Position Statement – December 2011

The flawed proposition of drug legalisation

Various well funded pressure groups have mounted campaigns to overturn the United Nations Conventions on drugs. These groups claim that society should accept the fact of drugs as a problem that will remain and, therefore, should be managed in a way that would enable millions of people to take advantage of an alleged ‘legal right’ to use drugs of their choice.

It is important to note that international law makes a distinction between “hard law” and “soft law.” Hard law is legally binding upon the States. Soft law is not binding. UN Conventions, such as the Conventions on Drugs, are considered hard law and must be upheld by the countries that have ratified the UN Drug Conventions.

International narcotics legislation is mainly made up of the three UN Conventions from 1961 (Single Convention on Narcotic Drugs), 1971 (Convention on Psychotropic Substances), and 1988 (Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances):

• The 1961 Convention sets out that “the possession, use, trade in, distribution,import, export, manufacture and the production of drugs is exclusively limited to medical and scientific purposes”. Penal cooperation is to be established so as to ensure that drugs are only used licitly (for prescribed medical purposes).

• The 1971 Convention resembles closely the 1961 Convention, whilst
establishing an international control system for Psychotropic Substances.

• The 1988 Convention reflects the response of the international community to increasing illicit cultivation, production, manufacture, and trafficking activities. International narcotics legislation draws a line between licit (medical) and illicit (non-medical) use, and sets out measures for prevention of illicit use, including penal measures. The preamble to the 1961 Convention states that the parties to the Convention are “Recognizing that addiction to narcotic drugs constitutes a serious evil for the individual and is fraught with social and economic danger to mankind”. The Conventions are reviewed every ten years and have consistently been upheld.

The UN system of drug control includes the Office of Drugs and Crime, the International Narcotics Control Board, and the Commission on Narcotic Drugs. The works of these bodies are positive and essential in international drug demand and supply reduction. They are also attacked by those seeking to legalise drugs.

It is frequently and falsely asserted that the so-called “War on Drugs” is inappropriate and has become a very costly and demonstrable failure. It is declared by some that vast resources have been poured into the prevention of drug use and the suppression of illicit manufacturing, trafficking, and supply. It is further claimed that what is essentially a chronic medical problem has been turned into a criminal justice issue with inappropriate remedies that make “innocent” people criminals. In short, the flawed argument is that “prohibition” monies have been wasted and the immeasurable financial resources applied to this activity would be better spent for the general benefit of the community.

The groups supporting legalisation are: people who use drugs, those who believe that the present system of control does more harm than good, and those who are keen to make significant profits from marketing newly authorised addictive substances. In addition to pernicious distribution of drugs, dealers circulate specious and misleading information. They foster the erroneous belief that drugs are harmless, thus adding to even more confused thinking.

Superficially crafted, yet pseudo-persuasive arguments are put forward that can be accepted by many concerned, well intentioned people who have neither the time nor the knowledge to research the matter thoroughly, but accept them in good faith. Frequently high profile people claim that legalisation is the best way of addressing a major social problem without cogent supporting evidence. This too influences others, especially the ill informed who accept statements as being accurate and well informed. Through this ill-informed propaganda, people are asked to believe that such action would defeat the traffickers, take the profit out of the drug trade and solve the drug problem completely.

The total case for legalisation seems to be based on the assertion that the government assault on alleged civil liberties has been disastrously and expensively ineffective and counter-productive. In short, it is alleged, in contradiction to evidence, that prohibition has produced more costs than benefits and, therefore, the use of drugs on a personal basis should be permitted. Advocates claim that legalisation would eliminate the massive expenditure incurred by prohibition and would take the profit out of crime for suppliers and dealers. They further claim that it would decriminalise what they consider “understandable” human behaviour and thus prevent the overburdening of the criminal justice system that is manifestly failing to cope. It is further argued irrationally that police time would not be wasted on minor drug offences, the courts would be freed from the backlog of trivial cases and the prisons would not be used as warehouses for those who choose to use drugs, and the saved resources could be used more effectively.

Types of drug legalisation

The term “legalisation” can have any one of the following meanings:

1. Total Legalisation – All illicit drugs such as heroin, cocaine, methamphetamine, and marijuana would be legal and treated as commercial products. No government regulation would be required to oversee production, marketing, or distribution.

2. Regulated Legalisation – The production and distribution of drugs would be regulated by the government with limits on amounts that can be purchased and the age of purchasers. There would be no criminal or civil sanctions for possessing, manufacturing, or distributing drugs unless these actions violated the regulatory system. Drug sales could be taxed.

3. Decriminalisation – Decriminalisation eliminates criminal sanctions for drug use and provides civil sanctions for possession of drugs. To achieve the agenda of drug legalisation, advocates argue for:

• legalising drugs by lowering or ending penalties for drug possession and use – particularly marijuana;

• legalising marijuana and other illicit drugs as a so-called medicine;
• harm reduction programmes such as needle exchange programmes, drug injection sites, heroin distribution to addicts, and facilitation of so-called safe use of drugs that normalize drug use, create the illusion that drugs can be used safely if one just knows how, and eliminates a goal of abstinence from drugs;

• legalised growing of industrial hemp;
• an inclusion of drug users as equal partners in establishing and enforcing drug policy; and

• protection for drug users at the expense and to the detriment of non-users under the pretence of “human rights.”

The problem is with the drugs and not the drug policies

Legalisation of current illicit drugs, including marijuana, is not a viable solution to the global drug problem and would actually exacerbate the problem. The UN Drug Conventions were adopted because of the recognition by the international community that drugs are an enormous social problem and that the trade adversely affects the global economy and the viability of some countries that have become transit routes.

The huge sums of illegal money generated by the drug trade encourage money laundering and have become inextricably linked with other international organised criminal activities such as terrorism, human trafficking, prostitution and the arms trade. Drug Lords have subverted the democratic governments of some countries to the great detriment of law abiding citizens.

Drug abuse has had a major adverse effect on global health and the spread of communicable diseases such as AIDS/HIV. Control is vitally important for the protection of communities against these problems. There is international agreement in the UN Conventions that drugs should be produced legally under strict supervision to ensure adequate supplies only for medical and research purposes. The cumulative effects of prohibition and interdiction combined with education and treatment during 100 years of international drug control have had a significant impact in stemming the drug problem. Control is working and one can only imagine how much worse the problem would have become without it. For instance:

• In 2007, drug control had reduced the global opium supply to one-third the level in 1907 and even though current reports indicate recent increased cultivation in Afghanistan and production in Southeast Asia, overall production has not increased.

• During the last decade, world output of cocaine and amphetamines has stabilized; cannabis output has declined since 2004; and opium production has declined since 2008. We, therefore, strongly urge nations to uphold and enhance current efforts to prevent the use, cultivation, production, traffic, and sale of illegal drugs. We further urge our leaders to reject the legalisation of currently illicit drugs as an acceptable solution to the world’s drug problem because of the following reasons:

• Only 6.1% of people globally between the ages of 15 and 64 use drugs (World Drug Report 2011 UNODC) and there is little public support for the legalisation of highly dangerous substances. Prohibition has ensured that the total number of users is low because legal sanctions do influence people’s behaviour.

• There is a specific obligation to protect children from the harms of drugs, as is
evidenced through the ratification by the majority of United Nations Member States of the UN Convention on the Rights of the Child (CRC). Article 33 states that Member States “shall take all appropriate measures, including legislative, administrative, social and educational measures, to protect children from the illicit use of narcotic drugs and psychotropic substances as defined in the relevant international treaties, and to prevent the use of children in the illicit production and trafficking of such substances”.

• Legalisation sends the dangerous tacit message of approval, that drug use is
acceptable and cannot be very harmful.

• Permissibility, availability and accessibility of dangerous drugs will result in
increased consumption by many who otherwise would not consider using them.

• Enforcement of laws creates risks that discourage drug use. Laws clearly define what is legal and illegal and emphasise the boundaries.

• Legalisation would increase the risks to individuals, families, communities and world regions without any compensating benefits.

• Legalisation would remove the social sanctions normally supported by a legal system and expose people to additional risk, especially the young and vulnerable.

• The legalisation of drugs would lead inevitably to a greater number of dependencies and addictions likely to match the levels of licit addictive substances. In turn, this would lead to increasing related morbidity and mortality, the spread of communicable diseases such as AIDS/HIV and the other blood borne viruses exacerbated by the sharing of needles and drugs paraphernalia, and an increased burden on the health and social services.

• There would be no diminution in criminal justice costs as, contrary to the view held by those who support legalisation, crime would not be eliminated or reduced. Dependency often brings with it dysfunctional families together with increased domestic child abuse.

• There will be increases in drugged driving and industrial accidents.

• Drug Control is a safeguard protecting millions from the effects of drug abuse and addiction particularly, but not exclusively, in developing countries.

• Statements about taxation offsetting any additional costs are demonstrably flawed and this has been shown in the case of alcohol and tobacco taxes. Short of governments distributing free drugs, those who commit crime now to obtain them would continue to do so if they became legal.

• Legalisation would not take the profit out of the drug trade as criminals will always find ways of countering legislation. They would continue their dangerous activities including cutting drugs with harmful substances to maximise sales and profits. Aggressive marketing techniques, designed to promote increased sales and use, would be applied rigorously to devastating effect.

• Other ‘legal’ drugs – alcohol and tobacco, are regularly traded on the black market and are an international smuggling problem; an estimated 600 billion cigarettes are smuggled annually (World Drug report 2009). Taxation monies raised from these products go nowhere near addressing consequential costs.

• Many prisons have become incubators for infection and the spread of drug related diseases at great risk to individual prisoners, prison staff and the general public. Failure to eliminate drug use in these institutions exacerbates the problem.

• The prisons are not full of people who have been convicted for mere possession of drugs for personal use. This sanction is usually reserved for dealers and those who commit crime in the furtherance of their possession.

• The claim that alcohol and tobacco may cause more harm than some drugs is not a pharmacokinetics of psychotropic substances suggest that more, not less, control of their access is warranted.

• Research regularly and increasingly demonstrates the harms associated with drug use and misuse. There is uncertainty, yet growing evidence, about the long-term detrimental effects of drug use on the physical, psychological and emotional health of substance users.

• It is inaccurate to suggest that the personal use of drugs has no consequential and damaging effects. Apart from the harm to the individual users, drugs affect others by addiction, violence, criminal behaviour and road accidents. Some drugs remain in the body for long periods and adversely affect performance and behaviour beyond the time of so-called ‘private’ use. Legalisation would not diminish the adverse effects associated with drug misuse such as criminal, irrational and violent behaviour and the mental and physical harm that occurs in many users.

• All drugs can be dangerous including prescription and over the counter medicines if they are taken without attention to medical guidance. Recent research has confirmed just how harmful drug use can be and there is now overwhelming evidence (certainly in the case of cannabis) to make consideration of legalisation irresponsible.

• The toxicity of drugs is not a matter for debate or a vote. People are entitled to their own opinions but not their own facts. Those who advocate freedom of choice cannot create freedom from adverse consequences.

• Drug production causes huge ecological damage and crop erosion in drug producing areas.

• Nearly every nation has signed the UN Conventions on drug control. Any government of signatory countries contemplating legalisation would be in breach of agreements under the UN Conventions which recognise that unity is the best approach to combating the global drug problem. The administrative burden associated with legalisation would become enormous and probably unaffordable to most governments. Legalisation would require a massive government commitment to production, supply, security and a bureaucracy that would necessarily increase the need for the employment at great and unaffordable cost for all of the staff necessary to facilitate that development.

• Any government policy must be motivated by the consideration that it must first do no harm. There is an obligation to protect citizens and the compassionate and sensible method must be to do everything possible to reduce drug dependency and misuse, not to encourage or facilitate it. Any failures in a common approach to a problem would result in a complete breakdown in effectiveness. Differing and fragmented responses to a common predicament are unacceptable for the wellbeing of the international community. It is incumbent on national governments to cooperate in securing the greatest good for the greatest number.

ISSUED this 21st day of December, 2011 by the following groups:
Drug Prevention Network of the Americas (DPNA)
Institute on Global Drug Policy
International Scientific and Medical Forum on Drug Abuse
International Task Force on Strategic Drug Policy
People Against Drug Dependence & Ignorance (PADDI), Nigeria
Europe Against Drugs (EURAD)
World Federation Against Drugs (WFAD)
Peoples Recovery, Empowerment and Development Assistance (PREDA)
Drug Free Scotland

Theresa May, the Home Secretary, issued a humiliating rebuke to her drug advisers after they called for the possession of drugs to be decriminalised.

The Home Office said there was no intention to give people a “green light” to use drugs because they “destroy lives and cause untold misery”.

The Advisory Council on the Misuse of Drugs (ACMD) risked a fresh row with the Home Office after suggesting those who possess any drug, including cocaine or heroin, for personal use should be taken out of the criminal justice system.

The Government issued a blunt statement insisting drug laws would not be liberalised and “decriminalisation is not the answer”. It is the latest in a series of run-ins between Whitehall’s official drug advisory body and the Home Office.

In 2009, the then Home Secretary Alan Johnson, sacked the ACMD chairman Professor David Nutt after he openly criticised the Government’s stance on cannabis. He had also previously said taking Ecstasy was no more dangerous than riding a horse.

The ACMD called for a review on how those caught in possession of drugs are handled in a submission to the Sentencing Council, which is consulting on guidelines for courts on drug offences.
However, it is not in the remit of the Sentencing Council to consider what would effectively decriminalisation and the ACMD only included its comments in the final section asking for any further comments. It wrote: “There is an opportunity to be more creative in dealing with those who have committed an offence by possession of drugs.

“For people found to be in possession of drugs (any) for personal use (and involved in no other criminal offences), they should not be processed through the criminal justice system but instead be diverted into drug education/awareness courses.”

The courses “would be the equivalent of the apparently successful ‘speed awareness’ courses to which drivers can be referred as a diversion”, the council added. It also suggested that those accused of possessing drugs could also face “more creative civil punishments”, such as the loss of a driving licence or passport.

A spokesman for the Home Office said: “We have no intention of liberalising our drugs laws. Drugs are illegal because they are harmful – they destroy lives and cause untold misery to families and communities. “Those caught in the cycle of dependency must be supported to live drug free lives, but giving people a green light to possess drugs through decriminalisation is clearly not the answer.”

Source: www.telegraph.co.uk 18th Oct 2011

Following the Scottish example, England has piloted drug courts using specially trained magistrates to closely supervise treatment-based community sentences. This initial report found no major glitches but low throughput and uncertain cost-benefits.

Summary The Dedicated Drug Court framework for England and Wales provides for specialist courts which exclusively handle cases relating to drug misusing offenders from conviction through sentence to completion (or breach) of a community order with a Drug Rehabilitation Requirement (DRR). Two magistrates’ courts (Leeds Magistrates’ Court and West London Magistrates’ Court) have been piloting drug courts implemented in line with the Ministry of Justice’s framework.

The critical factors for implementation success are an understanding of local context and scale of need, the enthusiasm of the local judiciary and partner agencies, good partnership working, availability of resources to deliver the drug court and its associated treatment services, the depth of understanding by all staff of offender motivation and, in particular, recognition of the points at which an offender is most likely to make progress in reducing or stopping drug use. Continuity of judiciary is key to successful implementation of a drug court. It provides the focus for communication between the court and the offender and across magistrate panels. Continuity of judiciary was a strong planned feature of both courts. Based on analysis undertaken with data from the Leeds pilot, there is strong evidence that continuity of magistrates has a statistically significant impact on several key drug court outcomes. Greater continuity of magistrates experienced by offenders is associated with their being less likely to miss a court hearing, more likely to complete their sentence, and less likely to be reconvicted.

Break-even analysis showed that (compared to normal adjudication) an extra 8% of offenders seen by the courts would need to stop taking drugs for five years or more following completion of the sentence to provide a net economic benefit to the wider society, and 14% in order to provide a net economic benefit to the criminal justice system. A robust quantification of impact was not possible because of the difficulties in collecting sufficient data on a comparison group of offenders not processed through drug courts.

Findings Commissioned by the UK Ministry of Justice, the report describes the implementation rather than the outcomes of England’s pilot drug courts. In line with international understandings, the courts were intended to specialise in drug-related offenders, presided over by sentencers specially trained for this task who order treatment-based sentences and closely supervise the offender’s progress, aided by regular tests for illegal drug use. The aim is maximise the rehabilitative impact of the sentence by increasing compliance and engagement with treatment through criminal justice pressure (ultimately the prospect of receiving a more typical punishment-based sentence if the drug court’s order fails) and rewards (of which one of the most powerful seems to be the unfamiliar experience of being congratulated by a judge or magistrate).

The report identified no critical fault lines in the implementation of the courts. However, these were particularly promising sites: the Leeds court built on a pre-existing system and in London, court staff were enthusiastic about the proposal and had already been working towards creating a drug court. Nevertheless, offender throughput was lower than expected. Over the 17 months of the evaluation, the London court sentenced just 60 new offenders while in Leeds the total was 276. Low throughput raised costs per offender. Compared to a standard 12-month drug rehabilitation requirement order implemented through normal adjudication, supervising the order through the drug courts cost £4633 extra per offender.

With no comparison group of normally adjudicated offenders, the evaluation was unable to say whether this was money well spent. They were, however, able to calculate the drug use reductions the courts would have to ‘buy’ in order to meet their extra costs – as noted in the abstract, the answer was 8% of offenders ceasing drug use for at least five years compared to the numbers doing so on a normally adjudicated drug rehabilitation requirement order. This calculation though excludes the base costs of normal adjudication and of a normally supervised drug rehabilitation requirement order. This seems to mean that the 8% would also have to be over and above the proportion of offenders who remain abstinent after normal judicial processing. The report gives no indication of how much success would be needed to match the total costs incurred by the criminal justice system in implementing all the elements of a drug court-supervised drug rehabilitation requirement order.

The report’s emphasis on offenders seeing the same magistrate(s) for their sentencing and throughout subsequent progress reviews is backed by evidence from Leeds that continuity is substantially associated with better compliance and drug use and crime outcomes. Steps were taken to reduce the risk that continuity was caused by high compliance and good progress rather than vice versa. However, without actually allocating offenders at random to see or not see the same magistrates, it is impossible to eliminate this possibility. Assuming the effect was real, it is of concern that organising continuity was a challenge, and especially so for ‘breach’ hearings dealing with unacceptable failures to comply with the order, which national regulations required to occur within a set period. Unfortunately, these crucial junctures are just when continuity is most needed, requiring an understanding of whether the offender will do better on a revised order, or the order has failed and should be revoked, often resulting in imprisonment.

A final caution over any such report is that some leading criminologists accuse the UK government of manipulating and distorting criminological research for political gain, to the point where the professor of criminology at the Open University has called for a boycott of government-commissioned work. The featured report was commissioned by the UK Ministry of Justice, a ministry carved out in part from the Home Office, one of the main targets of these accusations.

Scotland preceded England in formally piloting drug courts in Glasgow from 2001 and in Fife the following year. As in England, implementation was not entirely smooth but better than might have been expected. There was a high but it was thought acceptable failure rate, probably aided by Scotland’s more flexible application of drug treatment and testing orders, predecessors to the drug rehabilitation requirements used later by the English courts. However, crime impacts were questionable. Within one year 50% of drug court offenders had been reconvicted and within two years 71%, and the average frequency of reconvictions only slightly dipped in the two years after the order was imposed compared to the two years before. There was no clear crime-reduction benefit from supervising the orders through the drug courts (at an average cost of nearly £18,500 per order) as opposed to normal adjudication. But, as in England, the costs imposed on society by persistent, high-rate offending and drug-related mortality and morbidity, are such that even modest improvements might be cost-beneficial overall.

International experience and research relating to drug courts suggests it is important for courts to emphasise rewards as well as punishments, see offenders frequently enough to apply these swiftly in response to progress, deploy a range of rewards and sanctions short of revocation which are consistently applied, have a strong and sure ultimate sanction when the programme fails, make these consequences absolutely clear to offenders, have rapid access to a range of treatment options, maintain continuity in the judge dealing with the case, and to attend to the range of the individual’s needs. Willingness to continue despite some initial offending makes the structure imposed by stringent requirements and monitoring a positive feature rather than one which leads most offenders to fail. Consistent judicial supervision, the fact that this forces addicts (back) in to treatment, and drug testing which provides a shared measure of how treatment is progressing, probably all play their parts.

Source: www.findings.org.uk March 2009

Conference in Moses Room, House of Lords, 28th November 2002-11-28 CONSENSUS OF CONFERENCE

● In the light of the most recent international evidence regarding the adverse effects of cannabis, we urge the Prime Minister and the Home Secretary to reconsider their determination to reclassify Cannabis from a schedule B to schedule C drug.

● We are concerned that reclassification sends the message ‘it is ok to take cannabis’ or ‘cannabis is harmless’ or ‘taking cannabis is legal now’, especially to young people. We therefore strongly oppose reclassification.

● Instead, we urge the Prime Minister and the Home Office not to play down the many adverse and sometimes irreversible health effects of cannabis but to send out the clear message that cannabis is both harmful and, for that reason, illegal.

● We urge the Prime Minister – in the light of recent evidence – to reassess the adverse physical, emotional, mental and spiritual impact cannabis abuse has on individuals, but also to assess the adverse effects of cannabis on society including families with a special reference to ethnic minorities, the education system, the National Health Service, the Police, the criminal justice system.

● We are concerned that drug prevention is not given the emphasis it deserves, that ‘mixed messages’ are sent out and in particular we are very concerned at public funding of organisations whose ‘drug education material’ appears to promote rather than prevent drug abuse.

● We urge the Prime Minister to allocate more resources on prevention of cannabis abuse. Prevention is better than cure. We believe that these resources will be well spent. Our society and especially our young people deserve to be protected from cannabis abuse.

Illegal drugs not only harm a user’s mind and body, they devastate families, communities, and neighborhoods. They jeopardize public safety, prevent too many Americans from reaching their full potential, and place obstacles in the way of raising a healthy generation of young people.

To address these challenges, today we are releasing the 2012 National Drug Control Strategy — the Obama Administration’s primary policy blueprint for reducing drug use and its consequences in America. The President’s inaugural National Drug Control Strategy, published in 2010, charted a new direction in our approach to drug policy. Today’s strategy builds upon that approach, which is based on science, evidence, and research. Most important, it is based on the premise that drug addiction is a chronic disease of the brain that can be prevented and treated. Simply put, we are not powerless against the challenge of substance abuse — people can recover, and millions are in recovery. These individuals are our neighbors, friends and family members. They contribute to our communities, our workforce, our economy, and help make America stronger.

Our emphasis on addressing the drug problem through a public health approach is grounded in decades of research and scientific study. There is overwhelming evidence that drug prevention and treatment programs achieve meaningful results with significant long-term cost savings. In fact, recent research has shown that each dollar invested in an evidence-based prevention program can reduce costs related to substance use disorders by an average of $18.

But reducing the burden of our nation’s drug problem stretches beyond prevention and treatment. We need an all of the above approach. To address this problem in a comprehensive way, the President’s new strategy also applies the principles of public health to reforming the criminal justice system, which continues to play a vital role in drug policy. It outlines ways to break the cycle of drug use, crime, incarceration, and arrest by diverting non-violent drug offenders into treatment, bolstering support for reentry programs that help offenders rejoin their communities, and advancing support for innovative enforcement programs proven to improve public health while protecting public safety.

Together, we have achieved significant reform in the way we address substance abuse. And the Affordable Care Act will — for the first time — require insurers to cover treatment for drug addiction the same way they would other chronic diseases. This is a revolutionary shift in how we address drug policy in America.
Over the past three decades, we have reduced illegal drug use in America. Over the long term, rates of drug use among young people today are far lower than they were 30 years ago. More recently cocaine use has dropped nearly 40 percent and meth use has dropped by half. And we can do more. As President Obama has noted, we have successfully changed attitudes regarding rates of smoking and drunk driving, and with your help we can do the same with our illegal drug problem.

Source: R. Gil Kerlikowske
Director, White House Office of National Drug Control Policy 18th April 2012

The fashionable party drug mephedrone has been linked to up to 98 recent deaths in Britain, the Government’s advisers warned last night, as they called for tougher action to combat the proliferation of legal highs.

The Advisory Council on the Misuse of Drugs (ACMD) said unscrupulous manufacturers made a mockery of the law by falsely advertising addictive substances as “plant food” or “bath salts”. Its chairman, Professor Les Iverson, warned young users of “designer drugs” were playing “Russian roulette” with their lives – and said the effects were already being seen in hospitals. He said: “We are not seeing just a nice party drug but something that can kill.”

Prof Iverson released figures showing that in the past two years mephedrone had been confirmed as a factor in 42 deaths and had not been ruled out as contributing to another 56.
Users of designer drugs – created in labs to mimic the make-up of banned substances such as ecstasy and amphetamines – suffered such extreme side-effects that they had to be sedated. They had also been treated for paranoia, psychosis, high heart rates and raised blood pressure, he said. He added: “Users are playing Russian roulette. They are buying substances marked as research chemicals. The implication is that you should do the research on yourself to find out whether they’re safe or not. This is a totally uncontrolled, unregulated market.”

The first large quantities of legal highs, or psychoactive drugs – many made in China – appeared in Britain two years ago. They can be easily bought online or from shops selling drug paraphernalia and herbal goods. Some undergraduates also sell them to fellow students. The ACMD said: “Many people importing these new substances appear to have had no previous involvement in the illicit drug trade and are just in it to make a quick buck. They have included students who have set up websites to supply nationally and who also supply the local student population.”

Ministers have outlawed several such substances, but the ACMD warned that producers were sidestepping the bans by tweaking the composition of drugs. It backed creating a new system of broader bans in which all substances chemically similar to controlled drugs were automatically made illegal. The ACMD also called for suppliers to have to demonstrate that legal highs were not being produced for human consumption and for a fresh drive to alert the public to their dangers.

Roger Howard, chief executive of the UK Drug Policy Commission, backed the proposals. He said: “We have rapidly growing numbers of psychoactive drugs on the market and it’s increasingly difficult for police to identify the different drugs they are finding.”

The Home Office said it was considering the recommendations and added: “The Government is leading the way in cracking down on legal highs by outlawing not just individual drugs but whole families of related substances.”

By numbers…
2009 The year police made first seizure of mephedrone. It was banned in 2010.
£15 Approximate price of a gram before it was classified.
98 The number of deaths recently linked to mephedrone.

Source: The Independent 26th October

Congratulations to our colleague Manuel Pinto Coelho in Portugal.  This is an enormous victory!  The very liberal drug policy of Portugal is crumbling.

———————————————

 Dear colleagues,

As you can see, although in Portuguese, it is official – Portuguese IDT and all its staff including the president Goulão has been abolished.

 The mask fell down and there is no more “magnificent Portuguese model – an example to the world”. I hope Portuguese authorities decision may arrive in time to dissuade the rest of the world don’t follow countries like Mexico, Argentina and Czech Republic – as you know unfortunately they did bite the hook and decriminalized drugs already.

 The magnificent Health Minister Paulo Macedo (ex-responsible by the treasure and finances) is now trying to understand how it was possible the existence of so many holes of so many millions of euros, opening the eyes FINALY to some personal and/or corporate interests some years ago installed… and as you can imagine there is a (very) few people very worried about…!

 Now there is the SICAD with the competencies of…

 ”…planeamento e acompanhamento de programas de redução do consumo de substâncias psicoactivas, na prevenção dos comportamentos aditivos e na diminuição das dependências num novo serviço criado no âmbito da administração directa do Ministério da Saúde”

 that means, the”… planning and following up of programs to reduce the consumption of psychoactive substances, prevention of addictive behaviours and diminishing of dependencies in a new service born in Health Ministry direct administration.”

 Treatment and harm reduction structures are since today within the responsibility of the several structures in the ground of National Health Service untied to central services… So the licences to internments and other services became responsibility of each and every ARS – Health Regional Administration accordingly its needs in the ground.

 This is a big victory of good sense and REASON and very good news to everyone who suffer with drug dependence, giving to all of us more wings to believe that our efforts must go on moving always forward a drug free society

 Manuel Pinto Coelho, International Task Force on Strategic Drug Policy.  Dec. 2011

This letter is from Dr. Pinto Coelho from Portugal – his English is not perfect but the gist of the paper is very clear .. i.e. the media claims that decriminalisation in Portugal has been successful are simply not true.

The factual picture of Portuguese drug policy
Reaching out English Parliament and David Cameron
 

The Executive Office of the President Barak Obama Drug Control Policy, Director Gil Kerlikowske, in a letter to a member of the International Task Force on Strategic Drug Policy and Drug Watch International, is peremptory: “Our analysts found that claims that decriminalization has reduced drug use and had no detrimental impact in Portugal significantly exceed the existing scientific basis. Because this conclusion largely contradicts prevailing media coverage and several policy analyses in Portugaland the United States, my staff has heavily documented the sources of the data and information contained in this working paper. Please feel free to use this document in part or in whole to help strengthen your own efforts to advance a more honest discussion of decriminalization in Portugal and of the drug policy choices with nations are grappling today.”
 
This report is a consequence of a complete absurd campaign of an unacceptable manipulation of Portuguese drug policy facts and numbers, rose on the 33 pages of a so original as misleading book written by a writer/lawyer, Glenn Greenwald, fluent in Portuguese (on the eve of two important elections in Portugal), for the American “libertarian” think-tank Cato Institute -  a long time advocate of drug legalization.
 
That book, underestimating the readers’ understanding and suggesting the contrary to what the numbers show clearly and unequivocally, has been carried out unconscientiously and naively by some usually responsible national and international press all over the world that boosting the proliferation of the Portuguese “good news” are dangerously distorting the projection of the reality: “The Guardian” -“Britain looks at Portugal´s success story over decriminalizing personal drug use” (September 5th 2010), “The Economist” – “The evidence from Portugal since 2001 is that decriminalization of drug use and possession has benefits and no harmful side-effects” (August 27th 2009) and the Portuguese magazine “Visão” – “Portugal inspira Obama” (Maio 7, 2009) are just a few of the publications that mimicked the phenomena.
 
It was so effective that irreparable damages are already there – Czech Republic, Mexico and Argentina copied the Portuguese “good example” and did decriminalize drugs too…
 
That is the razing power of an attractive fallacy!
 
But lets go to the data (and his sources) and to that high representative USA official above letter: “Drug-induced deaths in Portugal that decreased from 369 in 1999 to 152 in 2003, climbed to 314 in 2007 – significantly more than the 280 deaths recorded when decriminalization started in 2001”. (EMCDDS, Statistical Bulletin 2009, Table DRD-2.)
 
“…the report´s claims of Portuguese drug legalization success, however it trumpets a decline in the lifetime prevalence rate for the 15-19 age group from 2001 to 2007, while discounting a larger lifetime prevalence increase in the 15-24 age group and ignoring the substantially larger lifetime prevalence increase in the 20-24 age group over the same period. (Greenwald, p.14.) Furthermore, the report emphasizes decreases in lifetime prevalence rates for the 13-18 age group from 2001 to 2006 and for heroin use in the 16-18 age group from 1999 to 2005, but once again downplays increases in the lifetime prevalence rates for the 15-24 age group between 2001 and 2006, and for the 16-18 age group between 1999 and 2005”. (Greenwald, pp. 12-14.)
 
“… despite an assertion in the Cato Institute report that increases in lifetime prevalence rates for a general population are “virtually inevitable in every nation”, EMCDDA data indicate that countries have been able to achieve decreases in lifetime prevalence rates, including Spain, for cannabis and ecstasy use between 2003 and 2008.” (EMCDDA, Statistical Bulletin 2009, Table GPS-1.)
 
To this painful data we must add:
 
“There is a notorious growing consumption of cocaine in Portugal, although not as severe as that which is verifiable in Spain. The increase in consumption of cocaine is extremely problematic”. (EMCDDA Executive Director, Wolfgang Gotz, Lisbon, May 2009.)
 
“While amphetamines and cocaine consumption rates doubled in Portugal, cocaine drug seizures have increased sevenfold between 2001 and 2006, rating Portugal the sixth highest in the world.” (World Drug Report, June 2009.)
 
“Behind Luxembourg, Portugal is the European country with the highest rate of consistent drug users and IV heroin dependents”. (Portuguese Drug Situation Annual Report, 2006)
 
“Portugal keeps on being the country with the most cases of injected drug related AIDS (85 new cases per one million of citizens in 2005, while the majority of other EU countries do not exceed 5 cases per million) and the only one registering a recent increase. 36 more cases per one million of citizens were estimated in 2005 comparatively to 2004, when only 30 were referred. It is the only country recording a recent increase. 703 newly diagnosed infections, followed from a distance by Estonia with 191 and Latvia with 108 reported cases.” (EMCDDA, November 2007.)
 
“The highest HIV/AIDS mortality rates among drug users are reported for Portugal, followed by Estonia, Spain, Latvia and Italy; in most other countries the rates are low” (EMCDDA – November 2010).
 
“In Portugal, since decriminalization has been implemented in July 2001, the number of drug related homicides has increased by 40%. It was the only European country with a significant increase between 2001 and 2006.” (World Drug Report, June 2009.)
 
This is the factual picture of Portuguese drug policy.
Unfortunately for drug dependent’ and their extended families and friends, a lie, as convenient as it could be, no matter how many times affirmed, no matter how insistently repeated, would never become the truth. So, “resounding success” seems a gross overestimate. It is rather simple and easy to grasp the reality of the facts, with one look at the real figures, the official figures.
Extraordinarily Mr. Greenwald managed to picture it otherwise and most of the world press bought it. Subsequently some governments disgracefully did too (USA fortunately didn’t) and others are pathetically wondering to “experiment the potential benefits of innovations like Portugal’s.” (“The Observer” Sunday 5 September 2010.) …
 
Manuel Pinto Coelho
Medical Doctor, Chairman of the Association for a Drug Free Portugal – member of World Family Organization and World Federation Against Drugs
Member of International Task Force on Strategic Drug Policy
Portugal Delegate of Drug Watch International
Portugal representative of European Cities Against Drugs
 
 
P.S.  I am political independent – I am not enrolled to any political party.
        I do not practice or have any links to any drug dependence facilities.

Latest in an impressively coherent and persistent series of studies of how US courts specialising in supervision and treatment of drug-related offenders can do more to reduce drug use and crime. Triaging offenders to more or less intensive programmes and then adjusting based on actual progress made significant differences.

Summary Drug courts specialise in closely supervising (through regular urine tests and court appearances) and ordering the treatment of drug-related offenders to improve compliance with treatment as an alternative to prosecution or imprisonment. Judges impose sanctions or offer praise or more tangible rewards and adjust treatment depending on progress. However, in the USA this intensive process is available to only a small minority of potentially suitable offenders. Extending the reach of drug courts may be more feasible if intensive supervision and treatment are reserved for offenders who need them in order to do well, and if these decisions can to a degree be routinised rather than made on an individual basis.

Background to the study

One step towards this is to match intensity to the risk that the offender will fail to meet the requirements of the court, imposing stricter supervision on offenders assessed as high risk before the start of their sentences. As described by Findings, this has been trialled by the research group responsible for the featured study. They found that high risk (antisocial personality disorder or a history of treatment for drug abuse problems) offenders were more likely to test negative for drugs and to complete their court orders when they had been randomly assigned to fortnightly court progress hearings rather than hearings ‘as needed’ in response to infractions. A further trial implemented this matching procedure and again found better outcomes among high risk offenders matched to fortnightly hearings.

However, predicting in advance how offenders will react to different drug court requirements is an imperfect science. Another step forward is to adapt these to how offenders actually do respond, if possible based on pre-set criteria derived from research findings. For example, if a participant misses a set number of counselling sessions, an ‘adaptive’ regimen might stipulate a motivational enhancement intervention. Treatment staff retain authority to override or alter an adaptation, but typically have to explain their decisions. The featured study was the first major test of adaptive programming in a drug court.

Deciding who needs more supervision or treatment

The criteria for adapting the drug court regimen and the adaptations were developed by the drug court team and research staff with a view to being feasible as well as effective. As in earlier studies in the series, first offenders were categorised as high or low risk and assigned on this basis to fortnightly or as-needed hearings. Monthly assessments identified those who did not comply with the court’s requirements, indicated by two or more unexcused missed counselling sessions or failures to provide a valid urine specimen. In these instances it was assumed that judicial supervision was inadequate and it was stepped up to fortnightly or, if already fortnightly, further infractions would result in conviction for the original offence.

At other times offenders might attend treatment and comply with tests, but still carry on using illegal drugs, indicated by two or more positive urine tests. In these instances it was assumed that the treatment A minimum of four months (approximately 18 weeks) of weekly group psychoeducational counselling sessions covering the pharmacology of drug and alcohol use, progression from substance use to dependence, the impact of addiction on the family, treatment options, HIV/AIDS risk reduction, and relapse prevention strategies. Participants could also attend group or individual treatment sessions based on clinical need. was inadequate and its intensity was stepped up to include clinical case management entailing an additional two therapeutic group sessions per week and one individual session per month focused on motivational enhancement and relapse-prevention techniques.

A pilot study demonstrated the feasibility and promise of this approach, paving the way for the featured study.

About the study

Essentially the featured study tested whether in addition to triaging based on starting risk levels, adjusting treatment and supervision based on the offender’s actual progress improved outcomes. Both the pilot and the featured study were conducted in a drug court in the city of Wilmington, the largest in the USstate of Delaware. It accepted adult local residents charged with a misdemeanour Less serious offences such as possession or use of cannabis or possession of equipment related to drug use. without a history of a serious violent offending, and who drug court treatment staff assessed as meeting criteria for substance abuse or dependence. Defendants plead guilty but will be absolved if they satisfactorily complete Minimum requirements are attending at least 12 weekly group counselling sessions, providing at least 14 consecutive weekly drug-negative urine specimens, remaining arrest free, obeying programme rules and procedures, and paying a $200 court fee. the drug court programme and are not arrested for the next six months. Failing this they are convicted, have a criminal record, stand to lose their driving licences, and to be sentenced to a period on probation.

In 2009 and 2010 researchers approached 335 consecutive drug court defendants of whom 130 agreed to join the study (risking allocation to more intensive supervision and treatment than usual) and 125 actually started the programmes it tested. All were triaged based on their risk levels As in previous studies, antisocial personality disorder or prior treatment for drug problems indicated high risk and fortnightly hearings. to fortnightly or as-needed hearings and their progress was monitored monthly by researchers and reported back to the drug court.

Using the criteria outlined above, for a randomly selected 62 offenders, these monthly assessments determined Unless the drug court team or judge decided otherwise. whether those failing to comply with attendance and testing requirements were subject to more frequent or stricter supervision, and whether those still using drugs were directed in to more intensive treatment. Remaining offenders were subject to the court’s usual procedures.

Primarily at issue was whether adapting treatment/supervision to progress reduced drug use, as indicated by weekly urine tests over the first 18 weeks of the drug court sentence, the minimum needed to complete it.

Main findings

The key finding was that offenders subject to the predetermined adaptations were less likely to use illegal drugs. Of the urine tests they took, 68% indicated they were drug free compared to 49% of comparison offenders. Assuming missed tests would have indicated drug use, the figures were 61% and 46%. Under either assumption, offenders whose supervision and treatment were adapted to their progress were over twice as likely as other offenders to submit a urine test negative for illegal drugs, a statistically significant difference, and one which was apparent over the entire 18 weeks.

In contrast, the proportions of offenders who satisfactorily completed the drug court programme within 18 weeks (31% in the adaptive regimen, 23% of the remainder) or within a year (68% and 67% respectively) did not significantly differ.

Just over a third of both sets of offenders at some time failed to meet criteria for complying with attendance or urine test requirements. These infractions were much more likely (64% v. 30%) to be responded to by the court when offenders were subject to the adaptive regimen and the court had been alerted to the infraction by the researchers. Also, roughly the same proportions (a fifth to a quarter) of offenders continued to use illegal drugs, though in this case the court was no more likely impose consequences on offenders in the adaptive programme.

There was a (not statistically significant) tendency for more offenders in the adaptive programme to see the drug court’s procedures as fair, but otherwise no differences in perceptions of how effectively these acted as deterrents, attitudes to the judge, and satisfaction with drug court services, all of which were generally positive.

The authors’ conclusions

Findings confirmed that adaptive programming can promote abstinence from illegal drugs among misdemeanour offenders sentenced by a drug court. This improvement in drug abstinence rates appears to have been attributable to more intensive supervision of offenders who failed to comply with attendance and testing requirements, rather than to more intensive and individualised treatment in response to continued drug use.

As intended, the criteria set for adapting the regimen, alerts to when these were breached, and the clear structure for how the court should respond, seem to have helped staff identify and rectify mismatches between offenders and the supervision schedule they had been assigned to on the basis of their anticipated risk of failure. In theory, drug court staff could have made these adjustments on their own initiatives, but were much less likely to do so without the guidance and assistance of the adaptive structure. Lacking this, they imposed consequences in respect of less than one in three of the times when offenders failed to show up for treatment or testing, a ratio unlikely to optimally promote compliance with supervision requirements. The adaptive regimen meant fewer offenders ‘slipped through the cracks’ to continue noncompliant behaviour with relative impunity. There was no indication (if anything, the reverse) that this greater strictness jaundiced offenders’ views of the court or its procedures.

Strangely, while offenders whose programmes were adapted were more likely to test abstinent, they were no more likely to satisfactorily complete the drug court programme, despite the fact that a run of 14 ‘clean’ urine tests was perhaps the primary requirement. It could be that the adaptive regimen failed to affect the other criteria offenders had to meet to satisfy the court and expunge their offence, or that the court took other factors in to account in making these decisions.

One methodological concern is that under 4 in 10 of the offenders asked to join the study did so, reducing the degree to which the findings can be assumed to be representative of what would happen if such procedures were applied across the board. It seems likely that refusers were less motivated to comply with the court’s requirements or felt (perhaps due to their addiction) that they would be unable to satisfy the court if more intensively supervised. Also, rather than persisting impacts, these findings reflected periods when many offenders had recently ended or were still on drug court sentences.

There may be scope to improve criteria used to adapt supervision and treatment. For example, the assumption that non-attendance for counselling or testing does not require more intensive treatment may be false if offenders who have lapsed try to hide this by not turning up. And while supervision and treatment could be intensified in response to poor progress, there was no mechanism for good progress to trigger the reverse.

Marlowe D.B., Festinger D.S., Dugosh K.L. et al.
Criminal Justice and Behavior: 2012, 39(4), p. 514–532.

 This is the latest in an impressively coherent and persistent attempt to evidence howUSdrug courts can do more to reduce drug use and crime, including ways to conserve resources by reserving intensive intervention for offenders who need it. These studies have shown that triaging on the basis of initial risk and then adjusting in the light of experience, based on simple and clear criteria and feasible treatment and supervision enhancements, are both possible for US drug courts and effective in promoting abstinence from illegal drugs. In turn this finding confirms that some kind of courts are more effective than others. Generally drug court sentences are associated with lower crime and drug use rates than comparison sentencing options, but there are not enough rigorous and convincing studies to be sure that this is due to drug court procedures as opposed to the type of offenders seen by drug courts or some other factor. Feeling more the weight than the quality of the evidence, generally reviewers have cautiously concluded that drug courts are more effective then conventional sentencing, but this largely US evidence is of doubtful relevance to the UK, where negative findings from Scotland may have contributed to a waning in enthusiasm at a national level for extending the drug court model to more offenders. Details below.

About the study

While the strategies tested by the featured study and its predecessors may seem obvious, deciding on the criteria for risk, the dividing line between poor versus good progress, and corresponding adjustments to supervision and treatment, is not straightforward. In the US context, and particularly in the context of a court trying less serious offences, triaging on the basis of antisocial tendencies and prior drug treatment and then adjusting on the basis of two missed appointments or urine tests had in some respects the desired impact. As the authors pondered, the puzzle is why this impact did not extend to what for the offender is probably the critical outcome – successfully completing the sentence.

For society and Britainin particular, crime-reduction is probably the critical outcome. Whether the full adaptive regimen reduced criminal recidivism is as yet unreported, but a prior study found that the first step – triaging high-riskUS misdemeanour offenders to fortnightly supervision – did not do so to a statistically significant degree. According to their confidential accounts to researchers, among high-risk offenders in this study the reduction in the proportion who offended was greater (down by 23% v. 7%) when they had been left to the court’s usual (roughly monthly) hearings.

The authors of the featured study suggest that rather than intensified treatment, imposing tighter supervision and more certain sanctions was how the adaptive regimen helped offenders avoid illegal drug use. This raises the issue of whether for these types of offenders, treatment can be dispensed with altogether and supervision and sanctions relied on to enforce compliance. For what seems to have been a mainly methamphetamine using caseload, this was essentially the proposition tested in Hawaii. Where the featured study reserved more intensive treatment for offenders with positive urine tests, inHawaii they took this a step further by reserving treatment as such. There intensive urine testing allied with swift and certain but not severe sanctions for non-compliance dramatically curbed drug use, prison time and re-arrest rates among a high risk group of drug using offenders. Treatment was available for offenders who wanted it or whose repeat positive drug tests suggested it was needed, but few did want or need it – perhaps 1 in 10.

British policy and experience

In the featured study’s drug court it seems that most offenders confined their regular illegal drug use to cannabis. In Hawaii, a stimulant was the main problem drug and opiate use was rare. These caseloads are very different from the dependent heroin users who have committed serious and/or repeated offences who constitute the major part of the caseload in drug courts in England and Scotland. It seems unlikely that many in the UK would be considered at low risk of reoffending, that fortnightly classes would be considered an adequate treatment for their addictions, or that many could sustain four months without registering some form of illegal drug use in at least two weekly urine tests. Generally they would be considered to warrant at least the intensity of treatment reserved for the minority of poor responders in the featured study. Though this means that in the British context, risk criteria and adaptive responses would have to be different, the principle of establishing these, and doing so on the basis of evidence rather than intuition, is likely to be applicable. If costly sentence failure and imprisonment are to be avoided, it seems critical that such adjustments are made before offenders get to the point where their breaches lead the court to revoke the drug court order and re-sentence for the original offence.

Drug courts have operated in Englandand Scotlandfor several years but are not widespread. In six pilot English courts, involved offenders and professionals felt the courts were a useful addition to the range of initiatives aimed at reducing drug use and offending. They set concrete goals for offenders to meet, raised self-esteem, and imposed a degree of accountability for their actions on offenders. They were also seen as facilitating partnership working between agencies. However, Scottish courts too were seen as useful and effective, yet there was no reliable evidence that (despite costing substantially more per order and per successfully completed order) their sentences were any more effective than similar orders made by other courts, as assessed by the proportions of offenders reconvicted and the frequency of convictions.

The 2010 English drug strategy made no specific mention of drug courts. For more details on criminal justice policy it referred to a Ministry of Justice green paper, which warned that drug courts “will only be continued if they genuinely make a difference and are cost effective”. Evidence gathered for the paper was equivocal about the applicability of international evidence to England and Wales and did not list drug courts among its “promising approaches”. The applicability of reasonably promising evidence from overseas (primarily the USA) was also questioned by the UK Drug Policy Commission in its review of programmes for problem drug-using offenders.

Scotland’s drug strategy published in 2008 looked forward to the assessment of the country’s pilot drug courts cited above, which found no reliable crime-reduction impact but increased cost. A review of interventions for drug using offenders produced for the Scottish Government accepted these findings, and warned that the most rigorous international trials which randomly allocated offenders to drug courts or other judicial options found only weak crime reduction impacts which fell short of statistical significance.

Given the negative crime reduction findings in Scotland, the lack of evidence in the rest of Britain, and doubts about the validity and applicability of mainly USinternational evidence, the national-level impetus apparent a few years ago for trying drug courts in Britainmay have waned. Treatment allied with urine or other biological tests for drug use remain high on the UKagenda, but drug courts no longer appear to be seen as a prime means of ensuring and supervising such programmes. Nevertheless, such courts could be seen as one way to ensure offenders enter and comply with the treatment programmes (and specifically addiction treatment) the Ministry of Justice saw as effective in reducing the costs of crime, or one way local areas may choose to pursue the crime reductions which it suggested could attract financial rewards in ‘payment by results’ schemes.

Recent reviews

Reservations in the Scottish review cited above over the evidence for drug courts from randomised trials were echoed in a review conducted by British experts for the Swedish Council for Crime Prevention. It was able to synthesise crime-reduction results from just two high quality trials. Together these registered an advantage for drug courts versus comparison judicial options, but not one which was statistically significant. According to this analysis, treatment in general had been shown to reduce drug-related crime, but the same could not yet be said of treatment delivered via a drug court.

Mandated by USlaw, in 2011 the USGeneral Accounting Office investigated how well US adult drug courts have reduced crime and substance use and their associated costs and benefits. They reported that compared to alternative dispositions, generally studies found drug courts were associated with lower rates of criminal recidivism and relapse to drug use, but few studies were free of possible bias arising from non-random selection of drug court versus comparison offenders. Due mainly to reduced future victimisation and justice system expenditures, benefits to society expressed in financial terms usually but not always outweighed costs. This balance was partly dependent on the expense of the alternative disposal; if community sentences supervised by a drug court replaced prison, the cost savings were likely to be positive and substantial.

In hedging its cost-benefit findings, the General Accounting Office touched on a fundamental criticism of US drug courts – that most exclude violent or drug dealing offenders or those with extensive criminal histories and serious mental health issues. The upshot is often a caseload of low-level drug offenders who are otherwise generally law-abiding, many of whom might have been more cheaply and appropriately diverted out of the criminal justice system altogether. The report also echoed a general finding in other research syntheses – that the more sound the study, the less likely it is to find any substantial recidivism reductions due to drug courts.

How far most studies fall short of the gold standard randomised controlled trial was commented on by (at the time of writing) the latest synthesis of drug court studies. Among this “methodologically weak” body of work, just three of 92 studies of courts Other than those dealing with traffic-related offences. trying adults had randomly allocated offenders to these versus alternative judicial procedures. Across these three, recidivism was lower among drug court offenders, but the finding was not statistically significant. The next most sound studies typically attempted instead to match drug court and comparison offenders on key variables, or to adjust the findings for their relative risks of offending. Across these 20 studies, recidivism was modestly and significantly lower among drug court offenders, but such research designs have limited power to iron out the most important differences between offenders who are or are not referred to (or choose to be processed by) drug courts. Presumably crucial variables – like how committed the offenders is to succeed, their social and family support, or professional assessments of how well suited they are to a drug court regimen – are rarely available to researchers. Echoing the featured study, this synthesis found that drug use was lowest in courts which supervised offenders frequently and which – like the court in the study – could hold out the prospect that success would expunge the original offence. These too were among the effective ingredients identified in a major study funded by the US Department of Justice of 23 drug courts.

For Findings drug court analysis run this search. In particular see these background notes with a detailed consideration of one of the most methodologically rigorous studies to date, conducted in Baltimore with a caseload unusually relevant to the UK because it consisted mainly of heroin addicts with extensive criminal records. Though methodological concerns remained, it found that over the three years after offenders had been allocated to the court or to normal proceedings, the average numbers of new arrests and charges were significantly fewer among drug court offenders and drug use was lower.  

Source  www.findings.org.uk  30 March 2012

Evangelical patriarch Rev. Pat Robertson has long been a leader in the conservative movement advocating for a better civil and moral society. But his recent support of marijuana legalization couldn’t be more wrongheaded.

“I really believe we should treat marijuana the way we treat beverage alcohol,” Robertson said last week in an interview with The New York Times. “I’ve never used marijuana and I don’t intend to, but it’s just one of those things that I think: this war on drugs just hasn’t succeeded.”

“It’s completely out of control,” Robertson added. “Prisons are being overcrowded with juvenile offenders having to do with drugs. And the penalties, the maximums, some of them could get 10 years for possession of a joint of marijuana. It makes no sense at all.”

Robertson’s arguments are wrong on each and every fact. First, regulating marijuana like the way we regulate alcohol (or cigarettes) will only result in the increased use and abuse of marijuana, particularly among youths. As the late, great political scientist, James Q. Wilson, put it, “The central problem with legalizing drugs is that it will increase drug consumption.” Arguing that adding a dangerous substance to the legal marketplace will reduce its usage is to renounce all common sense. Does Robertson truly believe that addicts and first-time users will be curtailed once the substance they seek becomes easier to obtain?

To stay on alcohol for a moment: There are about 79,000 alcohol-related deaths each year. The Center for Disease Control calculated that excessive drinking cost the United States $223.5 billion annually and the government pays more than 60 percent of these health care costs. Is that really the model that Robertson would recommend for the betterment of society?

The Household Survey of Substance Abuse tells us that alcohol, more than tobacco and illegal drugs, is the most used and abused drug among youth. Why is that? Because alcohol is legal; drugs are not. Alcohol is easily available; drugs are less so. Alcohol is culturally acceptable; drugs are, for the most part, stigmatized, in large part because they are illegal. Robertson has long respected the importance of the law and the culture. It is a grave error for him to abandon that now.

As for his other claims, the 2011 World Drug Report paints a detailed picture of marijuana abusers. Among cannabis users in treatment in the United States, 80.5% are not married, 90% have obtained an education of 12 years or less; 25% are unemployed and 46% are not in the labor force (of which 55% are students). Of the cannabis users who entered treatment services from 2000 to 2008, nearly a quarter report psychiatric problems. In addition, new research suggests that driving under the influence of marijuana could double a person’s risk of getting in a serious or fatal car crash.

