrexone implants as a successful recovery-based model for addictions to alcohol and opioids, including heroin and prescription morphine

8)     The lack of reporting or acknowledgement of the evidence base that support use of naltrexone for alcoholism and opioid dependence

9)     The spread of Harm Reduction philosophy and measures, including needle distribution in the Asia Pacific and the promotion of the use of needles among many who do not currently use needles and the prohibitive cost of using agonist treatment in poor countries

10)  DFA’s Position Statement on Illicit Drug Legalisation/Decriminalisation and Regulation

Parliamentary members raised a number of questions including:

  • ‘Medical’ Marijuana and the difficulties/anomalies between US Federal and State laws. Director Kerlikowske indicated that there is a continuous flow of Federal information other legal drugs on the market that are more effective in helping people with relief of pain and nausea than the so-called ‘medical marijuana’. The challenge is to reach people within communities which are being targeted by expensive pro drug lobby campaigns
  • The reality of being able to effectively push back against the global illicit drug ‘business model’; Director Kerlikowke’s response was that there are numerous examples of the success of current push-back efforts, including a 40% reduction in cocaine use in the United States; Globally we have kept use down in overall illicit drug use (now 5% down from 6.1% 2011).
  • In particular, he emphasized that current legalisation moves are NOT the answer and will only lead to an increase in use (example of increasing misuse of prescription drug, alcohol and tobacco was given).
  • DFA members commented that increased supply reduction measures have shown reductions in use of illicit drugs and harm as result of less availability and higher prices in Australia
  • The Human Rights argument that supports the right to use illicit drugs without constraint in Australian and forms the rationale for Harm Minimisation in Australia is not an argument that has much currency in the USA or elsewhere.

 

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Does robust drug enforcement lead to an increase in drug users coming forward for treatment?

Recent debate on policy options for tackling the use of illegal drugs has stressed the merits of viewing drug use as a health rather than a criminal justice matter.

However, there are strong reasons for avoiding an ‘either or approach’ to drug enforcement and treatment and viewing these as complementary rather than as competing approaches to tackling the use of illegal drugs.

This article draws upon data from an evaluation of three major drug enforcement operations to show that in the aftermath of those operations, the proportion of drug users contacting drug treatment services markedly increased.

The implications of these results are that those planning drug enforcement operations should involve staff within drug treatment agencies to ensure that any increased demand for their services, in the aftermath of drug enforcement operations, can be met.

Further, the research shows the merit of viewing drug enforcement and treatment as complementary elements of a comprehensive drug strategy.

http://www.wfad.se/latest-news/1-articles/2043-does-robust-drug-enforcement-lead-to-an-increase-in-drug-users-coming-forward-for-treatment

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Own the Upside Presentation

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In the middle of this brief by tragic foray into violence…

“In the middle of this brief by tragic foray into violence…really sad… is ONE small reference to the single biggest contributing factor to the violence…ALCOHOL. Even in this shocking context, the inability or unwillingness to the ‘call out’ booze for the damage it is doing to our young, is a best staggeringly ironic and at worst culpably negligent. Come on people, our young people need a better model and if the adult population are willing or sadly, able, to stand up to give that and keep excusing themselves from responsibility, then the emerging generation will continue in this tragic process.”

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Hijacking Recovery: challenging the ‘user-centric’ redefinitions.

It has become increasingly difficult to find any ‘redemptive’ aspects to genuine health care and patient/client wellbeing when one looks at what has clearly become the ‘industry’ of addictionmaintenance for the purpose of – it would seem – anything but best practice health and wellbeing.Even the most ‘avid’ supporter of the ‘harm reductionist’ ideology has to raise their eyebrow at the self-protecting spin being engaged by practitioners seemingly much more interested in protecting an ideology that guarantees the funding flow for their vocational security, than seeing precious human individuals be given BEST options for health and restoration….Read More

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The Case Against Drug Legalisaion

Australia’s drug policy has been centred on harm reduction for 27 years
• It has supplied free needles for drug users
• Maintained users on methadone for up to 40 years
• Provided injecting rooms
• This is 27 years of facilitating drug use
• This could not possibly be construed as a war on drugs
• Therefore Australia21’s statement is further rendered meaningless

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The Protection of Children from Illicit Drugs – A Minimum Human Rights Standard

The recreational use of narcotic drugs and psychotropic substances is a matter on which all of us have opinions based on our cultural, social and/or moral background……Read More

 

 

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Piñera opposes legalization of marijuana in Chile

The President of Chile, Sebastián Piñera, criticized a possible legalization of marijuana in his country, which was proposed by two senators opposing a bill introduced last Wednesday before Congress.

“In these times when some advocate or promote the legalization of drugs, I mean that the government of Chile has a strong commitment to combat drug use,” Pinera said in a ceremony in which launched a Bill Prevention of Drug and Alcohol.

The questions of Piñera came after opposition senators that Fulvio Rossi and Ricardo Lagos Weber, son of former President Ricardo Lagos, presented a bill in Congress to legalize the cultivation, and personal consumption of marijuana in Chile.