Why should we promote the legalization of a substance that can irretrievably harm our children’s brains and makes our citizens less intelligent, less productive and less safe? Open and unrestricted drug use cannot coexist with a free, safe and productive society.

Moreover, Robertson’s claim that our prisons are overflowing with marijuana users are wildly exaggerated. The U.S. criminal justice system is the largest referral source for drug treatment programs. And, the large majority of inmates in state and federal prison for marijuana have been found guilty of much more than simple possession. The Office of National Drug Control Policy, for example, recently reported that of all the inmates in state prisons, 0.3% are arrested for offenses involving only marijuana possession.

Contrary to Robertson’s view, we have had successes in the fight against drugs. According to the Drug Enforcement Administration, 700,000 fewer teenagers used illicit drugs in 2010 than a decade earlier, a 16% decline. From 2000 to 2010, current marijuana use by teens has dropped 9%, methamphetamine use by teens has plummeted 60%, LSD use has dropped 50%, and current cocaine use among high school seniors has dropped 38%.

There have been other important victories, too. In the late 1980s and early 1990s, with the help of the Partnership for a Drug Free America, America’s policymakers and opinion shapers got tough on drugs. Through movies, television, mass media, and, yes, sermons, America sent a message: Drug use is not culturally or morally acceptable and it will not be tolerated. The nation was committed to defeating the cocaine epidemic, and it did.

We have much work left in our own fight against drugs. We need more drug education and prevention classes in schools, more rehabilitation and treatment centers, and more resources for law enforcement officials. But all this is for naught if our nation’s leaders, including its religious leaders, undermine and abandon the cause.

During a recent trip to Mexico, Vice President Joe Biden was right to reject the idea of legalization. “There is no possibility the Obama-Biden administration will change its policy on legalization,” he said. It’s time for a new bipartisan coalition committed to defending our children and our future from the dangers of drug abuse and addiction. Surrendering, like Robertson suggests, is not an option.

Editor’s note: William J. Bennett, a CNN contributor, is the author of “The Book of Man: Readings on the Path to Manhood.” He was U.S. secretary of education from 1985 to 1988 and director of the Office of National Drug Control Policy under President George H.W. Bush.

Source: William Bennett CNN 14th March 2012

After only a few years of usage, crystal meth can devastate a user’s health.
A GP in the Dungannon District has warned parents of the alarming rise in illegal drug abuse among young teenagers. “GPs are seeing an increasing number of patients with drug problems and unfortunately this is showing up in kids of as young as 13 or 14”, he said.
“There is a combination of the old drugs such as cannabis and cocaine and some of the newer drugs such as methedrone. “One of the problems is people seem to have the idea that these newer “designer drugs” are safe. However, they have a number of side effects Severe nosebleeds have been reported after snorting as well as anxiety and paranoia.
“There is also the risk of over-stimulating the heart and the nervous system, which would increase the chances of having a fit. “They can also become a gateway to other drugs. Another problem with these newer drugs is that the long term effects are unknown as they have not been around long enough to have been properly studied. “If you have any concerns with drug misuse you can contact your GP for advice. There are also a number of helplines to contact for confidential advice. An excellent local service is Breakthru in Dungannon. “They offer guidance and counselling for drug and alcohol problems. Their number is 02887753228.
Drug dealers in the Coalisland area are giving free doses of crystal meth to young teenagers.
The drug is an intensive stimulant with disinhibitory qualities. It can either be snorted or injected, or in its crystal form ‘ice’ smoked in a pipe, and brings on a feeling of exhilaration and a sharpening of focus. Smoking ice results in an instantaneous dose of almost pure drug to the brain, giving a huge rush followed by a feeling of euphoria for anything from 2-16 hours.
Overuse can bring on paranoia, short term memory loss, wild rages and mood swings as well as damage to your immune system. Overdosing can lead to severe convulsions followed by circulatory and respiratory collapse, coma and death. Some people have died after taking small doses.
The mix of chemicals, method of use and the user’s lifestyle can do serious damage to the mouth (‘Meth mouth’), with teeth rotting to the gum line as a result of the meth vapours.

Source: www.tyronetimes.co.uk 11th March 2012

Mexico’s violent drug cartels have reached the streets of Britain, France and the Netherlands, according to US immigration officials, with undercover British agents undergoing training in El Paso to combat the problem.

Three members of Britain’s Serious Organised Crime Agency (SOCA) met US agents on the Texas-Mexico border this week in a bid to put a stop to cartels taking hold on Britain and Europe. The British agents spoke about surveillance tactics, special operations teams and cybercrime units, according to a US immigration officials.

On Thursday, they watched how ICE investigators tore apart a car where a cargo of marijuana was found at the Paso del Norte Bridge in this West Texas city. The agents are expected to head to Miami next week to learn about port operations in the US.

“The most important lesson that we have shared with SOCA, is that if they are not prepared to deal with the Mexican cartels, they will spread like a cancer and will entrench themselves in the economy and community in an attempt to ‘legitimise’ their illicit profits.” Oscar Hagelsieb, an agent at the US Immigration and Customs Enforcement’s Homeland Security Investigations office, said. “They must also be aware of the violence that will undoubtedly follow.”

US authorities believe Mexico’s Sinaloa cartel has drug distribution networks in England and has established footholds in France and the Netherlands, among other places in Europe, he said.

Mexican crime groups have previously made attempts to establish a presence in Europe, Mr Hagelsieb added, “but not to the scope we are seeing now. The Sinaloa is the first cartel that can have an impact worldwide.”

SOCA was created in 2006 and is responsible for investigating drug trafficking, criminal organisations, cybercrime, counterfeiting, the use of firearms and serious robberies. In a statement read by one of the British undercover agents, the agency said it wanted its agents to come to El Paso as “it’s always better to be exposed to the problems and the environment first hand.”

“We want to learn from the special agents about the local, regional and international impact of the widely reported scale of drug trafficking that takes place across this border,” the statement said.

The British agents were also interested in how El Paso has managed to remain one of the safest cities in the US even though it’s across the Rio Grande from Ciudad Juarez, a city afflicted by one of the highest murder rates in the hemisphere.

US Immigration and Customs Enforcement’s Homeland Security Investigations collaborates with local agencies, targeting specific criminal groups and gathering intelligence on them, Mr Hagelsieb said. “We are able to intercept them at points of entry before they cross back and forth.”

Source: The Telegraph March 2012

A pill that makes alcoholics want to drink less has been developed by scientists for the first time, a conference has been told.

The drug is thought to work by blocking mechanisms in the brain that give alcoholics enjoyment from drink and so helps them fight the urge to drink too much. It only needed to be taken when people were going out where they might be tempted to drink alcohol. Alcoholics taking the drug and having counselling more than halved the amount of alcohol they drank per day and binged on fewer days. The findings were presented at the European Psychiatric Association (EPA) congress in Prague.

The drug, developed by Lundbeck pharmaceutical company, called nalmefene is not licensed yet and is currently going through clinical trials. There are other drugs on the market that make addicts ill if they drink any alcohol at all but this is thought to be the first aimed at reducing the amount of alcohol consumed. Side effects included dizziness, nausea, fatigue, sleep disorder or insomnia, vomiting, cold-like symptoms or excessive sweating.

Dr David Collier, of Barts and The London School of Medicine, Queen Mary University of London and an investigator in a nalmefene study, said: “The people volunteering for these trials had real problems with alcohol dependence, most had never sought help before, and others had tried and failed with abstinence strategies – stopping drinking for good.”

“Abstinence is the right option for many people, but not everyone wants to do that, and in those that do try, it helps only about half of them. From our experience in these trials, reducing alcohol consumption to safer levels can be a realistic and practical treatment goal for people who are dependent on alcohol, that can bring many short- and longer-term benefits to health.”

“These trial results suggest that the combination of medication and counselling could offer a new option for people in the UK not currently treated for their alcohol dependence.” There are thought to be 1.6m people addicted to alcohol who are not currently being treated.

Andrew Langford, Chief Executive of The British Liver Trust said: “We are genuinely worried about the increasing numbers of people from all walks of life with alcohol problems who are functioning seemingly well with their lives yet have built up a need for alcohol. Many feel that they need to drink just to feel normal, increasing potential negative effects on their physical and emotional health, including liver disease such as cirrhosis and liver cancer.”

In the study, nalmefene was used as needed by the patients, who took one tablet only when they perceived that there was a risk of drinking alcohol. Both the nalmefene and placebo groups of the study received counselling to maximise their motivation to reduce their alcohol intake, and ensure they continued to take the medicine.

Over six months in the trial the average amount of alcohol consumed per day reduced from 84g per day – the equivalent to a bottle of wine – to 30g per day or a large glass of wine. The number of days they drank heavily reduced from 19 to seven in those taking the drug alongside counselling.

The large study was conducted with 604 patients in Austria, Finland, Germany and Sweden.

Source: www. WiredIn.org.uk 6th March 2012

Next November, Californians will ballot on allowing people 21 years and older to possess, cultivate and transport cannabis for personal use, as well as enable its commercial production and sale. Professor Keith Humphreys of Stanford University School of Medicine’s psychiatry and behavioural sciences departments, discusses the potential consequences.
He recently returned to Stanford after a one-year stint in the White House as a senior adviser on national drug control policy – and was a key speaker at the UK/European Symposium on Addictive Disorders in London last May.
Click here for related facts, also CannabisSkunk Support.
Q: There are estimates that, with legalisation, marijuana use could rise 50-100 percent%. Are those projections reasonable?
Humphreys: We know very well from other commodities that if you make something illegal, the price of it goes up. And when you make it legal, it becomes much cheaper. So the findings are credible. Why they’re scary is that big drops in price tend to affect mainly people with less disposable income… teenagers, the unemployed, other people who have just a small amount of extra money. This will drop marijuana to something they could easily afford to do on a daily basis.
It is not just legalising consumption; it is legalising production. That means you’re going to have an industry, like the tobacco industry, that will have lobbyists and marketers and lots of money. In fact, I wonder if tobacco companies might go into this business. They are well-positioned. They have the outlets and the pricing power. It will become a mass-produced, very cheap product.
Q: But the proposition also allows people to grow their own marijuana…
Humphreys: For the vast majority of people, if there’s a refined product in a nice package down at the store that costs 1/10th as much, and you don’t have to water or worry about sunlight, then they will buy it.
Q: What about the argument that taxing marijuana will provide much-needed revenue?
Humphreys: We should be legalising child pornography and human trafficking? There’s lots of awful things that raise money, and that doesn’t make them right. The second point is that taxes never recoup the harm from substances. If you look at all estimates of alcohol and tobacco taxation, it never even touched a fifth of the amount of health damage. So you get a little money in the short term, but in the long term, someone’s got to pay for car accidents and kids flunking out of school and things like that.
Q: What about the notion that by legalising it you take it out of clandestine operations?
Humphreys: You will probably get rid of some gun violence, for example. But look at the example of a tobacco company. You could have substantially more death. There’s lots of ways to do violence in this world. You can weaken government regulations in a way that results in thousands of people dying.

In terms of its medical use, I have compassion for patients; I was a hospice worker for many years. But I don’t feel that’s the typical person getting medical marijuana. A paper in the Harm Reduction Journal that profiled about 4,000 such people said the prototypical patient was a 30-year-old male who had been smoking pot for about 15 years and wasn’t seriously ill – that group is riding on our compassion for the people who have Aids, MS or cancer.
To me, it’s a pretty big jump to go from saying that this plant has some medical value, to saying that its consumption — and also its production and advertising — should be legalised.

Source: Addiction Today August 6th 2010

“The longer he is in Downing Street, the more aware the prime minister is becoming of the forces that can thwart progress… every attempt at reform has to fight its way past vested interests and the forces of bureaucratic inertia,” James Forsyth of The Spectator and Daily Mail recently noted. This coalition government’s humane goal of getting addicts off drugs in its first Drug Strategy is no exception.

On Friday, the National Treatment Agency for Substance Abuse sent a press release to treatment commissioners, saying how much they will get in 2011-12 from a £570million budget for community and prison drug treatment services – but throughout the press release  and accompanying three-page letter from NTA CEO Paul Hayes, there was not one recommendation that they use the funds for the coalition government’s reasonable goal of getting addicts drug-free.

There is mention of “recovery”, but the NTA does not define recovery, leaving it meaningless for those commissioners spending the pot of money.

It does mention people leaving treatment successfully – but how is that defined? Does it mean those classified this way in NTA annual reports who actually died? Does it mean patients who have been years on methadone must vomit blood, break their clavicles and limbs or have a stroke before they “successfully exit” their substitute drugs and are sent to rehab?

“I believe the sum is sufficient to enable the field to deliver the transformative change set out in the Drug Strategy and ensure that 2011-12 is the year of transition to a recovery-focused treatment system.” said Hayes. We agree that the sum is sufficient – but again note no mention of the government’s goal.

“”The fact that the prime minister has to devote such attention to checking his instructions are followed acrossWhitehalldoes suggest that parts of the Civil Service are forgetting that its role is to implement government policy,” Forsyth concludes. 

Source:  Addiction Today  Feb. 14^th 2011

Congratulations to our colleague Manuel Pinto Coelho in Portugal.  This is an enormous victory!  The very liberal drug policy of Portugal is crumbling.

———————————————

Dear colleagues,

As you can see, although in Portuguese, it is official – Portuguese IDT and all its staff including the president Goulão has been abolished.

The mask fell down and there is no more “magnificent Portuguese model – an example to the world”. I hope Portuguese authorities decision may arrive in time to dissuade the rest of the world don’t follow countries like Mexico, Argentina and Czech Republic – as you know unfortunately they did bite the hook and decriminalized drugs already.

 The magnificent Health Minister Paulo Macedo (ex-responsible by the treasure and finances) is now trying to understand how it was possible the existence of so many holes of so many millions of euros, opening the eyes FINALY to some personal and/or corporate interests some years ago installed… and as you can imagine there is a (very) few people very worried about…!

Now there is the SICAD with the competencies of…”…planeamento e acompanhamento de programas de redução do consumo de substâncias psicoactivas, na prevenção dos comportamentos aditivos e na diminuição das dependências num novo serviço criado no âmbito da administração directa do Ministério da Saúde”

that means, the”… planning and following up of programs to reduce the consumption of psychoactive substances, prevention of addictive behaviours and diminishing of dependencies in a new service born in Health Ministry direct administration.”

Treatment and harm reduction structures are since today within the responsibility of the several structures in the ground of National Health Service untied to central services… So the licences to internments and other services became responsibility of each and every ARS – Health Regional Administration accordingly its needs in the ground.

 This is a big victory of good sense and REASON and very good news to everyone who suffer with drug dependence, giving to all of us more wings to believe that our efforts must go on moving always forward a drug free society

 Manuel Pinto Coelho, International Task Force on Strategic Drug Policy.  Dec. 2011

The attraction that the medical profession has for medical marihuana continues to mystify me. Many of the same physicians who will exercise exemplary caution in caring for their patients, will throw caution aside when it comes to pot. I know internists in private practice who refuse to accept new patients if they smoke tobacco. I often wonder if they would have the same reaction if the patients smoke pot! Yesterday, I entered an online discussion by a medical group on this subject and I’ve pasted my comment below
The medical profession needs to apologize for letting the public down on this one – once again. In the early 1900s, although medical organizations like the AMA were against patent medicines and refused to post ads in JAMA that did not list the ingredients of the products being promoted, there were quite a few doctors who nonetheless sold and promoted the use of patent medicines, most of which were worthless elixirs of cocaine or morphine or heroin or cannabis or combinations thereof, laced with copious amounts of alcohol, coloring agents and flavorings. They were promoted as curing everything from the common cold to cancer. Although the docs knew better, they argued that they were giving their patients what they wanted and if they didn’t, the patients would buy them on the street from sidewalk vendors who were not trained healthcare professionals. Ethical?
As best we know, any “positive” effects of these nostrums came in the form of intoxication, a normal reaction to psychotropic substances, including alcohol. Therapeutic they were not. Even during alcohol prohibition (1919-1933), the federal government issued special prescriptions to physicians –only– that allowed them to prescribe “medicinal alcohol” in the form of wine, whiskey, and beer. Overnight, pharmacies became liquor stores. And doctors did, indeed, prescribe alcohol for medicinal purposes and plenty of it during Prohibition. Ethical?
Fast-forward to the 1980s and 1990s and along comes the return of “medical marihuana.” This time, however, it’s not in the form of a tincture but, instead, promoted for use in its crude form as smoked marihuana. Not surprisingly, smoked pot today is touted as a cure-all for anything that ails one, from stress, to headache, to multiple sclerosis, to cancer pain and even cancer itself. How could a drug that’s so great be overlooked for so long by so many? Moreover, as in the case of alcohol prohibition, only doctors in certain states can prescribe (or recommend) it for medicinal purposes only. Ethical?
What these brief histories have in common is the promotion and use of intoxicants for therapeutic purposes. In all three cases, doctors promoted the use of these substances knowing that the anecdotal evidence of efficacy was weak at best, unsupported by unbiased clinical trial data, and not likely to improve the patient’s condition but only mask symptoms temporarily through intoxication. Incidentally, we could add tobacco to this list, too. A favorite ad of mine comes from a 1950s magazine that shows a photo of a physician holding a cigarette with a caption proclaiming that in a national survey of physicians, more preferred Camels over any other brand of cigarette. Ethical?
Wake up, America, and realize that whatever therapeutic molecules we might be able to squeeze out of the pot plant must be synthesized, purified, and manufactured to measured standards and dosing units before being used in medical treatment. Consider morphine and codeine. We don’t recommend that people grow opium poppies, harvest them, extract and chew the gum to get pain relief. Instead, we have synthesized and standardized pharmaceutically pure opiate medicines. Current pot research is underway to isolate and restructure the genetic pathways that provide pot’s psychic effect. This, scientists say, will be accomplished without interfering or reducing in any way the therapeutic properties of the beneficial cannabinoids in the plant. The final product will be safe and effective – far more effective as a medicine than smoking pot because dosing will be concentrated and stronger – and not controlled because there will be no psychotropic response. In effect, if pot truly has medicinal benefits independent of its intoxicating effects, they should be more readily available and useful in a finished pharmaceutical form. Also, users will be spared the toxic effects of inhaling smoke. Smoking anything — paper, tobacco, dry leaves, or pot — is not good for lung tissue of any living organism. Finally, the new pot without its psychic effect can be compared to decaffeinated coffee. It will have many of the same properties of the real thing except the kick. And, let’s face it, a good cup of Starbuck’s decaf can’t be distinguished from the regular stuff.
When all this happens in a few years, pot heads now desperately trying to promote pot for everything and anything will be left with nothing but the fact that their story of pot’s medicinal history will join the other historical artifacts described above. Someday, their kids and grand-kids will look back and say the same thing that we say now when we look at those old cigarette ads from the 1950s: What were you thinking?

Source: John Coleman Drug-Watch International Feb.2010

Jay’s story has a familiar ring. The pre-teen experimentation with cannabis after his father walked out on the family, followed by flirtation with ecstasy and cocaine. He had smoked his first wrap of heroin before he was old enough to buy a pint of beer. But it was only when he was off the street, safely incarcerated in a young offender institution, that methadone was added to Jay’s palate. As the gaunt teenager with grey skin shuffled from foot to foot in the West London drizzle, uncaringly dressed in a hooded tracksuit, his pin-pricked pupils scanned the streets.
“I was running wild with a raging [heroin] habit when they got me,” he said. “They tried to detox me inside but as soon as I complained they put my dose of methadone up again. I came out needing drugs as much as when I went in.”
His six-month stretch inside passed in a methadone-induced daze with, according to Jay, little attempt by prison staff to offer him a pathway to drug-free recovery. When he was released two years ago, Jay, whose only family contact is an elder brother he occasionally stays with, swiftly returned to the messy chaos of an opiate-obsessed existence. He thinks that he will be back in prison within weeks. “Most junkies I know want to be clean but if you can’t do it when you’re inside, when can you?” he says.
Methadone, a heroin substitute that is more addictive than heroin itself, has assumed a dominant position in the State’s drug-control armoury. It is given to half the country’s estimated 300,000 heroin addicts while parliamentary answers have revealed that 65,000 prisoners were prescribed it in the past year, including nearly 20,000 on a maintenance programme which can last years — an annual rise of 57 per cent. In some patches of “broken Britain” it is responsible for more fatal overdoses than any other substance.
Supporters say it stabilises addicts and protects society by removing the need for drug-financing crime sprees. Opponents argue that the State is happy to “park” people on methadone for years, giving up hope that addicts will ever lead a productive, drug-free life.
One aspect most agree on is that drug addiction is a lucrative business. Professor Neil McKeganey, a leading opponent of mass methadone medicating, said: “There’s considerable financial incentive that drug users remain drug dependent.” Drug companies make millions from producing methadone, GPs in many parts of the country get paid in the region of £220 per methadone patient per year, pharmacists can get £200 administration fees plus about £1.50 per administered dose, while more than 150,000 people are employed in drug-action teams funded largely from the public purse.
Mark Johnson, a former drug user who founded the charity Uservoice, said that although prisons are the ideal location for rehabilitation because they are “the only place that removes some people from dysfunction and gives them a respite”, the authorities are increasingly opting for the methadone route. “All we’re doing is containing the problem, not solving it,” he said.
Several studies have shown that a residential-based abstinence programme lasting at least a month has a roughly one in four success rate, while a recent study on addicts in society showed that after three years on methadone only 3 per cent are drug-free.
Despite this, however, the Government, backed by a cadre of policy experts and health professionals, is increasing its multi-million annual spend on methadone maintenance programmes. At the same time, at least 20 residential rehabilitation centres have closed in the past two years because primary care trusts have stopped referring clients. Last month Middlegate Lodge, the only residential rehab centre specifically for teenagers, closed.
Just 850 prisoners were put on the relatively succesful 12-step abstinence programme last year. No figures are available for how many young offenders are prescribed methadone.
Inspectors’ reports into young offenders’ institutions record that while alcohol and cannabis are the biggest substance problems, the use of methadone is being encouraged and is increasing.
Kathy Gyngell, a drugs policy analyst for the Centre for Policy Studies, said that prescribing methadone to young offenders had become routine. She added: “It might appear the easier option but it leads to longer term problems. Individuals who historically used their short sentences to gain clean time now feel the necessity to carry on using methadone, as it takes no effort other than presenting themselves at the healthcare door to get it.”
David Burrowes, a Tory justice spokesman, said that drug treatment was “characterised by methadone” and that a variety of treatment options needed to be available.
Katherine, a former addict, whose descent into heroin addiction began after she was raped as a teenager, said that after a decade ricocheting between methadone in prison and heroin outside, she had finally kicked her habit after becoming one of the few prisoners to be offered a place on a RAPt (Rehabilitation for Addicted Prisoners Trust) abstinence programme.
“Methadone is not a solution,” said Katherine, who left prison drug-free in 2008. “The message it gives is, ‘You come in with a habit and we’ll keep the habit and let you back out into society with no changes whatsoever.” She said that even in prison, addicts are able to exploit the system by using cotton wool to absorb the sickly-sweet green methadone linctus, before selling it on to other inmates and buying heroin with the proceeds.
Rosie, who started taking heroin at the age of 14, was prescribed methadone after leaving a young offenders’ institution and said that she had never seen a succesful methadone-led withdrawal from drug use. “It’s almost more of a poison than heroin, there doesn’t ever seem to be an end to it,” she said. She became drug-free after attending an abstinence-based treatment centre provided by the Nelson Trust.
To its advocates, though, methadone is a useful tool. At best, it stabilises addicts before they are weaned off; at worst, it can be used to maintain addicts long term, minimising the need for them to commit crime to pay for street heroin. Overall, drug-related crime is estimated to cost the country more than £13 billion a year.
There are also risks associated with forcing prisoners to go cold turkey. Cynics suggest the prison authorities’ increasing enthusiasm for methadone may have something to do with the £750,000 it was forced to pay out in 2006 after almost 200 drug-addicted prisoners sued the Government, claiming that their rights were infringed when they were forced to withdraw suddenly.
Even for those who claim to have benefited from it, methadone is at best a stopgap. James, 30, from Renfrewshire, had been a heroin user for nine years when he was given methadone in Barlinnie Prison, Glasgow. “Everything in prison was all about drugs,” he said. “Sometimes you couldn’t get any heroin and you couldn’t eat your dinner, you were in bed with all your clothes on, teeth rattling. They put me on 30ml of methadone, a low dose, and it settled me. I was a lot calmer; it was like a safety net.”
Roger Howard, the chief executive of the UK Drug Policy Commission, an advocate for methadone, admits that it could not alone cure drug addicts. “What everyone wants is to reduce deaths from dangerous street heroin and to reduce criminality,” he said. “Methadone is not the problem. These people come with a bucketful of problems: abuse, unemployment, homelessness, family.”
Professor McKeganey, who works at the Centre for Drug Misuse at the University of Glasgow, warned that Britain was sleepwalking into a situation similar to that in the Netherlands, where the Government provided places at old people’s homes for those with long-term methadone habits: the so-called “geriaddicts”. Mr Howard agreed: “There is a cohort who are probably so damaged and with such profound health problems that they will never get a job and will for ever rely on the State.”
As he prepared to pad the darkened streets of West London in shoes as punctured as his bony, needle-marked forearm in an all-consuming search for his next hit, Jay pondered a parting question: if you could survive in prison on methadone alone, why not, when outside, give your daily, drug-free urine sample, take the supervised dose of methadone and shun street drugs?
“But where would it get me? All right, the craving for smack’s not there but you soon get the craving for the meth. Nobody I know on a heoin ’script is getting any better. They’re just surviving.”

Source: Times Online 17th March 2010

The cost of a quick fix
2.4m Methadone prescriptions written in 2007, a rise of 60 per cent since 2003
£1.2bn Amount spent annually by government (central and local) tackling drug use in England in 2009-10
£15.3bn The cost per year to society of problem drug use
£13.9bn The estimated cost of drug-related offending in 2003, made up of a £9.9 billion cost to victims of crime and £4 billion costs incurred by the criminal justice system
330,000 Estimated number of problem drug users in England, of whom 166,000 are in some form of treatment programme

Sources: NAO, Drugscope, Home Office

Whichever way you look at it, the Government’s increasing reliance on methadone to treat heroin addicts involves moral issues. Predominant among these is that the State is in effect cast in the role of drug dealer — conceivably for as long as the addicts live.
The uneasy relationship becomes especially problematic when users die of overdoses, having supplemented methadone with other street drugs.
Never forget how dangerous this is. When official figures show that in some areas a third of the people who die from drug-related causes have methadone in their bodies, put there by the taxpayer, and that this proportion doubled from 2006-08, we are on dodgy ethical ground.
Increasingly, it means the substance that is supposed to be a primary solution appears to be an intrinsic part of the problem. What methadone also represents is the transfer of personal responsibility for addiction away from the drug user. In this sense, the heroin substitute symbolises the cultural shift in modern drug policy: the addict is a victim who needs support and maintenance, rather than someone who should change their behaviour.
This official non-judgmentalism is interesting, especially when there is public debate about the resources devoted to the consequences of smoking, alcohol and overeating — which are not illegal. The merits of a humane approach to drug addiction are apparent. No one argues that methadone is not a useful part of the weaponry. It’s relatively cheap; it can stabilise the lives of addicts who shoplift or supply heroin to others; and of course, rather importantly, it allows the Government to say that it is doing something.
But what worries critics of methadone is not only its excessive use, but the lack of an exit strategy. In parts of the country there are addicts who have been taking it for decades. Even advocates concede that people are being kept on the drug for too long without any target to get them off.
All of which makes it troubling to hear that young offenders are being prescribed it, if only because, without any commitment to get them off drugs, they may end up “parked” for many years of dependency.
Professor Neil McKeganey, in his latest book, laments the lack of consensus about the goals of treatment, pointing out that although the majority of addicts want to be free of drugs, this is not facilitated by government policy. He wants to see a target limiting use to two years.
Methadone is a smokescreen for the absence of alternatives when it comes to problem use. There appears to be no new thinking, no initiatives, few open minds; and indeed little political will.
In a sense, the ubiquity of the heroin substitute is an admission that not only have social policies failed, but that we have no solutions for the consequences.

Source: Times Online 17th March 2010

THE Conservative’s Holyrood justice spokesman Bill Aitken is no stranger to controversy and his plain-spoken attack on the methadone programme has re-ignited the debate about how best to tackle Scotland’s appalling epidemic of drug addiction.
The debate about the effectiveness of the methadone programme has raged since its inception and there has always been opposition to the principle of handing out free opium-based drugs like methadone to addicts. But there is much in the basis of the scheme to commend it, not least that it has the potential to place those on the programme outwith the reach of criminals. Something that means addicts no longer have to steal to manage their habit and keeps them out of the clutches of gangsters should be a good thing. However, too many just use the methadone as part of their daily drugs routine and find ways of selling it on, despite measures like forcing them to take it in front of the pharmacist.

But the biggest flaw in the current system is that there is no incentive for the addicts to wean themselves off drugs altogether. The methadone programme is only a means to manage the habit, not break it and that must change. There is a great deal of truth in the belief that addicts must genuinely want to give up before any treatment can be successful, and that applies as much to alcohol, nicotine and gambling as it does to drugs. But therein lies the weakness in the system – following the logic, why should alcoholics not get free booze if it helps prevent them following a life of crime? Of course, that would be absurd, but so too is supplying junkies with more drugs for as long as they want without any prospect of a cure.

The extent of drug addiction across the whole of Scotland is only one facet of a wider social malaise, especially in the sprawling sink estates. Edinburgh has its own well-documented drug problems, but its scale is dwarfed by the problems affecting places like Easterhouse. Why is it that some of these places have lower life-expectancy than deprived Third World countries? Why are thousands of people in a prosperous country able to see out their lives without ever doing a useful day’s work? And why is it necessary to lock up more people here than in most comparable Western countries? That there is a deep social malaise in much of Central Scotland is not in any doubt and the answer does not lie in throwing more public money at the problems without a radical re-think.

Bill Aitken’s description of drug addicts sitting “fat and happy” on the methadone programme might be over-blown – few of them are what any normal person would recognise as happy – but he does have a point. Free drugs on the state should only be part of a habit-breaking programme – anything less is little more than state-funded dealing.

Source: Edinburgh Evening News 17 March 2008

“National Drug Treatment Monitoring System (NDTMS) data on treatment modalities shows that 131,110 people received substitute prescribing treatment. During the same period, 5,350 people received PTB-funded treatment in residential rehabilitation centres.”

“We should be justly proud of what has been achieved in drug treatment. The sustained investment in recent years has resulted in significantly increased capacity, accessibility and take-up of drug treatment services. However, there is both the need and opportunity to further improve retention and treatment outcomes, not least by ensuring that problem drug users are able to access core services such as housing, employment and training opportunities. It is the time to evaluate where we are and how we can make drug treatment even better.” Martin Barnes Drugscope

posted by Peter O’Loughlin on 14 Mar 2009 at 5:05 am

What Mr. Barnes failed to mention.

1. Drug related deaths in accordance with the UK official definition are at their highest for 5 years. (Health Statistics Quarterly 39. Office of National Statistics)

2. The level of HIV and other blood born diseases among Injecting Drug Users is higher now than at the start of the decade.

3 .In London where the prevalence of HIV is higher than anywhere else in England, 1 in 20 Injecting Drug Users is infected.

4 .In the remainder of England and Wales HIV among IDUs has risen from approximately one in 400 to 1 in 250 in 2006.

5 .The prevalence of hepatitis C among IDUs has increased from 33% in 2000 to 42% in 2006.

6. Approximately on in 5 IDUs has hepatitis B, which represents an increase of something like 200 per cent since 1997.

The foregoing is neither ‘uninformed’, or ‘unwarranted’ criticism, they are however the inescapable facts which Mr. Barnes seems either keen to suppress or is unaware of, In either event his opinion that “we should be justly proud of what has been achieved in drug treatment”, is hardly a balanced judgment of the escalation in both drug related deaths and disease which is being inflicted on our society. Nor the increasing level of drug offences and drug related crime.

Whether or not this catastrophic outcome of our drug treatment strategy can be wholly attributed to the harm reduction treatment protocols which has dominated it for so many years, and of which Mr. Barnes is an enthusiast, is the principle cause of the seemingly out of control increase in death, disease and crime, is debatable, what is not debatable is that we have no reason or justification to be proud that we have presided over an escalating and avoidable loss of life, death and criminal activity; nor is Mr. Barnes justified in claiming that we have.

Follow-Up Opinions

Failings Found In Needle Exchange Services.
posted by Mary Brett on 17 Mar 2009 at 1:49 pm
Among other failings found in a survey by the NTA of needle exchanges in England 2006, 50% of DATS had no access to virus testing on site, 40% no immunisation in place, about a third lacked hygiene and safer technique discussions.

Data collection was poor – DATS able to provide numbers of clients and visits, quantity of equipment distributed and returned were in the minority. Only 74% of DATS, 55% of needle exchange service providers and 48% of pharmacies provided information. There was a lack of training for co-ordinators and access to facilities was mostly limited to the working week. Very few operated at weekends or during the evening or night. Largely missing was any monitoring of discarded needles or injuries arising from them to the public.
Has anything been done to improve this situation? From the latest figures, quoted here, it would appear not to be the case.
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Quantity V Quality
posted by Peter O’Loughlin on 18 Mar 2009 at 6:11 am
Thank you for your revealing and interesting contribution Mary.

It seems as if the NTA’s obsession with numbers treated, rather than treatment outcomes could be a contributory factor to the spread of blood born disease.

It is also depressing to learn that those hardy souls in the front line for whom I have considerable respect and admiration, are being deprived of the fundamental training and facilities needed to improve outcomes.

No doubt the apparent focus on numbers is to enable those responsible to issue gushing reports of achievement through the simplistic process of counting the numbers of needles issued, rather than positive outcomes of how those who use the facilities might be engaged in recovery.

A case of ‘never mind the quality, feel the width’.

If we add to that the seeming disregard of the danger to the public caused by discarded needles, then harm reduction as it is being practised in this country is creating more problems than it is resolving.

It seems to me that those people who sit in their ‘ivory towers’ dreaming up ‘harm reduction’ solutions have failed to realise that addiction is not confined to office hours and that when the addicted are craving for a fix, the lack of a clean needle will not prevent them from using.

Now exactly what is it that Mr Barnes of DrugScope feels we have reason to be ‘justly proud of’?

Is it the number of needles issued?

The injury to children and others arising from discarded needles?

The lack of training and supervision and hygiene facilities? Or the escalation, in avoidable deaths and disease?

The one thing I do agree with Mr. Barnes on is that more, much more is needed to reduce both drug related deaths and disease, and the most realistic way of achieving that is through abstinence focused recovery.

What Mr Barnes seems unable to grasp is that there is a world of difference between abstinence and recovery. Nor does he seem willing to acknowledge that the outcome of addiction is always abstinence. The latter is not an option as Mr Barnes appears to be suggesting. It is achieved either through premature death, a reality which is already occurring, or abstinence focused treatment followed by on going after care; realities that neither Mr. Barnes or the NTA seem willing or able, to confront.

EACH year the Scottish Drug Misuse Database releases statistics laying bare the grim reality of drug addiction in Scotland. For a few days politician show angst at the tragedy that lies behind the statistics but somehow attention moves on as if this problem will resolve itself.

It is expected areas of high unemployment and poverty will feature prominently in the SDMD and yesterday’s figures offer little change. Glasgow, Dundee, Inverclyde and West Dunbartonshire all feature as areas showing significant levels of problematic drug abuse, though in truth all of Scotland is affected.

What continues to shock, however, is the numbers of young people under 15 years of age who present as problematic drug users and this year, as the figure records more than 100, that shock does not lessen.

Their first involvement is likely to occur as early as primary school but most often in first or second year secondary, their drug use developing usually from a habit of the illicit drinking of alcohol with school friends. Accessing of drugs builds from that background of irresponsible risk taking in public areas such as parks, isolated school play areas and the likes.

From my experience and talking to young people in prisons, it seems to me likely that school absenteeism arising from heavy drinking and the abuse of drugs (usually cannabis) created for these youngsters a self-imposed understanding of exclusion and thereafter educational failure that ensured that any chances they may have had of early success is denied.

Opportunities for gainful employment were also denied. It is in these circumstances that many turned to heroin, diazepam and cocaine – drugs identified in the most recent statistics as the source of much of the problematic drug misuse recorded. A spiralling downturn in life chances, an increased likelihood of arrest and incarceration and real possibility of drugs-related death beckons.

The latest figures reflect a 131 per cent increase in drugs-related deaths over the ten-year period to 2008 giving us a new yearly total of 574 deaths. 574 tragedies.

It is not the writing of new drugs strategies that will bring about a change in this situation. It’s government leadership to ensure that enforcement, health, education and prisons all work with the voluntary sector towards the sole outcome of reducing problematic drug abuse.

Source: http://news.scotsman.com 31st March 2010

Almost 30,000 prisoners are being kept dependent on drugs by the prison service rather than being put through detox programmes, according to a new report.
Methadone, along with similar drugs, is being prescribed too easily thanks to risk-averse clinical guidelines and inexperienced prescribers, concludes the Policy Exchange report, to be released on Monday.
“Perversely, the massive increase in opiate substitute medication has created a new kind of trade for drugs in prisons, as methadone and buprenorphine are readily traded among inmates,” said Max Chambers, author of the report, Coming Clean, Combating Drug Misuse in Prisons.
The report criticises clinical guidelines for not taking into account the length of sentence a prisoner is serving when prescribing treatment for drug addiction.
“Maintenance treatment, which is when a stable dose is prescribed often continued indefinitely, should only be given to prisoners serving 13 weeks or less and who don’t have time to complete a detoxification programme,” said Chamber.
Under current practices, however, every prisoner who has been receiving methadone in the community will have their drug habit maintained in prison, regardless of the length of their sentence.
Almost 20,000 maintenance prescriptions were made in 2008 to 2009. By 2011, when the Integrated Drug Treatment System is rolled out to all prisons in England and Wales, an additional 8,788 prisoners a year will be receiving methadone maintenance treatment.
The report also cites research showing that around £100m of drugs are smuggled into prisons each year. The majority of drug-dealing in prison involves the collusion of about 1,000 corrupt members of staff – equating to seven prison officers per prison. “They are able to smuggle drugs due to lax security arrangements and, given the inflated value of drugs in prison, are able to make substantial profits without fear of detection,” said Chambers. “A prison officer bringing a gram of heroin into prison every week – about the size of two paracetamol tablets – could expect to more than double his basic salary.”
Chambers cites evidence that accusations of corruption by prison officers are not routinely investigated by the Serious Organised Crime Agency or the Prison Service. “Information on the number of officers accused, charged, prosecuted or convicted of smuggling drugsor other contraband is apparently not collected at all by central government,” he said.
The report reveals that the number of prisoners using drugs is hugely underestimated. Mandatory drug testing figures indicate 7.7% of prisoners are using drugs but in a survey of prisoners conducted for the new report, the figure was found to be 35%, with 16% using drugs at least once a week – equivalent to about 14,000 prisoners.
Harry Fletcher, assistant general secretary of probation union Napo, said officers who smuggled drugs into jail routinely avoided detection. “It’s a serious problem but the government doesn’t keep statistics on how many staff are caught, which is extraordinary,” he said.
Fletcher said there were more than 6,000 prison officers convicted of disciplinary offences over the past four years, with 19 of them currently serving sentences. “Because there is no data on the extent of the problem we can’t devise solutions,” he said.

Source: www.guardian.co.uk 28th May 2010

Theresa May, the Home Secretary, issued a humiliating rebuke to her drug advisers after they called for the possession of drugs to be decriminalised.

The Home Office said there was no intention to give people a “green light” to use drugs because they “destroy lives and cause untold misery”.

The Advisory Council on the Misuse of Drugs (ACMD) risked a fresh row with the Home Office after suggesting those who possess any drug, including cocaine or heroin, for personal use should be taken out of the criminal justice system.

The Government issued a blunt statement insisting drug laws would not be liberalised and “decriminalisation is not the answer”. It is the latest in a series of run-ins between Whitehall’s official drug advisory body and the Home Office.

In 2009, the then Home Secretary Alan Johnson, sacked the ACMD chairman Professor David Nutt after he openly criticised the Government’s stance on cannabis. He had also previously said taking Ecstasy was no more dangerous than riding a horse.

The ACMD called for a review on how those caught in possession of drugs are handled in a submission to the Sentencing Council, which is consulting on guidelines for courts on drug offences.

However, it is not in the remit of the Sentencing Council to consider what would effectively decriminalisation and the ACMD only included its comments in the final section asking for any further comments. It wrote: “There is an opportunity to be more creative in dealing with those who have committed an offence by possession of drugs.

“For people found to be in possession of drugs (any) for personal use (and involved in no other criminal offences), they should not be processed through the criminal justice system but instead be diverted into drug education/awareness courses.”

The courses “would be the equivalent of the apparently successful ‘speed awareness’ courses to which drivers can be referred as a diversion”, the council added. It also suggested that those accused of possessing drugs could also face “more creative civil punishments”, such as the loss of a driving licence or passport.

A spokesman for the Home Office said: “We have no intention of liberalising our drugs laws. Drugs are illegal because they are harmful – they destroy lives and cause untold misery to families and communities. “Those caught in the cycle of dependency must be supported to live drug free lives, but giving people a green light to possess drugs through decriminalisation is clearly not the answer.”

Source: www.telegraph.co.uk 18th Oct 2011

The California Medical Association (CMA) took a major leap lacking science and common sense. With the issuance of a White Paper calling for the legalization of marijuana for medical and non-medial purposes, they have transitioned from a medical group into a lapdog of the drug legalization lobby.
“I am thoroughly appalled by the CMA’s decision to release this policy in an attempt to legalize a drug that we know causes so much harm to individuals and families,” said Eric Voth, M.D., F.A.C.P. and Chair of the Institute on Global Drug Policy. “The CMA has managed to single-handedly make a mockery of modern medicine and the ethical practices of physicians. There is nothing scientific about this White Paper – it is total politics.”

The White Paper just released contains a number of incorrect statements. Contrary to what the paper states:
• According to the National Household Survey on Drug Abuse, the rate of current, past 30-day use of marijuana by Americans aged 12 and older in 1979 was 13.2%. In 2008 that figure stood at 6.1%. This 54% reduction over that 29-year period is a major public health triumph, not a failure! Now, we must not only push back against the drugs but, the advocates who seek to normalize and legalize them.
• The Netherlands reclassified high potency marijuana as a “hard drug” because of the harms that have occurred from the drug and moved to shut down hundreds of “coffee shops” that serve marijuana. Their lenient policy caught up with them and they are moving back to more conservative actions.
• Portugal’s policy that decriminalized consumption and possession of illicit drugs in 2001 was a dismal failure. The 2007 national drug survey showed an increase in life-time prevalence of drug use in the general population, especially regarding cannabis use and use of cocaine has nearly doubled. Cocaine seizures increased seven-fold between 2001and 2006 and murders increased 40%.

“The CMA is dead wrong in asserting that the marijuana legalization movement is driven by the public. Instead it is driven by a group of well-financed legalization advocates. The ballot initiative to legalize pot was defeated in California and no other state has approved such an ill-advised policy, despite millions of dollars poured into this effort by ivory-tower elitists unaffected by the impact of drug use, like the rest of us. Even the issue of marijuana as medicine was rejected by two-thirds of the country,” stated Calvina Fay, Executive Director of Drug Free America Foundation.

“It is laudable that CMA supports more research and more education efforts to reduce marijuana use among children, adolescents, and young adults (although we believe it should include all adults). Ongoing research into potential medicines and cures is an important endeavor but, the solution should be to require marijuana to meet the standards of modern medicine, not by ballot initiatives or legislation and certainly not by legalizing it for recreational use” Fay concluded.
Drug Free America Foundation, Inc. is dedicated to fighting drug use, drug addiction and drug trafficking and to promoting effective sound drug policies, education and prevention.

Source: www.dfaf.org October 17, 2011

Irish research shows addicts on methadone programme still abusing crack cocaine and other substances. The Irish Government drugs policy needs to change
There has been an apparent levelling off of the need for opiate centred drug treatment. However the researchers believe their findings show that this is misleading. Their evidence suggests that multiple drug use is the norm among many addicts.

Realities of Drug Misuse Investigated

The study was led by Dr A. Jamie Saris (Principal Investigator) and Fiona O’Reilly (Primary Field Researcher), Dept of Anthropology at NUI Maynooth and is the result of a long-term study which closely examined the realities of drug misuse in three adjacent neighbourhoods.
Of 92 abusers surveyed, 98% were on a methadone drugs treatment programme yet almost two thirds claimed to have used heroin within the past 3 months. Whilst over half were on prescription tranquilisers almost as many had used illegally obtained tranquilisers. Nearly one third had used crack cocaine and more than one in five powder cocaine. “Multiple drug use is the reality for nearly all users, and official policy needs to have this understanding at its centre”, claims Dr Saris.

Stigma Against Heroin Among the Young

A surprising finding was that there is a stigma against heroin among many of the younger users (aged 16 to 25). But these individuals still abuse what the study team describe as a “dizzying array” of other substances. The established approach to treatment, being so heavily focused on heroin, means that the issues faced by such people are not being addressed.
Another problem with the focus on crack and heroin is that it sets the users of those drugs apart from society when, in fact, such people are rarely defined solely by their addiction. A lot of local community activities aimed at assisting users recognise that they often lead lives that are not so very different from everyone else.
Drug Treatment Services Should Focus on Individuals
However it is often difficult to justify such activities to official funders under the rubric of ‘treatment’, as currently understood. Dr Saris believes that it is important to understand who users are, what they are taking and why, so that the authorities can assign the appropriate resources, treatments or management systems.
Tony MacCarrthaigh chairs the Local Drugs Task Force that covers the area of the study and he agrees with Dr Saris. “Individuals and not chemicals, need to become the focal point of treatment, and that treatment needs to assist individuals in developing another orientation not just to drugs, but to life,” he said. (A Dizzying Array of Substances; An Ethnographic Study of Drug Use in the Canal Communities, Department of Anthropology, NUI Maynooth, 2010.)

Source: Apparent Success of Drug Treatment Aimed at Heroin is Misleading

http://news.suite101.com/article.cfm/apparent-success-of-drug-treatment-aimed-at-heroin-is-misleading-a259572#ixzz0tO3OAGXw

“Methadone prescriptions for heroin addicts would be cut and the National Treatment Agency that runs the programme scrapped under plans from the Tories favourite think-tank,” reports Rosemary Bennett, social affairs correspondent of The Times newspaper.
“The Centre for Social Justice, set up by Iain Duncan Smith, the Work and Pensions Secretary, said it was unacceptable that only 4% of addicts in treatment ever get “clean” and accused the agency of “pushing aside” proper rehabilitation. The Times has also learnt that the highly influential think-tank will use a report on Monday to throw its weight behind Ken Clarke, the Justice Secretary, who called for short prison sentences to be scrapped.The report will state that the CSJ agrees with him that short sentences of two months do nothing to help to rehabilitate offenders and should be replaced by community orders.”
The CSJ’s Green Paper on Criminal Justice and Addiction comes as the government considers major changes to drug policy and the future of the National Treatment Agency. Set up in 2001, the NTA oversees the controversial “harm reduction” strategy – most recent NTA treatment statistics show that of the 207,000 addicts a year who use ‘treatment’ services, only 8,980 completed their treatment drug free.4,600 addicts have access to residential rehabilitation.Numerous residential drug rehabilitation centres have closed because of lack of patients, despite no sharp fall in the number of addicts.
The CSJ said that the NTA, the running costs of which have spiralled to £18million a year, merely processes addicts with a “fatalistic” belief that they can never get clean. It wants it scrapped and replaced by an Addiction Recovery Board, chaired by a minister and charged with getting addicts off drugs altogether, using the best local private sector and charity programmes, or “recovery communities”.
The report says there is a role for methadone, but it should be used only as part of a wider treatment programme, with abstinence the goal.
“There is no strategy or incentive to reduce the numbers on maintenance treatment and move people into recovery,” the CSJ said. The report is also highly critical of how drug use is tolerated in prison: 55% of prisoners received into custody each year are classified as problematic drug users. According to the Ministry of Justice, one in five men who reports using mainstream drugs first used them in prison.

Source:www.addictiontoday.org. July 10th 2010

On Tuesday, July 20th 2010, internationally recognized anti-drug experts from every region of the world united to oppose a set of dangerous unproven global strategies recommended in the Vienna Declaration. The declaration is based on three false premises: 1) that the criminalization of illegal drug use fuels the HIV/AIDS epidemic, 2) that criminal justice and health promotion are conflicting approaches to drug policy, and 3) that the major costs of illegal drug use are those generated by the criminal justice system.
This document was released in anticipation of the 18th International AIDS Conference and has been under scrutiny by several non-governmental organizations. Calvina Fay, Executive Director of Drug Free America Foundation says, “There is no ‘reasonable evidence’ that supports the strategies outlined in the Vienna Declaration. Further, we should reject ineffective harm reduction tactics that are not based on scientific evidence while accepting drug use and creating an illusion that drugs can be used safely or responsibly. Such ill-conceived schemes foster the misunderstanding that drug use itself is not harmful and increases addiction.”
Many of the experts who opposed the Vienna Declaration know from research and practical experience that the optimal way to truly beat addiction, prevent the spread of AIDS and other sexually transmitted diseases, and prevent drug-related harm are effective strategies that target drug use and include prevention, education, treatment and law enforcement efforts and do not trade one for the other.
“The best foundation for prevention is policy. We know from experience that a balanced and restrictive drug policy is effective in keeping drug use at low levels. Since drug utilization in itself is an important risk factor for being infected by HIV, it is good AIDS-prevention to preclude illicit drug use. We must always strive to protect young people from getting involved with illegal drugs,” says Sven-Olov Carlsson, International President, World Federation Against Drugs.

To view the full joint statement issued opposing the Vienna Declaration, please visit www.wfad.se. If you would like to conduct an interview with Ms. Fay, Mr. Carlsson and/or other drug policy and prevention experts on this statement, please contact Lana Beck, Director of Communications with Drug Free America Foundation, Inc. at 727-828-0211 or 727-403-7571.

The World Federation Against Drugs (www.wfad.se) is a multilateral community of non-governmental organizations and individuals. Founded in 2009, the aim of WFAD is to work for a drug-free world. Drug Free America Foundation (www.dfaf.org) is a national and international nonprofit organization dedicated to fighting drug use, drug addiction and drug trafficking and to promoting effective sound drug policies, education and prevention. Drug Free America Foundation is a Non-Governmental Organization (NGO) in Special Consultative Status with the Economic and Social Council of the United Nations.

For More Info Contact Lana Beck 727-828-0211 or 727-403-7571 after hours

Source: Joint Press Release from www.wfad.se and www.wfad.se July 2010

The criminalization of illicit drug use provides positive health and social benefits by deterring nonmedical use of substances that cause great harm to HIV/AIDS-affected individuals. Incarceration that respects human rights and provides drug treatment services can accelerate an individual’s recovery from drug dependence and prevent drug-related harms to HIV/AIDS-affected individuals and prevent further proliferation of both diseases – HIV/AIDS and substance abuse.
In anticipation of the International AIDS Conference (AIDS 2010) from July 18-23, 2010,i the Vienna Declarationii was released by a group of non-governmental organizations (NGOs) and signed by private individuals to outline a global strategy to deal with the modern drug epidemic. The Vienna Declaration is based on three false premises:
1) that the criminalization of illegal drug use fuels the HIV/AIDS epidemic,
2) that criminal justice and health promotion are conflicting approaches to drug
policy, and
3) that the major costs of illegal drug use are those generated by the criminal justice system.

The prohibition of illegal drug use does not encourage the spread of HIV/AIDS, but rather it reduces illegal drug use among HIV/AIDS patients, as well as the non-infected population and thereby reduces the population vulnerable to HIV/AIDS infection by contaminated needles. Illegal drug use exacerbates weaknesses of the immune system, making individuals with AIDS more susceptible to infection and death. iii Marijuana use causes impaired immunity,iv v vi vii and opens the door for the virus that causes Kaposi’s Sarcoma,viii life-threatening for individuals with HIV/AIDS. Marijuana also contains bacteria and fungi that put users at risk for infection. ix x xi Illegal drug use among AIDS patients is life-threatening because these drugs lessen the effectiveness of anti-retroviral (ARV) medications.xii Nonmedical drug use is associated with increased risky sexual behaviors which promote transmission of HIV/AIDS in a way that needle exchange cannot prevent. xiii xiv
Illegal drug use also increases sexual violence which in turn results in more HIV infections, particularly among the most vulnerable members of society including womenxv as well as children. Mother-to-child transmission of HIV/AIDS now can be largely prevented by medical intervention; however, there is no protection for unborn fetuses from the adverse effects of a drug-using mother. xvi Joint Statement in Opposition to the Vienna Declaration Released July 20, 2010 Page 2

There are 200 million illegal drug users globally, making up 5% of the world population aged 16-64,xvii and an estimated 33.4 million people living with HIV/AIDS.xviii Since the emergence of the HIV/AIDS epidemic in 1981, an estimated 25 million people have died of HIV/AIDS-related causes and two million people die each year from this disease.xix These numbers are tragically high, but so is the number of global drug-related deaths, estimated at 223,000 each year. xx As previously noted, illegal drug use increases the risks associated with both contracting and treating HIV/AIDS. Reducing drug use must be part of the solution to curb the distressingly high HIV/AIDS death toll
.
The Vienna Declaration concludes that “reorienting drug policies towards evidence-based approaches that respect, protect and fulfill human rights has the potential to reduce harms deriving from current policies and would allow for the redirection of the vast financial resources towards where they are needed most: implementing and evaluating evidence-based prevention, regulatory, treatment and harm reduction interventions.” Prevention and treatment are admirable goals which aim to reduce illegal drug use; however many so-called “harm reduction” interventions normalize illegal drug use and inevitably lead to more nonmedical use of drugs, leading to more drug-caused harm. Real harm reduction is achieved by rejecting illegal drug use to improve the health and safety of would-be drug users.

To promote public health and public safety, and to reduce both illegal drug use and HIV/AIDS, the World Federation Against Drugs (WFAD), Drug Free America Foundation, Inc. (DFAF), Institute for Behavior and Health, Inc. (IBH) and numerous other organizations and individuals support a balanced restrictive drug policy that uses the criminal justice system, and the illegal status of nonmedical drug use, to reinforce both prevention and treatment. The current globally-endorsed balanced drug abuse prevention policy can be improved. Treatment systems can work together with the criminal justice system by incorporating new, effective and evidence-based strategies to reduce illegal drug use among criminal offenders. These approaches also reduce the commission of new crimes and associated incarceration.
The greatest costs of illegal drug use are not generated by the criminal justice system but by the nonmedical drug use itself. These costs include not only sickness and death but reduced productivity and the high healthcare costs generated by illegal drug use.

We are committed to efforts to improve current drug policy to further reduce illegal drug use by building on a balanced strategy that includes the criminal justice system. Rather than choosing between prevention and treatment on the one hand, and the criminal justice system on the other, it is important to find better ways for them to work together to achieve vital public health and public safety goals that neither can achieve alone. We know that the prevention of illegal drug use and HIV/AIDS prevention must go hand-in-hand; they are not in conflict with one another.

Organizations:
Sven-Olov Carlsson, International President, World Federation Against Drugs, www.wfad.se
Robert L. DuPont, M.D., President, Institute for Behavior and Health, Inc., www.ibhinc.org
David Evans, Esq., Executive Director, Drug Free Projects Coalition,
www.studentdrugtesting.org/
Calvina Fay, Executive Director, Drug Free America Foundation, Inc., www.dfaf.org
Members, International Task Force on Strategic Drug Policy, www.itfsdp.org Joint Statement in Opposition to the Vienna Declaration Released July 20, 2010 Page 3

Source: Joint Press Release www.dfaf.org and www.wfad.se July 20 2010

REFERENCES: XVIII International AIDS Conference. (2010). Retrieved July 12, 2010 from http://www.aids2010.org/
ii The Vienna Declaration. (2010). Retrieved June 30, 2010 from http://www.viennadeclaration.com/the-declaration.html
iii Antoniou, T., & Tseng, L. (2002). Interactions between recreational drugs and antiretroviral agents. Annual of Pharmacotherapy, 36, 1598-1613.
iv Cabral, G.A., & Vasquez, R. (1992). Delta-9-Tetrahydrocannabinol suppresses macrophage extrinsic anti-herpes virus activity, Proceedings of the Society for Experimental Biology and Medicine, 199(2), 255-63.
v American College of Allergy, Asthma and Immunology. (2004, November 17). Immunological changes associated with prolonged marijuana smoking.
vi Tashkin, D.P., Baldwin, G.C., Sarafian, T., Dubinett, S., & Roth, M.D. (2002). Respiratory and immunologic consequences of marijuana smoking. Journal of Clinical Pharmacology, 42(11 Suppl), 71S-81S.
vii Wu, T.C., Tashkin, D.P., Djahed, B., & Rose, J.E. (1988). Pulmonary hazards of smoking marijuana as compared with tobacco. New England Journal of Medicine, 318(6), 347-351.
viii American Association for Cancer Research. (2007, August 2). Marijuana component opens the door for virus that causes Kaposi’s sarcoma. ScienceDaily. Retrieved July 7, 2010 from http://www.sciencedaily.com/releases/2007/08/070801112156.htm
ix Fleisher, M., Winawer, S.J., & Zauber, A.G. (1991). Aspergillosis and marijuana. [Letter]. Annals of Internal Medicine, 115, 578-579.
x Ramirez, J. (1990). Acute pulmonary histoplasmosis: newly recognized hazard of marijuana plant hunters. American Journal of Medicine, 88(5), 60N-62N.
xi Taylor, D.N., Wachsmuth, I.K., Shangkuan, Y.H., Schmidt, E.V., Barrett, T.J., et al. (1982). Salmonellosis associated with marijuana: A multi state outbreak traced by plasmid fingerprinting. New England Journal of Medicine, 306(21), 1249-1253.
xii Ghaziani, A. (2005, October). Crystal methamphetamine use and antiretroviral drug resistance: A pilot study of behavioral and clinical correlates. International Association of Physicians in AIDS Care. IAPAC Monthly, 297-299. Retrieved July 9, 2010 from http://img.thebody.com/legacyAssets/22/36/meth.pdf
xiii Wechsberg, W.M., Parry, C.D.H., & Jewkes, R.K. (2010, May). Drugs, sex, gender-based violence, and the intersection of the HIV/AIDS epidemic with vulnerable women in South Africa. RTI Press. Retrieved July 9, 2010 from http://www.rti.org/pubs/pb-0001-1005-wechsberg.pdf
xiv Colfax, G., Coates, T.J., Husnik, M.J., Huang, Y., Buchbinder, S., Koblin, B., et al. (2005). Longitudinal patterns of methamphetamine, popper (amyl nitrite), and cocaine use and high-risk sexual behavior among a cohort of San Francisco men who have sex with men. Journal of Urban Health, 82(1 Suppl 1), i62-i70.
xv Wechsberg, W.M., Parry, C.D.H., & Jewkes, R.K. (2010, May). Drugs, sex, gender-based violence, and the intersection of the HIV/AIDS epidemic with vulnerable women in South Africa. RTI Press. Retrieved July 9, 2010 from http://www.rti.org/pubs/pb-0001-1005-wechsberg.pdf
xvi World Health Organization. (2010). PMTCT strategic vision 2010-2015: Preventing mother-to-child transmission of HIV to reach the UNGASS and millennium development goals. Retrieved July 9, 2010 from http://www.who.int/hiv/pub/mtct/strategic_vision.pdf
xvii United Nations Office on Drugs and Crime. (2010). World Drug Report 2010. New York: United Nations. Retrieved July 7, 2010 from http://www.unodc.org/documents/wdr/WDR_2010/World_Drug_Report_2010_lo-res.pdf
xviiiUNAIDS. (2009, December). Global facts & figures. Retrieved July 7, 2010 from http://data.unaids.org/pub/FactSheet/2009/20091124_FS_global_en.pdf
xixUNAIDS. (2009, December). Global facts & figures. Retrieved July 7, 2010 from http://data.unaids.org/pub/FactSheet/2009/20091124_FS_global_en.pdf
xx National Drug Research Institute. (2003, February 25). Tobacco, alcohol and illicit drugs responsible for seven million preventable deaths worldwide. Media release. Retrieved July 7, 2010 from http://db.ndri.curtin.edu.au/media.asp?mediarelid=40

President joins calls for debate after figures reveal extent of violence since launch of military offensive against cartels in 2006.

Murders in Mexico’s drug wars are becoming increasingly gruesome.

Mexico’s president, Felipe Calderón, has joined calls for a debate on the legalisation of drugs as new figures show thousands of Mexicans every year being slaughtered in cartel wars.
“It is a fundamental debate,” the president said, belying his traditional reluctance to accept any questioning of the military-focused offensive against the country’s drug cartels that he launched in late 2006. “You have to analyse carefully the pros and cons and key arguments on both sides.” The president said he personally opposes the idea of legalisation.
Calderón’s new openness comes amid tremendous pressure to justify a strategy that has been accompanied by the spiralling of horrific violence around the country as the cartels fight each other and the government crack down. Official figures released this week put the number of drug war related murders at 28,000.
Until recently the government regularly played down the general impact of the violence by claiming that 90% of the victims were associated with the cartels, with the remainder largely from the security forces. In recent months it has started to acknowledge a growing number of “civilian victims” ranging from toddlers caught in the cross fire to students massacred at parties.
Momentum behind the idea that legalisation could be part of the solution has been growing since three prominent former Latin American presidents signed a document last year arguing the case.
César Gaviria of Colombia, Fernando Cardoso of Brazil and Ernesto Zedillo of Mexico urged existing governments to consider legalising marijuana as a way of slashing cartel profits.
This year Mexico’s national congress began a debate on the possibility that resurfaced again this week during a series of round table discussions between the Calderón, security experts, business leaders and civic groups.
The “Dialogue for Security: Evaluation and Strengthening” is part of a new government effort to counter the growing perception in Mexico that the president’s drug war strategy is a disaster.
“I’m not talking just about legalizing marijuana,” analyst and write Hector Aguilar Camin said during the Tuesday session, “rather all drugs in general.”
After accepting the need to directly address the proposal, Calderón made it clear he did not support it. “It requires a country to take a decision to put several generations of young people at risk,” he said, citing a likely increase in consumption triggered by lower prices, greater availability and social acceptability.
He added that the predicted “important economic effects by reducing income for criminal groups” would be limited by the integration of Mexican drug trafficking into international markets where drugs remain largely underground.
Calderón did not mention current moves to soften drug laws in the US, including a planned vote in California in November on an initiative that would allow marijuana to be sold and taxed. Nor did he address the home grown argument that legalisation would remove the roots of the violence raging in the country.
“Legalisation would render the war pointless as drugs would become just another product like tobacco or alcohol,” Jorge Castañeda, a legalisation advocate and former foreign minister, told W Radio. He added that even if it did prompt an increase in drug use. “It is worth considering whether this is preferable to having 28,000 deaths.”
The new death toll, which was not broken down, is significantly higher than the informal counts kept by newspapers. Milenio newspaper put the number of drug-related deaths in July at 1,234.
Some leading critics of Calderón’s strategy, however, do not believe legalisation is the key to reining in the cartels and the violence, preferring to emphasize the need to increase efforts to go after money laundering and political corruption.
Edgardo Buscaglia, and expert in organised crime around the world, argues that the recent diversification of the Mexican cartels into other criminal activities ranging from systematic extortion to people trafficking would give them ample reason to keep fighting each other, even if drugs were legal. “Legalising drugs would be good public policy,” he said, “but it would not be a tool with which to combat organized crime.”

Source: guardian.co.uk, Wednesday 4 August 2010 20.13 BST

The following is an interesting article about Drug Courts in the USA and how successful they are. It is in response to criticisms by the NACDL about drug courts.
Setting the Record Straight: Criticisms Answered

The National Association of Drug Court Professionals (NADCP) Board of Directors has unanimously approved an official position statement regarding the 2009 report by the National Association of Criminal Defense Lawyers (NACDL) purporting to identify deficiencies in the practices of Drug Courts. Following the release of their report last September, NACDL used attacks on Drug Courts to launch an aggressive media campaign. Each attack on Drug Courts was met with a thorough and factual response from NADCP. These responses, and others, are listed below.

NADCP CEO West Huddleston and NADCP Chief of Science, Law, and Policy Doug Marlowe authored the official position statement to correct assertions made in the NACDL report that are unsupported by research, as well as address some areas of common concern. NADCP encourages Drug Court professionals to use the statement as a tool for answering these criticisms and concerns should they arise.

Missouri Law Quarterly
April, 2010

Drug Courts Save Lives and Money: So Why the Criticisms?
by Dr. Douglas Marlowe, Chief of Science, Law and Policy, NADCP

More research has been published on the effects of Drug Courts than on virtually all other criminal justice programs combined. By 2006, the scientific community had concluded beyond a reasonable doubt from what are called meta-analyses (highly advanced statistical procedures) that Drug Courts reduce crime and return financial benefits to society which are several times the initial investments. A large-scale study funded by the National Institute of Justice and recently completed in 2009—called the Multi-Site Adult Drug Court Evaluation, or MADCE— has confirmed, once again, that Drug Courts reduce crime, reduce substance abuse, improve family relationships, and increase employment and school enrollment.

Yet, just as the scientific evidence is coming in decidedly in favor of Drug Courts, criticisms of Drug Courts appear to be reaching a surprising crescendo in opinion editorials and non-scientific law journals. How can we explain this seeming paradox? If the criminal justice system endorses evidence-based practices, why should negative sentiments be rising alongside favorable research findings?

The answer is at least two-fold. One group of critics appears to be turning an intentionally blind eye to the research evidence to serve a drug-decriminalization policy agenda. Although they may use scientific language to defend their objections, no amount of data could ever dissuade them from their position. A second group of critics, however, recognizes the proven efficacy of Drug Courts, but worries that some Drug Courts might produce other negative side-effects which should also be taken into account, such as impeding zealous representation by defense counsel. Because these latter critics are swayed by data, their concerns are capable of being empirically tested; and if confirmed, can point the way toward corrective measures that will advance the field rather than move it further and further behind.

One would be hard-pressed to point to a negative commentary on Drug Courts that does not, within the same pages, endorse a drug-decriminalization or legalization agenda. For decades, drug legalizers could take steady aim at the so-called “War on Drugs” with its undue emphasis on mandatory sentencing and incarceration. Such criticisms were easy to level, because the War on Drugs has been both prohibitively costly and largely ineffective at reducing drug abuse or crime.

But Drug Courts throw a potential curve ball to these arguments. Drug Courts prove that drug abuse can remain illicit without necessitating a costly and draconian punitive response. We can hold people accountable for their dangerous behavior, while at the same time supervising them in the community and providing them with needed treatment and other services. This finding could be seen by some as sweeping the legs out from under the strongest rationale for drug decriminalization. And for this reason, it has elicited a steady stream of vehement antagonism framed in the guise of an objective scientific analysis.

Other critics, however, recognize that even beneficial treatments have the potential to cause unwanted side-effects. For example, aspirin is proven to reduce pain but in some cases can cause unintended ulcers or blood thinning. This has required the medical field to take remedial measures to reduce the likelihood that such side-effects will occur and to treat any negative symptoms that do emerge. By analogy, there is always the possibility that some Drug Courts might misapply their authority or mishandle their operations to the detriment of their participants. Moreover, there is the possibility that some types of addicted offenders might not respond well to the Drug Court model and should be treated in other ways.

There are two problems, however, with how these arguments have typically been framed by critics of Drug Courts. First, they assume facts not in evidence, and second, they often seek the wrong remedy. A review of the research literature through February of 2010 failed to uncover a single empirical study confirming any of the untoward effects that have been attributed by critics to Drug Courts. For example there is no reliable evidence (apart from some critics’ personal anecdotes) that Drug Courts impede adequate evidentiary discovery by defense counsel or sentence terminated defendants more harshly than if they had never entered the Drug Court.

It would not be a difficult matter, however, to study these questions in a scientifically defensible manner. If such negative effects do exist, then corrective measures can be developed and tested to address them. And finally, practice guidelines can be developed to ensure that all Drug Courts adhere to best practices and take reasonable efforts to avoid foreseeable injuries. There is no need to “throw out the baby with the bath water.” The indicated remedy is not to abandon the most successful program we have in the criminal justice system. The appropriate course of action is to conduct more sophisticated research to improve the intervention and to develop standards to guide the actions of Drug Court professionals.

Drug Courts are here to stay not because they are politically palatable, but because they have withstood, time and again, rigorous empirical scrutiny. They work where few other programs have. The time has come for the Drug Court field to reach full maturity. And like other mature disciplines, such as medicine or psychology, this means developing guidelines for effective and ethical practices.

The time has come for serious-minded constituencies to cease taking blind swipes at Drug Courts and vying for attention and limited resources. We need to come together to determine who should be treated in Drug Courts, how to optimize Drug Court operations, and how to avoid or redress any potential harms. This is what is meant by rational drug policy.

Governing Magazine
January, 2010
by West Huddleston, Chief Executive Officer, NADCP

John Buntin’s recent profile of Judge Stephen Alm and Hawaii’s promising H.O.P.E program is an encouraging sign that our nation’s probation system is ready for change (Swift and Certain, Hawaii’s Probation Experiment – November, 2009). In highlighting the development of the H.O.P.E. program, Mr. Buntin correctly identified systemic changes to our criminal justice system brought about by the growth and widespread success of Drug Courts, which now exceed 2,300 nationwide. In doing so, however, Mr. Buntin also raised serious questions about Drug Courts that rigorous research has already answered.

In the twenty years since the first Drug Court was founded there has been more research published on its effects than virtually all other criminal justice programs combined. The verdict? Drug Courts significantly reduce substance abuse and crime at less expense than any other justice strategy.

Mr. Buntin inferred that little is known about Drug Court participants once they leave the program. Here are the facts. Research demonstrates that nationwide, 70% percent of the 120,000 annual participants in Drug Court complete the program and 75% remain arrest-free. The longest study on Drug Courts to date shows that community reductions in drug abuse and improved employment and family functioning outcomes can last as long as 14 years.

Judge Alm suggested that most Drug Courts employ an “ineffective” reliance on future punishment. This is not the case. Drug Courts utilize close supervision, urine monitoring, and a system of graduated sanctions to ensure participants are immediately held accountable for not living up to their obligations. The approach is a vast improvement over traditional criminal justice responses, which are often applied inconsistently and in an all or nothing manner which emphasizes the draconian response of incarceration. This is just part of the reason why Drug Courts work better than probation, jails or prison and better than treatment alone.

The Sacramento Bee
October 16, 2010

Drug courts unfairly attacked
by West Huddleston, Chief Executive Officer, NADCP

Re “Fresh look at drug courts could also ease prison crisis” (Viewpoints, Nov. 9): In its latest attack on drug courts, the National Association of Criminal Defense Lawyers reveals a startling comfort with distorting facts and ignoring the truth. In misrepresenting its recent anecdotal report as a “study,” the NACDL chooses to ignore two decades of conclusive research, including hundreds of studies that prove drug courts reduce crime, reduce drug abuse, reunite families and save considerable money for taxpayers.

Here are the facts. Nationwide, 70 percent of the approximately 120,000 seriously addicted individuals who voluntarily enter drug courts with the assistance of their defense attorney complete it a year or more later and 75 percent of them remain arrest-free. A drug court participant is more than twice as likely to stay clean and remain arrest-free than is a newly released state inmate. Research also concludes that drug courts reduce drug abuse and improve employment and family functioning.

These effects are not short-lived. The longest study on drug courts to date shows these outcomes last as long as 14 years. Clearly, drug courts are not an experiment. They must be expanded to serve the 1.2 million substance-abusing arrestees before the courts. That is the real issue.

With every blind attack on drug courts, the National Association of Criminal Defense Lawyers calls into question only its own credibility.

The Miami Herald
October 13, 2009

Keep drug courts — they’re effective
by Dr. Douglas Marlowe, Chief of Science, Law and Policy, NADCP

The National Association of Criminal Defense Lawyers chooses to attack our nation’s most successful justice intervention for substance abusing offenders: drug courts (Cynthia Orr, Sept. 29 Other Views column, Rethink how we fight drugs).

It minimizes the impact of drug courts like the one in Miami-Dade, which has restored more than 12,000 lives and reunited tens of thousands of family members. NACDL only begrudgingly accepts drug courts as an interim improvement over the war on drugs until decriminalization is accomplished.

Two decades of research have proven that drug courts reduce crime, reduce drug abuse and save considerable money for taxpayers. The most conservative estimate is that every $1 invested in drug courts reaps between $2 to $3 in direct cost-savings to society.

Between 50 percent and 80 percent of all crimes are committed by substance abusers. NACDL’S assertion that drug courts are only treating low-level offenders is patently false. The majority of drug courts now treat serious offenders who have failed repeatedly in treatment and other dispositions.

NACDL recommends that drug courts treat high-risk offenders who would otherwise be in jail or prison bound in programs that do not require a guilty plea for entry.

But this would mean that serious and potentially violent offenders would face no legal repercussions whatsoever if they failed to complete treatment or even to attend it. When we consider the safety of our communities such recommendations cannot be taken seriously.

The Philadelphia Inquirer
October 24, 2009

Drug courts are needed; New Jersey shows why
by Yvonne Smith Segars, New Jersey Public Defender (As New Jersey Public Defender, Yvonne Smith Segars is the head of the New Jersey Office of the Public Defender, an agency overseeing the Public Defender offices throughout state.)

Last Saturday’s editorial, “Who needs drug courts?,” asks a simple question. In reality, the answer is far more complex. Drug courts are certainly not for everybody, and they were never intended to solve all of the problems plaguing the criminal-justice system.

In New Jersey, with all major stakeholders having a voice at the table, the judiciary, law enforcement, the defense bar, and the addiction-services community worked diligently to create a successful model. Nonviolent offenders clinically addicted to alcohol and drugs are given an opportunity to receive effective treatment.

The New Jersey Office of the Public Defender represents more than 90 percent of drug court participants, undermining the claim that drug courts favor a more privileged socioeconomic group. Of the 8,004 people who, with the advice of lawyers at their sides, participated in New Jersey’s drug-court program, 1,577 successfully graduated. While 61 percent of those entering the program complete it, the employment rate at the time of graduation is 90 percent and the percentage of negative drug tests is 96 percent. Within three years of graduating, only 3 percent return to prison for a new crime, compared with a 60 percent rate of recidivism for inmates who do not receive treatment.

Although there are serious concerns raised by the National Association of Criminal Defense Lawyers that need attention, we should not be dismayed nor distracted. Funding should continue for easily accessible substance-abuse education, prevention, and treatment. As a community, we all benefit each and every time a person triumphs over his addiction to alcohol or other drugs and becomes a law-abiding, tax-paying citizen. Who needs drug court? We all do.

Los Angeles Daily Journal
October 22, 2009

Drug Courts Are the Most Sensible and Proven Alternative to Incarceration: So What’s the Problem?
by West Huddleston, Chief Executive Officer, National Association of Drug Court Professionals

The National Association of Criminal Defense Lawyers recently released a report criticizing 2,100 (there are actually 2,369) Drug Courts that offer effective treatment instead of incarceration for drug addicted offenders. Instead, the NACDL calls for the decriminalization of highly addictive drugs such as methamphetamine, heroin and crack cocaine as the solution to the drug problem. According to Cynthia Orr, President of the NACDL, “Drug Courts have not stymied the rise in both drug abuse or exponentially increasing prison costs to taxpayers” because, according to the NACDL report, “Drug Courts focus on first-time or nonviolent offenders.” The evidence says differently.

It is now 20 years since the first Drug Court was initiated and there has been more research published on its effects than on virtually all other criminal justice programs combined. The scientific community has put Drug Courts under a microscope and concluded that Drug Courts work better than jail or prison, better than probation, and better than treatment alone. Most medications have less scientific evidence supporting their safety and benefit to the public. The research is unequivocal: Drug Courts significantly reduce drug abuse and crime and do so at less expense than any other justice strategy; and according to rigorous and replicated studies conducted by the University of Pennsylvania, the more serious the offender’s drug addiction and length of criminal record, the better Drug Courts work. Drug Courts are not for the fist time or the non-addicted offender. Those individuals will do just as well by diverting them to a disposition that leads to record expungement upon successful completion of court conditions. Drug Courts focus on high-value offenders; those who have the highest need for treatment and other wrap-around services, and who have the highest risk of failing out of those services without support and structure.

Research demonstrates that nationwide, 70% of the approximately 120,000 seriously addicted individuals who voluntarily enter Drug Court with the assistance of their defense attorney complete it a year or more later and 75% of them remain arrest-free. A Drug Court participant is over twice as likely to stay clean and remain arrest-free as a newly released state inmate. Research also concludes that Drug Courts reduce drug abuse and improve employment and family functioning. These effects are not short-lived. The longest study on Drug Court to date shows these outcomes last as much as14 years. And more research is coming out every day.

Still, no one would argue that Drug Courts have realized their full potential. Drug Courts have not been made available to everyone who needs them. Half of U.S. counties do not have a Drug Court and the Drug Courts that do exist only have capacity to serve 10% of the serious drug-abusing and addicted offenders estimated to be in need. That’s the real issue.

New York has implemented a Drug Court in every county in the state. In a three year study, the New York State Court System estimates that $254 million in incarceration costs were saved by diverting 18,000 drug offenders into Drug Court. During the entire fifteen-year time period Drug Courts have been in operation throughout the state, New York has witnessed historic reductions in crime. And through the first half of this year, crime has fallen another 4.7 percent. According to a recent Northwestern University report, alternatives to incarceration like Drug Courts could lead to the closing of four half-empty adult prisons in New York. And a number of states such as Alabama, Missouri, New Jersey and Texas, among others, are following suit. In fact, in 2008, 44 state budgets included a specific appropriation for Drug Courts, totaling $208,000,000 nationwide. The Obama Administration and Congress is also investing in new Drug Courts and increasing the capacity of the 2,369 Drug Court already in existence in all fifty states and U.S. territories with a 250% increase in federal appropriations from the year before. That’s a great start, but far from what we need to reach the 1.2 million seriously drug abusing or addicted offenders who need treatment.

If no other sentencing option can compare with its success, shouldn’t we finish the job and give everyone who needs it access to these life-saving courts? It’s simple really. Drug Courts remain constrained by limited resources and by the more popular thinking that an alcoholic or addict can be punished out of their dependence.

It is no secret that prison has accomplished little to stem the tide of crime or drug abuse. Upon their release from prison, between 60% and 80% of drug abusers commit a new crime (typically a drug-related crime) and 85% to 95% relapse quickly to drug abuse. In some states, such as California, more than 75% will be returned to prison. And amazingly, these disappointing figures have done little to curb prison spending. National expenditures on corrections well exceed $60 billion annually. On average, states spend $65,000 per bed, per year to build new prisons and $23,876 per bed, per year to operate them

Unfortunately, it is also not sufficient to simply offer more treatment. Left to their own devices without intensive supervision by a judge, approximately 25% of offenders never arrive for a single treatment session. And among those who do show for treatment, most drop out prematurely before receiving any benefits. The power and authority of the Court is necessary to keep them engaged in treatment long enough to experience any lasting gains.

Drug Courts are judicially supervised court dockets that strike the proper balance between the need to help addicted offenders get free from the gasp of drugs and the need to protect community safety; between the need for effective treatment and the need to hold people accountable for their actions; between hope and redemption on the one hand and productive citizenship on the other. Drug Courts keep drug-addicted individuals engaged in treatment for long periods of time, while supervising them closely and holding them accountable for their obligations to society, their families and themselves. Participants are regularly and randomly tested for drug use, required to appear frequently in court for the judge to review their progress, and immediately receive rewards for doing well and sanctions for not living up to their obligations. All of this with one simple goal; get the addict clean and sober.

And everybody benefits when an addict gets clean and sober in Drug Court. The most conservative estimates by researchers show that for every 1.00 invested in Drug Court, $3.36 are saved by the justice system and up to $12.00 (per $1 investment) are saved by the community on reduced emergency room visits and other medical care, foster care, and property loss.

In Drug Court, we have an effective intervention that is not being fully implemented. Now is not the time to change course. It is our hope that a drug-addicted citizen should not need to be arrested in order to receive the help they require. But for the 1.2 million drug-addicted arrestees currently involved in the adult criminal justice system, the verdict is in: Drug Court is the solution and the passport to a new way of life. Now we must make the investment and finish the job.

Source: http://www.nadcp.org/setting-the-record-straight 2010

RESPONSE TO THE NTA BUSINESS PLAN 2010/2011

Deirdre Boyd, CEO of the Addiction Recovery Foundation
Kathy Gyngell, chair of the Centre for Policy Studies’ Addictions working group

With the threat of abolition hanging over its head, the National Treatment Agency has cleverly extended its longevity by promising to mend its ways. It will, it announced on Friday, use the final two years of its now-extended life to change the policy it has promulgated over the past nine years.
“We’ve got to get rid of the centralised bureaucracy that wasteS money and undermines morale,” prime minister David Cameron stated in July. But the NTA would seem to have got the last laugh, with over £42.8million of taxpayer‘s money now allocated to it for two more years to change the disastrous system it created and has so steadfastly defended even in face of the indefensible.
The NTA will, it promises, help people get off the methadone dependency, tier 2/3 organisation dependency and state dependency which it created via its performance-managed targets. Its new Business Plan 2010/11, in a truly Orwellian “four legs bad, two legs good” style, now seemingly advocates the very abstinence approach its spokespeople have repeatedly declared to be unviable.
It will even consult rehabs, the NTA graciously announced – those very rehabs it has ignored for almost a decade and of whose success in getting addicts into drug-free and rewarding recovery Paul Hayes (yes, still the NTA’s CEO) has publicly belittled, scorned or downright denied. Could it be less than two years ago that the NTA’s ‘first point-of-contact’ told BBC Home Affairs editor Mark Easton that “rehab doesn’t work”? (see Comment 5th from bottom here for more derogatory comments from NTA senior managers).
But maybe this was not such a hard promise for the NTA top brass to make, as they look forward to their ‘brobdingnagian’ pension pots in two years’ time. After all, there are fewer rehabs to consult… For under the NTA regime, only 2-4% of addicts seeking help to quit drugs were actually referred to them. The result? Financial hardship, redundancies, the closure of over 20 specialist rehabs, more wing and bed closures and a loss of the real expertise required to rehabilitate addicts. And with their own personal futures well secured, would success of change be in their interest?
There isn’t any evidence for abstinence or for rehab, they have repeated declared. This is despite two national treatment outcomes surveys – Ntors and Doris – which indicate strongly to the contrary. It is also in face of experience. As Sir Ian Gilmore said yesterday, the “absence of evidence” about school milk for under fives is only that; it does not mean that it is not a good thing and has not helped children’s health. All experience suggests it certainly has, he insisted. Similarly with rehab: a joint report in 2008 by the Commission for Social Care Inspectorate with the NTA itself that “residential rehabs outstrip other sectors in every outcome group we measure”.
The NTA seems to have bamboozled the Department of Health and a too readily believing government. For who have they tasked to change their policy and now shift people into ‘recovery’? Brazenly, it has appointed as one of the duo the addiction psychiatrist most closely associated with the failed medico-clinical treatment approach of the past 20 years years, one of the the proponents and instigators of the last government’s failed treating-drugs-with-drugs approach so loved by the NTA, key lobbyist for counterintuitive, expensive and ethically questionable prescribing programmes: John Strang of the National Addiction Centre.
In his capacity as a director of the UKDPC – recipient of millions of charitable funds to, among other briefs, redefine for the nation the notion of (addiction) recovery – Strang chose to use this remit to ensure that any new official definition of recovery excluded full abstinence, ignoring all expert advice to the contrary.
Nor did he stop there. His UKDPC’s plan was to use this new definition of “recovery” to replace real total drug-free outcomes as the measure for the NTA’s Treatment Outomes Profile forms, meaning that their targets could be easily be hit. Very convenient. For, in one Orwellian sleight of hand, the NTA could claim a recovery outcome when no such thing had been achieved. A reduction in injection frequency would suffice. This would be the basis of NTA’s (aspirationless) claims of treatment success. In face of the derision this deserved, the NTA has gone on record saying it does not define recovery at all now – despite the fact that “recovery” is the raison d’etre of its Janus-faced Business Plan 2010/2011. That all the goals and actions therein are meaningless can thus be taken as read.
For example, there is apparently no plan to replace the discredited and bureaucratically heavy Top form. It will be forced on ever more people. The NTA states, too, that it has looked at the ASAM patient placement criteria. Yet instead of contacting the creators of this highly-researched method, it plans to reinvent the wheel and spend taxpayer money developing a version for its own purposes. It also plans to spend more taxpayer money on a mutual aid directory. Yet this is already provided free by Addiction Today. Under Championing abstinence-focussed treatment in the business plan… well, for further help interpreting the Business Plan’s double speak, read our glossary.
It is, however, commendable that Dr David Best, who has wriiten so cogently and expertly on abstinence-based recovery in the pages of Addiction Today and other professional journals, has been appointed as the other half of the recovery duo. We wish him the very best of luck in counterbalancing his former mentors, and getting them on the true road to recovery with a Damascene conversion. They should heed him, for he is the only person giving this exercise any credibility.
As David Cameron said in June,“There is a problem in our national health service, in that we spend too much time treating the symptoms rather than necessarily dealing with the causes… All addictions need proper attention, and proper treatment and therapy, to rid people of their addictions”.
We really would love to believe, as he and many in government must wish to believe, that we will witness the NTA’s respecting the trust that has been placed in it and seeking the rehab expertise that actually helps people to get off life-destroying drugs and rebuild their lives and their families’ lives. But the serious worry is that this initiative for change get will be lost in adherence to disinformation and blowback, and submerged in intransigent ideology about the non-recoverability from addiction. Of even more concern, will its lack of understanding continue to marginalise the expertise necessary to help the 330,000 or so addicts desperate for the sobriety which is the basis for them to get back, or get for the first time, their self esteem and their lives?
We will be happy to be proved wrong. But we are not holding our breath.

Source: www.addictiontoday.org. 10th August 2010

CALLS have been made for a rethink on the use of methadone in Scotland after official figures revealed the number of deaths in which it was implicated reached a ten-year high last year.
Amid a general fall in people being killed by drugs, fatalities in which the heroin substitute was cited as a contributory factor rose to 173 in 2009, up from 169 in 2008 and a surge of 51 per cent since 2007 when it was associated with 114 deaths. The controversial drug treatment was found to be at least partly responsible for more than a third (32 per cent) of all of the 545 drug-related fatalities in Scotland last year, and was associated with the second-highest number of drug-addict deaths after heroin or morphine, which contributed to 322 losses of life – 59 per cent of the total.

The 2009 methadone figure also equates to roughly one death every 48 hours.

The rising number of deaths linked to methadone led to calls for the policy of wide prescription of the treatment to addicts to be reviewed, with one drug-misuse expert describing the current situation as being of “enormous concern”.

Professor Neil McKeganey, the director of the Centre for Drug Misuse Research at Glasgow University, said: “The situation in relation to methadone – where it appears we have around a third of addict deaths associated with the drug we are prescribing most widely to treat drug addiction – is of enormous concern. We really ought to be looking again at this policy of widespread methadone prescribing. The statistics are inescapable – we ought to be looking at why we are doing it and whether all of those to whom it is being prescribed are deriving benefit from it.”

Peter McCann, the chairman of the Castle Craig Hospital for alcoholism and drug addiction, lent his weight to the calls, adding: “Today’s drug-death figures would have been described as totally catastrophic just a few years ago. There must now be a total rethink in Scotland along the lines of the National Treatment Agency in England which totally reversed its policy earlier this month. “They will be limiting the use of methadone with strict multi-disciplinary assessments at regular intervals. The policies prescribing methadone in Scotland have obviously failed and must be revised.”

Murdo Fraser, Scottish Conservative health spokesman, said the focus of the Scottish drugs strategy should be on recovery and abstinence. He said: “The attempts of the last decade to merely manage the problem, based on harm reduction and an over-reliance on methadone, just have not worked. The challenge now is to expand the range of rehabilitation services on offer and move to abstinence and recovery.”

But the treatment was defended by Biba Brand of the Scottish Drugs Forum: “We know from research that staying on methadone tends to prolong their life by about 13 per cent. “We also know that of those deaths that are occurring (overall], two-thirds are outwith treatment, so being in treatment – and generally that involves methadone – is helping people stay alive. Methadone can help save lives, but we need to help people progress through treatment.”

A Scottish Government spokesman added: “We do not favour one form of treatment over any other. Decisions on the most appropriate treatment to prescribe an individual are for clinicians, in discussion with their patients and in line with national guidelines.”

Overall, the number of people killed by drugs in Scotland fell by 5 per cent since 2008, but the 545 drug-related deaths during 2009 equated to the second-highest total ever recorded; an increase of 20 per cent since 2007 and a rise of 87 per cent since 1999.

A wider analysis, using figures recorded by the Office for National Statistics, showed the number of deaths related to drugs in Scotland last year was 716, down from 737 in 2008, but a rise from the 2007 total of 630.

This figure included people killed by solvent abuse, legal highs and through overdoses of prescription medication. It also included people dying with mental-health problems linked to drug abuse, as well as those killed by the health complications allied to contaminated drugs. More than a third of all deaths in Scotland, some 200, were in the Greater Glasgow and Clyde NHS board area, and this represented the highest total on record. Deaths in Lothian dropped, by 13 to 81, as did fatalities in Fife (37 to 32) and Forth Valley (23 to 14).

There was also a rise in the number of older people dying from drugs, with deaths among those aged 35 and over rising from 271 in 2008 to 296 in 2009, while at the same time deaths among users under 35 dropped from 303 to 249.

Source: News.Scotsman.com 18th Augutst 2010

by Eric Pierce

The Planning Commission will consider on Wednesday asking the City Council to revise the city charter to permanently bar medical marijuana dispensaries from operating in Downey.
Citing federal law that still makes it a crime to grow, use or possess marijuana, city administrators recommend the charter be amended to prohibit the dispensaries.

The City Council last year enacted a moratorium on medical marijuana clinics that is scheduled to expire Nov. 10.

In a report prepared by community development director Brian Saeki and senior planner David Blumenthal, city officials also cited reports of violent crime — specifically robberies and homicides — at dispensaries in neighboring cities.

“Besides crimes against persons and property, the operation of medical marijuana dispensaries has been linked to organized criminal activity, money laundering and firearm violations,” the report states.

California voters approved the use of marijuana for medicinal purposes in 1996. The state created a voluntary medical marijuana identification card program in 2003 to protect residents from state marijuana laws. The San Diego Union-Tribune reported in June that of California’s 481 incorporated cities, 132 have banned medical marijuana dispensaries. Another 101 have enacted temporary moratoriums.

Best, Best & Krieger, before they were fired as the city’s law firm, wrote a whitepaper suggesting Downey had the discretion to either regulate or prohibit medical marijuana clinics. The law firm also warned the city against “adverse secondary impacts” dispensaries could pose. “On balance, any utility to medical marijuana patients in care giving and convenience that marijuana dispensaries may appear to have on the surface is enormously outweighed by a much darker reality that is punctuated by the many adverse secondary effects created by their presence in communities,” Best, Best & Krieger wrote. “These drug distribution centers have even proven to be unsafe for their own proprietors.”

The city of Los Angeles recently approved a restrictive ordinance aimed at corralling the city’s estimated 400 medical marijuana dispensaries. Attorneys representing marijuana dispensaries given shut-down notices have said they will sue Los Angeles to remain open.

Only one medical marijuana dispensary has operated legally in Downey. It closed after the city’s moratorium went into effect late last year.

Source: www.thedowneypatriot.com 31st Aug.2010

Scottish Government figures show 168% increase at Craiginches since 2007
Drug seizures at Craiginches Prison in Aberdeen have nearly trebled in the last three years.
Scottish Government figures show there were 134 seizures at the jail last year, a 168% increase since 2007 when there were 50. The increase was far higher than the total across Scotland where drug seizures went up by 12% from 1,626 to 1,829 over the same period.
Labour called for a redoubling of efforts to rid Scotland’s jails of drugs. Yesterday, Chief Inspector of Prisons Brigadier Hugh Munro warned that drug testing needed to be tightened up because addiction programmes were rendered pointless by ineffective testing regimes.
The only other prison with a similar number of drug seizures in the north-east was Perth where the number has remained relatively static with an average of 138 over three years.
At Inverness Prison seizures were up from 11 to 19. The number at the two open prisons, Castle Huntly and Noranside, in Tayside, fell from 63 to 53, as did those at Peterhead, down from six to one.
North-east MSP and Labour justice spokesman Richard Baker said: “Drugs are far too prevalent in Scotland’s prisons and Brig Munro is quite right to say more needs to be done. “With a rising tide of drugs getting into our prisons there is a need to redouble our efforts to rid our prisons of drugs.”
The Scottish Prison Service (SPS) said increased seizures were a sign that efforts to reduce drug taking and smuggling into jails were working. An SPS spokesman said money had been invested in new technology such as mobile drug tracing and X-ray machines, and the “most effective deterrent” – sniffer dogs.
“New legislation will also tackle the issue of mobile phones which are a key element in drug trafficking in prisons,” he said. “High levels of finds, such as those at HMP Aberdeen which doubled in two years, are an indicator of success.”
The Tories released figures showing a 37% increase in the number of prisoners receiving the heroin substitute methadone. A snapshot of one day showed the number on the drug went up from 1,228 in 2006 to 1,679 this year. The percentage of the prison population on methadone went up from 17.1% to 21.5%.
Tory justice spokesman John Lamont said: “This is extremely worrying. This rise in prisoners in receipt of methadone suggests that efforts to move drug addicts towards abstinence are not working properly.”
A Scottish Government spokesman said the percentage of prisoners prescribed methadone had risen by less than 3% since the current SNP administration came into office in 2007. “Getting people into treatment is the most effective way of reducing drug use and breaking the links between drugs and crime,” he said. “Methadone has a role to play among a range of treatments and support available to help people recover from their drug problems.”
The SPS said 85% of prisoners on methadone were continuing medication prescribed before they were sentenced while 15% were on new prescriptions initiated in custody. “According to the latest prisoner survey in 2009, almost a quarter of prisoners are currently on a reducing methadone dose as part of their recovery programme,” a spokesman said.

Source: www.pressandjournal.co.uk 3rd Sept. 2010

The impact medical marijuana has had on our adolescent substance-abuse treatment program in Denver is profound.

The 2009 boom in marijuana distribution coincides with a tripling of teens referred to our program. Currently, 51 percent of our patients report getting their marijuana from someone with a medical marijuana license.

Not surprisingly, patient attitudes about marijuana are changing – and in ways that make it much more difficult for us to help them stop using the drug. Recently, a teenage boy said he couldn’t stop smoking marijuana because “it is my medicine for anger.”

Even worse, a few young adult patients in treatment for marijuana addiction have marijuana licenses. These patients struggle with conflicting messages from one physician who recommends smoking marijuana and another who recommends stopping.

In Denver, marijuana is advertised on billboards and in magazines and newspapers using themes that appeal to young people. Because youth are highly vulnerable to both the effects of advertising and the addictive potential of marijuana, it is not surprising that 60 percent of the state’s medical marijuana users are under 44 years old.

We must act swiftly to prevent situations such as this from getting worse.
Christian Thurstone, M.D. is the Medical Director of Adolescent Substance Treatment, Education and Prevention at Denver Health and Hospital Authority and Assistant Professor, Department of Psychiatry, University of Colorado Denver.

Source: http://ofsubstance.gov/cs/blogs Wednesday, October 13, 2010

The extension of “payment by results” to the treatment of drug addicts will test the method’s limits

AT PHOENIX FUTURES in Birmingham, Karen is six weeks into a programme of group therapy sessions, life-skills training and one-on-one meetings with her keyworker, Dean. Things are looking pretty good. A former heroin user, she was on methadone for years before going into residential rehab last October. Karen now takes a relatively low dose of Subutex, a weaker heroin substitute, which she intends to come off altogether over the next six weeks. She credits her treatment with giving her the stability to have her three-year-old son to stay with her at weekends, and hopes to take a course or get a job—and eventually to work with drug users—once she is fully abstinent.
There are many Karens in Britain, though most are not doing as well as she is. Around 320,000 people are thought to be on heroin or crack cocaine or both in England alone. Many more use cannabis (the most popular drug), powder cocaine or a constantly changing clutch of designer drugs and legal highs: in all, almost 3m in England and Wales used some sort of illegal drug in 2009-10. A big push by the previous Labour government lifted the numbers in treatment (see chart), and drug use seems to be falling a bit now. But it remains high by European standards. Some argue that too many users have been “parked” on methadone rather than encouraged to kick chemical dependence altogether.
Intent on remedying what the Conservatives see as the persistent ills of “broken Britain”, the Tory-led coalition government has big ambitions in drugs policy. It wants to get more people through treatment and functioning again—free of drugs if possible, but also employed, housed and law-abiding. There is a moral dimension to its emphasis on recovery rather than harm reduction, but also an economic one. Use of heroin or crack cocaine is linked to between a third and a half of all acquisitive crimes; an estimated 400,000 benefit claimants who are dependent on drugs or drink cost the Treasury £1.6 billion a year; and demands on the health service and criminal-justice system are great. The coalition’s commitment is real: at a time of screaming budget cuts, central-government funds for drug treatment in communities and prisons have barely been hit.
A key plank of the strategy is “payment by results”. This approach to delivering public services—rewarding charities, community groups or private firms not for what they do but for how well they do it—has been seized on gratefully by a cash-strapped government. Versions are being tried to get welfare recipients into work and discourage criminal reoffending. Now eight drug-treatment pilots are to be launched. This breaks new ground internationally, says Martin Barnes, the head of DrugScope, a drug-information charity.
No magic wand
The theoretical argument for payment by results is that, by rewarding only success, it drives up standards while reducing costs. “It will make organisations focus on delivering quality services because they won’t survive if they don’t,” says David Biddle, deputy chief executive of CRI, a charity whose drug and alcohol services have grown rapidly. Kent is one area chosen for a payment-by results pilot. “Commissioners will now have the opportunity to reward those who innovate, and deliver efficient and effective services,” says Amanda Honey of Kent County Council.
Not everyone is sure that payment by results will work in drug treatment, however. Outcomes are hard to measure. In welfare-to-work schemes, a claimant either gets and holds a job or he doesn’t. A prisoner is convicted of reoffending or he isn’t. With drugs, progress often consists of baby steps on various fronts, which is why the government proposes to pay for a range of positive outcomes including jobs, housing and so forth. Coming up with precise measures is proving hard.
Setting tariffs is difficult, too. Payment by results works only if risk is transferred to the provider. But drug users are prone to relapses, and recovery can take years. Most not-for-profits in drug treatment are small; they need payment along the way to cover their costs. If instead they become subcontractors to larger outfits, a one-size-fits-all approach could replace the tailored solutions seen by many as a key to success. Whoever is contracted, “if the basic tariff isn’t enough, it will wipe out the chances of the provider doing anything good. If it’s too much, then there is no risk transfer. If it’s the wrong mix [of incentives], then it encourages gaming,” says Lord Adebowale, the chief executive of Turning Point, a health and social-care organisation.
Despite the challenges, Turning Point and CRI are both interested in the trials. For its part, smaller Phoenix Futures has started offering a payment-by-results option off its own bat. “I wanted us to be ready,” says Karen Biggs, its chief executive.
But other uncertainties loom, as more administrative power is pushed down from Whitehall. From 2013 the funds earmarked by central government for drug treatment in the community (currently about £500m) will be handed over by Public Health England, a new bit of the NHS, to local authorities; drug and alcohol funding will merge, and perhaps disappear into the overall public-health pot. New elected police and crime commissioners will have a say in this area, as might local GPs newly charged with commissioning health care.
Anne Milton, the minister for public health, is determined that money will not leak away from drug treatment, counting on a national “outcomes framework” to make sure that needs which are not regarded as a priority locally continue to be met. Payment by results in this complicated and difficult area might prove transformative in all the right ways—or it might turn out an unholy mess. If it does work, says one sceptical charity, “they can use payment by results to deliver absolutely anything.”

Source: www.economist.com 14th April 2011

Letter published in The Times April 25th 2011
Sir,
Portugal is hardly the resounding success that the drugs liberalising lobby would have us believe
That fewer young people are trying drugs in Portugal may be the case (“Radical drug law could be imported to Britain”, April 22). But this simply reflects a Europe-wide trend, nowhere more evident than in the United Kingdom. The alarming Europe-wide increase in young people’s illicit drug use between 1995 and 2003 has come to a halt and is decreasing — in Portugal by rather less than the European average.
The picture painted by your report is less rosy overall when the data is examined fully. For according to Portugal’s Special Registry of the National Institute of Forensic Medicine, there has actually been an increase in Portugal’s drug-related deaths since decriminalisation was enacted, from 280 in 2001 to 314 in 2007. In well over half of these cases, opiates or opiates in combination with other substances (mainly cocaine or alcohol) were cited as the main substance involved.
Furthermore Portugal has been the only European country to show a significant increase in [drug-related] homicides between 2001 and 2006, by 40 per cent over a five-year period (2009 UNODC World Drug Report).
Finally, Portugal’s Instituto da Droga e da Toxicodependência reports that the overall prevalence of life time drug use increased from 7.8 per cent to 12.0 per cent in the period from 2001 to 2007, cocaine more than doubling and ecstasy close to doubling, with the prevalence of heroin abuse up from 0.7 per cent of the adult population to 1.1 per cent in the same period.
As to the decreases in new cases of HIV/Aids, not only is this also in line with a Western European trend but it is just as, if not more, plausible to associate this with Portugal’s annual increases in funding for treatment, detox and harm reduction than with the act of decriminalisation per se.
Portugal is hardly the resounding success that the drugs liberalising lobby would have us believe. And if it is what they are relying on to convert politicians and public to their cause it makes for a poor case.
Kathy Gyngell
Research Fellow, Centre for Policy Studies
Neil McKeganey
Professor of Drug Misuse, Centre for Drug Misuse Research, University of Glasgow
Mary Brett
Trustee, Cannabis Skunk Sense

Source: http://www.thetimes.co.uk/tto/opinion/letters/article2997948.ece 25.4.2011

BBC Radio 4’s Any Questions: The drug policy debate in early June mentioned an organisation in which I am involved – the UK National Drug Prevention Alliance – many times, so we must respond. In doing so, I hope to convey proven facts about the dangers of legalising drugs.

Nadine Dorries was correct that much modern cannabis is stronger than years ago but we do not agree with her figures. Typically, modern cannabis is three to four times stronger in THC, the psychoactive ingredient, than even the strongest cannabis of the 1960s and 1970s. This has been achieved by selective breeding and in response to consumer demand.

But the picture is more complex than ‘just’ THC strength. The presence – or rather absence in modern forms – of another chemical, CBD, appears to have aggravated the brain-damaging potential of cannabis. Use has also changed. Age of first use and regular use is earlier than in the 1960s and that is another damaging factor. The evidence caused the UK government, with cross-party agreement, to reclassify cannabis upwards two years ago. At the time (Sky News, 6 April 2008), prime minister David Cameron admitted that a parliamentary committee, of which he had been a member, had been wrong about lowering the classification of cannabis. Lessons have been learned and are unlikely to be overturned. Cannabis contributes substantially to academic under-achievement and very poor mental health, regardless of other effects.

On the wider question of decriminalisation and even legalisation of all drugs, the NDPA believes that a monstrous, well financed and very slick fraud is being perpetrated internationally and that this fraud has fooled some of the “great and good” who signed up as supporters. There is no evidence at all that either measure could reduce the total harm from drugs. The reverse is very much the case, with academic opinion saying that either measure would inevitably normalise and increase, use. The manifest harm from the legal drugs and the legislation on alcohol and tobacco, as variously applied around the world, confirms that. Comments on wishful good effects from decriminalisation were profoundly incorrect and reflect manipulative messages. For years, we have been bombarded with the Netherlands as the example of sound drug policy – despite the fact that the country, through its policies, created the largest base for drugs-related criminality in Europe with supply, warehousing, distribution and manufacture at astonishing levels. At one stage, the Netherlands had more drug related murder than anywhere else in Europe. The Netherlands is changing. It spends proportionally more than the UK on enforcement and is currently more effective and better organised than the UK.

Portugal and decriminalisation appears now to be “the new orthodoxy” for those with a certain direction of travel and for those “user advocates” who want more freedom to use, regardless of the wider social effects. But Portugal is being misrepresented, as demonstrated below.

1. The number of new cases of HIV and Hepatitis C in Portugal is eight times the average in other EU countries.
2. Portugal has the most cases of injected drug related Aids, with 85 new cases per million citizens. Other EU countries average 5 per million.
3. Since decriminalisation, drug-related homicides have increased 40%.
4. Drug overdoses have increased substantially, by over 30% in 2005.
5. There has been an increase of 45% in post mortems testing positive for illegal drugs.
6. Amphetamine and cocaine consumption has doubled in Portugal, with cocaine seizures increasing sevenfold between 2001 and 2006.

Finally, the suggestion that legalisation would somehow remove criminality from drug supply is ridiculous. Criminality loves use-reinforcing substances and behaviours. Over 20% of the UK tobacco market is smuggled, counterfeit or both. In some other countries, the figures are worse. Legalisation or decriminalisation of substances unfit for human consumption should occur only if a demonstrable “public good” can be evidenced. The problem for the legalisation lobby is that it
cannot.
DAVID RAYNES is executive councillor of the
UK National Drug Prevention Alliance (http:// drugprevent.org.uk/ppp/about-us).

Source: Addiction Today July/August 2011

BBC Radio 4’s Any Questions: The drug policy debate in early June mentioned an organisation in which I am involved – the UK National Drug Prevention Alliance – many times, so we must respond. In doing so, I hope to convey proven facts about the dangers of legalising drugs.

Nadine Dorries was correct that much modern cannabis is stronger than years ago but we do not agree with her figures. Typically, modern cannabis is three to four times stronger in THC, the psychoactive ingredient, than even the strongest cannabis of the 1960s and 1970s. This has been achieved by selective breeding and in response to consumer demand.

But the picture is more complex than ‘just’ THC strength. The presence – or rather absence in modern forms – of another chemical, CBD, appears to have aggravated the brain-damaging potential of cannabis. Use has also changed. Age of first use and regular use is earlier than in the 1960s and that is another damaging factor. The evidence caused the UKgovernment, with cross-party agreement, to reclassify cannabis upwards two years ago. At the time (Sky News, 6 April 2008), prime minister David Cameron admitted that a parliamentary committee, of which he had been a member, had been wrong about lowering the classification of cannabis. Lessons have been learned and are unlikely to be overturned.  Cannabis contributes substantially to academic under-achievement and very poor mental health, regardless of other effects.