 

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Brazil: Drug dealers say no to crack in Rio

RIO DE JANEIRO—Business was brisk in the Mandela shantytown on a recent night. In the glow of a weak light bulb, customers pawed through packets of powdered cocaine and marijuana priced at $5, $10, $25. Teenage boys with semiautomatic weapons took in money and made change while flirting with girls in belly-baring tops lounging nearby.Next to them, a gaggle of kids jumped on a trampoline, oblivious to the guns and drug-running that are part of everyday life in this and hundreds of other slums, known as favelas, across this metropolitan area of 12 million people. Conspicuously absent from the scene was crack, the most addictive and destructive drug in the triad that fuels Rio’s lucrative narcotics trade.

 

Once crack was introduced here about six years ago, Mandela and the surrounding complex of shantytowns became Rio’s main outdoor drug market, a “cracolandia,” or crackland, where users bought the rocks, smoked and lingered until the next hit. Hordes of addicts lived in cardboard shacks and filthy blankets, scrambling for cash and a fix.

Now, there was no crack on the rough wooden table displaying the goods for sale, and the addicts were gone. The change hadn’t come from any police or public health campaign. Instead, the dealers themselves have stopped selling the drug in Mandela and nearby Jacarezinho in a move that traffickers and others say will spread citywide within the next two years.

The drug bosses, often born and raised in the very slums they now lord over, say crack destabilizes their communities, making it harder to control areas long abandoned by the government. Law enforcement and city authorities, however, take credit for the change, arguing that drug gangs are only trying to create a distraction and persuade police to call off an offensive to take back the slums.

Dealers shake their heads, insisting it was their decision to stop selling crack, the crystalized form of cocaine.

“Crack has been nothing but a disgrace for Rio. It’s time to stop,” said the drug boss in charge. He is Mandela’s second-in-command—a stocky man wearing a Lacoste shirt, heavy gold jewelry and a backpack bulging with $100,000 in drugs and cash. At 37, he’s an elder in Rio’s most established faction, the Comando Vermelho, or Red Command. He’s wanted by police, and didn’t want his name published.

He discussed the decision as he watched the night’s profits pile up in neat, rubber-banded stacks from across the narrow street. He kept one hand on his pistol and the other on a crackling radio that squawked out sales elsewhere in the slum and warned of police.

The talk of crack left him agitated; he raised his voice, drawing looks from the fidgety young men across the road. Although crack makes him a lot of money, he has his own reasons to resent the drug; everyone who comes near it does, he said.

His brother—the one who studied, left the shantytown and joined the air force—fell prey to it. Crack users smoke it and often display more addictive behavior. The brother abandoned his family and his job, and now haunts the edges of the slum with other addicts.

“I see this misery,” he said. “I’m a human being too, and I’m a leader here. I want to say I helped stop this.”

For the ban to really take hold, it would need the support of the city’s two other reigning factions: the Amigos dos Amigos, or Friends of Friends, and the Terceiro Comando, Third Command.

That would mean giving up millions in profits. According to an estimate by the country’s Security Committee of the House and the Federal Police, Brazilians consume between 800 kilos and 1.2 tons of crack a day, a total valued at about $10 million.

It’s unclear how much Rio’s traffickers earn from the drug, but police apprehensions show a surge in its availability in the state. In 2008, police seized 14 kilos; two years later the annual seizure came to 200 kilos, according to the Public Security Institute.

Nonetheless, the other gangs are signing up, said attorney Flavia Froes. Her clients include the most notorious figures of Rio’s underbelly, and she has been shuttling between them, visiting favelas and far-flung high-security prisons to talk up the idea.

“They’re joining en masse. They realized that this experience with crack was not good, even though it was lucrative. The social costs were tremendous. This wasn’t a drug for the rich; it was hitting their own communities.”

As Froes walks these slums, gingerly navigating potholed roads in six-inch stiletto heels and rhinestone-studded jeans, men with a gun in each hand defer to her, calling her “doutora,” or doctor, because of her studies, or “senhora,” or ma’am, out of respect.

“While stocks last, they’ll sell. But it’s not being bought anymore,” she said. “Today we can say with certainty that we’re looking at the end of crack in Rio de Janeiro.”

———

Even those who question the traffickers’ sudden surge of social conscience say the idea of the city’s drug lords coming together to ban crack isn’t far-fetched. After all, a similar deal between factions kept the drug out of Rio for years.

Crack first took hold in Sao Paulo, the country’s business capital, during the 1990s. In the early 2000s, it spread across Brazil in an epidemic reminiscent of the one the U.S. had experienced decades earlier. A recent survey found it was eventually sold or consumed in 98 percent of Brazilian municipalities. Most of the cities were too understaffed, underfunded and uninformed to resist its onslaught.

And yet, an agreement between factions kept crack a rarity in Rio until a handful of years ago, said Mario Sergio Duarte, Rio state’s former police chief.

“Rio was always cocaine and marijuana,” he said. “If drug traffickers are coming up with this strategy of going back to cocaine and marijuana, it’s not because they suddenly developed an awareness, or because they want to be charitable and help the addicts. It’s just that crack brings them too much trouble to be worth it.”