On the wider question of decriminalisation and even legalisation of all drugs, the NDPA believes that a monstrous, well financed and very slick fraud is being perpetrated internationally and that this fraud has fooled some of the “great and good” who signed up as supporters. There is no evidence at all that either measure could reduce the total harm from drugs. The reverse is very much the case, with academic opinion saying that either measure would inevitably normalise and increase, use.  The manifest harm from the legal drugs and the legislation on alcohol and tobacco, as variously applied around the world, confirms that.  Comments on wishful good effects from decriminalisation were profoundly incorrect and reflect manipulative messages. For years, we have been bombarded with the Netherlandsas the example of sound drug policy – despite the fact that the country, through its policies, created the largest base for drugs-related criminality inEurope with supply, warehousing, distribution and manufacture at astonishing levels. At one stage, theNetherlands had more drug related murder than anywhere else inEurope. TheNetherlands is changing. It spends proportionally more than theUK on enforcement and is currently more effective and better organised than theUK.

Portugaland decriminalisation appears now to be “the new orthodoxy” for those with a certain direction of travel and for those “user advocates” who want more freedom to use, regardless of the wider social effects. ButPortugalis being misrepresented, as demonstrated below.

1. The number of new cases of HIV and Hepatitis C inPortugalis eight times the average in other EU countries.
2. Portugalhas the most cases of injected drug related Aids, with 85 new cases per million citizens.  Other EU countries average 5 per million.
3. Since decriminalisation, drug-related homicides have increased 40%.
4. Drug overdoses have increased substantially, by over 30% in 2005.
5. There has been an increase of 45% in post mortems testing positive for illegal drugs.
6. Amphetamine and cocaine consumption has doubled inPortugal, with cocaine seizures increasing sevenfold between 2001 and 2006.

Finally, the suggestion that legalisation would somehow remove criminality from drug supply is ridiculous. Criminality loves use-reinforcing substances and behaviours. Over 20% of theUKtobacco market is smuggled, counterfeit or both. In some other countries, the figures are worse. Legalisation or decriminalisation of substances unfit for human consumption should occur only if a demonstrable “public good” can be evidenced. The problem for the legalisation lobby is that it

cannot.

DAVID RAYNES is executive councillor of the

UK National Drug Prevention Alliance (http:// drugprevent.org.uk/ppp/about-us).

SourceAddiction Today July/August 2011

A highly-toxic class-A drug is being sold inScotland, according to senior police officers. ParaMethoxyMethylAmphetamine (PMMA) has been found in tablets which look like ecstasy.

The substance has also been found in drugs being sold as “legal highs” inScotland.

The Association of Chief Police Officers Scotland said it had recovered quantities of PMMA after a series of raids. It has been produced in pink tablets with a Rolex crown logo, and in white tablets with a four-leaf clover logo.

PMMA has also been recovered in powder form and police said it may also be present in other products and tablets.

Det Inspector Tommy Crombie, of the Scottish Crime and Drug Enforcement Agency, said: “PMMA is a stimulant similar to ecstasy but it is not as potent. Users… may be tempted to take more tablets to achieve the desired effect, increasing the risk of a potentially fatal overdose.”

“I would strongly advise drug users to avoid such products and follow harm reduction advice where necessary.”

From BBC News Scotland July 2011

The true cost of Scotland’s drug habit has been set out by a leading academic, who says a single addict sets the country back more than £60,000 a year.

Professor Neil McKeganey, director of the Centre for Drug Misuse Research at the University of Glasgow, has criticised Scottish Government policy and said the nation is “paying a massive price” for its drugs problem.  Scotland has some 55,000 addicts, so the annual bill in health care, criminal activity, drug driving and other social costs comes to almost £3.5 billion.

Writing in today’s Scotsman, Prof McKeganey argues Scottish society has grown too accepting of all forms of drug abuse and needs instead to preach a doctrine of abstinence. He questions the Scottish Government’s reliance on methadone as a substitute for heroin abusers and argues more effort is required to get addicts off drugs through abstinence.

“At the moment, we have about 22,000 addicts on methadone in Scotland,” he says. “When Scottish ministers are asked whether they have any plans for reducing that number, the typical answer is to say that prescribing methadone is the responsibility of individual doctors.  “Our political leaders, surrounded by those who counsel them on the benefits of methadone, find themselves passing responsibility for our national methadone programme on to the shoulders of those who are prescribing the drug in the first place. This situation is going to get worse.”

Prof McKeganey says Scotland’s drug problem is “virtually without equal anywhere in Europe” and that concern over “legal high” mephedrone, a substance sold as plant food which has become popular as a recreational drug and has been linked to a number of deaths, is just another symptom of the “culture of addiction”.

“What… should we make of a situation in Scotland where young people are prepared to consume plant food to obtain a desired high?” he says.

The Centre for Drug Misuse Research has estimated each problem drug user costs £60,703 a year, while a recreational drug user costs the state only £134.  The costs were calculated by considering the addict’s actions in terms of health, work, driving, crime and other social consequences, such as children in care and even addicts’ deaths.

In 2007, for example, problem drug users made 45,034 visits to accident and emergency departments at a total cost of £9,804,388, while the annual shoplifting bill is £50,611,921.

Prof McKeganey believes that key to tackling Scotland’s drug problem lies in a greater focus on abstinence. “If we are going to change the culture of acceptance around drugs, we need to do something that is almost beyond comprehension – we need to normalise abstinence,” he says.

The growing culture of middle-class drug use, where users argue it is a just reward for personal success, must he tackled, he argues, and there should be more visits to schools by drug addicts and their families to highlight the consequences of addiction.

Last night, a spokeswoman for the Scottish Drugs Forum defended the use of methadone for drug addicts and the necessity for support systems to help drug addicts, even during times of financial hardship.  “Methadone – along with psycho-social support to supplement the pharmaceutical prescription – has an important part to play in helping many people stabilise chaotic drug use, but other approaches must be available, including abstinence-based treatment, for people who want them and who could benefit from them,” she said.  “What matters most is having a range of high-quality and readily accessible treatment which best meets the needs of each individual at each stage of their journey away from harmful drug use.”

Tim Richley, of offenders’ charity Sacro, supported Prof McKeganey’s long-term goal, but said it would require gradual change. “I do understand the argument he is making and I would come down on the side of total abstinence as a good goal that we are trying to achieve, but other factors can help,” he said. “If they were to ditch methadone overnight, there would be a huge rise in criminal activity as addicts seek the money to buy heroin.”

A spokesman for the Scottish Government said it had invested a record £28.6 million in drug treatment and services. He went on:  “It is for individual clinicians to decide on the most appropriate medical treatment for any person, taking into account their lifestyle and what stage they are on the road to recovery.

“The Scottish Government’s new drugs strategy offers a blueprint for all our drug treatment and rehabilitation services based on the principle of recovery, not extending addiction, tailored to the personal needs of individuals.”
Source:  www.scotsman.com 29^th March 2010

Harm Reduction: More than just side effects!

 The recent stance from the managing editor of the South African Medical Journal in favor of the extremely controversial practice of decriminalizing drugs of abuse (Harm Reduction) is both surprising and disconcerting. It shows a mixture of “arm chair medicine”, selective quoting of studies and conventions, and some really flawed reasoning.

 One wonders when last he has sat in front of a drug addict who’s lost their family, through being consumed by an overriding passion for drugs, or lost their job due to multiple accidents in the workplace related to the abuse of cannabis, heroin or other drugs. Or when last has he treated a marijuana smoker who has developed schizophrenia as a result of his marijuana smoking, a complication which has become increasingly well established in medical publications over the last 4 years?

 Medical Science is exploding with new research on virtually a weekly basis, that proves the harmful effects of marijuana use including:

•  Causing psychosis in healthy people.^[1]
• Harming the brains of teenagers.^[2]
• Increasing the risk of testicular cancer.^[3]
• Poor foetal growth.^[4]
• Suppression of the immune system. ^[5]

 I suppose he has also not had to treat wash-out drug addicts from Switzerland like some of us have had to, where they have tried to regulate substance abuse through the medical provision of clean needles, syringes and drugs.

 The archaic argument that we cannot root out drug abuse by keeping it a crime is also a strange way of thinking to Doctors for Life. Since time began we have not managed to root out one single crime, but we are far from considering decriminalizing murder, rape, theft and fraud, to name but a few. Really, to use the example of Jackie Selebi’s corruption as a argument to legalize drugs is an illogical and distorted way of reasoning.

 Even though the article has quite a few references and appears very scientific, one is kind of left wondering what has happened to common sense. Dr van Niekerk keeps on quoting the fact that more harm is caused by legal drugs such as tobacco and alcohol (90% of all drug related deaths in theUK!) than illegal drugs, and somehow seems to miss the obvious point that having legalized them did not reduce the harm done by them. On the contrary, it appears to have increased the harm they cause. The implications of legalizing the use of drugs of abuse for the benefit of the economy of the country are vast. To mention just a few:

 Politoxemia, the simultaneous addiction to different drugs.

• The financial implication of increased accidents in the workplace.
• An increase in hours off work.
• Medical expenses for treating the complications of substance abuse.

 It also includes the expense of establishing an infrastructure of medical personal to oversee the handing out of these drugs (and that in a country where our health system is already overloaded). DFL finds the reasoning justifying decriminalization immature.

 Dr. van Niekerk also quotes the UN Single Convention on Narcotic Drugs of 1961, but does not mention the UNODC’s 52nd session of the Annual Commission on Narcotic Drugs March 2009, to whichSouth Africa is a co-signatory. When some parties tried to slip in a Harm Reduction policy (such as Dr. van Niekerk is supporting),Sweden,Russia,Japan,USA,Colombia,Sri Lanka andCuba refused to sign the document unless the reference to harm reduction was removed.

 Experiences of a few countries that have moved in the direction of decriminalisation should also be taken note of:

 The Alaska Supreme Court ruled in 1975 that the state could not interfere with an adult’s possession of marijuana for personal consumption in the home. Although the ruling was limited to persons 19 and over, a 1988 University of Alaskastudy, the state’s 12 to 17-year-olds used marijuana at more than twice the national average for their age group.Alaska’s residents voted in 1990 to re-criminalize the possession of marijuana, demonstrating their belief that increased use was too high a price to pay

 In Holland the Dutch government started closing down a third of their coffee shops because they found that many of the coffee shops had become a legal outlet for the illegal drug trade and after 15 years of legalised marijuana use, they were unable to separate the illegal and crime related activities from the legal trade. With the South African Police Force struggling to effectively police crime in the country, how do we think we ever are going to better the Dutch!

 The U.K.first reclassified marijuana as a less harmful Class C drug, but in January 2009 moved it back to a more dangerous Class B drug.

 Doctors For Life International is all in favour of doing more regarding the rehabilitation of drug addicts. But we do feel that having a prison sentence as an alternative to being sent for rehabilitation is a powerful incentive for many substance abusers to try and get help. To this end we would argue for more government funding to established rehabilitation units, and for NGO’s, who to a large extent have taken over the responsibility of the government in this regard.

 Doctors for Life International, represents more than 1800 medical doctors and specialists, three-quarters of whom practice in South Africa. Since 1991 DFL has been actively promoting sound science in the medical profession and health care that is safe and efficient for all South Africans. For more information visit: http://www.doctorsforlife.co.za

 References:

 ^[1] Causing psychosis in healthy people:                 

Dr Theresa Moore, Theresa HM Moore MSc, Dr Stanley Zammit PhD, Anne Lingford-Hughes PhD, Thomas RE Barnes DSc, Peter B Jones PhD, Margaret Burke MSc, Glyn Lewis PhD

Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review.UniversityofBristol, InstituteofPsychiatryinCardiffUniversity, Wales.

The Lancet, Volume 370, Issue 9584, Pages 319 – 328, 28 July 2007

 ^[2] Harming the brains of teenagers:                     

Manzar Ashtari, Ph.D: Children’sHospitalofPhiladelphia

Staci A. Gruber:HarvardMedical School

http://news.harvard.edu/gazette/story/2010/11/marijuana-study/

 ^[3] Increased risk of testicular cancer:                            

FredHutchinsonCancerResearchCenter: Stephen Schwartz

Association of Marijuana Use and the Incidence of Testicular Germ Cell Tumours

http://www.fhcrc.org/about/ne/news/2009/02/09/marijuana.html

Kristen Woodward, 206-667-5095 or kwoodwar@fhcrc.org

 ^[4] Poor foetal growth:                                            

Hanan El Marroun, Henning Tiemeier, Eric A.P. Steegers, Vincent W.V. Jaddoe, Albert Hofman, Frank C. Verhulst, Wim van den Brink, Anja C. Huizink.
Intrauterine Cannabis Exposure Affects Fetal Growth Trajectories: The Generation R Study
Journal of the American Academy of Child & Adolescent Psychiatry
December 2009 (Vol. 48, Issue 12, Pages 1173-1181)

 ^[5] Suppression of the immune system:                     

Venkatesh L. Hegde, Mitzi Nagarkatti and Prakash S. Nagarkatti.

Cannabinoid receptor activation leads to massive mobilization of myeloid-derived suppressor cells with potent immunosuppressive properties.

European Journal of Immunology, 2010; 40 (12): 3358-3371 DOI: 10.1002/eji.201040667

 Source:  Doctors for Life International, Dr.Thomas Gray 032 4815550  Jan 2011

David Raynes. Executive Councillor UK National Drug Prevention Alliance wrote to the BBC following the Any Questions programme on BBC Radio 4 with the following response.  Subsequently David appeared on the follow up programme.

 ANY QUESTIONS BBC Radio 4. The drugs policy debate

Date: Sat, 4 Jun 2011

 Dear Sir

Since our organisation, the NDPA, was mentioned several times in the programme please allow me to respond.

 Nadine Dorries was correct that much modern cannabis is stronger than years ago but we do not agree with her figures. Typically modern cannabis is three to four times stronger in THC (the psychoactive ingredient) than the /strongest/ cannabis of the 60s & 70s.

 This has been achieved by selective breeding and in response to consumer demand. But the picture is more complex than /just/ THC strength, the presence (or rather absence in modern forms) of another chemical, CBD, appears to have aggravated the ever present brain damaging potential of cannabis.

 Use has also changed, age of first use & regular use, is earlier than in the 60s and that is another damaging factor. The evidence caused theUKgovernment, with cross-party agreement, to reclassify cannabis upwards, two years ago.

 With Prime Minister David Cameron saying, (SKY NEWS SUNDAY APRIL 6TH APRIL 2008) that a parliamentary committee of which he had been a member, had been wrong about lowering the classification of cannabis.

 Lessons have been learned and are unlikely to be overturned.  We say that cannabis contributes substantially to academic  under achievement and very poor mental health, regardless of other effects.

 On the wider question of decriminalisation and even legalisation of all drugs, the NDPA says that a monstrous, well financed and very slick fraud is being perpetrated internationally and that this fraud has fooled some of the “great & good” who have signed up as supporters.

 There is no evidence at all that either measure could reduce the  total harm from drugs. The reverse is very much the case, with academic opinion saying that either measure would inevitably normalise and increase, use. The manifest harm from the legal drugs and the legislation on alcohol & tobacco, as variously applied around the world, confirms that.

 Comment from the panel on the good effects from decriminalisation was profoundly incorrect and just reflects implanted manipulative messages.

 For years we have been bombarded with theNetherlands as THE example of sound drug policy, this despite the fact that the country, through it’s policies, created the largest base for drugs related criminality inEuropewith supply, warehousing, distribution and manufacture at astonishing levels. At one stage the Netherlandshad more drug related murder than anywhere else inEurope. The Netherlandsis changing, it spends proportionally more than the UK on enforcement and is currently more effective and better organised.

 Portugaland decriminalisation appears now to be “the new orthodoxy” for those with a certain direction of travel and for those “user advocates” who want more freedom to use, regardless of the wider social effects.

ButPortugalis being misrepresented:

 1.       The number of new cases of HIV and Hepatitis C inPortugalis eight times the average in other EU countries

 2       Portugal has the most cases of injected drug related AIDS with 85 new cases per one million citizens. Other EU countries averaging 5 per million.

 3.       Since decriminalisation, drug related homicides have increased 40%.

 4.       Drug overdoses have increased substantially, over 30% in 2005

 5.       There has been an increase of 45% in post mortems testing positive for illegal drugs

 6.       Amphetamine & cocaine consumption has doubled inPortugalwith cocaine seizures increasing sevenfold between 2001 and 2006.

 Finally the suggestion that legalisation would somehow remove criminality from drug supply is ridiculous. Criminality loves use-reinforcing substances and behaviours. More than 20% of the UK tobacco market is smuggled, counterfeit, or both. In some other countries it is much worse.

 Legalisation or decriminalisation, of substances unfit for human consumption, should only occur if a demonstrable “public good” can be evidenced.

 The problem for the legalisation lobby is that it cannot.

 David Raynes. Executive Councillor UK National Drug PreventionAlliance

Revealed: Government helpline tells children ‘cannabis is safer than alcohol’

Children calling the Government’s drugs helpline are being told that cannabis is safer than alcohol and that ecstasy will not damage their health, an investigation by The Sunday Telegraph has found.

 Advisers manning the Frank anti-drug helpline are telling children cannabis is safer than alcohol

Advisers manning the “Frank” helpline are informing callers they believed to be children as young as 13 that alcohol is a “much more powerful drug than cannabis” and that using the illegal drug recreationally is not harmful because it “doesn’t get you that high”.

Callers are also being told that taking ecstasy will not lead to long-term damage and that if they are in doubt, to “just take half a pill and if you are handling that OK, you can take the other half.”   They are even being told that they would be able to smoke a cannabis joint, on top of ecstasy, with no ill-effects.

The advice, given to reporters who rang the helpline posing as young people, has alarmed anti-drugs campaigners who branded it “scandalous” and “irresponsible.”   Health experts have condemned the advice given to children as “frankly appalling”, “factually incorrect” and “worryingly cavalier”.

After being presented with the findings, the Government last night said it had launched an immediate investigation into the Frank service, which is funded by three separate departments, and said it would be taking action advisers involved.

Chris Grayling, the shadow Home Secretary, said: “The idea that the Government’s helpline should be saying to young people “go for it” and that cannabis should be class C when it has just been classified by the Government as class B, shows that the Home Office is all over the place in its approach to drugs.”

Professor Neil McKeganey, professor of drug misuse research, at Glasgow University, said: “Having read one of the transcripts, it is extraordinary that the Frank counsellor seems more concerned to place cannabis smoking in some kind of comfort zone of acceptable behaviour rather than address the risks of such drug use on the part of a 13-year-old child.”

Mary Brett, a spokesman for the Talking About Cannabis charity, said: “It is scandalous. These people are talking to kids, for goodness sake. Taking drugs can trigger all kinds of psychosis in people that have a genetic predisposition to it. Why are they not told that? Medical experts have said time and again that skunk, the newer type of cannabis that many young people are taking, is dangerous.

“These children are being told they can choose. But the risky bit of their brains develops before the inhibitory bit of their brain and they take risks.

“They have to be told ‘this is not for you’. When they hear fair, reasoned arguments against, they respond. It is obvious they are not hearing them from Frank.”

The helpline, established by the Government in 2003 with £3 million funding, was described in a Home Office drugs strategy recently as “the key channel by which Government communicates the dangers of drugs, including cannabis, to young people”.

But in calls to its helpline, manned 24 hours a day, seven days a week, reporters posing as teenagers were told by different advisers that drug taking was not harmful.    At no point in the conversations did the Frank team try to dissuade the callers from taking drugs.

The effects on the body were played down to the extent that one adviser, referring to ecstasy, said: “At the end of the day I know where you’re coming from – doing a pill and it felt great.”

Another counsellor said that cannabis, a class B drug, should be regarded as class C and that “cannabis doesn’t really get you that high. You know you are always in control”.   A third adviser stated: “nicotine is physically addictive. Cannabis isn’t. You can stop smoking it any time you want.”

Alcohol was presented as a much greater danger than illegal drugs, including heroin, more expensive and with many more negative effects.   One adviser told a caller: “The withdrawals of alcohol are worse than heroin for example; people can die when they become addicted to alcohol and stop suddenly.”

The reporters were also told that the police “would not do anything” if they found a young person with cannabis and that if they are caught with pills, they should say they were for their own use to avoid being prosecuted as a dealer.

In one call, where the reporter claimed to be the friend of a 13-year-old boy who had started smoking cannabis, the adviser said: “He won’t get addicted, no. Tell him you spoke to Frank and they told me it’s not as dangerous as alcohol. Tell him they said by using it recreationally, it’s not as bad as alcohol, because that’s the truth in terms of the power of the drug.”

He went on to say that if alcohol was illegal, it would be a class A drug, the most harmful category, whereas “cannabis should just be a class C drug”.   Another reporter, posing as a 15-year-old girl who had taken her first ecstasy tablet, asked if it would affect her health in any way.

The response was “Nah”. He told the caller that he could not say “go and take Es, you’re absolutely fine”, but that “in terms of taking a pill like that, it’s not going to affect your health”.   He went on to say “obviously you had a really good experience. It’s like most things, if you do it in moderation, you lessen your chances.

“A good idea is if you don’t know what it is you are taking, take a half a one and see how you go and if you are handling that OK, you can take the other half.” The adviser was also unsure what classification the Class A drug was.

During a discussion where the adviser talked about mixing drugs, the reporter asked if it was safe to have cannabis after taking an ecstasy pill.

The adviser said: “Again, I’m not condoning it but it wouldn’t spin you out like another pill or powder. If you’re asking me if you could have a spliff with it, would it have any major affects, generally speaking, no, although people are individuals so what works for one might not work for another, but generally speaking, no, you’d be able to have spliff with it.”

An estimated five million people in the UK are users of illegal or street drugs. Health experts are growing increasingly worried about the affects on young people’s mental health. There is also growing evidence that contrary to earlier assumptions, cannabis can be addictive.

Varieties of skunk, which contain much higher levels of tetrahydrocannabinol (THC), the active chemical, are more dangerous than the cannabis used in the 1960s and 1970s but are now widespread and often the choice of young people.

Dr Zerrin Atakan, consultant psychiatrist at the Institute of Psychiatry, said: “Any drug use while the brain is still developing may lead to structural or functional changes. One Australian study has shown that heavy cannabis users show clear structural abnormalities of the brain.

“Another recent study has also shown that cannabis use before 18 can lead to abnormalities in areas of the brain that control memory, attention, decision-making and language skills.

“Also, contrary to previously held beliefs, it is now considered that regular users can develop ‘tolerance’ to the drug, one of the main characteristics of addiction. Regular users require higher doses to become ‘stoned’. Some people find it very hard to give it up and become highly anxious if they do.”

According to the Home Office, drug use among all ages, including young people, has fallen in recent years. The Government, which downgraded cannabis to a grade C drug in 2004, has recently reclassified it to B.

A Government spokesman said: “It is completely unacceptable for a Frank adviser to be giving out wrong, misleading and inaccurate information. We are urgently looking into the matter and will identify the person or persons involved and take action.

“Frank is an important resource for young people who need help and advice about drugs. It is vital that Frank advisers give out correct and straight forward advice – we have therefore commissioned a review of the training advisers receive and will act upon it.”

Source: www.telegraph.co.uk  l8th April 2009

October 04, 2010

DODGY DOSSIER 3: NATIONAL TREATMENT AGENCY FIGURES

THE STATISTICS OF FAILURE IN THE NTA ANNUAL ACCOUNTS 2009/10, AND 2005 OUTCOMES RESEARCH

 by Deirdre Boyd

 If this country wishes to cut crime and get addicts into recovery, it is vital that our drugs policy is built on a solid foundation of fact not a quicksand of PR illusion which will bury us all. If failed so-called treatments and systems are promoted as successes, then truly successful treatments being considered by government might be discarded as unnecessary.

 That would be a tragedy for Britain. In an attempt to avert this, we must correct the errors published today by Robert Verkaik, home affairs editor of the Independent newspaper, who reiterated to the nation the NTA press release that “The long battle to break the link between drug addiction and criminal behaviour is being won. Nearly a half of all addicts who participated in drug courses in 2005 have been found to be free from addiction and no longer committing crime four years after leaving treatment. For those with cannabis or cocaine habits the success rates are as high as 69 per cent and 64 per cent respectively”. 

 Sorry but this is very far from the truth. It looks as if £848,960,000 has been spent in one year on people NOT leaving treatment satisfactorily.

 Deceptively, the NTA figures were placed beside the real success stories of addicts who now lead drug-free lives thanks to Rapt rehabilitation programmes, as though they were cause and effect. The reality under the NTA regime is that only about 2% of people seeking help get rehab (and a similar number get drug free).

 October is, of course, anniversary time: the NTA board meeting. This time last year, the National Treatment Agency for Substance Misuse used our hard-earned taxes to pay for positive PR in the Guardian, whose Terry Kirby wrote that it “has a seemingly perfect response” on spending resources (a Freedom of Information query from Addiction Today elicited that the NTA gave the Guardian £219,337 of our money in that 18-month period). Then Addiction Today number-crunched to put the record straight about lack of recovery-oriented treatment for addicts and thus dismal results. It was vital to identify what went wrong, as covering up the true figures denies tens of thousands – perhaps hundreds of thousands – of vulnerable people a chance to quit drugs and addiction for life.

 Since then, we have changed government and health secretary Andrew Lansley abolished the NTA. But it has two years to embed its practices and its staff into the Public Health Service. Can its directors live up to the trust placed in them by the prime minister over this transition period? Judge for yourself as we numbercrunch the NTA Annual Report 2009/10 and that press release.

 NTA ANNUAL REPORT 2009/10

 In its Annual Report 2009/10, the NTA chooses to quote for its figures a National Audit Office report, Tackling Problem Drug Use, which states that 213,000 people were in contact with the treatment system, 168,000 of these “in effective treatment” – and that only 28,000 “left treatment satisfactorily”. The first question is what happened to the other 140,000 people? The funding per person, according to the NTA report, was £3,000 – so that is £420,000,000 spent on people not leaving treatment satisfactorily. What happened to them?

 And the unexplained costs could be worse. The government-funded DTORS report estimated an average annual treatment cost not of £3,000 per patient but about £4,500 (Summary of Key Findings Research Report 23, section: Cost-effectiveness of drug treatment “With drug treatment costs of around £4,500 …”) but by Research Report 25 this figure had jumped to £6,064  (“The average cost of drug treatment over the whole DTORS sample was estimated to be £6,064…” So the NTA Annual Report 2009/10 could be indicating £848,960,000 spent on people not leaving treatment satisfactorily.

 Perhaps this is why Hansard, which prints all MPs’ speeches in the House of Commons, reported a comment in July by David Burrowes: “The annual report of the National Treatment Agency for Substance Misuse, which was presented to the House… is in stark contrast with the 30th report of the Public Accounts Committee in March, which concluded that £1.2billion is spent on tackling drug misuse without the government knowing the overall effect of that approach”.

 And what does “satisfactorily” mean? The previous annual report stated that “24,656 (41%) were discharged successfully, defined as those completing treatment free of their drug of dependency”. This last phrase is removed in the current version – perhaps because, last year, Addiction Today highlighted that it meant patients stopped using one drug but were using others. This is equivalent to saying that an alcoholic has completed treatment free of dependency on whiskey but is now dependent on vodka, brandy, high-strength lagers… Professionals refer to this as cross-addiction, where one drug is replaced with another and the addictive behaviours continue unchanged. The final figure came a maximum 8,980 people perhaps free from dependency: a similar number to those who managed to get into rehabs.

 “Changes in definitions mean that direct comparisons to previous years are not possible,” the NTA Annual Report states. So we must leave you to judge from last year’s for the moment. And ponder this…

 DODGY DOSSIER OF DISCHARGES

 As the NTA prepared for its 5 October board meeting this year, it issued a congratulatory press release not about these latest annual accounts but results from five years ago. “In an international first, the NTA tracked the post-treatment journey of thousands of drug users over a four year period and has discovered that almost half of those discharged in one year subsequently demonstrated sustained recovery from addiction,” said the press release. “Nearly half of those leaving treatment neither need further treatment nor were found to be involved in drug related offending”.

 “These findings are very exciting because they help us define more accurately what ‘success’ looks like for drug treatment,” trumpeted NTA CEO Paul Hayes, promoted from his career as a probation officer to this role and taking home a salary rivalling prime minister David Cameron (£135,000-£140,000 pa). NTA’s performance can also be credited to its executive director over these years, Rosanna O’Connor.

 The sad reality is that only “discharged” patients were included in the study. Again, we do not know what happened to the greater number not classified this way. Nor can we refer to the 41,475 (of 54,000) discharged people in the report as “participants” as the NTA has equated lack of proof of negative results as proof of positive results – see Professor Neil McKeganey’s expert opinion on this below.

 DISCHARGED OR DEAD?

Last year, when the NTA Annual Report referred to “individuals discharged”, a deeper look revealed that 905 were “discharged” from this earth completely, having died.

 More had “moved away”, had “treatment withdrawn” or are “not known”. 1,769 are said to have declined ‘treatment’ – perhaps due to the growing phenomenon of people refusing a lifetime on methadone, or a reflection of stories of a high-volume low-care organisation which gets vulnerable clients to sign DIR forms which they think give treatment but are refusal forms.

 *******

 Professor Neil McKeganey’s blog is copied below for clarity on this topic.

 NTA TREATMENT OUTCOME RESEARCH:
HARD EVIDENCE OR POLITICAL SPIN?
by Neil McKeganey,  Professor of Drug Misuse Research, University of Glasgow

 The National Treatment Agency has announced a near miracle in drug treatment. Followed up over a four-year period, the NTA has claimed that “Nearly half of those leaving treatment neither need further treatment nor were found to be involved in drug related offending”. When you recall that drug addiction is a “chronic, relapsing condition”, you might wonder how any treatment could be that good? Too good perhaps to be true?

 So what is the claim that addicts leaving treatment need no further treatment actually based on? Is it based on any sort of clinical or psychological assessment of the individual drug user to assess his or her level of continuing need? Have the researchers who have undertaken this work examined the living arrangements of the drug users concerned, have they looked at their contact with their children, at whether the individual drug user is in employment, at whether they are still using illegal drugs, at whether they are even using prescribed drugs? Do they know anything about the housing circumstances of the drug users involved?

 The answer to all those questions, sadly, is no.  The NTA has claimed near-miraculous success for drug treatment whilst knowing next to nothing about the lives of the people it is so eager to celebrate as treatment successes.

 hat the NTA has done is to undertake an analysis of client records to see whether drug users leaving treatment re-contact drug treatment over the next four years. If they  do not, then according to the NTA,  the individual must be well on the road to their sustained recovery. Here is another interpretation based on the same data: that a large proportion of individuals leaving treatment were so disappointed by their experience of treatment that they did not return. Another interpretation of the same data is that, having contacted drug treatment services with a drug problem and left those series with a drug problem, many drug users might have wondered at the point of recontacting services.

 Those interpretations would not be welcomed by those providing drug ‘treatment’ or those, like the NTA, responsible for improving the quality of drug treatment. There, I am afraid, is the rub. The assessment of the success or otherwise of treatment has to be based on a good deal more than an analysis of records undertaken by the very agency with a vested interest in the quality of the treatment being provided.

 So what about the claim that ‘treatment’ leads to a massive resolution in drug-related offending? That claim is based on the NTA looking to see whether individuals leaving treatment provided a positive drugs test to a criminal justice agency or contacted the Drug Interventions Programme over the next four years. One would not have thought it needed to be pointed out - but not being drug tested by the police and not contacting the Drug Intervention Programme is not the same thing as ceasing one’s involvement in drug-related offending. 

 The NTA has acknowledged that it cannot categorically assert that all individuals who do not return to treatment or contact the Drug Interventions Programme are leading entirely drug-free or crime-free lives. To do that, it says, would require each of the 40,000 clients in the study to be personally contacted and interviewed.

 In fact, what would be required is only to study a representative sample of treatment leavers. Despite its cautionary caveat, the NTA has done precisely what it should have  refrained from doing – claiming near-miraculous success for drug treatment on the slimmest-possible evidence base.

 The NTA has too much invested in a positive story of drug ‘treatment’ for it to be responsible for the evaluation of that treatment. What we need is for our drug treatment services to be subjected to rigorous and independent evaluation. Only then can we be assured that the claims we are reading in the press and elsewhere about the effectiveness of the treatment services provided are based on hard evidence rather than political spin. 

 Definition of treatment: click glossary.

 Comments

 If independent treatment agencies made such extravagant claims on such flimsy evidence they would ridiculed and in fact their medical staff could be reported to the GMC for misrepresentation.

 Posted by: Peter McCann | October 04, 2010 at 07:15 PM

  As a volunteer with a service user recovery involvement group, this report stinks. We are not allowed into the so-called rehabilitation group – because our job is to promote “best practice” involving the clients actively in the service. The slogan To empower is c**p. More fitting is control.

 Trying our hardest to fight for the rights of service users does not go down well with the services. When a service users tells me that they will except any s**te thrown at them, that tells it all.

 I will continue to be a pain in the butt because when I read these stupid reports it just strengthens my commitment, enthusiasm, motivation and passion.

 I sit round the tables of SUIP, SDRC, SDF and many more. The only reason they invite members of the group is because they have to tick the box.

 I have written to government, just to confirm what part they think service user involvement groups should play. They made it clear that it very important and will continue to support these groups. Well, they should pass this on to the highly-paid judgemental, non-empathy employers they have at present.

 As for the recovery stats, they should attend our group. We are the foot soldiers in the real world of recovery. The real story reads like a horror story. Wake up.

 Posted by: CONFUSED | October 07, 2010 at 12:24 AM

 I worked for one of the biggest providers of the type of ‘treatment’ cited in Dr McKeganey’s report. It has been my experience that this well known organisation is staffed almost through-out by unqualified and inexperienced staff. They operate like a fascist state within the organisation, disciplining individuals or threatening them with disciplinaries if they dare to dissent in any way. In other words if you dare to question the system they call ‘treatment’. It has been my observation over the time that I worked for them that they are very cosy and familiar with the NTA and seem to have extraodinary sway when it comes to commissioners and winning tenders.
The projects that they run are ineffective at best and actually dangerous for clients at worst. Their staff are so incompetent and lacking in self-awareness that there is no room for innovation or clinical excellence. Yet the U turn that has taken where CEOs and others at the top are now bleating on about being ‘recovery focused’! -What this actually means is that they are following the pound note – simple. They have little commitment, interest or knowledge around what is needed to treat addictive disorders and support individuals from a place of crisis and chaos into abstinent recovery.
It appalls me that this agency has any credibility as they have in my experience never shown any aptitude in assisting individuals into recovery. It therefore is only natural for me to question whether their overnight success and strong hold on voluntary sector tenders is closely linked to their relationship with the NTA.
I beleive that all these agencies should be subject to rigorous monitoring in order to assure ethical and clinical excellence.

 ted by: anonymous | October 07, 2010 at 08:25 PM

  I am a recovering addict doing some voluntary jobs and returning to college in January…. it appears what the real interest is . If the services were to keep in contact with their clients after rehab or detox or even self withdrawel , then one would know how the client is or is not doing well , in our after care lives theses things appear to go unnoticed. In my years as an addict for 29 yrs i, feel i have a little bit of experience also having taken on the link with recovering addicts , the after care structure needs to be totally adjusted to say the least. This will only be the time to try and find out about true recovery.

Source:  Addiction Today Oct. 4th 2010

Obama laughed and as someone said, it is no laughing matter. He laughed I think not at the question but at the sheer silliness people who want cannabis legalised, at the irrationality that lies behind the call. Much of the legalisation argument is founded on falsity. Cannabis particularly, low CBD cannabis, has all the harms of tobacco and much more. Tobacco and alcohol as legal drugs (in most countries) cause far more personal and social harm than all the illegal drugs put together. The trivialisation of cannabis harms has been going on for too long, the normalisation and legalisation of this substance would inevitably lead to MORE USE, more use means, without any doubt, MORE personal and social harm as night follows day. So legalisation would not reduce that harm it would on the hard evidence of the tobacco/alcohol model, increase it. The second string of the argument is that illegal drugs are a gift to organised crime and that legalisation would remove that gift. This is a naive or dishonest argument. Illegal sales can always undercut legal sales by price, legal sales would allow crime to produce something “stronger”, regulations around age of purchase would encourage crime to target those excluded by age. Legalisation would produce counterfeit (cheaper) product, the application of any tax at all would encourage crime-to avoid that tax. The end result of legalised cannabis would be more consumption, by more people, for more of their lives. All that amounts to more harm. Just as we have with tobacco and alcohol. If anyone doubts what I say I ask them to consider the personal and social harm from alcohol in those countries where use is culturally or religiously taboo and to compare with similar sized societies where use is allowed and normalised. So why did Obama laugh? I suggest he knows the truth of what I speak, he knows that the tide of scientific opinion continues to move against the safety and harms of cannabis. He knows that the UK has only recently because of that social and personal harm and at the request of our National Director of Mental Health, reclassified cannabis to a more serious drug, (where it historically was under our system). We have rejected the nonsense of the pothead and stoner lobby. So should the USA. You should get off your drugs and get back to work.

Source: David Raynes response to article about drug use in USA March 2009

ACHIEVING THE PRESIDENT’S GOALS FOR REDUCING

YOUTH DRUG USE

Results from the 2004 Monitoring the Future Study

This year’s results from the Monitoring the Future (MTF) study further consolidate the historic reductions observed in last year’s results. In 2003, current use of any illicit drug and marijuana current use each declined 11 percent—exceeding the President’s strategic goal of a 10 percent reduction in 2 years from the 2001 baseline. This year’s MTF results indicate that current use of any illicit drug has declined 17 percent since 2001, while current marijuana use has dropped 18 percent.

Highlights of findings from the 2004 MTF on youth use of illicit drugs, alcohol, and tobacco; changes in anti-drug attitudes; and the impact of anti-drug advertising include the following—all changes discussed here are statistically significant:

Changes Since 2001 in Substance Use Among Grades 8, 10, and 12 Combined

Use of any illicit drug in the past 30 days (current use) among students declined 17 percent, from 19.4 percent to 16.1 percent. Similar declines were seen for past year use (13%, from 31.8 % to 27.5 %) and lifetime use (11 %, from 41.0 % to 36.4 %).

As a result of these dramatic declines, approximately 600,000 fewer youth in 2004 are using illicit drugs than in 2001.

Marijuana use, the most commonly used illicit drug among youth and the drug of primary interest to the Media Campaign, also declined significantly. Current use declined 18 percent, from 16.6 percent to 13.6 percent; past year use declined 14 percent, from 27.5 percent to 23.7 percent; and lifetime use declined 11 percent, from 35.3 to 31.3 percent.

Declines in youth drug use were not limited to these two categories. The use among youth of many of the most commonly used classes of substances are in decline, including LSD, MDMA (ecstasy), amphetamines, methamphetamine, steroids, alcohol, and cigarettes.

The use among youth of the hallucinogens LSD and ecstasy among youth has plummeted.  Lifetime use of LSD fell 55 percent (from 6.6% to 3.0%) and past year and current use each dropped by nearly two-thirds (from 4.1% to 1.6% and 1.5% to 0.6%, respectively).

Lifetime use of ecstasy dropped 41 percent, from 7.4 percent to 4.4 percent.  Past year and current use were each cut by more than half (from 5.5% to 2.5% and 2.3% to 0.9%).

Use of amphetamines, traditionally the second most commonly used illicit drug among youth, also dropped over the past two years. Lifetime use declined 20 percent, from 13.9 percent to 11.2 percent. Past year use fell 21 percent (from 9.6% to 7.6%) while current use fell 24% percent (from 4.7% to 3.6%).

Lifetime, past year and current use of methamphetamine among youth declined by 25 percent each — from 5.8 percent to 4.5 percent, 3.4 percent to 2.6 percent, and 1.4 percent to 1.1 percent, respectively.

Lifetime and annual use of steroids dropped 28 percent and 23 percent, respectively (from 3.2% to 2.3% and from 1.9% to 1.5%).

The use of alcohol, the most commonly used substance among youth, also declined. 

Lifetime, past year and current use each declined by 8 percent (from 65.7% to 60.5%, 58.4% to 54.0%, and 35.7% to 32.9%, respectively). However, there was little improvement in these measures between 2003 and 2004. Reports of having been drunk in the past two weeks declined between 10 and 12 percent in each of the three prevalence categories.

Cigarette smoking among youth continued to decline. Lifetime and current use each dropped 20 percent (from 49.1% to 39.5% and 20.3% to 16.1%, respectively). However, there was little improvement in these measures between 2003 and 2004.

MTF began collecting data on the non-medical use of Oxycontin in 2002. In 2004 there was a 24 percent increase in past year use of Oxycontin for all three grades combined compared to 2002, from 2.7 percent to 3.3 percent.

Changes From Last Year in Substance Use among Grades 8, 10, and 12

MTF collects data from three specific grades: 8th, 10th and 12th graders. There were no statistically significant changes between 2003 and 2004 found for any grade in lifetime, past year, and past month use of hallucinogens in general; hallucinogens other than LSD; cocaine in general; crack cocaine; amphetamines; tranquilizers; heroin and other narcotics; and being drunk. Additionally, there were no statistically significant changes for any grade in lifetime or past year use of Oxycontin, Vicodin, or Ritalin and past year and past month use of alcohol. The following statistically significant differences were found:

Among 8th graders:

Any illicit drug use in the past month declined 13 percent, from 9.7 percent to 8.4 percent.

Marijuana/hashish use in the past month declined 15 percent, from 7.5 percent to 6.4 percent.

Lifetime inhalant use increased 9 percent, from 15.8 percent to 17.3 percent.

Lifetime, past year, and past month use of methamphetamine declined 36 percent (from 3.9%to 2.5 percent), 40 percent (from 2.5%to 1.5%), and 50 percent (from 1.2% to 0.6), respectively.

Lifetime and past year use of steroids declined 24 percent and 21 percent, respectively (from 2.5% to 1.9% and from 1.4% to 1.1%).

Among 10th graders:

Lifetime use of MDMA (ecstasy) declined 20 percent, from 5.4 percent to 4.3 percent.

Past month use of powder cocaine increased 36 percent, from 1.1 percent to 1.5 percent.

Past year use of GHB declined 43 percent, from 1.4 percent to 0.8 percent and past year use of Ketamine declined 32 percent, from 1.9 percent to 1.3 percent.

Lifetime use of steroids dropped 20 percent, from 3.0 percent to 2.4 percent.

The only decline in 2004 of cigarette use occurred among 10th graders. Lifetime cigarette use declined 5 percent, from 43.0 percent to 40.7 percent, and smoking half a pack or more per day declined 20 percent, from 4.1 percent to 3.3 percent.

Among 12th graders:

Lifetime use of LSD declined 22 percent, from 5.9 percent to 4.6 percent.

There were no statistically significant changes found in each grade from last year in lifetime, past year, and past month use of hallucinogens in general; hallucinogens other than LSD; cocaine in general; crack cocaine; amphetamines; tranquilizers; heroin and other narcotics; lifetime, past year and past month use of alcohol; and being drunk. 

Anti-Drug Attitudes

A key aim of the Media Campaign is to improve youth anti-drug attitudes and perceptions; these changes are thought to be precursors to positive behavior change. We have seen improvements among youth in the perception of the harmfulness of using drugs and disapproval of people who use them, particularly for marijuana.  Statistically significant changes include the following:

Among 8th graders, both the perception of the harmfulness of trying marijuana once or twice and smoking it regularly improved from the previous year, by 6 percent and 3 percent, respectively. Perceived harmfulness of smoking one or more packs of cigarettes a day also improved significantly from the previous year, by 8 percent. The levels of these measures in 2004 are the highest they have been since 1993.

Among 10th graders, perceived harmfulness of trying MDMA (ecstasy) once or twice increased by 4 percent, while perceived harmfulness of smoking one or more packs of cigarettes per day increased by 4 percent as well. While the increases from the previous year in all other measures of perceived harmfulness were not statistically significant, the 2004 levels are the highest they have been in recent years.

Among 12th graders, perceived harmfulness of taking heroin regularly declined by 3 percent, while perceived harmfulness of taking heroin occasionally without using a needle and taking one or two drinks nearly every day increased, by 4 percent and 14 percent, respectively. There were no other statistically significant changes in perceived harmfulness among 12th graders.

Among 8th graders, disapproval of people who try marijuana once or twice increased by 3 percent from the previous year, as did disapproval of people who smoke marijuana occasionally and those who take LSD regularly, increasing by 2 percent and 5 percent, respectively.

Among 10th graders, disapproval of people who smoke marijuana occasionally increased by 4 percent; those who smoke marijuana regularly increased by 3 percent, those who try inhalants regularly increased by 1 percent, and those who try MDMA once or twice increased by 3 percent.

As with perceptions of harm, the 2004 levels of disapproval are the highest they have been since 1993 (8th graders) and 1994 (10th graders).

Impact of Anti-Drug Advertising

Exposure to anti-drug advertising (of which, the Media Campaign is the major contributor) has had an impact on improving youth anti-drug attitudes and intentions. Among all three grades, such ads have made youth to a “great extent” or “very great extent” less favorable toward drugs and less likely to use them in the future over the course of the Media Campaign (i.e., since 1998). However, more than half of the increase in most of these outcomes among all three grades has occurred in the past three years. This is particularly striking among 10th graders, the primary target audience of the Media Campaign.

Source: ONDCP, USA, December 21, 2004.

A personal view by David Raynes

The background to and an account of the hearing, in London on 5^th February 2008, of evidence to the UK Advisory Council on the Misuse of Drugs. It met to take this evidence on re-classifying cannabis to Class B from C under the UK system.

There is surely hardly an observer of drug politics in the world who does not know that the UK, four years ago, surprisingly downgraded cannabis from B to C. under our A to C classification system of potential harm, (Also used to establish social sanctions against use & trafficking). With only a short debate in parliament, the issue was driven through by Home Secretary David Blunkett (now out of government) who had only weeks before, entered the UK Home Office as the responsible Minister.  The issue was noticed and claimed around the world as a victory for the drug legalisation lobby who clearly thought this was a step on the way to their nirvana of legal dope for all. Such an action would have been unthinkable for Blunkett’s predecessor Jack Straw (still in Government). Perhaps Prime Minister Blair took his eye off the domestic ball; bogged down over Iraq, he gave Blunkett his way while apparently we are now told, “having real doubts” himself. Thus are we governed.

The downgrading reverberated around and beyond the English speaking world; such is the power of the internet.  Some lobbyists lied about it, saying the UK had made cannabis legal. It had not, it had messed up, confusing the anti-use message and, strangely, had to put up the penalties for trafficking all Class C drugs because Blunkett had apparently not appreciated his proposed action held the danger of making Cannabis trafficking a minor crime compared to tobacco trafficking. Politically unsustainable. He swears now to this writer he had no external influences on him. Foreign readers may not know he is blind. Does his denial of external influence during his arrival briefing and subsequently before his announcement, sound credible?

Cannabis downgrading (and ultimately legalisation) had been heavily pushed in the UK, since the mid 90s, by a small but noisy, largely London based, media lobby. The downgrading and even legalisation issue was taken to the heart of an educated elite, perhaps fearful their kids might get arrested for pot smoking and not overly concerned about the wider social consequences of cannabis use, especially on the socially disadvantaged.

The statutory body that advises government on drugs, the Advisory Council on the Misuse of Drugs (ACMD) had also advanced the downgrading issue. A report from the “Police Foundation” (not much to do with the Police) led by Baroness Runciman also contributed to this new golden age of pro-pot haze and muddled thinking. A current Liberal Democrat candidate for Mayor of London, then a senior Policeman, made his own timely contribution by announcing the relaxing of the policing of cannabis the day before a pro-pot march. The scene was set. South London lapsed into a drugs no-mans land of dealers in all illegal substances. Great work! Really helpful to anxious parents. A real mess of confusing signals.

A couple of oddball Chief Constables added their pro-drugs bit and in all the UK parliamentary parties there were similar odd (but minority) contributors to the general nonsense. None of these people thinking through exactly how this idea would further damage Britain’s already bad drug using culture. Rank and file Police Officers, the key top scientists and many experienced drug workers, of course opposed the changes but were ignored. David Blunkett astonishingly refused to see six top scientists & doctors who strongly opposed his downgrading.

The UK continued to develop one of the biggest drug problems in Europe. We have difficulties with all drugs, legal or illegal. In a separate earlier action in 1999, focussing on “the drugs that cause most harm” (I always wonder who thought up that phrase), UK Customs had stopped targeting cannabis imports and the UK was flooded with the stuff, much of it Moroccan Cannabis Resin and according to users, of poor quality. The price after 2000 dropped as supplies increased, “Blunkett’s Blunder” in downgrading took effect three years later.  “Age of first use” dropped alarmingly as did “age of first regular use”. Reportedly, kids–often pre teen were/are using cannabis on the way to school, at school and on their way home. The effect of this is that these kids become un-teachable, discipline breaks down, they fail academically, some drop out of education, they are forever damaged. Many, too many, become mentally ill, some diagnosed psychotic, others below formal diagnosis as mentally ill, are nevertheless unable to really contribute to society and cause huge distress to their families. The unemployment or mentally disabled register looms for many, their jobs taken by educated hard-working Poles and others from Eastern Europe. The government becomes seriously worried. Alarm bells ring in the Department of Social Security and in the Department of Health, both now picking up the pieces of the very wrong Home Office policy. The downgrading policy is looking expensive and socially damaging.

Out on the streets, the imported poor quality cannabis resin was gradually replaced by home grown and Dutch “sinsemilla” or “skunk” cannabis, this getting progressively stronger but strength alone being only one of several contributing factors to damage.. Frequency of use and age of first use is also important, and, in the view of this writer, so is the different ratio of THC to CBD in this new fresh, home grown “super-weed”. The belief is that CBD moderates the effect of THC on the brain.

A new Home Secretary, (Blunkett having left government), took over and anxiously asked the ACMD for advice –yet again, on cannabis classification. The ACMD resorted to “return-to-sender” for this enquiry after a half-hearted review where, according to inside information, there was no vote merely a decision by the Chairman, Sir Michael Rawlins and a round the table “chat”. Dissent in the ACMD, is not encouraged our spies tell us; the ACMD members, all of them, have only negligible knowledge of the drugs market. The self-selection of new members keeps out those who oppose liberalisation so plainly, the internal debate is and can only be, very one-sided.  Perhaps the Home Office should ensure more balance?

No change then, the cannabis problem for teenagers and pre-teens gets worse. In 2007 the spin doctors and even Ministers take comfort in figures from the British Crime Survey which shows a slight reduction in cannabis use at ages 16 to 24. No one other than this writer mentions this is simply because cannabis for older young people is becoming unfashionable and gets replaced by cocaine, crack-cocaine and (particularly) gross & physically damaging alcohol consumption. Government has allowed 24 hour alcohol licensing despite widespread public concern.  Cocaine use in the UK has also zoomed up. The infection spreads to Ireland, that society develops a similar drug habit.

The regular discovery of organised Cannabis Farms, a new phenomenon in the UK (although known elsewhere, for example in Canada) and an entire new industry in the UK since “Blunkett’s Blunder”, goes unexplained, Cannabis use is down we are emphatically told. When this writer challenges this and points to the farms, one joker (A Professor and a pro-pot lobbyist) suggests the UK is a substantial exporter of cannabis. A statement that defies belief, there is no evidence of such a thing, not substantial anyway. Things are spiralling out of control. Britain is a nation of sick young people; drugs of all sorts are cheaper than ever, youth is more affluent than ever. Prime Minister Tony Blair, architect of “Blair’s Britain” and now being blamed for “Blair’s Feral Youth” is forced from office in the autumn of 2007, largely over Iraq and his handling of the Middle East but his party and most other people are basically just sick of him. This writer tells the media that the cannabis market has widened and deepened, the totality of use is higher. If it is not, where is the output of the cannabis farms going?

A new broom and a largely new group of Government Ministers take over in autumn 2007. Gordon Brown as new Prime Minister is a dour Scot, son of a church Minister he sets a different social tone to Blair and just maybe, has more integrity and social conscience. Consideration is suddenly being given to abandoning plans for giant casinos; 24 hour drinking is being reviewed, so is cannabis policy. Brown appoints a new Home Secretary, Jacquie Smith, first woman in that position. She is a self confessed experimenter with pot at University but all credit to her, she and Brown, together, take a different tone on drugs issues. She is after all a mum and mums (good for them) are driving a new national wave of sustained protest about kids being mentally damaged by pot. Brown signals he is minded to re grade cannabis to where it was, back to Class B, ending the confusion and sending clear messages about the harms. Smith refers the issue once again, back to the ACMD. The implication, clear beyond any doubt, is that Brown and Smith want, and will have, cannabis re-graded even if the ACMD do not support it. On the fringes of the ACMD there are dark mutterings about resignations if their views are ignored. Some observers may think that would be a good thing.

So we arrive at 5^th February 2008. The ACMD is forced; reluctantly it seems, to hold some of its hearings in public (Why not all in public you might ask-Parliament is after all in public). It arranges a one day hearing in the City of London. Public access is limited because numbers are limited and prior application and approval are needed.  Questions to witnesses by members of the public are strictly forbidden though there is a short public comment/question session at the end.

Chairman Sir Michael Rawlins runs a tight ship, ACMD members call him “Sir”, he calls them by their first names. Very few ACMD members ask questions. Of those that do the most active seem to do it to show how clever they are, not, particularly, to illuminate the real issues. We get no indication or feel for what most members think at all. There is a pre-occupation with the penalties for drugs use & possession, not the science and social science of harm-potential and the actuality in the country. Arguably the very things that should most concern this committee. Astonishing.

Early witnesses from the Forensic Science Service and GW Pharmaceuticals confirm that herbal cannabis seizures (home grown) in the UK, are gradually getting much stronger in THC and that this new form of the drug contains hardly any CBD, leaving the effects of strong THC unconstrained. Resin we are told, long the staple of the UK market, is declining in market share and historically had almost equal amounts of THC & CBD. More work is needed on the issue of CBD but it is plain that by selection, a much higher THC-containing product is gradually taking over the market. It will continue to do so. Other academic witnesses on the potential mental health effects tell us that CBD may be “anti-psychotic”. The absence of CBD may therefore be aggravating the mental damage from the stronger THC. The new selected cannabis may be two or three times stronger, certainly not the 10 or 20 times of the tabloid press and even some over zealous commentators on my side of the debate. Cannabis is not homogeneous and techniques are available in the market to sieve it and extract a higher THC product. The mental health ill effects are more marked in young men; by 2010 cannabis use will be implicated in 25% of schizophrenia cases. Professor Robin Murray has spoken of 1500 cases a year, very expensive to treat and of course this is only the clinically diagnosed.

The most telling early witnesses are from “SANE” & “Rethink”, both mental health charities. Marjorie Wallace from SANE talks of the “confusion about legality & safety” and that cannabis is implicated in 80% of 1^st episode psychosis. She says, “Only re-classification can counter the mixed messages”. There is then, an immediate and astonishing outburst from Chairman Sir Michael, angry, venomous, red-faced. (This is a really serious scientific approach, observe and learn I think to myself?) He barks out, “Are you really wanting people to go to prison for five years for possession”? 

Any minor confidence one might have had in a dispassionate scientific appraisal, led by Sir Michael at least, surely evaporated. His remarks are nonsense of course and misleading of the ignorant. Sentencing guidelines and historical fact show that imprisonment for just personal use possession, of any illegal drug, hardly occurs in the UK. Why bother with the facts when you are Chairman of such an important meeting, advising government, confident, despite the evidence, that you know best? Does the Home Office know he is behaving like this?

The position of “Rethink” is truly hard to fathom. They accept all the harms of cannabis, indeed they tell us about them, yes they are getting worse but to them, re-classifying so that the public can understand this better, is astonishingly not important. To this observer they seem to have been “got at” by someone, so perverse is their position. Is their funding being threatened if they take a more robust view?  Their position is surely odd especially seen in the light of the remarks by Wallace. This observer smells something very wrong indeed. They are in the same business as SANE, or ought to be. Just what is going on?

Professor Louis Appleby, National Director of Mental Health for the Department of Health gives an impressive presentation, he is clear about the mental harm, we hear of patient suicides and homicides, figures trip out, “68% had taken cannabis”, we (as a society) are “guilty of complacency” (about cannabis), “causal factor”, “benefits from re-classification”. “health perspectives” and much more. Professor Appleby is hugely convincing. He is in no doubt at all that re-classification is needed. One is encouraged that here, at last, we have a public servant being so clear about what is needed and why.

Another presentation about the physical harms is convincing that in cannabis there are all the harms of tobacco and more. Talk of head & throat cancers, early emphysema etc. A second presentation about cannabis & driving illuminates the fact that cannabis is now by far the most common drug found in those arrested under the Road Traffic Act. Cannabis influenced drivers exhibit “poor road tracking” & “divided attention”.

Debra Bell of the “Talking about Cannabis” mum’s pressure group then speaks, together with another mum, an anonymous Barrister, whose own family life, like Debra’s has been severely and permanently damaged by teenage cannabis use. Promising young people damaged mentally and permanently, we are told. Educational under-achievement, wasted years. We are told of the thousands of hits on Debra’s website, the families feeling “let down” by government and the ACMD, the widespread feeling that cannabis use has become acceptable and that parents and teachers were undermined by Blunkett’s downgrading.  Debra tells of the phone calls, parents at their wits-end, desperate and helpless in the face of kids who say cannabis is not so bad, “the government downgraded, it must be OK”. Some kids who even think it is legal. These mums must really worry Prime Minister Brown. These are articulate and educated people, they are not going to give up. They are also voters. These are the people we need to take the campaign against cannabis use forward. They bring a new focus to the battle.

M/s Cindy Burnett. Representing the Magistrates Association & Youth Courts. She is very convincing, she and colleagues are “worried about the message”, “downgrading sent the wrong message”, “caused confusion”. “unnecessary”, “poor effect on health”, “increased addiction”, “ youthful “addiction to cannabis”, “downgrading had a bad effect”, “shoplifting driven by drug addiction” (cannabis), “wrong in principle”, “badly handled”, “downward spiral”, need for Youth courts to be supportive. All strong stuff. The ACMD listen in silence, are they taking it in? Who knows?

A few government apparatchiks from the Home Office talk about their wonderful publicity campaign, they show some clips, fancy indeed but have they worked? How could these adverts turn back the bad effect of downgrading? Like swimming against a strong current. Such stuff keeps people in work but will probably have little effect.

The next speaker is Professor Simon Lenton from the National Drug Research Institute of Australia, his presence confuses, just why is he, particularly him here? I notice he pops up later in the programme again on behalf of The Beckley Foundation, (run by our disgraced ex Deputy Drugs Czar Mike Trace who resigned from the UN when exposed as linked with the George Soros inspired legalisation campaign and “Open Society”). I wonder who has paid Lenton’s fare, was it George? He can afford it. I certainly hope it was not UK public money.

Again, I ponder just why his presence is allowed by Sir Michael.

Lenton is badly briefed about the UK debate and absolutely confused; he addresses us on “The impact of the legislative options for Cannabis”. He seems to think that the lobby against cannabis and for re-classification in the UK is from people who want to “lock users up”; he is more concerned about the social sanctions than about the adverse effects. He does not appear to understand that those who want cannabis upgraded, re-graded to where it historically was, are quite prepared to examine different social sanctions, we know, everyone knows, the UK cannot arrest its way out of our drug problem.  Does he not know the pressure is about putting cannabis back where it belongs? To send a signal about the real harms. To start to change the damaging culture created around use, by the downgrading.

Is Lenton a closet legaliser cloaked in fine words, hiding his real intentions? I “Google” Lenton when I get home and check my files. Yes I thought I had heard of him from Australian friends. As I suspected, keywords, legalisation, Lindesmith, International Harm reduction, support for changes to the UN Drug Conventions etc, need I go on? That and the link with Trace tell me enough.

Does Sir Michael Rawlins understand this chap is a covert pro pot lobbyist? Does the Home Office know the witnesses have been rigged like this?

Steve Rolles from Transform, the UK’s main drug legalisation lobby group (for legalising of all drugs) speaks to us. I know him well and away from this subject can enjoy his company. He is a bright guy. His thunder has been stolen by Lenton he complains! Yes Steve we are having views like yours laid on pretty thick are we not? Is this deliberate? Is Sir Michael rigging all this stuff, does he understand it? If not him just who is rigging it? Legalisation is not up for discussion any more so just why does Transform get a slot (Debra Bell nearly did not!). Steve though admits “Cannabis is more harmful than we thought”. Well more harmful than you thought Steve, my view has been consistent since I met my first pot-heads in the 60s. My allies have always said Blunkett got it wrong, indeed the World Health Organisation indicated the mental harms of pot in its 1997 report.   Rolles advises the ACMD to concentrate on a “Scientific Harm Assessment”. Yes, I can live with that; as long as they take in all harm not just harm to the individual. Yes and they should remember that defining the social penalties for use or trafficking are not what they (the ACMD) are about, leave that to others. Rawlins passion about that penalty issue nags at me.

Do the ACMD silent members (maybe most of them) know they are being manipulated? Again, does the Home Secretary know about this? This loading the witnesses with legalisers when that is not on any agenda is surely verging on the corrupt. No wonder they want to keep out those of a different view. I reflect that it is apparent there are at least two other days of private hearings, just who are this group listening to then?  Would a “Freedom of Information” request flush it out? Can Jacquie Smith just ask? Will she? Perhaps, I muse, she will if she gets a copy of my note.

The penultimate speaker is Simon Byrne Assistant Chief Constable Merseyside Police. He is the Association of Chief Police Officers lead on cannabis. He is a reassuring and sensible figure, ACPO have changed their view, they are seeing the problems with youngsters on the ground, and, picking up the pieces. He is also not interested in locking youngsters up; he wants early intervention, guidance to youngsters and strong signals sent out that use is potentially very damaging. Byrne tells us there have been 2000 cannabis farms found in England & Wales in the last few years since downgrading, that this is a huge new criminal industry since “Blunketts Blunder” (though he does not call it that). Illegal immigrants, often Vietnamese are involved; it is taking up lots of police time. UK based readers may remember downgrading was partly sold as saving police time.  Byrne speaks of confused public views on cannabis; he and his colleagues are now strongly for re-classification to B. Re-classification would reinforce the perceptions of harm. Is anyone listening?

Next witness is Lenton again, this time on behalf of Beckley Foundation.  “Is cannabis use a contributory cause of psychosis”? He is reading a presentation prepared by Wayne Hall & Robin Room.  Yes it is a cause, and more, 1 in 10 users become dependent. Really? Age of first use is important. Well we agree. We just do not agree on a part of the solution, telling the public the truth by classifying the cannabis in the right place.

There is a brief open forum, I manage to chide Lenton for his ignorance about the reasons behind the desire for re classification, I speak about parents and supporting them, telling the truth about cannabis, there is applause from some of the public.  An ACMD member says they are not forgetting the individual sad cases they have heard about (from the mums), he looks at me, he is, I think, defensive, a man with a conscience. I remind the ACMD that Robin Murray’s 1500 schizophrenia cases a year are the tip of an iceberg, there are a quarter of a million people under 35 unable to work and claiming sickness benefits through mental illness, often associated with drug use.  There are thousands of others not in the statistics because their illness is not clinically diagnosed; the prisons are full of those who are said to be mentally ill.

A few other speakers, first a mum, then a legalise cannabis advocate, and more, it comes to an end. It is over. Lenton follows me and speaks to me outside. He is uneasy and edgy.  We debate changing the UN conventions, he wants it, I do not. The best kept international conventions of all I say. Their strength is in the fact that everyone keeps to them. I know but he appears not to, that the UK Government has explicitly said it wishes no change in the conventions. He wants “more freedom for States to do their own thing”. What are those things I say, what can states not do that you want them to do? We in the UK have prescribed heroin for years to a minority of users, the British system. He struggles to answer. He wants the Dutch to be able to deal with and control, (legitimise he means), their cannabis growers. Why I ask? Do neighbours want that? Does he not understand that one European country can not do that independently of the rest? Do the Dutch, most of them, even want that? (We know from an opinion poll that 70% do not want it). I remind him that Dutch drug policy has made the Netherlands, which is a first world country and economy, have a third-world drugs manufacturing, warehousing and distribution problem. Astonishing levels of drugs based criminality feeding ATS (amphetamine type substances) to the whole world, including Australia. . He has no other ideas when challenged. He is plainly not used to being properly challenged. Why is someone with his views here, in this meeting, priming people who are going to advise our government? Who invited him?

As I travel home, I reflect, we have heard very strong messages about the harms of cannabis, is the ACMD about to change its position? I very much doubt it. They seem to be set in their ways, closed off to the harms, controlled tightly by Rawlins, most of them not taking part in the debate. I remember the question “do users mix cannabis with tobacco”. Quite extraordinary, he is in another world.

We have though, I think, seen the cannabis legalisation argument holed below the waterline; they will keep trying but that legalisation debate is surely over in the UK. If it is really over here perhaps it will be over everywhere else. What happens in the UK is of enormous influence because of the English language and the Internet.

Will UK Prime Minister Gordon Brown and Home Secretary Jacquie Smith re classify cannabis even if the ACMD is not with them? Yes probably. They will have the support of most MPs; the Conservative parliamentary opposition is supporting it. Even some important Liberal Democrats including the then leader (our third party) who have historically been weak and wrong on drug policy have been seen at Debra Bell’s meetings, that is really good. They are also getting the cannabis harm message.  Drug Policy is best when all parties are in broad agreement. Britain’s drug policy failure can I think, be tracked back to the breaking of that unanimity in the mid 90s.

Prime Minister Brown has “made his views clear” on cannabis, he said that this week at “Prime Ministers Questions” in the House of Commons. Brown has widely been accused by his opponents of dither and “government by review”, of putting off decisions. On this I think, based on the evidence, he means business.

David Raynes.

Member. International Task force on Strategic Drug Policy

http://www.itfsdp.org/members.php

Executive Councillor National Drug Prevention Alliance UK

February 2008

Should drugs be legalized? Some people think so, like a recent article written by Ethan Nadelmann in Foreign Policy magazine. The Executive Director of UNODC, Antonio Maria Costa, put forward his views on the topic to a meeting in New Orleans hosted by the Drug Policy Alliance. Here is a full text of the speech:

Ladies and Gentlemen,

From both sides of the aisle, there have been noises about my presence here. Is it right to invite this fellow, the so-called drug czar of the United Nations, to our annual conference?  Indeed, in some of the pro-legalization literature I am depicted as a die-hard prohibitionist, a drug control Taleban, a naive proponent of a drug free world, even a general in the war on drugs.

I have heard similar complaints from the opposite front: what is the point of the UNODC Executive Director joining the caucus of those who ask for the end of drug control, mixing with drug legalizers, the radical fringe of the pro-drug lobby, pressing for a world of free drugs that will never come?

I am glad that eventually we all decided that this exchange of views could be constructive, and help public opinion understand better a century-old drama: drug abuse, and the damage that it causes.

Is there some common ground between those who insist on a world free of drugs, and those who propose a world of free drugs? By the time this session is over, I hope we will all be able to answer in the affirmative. Here are a few pointers:

• First, health and security have to be protected when we talk about society, including when we talk about how society deals with drugs.
• Second, as a corollary, we can all agree on the need to reduce the harm caused by drugs — by preventing their use, by treating those who abuse them, and by limiting the damage they cause to the individual and society.
• Third, I hope we also agree on the need to ensure that drug policy is evidence-based, not the result of political considerations or ideological preferences.
• Fourth, I submit that the dichotomy prohibition vs legalization is a misnomer. Such a confrontation is too simplistic for scientific deliberations, nor does it help those whom we all wish to assist: our brothers and sisters, the drug addicts.
• Fifth, and finally, I hope you also agree that it is more accurate to refer to our divergence as a difference about the degree to which addictive substances (drugs, alcohol and tobacco) should be regulated. 

If these points are accepted, the discussion is to be centred on  where the bar is set , how to define the degrees of regulation. In other words, instead of accentuating our differences, I hope we build on the ground we share.

Let me begin with the world drug situation: where do we stand?

The world drug situation

In a recent article Ethan Nadelmann wrote: “it is dangerous when rhetoric drives policy”. I agree.  Res, not verba, [actions, not words] my ancestors the Romans, would have said. So let’s begin with the facts.

A growing body of evidence, including recent UNODC World Drug Reports, shows that the drug market has stabilized over time and space. [Opium in Afghanistan is mostly an insurgency issue (4/5 of the cultivation takes place in the areas controlled by the Taliban).]

On the basis of this evidence, I can state that, since a few years, for all drugs there are signs of world market stability (for opiates, cocaine, cannabis, and ATS). What I mean is that in every component of the drug business (cultivation, production, consumption), aggregate totals have lost the upward momentum they had in the 1980s and ’90s. Of course, world aggregates hide improvements in some countries and for some drugs, offset by deterioration elsewhere. Yet, the global totals are stable. This is what I like to call containment.

This finding refers to the past few years. Hopefully, in the period ahead evidence to support this claim – over the long term – will become statistically and logically incontrovertible.

Next question: how did this market change come about? Is this the result of the UNGASS process? I see correlations over time and space, but evidence of causality is hard to come by (social sciences are generally poor in proving cause/effect relations). Drug trends respond to a wide range of factors, especially changes in society’s revealed preferences. Yet for me, the result is what counts. If you have evidence to refute our data, I would like to see it.

Despite evidence of containment the world still has an enormous drug problem. There are some 25 million problem drug users. But let’s keep this in perspective – that’s less than 0.6% of the world’s population. Even if you take into account the number of people who take drugs at least once a year (approximately 200 million people), this is still below 5% of everyone on the planet.

By comparison, 50% of the world’s population uses alcohol, and 30% smoke. Alcohol, we know, kills 2.5 million people a year. More than half of all homicides and road-accidents, and most domestic violence, is alcohol-related. Tobacco kills 5 million people a year, because of cardio-vascular diseases and cancer — two of the greatest killers of our time.

What is my conclusion? There is growing public and medical pressure to tighten controls on the consumption of alcohol and cigarettes. That’s right. So why increase the public health damage caused by drugs by making them more freely available: drugs whose damage — thanks to the controls – is limited to 1/10th the casualties caused by tobacco? Why ignore the knowledge that we have gained from our experience with other addictive substances? 

If dreams come true…..

In order to show where I like to set the drug control bar, let me begin with the slogan so many of you have ridiculed:  a drug free world. Wait, wait: hold on to the tomatoes – I am not the author of this slogan. While in my life time I would certainly like to see a world without drugs, I have never used this slogan. Actually, you will not find it in any of my speeches, nor in any of the official United Nations documents, starting from the most relevant of them: the conventions (of 1961, 1971, and 1988) that created the UN drug control regime, and the General Assembly resolution about drugs (most notably from the UNGASS, 1998).

Yes, of course, several years ago (ie BC, before Costa) my Office put out posters with that slogan screaming across the page. While I never used this concept, personally I see nothing wrong with it. Is a drugs free world attainable? Probably not. Is it desirable? Most certainly, yes. Therefore I see this slogan as an aspirational goal, and not as an operational target – in the same way that we all aspire to eliminate poverty, hunger, illiteracy, diseases, even wars.

So let’s move on. I start with a series of (hypothetical) situations that I deem useful to set priorities in drug policy. I present them to you as dreams.

First, I invite you all to imagine that this year, all drugs produced and trafficked around the world, were seized: the dream of law enforcement agencies. Well, when we wake up having had this dream, we would realize that the same amount of drugs – hundreds of tons of heroin, cocaine and cannabis – would be produced again next year. In other words, this first dream shows that, while law enforcement is necessary for drug control, it is not sufficient. New supply would keep coming on stream, year after year.

So let’s dream a second time. Let’s dream that, by some miracle, we can convince farmers around the world to eradicate the thousands of hectares of drug crops, replaced by the fruits of development assistance (in Afghanistan, Colombia, Morocco, and Myanmar). A great dream of course, but yet again one that would not on its own solve the world drug problem. Why? Because when we wake up after this second dream we would realize that other sources of supply would inevitably open up somewhere else on the planet, to satisfy the craving of millions of drug users around the world.

So we come to a third dream which is the real challenge of drug policy: to reduce the demand for drugs. Prevention, treatment and reintegration, combined in a single health based programme, must be our priority. Of course the world’s supply of drugs needs to be reduced, but lower demand for drugs is the required condition to make drug policy realistic and pragmatic.

I hope you agree on this sequence, to separate the three elements of the drug chain, and their primary agents:  supply, by farmers in need of assistance;  trafficking, by criminals deserving retribution; and demand, by addicts in need of health care. At the UN, governments have captured this concept nicely in the expression shared responsibility.

Our Office focuses on the first and third part of this trilogy, namely the farmers and the drug users. Going after the traffickers is the role of law enforcement agencies. We help indirectly in this endeavour by promoting criminal justice and counter-narcotics cooperation. I take this opportunity to salute the work of counter-narcotics officials around the world whose important work is often carried out at the cost of their lives: please recognize that they deal with loathsome predators who exploit human vulnerability for the purposes of profit.

Health and Security  

With two building blocks of my argumentation in place (namely, stability of the world drug market and the priority of reducing drug demand), let me now turn to the issues of health and security.

Some people say that drug use is a personal and private choice – and nobody else’s business.

I have a few problems with this argument. First, there is a health issue. A growing body of scientific evidence shows that drug abuse is a disease affecting the brain, as much as any other neurological or psychiatric disorder. It is both triggered by vulnerability, and, in turn, deepens vulnerability. This has consequences both for the drug user and society as a whole. 

Second, if people don’t care about the dangers to themselves, what about the dangers that drugs cause to others: like road accidents or crimes committed by people under the influence of psycho-active substances, or the spread of blood borne diseases to others? The pharmacological effects of drugs are independent of their legal status. Drugs are not dangerous because they are illegal. They are illegal because they are dangerous. No wonder that public outcry against the collateral damage of drug use is building, just like successful campaigns against passive smoking or drunk driving. 

Third, drugs threaten security – not only public safety in inner-cities, but the security of states — think of Central America, the Caribbean and West Africa, caught in the cross-fire of drug trafficking.

I know your argument on this last point. Prohibition causes violence and crime by creating a lucrative black market for drugs: so, legalize drugs to defeat organized crime. Thus far, as an economist, I agree with you. But this is not only an economic argument. Legalization may reduce the profits to organized crime, but it will also increase the damage done to the health of individuals and society. Evidence shows a strong correlation between drug availability and drug abuse. Let us therefore reduce the availability of drugs – through tackling supply and demand – and thereby reduce the risks to health and security.  

In short, drug policy does not have to choose between either (i) protecting health, through drug control, or (ii) ensuring law-and-order, by liberalizing drugs. Democratic governments can and must protect both health and safety.

Besides, just because something is hard to control doesn’t mean that its legalization will solve the problem. For example, it is hard to stop human trafficking – a modern form of slavery. This is a multi-billion dollar business. Because the problem is out of control, would you equally propose that we accept it?

Let’s Not Condemn People to a Life of Addiction  

In order not to condemn people to a life of addiction, my Office is putting a strong emphasis on drug prevention and treatment. This goes back to the roots of drug control. The 1961 Convention on Narcotic Drugs is based on the premise that health is the first principle of drug control. This becomes more relevant every day as a growing body of medical and scientific evidence shows that drug addiction is an illness. So let’s treat it that way. There are no ideological debates about curing cancer or diabetes. So why have them about drug addiction? People to the left or right of the political spectrum are not divided on the need for preventing or treating tuberculosis and HIV/AIDS. So why with drugs?

Scientific evidence has proven that drug dependence is a health and social issue, the result of nature and nurture. People are vulnerable to addiction because of a mix of genetic, personal and social factors: gene variants , namely genetic predisposition to addiction, childhood, pre-natal stress and inadequate parental care, neglect, abuse, low school engagement, lack of bonding, and social conditions , marginalization, exclusion, poverty, latent or overt psychiatric disorders as well as popular culture and peer pressure.

There is a double jeopardy at play here: not only are such people more vulnerable to addiction, but addiction deepens their vulnerability. As a result, the disadvantaged are pushed even further away from society.

If drugs were legalized, these people would be condemned to a life of dependence. The privileged can afford expensive treatment for their drug habits, or those of their kids. But what about the less fortunate who lack the same means and opportunities?

Now extrapolate the problem onto a global scale. Imagine the impact of unregulated drug use in developing countries where no prevention or treatment are available. This would unleash an epidemic of drug addiction and all the social and health consequences that go with it.

Instead of reducing harm, there would be increased damage to individuals and communities because of drugs. Will you share the responsibility for the overdoses, HIV, and broken lives?

Beyond 2008 

Ladies and gentlemen, if you really want to rethink drug policy, then help rebalance global drug control in favour of prevention and treatment. You are an outspoken Alliance. Be more radical. Go beyond handing out condoms, clean needles or a bowl of soup. Offer all drug addicts a comprehensive package that includes prevention, treatment and reintegration, not only harm reduction gadgets. Join me as an “extremist of the centre”. We have been hearing about a balanced approach for a quarter century. It’s time to turn it into reality.

If you want to shake things up, if you want to break the vicious circle of dependence and disadvantage, then:

Do not only:

- prevent the spread of diseases that precede and accompany drug use, like HIV and hepatitis.

This is a noble aim that we all share. But let us go further and:   

- devote more attention to prevention and early detection of drug vulnerability;

- reach out to people who need treatment, on a non-discriminatory basis;

- support the mainstreaming of drug therapy into high-quality and accessible public health and social services.

Let us also:

- promote alternative measures to prison for drug addicts, offering them rehabilitation programmes;

- treat all forms of addiction. There is no consolation for stabilizing drug trends if people turn instead to other substances; 

- finally, and most importantly, make drug control a society-wide issue.

Drug policies are too important to be left to drug experts like you and me, and to governments alone. It is a society-wide responsibility that requires society-wide engagement. This means working with children, starting from parents and teachers, to ensure that they develop self-esteem. Support family-based programmes, because prevention begins at home.

Schools teach life-skills. They should also teach the dangers of drugs. Help young people engage in healthy activities, like sports and culture, to prevent social isolation that leads to drugs and crime. Invest in better understanding, preventing and treating the illness of addiction.   People can be steered away from drugs. And those that do suffer the misery of addiction can be brought back into society. This is the true meaning of harm reduction which goes far beyond its usual narrow definition. My Office promotes this approach, together with the World Health Organization.

Ladies and Gentlemen,

The strength of the international drug control system is its universality, with all governments solidly behind the United Nations drug conventions and strongly supportive of my Office. I hope I have won you over as well. If not, any change you would like to make to the existing drug control regime must be done by governments. You can influence the process. The review of UNGASS is a golden opportunity. We all want to help the poor farmers – to switch from crops to sustainable livelihoods. We all want to help the drug addicts – to save them from a life of misery. We all want to reduce the violence and crime associated with the drug economy.

So let’s build on this common ground to make a safer and healthier world.  Thank you for your attention.

Source:  Antonio Maria Costa. United Nations Office Drug Control. Dec. 7^th, 2007

By Mary Brett, BSc.

Today’s cannabis is much stronger
In 1971 drugs were classified in the UK,and cannabis was placed into the B category. Since then it has changed out of all recognition. The THC (tetrahydrocannabinol, the psychoactive ingredient) content at that time was under 1%. This rose in 2002 to more than 7%. Specially cultivated varieties like skunk and nederweed can have THC contents of more than 30%.

Even more alarming is the fact that the class A cannabis oils with up to 60% THC are now also downgraded to class C. Although rare in Britain, these powerful mind bending drugs should stay where they were, in their proper place, alongside cocaine and heroin.

Persistence in the cells
THC is rapidly absorbed into the blood and then sequestered into fatty tissue in the body, especially the cell membranes of the brain. Release of THC back into the blood is very slow. Fifty per cent will still be there after a week and 10% a month later. The prolonged presence of the drug in our brain cells, results in the disruption and impairment of the chemical communication system, the neurotransmitters between the cells, for some considerable time.

Dependence and addiction
Because THC mimics and so replaces one of the neurotransmitters, anandamide, it has its own receptor sites. These occur in many different areas of the brain so many systems are affected. These include concentration, memory, learning, motor skills, judgment, reasoning, planning, logical thoughts, reward, pain, sound and colour perception. Tolerance and physical addiction occur and withdrawal symptoms are common when use of the drug ceases, though not so severe as the “cold turkey” of heroin withdrawal due to its persistence in the body.7 The earlier the child starts to use cannabis, the greater the escalation of use. In September 2002, out of 6 million drug addicts in the USA, two thirds were cannabis dependent. More were being treated for cannabis than for alcohol addiction. Psychological addiction has been recognized for many years and is very difficult to treat.

Driving and flying hazards
Psycho-motor skills are affected so cannabis intoxication is a driving hazard In some American studies, cannabis has been implicated as many times as alcohol in accidents, although 10 times as many people drink. In Norway, 56% of drug-impaired drivers who tested negative for alcohol tested positive for THC.12 It has been estimated that in 2001, out of 4 million high school seniors in the US, approximately one sixth admitted to driving under the influence of cannabis. Of these, 38,000 reported crashing as a result. Alcohol was blamed for 46,000 accidents. Airline pilots on flight simulators could not land their planes properly even 24 hours after a joint and had no idea they had a problem. Someone having a joint today should not be driving tomorrow.

Psychiatric risks/schizophrenia/psychosis
Mental illness and cannabis have been linked for a long time15 but 3 papers in the BMJ in November 2002 brought the subject sharply into focus.16 Studies from New Zealand, Australia and Sweden found strong links with a variety of mental disorders including schizophrenia, psychosis, depression and anxiety. A separate Dutch study noted that 50% of psychiatric cases were due to cannabis. Professor Robin Murray of The Institute of Psychiatry has been widely quoted recently in the press, saying that cannabis is the “number one problem facing mental health services in inner cities”. A colleague, Dr Paddy Powers said that cannabis is a factor in 70 to 80% of all psychosis cases. Over 2000 cases of cannabis psychosis in a 2-year period caused an experiment in decriminalization in Alaska to be terminated by public referendum in 1991.

THC increases the amount of the neurotransmitter dopamine released in the brain. The psychiatric symptoms of schizophrenia are mediated by dopamine. This may prove to be the link. A Swedish scientist, Jan Ramstrom, said in 1989, “Cannabis is one of the most psychopathogenic narcotic preparations. It is worth mentioning that the opiates (heroin etc), apart from the development of dependence itself, produce far fewer toxically precipitated psychiatric complications than do cannabis preparations”

Violence
One of the cries of the liberalisers of this drug is, “Better for kids to sit around stoned and peaceful rather than be drunk and violent”. Not so! A New Zealand paper in 2002 showed young male users to be 5 times more likely to be violent than their non-using peers.

Overdosing?
Maybe you can’t overdose on cannabis; tobacco smokers don’t overdose either; in US records for 1999, of 664 marijuana related deaths, 187 of them involved only marijuana. Mentions of marijuana use in emergency room visits has risen in the United States by 176% since 1994, surpassing those of heroin. 110,000 such visits were recorded in 2001.

Personality changes
Even on one joint a month, a “cannabis personality” develops within a year or so. Users become inflexible, can’t plan their days properly, can’t take criticism or criticise themselves. At the same time they feel lonely and misunderstood. Trying to talk sense to them becomes a futile exercise.26 They are more likely to drop out of school, steal, become violent, run away from home or contemplate suicide.27 Adolescents with their immature brains are particularly vulnerable to mind-altering drugs. Personal and emotional development can be severely compromised.28

Cognitive impairment/school performance
Teachers will tell you that school performance begins to decline with those using cannabis. An American paper showed that youths with an average grade D or below, were more than 4 times as likely to have used cannabis in the past year as those with an average grade A. Australian researcher, Dr Nadia Solowij, said, “Use more often than twice a week for even a short period of time, or use for 5 years or more at a level of even once a month, may each lead to a compromised ability to function to their full mental capacity, and could possibly result in lasting impairments”.

A study of municipal workers found those using cannabis on or off the job reported more “withdrawal behaviours”, leaving work without permission, daydreaming, shirking tasks and spending work time on personal matters. All practices that adversely affect productivity and morale, not only for the users but also their colleagues.

Lung disease – emphysema/ bronchitis/cancer
Cannabis smoke contains between 50 and 70% more of the carcinogens found in unfiltered tobacco smoke.32 The amount of tar and levels of carbon monoxide absorbed are 3 to 5 times more than for the same amount of tobacco.33 Pre-cancerous changes have been seen in the airways of 20 to 30 year olds,34 and rare head and neck cancers, formerly only seen in older tobacco smokers are now being seen in young cannabis users. A case of emphysema showing a pair of lungs shot through with holes from cannabis use is yet another item in this sorry saga.

Effects on the reproductive system and children
Cannabis can suppress ovulation in women and if they smoke when pregnant, the baby will be lighter and have a smaller head circumference. A long running study of children in Canada by Peter Fried has discovered deficits in their cognitive functioning at 9. One form of leukaemia is 10 times more common in these offspring.

A reduction in sperm count and the presence of abnormal sperm has been documented for years. Some men complain of impotence. Cannabis smoking in the previous hour has been associated with a fivefold increased risk of heart attack in middle-aged people.

The gateway effect
Australian researchers found that weekly users were 60 times more likely to move on to other drugs, the strongest association being in 14 to 15 year olds. A possible genetic link was dismissed by a study of 300 pairs of same-sex twins in New Zealand. Use of cannabis by one of them before the age of 17 meant that he or she was 2 to 5 times more likely to have drug problems and dependency later in life, than their sibling. Professor Denise Kandel and her team in the USA have researched this topic for the past 20 years or so. They have consistently found that level of usage is a major factor.

Medical Use
Pure synthetic THC, Nabilone, is already available in the UK for the nausea of chemotherapy and the stimulation of the appetite in AIDS patients.51 No-one should have a problem with extracts of cannabis being purified and tested, as they are now in Britain, if, according to the EU rules for medicines they prove to be efficacious, but cannabis, per se, with its 400 chemicals would never pass the tests. Nabilone anyway is by no means the first choice of doctors because of its side effects.54 The warning on it reads, “THC encourages both physical and psychological dependence and is highly abusable. It causes mood changes, loss of memory, psychosis, impairment of coordination and perception, and complicates pregnancy”.

Keith Stroup, an American pot-using lawyer said in 1979, “We will use the medical marijuana argument as a red herring to give pot a good name”.

In conclusion
For a UK government which banned beef-on-the-bone with its infinitesimal risk of transmitting CJD, it is astonishing that they should relax the law on a drug which has been proved to be so damaging.

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This digest is an extract of a much longer paper prepared by Mary Brett, BSc., Head of Personal, Social and Health Education at Dr Challoner’s Grammar School in Amersham, Buckinghamshire, England, and a former Executive Councillor of the National Drug Prevention Alliance. The full paper runs to 9 pages, including 54 technical references. The full paper may be requested from Mrs Brett by emailing her on mary.brett@dsl.pipex.com

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For further extensive references and research digests on cannabis and other drugs, access the NDPA website on www.drugprevent.org.uk – and see also its links to several other sites in a range of countries.

It is a cocktail of heroin and cold medicine that can kill your child – and it goes by the name ‘Cheese’. Police in New York are on alert for a wave of deaths as young children get hooked on the latest fad drug to sweep the city.
Coined ‘Cheese’ by the schoolchildren who are addicted to it, the brown powder gives a high for just $2 that can easily be sniffed between lessons.
Victims: Oscar Gutierrez, 15, and Nick Cannata, 16, both died after becoming addicted to ‘Cheese’. Dealers are increasingly the drug, known as ‘starter heroin’, at children to get them addicted young
Dealers have been stamping packets with child-friendly brands like Lady Gaga, Mickey Mouse, the Looney Tunes logo and characters from the Lion King in order to lure in ever younger customers. But once children are hooked they find it incredibly hard to quit – withdrawal symptoms start within six hours meaning addicts have to dose themselves up to 15 times per day.
The dark twist is that ‘Cheese’ also contains a potentially fatal amount of acetaminophen, a common ingredient in cold medicines like Tylenol, giving rise to its other name – ‘Tylenol With Smack’.
The drug has been linked to a string of fatalities in Texas and now police in New York fear it is heading their way too ‘It can ruin lives,’ said an NYPD commander who recently taught patrol officers how to spot it.
Lethal: Cheese is a combination of heroin and cold medicine which is highly addictive and is said to be behind at least 20 deaths in the U.S.
‘Cheese’ has been on the radar of drugs officials since 2005 since when it has been blamed for more than 20 deaths in Dallas alone. Although just 2.6 per cent of high school students have tried heroin, dealers are using ‘Cheese’ to get them hooked at a lower cost. The drug is made by mixing the heroin powder with cough medicine, possibly with the addition of water or other ingredients, and then usually snorted.It has a heroin purity of up to 8 per cent, well below the level of intravenously injected drugs, but enough to make it addictive.
Police have found that children as young as 12 have become hopelessly addicted to the drug and only escaped its clutches with the constant help of their families.
Among those who lost their child to ‘Cheese’ is Dave Cannata from Dallas, who now travels the U.S. warning other parents about the drugs. Mr Cannata found son Nick dead in his bedroom five years ago after he overdosed on the cocktail. The 16-year-old had only been out of rehab for six months when he came home and apparently went straight to bed. He was found dead the next morning.
‘Parents need to be scared of this stuff,’ Mr Cannata said. ‘Every day I look at his picture and I wish that I spent the 40 grand a month to send him away to get some help. ‘You have to jump on the problem right away. This drug is so highly addictive.’
The Drug Enforcement Agency refers to ‘Cheese’ as ‘starter heroin’ because of the low amount of the drug in it. Over time users build up their tolerance level so they need increasingly large amounts to get high – before moving on to the real thing.

Source: – http://www.dailymail.co.uk 14th Oct 2010

Dr. Dewey, a Physiatrist and Scientist has studied for over 20 years the brains of people using all kinds of drugs.

At a forum in Ronkonkoma,he presented information about a recent study with teenagers who smoke marijuana. He asked for subjects only using marijuana. He needed 400 teenagers just using pot. He received 7000 responses.

He selected 400 teenagers and tested them. In 72% of the marijuana use Methamphetamine was found. Every subject indicated that they were not using Methamphetamine.

Dr. Dewey stated that the pot is laced with Methamphetamine. This is very alarming said
Ginger Katz CEO of The Courage to Speak Foundation.

Source: Ginger Katz Founder & CEO of The Courage to Speak Foundation Oct 2010

Scottish police forces have seized almost £40m worth of cannabis plants since 2006.
A campaign is being launched to encourage the public to help weed out cannabis factories. The Scottish Crime and Drug Enforcement Agency (SCDEA) wants people to provide anonymous information on houses and flats they suspect are being used to cultivate cannabis.
The campaign comes as new figures showed police forces have seized almost £40m worth of the plants since 2006. The SCDEA is spending £25,000 on the campaign.
Cultivations have been detected by all eight police forces across Scotland in both rural and urban settings and in a variety of properties, including flats, houses, farm buildings and industrial premises. The public are being asked to use their “natural senses” to look out for signs which may indicate the presence of a cannabis factory.
‘Tell-tale signs’
These include blacked-out windows, occasionally with condensation on them, or curtains or blinds that are permanently closed.
Another sign is when premises appear unoccupied most of the time but there are people, often of south-east Asian appearance, seen visiting late at night.
Cannabis farm tell-tale signs
• Blacked-out windows
• Curtains or blinds that are permanently closed
• A strong, sweet distinctive smell
• Unusual levels of heat coming through walls and floors
• A hum or loud buzzing sound caused by fans
• Premises seem unoccupied most of the time but people are seen visiting late at night
Since 2006, police in Scotland have detected 278 commercial cannabis cultivations and seized 130,716 plants valued at £39.2m. Of the 304 people arrested, 74% were Chinese and 22% were Vietnamese.
Launching the campaign, Justice Secretary Kenny MacAskill said: “Even the smallest piece of information about an individual or group’s activity can be the key that unlocks the door to disrupting an entire criminal empire.
“The fact that so many of the individuals involved in cannabis cultivation are of south-east Asian origin should not be seen as us targeting a community. “Nine out of 10 of those arrested for these particular crimes are of south-east Asian descent and it would be negligent if we refused to acknowledge that reality. These are not the kind of neighbours anyone wants or needs” Gordon Meldrum SCDEA director general added: “But I hope that we will also get the support of those communities with family ties to that region of the world.”
‘Safety risks’
The agency has warned that cannabis factories pose serious safety risks, with properties often destroyed internally to maximise space for plants.
It has also argued they represent a serious fire and electrocution risk because electricity supplies are interfered with and powerful lighting is left on for long periods of time. SCDEA director general Gordon Meldrum said: “These illegal and highly dangerous cultivations are quite literally on people’s doorsteps. These are not the kind of neighbours anyone wants or needs.”
Police said anyone who wanted to report suspicious activity should call Crimestoppers or give information anonymously online at www.crimestoppers-uk.org.

Source: www.bbc.co.uk 30th August 2010

A third of 14 to 16-year-olds drink every weekend.
Children should learn first aid skills to help friends who become dangerously drunk, the British Red Cross has said.
Its survey of 2,500 11 to 16-year-olds found 10% had been left with a drunk friend who was sick, injured or unconscious and 14% said they had been in an alcohol-related emergency.
The Red Cross wants to promote a broad range of first aid skills, but says the effects of alcohol are a key concern. The charity Drinkaware backed the call, but said parents needed to give advice.
Official figures show that there were more than 7,000 hospital admissions between 2006 and 2009 involving under-15s and alcohol.
Many youngsters told the survey that they drank – 23% of 11 to 16-year-olds said they have been drunk, while one in three 14 to 16-year-olds said they drank most weekends.
Many of those who said they had witnessed an alcohol-related emergency said they had panicked, or did not know what to do. Almost half said they were worried about their friend choking on vomit or simply not waking up.
Joe Mulligan, from the British Red Cross, said: “We need to ensure that every young person, irrespective of whether they have been drinking, has the ability and confidence to cope in a crisis.”
The agency hopes new online training materials, including videos on YouTube, will reach children directly. Its campaign, called Life – Live It, is also sending Red Cross trainers into schools and offering first aid packs to teachers.
Children can learn skills including the recovery position, to avoid someone choking on their own vomit, and resuscitation techniques.
Chris Sorek, from charity Drinkaware, said the findings reinforced the need for children of all ages to be educated about alcohol misuse. “It’s not surprising that children under 16 don’t know how to deal with alcohol emergencies. Ideally they should enjoy an alcohol-free childhood, so we wouldn’t expect them to know what to do.
“But with the young people who drink alcohol drinking at very high levels, it’s important they are equipped with the tips they need to keep themselves and their friends safe.”
But he said that parents played a vital role in educating their children about the dangers of alcohol misuse.
First aid has been part of the school curriculum for two years, but the survey also found that only 5% of those surveyed had received first aid training at school. As well as dealing with alcohol-related problems, the campaign aims to help teach children how to help people with asthma attacks, head injuries, choking and epileptic seizures.

Source: BBC News 13th Sept.2010

A third of 14 to 16-year-olds drink every weekend Children should learn first aid skills to help friends who become dangerously drunk, the British Red Cross has said.
Its survey of 2,500 11 to 16-year-olds found 10% had been left with a drunk friend who was sick, injured or unconscious and 14% said they had been in an alcohol-related emergency.
The Red Cross wants to promote a broad range of first aid skills, but says the effects of alcohol are a key concern. The charity Drinkaware backed the call, but said parents needed to give advice.
Official figures show that there were more than 7,000 hospital admissions between 2006 and 2009 involving under-15s and alcohol.
Many youngsters told the survey that they drank – 23% of 11 to 16-year-olds said they have been drunk, while one in three 14 to 16-year-olds said they drank most weekends.
Many of those who said they had witnessed an alcohol-related emergency said they had panicked, or did not know what to do. Almost half said they were worried about their friend choking on vomit or simply not waking up.
Joe Mulligan, from the British Red Cross, said: “We need to ensure that every young person, irrespective of whether they have been drinking, has the ability and confidence to cope in a crisis.”
The agency hopes new online training materials, including videos on YouTube, will reach children directly. Its campaign, called Life – Live It, is also sending Red Cross trainers into schools and offering first aid packs to teachers.
Children can learn skills including the recovery position, to avoid someone choking on their own vomit, and resuscitation techniques.
Chris Sorek, from charity Drinkaware, said the findings reinforced the need for children of all ages to be educated about alcohol misuse. “It’s not surprising that children under 16 don’t know how to deal with alcohol emergencies. Ideally they should enjoy an alcohol-free childhood, so we wouldn’t expect them to know what to do.
“But with the young people who drink alcohol drinking at very high levels, it’s important they are equipped with the tips they need to keep themselves and their friends safe.”
But he said that parents played a vital role in educating their children about the dangers of alcohol misuse.
First aid has been part of the school curriculum for two years, but the survey also found that only 5% of those surveyed had received first aid training at school. As well as dealing with alcohol-related problems, the campaign aims to help teach children how to help people with asthma attacks, head injuries, choking and epileptic seizures.

Source: BBC News 13th Sept.2010

Impact of Parental Substance Misuse on Children’s Educational Attainment, A One Day Conference, Thursday 2nd December 2010, Glasgow

This conference organised by the University of Glasgow will focus on drug and alcohol misuse in families and its impact on educational attainment. Key experts with explore current trends and issues, new research, new approaches to supporting children and provide practical information which can be implemented in the work setting.

The conference should be of interest to anyone working with children and young people who are affected by drug or alcohol misuse from health, education and social care settings.

For a conference leaflet visit
http://www.gla.ac.uk/departments/developmental/cpd/newcourses/ or telephone
0141 201 9264/9353

Methadone for drug addicts costs the taxpayer £105m in four years
METHADONE for drug addicts has cost the Scottish government more than £105million in just over four years, it was revealed yesterday.
An average of £67,838 was spent every day buying and dispensing the heroin substitute since March 2006 – despite experts claiming it does not work.
More than 100 people have died of methadone overdoses in that time.
And there are fears that addicts are being “parked” on the substance as Scotland’s drug problems spiral out of control. Rehabilitation workers have joined politicians in calling for a radical overhaul of treatments.
Professor Neil McKeganey, of the Centre for Drug Misuse Research in Glasgow, described the bill as “staggering”. He said: “Scotland needs to address its reliance on methadone, which has become our main drug treatment – but it is costly and delivering dubious results. It is becoming difficult to persuade the Scottish government to look at alternatives. The solution is to get people off drugs and into drug treatment services. But that can’t be done by putting people on methadone indefinitely.”
Mark Hepburn, clinical director of the Alexander Rehabilitation Clinic at Oldmeldrum in Aberdeenshire, said: “My criteria for recovery is not for a drug-maintained life, but a drug-free one. But we are just parking people on it.”
Former Aberdeen heroin addict Barry Glaze, 29, was on methadone for five years and now believes it made coming off drugs harder. He said: “I started taking heroin when I was 16 and was first prescribed methadone when I was 19. It wasn’t until I was 25 that I came off it and that was after I asked my GP. If I hadn’t, I would probably still be on it.”
Labour justice spokesman Richard Baker said: “There have been too many cuts in services that work with addicts, and unless we see support for these services then these figures will not go down”.
The government spent £20.5million prescribing the drug in 2006-07, £24.7million in 2007-08, £27.5million in 2008-09 and £27.9million in 2009-10.
A government spokesman said: “We know that the annual cost of drug misuse in the wider context of total economic and social costs is estimated at £3.5billion.
“That’s over £60,000 per problem drug user – a cost for the whole community. However, these costs typically decrease by tens of thousands of pounds once an individual engages in treatment to support their recovery.
“That’s why we are providing a record £28.6million investment in frontline drug treatment services in 2010-11 and our view is that the overarching aim of all drug treatment services should be recovery and this is at the core of our drugs strategy.”

Source: http://www.dailyrecord.co.uk/news 30.09.10

Legalise drugs and a worldwide epidemic of addiction will follow
Those who argue we should decriminalise the trade in narcotics are blind to the catastrophic consequences
The debate between those who dream of a world free of drugs and those who hope for a world of free drugs has been raging for years. I believe the dispute between prohibition and legalisation would be more fruitful if it focused on the appropriate degree of regulation for addictive substances (drugs, but also alcohol and tobacco) and how to attain such regulation.
Current international agreements are hard to change. All nations, with no exception, agree that illicit drugs are a threat to health and that their production, trade and use should be regulated. In fact, adherence to the UN’s drug conventions is virtually universal and no statutory changes are possible unless the majority of states agree – quite unlikely, in the foreseeable future. Yet important improvements to today’s system are needed and achievable, especially in areas where current controls have produced serious collateral damage.
Why such resistance to abolishing the controls? In part, because the conventions’ success in restraining both supply and demand of drugs is undeniable.
Look first at production. Drug controls slashed global opium supply dramatically: in 2007, it was one-third the level of 1907. What about recent trends? Over the last 10 years, world output of cocaine, amphetamines and ecstasy has stabilised, and in many instances dropped. Cannabis output has declined since 2004. Since the mid-90s, opium production moved from the Golden Triangle to Afghanistan where it grew exponentially at first, but started to decline (since 2008).
My first point is factual: in the distant past as well as recently, production controls have had measurable results. What about drug-use levels? There are 25 million addicts (daily use) in the world, 0.6% of the population. Ten times as many people (5% of the world’s population) take drugs at least once a year. As these amounts are relatively small, statements such as “there are drugs everywhere” or “everybody takes drugs” are nonsense. The drug numbers compare well with those of tobacco, a legal drug used by 30% of the world’s population. Even more people consume alcohol. Tobacco causes 5 million deaths per year and alcohol 2 million, against the 200,000 killed by illicit drugs.
My second point is logical: in the absence of controls, it is not fanciful to imagine drug addiction, and related deaths, as high as those of tobacco and alcohol. What are recent drug-use trends? In rich countries, addiction is high but declining. In North America and Australia, it has declined in the past 10 years, especially among the young. In Europe, opiates use has declined, offset by greater cocaine sales; cannabis and amphetamines are stable or lower. In developing countries, drug use is low, but growing. In South America and west Africa, this applies to cannabis and cocaine; in Asia and southern Africa to heroin.
My third point is intuitive: rich countries are addressing the drug problem, while poor countries lack resources to do so. With the building blocks of my reasoning in place (stability of the world drug supply; alcohol and tobacco hurt more than drugs; the divergent drug trends in poor and rich nations), I find it irrational to propose policies that would increase the public health damage caused by drugs by making them more freely available.
At the same time, drug controls are not working as they should. The resulting collateral damage is the platform upon which critics build the abolitionist argument.
Let’s look at health, security and human rights. Health must be at the centre of drug control, because drug addiction is a mix of genetic, personal and social factors: gene variants (predisposition), childhood (neglect), social conditions (poverty). The pharmacological effects of drugs on health are independent of their legal status. Drugs are not dangerous because they are illegal: they are illegal because they are dangerous to health. Unfortunately, ideology has displaced health from the mainstream of the drug debate and this has happened on both sides of the prohibition versus legalisation dispute.
In the past half-century, drug control rhetoric by governments has been right, but prevention and treatment programmes have lagged. Priority was wrongly given to repression and criminalisation. Similarly, those in favour of legalisation have lost sight of health as the priority. They prioritise handing out condoms and clean needles, while addicts need prevention, treatment and reintegration, not only harm reduction gadgets. In short, the debate on drug policy has turned into a political battle. But why? There are no ideological debates about curing cancer, so why so much politics in dealing with drug addiction?
But there is more. Drugs do harm to health, but they can also do good. Greater use of opiates for palliative care would overcome the socio-economic factors that deny a Nigerian suffering from Aids or a Mexican cancer patient the morphine offered to Italian or American counterparts. Yet such relief is not happening.
Next is the security question. Drugs pose a threat not only to individuals. Entire regions – think of Central America, the Caribbean and Africa – are caught in the crossfire of drug trafficking. In Mexico, a bloody drug war has erupted among crime groups fighting for the control of the US drug market. The legalisers’ argument on security is striking, though it leads to the wrong conclusion. Prohibition causes crime by creating a black market for drugs, the argument goes, so, legalise drugs to defeat organised crime. As an economist, I agree. But this is not only an economic argument. Legalisation would reduce crime profits, but it would also increase the damage to health, as drug availability leads to drug abuse.
Drug policy does not have to choose between either protecting health, through drug control, or ensuring law and order, by liberalising drugs. Society must protect both health and safety.
In a world of free drugs, the privileged rich can afford expensive treatment while poor people are condemned to a life of dependence. Now extrapolate the problem on to a global scale and imagine the impact of unregulated drug use in developing countries, with no prevention or treatment available. Legalised drugs would unleash an epidemic of addiction in the developing world.
Last but not least, there’s the question of human rights. Around the world, millions of people caught taking drugs are sent to jail. In some countries, drug treatment amounts to the equivalent of torture. People are sentenced to death for drug-related offences. Although drugs kill, governments should not kill because of them. The prohibition versus legalisation debate must stop being ideological and look for the appropriate degree of controls. Drug control is not the task of governments alone: it is a society-wide responsibility. Are we ready to engage?

Source: Antonio Maria Costa www.observer.guardian.co.uk 5th Sept 2010

Contrary to the beliefs of those who advocate the legalization of marijuana, the current balanced, restrictive, and bipartisan drug policies of the United States are working reasonably well and they have contributed to reductions in the rate of marijuana use in our nation.

The rate of current, past 30-day use of marijuana by Americans aged 12 and older in 1979 was 13.2 percent. In 2008 that figure stood at 6.1 percent. This 54-percent reduction in marijuana use over that 29-year period is a major public health triumph, not a failure.

Marijuana is the most commonly abused illegal drug in the U.S. and around the world. Those who support its legalization, for medical or for general use, fail to recognize that the greatest costs of marijuana are not related to its prohibition; they are the costs resulting from marijuana use itself.

There is a common misconception that the principle costs of marijuana use are those related to the criminal justice system. This is a false premise. Caulkins & Sevigny (2005) found that the percentage of people in prison for marijuana use is less than one half of one percent (0.1-0.2 percent). An encounter with the criminal justice system through apprehension for a drugrelated crime frequently can benefit the offender because the criminal justice system is often a path to treatment.

“A useful analogy can be made to gambling. Legalized gambling has not reduced illegal gambling in the United States; rather, it has increased it.”