Duarte believes dealers turned to crack when their other business started losing ground within the city.

Police started taking back slums long given over to the drug trade as Rio vied to host the 2014 World Cup and the 2016 Olympics. The plan disrupted trade, and the factions began hemorrhaging money, said Duarte. Crack seemed like the solution, and the drug flooded the market.

“Crack was profit; it’s cheap, but it sells. Addiction comes quick. They were trying to make up their losses,” he said.

Soon, the gangs were being haunted by the consequences.

Unlike the customers who came for marijuana or cocaine, dropped cash and left, crack users hung around the sales points, scraping for money for the next hit. They broke the social code that usually maintains a tense calm in the slums; they stole, begged, threatened or sold their bodies to get their next rock. Their presence made the hard life there nearly unbearable.

The Mandela drug boss said crack even sapped the drug kingpins’ authority.

“How can I tell someone he can’t steal, when I know I sold him the drugs that made him this way?” he said.

Many saw their own family members and childhood friends fall under the drug’s spell.

“The same crack I sell to your son is being sold to mine. I talked to one of the pioneers in selling crack in Rio. His son’s using now. Everyone is saying we have to stop.”

In Mandela, residents had to step over crack users on their way between home and work and warn their children to be careful around the “zombies.”

“There were robberies in the favela, violence, people killed in the middle of the street, people having sex or taking a crap anywhere,” said Cleber, an electronics repair shop owner who has lived in Mandela for 16 years. He declined to give his last name because he lives in a neighborhood ruled by gang members, and like many, prefers not to comment publicly.

“Now we’re going out again, we can set up a barbecue pit outside, have a drink with friends, without them gathering around,” he said. “We’re a little more at ease.”

Researcher Ignacio Cano, at the Violence Analysis Center of Rio de Janeiro State University, said crack is still being sold outside only select communities and that it’s hard to tell if the stop is a temporary, local measure or a real shift in operations citywide.

He said unprecedented pressure bore down on drug gangs once they began selling crack. In particular, the addicts’ encampments were sources of social and health problems, drawing the attention of the authorities.

Since March 2011, dawn raids involving police, health and welfare officials began taking users off the streets to offer treatment, food, a checkup and a hot shower. Since then, 4,706 people have cycled through the system. Of those, 663 were children or teenagers.

“I have operations every day, all over Rio,” said Daphne Braga, who coordinates the effort for the city welfare office.

At the same time, crack became such a dramatic problem nationally that the government allocated special funds to combat it, including a $253 million campaign launched by President Dilma Rousseff in May 2010 to stem the drug trade. Last November, another $2 billion were set aside to create treatment centers for addicts and get them off the streets.

In May, 150 federal police officers occupied a Rio favela to implement a pilot program fighting the crack trade and helping users.

“There are many reasons why they might stop,” said Cano.

———

Crack’s social cost is clear where the drug is still sold, right outside Mandela and Jacarezinho. In the shantytown of Manguinhos, along a violent area known as the Gaza Strip, an army of crack addicts lives in encampments next to a rail line.

Another couple hundred gather inside the slum, buying from a stand inside a little restaurant. Customers eat next to young men with guns and must step around a table laden with packaged drugs and tightly bound wads of cash to use the restroom. Crack users smoke outside, by the lights of a community soccer field where an animated game draws onlookers late into the night.

The Rev. Antonio Carlos Costa, founder of the River of Peace social service group, knows the dealers and believes the ban on crack here is “real, without return, and has a real chance of spreading to other favelas.”

That’s good news for residents, he said, but users will have to migrate to look for drugs, and that might expose them to real risk.

“They won’t be welcome. This society wants them dead,” he said. “This won’t be a problem that can be solved only with money. We’ll need professionals who really take an interest in these people. We’ll need compassion. It’ll be a challenge to our solidarity.”

Also predicting risks, attorney Froes has prepared a civil court action demanding local and state governments prepare treatment centers for users.

“There will be a great weaning of all these addicts as they’re deprived of drugs,” she said. “We’re not prepared to take on all the people who will need care.”

The addicts recognize the difficulty of their own rehabilitation.

One 16-year-old boy laying on a bare piece of foam said he’d studied until the 2nd grade but couldn’t read. Now, he was going on his third year in the streets.

“Who is going to give me work?” he asked.

Sharing his mattress was a 28-year-old woman. It had been three years since she last saw her three children and parents in Niteroi, the city across the bay from Rio. She was filthy, all of her body bearing the marks of life on the streets: bruises and open wounds, missing front teeth, matted hair.

“I wasn’t born like this. You think my parents want to see me now?” she asked. “I can’t go back there.”

A teenager with jaundiced, bloodshot eyes said she couldn’t remember how long she’d been on the streets, or her age.

She knew her name—Natalia Gonzales—and that she was born in 1997.

“I have nowhere to go,” she said, tears rolling down her cheeks. Softly, she started to sing a hymn, and its call for salvation in the afterlife took on an urgent note.

“God, come save me, extend your hand,” she sang. “Heal my heart, make me live again.”

 

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