More than a third, 37 percent, of treatment admissions reported in the Treatment Episode Data Set, TEDS, collected from state-funded programs were referred through the criminal justice system. Marijuana was an identified drug of abuse for 57 percent of the individuals referred to treatment from the criminal justice system.

The future of drug policy is not a choice between using the criminal justice system or treatment. The more appropriate goal is to get these two systems to work together more effectively to improve both public safety and public health. In the discussion of legalizing marijuana, a useful analogy can be made to gambling. MacCoun & Reuter (2001) conclude that making the government a beneficiary of legal gambling has encouraged the government to promote gambling, overlooking it as a problem behavior. They point out that “the moral debasement of
state government is a phenomenon that only a few academics and preachers bemoan.”
Legalized gambling has not reduced illegal gambling in the United States; rather, it has increased it. This is particularly evident in sports gambling, most of which is illegal. Legal gambling is taxed and regulated and illegal gambling is not. Legal gambling sets the stage for illegal gambling just the way legal marijuana would set the stage for illegal marijuana trafficking.
The gambling precedent suggests strongly that illegal drug suppliers would thrive by selling more potent marijuana products outside of the legal channels that would be taxed and otherwise restricted. If marijuana were legalized, the only way to eliminate its illegal trade, which is modest in comparison to that of cocaine, would be to sell marijuana untaxed and unregulated to any willing buyer.

Marijuana is currently the leading cause of substance dependence other than alcohol in the U.S. In 2008, marijuana use accounted for 4.2 million of the 7 million people aged 12 or older classified with dependence on or abuse of an illicit drug. This means that about two thirds of Americans suffering from any substance use disorder are suffering from marijuana abuse or marijuana dependence.

If the U.S. were to legalize marijuana, the number of marijuana users would increase. Today there are 15.2 million current marijuana users in comparison to 129 million alcohol users and 70.9 million tobacco users. Though the number of marijuana users might not quickly climb to the current numbers for alcohol and tobacco, if marijuana was legalized, the increase in users would be both large and rapid with subsequent increases in addiction.

Important lessons can be learned from those two widely-used legal drugs. While both alcohol and tobacco are taxed and regulated, the tax benefits to the public are vastly overshadowed by the adverse consequences of their use. Alcohol-related costs total over $185 billion while federal and states collected an estimated $14.5 billion in tax revenue; similarly, tobacco use costs over $200 billion but only $25 billion is collected in taxes. These figures show that the costs of legal alcohol are more than 12 times the total tax revenue collected, and that the costs of legal tobacco are about 8 times the tax revenue collected. This is an economically disastrous tradeoff.

The costs of legalizing marijuana would not only be financial. New marijuana users would not be limited to adults if marijuana were legalized, just as regulations on alcohol and tobacco do not prevent use by youth. Rapidly accumulating new research shows that marijuana use is associated with increases in a range of serious mental and physical problems. Lack of public understanding on this relationship is undermining prevention efforts and adversely affecting the nation’s youth and their families.

Drug-impaired driving will also increase if marijuana is legalized. Marijuana is already a significant causal factor in highway crashes, injuries and deaths. In a recent national roadside survey of weekend nighttime drivers, 8.6 percent tested positive for marijuana or its metabolites, nearly four times the percentage of drivers with a blood alcohol concentration (BAC) of .08 g/dL (2.2 percent). In another study of seriously injured drivers admitted to a Level-1 shock trauma
center, more than a quarter of all drivers (26.9 percent) tested positive for marijuana. In a study of fatally injured drivers in Washington State, 12.7 percent tested positive for marijuana. These studies demonstrate the high prevalence of drugged driving as a result of marijuana use.
Many people who want to legalize marijuana are passionate about their perception of the alleged failures of policies aimed at reducing marijuana use but those legalization proponents seldom—if ever—describe their own plan for taxing and regulating marijuana as a legal drug. There is a reason for this imbalance; they cannot come up with a credible plan for legalization that could deliver on their exaggerated claims for this new policy.

“Reducing marijuana use is essential to improving the nation’s health, education, and productivity.”

Future drug policies must be smarter and more effective in curbing the demand for illegal drugs including marijuana. Smarter-drug prevention policies should start by reducing illegal drug use among the 5 million criminal offenders who are on parole and probation in the U.S. They are among the nation’s heaviest and most problem generating illegal drug users.

Monitoring programs that are linked to swift and certain, but not severe,
consequences for any drug use have demonstrated outstanding results including lower recidivism and lower rates of incarceration. New policies to curb drugged driving will not only make our roads and highways safer and provide an important new path to treatment, but they will also reduce illegal drug use.

Reducing marijuana use is essential to improving the nation’s health, education, and productivity. New policies can greatly improve current performance of prevention strategies which, far from failing, has protected millions of people from the many adverse effects of marijuana use.
Since legalization of marijuana for medical or general use would increase marijuana use rather than reduce it and would lead to increased rates of addiction to marijuana among youth and adults, legalizing marijuana is not a smart public health or public safety strategy for any state or for our nation.

Source: Published: Tuesday, 20 Apr 2010 Robert du Pont,Institute for Behavior and Health

For the past six months, I have attended the public forums and workshops on poverty and early childhood education in Erie and America. It is agreed that many factors cause poverty, but I will focus on issues with which I have professional experience and knowledge.

I am a registered pharmacist, and during my 35-plus years as Director of Pharmacy Services, both in government and the private industry, I have taught thousands of individuals about drug, alcohol and health issues. To increase and support early educational endeavors for our children, we must first address the abuse of drugs, both legal and illegal, and alcohol.

I was the first pharmacist on the East Coast to start the “Methadone Program” with Dr. B. Kissin in Brooklyn in the early 1970s, dispensing methadone and counseling addicts on the dangers of heroin and other drugs that could kill them or their unborn child.

I have collaborated, assisted and cooperated with local police departments, the U.S. Drug Enforcement Agency and school programs such as Drug Abuse Resistance Education (D.A.R.E.). I have also been a community instructor on medication management.

At the May 27 Economic Summit on Early Childhood Education, Dr. Judy Cameron, a University of Pittsburgh neuroscientist, gave a presentation on “The Science of Early Brain Architecture and the Future of Early Childhood Policy.” Yet there was no discussion relative to the environmental factors in a household. How many children are exposed to secondary/passive illegal and legal smoke? When a mother inhales illegal substances (marijuana and crack cocaine), the effect on the developing fetus is magnified two- to 10-fold.

Our counseling program in Brooklyn had an average success rate of 30 percent with females (some pregnant, some not) who asked me questions that I answered in plain truth: “If you keep this up, you are going to die early or you are going to lose your baby. Period.”

Those in the methadone program who did not pass the drug screen were dropped from the program after one warning. Addicts developed trust because I talked to them in confidence and was a source of good and reliable drug information. I was “the man” who knew drugs.

Many will counter this point because of their agendas. Medical marijuana has been legalized in 14 states. The dummying up of America will continue if we don’t educate individuals that marijuana has equal or more toxic effects than alcohol. It is only when deaths hit families and friends that the anti-drug message sinks in.

In the past 20 years, the family has fragmented so that there is no male hero for the child. There was an added positive response from those I helped when they came from a family unit with a mother and father, because family members have to reinforce this message.

Why has there been such an increase in Attention Deficit Hyperactivity Disorder in our children during the same time period? The fact is that drugs change the maturing of cells in the body and the brain. The mere fact that we are addressing early education for children after birth but are not addressing the effects of both legal and illegal drugs before birth, resulting in mental retardation, a decrease in the attention span and learning abilities of that young child in school, is somewhat backward.

There is debate about whether poverty causes drug abuse or drug abuse causes poverty. I believe it’s the latter.

I recommend a written contract/commitment between parent(s) and assistance program managers (private or government-run) with specific guidelines to decrease the usage of illegal drugs. If the commitment is to raise a person out of poverty, then there has to be a commitment from the person to help themselves, too.

If the government orders that all recipients who receive government financial support, not including the elderly or those with disabilities and legitimate medical conditions, must submit to random drug urine tests, there will be a drastic drop in drug abuse and subsequently a reduction in poverty. If an individual fails the drug test twice in 60 days, they would forfeit financial support for 12 months and be required to attend a drug-abuse program to re-enter the program. If they fail again, they should be permanently removed from all government-assistance programs.

Many citizens have to submit to random drug screens, at any time, when we are employed but those receiving government funds have no responsibility or accountability to either the government, the program or themselves. Why do we hold these individuals to different standards?

When programs don’t contain measurements, standards and contracts for accountability, they will fail and poverty will continue.

Let me close with two quotes: “All truths are easy to understand once they are discovered the point is to discover them” (Gallileo) and “Is silence an endorsement?” (Aliota).

LOU ALIOTA of Millcreek Township, is a registered pharmacist and is a private health-care consultant.

Source: Op-Ed from Erie Times-News (Erie, Pa.) – August 20, 2010

Wednesday 01 September 2010

The Local Alcohol Profiles for England (LAPE 2010) have just been released by the North West Public Health Observatory – profiling 23 alcohol-related indicators for every local authority and 24 for every primary care trust in England.
The profiles provide a national ‘map’ of alcohol-related harms.
Key findings from the profiles:
• Over the five years to 2008/09 there has been around a 65% increase in the number of people being admitted to hospital due to alcohol to 606,799 individuals – an increase of over 240,000 people.
• There were 945,469 admissions to hospital for alcohol-related harm in England in 2008/09. This is 825 alcohol-related admissions a day more than five years ago.
• Two thirds (65%) of all the local authorities suffering the highest levels of overall harms are in the North West and North East regions of England (1). The ten local authority areas with the highest levels of combined alcohol-related harm (2) are, in descending order, Manchester, Salford, Liverpool, Rochdale, Tameside, Islington, Middlesbrough, Halton, Oldham and Blackpool.
• By comparison East of England and South East region contain two thirds (65%) of all the local authorities with the lowest overall harm (1). The ten local authorities with the lowest levels of alcohol-related harm (2) are, in ascending order, Broadland, East Dorset, South Northamptonshire, Babergh, Three Rivers, South Norfolk, Hart, Sevenoaks, Wokingham and North Kesteven.
• Between 2006 and 2008 there were 11,247 deaths from chronic liver disease in men. The number of male deaths from chronic liver disease continues to rise steadily and increased by 12% for the five years up to 2008.
• Across England, there were 415,059 recorded crimes attributable to alcohol in 2009/10; equivalent to 8.1 crimes per 1,000 population. The highest rates of alcohol-attributable crime occur in the London region where there were 12.2 crimes per 1,000 residents, although this has decreased by 2.1% from the previous year. The lowest rate is in the North East region at 6.2 crimes per 1,000 which also showed the largest decrease (13.5%) from the previous year.
• Trends in alcohol-related harms vary between local authority areas. For instance, 64% saw an increase of over 5% in hospital admissions for alcohol-related harm in 2008/09, whilst only 7% showed a decrease of over 5%.
(1) Local authorities are categorised into five levels of harm using a clustering methodology that assigns LAs which have similar alcohol profiles to the same category. Months of life lost due to alcohol (males), months of life lost due to alcohol (females), NI39 (alcohol-related hospital admissions), alcohol-attributable recorded crimes, claimants of Incapacity Benefits due to alcoholism, increasing risk drinking, and higher risk drinking were used to determine clusters.
(2) Ranking for highest and lowest levels of alcohol-related harm use the same data as above and are ranked according to the highest combined rank across the seven harm indicators. City of London and the Isles of Scilly are excluded (figures for these areas should always be viewed with caution due to their small resident populations).
Visit the Local Alcohol Profiles for England website.

Source: www.alcoholconcern.org.uk 1.09.2010

Friday, 20 August 2010 06:42

The British Home Office has restated its position on drugs, after the outgoing president of the Royal College of Physicians Ian Gilmore called for a review of the law.
Speaking to the BBC, Sir Ian Gilmore said that the present policy of prohibition is not a success.
Responding to Sir Ian’s comments, a Home Office spokesperson said: Drugs such as heroin, cocaine and cannabis are extremely harmful and can cause misery to communities across the country. The government does not believe that decriminalisation is the right approach. Our priorities are clear; we want to reduce drug use, crack down on drug related crime and disorder and help addicts come off drugs for good.

The journalist who chose the headline would have known that ‘Cold Turkey’ implies a harsh treatment. Using residential rehabs to help those addicted to recover may be tough but it is not inhumane – and far better than allowing drug dependents to languish for years in addiction to methadone….. The great sadness is the number of residential rehabs which were forced to close when the NTA preferred methadone maintenance to treatment towards abstinence. NDPA

David Cameron is to push ahead with radical “abstinence” plans for the most serious drug addicts.

There are estimated to be 200,000 seriously-addicted users of heroin, crack and cocaine Photo: ALAMY

The Coalition is working on proposals to stop the widespread prescription of methadone for heroin users and instead increase the use of “cold turkey” residential treatment programmes.

Drug services are expected to be paid by results if they manage to get addicts off heroin and cocaine. It also emerged last week that ministers are considering withholding benefits from those refusing treatment.

Theresa May, the Home Secretary, has been charged with drawing up the new strategy despite pressure from the Department of Work and Pensions to take the lead in tackling addiction.

There are estimated to be 200,000 seriously-addicted users of heroin, crack and cocaine and many existing programmes have focused on keeping them away from crime rather than treating their addiction.

James Brokenshire, the Drugs Minister, said: “We are looking to have greater emphasis on recovery rather than simply on treatment itself. The aim is to get people clear of addiction.”

Mr Brokenshire said that there should only be a limited role for methadone in treatment. “[Methadone] should be seen as part of a pathway taking people to a position where they are clear of addiction,” he said.

Source: Telegraph 23rd August 2010

A sickness at the heart of Europe

Drug policy public hearing – a revivalist meet for the disciples of dope.

A Brussels Parliament sketch by Peter Stoker – Director, National Drug Prevention Alliance

_____________________________________________________________

In the comfortable and prestigious surroundings of the European Parliament, a ‘Public Hearing’ was – in the event – heard by very few of The Public. Perhaps this is just as well, for the average citizen might have torched this expensive building, built from his tax money, had they heard what was being said.

Under the name of the Civil Liberties,  Justice and Home Affairs Committee, the hearing concerned what was euphemistically called the ‘Anti-Drug’ Strategy, 2005 – 2012, and its attendant ‘Action Plans’ (2005 – 2008 and 2009 – 2011). Enthusiasts of drug policy will know the special significance of 2008; this is the year in which the UN is set to review its Conventions on Drugs, for which more than 100 nations have signed up, thereby generating an enormous and positive influence on drug policy around the world. It is precisely because the Conventions have a positive influence, a bulwark against legalisation, that they are hated by the pro-legalisation crowd. They would kill them today if they could but meanwhile they are working behind and in front of every available screen to administer a death blow as soon as they can.

Deep concern for the public health, social cohesion and safety of European society was cited as the drive for the ‘Anti-Drug’ Strategy – surely matters of interest to The Public, but this meeting was populated by a rather different variety of human being.

Instead of the public there was a collection of around 150 people – of which more than 100 came ‘on a mission from Gomorrah’, bearing banners and leaflets, and demanding a Europe of free drugs – not a Europe free of drugs. Largely in harmony with this aspiring cluster were some 15 MEPs who, if they spoke at all, spoke in terms which garnered the applause of the 100. Also on hand were around 25 EU officials who maintained at discreet silence – in all but one noteworthy case. Mathematicians amongst you will note that this leaves about five people are not accounted for? Who they? The prevention platoon – including yours truly.

Known drug legalisers and liberalisers were greeted like old friends – which maybe they were – and were given reserved seating plus arranged speaking slots in the agenda. Thus were we treated to presentations by ENCOD, TNI, IAPL and others who would not be given house room in any self-respecting house.

Looking on benevolently but keeping a low profile was Mike Trace, the disgraced former Deputy Drugs Tsar for the UK who, on the eve of his elevation to head of Demand Reduction for the UN, was spectacularly exposed by the London Daily Mail as running covert operations with legaliser bodies, notably those bankrolled by George Soros. Trace was obliged to resign his seat at the UN even before he had begun warming it, but he remains a force on the UK and European scene, the beneficiary of a determined rehabilitation scheme by those who feel there is still some useful mileage in him. He is a top cat in Drug Treatment Limited, in the Beckley Foundation, and in RAPt – the Rehabilitation of Addicted Prisoners Trust – the breadwinner job he has held since before his heady days of Drug Tsardom.

The meeting was chaired by Belgian MEP Antoine Duquesne, and did little to diminish his reputation as a strange person. A welcome was offered by the Health Minister for Luxemburg, who promised that of all present today had left their dogmas leashed up outside the front door, and that no preachers had been admitted. Our main goal, he suggested, should be free to reduce Harm … not only the physiological harm drug-users suffer but also the harm of their social exclusion (presumably users should be set on a pedestal in society). The minister concluded by entreating all present to not stick to a static view; there are many approaches, he said, witness the contents of the Action Plan produced by the splendidly named Horizontal Drug Group on the 23rd of February this year.

Next up was a spokesman for the Pompidou Group, Bob Kaiser, who did his best to maintain gravitas in presenting a predictable and unimaginative series of recommendations, ending with the plea that money should not be spent on new organisations (the implication being that it was better to spend it on old organisations – like his).

Paul Griffiths, spokesman for the Lisbon-based monitoring centre, EMCDDA,  uttered the recurrent plea for more and better data, not withstanding what he saw as improvements in recent years. We needed, he said, to get much better at collecting evidence, if – that is – evidence-based policy (as distinct from policy-based evidence) is the goal.

A sanguine spokesman from the International Red Cross made new friends in the audience when he asserted that the notion of a drug-free world is unrealistic and that it was in the nature of man to swallow psychoactive substances – much in the way he had evidently swallowed this rhetoric. He lost one friend, however, when he dismissed the concerns of of Madame Roure, MEP for Lyon, France, who spoke of young children in deprived areas being drawn into drug use; that – said the Red Cross man – was a South American or Eastern Europe problem i.e. nothing for us civilised types over here to get excited about. Madame R gave him a short shrift; she was, she said, talking about the fair city of Lyon – not Bogota or Bucharest.

Luc Beauman, spokesman for ENCOD, knew he was preaching to the converted. From his position on the top table he presented a relaxed and intellectually stylish restatement of their position. At this, the 100 erupted into thunderous and extended applause, holding aloft colourful if modestly-sized banners (possibly designed to fit comfortably inside one’s jacket).

It was then that the assembled drug freedom fighters in the cheap seats became restless. Surely, the first cautiously suggested, it is the system of making drugs illegal which just makes prevention harder to appear: wouldn’t a bright new day dawn and everything be super if we just legalised them all?. Others quickly followed over this rickety bridge head: A man from Bologna complained that he couldn’t get a drink after 9pm or smoke cigarettes in shops – this is Prohibitionism even with legal drugs, so it’s just part of the same problem, and we must recognise that prohibitionists are dangerous animals. The appropriately-named ‘Freek’ Polack claimed that he had just one question for the Parliament – then proceeded to ask five; the gist of it was that policies which don’t enable drug use are failures, so why are we silent on this failure? He was received in silence.

An impassioned plea from a hirsute young German drug user took the form of a velvet trap – “You say we need your help, I say you need our help, so when will you stop isolating and demonising us?” (as in ‘When did you stop beating your wife?’).

An Italian plaintiff said he knew of five people, arrested for drug possession who, when their names were published in the media, committed suicide.The notion of an early death during this meeting was perhaps growing in the minds of some, who were by now finding the whole affair life-threatening.

In the name of balance, a Belgian prevention centre worker was invited to speak. He remarked that the discussions “seemed to getting very polemical” – perhaps unintentionally implying that they had not been polemical from the kick-off.

ENCOD’s Luc Beauman took another bite at the cherry; if cannabis is demonised, he opined, then kids don’t take any drug information seriously. Ergo, unreliable prevention messages damage all prevention messages, so his argument went.

 ( Unreliable libertarian messages did not, it seemed, qualify for the same criticism). ‘Regulation’ – the new buzzword for Legalisation – would usher in a new dawn of ‘ sincere and and honest information’. This would be best achieved by involving citizens, a pious hope of politicians since the 1980s but sadly a hope yet to be realised. 2008 or 2012 were, said Luc, intolerably far away … “What do we want? Regulation! When do we want it? Now!” … and so on …

It was left to the one civil servant who did speak to administer a cold douche of reality. Carel Edwards, Head of the Anti-Drugs Coordination Unit at the EC, told it how it was – and is likely to remain. He was given just six minutes to speak; and said “If you think I can, or will state that the EC position in six minutes, think again”. If today had demonstrated anything, he said, it had demonstrated once again the enormous confusion over the whole subject. The notion that opinions from street level would reach to and direct the top of government is the kind of dream that only comes from those smoking unusual tobaccos. In support of this he cited how few MEPs were here today – and the fact that no of single member state has yet reached what can be called a consenus on drug policy.

He made a somewhat bizarre reference to the Institute for Global Drug Policy Conference held in the European Parliament building about a month ago, characterising this as “Americans expressing a very repressive policy” (It seems that an attendance register, showing the wide variety of European and worldwide delegates at that meeting might helpfully enlighten him). In closing, he said the EC’s aim was to produce an ‘ideology-free, evidence-based’ policy. Those who wanted to debate ideology should go elsewhere; coming as it did after three and a half hours of almost unceasing ideology-pushing, this remark fell on stoned and stony ground alike.

                                                ***************

Support for legalising cannabis has dropped from more than a third of people in Scotland to less than a quarter, a study has suggested.
However, most people made a distinction between cannabis and other drugs.
The findings come in a Scottish government study into the public’s attitudes towards illegal drugs and drug misuse.
It showed 47% of people knew someone who had tried illegal drugs, up from 41% between 2001 and 2009.
Statistics from the British Social Attitudes Surveys in the 1980s and 1990s, along with the Scottish Social Attitudes Survey 2001, indicated an increasingly tolerant attitude towards the legalisation of cannabis.
The results from the Scottish Social Attitudes Survey 2009 have now suggested a reverse in this trend.
Mental health
Support for legalising cannabis fell from 37% in Scotland in 2001 to 24% in 2009. Among those who had themselves tried cannabis, support for its legalisation fell from 70% to 47% over the same period.
The views were accompanied by a hardening of attitudes towards prosecution for the possession of cannabis.
The report found the trend may be linked to the mental health debate surrounding new stronger forms of cannabis, called skunk, or it may reflect a changing trend in attitudes towards illegal drugs in general.
In 2008 the government introduced a new strategy to tackle the nation’s drug problems by focusing on “recovery and helping people live drug-free lives”.
In principle this appeared to be supported by the Scottish public, with 80% saying “the only real way of helping drug addicts is to get them to stop using drugs altogether”.
How this should be done was not so clear, the report found.
There was widespread support for enforcement, with only 16% of people agreeing that personal use of heroin should not result in prosecution.
Although education was generally supported as the focus of drugs policy, only 44% of people believed this “education” should involve young people being given more information on how to use drugs more safely.
The survey also indicated that communities with higher signs of heroin use were more likely to be comfortable living near a recovering heroin user. This may mean that actual contact with such issues helps to allay public anxiety, it suggested.

Source: www.news.bbc.co.uk 25th May 2010

Over the past ten days, 40 reports were received by the National Poisons Information Centre regarding persons suffering severe adverse reactions attributed to using a new head shop substance “WHACK”.
The majority of these individuals are young males in their twenties. They live in different parts of Ireland with 20 presenting in the mid-Western region. They have suffered a range of symptoms including increased heart and breathing rates and raised blood pressure. Emergency Physicians and GPs have described that the majority suffered from differing levels of anxiety with at least 7 cases experiencing psychotic episodes. This psychosis is severe and is proving difficult to treat.

The National Poisons Information Centre, the Forensic Science Laboratory, the Irish Medicines Board and others are monitoring closely the emergence of any new psychoactive substances.

On the 11th May 2010, the Government brought in new legislation. This legislation has brought under control approximately 200 individual substances and covers the vast majority of products of public health concern, which were on sale in head shops.

In addition to the recent controls on legal highs introduced by the Minister for Health and Children, the Minister for Justice and Law Reform is bringing forward the Criminal Justice (Psychoactive Substances) Bill 2010 which aims to ensure that the sale or supply of substances which may not be specifically proscribed under the Misuse of Drugs Act, but which have psychoactive effects, will be a criminal offence.

The advice from the HSE is not to try this dangerous drug or other similar substances as the effect on an individual can impact significantly on one’s health.

Source: HSE Press & Media, Dr Steevens’ Hospital, Dublin 8, 09/06/2010

“This report summarises the key findings from a report exploring public attitudes towards illegal drugs and drug misuse in Scotland, based on data from the 2009 Scottish Social Attitudes survey. It focuses in particular on attitudes towards opiate misuse, and on views of potential policy responses to this. However, it also places such attitudes in the context of wider views and experiences of illegal drugs.”

Main Findings

■ Support for legalising cannabis – which increased in Scotland (as in the rest of the UK) in the late 1990s – has fallen considerably in more recent years, from 37% in 2001 to 24% in 2009. Attitudes towards prosecution for possession of cannabis for personal use also hardened between 2001 and 2009.
■ Most people said taking cocaine occasionally is wrong – 76% rated it as 4 or 5 on a scale where 5 meant ‘very seriously wrong’.
■ 45% of people agreed that ‘Most people who end up addicted to heroin have only themselves to blame’, while just 27% disagreed.
■ Around half (53%) disagreed that ‘most heroin users come from difficult backgrounds’ (29% agreed).
■ Among those in paid employment, around half (47%) said they would be ‘very’ or ‘fairly comfortable’ working alongside someone they knew had used heroin in the past, while around 1 in 5 would be uncomfortable.
■ Just a quarter (26%) said they would be comfortable with someone who was receiving help to stop using heroin moving near to them, while half (49%) would be uncomfortable.
■ There was no public consensus on what should be the top government priority for tackling heroin use in Scotland – 32% chose ‘tougher penalties for those who take heroin’, 32% ‘more help for people who want to stop using heroin’ and 28% ‘more education about drugs’.
■ Just 16% agreed that people who possess heroin for personal use should not be prosecuted (compared with 34% for cannabis).
■ Public support for providing clean needles to injecting drug users fell from 62% in 2001 to 50% in 2009.
■ Opinion on educating young people about safer drug use was split – 44% agreed that young people should be given information about how to use drugs more safely, but 40% disagreed.
■ Four out of five (80%) agreed that ‘the only real way of helping drug addicts is to get them to stop using drugs altogether’. However, 29% agreed that ‘most heroin users can never stop using drugs completely’, while 27% said they neither agreed nor disagreed or did not know.
■ 63% disagreed that ‘Someone who has been a heroin addict can never make a good parent, even if their drug problems are in the past’.
■ Around two thirds (64%) said that young children of heroin users should be placed into temporary foster care until the parents stop taking heroin. A further 1 in 5 believed the child should stay at home while the family receives help from social workers and just 8% said the child should be permanently adopted by another family.
The full report is also accessible online.

Source: http://uwsnealb.wordpress.com/2010/05/28/scottish-social-attitudes-survey-2009-public-attitudes-to-drugs-and-drug-use-in-scotland/ May 25 2010

Support for legalising cannabis has dropped from more than a third of people in Scotland to less than a quarter, a study has suggested.
However, most people made a distinction between cannabis and other drugs.
The findings come in a Scottish government study into the public’s attitudes towards illegal drugs and drug misuse.
It showed 47% of people knew someone who had tried illegal drugs, up from 41% between 2001 and 2009.
Statistics from the British Social Attitudes Surveys in the 1980s and 1990s, along with the Scottish Social Attitudes Survey 2001, indicated an increasingly tolerant attitude towards the legalisation of cannabis.
The results from the Scottish Social Attitudes Survey 2009 have now suggested a reverse in this trend.
Mental health
Support for legalising cannabis fell from 37% in Scotland in 2001 to 24% in 2009. Among those who had themselves tried cannabis, support for its legalisation fell from 70% to 47% over the same period.
The views were accompanied by a hardening of attitudes towards prosecution for the possession of cannabis.
The report found the trend may be linked to the mental health debate surrounding new stronger forms of cannabis, called skunk, or it may reflect a changing trend in attitudes towards illegal drugs in general.
In 2008 the government introduced a new strategy to tackle the nation’s drug problems by focusing on “recovery and helping people live drug-free lives”.
In principle this appeared to be supported by the Scottish public, with 80% saying “the only real way of helping drug addicts is to get them to stop using drugs altogether”.
How this should be done was not so clear, the report found.
There was widespread support for enforcement, with only 16% of people agreeing that personal use of heroin should not result in prosecution.
Although education was generally supported as the focus of drugs policy, only 44% of people believed this “education” should involve young people being given more information on how to use drugs more safely.
The survey also indicated that communities with higher signs of heroin use were more likely to be comfortable living near a recovering heroin user. This may mean that actual contact with such issues helps to allay public anxiety, it suggested.

Source: www.news.bbc.co.uk 25th May 2010

Over the past ten days, 40 reports were received by the National Poisons Information Centre regarding persons suffering severe adverse reactions attributed to using a new head shop substance “WHACK”.
The majority of these individuals are young males in their twenties. They live in different parts of Ireland with 20 presenting in the mid-Western region. They have suffered a range of symptoms including increased heart and breathing rates and raised blood pressure. Emergency Physicians and GPs have described that the majority suffered from differing levels of anxiety with at least 7 cases experiencing psychotic episodes. This psychosis is severe and is proving difficult to treat.

The National Poisons Information Centre, the Forensic Science Laboratory, the Irish Medicines Board and others are monitoring closely the emergence of any new psychoactive substances.

On the 11th May 2010, the Government brought in new legislation. This legislation has brought under control approximately 200 individual substances and covers the vast majority of products of public health concern, which were on sale in head shops.

In addition to the recent controls on legal highs introduced by the Minister for Health and Children, the Minister for Justice and Law Reform is bringing forward the Criminal Justice (Psychoactive Substances) Bill 2010 which aims to ensure that the sale or supply of substances which may not be specifically proscribed under the Misuse of Drugs Act, but which have psychoactive effects, will be a criminal offence.

The advice from the HSE is not to try this dangerous drug or other similar substances as the effect on an individual can impact significantly on one’s health.

Source: HSE Press & Media, Dr Steevens’ Hospital, Dublin 8, 09/06/2010

The Government’s official drug advisers will recommend later this month that the “legal high” mephedrone should be banned because of the potential serious risks to public health.  But the drug – a legal stimulant sold as plant food and known as miaow-miaow – will not be formally banned until at least the summer as further consultation is needed on whether it should be a Class A, B or C drug.

Pressure on the Government to outlaw mephedrone intensified yesterday when a post-mortem examination on John Sterling Smith, 46, of Hove, East Sussex, showed he died from mephedrone poisoning. His family said they were stunned and called for a ban. Results of toxicology tests released last night blamed mephedrone for his fatal cardiac arrest.  A Sussex Police spokeswoman said that Mr Smith collapsed at a party in Hove in the early hours of February 7. “Two men, aged 35 and 40, both from Brighton, were arrested on suspicion of supplying Class A drugs and released on police bail until May 5 pending further inquiries,” she said.

Headteachers called yesterday for action on the drug, which has been linked with at least five deaths.  Louis Wainwright, 18, and Nicholas Smith, 19, from Scunthorpe, died after taking mephedrone, which can be bought for £4 and is also known as “M-cat”. Both teenagers had been drinking alcohol and police said last night that they may have taken the heroin substitute methadone too.  There have been two other deaths in Britain linked to mephedrone, which is illegal in countries including Norway, Germany and Finland.

The Advisory Council on the Misuse of Drugs at present lacks sufficient members to make a formal recommendation, but the appointments process is being brought forward to next week to get over the legal problem. A spokesman said: “The council has been looking at the dangers of mephedrone and related cathinone compounds, as a priority. The ACMD held an evidence-gathering meeting on February 22 and continues to carefully work on considerations with a view to providing advice to ministers on March 29.”

Alan Campbell, a junior Home Office minister, said: “We are determined to act swiftly but it is important we consider independent expert advice to stop organised criminals exploiting loopholes by simply switching to a different but similar compound.”  The Home Office denied that the sacking of Professor David Nutt, former chairman of the council, and subsequent resignations of key members of the organisation had led to “inordinate” delays in considering a ban.

Professor Nutt warned yesterday against a hasty reaction, saying a ban had to be based on “sound science”.

Tim Hollis, the Association of Police Chief Constables’ spokesman on drugs, said a ban would enable police to act against those possessing and supplying the drug. He spoke as Mike Stewart, head of Westlands School in Torquay, Devon, said teachers were in the absurd position of having to hand back packages of the drug seized in lessons.  Side-effects of mephadrone include high blood pressure, a burning throat, nose bleeds and purple joints.

Source:   Times online 18th March 2010

The latest scientific conclusions — which are causal, not merely correlative — show that pot use significantly increases the likelihood of mental illness.
Back in the 1970s, when I was first exposed to the idea of decriminalizing illegal drugs, it seemed like a good idea. My interest was abstract: I didn’t smoke pot. My wife and I signed a marijuana decriminalization petition one evening around 1980 for a group that acted like they had fallen out of a Cheech and Chong movie. They asked if we could contribute a joint or two to the cause. They were utterly shocked when we told them: “We don’t smoke pot.” They just could not imagine that anyone would support decriminalization without a more personal interest.
There’s no question that making drugs illegal creates serious problems for our criminal justice system. It clogs the courts, it corrupts police officers and government officials, and it funds some really sleazy people. All of this is true — but it turns out that there are some substantial social costs on the other side that simply don’t get any attention. While it may sound like I have been watching Reefer Madness (1936) – a tragically overwrought portrayal of the dangers of marijuana — it turns out that mental illness is one of those social costs.
A surprising number of scholarly studies in the last 25 years have demonstrated that marijuana use seems to cause an increase in psychoses such as schizophrenia, and somewhat less dramatic mental illnesses such as bipolar disorder.
Let me emphasize: This isn’t just correlation analysis — finding that people with a current mental illness are disproportionately potheads. I am well aware that people with significant mental illness problems tend to “self-medicate” using various psychoactive drugs (including alcohol). No, these are longitudinal studies that show the marijuana use comes first, with the mental illness later in life.
The first of these, involving Swedish conscripts, was published in the Lancet in 1987. Those who had used marijuana heavily by age 18 were six times more likely to develop schizophrenia. A British medical journal paper published in 2002 performed a longitudinal study in New Zealand and found that:
Firstly, cannabis use is associated with an increased risk of experiencing schizophrenia symptoms, even after psychotic symptoms preceding the onset of cannabis use are controlled for. … Secondly, early cannabis use (by age 15) confers greater risk for schizophrenia outcomes than later cannabis use (by age 18). The youngest cannabis users may be most at risk because their cannabis use becomes longstanding.
This paper, from the British Journal of Psychiatry in 2004, should also make you a bit concerned. From the abstract:
On an individual level, cannabis use confers an overall twofold increase in the relative risk for later schizophrenia. At the population level, elimination of cannabis use would reduce the incidence of schizophrenia by approximately 8%, assuming a causal relationship. Cannabis use appears to be neither a sufficient nor a necessary cause for psychosis. It is a component cause, part of a complex constellation of factors leading to psychosis.
There’s unquestionably a genetic component. This Schizophrenia Bulletin (2008) paper tells us:
Cannabis use is considered a contributory cause of schizophrenia and psychotic illness. However, only a small proportion of cannabis users develop psychosis. This can partly be explained by the amount and duration of the consumption of cannabis and by its strength, but also by the age at which individuals are first exposed to cannabis. Genetic factors, in particular, are likely to play a role in the short- and the long-term effects cannabis may have on psychosis outcome. … Evidence suggests that mechanisms of gene-environment interaction are likely to underlie the association between cannabis and psychosis.
Obviously, only a fraction of pot smokers are going to go crazy and join the 1-3% of Americans who are psychotic. Think of smoking marijuana on a regular basis as playing Russian roulette once with a 50-shot cylinder, one of which has a live round. (Of course, now that you know that, maybe you do have to be crazy to smoke marijuana.)
At this point, you may be saying: “Big deal! It’s my life! If I want to smoke pot and risk going crazy, that’s my choice!” I would concede that point, except that as of 2002, schizophrenia alone of the mental disorders was costing the United States $63 billion a year in medical costs and in disability payments. Much of that cost is directly governmental, since schizophrenics usually aren’t able to work and thus are reliant on the government.
You might also argue: “What about alcohol? Doesn’t it have risks?” No question — and these risks have been recognized for a long time. Arguing for decriminalization of marijuana because alcohol is a big problem is like arguing that because one of your feet is gangrenous the doctor should also amputate the healthy foot just to be even-handed. (Or even-footed, I suppose.) If anything, instead of decriminalizing marijuana, we should be looking at discouraging alcohol — and recognizing that while Prohibition didn’t work, there may be approaches more educational, and less drastic, that can.

Source: http://pajamasmedia.com/blog/author/claytonecramer/ March 3, 2010

Last week, it was announced that the Conservative government will soon unveil a new national anti-drug strategy. The plan is said to feature a get-tough approach to illegal drugs, including a crackdown on grow-ops and drug gangs. And while it will also (wisely) include tens of millions for rehabilitation of addicts and for a national drug prevention campaign, it is said to retreat from safe-injection sites and other fashionable “harm-reduction” strategies introduced by the previous Liberal government. To which we say: Good. This editorial column has long urged a softening of drug policy on marijuana and other non-addictive recreational substances. But heroin and similarly addictive drugs are a different story. Moreover, safe injection sites don’t work. And they send the wrong message, too, promoting disrespect for the rule of law by having government facilitating the consumption of illegal substances.

 Too bad most of the proof to back these positive claims come from SIS proponents or the academics who devise harm-reduction theories. Police here, and in Europe (where they have lots of experience with SISs) tell a very different tale.

 When Insite applied to have its three-year licence renewed last fall, the RCMP told Health Canada it had “concerns regarding any initiative that lowers the perceived risks associated with drug use. There is considerable evidence to show that, when the perceived risks associated to drug use decreases, there is a corresponding increase in number of people using drugs.”

Reports that the Harper government is preparing to announce changes to Canada’s outdated 20-year-old national strategy on illicit drug use should be reason for optimism.Source:Addiction & Recovery News May 2007

Source:Addiction & Recovery News May 2007

One of many reasons that attendance at Alcoholics Anonymous (AA) meetings helps people with alcohol use disorders stay sober appears to be alleviation of depression. A team of researchers has found that study participants who attended AA meetings more frequently had fewer symptoms of depression – along with less drinking – than did those with less AA participation. The report will appear in the journal Addiction and has been release online.

“Our study is one of the first to examine the mechanisms underlying behavioral change with AA and to find that AA attendance alleviates depression symptoms,” says study leader John F. Kelly, PhD, associate director of the Massachusetts General Hospital (MGH) Center for Addiction Medicine. “Perhaps the social aspects of AA helps people feel better psychologically and emotionally as well as stop drinking.”

The authors note that problems with mood regulation such as depression are common among people with alcohol problems – both preceding and being exacerbated by alcohol use. Although AA does not explicitly address depression, the program’s 12 steps and social fellowship are designed to support participants’ sense of well being. While mood problems often improve after several weeks of abstinence, that process may happen more quickly in AA participants. The current study was designed to investigate whether decreasing depression and enhancing psychological well-being help explain AA’s positive effects.

The researchers analyzed data from Project MATCH, a federally funded trial comparing three treatment approaches for alcohol use disorder in more than 1,700 participants. While participants in that study were randomly assigned to a specific treatment plan, all were able to attend AA meetings as well. Among the data gathered at several points during Project MATCH’s 15-month study period were participants’ alcohol consumption, the number of AA meetings attended, and recent symptoms of depression.

At the beginning of the study period, participants reported greater symptoms of depression than would be seen in the general public, which is typical among alcohol-dependent individuals. As the study proceeded, those participants who attended more AA meetings had significantly greater reductions in their depression symptoms, along with less frequent and less intensive drinking.

“Some critics of AA have claimed that the organization’s emphasis on ‘powerlessness’ against alcohol use and the need to work on ‘character defects’ cultivates a pessimistic world view, but this suggests the opposite is true,” Kelly says. “AA is a complex social organization with many mechanisms of action that probably differ for different people and change over time. Most treatment programs refer patients to AA or similar 12-step groups, and now clinicians can tell patients that, along with supporting abstinence, attending meetings can help improve their mood. Who wouldn’t want that?”

Source:http://www.medicalnewstoday.com/articles/177607.php

Re: Take ideology out of decisions, by Keith Baldrey, In My Opinion, Burnaby NOW, May 7.
Mr. Baldrey makes a number of misleading statements about me and about opponents of Insite in general. I am the author of the “flawed and questionable report” criticizing the Insite evaluations that Mr. Baldrey referred to. Mr. Baldrey and other supporters of Insite and of harm reduction as the new way to deal with drugs seem to lack any real argument for Insite and its parent ideology – yes, ideology – so they attack the critics themselves. So please let me respond.
First, my report was not flawed or questionable. I am more than amply qualified to comment on printed research reports. In fact, any grad student would see the flawed assumptions and conclusions made in the Insite evaluations, regardless of what journal they were published in. I have worked in the addictions field in B.C. and in Canada for almost 30 years, and, until I disagreed with harm reduction, I was well respected by the people who now attack me merely for expressing professional concerns about the direction drug policy was taking – downward.
Second, I did not write the report for a “prohibition group,” as Mr. Baldrey asserts. I wrote it for the Royal Canadian Mounted Police, a key stakeholder in Insite and in drug problems in Canada. They merely wanted a review by someone not ideologically wed to Insite. I stand behind the report and everything I said as true and valid based on reading the published Insite research.
I did not write the paper as director of research for the Drug Prevention Network of Canada, or for them. Incidentally, the Journal of Global Drug Policy and Practice, in which my article was published, is a scientific peer-reviewed journal. Public accusations otherwise should be made with caution.
Third, my paper was but one of three academic reports critical of Insite. Garth Davies, a colleague of Neil Boyd’s at Simon Fraser University, wrote one that was equally critical. A federal panel of experts recently released another, saying essentially the same things.
For example, drug overdose deaths have actually increased in Vancouver and in the Downtown Eastside since Insite was initiated. Insite may or may not be preventing up to one overdose death a year. This is fact.
But Mr. Baldrey refers to reports claiming overdoses have gone down. Somebody is indeed putting out misleading information, but it is not me or others concerned about Insite. It is Insite and its supporters. The fact is that Insite is not doing what it set out to do – reduce infections, prevent overdose deaths and reduce public disorder.
Nor is it demonstrating a unique ability to get people into treatment where they belong. It is drawing funds that could be used for more effective things and taking our attention from the real problems – drug use and addiction.
Mr. Baldrey refers to specific people as experts in harm reduction, etc. What he does not say is that these individuals, and many others involved with Insite, are avid proponents of legalizing drugs. I do not fault them or anyone else for holding this ideology, except when people use their positions or authority to unilaterally push it on the public or to lend credence to it by their names, when no such credence exists.
The fact that so many supporters of Insite and of harm reduction are so rabidly pushing it and skewing the facts even when flaws are identified, and that they disparage their opponents, tells me they are so caught up in ideology themselves that they can no longer be objective.
And as for “moralizing,” no one is moralizing here. The Insite test study did not meet its stated objectives. That is not moralizing.
But Mr. Baldrey seems to be saying that any “moralizing” is bad. The fact is “moralizing” is to some extent inevitable in any human discourse. We all have some moral reference point that underlies our ideas and choices at the deepest levels. Trying to entirely exorcize human debate of values – the outgrowth of our morality – is itself impossible.
Mr. Baldrey, you are very loose and misleading in your accusations. I could go on in pointing them out. But suffice it to say, throwing mud and attacking people is neither professional nor a sign of a noble cause.
It comes from an arrogant belief that anyone who disagrees with harm reduction or Insite is somehow stupid, misinformed or an ideologue. I am frankly embarrassed at how deeply this blind arrogance has gotten into otherwise intelligent people and at the utter lack of professionalism their attacks display.
Colin Mangham, PhD, is a Langley resident.
Source: Canada.com – Burnaby Now May 10th 2008

I have read with interest the article in “The Province” Newspaper from British Columbia dated February 16th, 2009 entitled “Huge Price Tag Leads to Call for Audit, and then the articles in the Ottawa Citizen recommended an injection site in Ottawa of Intravenous Drug users.
The newspaper investigated the cost of funding the “Downtown Eastside” in Vancouver dealing with providing housing and support for the residents. This is the first time such an investigation takes place and the result are staggering given the cost was approximately $360 million dollars per year. The article mentions that is cost approximately $ 1 million dollars a day with most of that for the roughly 5,000 disabled people in the community.
It further states that this spending continues to go unabated, with no one in control of the purse strings as conditions continue to deteriorate at street level.
Given these staggering statistics, I believe it would be a good time for the city of Ottawa to do a cost study of their homeless and addicted population to ascertain the cost before going forth with any other programs especially the recommendation for an injection site for intravenous drug users. It would be best practice to evaluate the pilot project in Vancouver when one reads Dr. Raymond R. Corrado’s and Dr. Irwin Cohen “Analysis of the Research Literature on INSITE: Vancouver’s Injection Site Summary”, and the Health Canada report on Vancouver’s Insite.
The stated Insite objectives were:
- Increasing access to health and addiction care;
- Reducting overdose fatalities;
- Reducing the transmission of blood borne viral infections like HIV and hepatitis C;
- Reducing other injection related infections such as skin abscesses; and
- Improving public order.
My question is, have they met their stated objective and if not should we not reconsider it’s effectiveness.
Dr. Carrado states:
“The pilot of a supervised injection site in Vancouver Downtown Eastside was established as a response to high rates of blood born disease (Hepatitis B, Hepatitis C and HIV/AIDS) and a large number of overdoses among intravenous drug users population”
Here are some of their findings:
Blood-borne diseases::
“Dr. Corrado states that there was a “GOOD LIKELIHOOD” that there was a reduction in the spread of blood-borne diseases since several of Insite clients stopped sharing syringes. However, he also underlines that due to the lack of direct measures of blood-borne diseases, it’s not possible to estimate the extent of the reduction.”
In the final report of Health Canada, the Expert Advisory Committees on Vancouver’s INSITE and other Supervised Injections Sites: What has been learned from research from Health Canada states:
Page 11
“There is no direct evidence that SIS’s reduce the spread of HIV infection, and the mathematical models used are based on assumption that may not be valid.
Baseline rates of needle sharing have not been reported for SIS users.
Self-reports of changes in needle sharing beyond the walls of SISs have been validated.
More objective evidence of sustained changes in risk behaviors and a comparison or control group study would be needed to confidently state that SISs have a significant impact on these behaviors.”
Dr. Carraro then states:
” Insite did achieve its objective of reducing the number of fatal drug overdoses. In fact, drug overdoses were minimized and deaths were avoided.”
The Health Canada report states:
Page 11
“There is no direct evidence that SIS influence overdose death rates and large scale and long term, case-controlled studies would be needed to show that SISs influence overdose death rates among those who use INSITE. Mathematical modeling is based on assumptions that may not be valid.”
The overdose rates increased in Vancouver since the Injection site opened it’s doors.
Dr. Irwin Cohen states in his report:
“Several limitations exist within the research and evaluation on supervised injection sites. There are methodological problems regarding outcome measures, as well as an overall lack of research rendering it difficult to compare supervised injection sites to other types of interventions ( i.e.: needle exchange programs and methadone treatment programs). Furthermore, the limitations also result in restricting comparisons of research findings form one study to another.
Health Canada study states the following with regards to limitations of research in the Cost-Effectiveness and Cost Benefit section on page 13 of report.
” While some longitudinal studies have been conducted, the results have yet to be published and may never be published given the overlapping design of the cohorts. Until these studies have been undertaken it will not be possible to show with any certainty that INSITE is cost-effective or to show that the economic benefits exceed the costs.
Mathematical models used to estimate benefit-cost ratios use estimates of the frequency of needle
sharing involving HIV positive and HIV negative injection drug users and estimates of HIV transmission rates have not been locally validated.
Mathematical models used to estimate benefit-cost ratios with respect to lives saves have incorporated an assumption about the economic value of the lives of injection drug users that has not been validated.”
In summary, on page 3 of the Health Canada report, Insite accounts for less than 5% of injections at the site. Many people have been referred to health and addiction care but have not been followed up to see how many have actually gone or how many have successfully recovered from their addiction? The report on page 11 states that Insite saves about one life a year as a result of intervening in overdose events, but overdose rates have increased in Vancouver. I’ve addressed the HIV/HepC results. In the area of Public order what they fail to mention is that the police presence was increased which could explain why there was no increase in crime and loitering. I do not feel that Insite has accomplished it’s stated objectives.
Given the above direct quotes from the Insite report and others, Ottawa should investigate if the site has met these objectives and if not then question the validity of the pilot project and should question whether it should follow suite based on these findings. The fact that it is costing $360 million dollars per year to manage the poorest postal code region in Canada without any improvement in the lifestyle of its residents should be audited and whatever change is required should be implemented without delay. The price tag speaks for itself.
Will Ottawa be next with these statistics given we are modeling Vancouver’s Downtown Eastside philosophy based on Harm Reduction as best practices.
Andre Bigras,
Drug Prevention Network of Canada.

As kids flood weed outlets, Ramon Cortines admits there’s no plan

Los Angeles City Hall is thrashing around as the City Council and mayor belatedly try to control a pot-shop explosion they ignited, which has spawned dozens of freewheeling weed emporiums near public schools. The Los Angeles school board’s response? Nada.

That’s what the Los Angeles Unified School District has done to stop kids from trekking a short distance from Fairfax, Hollywood and other high schools and middle schools to score buds at unregulated neighborhood pot shops that have opened, often in the same block as schools or very nearby.

The LAUSD school board and Superintendent Ramon Cortines have held no meetings about the impact on kids, have no idea how many children are turning to the flood of easy weed, have not tried to assess the money the dispensaries are making off healthy kids, and have not trained faculty and administrators in how to deal with ever-younger stoned students.

Now, following routine questions from L.A. Weekly, some school board members are pledging to deal with it.

The lack of interest from LAUSD’s top officials seems unlikely to help the district — already hammered by high dropout rates and intense competition from charter schools — to win back parents. Scott McNeely, of the Pico Neighborhood Council, complained to the City Council last summer when he heard about 17 dispensaries within a mile and a half of his home, three near elementary schools. “It’s a little discomforting when parents try to walk their kids to and from school and the kids smell marijuana smoke in the air,” he says. “It’s long past time for the LAUSD to weigh in on this issue and pressure the City Council, work with the City Council, just as we are doing. … The school board needs to raise a little hell.”

Some school board members believe the weed-and-kids situation is out of control. “After school you can see students stopping at the dispensary before going home,” says school board member Tamar Galatzan. “That’s unacceptable.”

The first sign that kids were being affected by the medical-pot explosion — and even directly targeted — arose at Grant High School in Van Nuys. It was the end of summer 2006 and time, apparently, to get back to the San Fernando Valley’s version of the three R’s: reading, writing and rolling joints.

On August 10 of that year, Van Nuys police found that a nearby marijuana dispensary, Pacific Support Services, had left fliers on cars in the Grant High School student parking lot. The fliers were emblazoned with the iconic, three-leaf marijuana bud, and underneath was a friendly message:

“It is still legal to own, grow and smoke marijuana as long as you do it properly. Qualification is simple and our experienced physicians are more than happy to help you,” it informed students, who probably had no idea California law gives seriously ill patients the right to smoke pot if they merely obtain a doctor’s verbal recommendation.

The flier language was directly aimed at those who might be tempted to spend their burgers-and-fries money: “$15 off with this flier. … If you do not qualify for a recommendation your visit is free.”

In other cities, the targeting of an academically struggling school like Grant High and its mostly minority, mostly working-class students, which resulted in a Los Angeles Daily News story, might have prompted school leaders to act. But it just floated right over the heads of the seven LAUSD board members.

“We had so many other things going on that I guess we just plain missed it,” says school board member Marguerite LaMotte, who represents much of South Los Angeles. “I can’t speak for the rest of the board but myself, I was more worried about the gangs, the liquor stores and all the other problems in my district. … There’s so much going on in my district.”

Since then, neither the school board nor Cortines has done anything — no new policies, rules or special teacher or principal training — to protect children from unregulated pot dispensaries.

Mayor Antonio Villaraigosa and the City Council today have no idea how many pot stores exist, where they are, where they are getting their pot, who is financing them or where the huge profits are going. The exact number of stores in L.A. is a highly fluid calculation, with dispensaries opening and closing daily and dozens filling out paperwork but never switching on the lights. On paper, there are more than 1,000; hundreds are believed to be actually operating.

An analysis by the Los Angeles Times showed that at least 240 of the 1,000 dispensaries are within 1,000 feet of a school, park or library. Teenagers can be seen heading into them after school lets out in Hollywood, Fairfax, Northridge, the San Fernando Valley, Wilshire District and other areas.

According to both police and residents, many medicinal-marijuana shops are covertly targeting healthy kids as young as 14 through street contacts who urge students to “get your card.”

Yet the City Council and school board have yet to open a meaningful dialogue. “On issues that impact LAUSD, there’s been a lack of formal or even informal communication and coordination between the [City] Council and the school board,” says board member Galatzan. “This is the latest manifestation of that problem.”

Galatzan, an attorney who works for the L.A. City Attorney’s Office dealing with street-level crime, supports a tough ordinance proposed by her boss, City Attorney Carmen Trutanich, which among other things would ban dispensaries within 1,000 feet of a school.

The Los Angeles City Council failed for years to adopt state-required local medical-marijuana regulations that other cities, including San Francisco, Oakland and Berkeley, long ago debated and approved.

Those three politically liberal cities cracked down on pot profiteers while adopting rules that allow the ill to easily obtain weed. The City Council here, gridlocked and unable to decide what to do, instead adopted a series of moratoriums — and then missed the state’s legal deadline for acting. Now the council is unhappy with Trutanich’s plan, and is looking at its options once again.

At the time of the Grant High incident, Los Angeles dispensaries had mushroomed from just four in 2005 to dozens in 2006. That was before the great medical-bud flood of the last 18 months.

LaMotte and recently elected school board member Steve Zimmer say they too support a 1,000-foot restriction. Zimmer, however, says his is a narrow endorsement of that one provision. He has problems with the rest of Trutanich’s ordinance, which bans the selling of pot over the counter and profiting from it. Zimmer particularly objects to calls to shut down the existing pot stores.

“I support the 1,000-feet restriction because I believe in creating ‘safe passages’ for our students to travel to and from school,” Zimmer says. “But I also support medical marijuana, and I think Trutanich and [Steve] Cooley are focused too much on suppression and not enough on harm reduction.”

Zimmer insists, “They won’t get one student to stop smoking weed by shutting down the dispensaries.”

Frank Sheftel, an advocate of the medical-marijuana movement and co-founder of the Toluca Lake Collective, a medicinal-pot outlet, favors a restriction of 600 feet, as with liquor stores and pharmacies. “Why create a different set of standards for this industry?” he asks.

But Galatzan notes that pharmacies require written physician prescriptions — not verbal recommendations, as with medical pot — and are so heavily regulated that no L.A. schoolchildren can score drugs at pharmacies. Moreover, liquor stores operate under strict laws forcing them to check age and I.D. Pot stores “are totally different from liquor stores, where kids are not allowed, because minors are [being] allowed into dispensaries,” Galatzan says.

David Berger, a special assistant to Trutanich, tells the Weekly that at least two police investigations are under way involving students and medical marijuana. One stems from a community complaint about a dispensary whose “stoned people” hang out next to a Lexington Avenue elementary school. The other is in Venice, where a pot store opened directly across from one public school and down the block from another. Berger says, “LAPD is documenting all this stuff for us now.”

Source:paulteetor@verizon.net. 5th Nov. 2009

This study was designed to document knowledge about Kuwaiti drug users and to investigate whether or not there is an association between their poor self-concept and high level of anxiety. One hundred and seven incarcerated drug users, 107 individuals serving prison terms for offenses other than drug use, and 107 “normal” individuals were included in this pilot study. The Arabic version of Rosenberg’s Self-Esteem Scale and Spielberger’s State-Trait Anxiety Inventory were used to measure the subjects’ self-esteem and state-trait anxiety, respectively. The results documented revealed that there is a relationship between levels of self-esteem and anxiety in Kuwaiti drug user behavior.

Source: Substance Use & Misuse 1996, Vol. 31, No. 7, Pages 937-943

A ground-breaking report into the use of the stimulant MDMA has revealed it claimed 82 Australians over five years from 2000 – and the number fatalities is increasing.
The National Drug and Alcohol Research Centre’s study into MDMA-related deaths is the most comprehensive examination to date, and has prompted calls for more research. Last year, Perth teenager Gemma Thoms collapsed at the Big Day Out and died in hospital. She swallowed three ecstasy pills at the festival gates to avoid being caught by police.
Her mum, Peta, is planning to hand out leaflets at today’s Big Day Out warning revellers about the dangers. Concert organisers had promised to design and print flyers for all the 40,000 people expected to attend the festival.
Additional figures obtained by The Sunday Times this week show 23 people died as a result of taking ecstasy in Australia from 2006 to 2008. There could be more, with a number of cases still under investigation. Of those, 10 deaths were reported in 2006, seven in 2007 and six in 2008, with 65 per cent of victims aged 20-29 and more than 70 per cent male.
More than 80 per cent of the deaths were unintentional and 15 of the 23 victims took other drugs with the MDMA, including cannabis or alcohol. In the earlier cases examined by the National Drug and Alcohol Research Centre, 91 per cent of the deaths were directly caused by drug toxicity and MDMA was the sole drug involved in a quarter of cases.
It also contributed to a number of drownings, cardiovascular problems and car crashes. Last week, The Sunday Times revealed that ecstasy had never been cheaper in Perth, with the street price dropping for the first time last year.
A survey by the National Drug Research Institute also found that young users were taking the party drug more often and in bigger quantities. The number who binged on the drug rose from 22 per cent in 2008, to 40 per cent in 2009.
Funded by the Federal Department of Health and Ageing, a separate National Drug and Alcohol Research Centre report found the median age of ecstasy fatalities was 26, with the youngest victim 17 and the oldest 58.
“There are a lot of accidental deaths where MDMA is thought to have played a role . . . and this seems to be a more prominent and prevalent concern,” the centre’s assistant director Louisa Degenhardt said. “A lot of bad things can happen when combining drugs because accidents happen when people are intoxicated with any drug.”
Royal Perth Hospital emergency 2medicine specialist Daniel Fatovich warned that cheaper prices meant more West Australians could afford more pills, increasing the risk of overdoses.

Source www.perthnow.com.au January 30, 2010

Cannabis use among Britain’s young offenders is “out of control”, up by 75 per cent in some areas and fuelling a crime epidemic, with youngsters stealing to fund their addictions, according to two studies.

A national survey of Youth Offending Teams indicates that two-thirds of them have seen an increase in cannabis use of between 25 per cent and 75 per cent since David Blunkett, the then Home Secretary, downgraded the drug to class C in 2004. Some 90 per cent of all young offenders are using cannabis in some areas, a far greater proportion than the general youth population.

Research carried out by King’s College London has indicated that 25 per cent of young offenders in Sheffield have turned to crime to fund their habit. This contrasts with previous government research which said that “cannabis use was unlikely to motivate crime”.

A rise in young people smoking cannabis openly has led to a rise in the fear of crime in the community, leading Sheffield’s police chief to warn of the threat that cannabis poses to the “fabric of society”.

Fifty out of 51 of the youth courts in England and Wales are so alarmed that they have written to Jacqui Smith, the Home Secretary, urging an upgrading of cannabis back to class B. Within a month of Gordon Brown taking over as Prime Minister in June, Ms Smith signalled a review of the controversial decision to downgrade cannabis amid growing fears of the serious mental health implications of stronger varieties of the drug, first highlighted in the IoS in March. A detailed review in The Lancet concluded that the drug increases the risk of psychosis by 40 per cent – and younger users are most at risk.

But Mr Blunkett’s decision to reclassify the drug three years ago has had another, more sinister impact, with organised crime taking a much more active role in the production and distribution of cannabis.
Detectives say that the changing nature of cannabis – as imported cannabis gives way to the much more damaging skunk variety, grown in this country – has also played into the hands of criminals. Drugs experts and police also say that Britain for the first time is an exporter of the drug.

John House, the Chief Superintendent of South Yorkshire Police, said:
“Cannabis production in this country is rising exponentially. We used to be a net importer of cannabis from places like Morocco, but there are indications that we are now starting to export cannabis.”

Youth Offending Teams said that since reclassification dealers were finding it easier to convince young people to try what they now wrongly regarded as a relatively harmless drug. Nationwide, YOTs deal with 10,000 youngsters up to the age of 17 who come before the courts, but whose punishment falls short of being sent to a secure unit.

Darren Johnson, the secretary of the Association of Youth Offending Team Managers, said that cannabis consumption was “out of control” in some areas, with nine in every 10 youth offenders reporting that they used the drug.

Overall, official figures suggest cannabis use is stable, but that masks a very different picture among the most vulnerable youngsters in society, say experts. Lord Ramsbotham, the former chief inspector of prisons, said: “Downgrading cannabis was a mistake because it made it out to be less dangerous than it is. Adult minds and adolescent minds are different and young people must not play games with this stuff. ”

Ch Supt House, who commissioned the King’s College research, said: “The reclassification of cannabis was a decision taken based on a different drug. It wasn’t taken bearing in mind the strength of new cannabis, or the potential damage to social fabric caused by open cannabis smoking in the street by those who don’t perceive it as a serious crime.”

The number of cannabis factories closed down by the Metropolitan Police has more than doubled in the past two years as organised gangs invest more in cannabis production. In March, the charity DrugScope revealed that, on average, UK police were raiding three cannabis farms a day with 400 plants regularly recovered at raids. Around two-thirds to three-quarters of UK cannabis farms are now run by Vietnamese criminal gangs.

Tim Hollis, the Chief Constable of Humberside, and chairman of the Association of Chief Police Officers drugs committee, said: “A large number of police forces are increasingly coming across cannabis factories, where there is significant investment by criminals in the infrastructure to produce cannabis in considerable quantities. There is increasing evidence of the scale and the geographic spread. This isn’t just happening in urban areas, now we are finding them in the more traditional, rural areas.”

Growing new strains of cannabis under ultra-violet lights, dealers are producing stronger varieties such as skunk, linked with the massive rise in cannabis-related hospital admissions and addictions among young people. These have triggered the current government review by the Advisory Council on the Misuse of Drugs into whether cannabis should revert to being a class B drug. The Home Secretary will announce her decision next April – and experts are divided, with many believing the most pressing issue is one of mental health provision rather than primarily an issue of criminality.

Professor Sue Bailey, a forensic psychiatrist who works with young offenders with mental health problems, said: “From my own experience in clinical practice over the last three years I can say cannabis use has increased, the amounts young people are smoking have increased but the most critical factor is that they seem to be starting younger.”

Emma Warren, a mentor at Live, a magazine produced by young people in south London where half of the youngsters are referred by agencies such as YOTs and the Probation Service, said: “Cannabis is seen as very everyday, it is normalised, even more so than in previous generations.
While most people who smoke do so recreationally, the ones that do fall, fall harder now than they did before.” Mann-Ray, a 19-year-old photographer with Live, has never used cannabis but sees it as a part of everyday life. He said: “Everybody smokes now, even sensible people. They think it’s not a big deal, that it’s as harmless as air. In the past people used to hide it, but now they are really open, even at college.”

This worrying trend continues, according to Clare McNeil, spokeswoman for Addaction, a drug treatment charity: “Over half the young people we work with are being seen due to cannabis use and a quarter of these are using skunk – a proportion that is growing. Cannabis is seen by young people as a ‘safe’ drug and many young people will smoke skunk in the same way as they drink lager. Whether cannabis is class B or C doesn’t make any difference to the young people we work with, many of whom actually think the drug is legal.”

Rethink, the mental health charity, is calling for young people to be educated on the dangers of the drug after its research found that around half of young people think cannabis is safer than alcohol and a quarter say that it is better for you than coffee.

“Jacqui Smith should use the current review to deliver the ‘massive’
public education campaign which Charles Clarke promised in 2005,” says Jane Harris, the head of campaigns at Rethink. “This is the key task, which we should all focus on instead of fiddling with the classification system.”

And Darren Johnson, spokesman for YOT managers, said: “The main impact of reclassification would not necessarily be a change in use but rather a change in the police approach to it, namely the police would arrest more young people, thus bringing more into the criminal justice system.” Police or politicians alone will not be able to solve the problem, says Chief Constable Hollis: “Young people do not make choices based on the classification of drugs… we need to think about how we communicate with them to make better-informed choices, which is quite a challenge, but I think it needs some real humility and for us to be honest with ourselves. Clearly the police have a role to play… but anyone who thinks a police officer or a politician in a grey suit can stand up and say, ‘Don’t do this, children, because…’ and thinks that will have a huge impact is naive.”

Source: http://news.independent.co.uk/uk/crime/article2966955.ece 16.09.2007

THOUSANDS of pounds is being paid out in compensation to drug addict prisoners being forced to go cold turkey in Welsh jails, a Wales on Sunday investigation has revealed.
While many victims of crime receive paltry sums in compensation after the turmoil they have been through, the Prison Service is being forced to pay out to jailbirds having to go without drugs. It followed claims the practice amounts to assault and a breach of human rights.
Almost £11,500 was paid out to three drug addicts in Cardiff and Parc prisons in the past year alone.The sum paid to addicts was part of more than £50,000 paid out in compensation to prisoners in Welsh jails last year for a number of reasons.
The Ministry of Justice said they had to settle a number of compensation claims for prisoners due to “the way they went through detox”. But the payouts have been fiercely criticised, with one MP describing it as “a lose-lose situation for the taxpayer”.
The settlements originate from a test case two years ago when six claimants from across Wales and England were given the green light to sue the Home Office They said once in jail, and under the responsibility of the Prison Service in England and Wales, they were made to go cold turkey – where drugs are withdrawn or cut short.
Our probe comes amid increasing evidence convicts are exploiting human rights laws to make a profit from their time in jail. The figures were finally released after Wales on Sunday complained to the National Offender Management Service following seven months of heel-dragging by officials.
Conservative MP David Davies said: “Not only are they getting compensation, they are being funded by the taxpayer to put these claims in. It’s a lose-lose situation for the taxpayer. “Cold turkey is not all it’s cracked up to be. People seem to have got their ideas from Trainspotting.
“Actually, most informed medical opinion says taking alcohol away from an alcoholic can be a far more difficult experience for them. “I’ve got no sympathy for them, I’m afraid. Nobody forces them to get into crack in the first place.”
Peter Stoker, Director of the National Drug Prevention Alliance, said he thought lawyers were taking advantage of the system and big changes needed to be made. Prisoners should “absolutely” not be able to get drugs in jail, he added. He said: “They’ve been put up to it. There are a lot of liberal lawyers and organisations around and this is the kind of thing that they will come up with.
“My gut feeling is like a lot of people’s gut feeling, that I think there has to be a question as to what extent somebody who is convicted has foregone many of their human rights by committing the crimes they did in the first place. “I don’t think there’s anything wrong with trying to wean prisoners off drugs as soon as possible. “I find it as wacky as the general public do. All I can say is I think it’s now generating enough concern that it’s time the Government and the Prison Service looked at it again.”
But the charity Drugscope defended the practice, saying the Prison Service had a “duty of care” to prisoners with a drug addiction. Chief Executive Martin Barnes said: “It is clearly established in law that prisoners are entitled to the same standard of health care that they would receive in the community; the medical care received by claimants under the original action had fallen well below acceptable standards. After seeking legal advice, the Home Office accepted full liability in all the cases. “It is clear, however, that short, sharp, enforced detoxification is still the experience for many entering prison, even for those who were in receipt of a prescribed substitute drug such as methadone prior to custody. “Not only can enforced detoxification be extremely unpleasant, it does not mean that someone will remain free of drugs or their dependency.”
The Ministry of Justice said: “Each compensation claim received by the Prison Service is treated on its individual merits. Legal advice is sought and, on the basis of that advice, a decision is made on whether or not the claim should be defended. “We cannot therefore comment on individual cases or the reasons that they were settled, as the terms of each settlement vary and may be subject to confidentiality clauses.”
Source: Wales On Sunday : Jan 20 2008

An angry row has blown up over proposals to upgrade cannabis to a class B drug, with leading experts from the Advisory Council on the Misuse of Drugs (ACMD) accusing the Government of a “deliberate leak” of its plans.
Ignoring a directive not to speak to journalists about reports that the Government has already made its mind up, ACMD member Professor Les Iversen, a pharmacologist at Oxford University, said: “I was not pleased to read what appears to be a deliberate leak about the government’s alleged intention to reclassify, regardless of advice received.
“If ACMD were to recommend no change and this were to happen, I believe it would be the first time that any Home Secretary acted against the recommendations offered and it would call into question the whole function and future of this group.”
The outburst followed claims that Gordon Brown and the Home Secretary, Jacqui Smith, were determined to reverse the decision to downgrade the drug to class C when the ACMD completes its report in the next few months. Although its recommendations are not yet known, ministers are already making clear that Ms Smith is prepared to overrule the expert body.
But one former member of the influential council last night claimed the ACMD was totally opposed to the Government’s stance. “There is no way that the ACMD would support any reclassification of cannabis, unless there were some political shenanigans going on,” said the Reverend Martin Blakeborough.
Rev Blakeborough, who runs the Kaleidoscope drug abuse charity, said: “There is no significantly new evidence to suggest that cannabis is any more harmful than in the last review we did 18 months ago.”
“The only reason that the ACMD is being forced to discuss this matter is because every new Home Secretary seems to want to show how tough they are,” he added.
Professor David Nutt, chair of the ACMD’s technical committee, which will start taking evidence on classification at a public meeting next month, said: “In the end, as with all laws, it’s a political decision – the ACMD only advises.”
But David Raynes, of the National Drug Prevention Alliance, criticised the ACMD’s stance and said that it was dominated by people who advocate “harm reduction” and whose sympathies lie with pro-legalisation campaigners: “I actually think that the harm reduction/liberalisation/legalisation lobby is too strong in there (and in the Home Office). Some ACMD members are genuine but misguided, some are just the great and good with little understanding of the legalisation game that is being played by others.”
The controversy comes days after new figures revealed that almost 500 people are being treated by the NHS every week for cannabis-related mental health problems. Since the Government downgraded it from a class B to a class C drug in 2004, the number of adults being treated for its effects has risen from 11,057 in 2004-05 to 16,685 in 2006-07. Also, the number of children needing medical attention because of cannabis use has increased to more than 9,200 – up from 8,014 in 2005-06.
Fears over the hidden health risks of the drug, particularly on the mental health of young people, have prompted the calls for a review of cannabis. More than 2.5 million 16-24 year-olds have used the drug. The ACMD is expected to make its own recommendations known in April.
In a statement, a Home Office spokesman reiterated that the ACMD’s role is confined to providing “advice on classification”.

Source: The Independent on Sunday. 20th January 2008

Gun crime has risen by four per cent, according to government statistics Drug offences have leapt by 21 per cent in just one year, latest figures showed yesterday, piling more pressure on Gordon Brown to reverse the Government’s “softly-softly” stance on cannabis.

The number of drugs crimes recorded by police has now leapt by more than 60 per cent in the three years since Labour relaxed the law on cannabis possession – downgrading it from Class B to Class C so that most users no longer face arrest. Home Office crime figures also show burglary rising by five per cent year-on-year – reversing a long term fall – and a significant four per cent rise in gun crime.

Overall crime levels were unchanged over the year, according to the figures, while there were slight falls in violent crime and car thefts.

Those successes were marred, however, by the huge rise in drug crime which soared to 55,700 in the three months to September last year – up by more than a fifth on the previous year and equivalent to more than 600 people every day caught dealing or possessing drugs.

Critics claimed the sharp rise was further evidence that former Home Secretary David Blunkett’s decision to relaxing the law on cannabis was a serious blunder. At the time of the controversial reclassification in 2004, the police counted 34,600 drugs offences between July and September, and since then the figure has climbed steadily to the present peak of almost 56,000.

The Home Office argues that the trend is due to police officers being more willing to hand out on-the-spot official cautions to cannabis users, without facing the paperwork and red-tape connected with arresting and prosecuting them. But critics claim that argument no longer explains the continuing trend three years after the law was relaxed.

Gordon Brown is currently weighing up whether to reverse David Blunkett’s move and to toughen the law by restoring cannabis to Class B. Chief police officers, magistrates and a range of medical experts have backed the move, and ministers are now waiting for the latest report from the Advisory Council on the Misuse of Drugs in the coming weeks.

The Advisory Council on the Misuse of Drugs will offer its latest report within the next few weeks. Pressure has grown for a change following further evidence of the serious mental health damage which cannabis users are facing as highly potent “skunk” varieties have become more popular – now accounting for
75 per cent of all drugs seized.

In some parts of the country the number of diagnosed mental disorders blamed on cannabis use have risen tenfold over the past decade, and the number of people undergoing treatment for cannabis use has soared to a record 25,000.

Yesterday’s figures also reveal a five per cent year-on-year rise in domestic burglary, as measured by the British Crime Survey, based on household interviews – which ministers claim gives the most accurate picture of crime trends.

Police recorded 67,000 break-ins from July to September – equivalent to
728 per day, or one every two minutes. The increase in BCS figures brings to an end a long-term decline in burglary levels, and will raise fears that increased drug use is driving a resurgence in thefts from homes.

The BCS results showed overall crime levels were stable, as were levels of violent crime and vehicle thefts. Shadow home secretary David Davis said: “These latest official figures show that Labour is failing to combat both violent crime and its causes.

“Violent crime is fuelled by drugs and Labour’s chaotic and confused policy on drugs. “Drugs wreck lives, destroy communities and are a major symptom of our broken society.

“The Government’s complacency shows they are part of the problem, not the solution.” Liberal Democrat home affairs spokesman Chris Huhne said: “Violent crime – including, most alarmingly, gun crime – is still far higher than 10 years ago and has to be tackled much more vigorously.

“Police should be devoting more time to stop and searches for knives and guns, and the Government needs to clamp down with a major new effort to stop gun smuggling.

“Nine times more officials are allocated to tackling cigarette smuggling than gun smuggling, which is a crazy set of priorities.” Home Secretary Jacqui Smith said: “These latest crime figures contain some excellent results and I am particularly pleased that the risk of being a victim of crime is now at a historically low level.”

Source: Daily Mail 24 Jan 2008

The UK has third highest teenage cannabis use in OECD. A report by UNICEF into child poverty in 21 industrialised countries found that the UK was third highest in terms of the proportion of 11, 13 and 15 year- olds who said they had taken cannabis in the last 12 months. The percentage of children who had used cannabis was 35 per cent in the UK, compared to 27 per cent in France, 18 per cent in Germany and less than 5 per cent in Sweden and Greece (UNICEF, An Overview of Child Well-Being in Rich Countries, 14 February 2007, Figure 5.2c).

• Increase in Class A drug use. The number of people using Class A drugs in the last year has gone up by a quarter, from 2.7 per cent in 1998 to 3.4 per cent in 2006-07(Home Office, Drug Misuse Declared: Findings from the 2006/07 British Crime Survey, October 2007).
Drug offences increased. Total recorded drugs offences have increased from 135,945 in 1998-99 to 194,502 in 2006-07, an increase of 43 per cent (Home Office, Crime in England and Wales 2006/07, July 2007).

Source: Keith Girling News Blog. 24th January 2008

Pushers caught with up to £100,000 of cocaine or heroin face downgraded sentences.

Mark Macaskill
DRUG dealers caught with heroin and cocaine worth up to £100,000 could be jailed for as little as 15 months under new guidelines issued by the Crown Office. Senior prosecutors have been ordered to ignore existing rules that state anyone caught with Class A drugs worth £20,000 or more should appear in the High Court, which can impose a maximum life sentence.
Now dealers caught with hauls worth up to £100,000 will appear before sheriff courts that can only hand out a maximum five-year jail term. It means that offenders – who in Scotland are eligible for release after serving a quarter of their sentence – could be back on the streets after 15 months behind bars.
The move is aimed at reducing the workload on the country’s High Courts, many of which are struggling to cope with a rising tide of crime. However, it has provoked anger among senior police officers, prosecutors and drugs campaigners who have accused the Crown Office of downgrading the offence to save money.
According to government figures published last year, heroin seizures in Scotland in 2005 rose by 27% on the previous year from 2,224 to 2,816, while cocaine hauls increased by 23% from 709 to 870 over the same period.
“The public will be getting more and more concerned that we are heading towards a soft touch Scotland,” said Bill Aitken, justice spokesman for the Scottish Conservatives. “I would be deeply concerned at anything that sends out a signal that drug trafficking is in any way seen as a second-class crime.”
Alistair Ramsay, chairman of Drugwise, the Glasgow-based drugs advice service, said: “You have to be horrified that these kinds of sentences are being used to save money and time. “If courts take a more lenient line, the message is clear that society, particularly in Scotland, is becoming more tolerant of drugs. That is the wrong message.”
A senior police officer, who asked not to be named, added: “My concern is that £100,000 is a lot of drugs – the equivalent of about 1Åkg of heroin. People have to be punished in relation to the quantity of drugs they are smuggling. This isn’t much of a deterrent.” There are already signs that the new guidelines are being implemented. Last week, a man who had pleaded guilty to smuggling £50,000 worth of heroin from Liverpool destined for Aberdeen, appeared at Dundee sheriff court.
The case was originally marked by the procurator fiscal for the High Court but, the decision was overruled by the Crown. He is expected to be sentenced next month. Last week, the Crown Office insisted that drugs offences were still viewed seriously and would be treated as such.
“We have a duty to review our prosecution policy on which court should hear a particular case,” it said.

Source: The Sunday Times April 20, 2008

“There are few substances which are surrounded by more controversy, and which have at the same time such important and potentially far-reaching public health implications”, the late Professor Henry wrote.
The ACMD, the body tasked to adjudicate the evidence on cannabis, never shared this view and as a result fell foul of the debate. It has taken the sacking of Professor Nutt, the brouhaha and the publicity surrounding it, to pull attention back to the science on cannabis effects; science that he and the ACMD were so slow to assess, so little interested in and so quick to dismiss.
Last week the BBC’s The Report programme asked the question of why on earth the ACMD recommended cannabis’ downgrading in the first place. Labour MP Gwyn Prosser explained. For those arguing in favour, in the pro-liberalism political climate of David Blunket’s accession to the Home Office, “it was all but a done deal, they were pushing at an open door ….” The ACMD was party to that process.
Its first cannabis report (the only one that the ACMD Chair ‘had pleasure in enclosing’ to the Home Secretary), which recommended reclassification to C, was just 22 pages long. As a review of the classification of cannabis preparations, ‘in light of the current scientific evidence’, it was nominal and cursory. It drew not at all on the “large scientific literature on the effects of cannabis on human health and human society” available at the time. Its recommendation was based on drugs use prevalence statistics, speculations about and reports on decriminalisation regimes. Of the 24 references listed, only 4 referred to the scientific literature on effects. Yet when Mary Brett, a biologist and former grammar school head of health education, surveyed it for herself, she found no less than 44 pre 2002 scientific publications on the negative impact of cannabis; evidence of psychosis in cannabis users dating back to 1972. The review skated over the evidence and paid lip service to cannabis harms alone.
Professor Robin Murray’s new research on the causal link between cannabis and schizophrenia was published eight months afterwards. In 2005 Charles Clarke not unreasonably requested the ACMD to examine all the evidence relating to mental health; he directed them to the changed content of cannabis; forensic lab data was already showing that consumption had shifted from imported resin to home grown herb with a much higher THC content and a dangerously altered THC/CBD ratio – ’skunk’ which had become a rite of passage for ever younger teenagers.
The ACMD were quick to express their misgivings. Politicians were ‘pandering to the media’ said Lord Adebowale, a non-scientist ACMD member. He was not convinced there was fresh evidence. Sir Michael Rawlins (then Chairman) also seemed to have closed his mind. At a conference in the April of that year he confirmed he would not be ‘confused’ by the new data. True to his word only 5 pages of the 36 page response dealt with the massive output on the effects of cannabis on mental health, described as a ‘biologically fraught hypothesis’. Cannabis could lead to short lived panic attacks and worsen the symptoms of schizophrenia, it conceded. It could ameliorate them too. It was not a necessary, nor a sufficient, cause for the development of schizophrenia. The evidence for consumption of more potent cannabis was lacking. That was the medicine doled out to the Home Secretary. He took it.
So when Jacqui Smith asked them to look at the evidence again the ACMD were visibly affronted. Sir Michael Rawlins made his discontent public, the 10 minutes slot for cannabis on the agenda collapsed to two. He devoted them to grumbling – saying that he wished they had not been asked. One (non scientific) Council member said afterwards he had no intention of ploughing through the evidence again.
In the meantime the ACMD’s deputy chair had already queered the pitch for a dispassionate review. In full media glare Professor David Nutt had published an article in the Lancet in which he set out to demonstrate, through delphically derived but incomplete polling, a new classification of harms in which alcohol and tobacco emerged more harmful than cannabis and ecstasy. His intention was clear – to invalidate the distinction between licit and illicit substances.
What he ignored (or perhaps pandered to) was the fact that while the excess mortality and healthcare costs associated with the use of tobacco and alcohol are well known, those for cannabis remain largely unknown. He took the lack of comparable definitive evidence on cannabis concerning the population as a lack of evidence of its harm for either individuals or society.
At 56 pages long, the ACMD’s final report referred to more scientific papers than before. But if a precautionary principle was applied it was to the data itself, not to its implications or to their classification recommendation. So cautious were they that they completely ignored the key published British longitudinal data on cannabis use and schizophrenia. They relied instead on a GP data base survey they decided to commission from one of their own members
The analysis they so bizarrely ‘ostracized’ was of a South East London longitudinal cohort covering the period between 1966 and 99 which uniquely allowed for the examination of trends in cannabis use prior to first presentation with schizophrenia. It demonstrated a continuous and statistically significant rise in the incidence of schizophrenia between 1965 and 1997, one which had doubled over the last 3 decades, with the greatest increase in people under 35. It suggested that up to 20% of schizophrenia cases could be cannabis attributable.
The ACMD’s decision to rely exclusively on a survey of its own commissioning which did not specifically look at cannabis use was curious. Presented by one of its own members, Professor Ilana Crome, as unpublished evidence, she reported the annual incidence of diagnosed schizophrenia and psychoses had fallen between 1996 and 2005. Professor Murray dismissed this as invalid: “I have known about this study since its inception and advised the authors that they were unlikely to be able to come up with meaningful results. Firstly, a major problem concerns the diagnoses. In my experience GP diagnoses of psychiatric disorders are not very accurate. Secondly, we do not know how many cases of psychosis are dealt with exclusively by psychiatrists and GPs don’t know.”
His contention is that there is no significant or well done study that has not shown early onset of cannabis use to be associated with psychosis. Since 2002 he points to no less than eight cohort studies all of which show the risk of psychosis to be higher in those that smoke cannabis – a risk that increases by 6 to 7 times for heavy smokers, risks that for adolescents are disturbingly high and that show early users run into greatest problems. Starting by 15 the risk is 4 times higher than starting at 18 – a data trend which suggests the risk multiplies for each year younger.
Yet the ACMD remained adamant that these studies did not meet their bar of ‘proof beyond reasonable doubt’ and that more research was required. Others scientists begged to differ saying the persistent association was robust to methodological challenges.
Whether recently published findings which confirm that THC induces a transient, acute psychotic reaction in psychiatrically well individuals would have persuaded them, is anyone’s guess. Meanwhile the ‘Cannabis Dependency Units’ as psychiatrists describe their first contact schizophrenia wards, continue to take their toll. And while Holland finds its three dedicated residential rehabs for their severest adolescent (13 – 20) cannabis dependents to be insufficient and is building more, to create 600 places, we, in the UK, have none. We leave our stoned and de-motivated youngsters on the streets. For that we can thank the ACMD’s lassitude.
Source: by Kathy Gyngell, UK Centre for Policy Studies 29th November 2009

This month, the National Treatment Agency published the staggering figure of nearly 25,000 young people under 18 getting “treatment” for their drugs and alcohol problems.[1] 10 years ago, the thought of so many young teenagers using drugs to this degree was unimaginable, writes Kathy Gyngell, chair of the Prisons and Addiction forum at the Centre for Policy Studies.
The sad fact is that, despite 10 years of a drug strategy purportedly designed to reduce use by young people, there are thousands of children beginning their lives so damaged by drugs that they need treatment. This is major social problem that can neither be denied nor brushed under the carpet. What teenagers do today determines the scale of the drugs problem tomorrow.
National school-age statistics show that a staggering 25% of UK children (aged 11–15) have tried drugs and that 10% of them use drugs regularly.[3] This is way higher than the European average. It is also likely that levels of teenage cannabis use are higher than the published statistics, as the Advisory Council on the Misuse of Drugs recently acknowledged.
Hospital admissions reflect the rising strength of cannabis and that children are moving earlier to Class A drugs. With the UK cannabis market dominated by high-THC skunk – which, according to a former head of the Dutch Police Narcotics Division, should now count as a ‘hard drug’ – what we are witnessing is an earlier and disturbing shift to hard drug use.
When drugs services and drugs advisors have no more urgent need than to highlight “the problems faced by young people when they reach 18 and are no longer eligible for specialist services” and “to ease their transition to adult services”, the outlook is dire indeed.
The NTA’s tables reveal that 1,600 teenagers are receiving “treatment” for heroin, cocaine and crack addiction. They reveal that 29%, some 6,000 in all of those in treatment, receive‘harm reduction’ interventions – usually understood to be a euphemism for prescribing an opiate substitute like methadone. As Professor Neil McKeganey, a leading expert in drugs misuse, said: “The idea of starting someone under 18 on a methadone prescription with an implicit expectation that they may be on that drug for the next 10 or more years is appalling. We need services to think beyond the chemical”.[6]
ONLY ONE REHAB FOR CHILDREN IN THE UK
The desperate fact though, is that there is still only one small dedicated residential rehabilitation centre [Middlegate Lodge] with statutory funding for no more than 12 children/teenagers at a time in the country.
Last year, Mike Trace, Chief Executive of the Rehabilitation of Addicted Prisoners trust, spoke of the urgent need for residential treatment for young, under 18, addicts.[7] Young addicts, he said, were unlikely to get better within the environment they had grown up and that had fed their problems.
How much of the National Treatment Agency’s dedicated funding of £25 million is spent on this?
How many teenagers are emerging drug free from their encounters with services?
It is simply not enough for the NTA to tell us that the proportion of young people who “complete an intervention according to the goals set out in their care plans’ is 57%. Unless we know what the goals of their care plans are in the first place and what the aspirations are for the young people in question, it is a meaningless statement. As we already know from adult services, “completing treatment” can be a measure of virtually nothing.

Source: Addiction Today Jan.2009

Hospitals and prisons will be supplied with syringes, swabs, citric acid and even spoons. The Government says the aim is to cut the numbers of addicts getting hepatitis C through sharing needles. But drug expert Professor Neil McKeganey said they should concentrate on getting addicts OFF drugs, rather than help to feed their habits.
Prof McKeganey, of Glasgow University’s Centre for Drug Misuse, said: “I think that the Scottish Government are labouring under the mis-apprehension that if they provide drug users with the means of using illegal drugs that they will effectively reduce some of the harm. “Yet we have in Scotland record levels of drug related death, record levels of hepatitis C infections these are indications of failure to prevent harm. I think that such a sum of money would be much more usefully spent on funding abstinence based programmes.”
He added: “Our government is so wedded to the principle of harm reduction that they are giving inadequate resources to those places which are about abstinence That is what we have been doing of the last 15 years and failing.
“If we continue doing that then we will continue to fail.”
The Scottish Government is inviting bids from firms to supply the gear.
A spokesman said: “Scotland is in the middle of a hepatitis C epidemic and it would be irresponsible to ignore that. To tackle this effectively we must reduce, as much as possible, the frequency of intravenous drug users sharing injecting equipment.”

Source: The Scottish Sun Tues.19th Jan 2010

One of the challenges about addiction is the difficulty we have in putting it into a particular “box”. Is it a learned behaviour? is it down to environmental and social influences? Is it a disease?
I am most comfortable with calling addiction a bio-psycho-social condition and taking the complexities on the chin.
The genetics of addiction are beginning to unravel, though it is a not an easy area. Twin studies point towards a genetic component. Adoption studies show that if you are born to an alcoholic parent your personal risk of developing alcoholism is increased.
If both your parents are alcoholics, the risk goes up again. That risk stays with you, even if you are adopted at birth into a non-alcoholic family, suggesting that there is more than learned behaviour and social influence at play.
It appears that some of us are more vulnerable to addiction because of our genetic makeup with around ten genes being strongly implicated and dozens more being associated.
Believe it or not, we have genes for risk taking too, meaning some of us are more willing to try ‘dangerous’ drugs or drink in a riskier way than others.
We also know that there is an overlap across substances. If your twin is addicted to one drug, the chances are you will be vulnerable to that too, but you will also be more vulnerable to other substances. It’s often unhelpful to think in terms of the drug being the problem, it’s more accurate to think that ADDICTION is the problem.
In an abstinence service like ours we can’t quantify that risk, but experience suggests it is significant and we suggest abstinence to all our clients for illicit drugs and alcohol.
But, as I say, it is not simple, it’s a complex interaction between genes and environment with trauma in earlier life being a powerful predictor of later addiction.
Newspapers and some individuals tend to subscribe to the moral model of addiction which goes ‘addicts are bad people with no will power who do bad things’. This model has the advantage of being really simple and easy to understand, but it has a flaw. It is wrong.
The days of that model are numbered as we discover more and more about the complex interactions which generate addiction and open pathways to help those who suffer from addiction (and isn’t addiction true suffering?) find recovery.

Source: WiredIn Community Blog 21sxt Oct.2009

By Robin Murray
Classification isn’t all-important. What’s crucial is that we recognise cannabis does increase the risk of schizophrenia.
The Advisory Council on the Misuse of Drugs (ACMD), on which Professor David Nutt sits, has an unfortunate history in relation to cannabis. In 2002, it boobed by advising David Blunkett, then home secretary, that there were no serious mental health consequences of cannabis use; the council had done a sloppy job of reviewing the evidence. Since that time, they have been trying to regain credibility, and now accept that heavy use of cannabis is a risk factor for psychotic illnesses including schizophrenia. However, Professor Nutt’s comments demonstrate how difficult it has been for some members of the committee to accept their error.
Professor Nutt states that, in 2007, the ACMD were asked to review the situation again because “supposedly, skunk use had been increasing and it was getting stronger”. In fact, the ACMD itself concluded that street cannabis was getting more potent and a Department of Health survey has shown that skunk has been taking an ever-larger share of the market.
Professor Nutt states that “there has been a lot of commentary and some research as to whether cannabis is associated with schizophrenia.” It is crystal clear that people with schizophrenia use more cannabis than the general population; there is no dispute about this. The question is whether the use of cannabis contributes to the onset of psychosis including schizophrenia in a causal manner. Here the evidence, although not yet conclusive, has been mounting steadily over the past six years.
Professor Nutt contrasts a 2.6 fold increase in risk of psychosis carried by using cannabis with a twentyfold increase in risk of lung cancer if one smokes cigarettes. Unfortunately, he is not comparing like with like. The twentyfold increased risk is not carried by just being a cigarette smoker but rather by being a long-term heavy smoker. For cannabis, the risk of psychosis goes up to about six times if one is a long-term heavy cannabis smoker.
Next Professor Nutt claims that the incidence of schizophrenia is falling while consumption of skunk has been rising. Sadly, the paper he points to is a study of diagnosis in general practice and we know that GP records on psychosis are far from accurate. The only good longitudinal data on the incidence of schizophrenia in the UK comes from south London, where the incidence doubled between 1964 and 1999. There are probably several factors contributing to this but abuse of drugs is likely to be one.
Personally, I care little whether cannabis is classified as a class B or class C drug. Fourteen year olds starting daily cannabis use do not agonise over its exact classification; many do not even think it is a drug and few have any knowledge of its hazards. By comparison, most adults in the UK drink alcohol in moderation, but do so in the knowledge that drinking a bottle of vodka a day is likely to be injurious to health, and few are in favour of daily drinking from age 14 years.
Both Professor Nutt and I agree that what we need is a major educational campaign to inform the public about the risks associated with heavy use of cannabis particularly in early adolescence. Fortunately, there has been some progress in public understanding and, as a consequence, use of cannabis has been falling for the past five years.
Source: guardian.co.uk, Thursday 29 October 2009

Mephedrone — a stimulant that is currently legal in both the U.K. and the U.S. — has gained recent and surprising popularity among club-goers in the U.K., according to Britain’s National Addiction Center.
The BBC reported Jan. 14 that the drug, also known as meph, 4-MMC, MCAT, Drone, Meow or Bubbles, was the fourth-most popular drug cited by readers of Mixmag, a popular British dance magazine.
“It’s come from nowhere to become very popular,” said researcher Adam Winstock. “For a drug that’s been around for a relatively short amount of time, mephedrone has certainly made a big impact on the dance drug scene.”
Users describe the drug’s high as falling somewhere between that of ecstasy and cocaine. The drug is sold legally in the U.K. as a plant food; it is a powder that can be taken in pill form, snorted, mixed with liquid or even injected.
Side effects include headaches, heart palpitations, and nausea.
Source: BBC 14th Jan 2010

These video case studies are part of a free online course from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) that demonstrates quick and effective strategies for screening patients for heavy drinking and helping them to cut down or quit.
Based on the NIAAA Clinician’s Guide, the course features four 10-minute video case scenarios, each led by an expert clinician who offers insights and engages viewers in considering different strategies for treatment and followup. The course is designated through Medscape® for 1.5 credit hours for physicians, and for nurses, 1.5 nursing contact hours (0.25 hours in pharmacology).
• Free CME/CE credit for physicians or nurses through Medscape®
• Four interactive 10-minute video cases
• Evidence-based clinical strategies
• Patients with different levels of severity and readiness to change
http://www.niaaa.nih.gov/Publications/EducationTrainingMaterials/VideoCases.htm 2008
Source: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Website: http://www.niaaa.nih.gov/
Email: niaaaweb-r@exchange.nih.gov

A new study suggests that young people without jobs often have the risk of poor health throughout their lives, with one out of ten blaming drug or alcohol addiction on unemployment.
The Prince’s Trust survey of more than 2,000 unemployed people aged between 16 and 25 also found that they could receive “permanent psychological scars” due to constantly feeling ashamed, rejected and unloved.
Nearly one out of four jobless youngsters believed their unemployed statues led to arguments between them and their parents or other family members. Almost the same number of people exercised less and blamed unemployment for an unhealthy lifestyle, while 15percent said their life had no direction. One in three youngsters without a job felt low or depressed and one out of 10 felt almost no one loved them.
“Unemployment has a knock-on effect on a young person’s self-esteem, their emotional stability and overall wellbeing. The longer the period a young person is unemployed for, the more likely they are to experience this psychological scarring,” the Daily Express quoted economist Professor David Blanchflower, as saying in the report. “This means an unhappy and debilitated generation of young people who – as a result – becomes decreasingly likely to find work in the future,” he added. “The implications of youth unemployment stretch beyond the dole queue. The emotional effects on young people are profound, long-term and can become irreversible. We must act now to prevent a lost generation of young people before it is too late,” Martina Milburn, chief executive of the Prince’s Trust, said.
She added: “Young people bore the brunt of the recession last year, with one in five 16-to-24 year olds out of work today. The result is a generation of undiscovered skills and talents. We must invest in these young people, re-building their self-esteem, to ensure that today’s unemployed do not become tomorrow’s unemployable.”
Source: http://blog.taragana.com/health/2010/01/04

Just as Britons brew black coffee to cope with holiday hangovers, they are also digesting a new report that warns the country’s notorious drinking culture is putting an unacceptable strain on hospitals and medical staff.

The cash-strapped National Health Service — the U.K.’s taxpayer-funded medical system — now spends 2.7 billion pounds ($4.4 billion) a year treating patients for drink-related problems, double the amount five years ago, the report said. Total funding for the health care system is currently around 100 billion pounds a year.

The report — published by the NHS Confederation, a health-care providers organization, and the Royal College of Physicians, which represents doctors — warns that about 10.5 million adults in Britain drink above sensible limits, and 1.1 million people have some form of alcohol addiction. The government currently recommends that men should not drink more than three or four units of alcohol a day, and women should not drink more than two or three. A small glass of wine or beer has just over one unit.

One study at a hospital in Leeds, northeast England, found that one-fifth of all emergency-room admissions over four months were for alcohol-related conditions, the report said.

Professor Ian Gilmore, president of the Royal College of Physicians, said the National Health Service could not afford to continue treating alcohol-related problems at current levels, and that health-care providers must be more proactive in preventing people from drinking too much.
Source:. – Erie Times-News, Erie, Pa. January 03 2010

In 2006, it was estimated that 166 million adults worldwide aged 15-64 years (1 in 25 people in that age range) had used cannabis, despite the risks of its adverse effects on health. The issues surrounding cannabis use are discussed in a Review in this week’s edition of The Lancet, written by Professor Wayne Hall, School of Population Health, University of Queensland, Brisbane, Australia, and Professor Louisa Degenhardt, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

The estimates on cannabis use come from the UN Office on Drugs and Crime. Use was highest in the USA, Australia and New Zealand, followed by Europe. Because of their large populations, 31%, 25% and 24% of the world’s cannabis users are estimated to be from Asia, Africa, and the Americas respectively, with Europe next on 18% and Oceania on 2%.

Trends in cannabis use are highly variable within and between regions. Although Australia and New Zealand are in the highest use category (>8% of the population aged 15-64 years are users), in both countries use is declining; similar trends have been reported in Western Europe. In contrast, use may be increasing in some low and middle income countries, a trend that has been reported in Latin America and several countries in Africa.

North American research has shown 10% of ever-users of cannabis become daily users, while 20-30% become weekly users. Use typically begins in teenage years, peaks in early and middle 20s, before declining as young people enter full-time employment, marry, and have children.

The active component of cannabis, tetrahydrocannabinol (THC), leaves users with a mild euphoric high, occurring around 30 minutes after smoking and typically lasting 1-2 hours. Between 5% and 24% of the ‘smoked’ THC reaches the brain. Acute adverse effects include anxiety, panic reactions and psychotic symptoms, most commonly reported by those new to the drug. Concerns exist regarding increasing THC content in cannabis, but evidence on this issue is very limited. Over the past three decades some research has suggested that THC content in seized cannabis products may have risen over that time.

Cannabis use slows reaction time, information processing, and co-ordination-increasing the risk of road accidents for intoxicated users. Cannabis use impairs driving ability more modestly than alcohol use, since cannabis-affected drivers drive more slowly and take fewer risks. But studies suggest cannabis use at least doubles the risk of a road accident, with some suggesting an even steeper increase. A French study estimated that 2.5% of fatal accidents could be attributed to cannabis, compared to 29% to alcohol. Use of cannabis in pregnancy could reduce birthweight, but does not appear to cause birth defects.

Around 9% of people who ever use cannabis will become dependent , with 1-2% of adults affected in any one year. The equivalent lifetime risks are 32% for nicotine, 23% for heroin, 17% for cocaine, 15% for alcohol, and 11% for stimulant users. Some cannabis users seek help to stop report withdrawal symptoms, which include anxiety, insomnia, appetite disturbance, and depression. Cognitive behavioural therapy reduces cannabis use and cannabis-related issues, but only 15% of people remain abstinent 6-12 months after treatment.

Regular cannabis smokers report more symptoms of chronic bronchitis (wheeze, sputum production, and chronic coughs) than do non-smokers. Cannabis smoke contains many of the same carcinogens as does tobacco smoke, with some present in higher concentrations. Case-control studies of lung cancer have found associations with cannabis use but their interpretation is uncertain because of confounding: most frequent and long-term cannabis users also smoke tobacco.

Deficits in verbal learning, memory, and attention are most consistently reported in heavy cannabis users, but these have been variously related to duration and frequency of use, and cumulative dose of THC. More functional brain imaging studies on larger samples of long-term users are needed to see if cognitive impairments in long-term users are correlated with structural changes in brain areas implicated in memory and emotion.

Cannabis use is associated with poor educational attainment, but the cause and effect of this relationship is unclear. The most plausible hypothesis is that impaired educational outcomes are attributable to a combination of higher pre-existing risk, effects of regular cannabis use on cognitive performance, increased affiliation with peers who reject school, and a strong desire to make an early transition into adulthood.

In the USA, Australia, and New Zealand, regular cannabis users are much more likely to use other illicit drugs later on, including heroin and cocaine, and the earlier the age at which a young person uses cannabis, the more likely they are to use heroin and cocaine. This could be for a number of reasons: cannabis users have more opportunities to use other illicit drugs because cannabis is supplied by the same black market; those who are early cannabis users are more likely to use other illicit drugs for reasons that are unrelated to their cannabis use; and pharmacological effects of cannabis increase the propensity to use other illicit drugs. This issue remains the subject of considerable debate.

Cannabis can have an effect on the mental health of users. Studies suggest the risk of schizophrenia more than doubles in those who have tried cannabis by age 18. A meta-analysis reported in The Lancet in 2007 showed a 40% increase in risk of psychotic symptoms or disorders in people who had ever used cannabis, with the highest risk among regular users, and particularly among those with a vulnerability to psychosis. In the case of depressive disorders and suicide, the relationship with cannabis is uncertain.

The authors say that the public health burden of cannabis use is probably modest compared with that of alcohol, tobacco, and other illicit drugs. A recent Australian study estimated that cannabis use caused 0.2% of total disease burden in Australia-a country with one of the highest reported rates of cannabis use. Cannabis accounted for 10% of the burden attributable to all illicit drugs (including heroin, cocaine, and amphetamines). It also accounted for around 10% of the proportion of disease burden attributed to alcohol (2.3%), but only 2.5% of that attributable to tobacco (7.8%).

They conclude: “The most probable adverse effects [of cannabis] include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health.”

Source: The Lancet

http://www.medicalnewstoday.com/articles/167873.php Oct.2009

Comments on this article below:
When 96 percent of humanity is doing the right thing, i.e., not using cannabis, it’s time to celebrate civilization but, of course, the Lancet may not see it this way.

Most nations of the world prohibit the production and distribution of cannabis. Few prohibit beverage alcohol and do so mostly, if not exclusively, for religious, not health, reasons. Reportedly, an estimated 2 billion people worldwide use beverage alcohol regularly. This represents approximately 29.9 percent of the estimated 6.7 billion persons on Earth. Using the logic of the Lancet’s analysis, almost eight times as many persons consume beverage alcohol on a regular basis, despite adverse health effects, than consume cannabis on a regular basis, despite adverse health effects. (Note: This metric would be slightly lower if we could remove from the analysis the number of under-15 years of age persons who consume beverage alcohol on a regular basis. We were unable to do this on a global basis.)

Conclusion? Prohibition works!

Thanks, Lancet, for making the case for the Single Convention and domestic cannabis controls.

Source: John Coleman Drugwatch International Nov.2009

“Sewages is more than just filth. It’s evidence of our worst habits, everything from caffeine to cocaine, all ingested and flushed down the toilet. Now scientists are using wastewater to drug-test entire cities, and the results are sobering.”

Excerpt:

“In 2001 Daughton proposed the novel ideal of testing for illicit drugs in wastewater…..Sewer epidemiology stalled stateside until 2006, when environmental chemist Jennifer Field of Oregon State University hit upon the idea as a way to help assess Oregon’s growing meth problem…Field began conducting a small proof-of-concept study, analyzing teaspoon-size samples of wastewater from 10 cities left over from an older environmental study. She found that a sample from a popular gambling destination boasted the widest range of drugs, while one from an affluent town tested positive exclusively for cocaine…Her team made headlines last august when they presented these and other findings at the American Chemical Society meeting in Boston. Their results – similar to those of Zuccato and Fanelli – showed cocaine levels highest on the weekends while levels of methamphetamine remained constant. ‘once you’re hooked, you’re hooked,’ field points out.

“Today, Field is heading up the most ambitious community urinalysis test yet. She’s soliciting wastewater samples from 130 treatment plants throughout Oregon, which service approximately 80 percent of its 3.7 million resisdents…Oregon Health Sciences Universitiy, which is footing the $30,000 bill through its Medical Research Fund, stands to gain a trove of data about drug use in individual communities, since Field will have direct estimates from areas in which surveyors have surely never set foot.

“…For marijuana, the target molecule is THC, which is tricky in its owns right. ‘There is a wide variation in the amount of active ingredient in grass,’ Fanelli says. He relies on average potency, which can be gleaned from pot busts. Sewer epidemiologists must factor in all of these variables….And some people worry about how such methods might infringe on their civil liberties. One of the calls Field received after news broke about her proof-of-concept study, for instances, was from High Times magazine. ‘They wanted to know about privacy, she says.”

Source: Popular Science, March 2008

Being a teenager isn’t as risky as it used to be, but too many teens still put their lives and their health at risk, a CDC survey shows.

Every two years, the CDC conducts its huge Youth Risk Behavior Survey. It contains detailed data from more than 14,000 questionnaires anonymously completed by teens in grades 9 through 12.

Overall, the 2007 results suggest that teens are acting more responsibly. Fewer are sexually active, nearly all wear seat belts, drinking and drug use are down, 80% of kids don’t smoke, and there are fewer suicide attempts.

This is good news to Howell Wechsler, EdD, MPH, director of the CDC’s Division of Adolescent and School Health. In some cases, the new numbers begin to approach the CDC’s Healthy People 2010 objectives. “What we are seeing is from the early to mid-1990s to now, on a large number of health risk behaviors, we are seeing very, very encouraging progress,” Wechsler tells WebMD.

Even so, the new numbers are enough to take a parent’s breath away:
• 7% of teens say they’ve attempted suicide (down from nearly 9% in
2001).
• 35% of teens say they’re sexually active (down from 37.5% in 2001).
• 18% of teens say they carry a gun, knife, or club (no significant change from 2001).
• 20% of teens say they smoke cigarettes (down from 36.4% in 1997).
• Nearly 45% of teens say they use alcohol (down from 50% in 1999).
• About 20% of teens say they use marijuana (down from nearly 27% in 1999).
• Only about 21% of kids eat five or more servings of fruits and vegetables (down from 24% in 1999).
• 25% of teens play video games or use the computer for three or more hours a day (up from 21% in 2005).
• More than 65% of kids don’t get enough exercise , and 25% of teens say they don’t even get an hour of exercise on any day of the week.

“We are gratified that there is progress being made,” Wechsler says. “But my take on it is this: I have a bunch of kids myself and I am not going to be satisfied until we meet our goals — and in most areas we are still not meeting our Healthy People 2010 objectives. So I see no cause to be overly
satisfied.”

(Which teens are most at risk? Find out from guest blogger Howell Wechsler on WebMD’s News Watch blog.)

Best States/Cities, Worst States/Cities

In some cases, the overall numbers conceal states and localities where teen behavior is much better — and much worse — than average:
• 62.2% of Kentucky kids have tried smoking cigarettes, compared with only 24.9% of Utah teens (national average: 50.3%).
• 34.5% of West Virginia teens use tobacco products, compared with only 8.9% of kids in Vermont (national average: 25.7%).
• 44.7% of Alaska teens have tried marijuana, compared with only 17.4% of Kentucky kids (national average: 38.1%)
• 90.8% of kids in New York attend physical education classes at least once a week vs. 28.4% of kids in South Dakota (national average: 53.6%).
• 49.7% of Baltimore teens are sexually active, compared with 17.5% of San Francisco teens (national average: 35%).
• 39.2% of ninth to 12th graders in Dallas have been offered, sold, or given an illegal drug, compared with 13.5% of teens in Baltimore (national average: 22.3%).

Wechsler says the survey data don’t show exactly why teens in some areas take fewer health risks than teens in other areas. But he says that state and local efforts to reduce specific risk behaviors pay off. He points to anti-tobacco efforts as an example.

“One thing that is instructive is the tremendous difference in resources different states put into this,” Wechsler says. “In some states, teen tobacco use is much lower than the national rate. And we see this in exactly those states where they have made substantial investments in tobacco
reduction.”

Even Good Teens Take Risks — What Parents Must Do

If none of this sounds like your teenager, listen to Nancy Cahir, PhD, a child/adolescent/adult psychologist in private practice in Atlanta.

“What I have seen in my practice is even parents who think it couldn’t happen to their child — well, it can,” Cahir tells WebMD. “Even with the ‘perfect child,’ there may be hidden issues; even in good families, bad things can happen. There is no discrimination when it comes to high-risk behavior for teens.”

Parents have a responsibility to involve themselves in their children’s lives, Cahir says. They cannot assume their teen is doing fine because they haven’t had calls from the school or because their teen’s grades are good.

“Parents, I say stay close to your children. Know your kids the way you know your best friend, and keep in touch with them,” she says. “Spend time with them, know their friends, and know the parents of the children your children hang out with. Say to them every day, ‘Did you have a difficult day? What’s going on with you? How are you doing?’”

It’s probably not news that teens can be moody, even surly at times. Your teen may respond to your inquiries with something like, “My life is none of your business.”

Not so, says Cahir.

“Every parent has the right to say, ‘It is too my business,’” she says. “Parents sometimes shy away from being more involved because they don’t want to seem intrusive. But it is their business to know whom their child hangs out with, to know whether the child is in distress, and to help their children through these difficult times. Sometimes kids don’t like hearing that, and may respond in defiant ways, but parents must toe the line and say, ‘We have a right to know.’”

But Wechsler agrees with Cahir that communication is not only what your children need, but what they truly want.

“As a parent of two teens myself, you tend to believe them when they walk out of the room and don’t express any interest in hearing from you,” Wechsler says. “But kids really do want that communication with parents. They really do want to hear their parents’ values. They really need their parents to monitor their whereabouts and stay in touch and stay a very strong part of their lives.”

Cahir says the key to communicating with teens is developing mutual respect.

“Each member of a family should treat the others members like a best friend or at least as a guest in the house,” she says. “If you are angry with your teen, or your teen is angry with you, you have to talk it out in a way that is not hostile or aggressive. I’ve seen some families go after each other tooth and nail and they end up really harming each other.”

If communication breaks down, it may be time for the family to sit down with a professional to learn how to express disagreements in a constructive way.

The full CDC report, “Youth Risk Behavior Surveillance — United States, 2007,” is available on the CDC’s web site. For comparison, earlier years’ reports are also available.

Source:CBS News Web 4 June 2008

Drug policy public hearing – a revivalist meet for the disciples of dope.

A Brussels Parliament sketch by Peter Stoker – Director, National Drug Prevention Alliance
_____________________________________________________________

In the comfortable and prestigious surroundings of the European Parliament, a ‘Public Hearing’ was – in the event – heard by very few of The Public. Perhaps this is just as well, for the average citizen might have torched this expensive building, built from his tax money, had they heard what was being said.

Under the name of the Civil Liberties, Justice and Home Affairs Committee, the hearing concerned what was euphemistically called the ‘Anti-Drug’ Strategy, 2005 – 2012, and its attendant ‘Action Plans’ (2005 – 2008 and 2009 – 2011). Enthusiasts of drug policy will know the special significance of 2008; this is the year in which the UN is set to review its Conventions on Drugs, for which more than 100 nations have signed up, thereby generating an enormous and positive influence on drug policy around the world. It is precisely because the Conventions have a positive influence, a bulwark against legalisation, that they are hated by the pro-legalisation crowd. They would kill them today if they could but meanwhile they are working behind and in front of every available screen to administer a death blow as soon as they can.

Deep concern for the public health, social cohesion and safety of European society was cited as the drive for the ‘Anti-Drug’ Strategy – surely matters of interest to The Public, but this meeting was populated by a rather different variety of human being.

Instead of the public there was a collection of around 150 people – of which more than 100 came ‘on a mission from Gomorrah’, bearing banners and leaflets, and demanding a Europe of free drugs – not a Europe free of drugs. Largely in harmony with this aspiring cluster were some 15 MEPs who, if they spoke at all, spoke in terms which garnered the applause of the 100. Also on hand were around 25 EU officials who maintained at discreet silence – in all but one noteworthy case. Mathematicians amongst you will note that this leaves about five people are not accounted for? Who they? The prevention platoon – including yours truly.

Known drug legalisers and liberalisers were greeted like old friends – which maybe they were – and were given reserved seating plus arranged speaking slots in the agenda. Thus were we treated to presentations by ENCOD, TNI, IAPL and others who would not be given house room in any self-respecting house.

Looking on benevolently but keeping a low profile was Mike Trace, the disgraced former Deputy Drugs Tsar for the UK who, on the eve of his elevation to head of Demand Reduction for the UN, was spectacularly exposed by the London Daily Mail as running covert operations with legaliser bodies, notably those bankrolled by George Soros. Trace was obliged to resign his seat at the UN even before he had begun warming it, but he remains a force on the UK and European scene, the beneficiary of a determined rehabilitation scheme by those who feel there is still some useful mileage in him. He is a top cat in Drug Treatment Limited, in the Beckley Foundation, and in RAPt – the Rehabilitation of Addicted Prisoners Trust – the breadwinner job he has held since before his heady days of Drug Tsardom.

The meeting was chaired by Belgian MEP Antoine Duquesne, and did little to diminish his reputation as a strange person. A welcome was offered by the Health Minister for Luxemburg, who promised that of all present today had left their dogmas leashed up outside the front door, and that no preachers had been admitted. Our main goal, he suggested, should be free to reduce Harm … not only the physiological harm drug-users suffer but also the harm of their social exclusion (presumably users should be set on a pedestal in society). The minister concluded by entreating all present to not stick to a static view; there are many approaches, he said, witness the contents of the Action Plan produced by the splendidly named Horizontal Drug Group on the 23rd of February this year.

Next up was a spokesman for the Pompidou Group, Bob Kaiser, who did his best to maintain gravitas in presenting a predictable and unimaginative series of recommendations, ending with the plea that money should not be spent on new organisations (the implication being that it was better to spend it on old organisations – like his).

Paul Griffiths, spokesman for the Lisbon-based monitoring centre, EMCDDA, uttered the recurrent plea for more and better data, not withstanding what he saw as improvements in recent years. We needed, he said, to get much better at collecting evidence, if – that is – evidence-based policy (as distinct from policy-based evidence) is the goal.

A sanguine spokesman from the International Red Cross made new friends in the audience when he asserted that the notion of a drug-free world is unrealistic and that it was in the nature of man to swallow psychoactive substances – much in the way he had evidently swallowed this rhetoric. He lost one friend, however, when he dismissed the concerns of of Madame Roure, MEP for Lyon, France, who spoke of young children in deprived areas being drawn into drug use; that – said the Red Cross man – was a South American or Eastern Europe problem i.e. nothing for us civilised types over here to get excited about. Madame R gave him a short shrift; she was, she said, talking about the fair city of Lyon – not Bogota or Bucharest.

Luc Beauman, spokesman for ENCOD, knew he was preaching to the converted. From his position on the top table he presented a relaxed and intellectually stylish restatement of their position. At this, the 100 erupted into thunderous and extended applause, holding aloft colourful if modestly-sized banners (possibly designed to fit comfortably inside one’s jacket).

It was then that the assembled drug freedom fighters in the cheap seats became restless. Surely, the first cautiously suggested, it is the system of making drugs illegal which just makes prevention harder to appear: wouldn’t a bright new day dawn and everything be super if we just legalised them all?. Others quickly followed over this rickety bridge head: A man from Bologna complained that he couldn’t get a drink after 9pm or smoke cigarettes in shops – this is Prohibitionism even with legal drugs, so it’s just part of the same problem, and we must recognise that prohibitionists are dangerous animals. The appropriately-named ‘Freek’ Polack claimed that he had just one question for the Parliament – then proceeded to ask five; the gist of it was that policies which don’t enable drug use are failures, so why are we silent on this failure? He was received in silence.

An impassioned plea from a hirsute young German drug user took the form of a velvet trap – “You say we need your help, I say you need our help, so when will you stop isolating and demonising us?” (as in ‘When did you stop beating your wife?’).

An Italian plaintiff said he knew of five people, arrested for drug possession who, when their names were published in the media, committed suicide.The notion of an early death during this meeting was perhaps growing in the minds of some, who were by now finding the whole affair life-threatening.

In the name of balance, a Belgian prevention centre worker was invited to speak. He remarked that the discussions “seemed to getting very polemical” – perhaps unintentionally implying that they had not been polemical from the kick-off.

ENCOD’s Luc Beauman took another bite at the cherry; if cannabis is demonised, he opined, then kids don’t take any drug information seriously. Ergo, unreliable prevention messages damage all prevention messages, so his argument went.
( Unreliable libertarian messages did not, it seemed, qualify for the same criticism). ‘Regulation’ – the new buzzword for Legalisation – would usher in a new dawn of ‘ sincere and and honest information’. This would be best achieved by involving citizens, a pious hope of politicians since the 1980s but sadly a hope yet to be realised. 2008 or 2012 were, said Luc, intolerably far away … “What do we want? Regulation! When do we want it? Now!” … and so on …

It was left to the one civil servant who did speak to administer a cold douche of reality. Carel Edwards, Head of the Anti-Drugs Coordination Unit at the EC, told it how it was – and is likely to remain. He was given just six minutes to speak; and said “If you think I can, or will state that the EC position in six minutes, think again”. If today had demonstrated anything, he said, it had demonstrated once again the enormous confusion over the whole subject. The notion that opinions from street level would reach to and direct the top of government is the kind of dream that only comes from those smoking unusual tobaccos. In support of this he cited how few MEPs were here today – and the fact that no of single member state has yet reached what can be called a consenus on drug policy.

He made a somewhat bizarre reference to the Institute for Global Drug Policy Conference held in the European Parliament building about a month ago, characterising this as “Americans expressing a very repressive policy” (It seems that an attendance register, showing the wide variety of European and worldwide delegates at that meeting might helpfully enlighten him). In closing, he said the EC’s aim was to produce an ‘ideology-free, evidence-based’ policy. Those who wanted to debate ideology should go elsewhere; coming as it did after three and a half hours of almost unceasing ideology-pushing, this remark fell on stoned and stony ground alike.

***************

Shaun Bailey was born on the west London estates that have been linked to investigations into the murder of WPC Sharon Beshenivsky. Here he describes how pop culture and liberal politics have created a feral generation hooked on drugs, crime and violence

I come from a black working-class environment, born and brought up by my single mother on the North Kensington estates in London. Where I live the peer pressure to offend surrounds you. Crime is everywhere. The teenage pregnancy rate is well above the national average. There is a drugs epidemic. There are significant mental health and disability issues. Most people remain trapped.
Yet just a few yards away, on the other side of Ladbroke Grove, you can find houses worth millions of pounds where bankers, celebrities and media stars discuss being attacked and the threat of burglary rather than the problems of today’s youth.
I am one of the lucky ones. Thanks in part to a determined mother, I just scraped into university. But I returned to the North Kensington estates seven years ago as a volunteer youth worker and I came to see from street level how the cycle of deprivation and crime works in the inner cities of Britain.
The level of crime on the estates was already astonishing, but over the past four years the levels of violence with drugs, guns and knives among the younger kids has got much worse.
Eight years ago it would have been fantasy stuff to carjack. Four years ago maybe you would have found one person who’d entertain it and everybody would have thought he was a lunatic. Now I could show you at least 15 people who would consider it, 10 or 15 who would do it and five who have done it.

Kids are carrying guns now because guns are linked to bigger crime. They are selling crack because crack has a shorter turnaround and a higher profit than the likes of weed and heroin. People who smoke crack are so desperate they’d do anything for the money. And the dealers get high on the power.
I know one guy who’s only 17 years old and is a very successful crack dealer. “It’s not so much the money, Shaun,” he told me, “it’s the fact that I’ve got people who work for me.”
For rock he was able to get people to wash his car, clean his house, beat people up, steal stuff for him, send them on missions just because it made him feel powerful.
Crime starts younger, spreads wider and goes further. The number of kids growing out of crime is getting smaller. It’s why we get this horrible stuff with guns and knives: the serious nature of their offences is growing as the percentage of kids staying in crime rises.
The real scary thing is the young age at which it happens. Serious criminals used to be in their late twenties. If you came into my area and interviewed my boys, they have been involved in quite horrible stuff and they are not yet 16 or 17.
THE estates themselves are part of the problem. The blocks were badly designed. We are all too close to each other. On top of each other. One of the estates was built for 1,100 people but now houses 1,450.
There are a lot of Moroccans, a lot of blacks. Everybody there is poor. Overcrowding has an impact on how young people behave.
Most of the flats are built in such a way that nobody can sit around a table. Traditionally a table is where a family has discussions, where parents give attitudes to their children. If children come home and their parents are cooking them food, it establishes their dependency. It gives the parents authority. They can say: “You need to come in for dinner.” They can set rules and boundaries.
That doesn’t happen here. There is no room for a table. We all eat dinner off our laps. Families start to not eat together because there is no point. We don’t have any space at any time. That’s why some parents can’t love their children. They are too busy surviving.
If you talk to those families where children are behaving the worst, you find that the kids have no rules and no boundaries. The reason is that the parents have never had any point at which to put them in place.
Many of the young people I deal with have never spent any meaningful time with their mothers or their fathers. Their parents didn’t do anything with them and they have no set of family rules that govern them.
If you are the younger end of an overcrowded family you share a bedroom with your older brother. Maybe there are three of you in one small bedroom. You have no privacy so you come out of your flat for privacy. You stay on the block because you are comfortable there. It becomes your extended bedroom.
As time has gone on, the people who hang around the block have aged from cute little five-year-olds to 15, 16, 17, 18-year-olds. In some cases 21-year-olds are still hanging around.
On one of the estates here there are 1,600 young people and kids under the age of 19. The sight of a big group of young people just terrorises most people. This is where it starts. The kids are perceived as a threat. They are dealt with in that manner. Then they take on the role they were handed. Put that with difficult parenting and you’ve got a problem.
This was an area where poor white people were sent who couldn’t afford to live anywhere else. The estates have also become home to London’s largest Moroccan enclave and to Jamaican, Portuguese and Spanish communities. But, although we have been housed in our racial groups, racial tension is not a feature of life here. When they found the alleged July 21 bombers on our estates, no form of war took place.
Instead a child is known by the estate he comes from. Kids will fight with other kids just because they are on their road. You defend your “ends” — your locale — because you don’t want to be seen to come from where the pussies live. You club together loosely to make sure you stand up for each other. It is an easy step from here to the creation of gangs.
Some gangs have names. There is the Cold Hearted Crew, the Heartless Crew. The names are always about being mean and tough: Cutlass, Beg for Mercy. Imagine you are a nine-year-old boy living here. You see these groups of older boys. They seem to be tough. They seem to be having a good time. Nobody interferes with them. You want to be a man and these appear to be men to you.
In some of the gangs, some of the slightly older ones have already been in prison. To the kids on the street, prison has become a badge of honour. It’s almost getting to the point that you have to go to prison.
All their talk is about f****** people up. There is no notion of conflict resolution other than battering people. Violence is deeply ingrained in their culture of “respect”. They have to take people on just because what is said might be disrespectful to them. They have to batter them. They have to be in charge. To be in charge they have to be physically violent.
Not having parental love is one reason the kids argue about respect so much. Their view is you have to be a “bad boy” or people don’t leave you alone. With white boys, it’s about being a nutter. You’ve got to be a nutter. You don’t want anyone f****** with you, you’ve got to f*** them up, you’ve got to show people you’re a nutter. The black boy will say things like “bad boy, gunman, man don’t take no shit”. They talk about blowing people’s heads off and about stabbing people.
The kids here also feel they have to have money. When you are poor, you see people on telly with phones, cars, iPods. To you the gang is the best way of getting this stuff because they steal, they rob.
The great majority of them who are “going out there” — that means going out to rob, to make money — are just 14 or 15. They use terms such as “running up in your house” (aggravated burglary). They talk about needing £100-£400 a week. If you have that kind of money, you have respect and you can buy all the cool stuff and you can show them you’ve got it. If you stand around with these boys, it’s not long before someone pulls out a wedge of money. They won’t say anything; it is just to look cool.
Young people here watch a lot of television, particularly MTV. It shows them cars and cribs (houses) and girls. They want it all. They don’t learn about real economics, what’s involved in working for money. That’s why you see them performing some really ugly crimes now, because that is the only way they can finance this lifestyle.
It means they do 20 minutes of something dangerous, then bang, they’ve got all the money. They have the whole of next week, next month doing nothing, waiting for the funds to run out and being forced to do something else.
Lots of kids here, getting towards 25%, smoke weed and skunk. It’s a serious problem. Use is starting younger than it did. It affects their mental health. It undermines their schooling and their life prospects. At our local park, young schoolgirls come around and smoke, young schoolboys, too. They smoke on the way to the bus to go to school. It affects their ability to concentrate.
Weed affects their brain chemistry while their brains are still forming. These kids need all the motivation they can get. The drugs rob them of it. So they move into crime and become more addicted and need to smoke more. So they get excluded, sent to a referral unit or are truanting more or less permanently.
This is one thing that middle-class adult smokers who support liberalising drugs don’t understand. As adults it may not be affecting their brain chemistry doing it once a week. They also have jobs to go to. They may control it. But these young kids don’t.
When the liberal classes have the view that “oh, we can all smoke a bit”, they do not realise how it generates crime for young people here who need to finance their habit. By not making drugs seem like a big deal, by decriminalising the drug, they are criminalising the kids.
This sanctioning of drugs pushes poor kids into bullying at school, then into low-level crime to get the money for drugs. This introduces them to criminality. Most children don’t begin with the desire or the confidence to rob someone. But once they bully for items at school they gradually build up and their targets become more frequent and bigger until they rob adults.
Drinking, smoking and hanging around with undesirables also leads some girls to adopt a different sexual code. They let themselves be shared by the boys. I have been told that if a girl fancies your friend, you’ll make her sleep with you first to get to your friend. Young girls are starting to accept this. They mistake sex for affection.
The next step up from this is when you get girls starting to have a baby just to get real love. Many of the teenagers are the children of the first generation of single mothers to be housed here. The assumption became that it was all right for mothers to have babies on their own. So it is doubly like that for their daughters.
But what you see now is the mother and daughter fighting for attention from the men. I watch a lot of the single mothers round here. I see they are struggling with the loneliness, the depression, the mental health problems. It is getting worse with every generation.
One of the most corrosive aspects of life here is the low expectations placed on parents. Nothing happens to you if you don’t look after your child. Too much of our policy around young people is nothing to do with their parents. Yet all parents need to be involved, need to have responsibility, need to feel the pain if their teenagers are offending.
In turn they need to have higher expectations of their children. Compare what the well-off expect from their children with what the poor think they can achieve: it is so vastly different it is unbelievable.
The parents I speak to do not find parenting easy. They lack information and practical support. None of this is helped by the lack of married families. Marriage does not exist among the black community. It is why we have so many problems with the men.
If you talk to young people, they all support marriage. But people with our lives, in our circles, understand you are better off if you are a single parent. It has reached the point where a lot of people who are not single parents present themselves as such because it makes financial sense.
If anybody thinks that people like us don’t sit around and have these discussions, they are deluding themselves. We soon figure out which way it will make us the most money. And that’s an example of how we are trapped by government policy, which discourages us from raising our children in nuclear families.
SCHOOL was where young people could have gained some moral fibre, but governments have got rid of schools that gave strong moral messages. Young people want boundaries, but school has been emasculated so it can’t give them.
Removing religion and what it is to be British from school has been a disaster. Where else are young people going to learn ethics? Citizenship is not enough. That’s how we’ve had bombers here. They’ve come here and not been exposed to the good things about being British.
Put this with the failure of school to give children real skills. Some are not going to be academically sharp, yet school is finding nothing for them to do. We live in a world of trade and real skills, vocational skills. Yet school is GCSEs or nothing. This creates a separation between mainstream society and the rest of us. This is stopping our children from succeeding, because they go for a job and people start speaking and they literally cannot understand them.
The failure of the schools to impart the most basic of social skills is astonishing. The teenagers here cannot speak to people they don’t know as they only know how to speak their own slang. This estate is not conducive to our kids being socially educated.
You are talking about boys of 22, 23 and 24 who have never been anywhere near a job. They don’t have the academic skills and they definitely don’t have the social skills to attack a job.
They are not able to talk to people without just saying, “wha’d’you want, wha’d’you want?” Not getting offended, not getting scared when somebody asks them a question, not seeing it as a challenge to their respect when they are told or asked to do something — this is all beyond them.
Yet all they talk about is money, money, money. How to raise it. Ways to spend it.
The music our children listen to says you are not worth anything unless you have lots of money. Your worth is directly related to the money you have in your pocket. All this reinforces the need, especially for these children, to get stuff, to expect stuff and to have stuff. It shows them the end product; it doesn’t show them the work involved.
They see the Wayne Rooneys, the Beckhams and their huge financial success. They have false aspirations and then they don’t concentrate on what’s real, on what’s possible for us. So the kids feel they have to have money and this leads to crime.
The education that goes on in school around drugs and sex is also ridiculous, because it is just about the technicalities. It has not dealt with the pressures and realities for kids here. When I spoke in a girls’ school and used the word abstinence, only three out of 90 of them knew what it meant.
There are a lot of really good things about Britain as a place and British people as a body. These are things that children should be taught straight up; they should learn about the community that is Britain and what it is to be British. But by removing the religion that British people generally take to, by removing the ethics that generally go with it, we’ve allowed people to come to Britain and bring their culture, their country and any problems they might have with them.
I can see the argument for taking religion out of the state, out of politics. But as a moral guideline, they need to be maintained. Losing them has meant that people have come here and had very little respect for us.
That lack of integration and lack of saying to people: if you are going to come to England, this is what we expect. That is why the Muslim religion is so powerful among the Muslim people (here).
Sex education in school is just science. Science is not what happens on the street; it is not what happens in bedrooms up and down the country. The fact that young people feel they should be having sex should be addressed. When you say to them here’s condoms, you confirm that young people should have sex. What we should be saying is “No!”
Parents should be told that contraception is being handed out and absolutely they must be told if an abortion is being arranged, because you are talking about the physical and mental health of their children.
Hiding it from the parents deprives them of their responsibility and the opportunity to exercise it. It emasculates the caring parents and it gives dependency to the uncaring ones. If you take that away from them they expect everything else to be done for them.
THEN there is multiculturalism. What it does is rob Britain of its community. Among the working class, unless you are already one of those “Queen and country” sort of British people, you are lost. You don’t know what to do. You bring your children to school and they learn far more about Diwali than Christmas.
I speak to people from Brent in northwest London and they’ve been having Muslim and Hindi days off. What it does is rob Britain of its community. Without our community we slip into a crime-riddled cesspool.
There are a lot of really good things about Britain as a place and British people as a body. These are things that children should be taught straight up; they should learn about the community that is Britain and what it is to be British. But by removing the religion that British people generally take to, by removing the ethics that generally go with it, we’ve allowed people to come to Britain and bring their culture, their country and any problems they might have with them.
I can see the argument for taking religion out of the state, out of politics. But as a moral guideline, they need to be maintained. Losing them has meant that people have come here and had very little respect for us.
That lack of integration and lack of saying to people: if you are going to come to England, this is what we expect. That is why the Muslim religion is so powerful among the Muslim people (here).
It’s like we are ashamed of where we come from.
Lots of people come to Britain and think they’ll be rich. But then they find it’s not so easy and are resentful. They are alienated because they haven’t been exposed to the good things in Britain — our ethics. That’s why we’ve now got a nation of people who wouldn’t do anything for the country. They wouldn’t fight for their country. Why would they? The nation has done nothing for them as far as they are concerned.
The more liberal we’ve been, the more the poor have suffered.
Poor people don’t need all this liberalism. They need direction. Everybody talks about “my rights” — but there is some point when your behaviour needs to be balanced by your duty to your community.
The working class look to rules. The rules are important to them. Take away the rules and they are left in limbo. So they form their own: the kind that are driven by pop economics and lead to crime.
The liberal intelligentsia relax the rules for themselves, not for us.
Bailey’s law: Six ways to stop youngsters growing into criminals
Establish boundaries early
Once children acquire a criminal mentality, they find it hard to lose, says Bailey. So it is important for parents and schools to lay down a clear moral framework from the outset.
This may seem obvious, but for people on deprived estates it’s not easy. They are bombarded by conspicuous consumption elsewhere but have to be taught that money and goods must be earned, not taken. Parents and schools must not shirk from making clear what is right and wrong.
Bailey believes that in other countries, including Jamaica, where his mother came from, parents and schools impose stricter discipline and better behaviour.
Keep them busy
The best way of preventing temptation turning into criminality is to keep youngsters occupied with other things. “You can’t stop people using drugs unless they are busy, unless they have some type of tie to society,” says Bailey. This requires jobs, education, sports or hobbies.
On one estate Bailey helped youngsters get licences to drive mopeds so they could deliver pizzas. “It was about giving them a link to wider society,” he says. “I found it transformed the young people involved.”
He also ran a project to help youngsters repair their mopeds, which led to some training as mechanics.
Be straight, be firm
In Bailey’s eyes, “young people want boundaries”. They want guidance on what is acceptable and what is not. But too many people and institutions are afraid of setting clear boundaries for fear of causing offence. They are, he says, too politically correct. “We make a point of telling youngsters the truth and we find that they grow from it,” he says.
Shield young people from commercial exploitation and celebrity culture
He believes the media, including some music magazines and television channels that promote the “coolness” of money and drugs, are corrosive. He suggests the promotion of violence and pornography, especially by some parts of the music industry, should be challenged.
Don’t wait for the problem to come to you: go and tackle it before it is too late
Instead of setting up a youth or drug centre in a particular building and waiting for people to drop in, go out on the streets. Bailey seeks out and befriends youngsters on the streets of North Kensington and gains their trust.
Keep it local
National initiatives may struggle to work because youngsters are territorial. It’s important to understand an area’s history, culture and needs.
This article is taken from Shaun Bailey’s pamphlet. No Man’s Land: how Britain’s Inner City Youth are Being Failed, to be published tomorrow by the Centre for Policy Studies. www.cps.org.uk
Source: From The Sunday Times November 27, 2005

Professor Nutt was funded by the West Australian Government to come to Fremantle as a key note presenter at its bi-annual Harm Reduction/drug legalisation Drug and Alcohol Authority Symposium. Supposedly an education forum for the massive network of drug and alcohol field workers, Nutt set about not only minimising the harms of cannabis and ecstasy but promoting them.He claimed that ecstasy is being used by therapists to treat PTSD in Europe and that cannabis should be used as treatment for cannabis withdrawal paranoia and panic attacks – what he should have pointed out is that these episodes are horrifying and last many years after the first attack.Nutt did not declare his conflicting interest e.g. that he sits on the advisory boards of several international pharmaceutical companies.Now I wonder why that would be!

Source: e-mail from G. Mullins, contact in Australia. Nov. l0th 2009

The CDC report “Deaths: Final Data for 2006” released in April 2009, reveals a spectacular 15% increase in drug induced deaths in 2006 compared to 2005 (latest data available.) These 2006 rates once again have reached yet another new national all-time record high for the 16th consecutive year. It reports that 38,396 Americans died in 2006 directly from “Drug-induced causes” the vast majority of which were overdose deaths from use of illegal drugs or from illegal use of legal drugs. ( See page 93 of 135 of the CDC report at link: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf )

Steadily increasing OD deaths over the past two decades strongly indicate that current national drug OD death rates in 2009 are raging out of control at national crisis levels. The graph shows the 2006 total of 38,396 deaths with the trend line heading off the chart! This calculates to a rate of over 3,000 deaths occurring MONHLY and rising.

Parents’ drug prevention organizations from throughout the nation recognize that the vast majority of those drug overdose deaths result from the early introduction and addiction of schoolchildren to drugs and alcohol (which is an illegal drug for teens) in their schools. Therefore they have petitioned President Obama and Congress for early enactment of the demand-reducing national drug prevention strategy of implementing a federal mandate for health screening all secondary school students for drugs by Random Student Drug Testing (RSDT) see attached. The legislative precedent for such a mandate is the federal mandate for the 21 drinking age that Congress enacted in 1984 in reaction to widespread tragic teen auto crashes, injuries and deaths on the nation’s highways that had directly resulted from states authorizing teen alcohol use in the 1970s.

“Diagnostic drug testing is the very best means ever found for effectively reducing the kids’ exposure to the deadly disease of drug addiction. This has been well demonstrated in the military, businesses, transportation industry and in the over 4,000 U.S. schools currently using drug testing,” said Joyce Nalepka, president of Drug Free Kids: America’s Concern and former president of Nancy Reagan’s National Federation of Parents. “We parents sincerely appreciate that RSDT is fully supported by Congress, the ONDCP, the U.S. Education Department, DEA, U.S. Justice Department, and all health-related federal agencies,” she added.

Congress should reject recent efforts by professional drug legalization lobbyists to soften federal laws on drug abuse and reduce federal support for RSDT. Their frenzied attempts to get street drugs legalized will only help drug traffickers reap further profits from the drug-related destruction of families, schools and communities throughout the nation. Congress must support parents and their children against the drug traffickers.

“This avalanche of tragic drug overdose deaths among our children should serve as a wake up call to all members of Congress. They must support America’s drug-besieged parents who demand that federal support continue and be increased for utilizing RSDT as a compassionate non-punitive means of reducing the nation’s inordinate demand for drugs and reducing the ultimate harm of massive drug overdose deaths,” said

Source DeForest Rathbone, Chairman of the National Institute of Citizen Anti-drug Policy (NICAP.)
April 30, 2009

By Carolyn Plocher (Bio | Archive)
October 14, 2009 – 17:03 ET
•
England can’t afford to help Alzheimer’s patients pay for their medicine, but it can offer free shooting galleries to heroin addicts.
On Oct. 14 CNN’s “American Morning” aired a segment about the controversial program that “gives heroin to heroin addicts at the taxpayers’ expense.” Correspondent Paula Newton declared, “A safe, steady supply of heroin is apparently just what the doctor ordered … As radical as it is, for some it is really working.” She also said that the British government’s decision to dole out 97 percent pure heroin – “better than anything sold on the street” – “takes heroin off the streets.”
John Strang, a member of King’s Health Partners claimed that the “intensity of the program is quite striking. The bond that is formed and the commitment that’s established between the patient coming in for treatment and the staff is far greater than you’d ever ordinarily see.” Not surprisingly, King’s Health Partners is affiliated with Britain’s National Health Services.
Newton summarized the rest of Strang’s interview:
The key seems to be treating heroin addiction like any other illness, and then having the patience to see the treatment through – even if that means the government is the drug dealer of choice for months, if not years.
That should comfort British taxpayers, who are shelling out $22,000 per year per addict for the program.
Although Newton mentioned in passing that “the jury is still out on this study as to what it actually does to get people off heroin permanently and get clean,” she cited the study’s claim that the program had reduced “street heroin by three-quarters and the crimes committed in trying to get that drug by two-thirds.”
“Taking heroin off the streets is making a difference,” Newton declared.
But if Newton had given any air time to critics of the program, its faults would have been glaringly obvious.
Susie Squire, the Political Director at the U.K.’s TaxPayers’ Alliance, voiced the worst of it back in Septemper:
Many taxpayers will have a massive problem paying for addicts’ heroin, particularly at a time when the NHS is unable to provide them with doctor’s appointments or life-saving cancer drugs.
This approach also reflects a poverty of ambition, with the Government merely accepting hard drug use and instead of trying to crack down and stamp it out, giving out lethal drugs for free.
Heroin addicts attend a clinic twice a day to inject themselves with diamorphine – the medical term for heroin – in the hope that their addiction will fade away. Some liken the idea to making children available to pedophiles in order to help them overcome their problem.
Reminiscent of Jonathan Swift’s “A Modest Proposal,” a blogger recommended this solution: “Perhaps the children taken off mothers that Barnardos [a UK children's protection service] disapproves of can be given to the kiddy fiddlers and then another problem will be solved.” Another blogger quipped, “If the government gives me money then I promise to stop stealing it.”
Mary Brett, the U.K . representative of Europe Against Drugs, feared that the program “will start with the most hardcore cases, but treatment services will find it easier to just give them a prescription, and more and more will be included in this scheme.”
Indeed, Russia, which has a notorious drug reputation, refuses to even consider implementing the program, stating that methadone – the heroin substitute used to wean addicts – “could seep into the black market, given the high level of corruption at many Russian clinics.”
Proponents of the program argue that, since it began in 2005, it has been extraordinarily successful in fighting illegal drug rings and drug related crimes. Of course it’s rarely mentioned that the program only involved 127 heroin addicts. Theodore Dalrymple, a diehard critic of “drug maintenance programs” and author of “Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy,” said:
The patients are self-selected: they have some motivation to change, otherwise they would not have attended the clinic in the first place. Only a minority of addicts attend, and therefore it is not safe to conclude that, if other addicts were to receive methadone, their criminal activity would similarly diminish.
In fact, the study’s coordinators had difficulty recruiting volunteers because the eligibility criteria and demands of the program were so stringent.
Furthermore, Dalrymple suggested that the real difference between the before and after crime rate could be “considerably less” because “the patients have an incentive to exaggerate it to secure the continuation of their methadone.”
As proof, other countries that have implemented similar programs with larger groups have reported little if any success. Neil McKeganey, of the Centre for Drug Misuse Research at Glasgow University, pointed out that in Scotland 22,000 people are on methadone but there has been no “linked reduction in crime or in the deaths of addicts.”
Even parts of England that have participated in drug maintenance programs have failed to improve. For example, in Liverpool 2,000 people are prescribed methadone for their drug addictions but it’s still the world capital of drug-motivated burglary.
In fact, the program could actually do more harm than good. A shocking 2007 Justice Department study discovered that buprenorphine – another opium derivative that was being used to treat heroin addicts in prison – became the third drug of choice for addicts after marijuana and heroin itself. Similar studies discovered that buprenorphine was 15 times as addictive as heroin.
But even if the program isn’t helping drug abusers kick their habits, the government argues that at least it’s having a big impact on crime … or is it? The British government views an addict as “a person who is ill, like someone with pneumonia, whom it is the duty of the system – the paraphernalia of doctors, nurses, social workers, drug counselors and so forth – to cure.” Therefore, the government believes that if it gives addicts free needles, then they won’t “steal, rob, and burgle.” But the premise is wrong.
The majority of heroin addicts already had an extensive criminal record before they tried heroin for the first time. In other words, criminality is more likely to cause addiction than addiction is to cause criminality.
So if this program doesn’t cure addicts and it doesn’t prevent crime, what other options are there?
First, drug addiction needs to be viewed as a choice, not an illness. Mao Zedong, the former leader of China, cured 20 million opium addicts over just one weekend by announcing that anyone still addicted would be shot on Monday. Dalrymple gave a less extreme example with the “huge numbers of American servicemen addicted … to heroin during the Vietnam war.” He said:
Almost all of them gave up spontaneously soon after their return to the US, and two years later their rate of addiction was no higher than that among drafted conscripts who never made it to Vietnam because the war ended.
And addiction doesn’t come from a one-time adventure, or even a few episodes. In fact, addicts usually spend a year intermittently using heroin before they decide to use it regularly.
Addiction is a choice, and with that choice, the responsibility falls on the addicts – not the government – to walk away from that disastrous life. Perhaps that’s why drug abstinence programs are more successful than drug maintenance programs. The addict has made the choice and “maintaining” even small doses of the drug isn’t acceptable.
It’s hard to believe that with this much information easily accessible via Internet that CNN could present even a small portion of the other side of the story.

Source: www.newsbusters.org 14th Oct.2009

September 29, 2009

A recent analysis of official reports on the Sydney Kings Cross injecting room confirmed that unavailability of heroin is of far greater significance in preventing heroin deaths than the availability of injecting rooms.
Less than 9,800 drug users were registered at Kings Cross, a small number of illicit drug users in New South Wales. Most drug users lived well away from Kings Cross and used the rooms only occasionally so most drug use was elsewhere.
The severe heroin drought at the end of 2000 led to the reduction in drug deaths. In fact, timely ambulance attendance is more likely to prevent a drug death than any other factor.
Source: Kings Cross Injecting Centre Fails to Reduce Overdose Deaths, Dr Sullivan PhD. Click here for the research.
DRUG ADVISORY COUNCIL OF AUSTRALIA COMMENTS
This study confirms overseas research that indicates that injecting rooms are a failure and are being closed down. Restriction of illicit drug supply is effective in reducing use and deaths.
Reducing the demand for illicit drugs is a key to successful drug policy.
Drug policy should divert identified drug users into court ordered and supervised detoxification and rehabilitation to get them drug free.
THE DRUG ADVISORY COUNCIL SUPPORTS:
• More detoxification & rehabilitation that gets illicit drug users drug free.
• Court ordered and supervised detoxification & rehabilitation.
• Less illicit drug users, drug pushers and drug related crimes.
Posted at 10:40 AM in News, Policies, legislation | Permalink
Comments
A very good point. So let’s destroy the heroin fields in Afghanistan!
Posted by: Frugal Dougal | September 29, 2009 at 04:54 PM
There were 2,106 overdose “events” treated at the Centre during the trial period. Nobody died during this time and yet, according to the study, no deaths were necessarily prevented, because these people could have been treated by paramedics or in a hospital ED.
True – as long as they were using with a responsible friend who could call out an ambulance. But the target group, street injecters, often don’t.
It is impossible to say exactly how many of these 2,000+ events would have been fatal had they happened elsewhere, but to choose instead to look for the effect of a single clinic by using overall population data is misguided, or just plain dishonest.
What this study shows most clearly is that people will take the evidence that suits their ideology and use it to attack the good work that is being done by others, simply because, in their opinion, it is “wrong”. Whether lives are saved, or not, is secondary.
Posted by: Adam Baxter | September 30, 2009 at 10:59 AM

 Jul 10, 2008

A Review of What Works

Introduction
Alcoholism affects millions of people in the United States alone. According to the National Institute of Alcohol Abuse (NIAA), a division of the National Institutes of Health in Bethesda, Maryland USA, at least 700,000 Americans receive treatment for this disease every day. Some kinds of treatment, such as Alcoholics Anonymous (AA) have been around for many years while others are relatively new. Clinical research to determine the effectiveness of these various treatments has resulted in some important findings.
In October 2000 the NIAA released a summary of its conclusions based on fifteen years of research on alcohol treatments. According to the NIAA, self-help programs such as AA, psychotherapy and pharmacotherapy, either alone or in combination, are in fact effective and do reduce the use of alcohol.
Alcoholics Anonymous
Of all the treatments for alcohol misuse, Alcoholics Anonymous (AA) is probably the most well known. In AA, a form of “self-help” treatment, participants take part in a series of mental, written and verbal activities that can lead to recovery and abstinence. In one study, alcoholic patients who received inpatient and outpatient psychotherapy, as well as AA, had better outcomes than those patients who attended only one kind of treatment.
It is thought that AA helps people because it provides a new social network that replaces the alcohol abuser’s usual group of friends who drink with him or her, and provides a fellowship that inspires motivation and lends support toward the goal of reaching and maintaining abstinence. AA also teaches a set of coping skills so that, when stressed, the alcohol abuser has more constructive ways of coping, and does not need to turn to alcohol to escape his or her problems.
Another study, conducted at a Department of Veteran Affairs hospital, indicated that those alcoholic patients who underwent either cognitive-behavioral therapy (CBT) or a 12-step program in combination with CBT did better, over the long run, than those who participated in the 12-step program alone. (CBT entails learning coping skills, new ways of interpreting and reacting to stressful situations, and changing one’s destructive or maladaptive behavior patterns.) The patients who received the combination treatment stayed sober longer and were able to hold down a job for longer periods than those patients who received only CBT.
Both of these studies seem to show that a combination of some kind of psychotherapy and a 12-step program such as AA produces the most beneficial results for patients who use alcohol in excess.
Other beneficial treatments
Other promising treatments of alcohol abuse that are being studied include Motivational Enhancement Therapy (MET); couples therapy; Brief Intervention Therapy; dual-addiction treatment; and pharmacotherapy.
Motivational Enhancement Therapy: The key component of MET is an interviewing technique conducted by a trained psycho-therapist. The goal of this method is to increase an individual’s degree of motivation to stop drinking and to maintain abstinence. This is accomplished by the therapist gauging the individual’s readiness to change and then adjusting feedback accordingly. An intensive, individualized interviewing strategy, MET was demonstrated to overcome many patients’ disinclination to address their alcohol problem in treatment and increase their willingness to change.
Couples Therapy: Patients who include their non-alcohol abusing partners in their psychotherapy are more apt to attend therapy, and more likely to alter their unhealthy drinking habits. In one model of couples therapy known as Behavioral-Marital Therapy (BMT), communication and conflict-resolution skills are taught. When a relapse-prevention plan was added to this model, alcohol abstinence rates were even higher.
Brief Intervention Therapy: This treatment method usually takes place when alcohol users visit their primary care physicians. It typically entails the imparting of information about the negative consequences of drinking to excess, as well as supportive programs in the community. Two studies, carried out in the United States and Canada, showed that patients did reduce their alcohol consumption as a result of these interventions. This treatment seems to work best with those individuals who are at-risk for alcohol abuse. Those who are already dependent are better off being referred to specialized treatment programs.
Dual-addiction treatment: This method attempts to target both cigarette (nicotine) and alcohol dependencies at once. The use of one of these substances seems to make an individual more susceptible to dependence on the other. The rationale behind dual-addiction treatment is that reducing dependence on one may help a person reduce his or her reliance on the other. Although this is a newer approach to treatment, a recent study seems to suggest that this is indeed the case.
Pharmacotherapy: Finally, if taken on a regular basis, the drug naltrexone, approved by the U.S. Food and Drug Administration in 1995, can be a valuable aid in preventing relapse among recovering alcoholics receiving psychotherapy. Another medication, acamprosate, proved helpful in several European trials. (Editor’s note: It is now undergoing clinical trials in the United States.) Zofran, a medication usually used to prevent nausea during chemotherapy for cancer, was beneficial in the treatment of early-onset (i.e. those who started drinking heavily before age 25) alcoholism. Sertraline (Zoloft), an anti-depressant, was found to be helpful in reducing drinking in those with late-onset alcoholism.
Summary
Using proven methods of evaluating medical therapies, recent research reveals that many effective treatments exist to help people to stop drinking and maintain abstinence. These treatments include self-help groups such as AA, psychosocial approaches and medications.
Continued research in the field of alcoholism is likely to produce highly specific medications that will reduce the craving for alcohol. It will also yield an even broader range of therapies, including those mentioned here, that will improve the alcohol abusing person’s chance for recovery.
Over time, those who suffer from alcohol abuse and/or dependence will have even more and possibly better options for successful treatment. In the meantime, effective treatments already being offered by mental health professionals and community groups have been demonstrated to reduce alcohol use and promise a better life for people who make use of them.

Source: Jul 10, 2008 WorldWideAddiction.com

In May 2008 the current Home Secretary Jacqui Smith announced that she would reverse the 2004 decision and put cannabis back into category B.
The move went against the ACMD’s latest recommendations, but was, she said, necessary because of research linking heavy use of the drug with schizophrenia and other mental illnesses.

Ms Smith said she was particularly concerned over the rise in consumption of super-strength strains of cannabis, such as “skunk”.
The Home Office say such strains account for 80% of all cannabis seizures in the UK.

Read the article

http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/7845023.stm

*** THE NEW APPROACH

Class A: Ecstasy, LSD, heroin, cocaine, crack, magic mushrooms,
amphetamines (if prepared for injection).
Possession: Up to seven years in prison or an unlimited fine or both.
Dealing: Up to life in prison or an unlimited fine or both.

Class B: Cannabis, amphetamines, Methylphenidate (Ritalin), Pholcodine.
Possession: Up to five years in prison or an unlimited fine or both.
Dealing: Up to 14 years in prison or an unlimited fine or both.

Class C: Tranquilisers, some painkillers, Gamma hydroxybutyrate (GHB),
Ketamine.
Possession: Up to two years in prison or an unlimited fine or both.
Dealing: Up to 14 years in prison or an unlimited fine or both

Source: ECAD Newsletter 25th Jan. 2009

NDPA COMMENT
The following item on BBC Online (Newsbeat) 13th July has a spokesperson from the Department of Health declaring that “The government has invested £406 million for drug treatment in 2009/10, of which £24.7 million is available to support young people’s treatment,” … And yet the only residential rehab in the country for those age under 18, Middlegate Lodge, is fighting closure for lack of funds. ‘Treatment’ in the UK often means methadone maintenance (useless for cocaine addiction) or counselling sessions for a few weeks – also useless if the young person is still living in the same area and meeting the same using friends. The Department of Health and the National Treatment Agency need to seriously re-consider ‘treatment’ – and not only for young people – and to seriously invest in more effective drug prevention.

Cocaine A&E cases hit record high
Seventeen people a week are now being admitted to accident and emergency departments after taking cocaine, according to official government figures seen by Newsbeat.

More than one million people regularly use cocaine in the UK
Doctors treated 894 people in England for a “cocaine-induced health emergency” in 2007/8, compared with 740 in 2006/7 and just 448 in 2003/4.
The total number of people taken to hospital after using any type of illegal drug has risen 45% in five years to 9,543, according to the figures obtained by the Liberal Democrats.

“These statistics are really shocking,” said the Liberal Democrat health spokesman Norman Lamb. The price of cocaine has come down significantly but at the same time it has also [become] chic. That hides the massive health risks.”

Health problems
More than one million people regularly use cocaine in the UK – more than any other European country – according to the UN’s latest report.

Snorting the drug in large or strong quantities often leads to hallucinations and disorientation. At the extreme end “cocaine poisoning” can occur where the user starts fitting and vomiting.
Cocaine use also constricts blood vessels and can result in a rise in body temperature, burst blood vessels and, in some cases, death from brain seizures, heart failure and respiratory problems.
Research in the medical journal Circulation suggests that up to 25% of heart attacks in people under 30 can be blamed on regular cocaine use, instead of the more typical coronary artery disease.
John, not his real name, from Northampton told Newsbeat he collapsed in a pub after months of serious cocaine use.
“I had bought coke that day and had been using it. As the night went on I got more paranoid to the point where not a lot was making sense. That’s when the anxiety set in,” he said.
“I remember getting up and thinking I need to get out and within five steps I collapsed and started having fits on the floor. It felt as if I was being kicked to pieces on the ground.”
“I can’t remember a great deal from that evening. I went straight to hospital and was seen by the mental assessment team and that is when I realised I needed to change my life.”

Falling price, growing use
Doctors say the falling price of cocaine means users are more likely to take larger amounts on a night out, increasing the risk of an accidental overdose. The average street price of the drug is now down to £42 a gram – partly because it is increasingly cut with other chemicals – according to the charity DrugScope.

That could make a line more dangerous as people either react badly to the cutting agent or get used to the low purity making them more vulnerable if they accidentally come across a strong batch.
The government’s drug advisors warned last year that they are seeing more cases of young people ending up in hospital after snorting lines of MDMA – or powdered ecstasy – thinking it was cocaine.
Kerry, 23, from Kent, told Newsbeat she had a couple of bad nights on coke before deciding to stop taking the drug for good.
“I was doing too much of it. I remember being sick a few times and eventually I was found underneath the building fitting with my eyes rolling up the back of my head,” she told Newsbeat.
“I don’t remember any of it. I just remember waking up with my friends in front of me crying. They wanted to call an ambulance but I just about managed to come round but was hazy for about three days.”

‘Record investment’
Six months later one of Kerry’s best friends died on a night out after taking the drug.
“She hadn’t touched it for a while and then one weekend she got the wrong sort of stuff – which was mixed with MDMA and some other things – and then once it went up her nose it killed her,” she said.
“By the time she got to the hospital it was too late; she died in the ambulance. I was devastated because we both just thought it was a bit of fun and it would never happen to us.”
While government surveys show that drug use as a whole has fallen since records began in 1995, the number of adults taking cocaine has risen from 0.6% in 1994 to 2.3% last year.
A spokesperson for the Department of Heath said tackling drug misuse remains a priority.
“The government has invested £406 million for drug treatment in 2009/10, of which £24.7 million is available to support young people’s treatment,” she said.
“Drugs use amongst young people is actually declining. Thanks to record investment, specialist substance misuse services have expanded greatly and there are now more young people getting treatment.
“This is encouraging and reflects our continuing efforts to tackle drug use amongst young people.”

Four out of ten teenagers know someone with mental health problems caused by cannabis, a report shows. More than half of youngsters questioned also believed that those smoking the drug lose motivation and do badly at school.
The survey, by the Home Office funded drugs advice service Frank, is fresh evidence that the supposedly soft drug has harmed the health, education and careers of millions of teenagers. It comes a week after a study showed that even one-off users of cannabis show signs of behaviour linked to schizophrenia, with half of those tested having an ‘acute psychotic reaction’.
The results challenge the orthodoxy – followed by Frank in its guidance to youngsters – that cannabis is dangerous only to heavy users or those who already have mental health problems.
The advice service’s report showed that 42 per cent of 11 to 18-year-olds knew someone who had suffered mental problems from the drug, including paranoia, panic attacks and memory loss. The figure suggests that 1.5million teenagers have had direct experience of the harm caused by cannabis.
It could be a reason why fewer youngsters have been taking the drug, with use falling since 2001. However, the number of under-25s smoking cannabis was still almost one in five last year. Among those who knew someone who had suffered damage from cannabis, 64 per cent said the harm took the form of panic attacks.
The survey of 28,000 teenagers, which was carried out through a social-networking website, also found that 56 per cent of those questioned ‘associate cannabis use with losing motivation and doing badly at school or college’. Almost 15 per cent said they used cannabis, which they claimed helped them cope with life. But only 11 per cent said they thought using the drug made them look cool.
The criminal status of cannabis was downgraded to Category C by Labour in 2004, meaning it ranked alongside performance-enhancing drugs used by cheating athletes. This meant users would be arrested only rarely if caught by police.
However, deepening concerns over the mental health effects of the drug – and the stronger varieties now sold on the streets – meant it was pushed back into the more serious Category B this year. But still only a few of those caught with cannabis will be arrested, with police more likely to use powers to hand out on-the-spot fines.
Frank spokesman Chris Hudson said: ‘The majority of teenagers don’t want to risk their health by using cannabis, however some people choose to take the risk.
‘Others wrongly believe cannabis is harmless because it is a plant. Cannabis messes with your mind – and reactions can be more powerful with stronger strains such as skunk, which is around twice as potent.’ The organisation is to start an anti-cannabis advertising campaign next week, timed to catch teenagers during their summer holidays when they may be tempted to use drugs.
The Frank website currently states that only regular use of cannabis is associated with the risk of mental illness. It also says that nobody knows whether stronger strains of the drug carry higher risks. Phone lines run by the advice organisation, paid for out of a Home Office subsidy of £6.5million a year, can be even less discouraging.
One caller was told earlier this year: ‘Alcohol is a powerful drug in what it does to your body and how many brain cells it kills and stuff. Cannabis is not to be taken lightly, but it’s a lot less powerful. If alcohol were illegal it would be a Class A drug. Cannabis should just be a Class C drug. In terms of its effects it’s a lot less powerful than drinking.’
Anti-drug campaigners welcomed the Frank research. Mary Brett of Europe Against Drugs said: ‘Frank has been stuck in a time warp. Their website still isn’t up to date. They have always said you should steer clear of cannabis if you have a history of mental illness. It doesn’t seem likely that the damaged people known to 42 per cent of teenagers all had a history of mental illness.’
Source: Daily Mail 6th Aug. 2009

The following letter from Peter O’Loughlin regarding the NTA Report is very illuminating. Harm Reduction is central to the UK government policy on drugs but the continued increase in deaths related to drug misuse must surely necessitate a change. Prevention first, then intervention, then treatment leading to abstinence. Treatment should include the choice of residential for those who desire it and harm reduction should be used as a last resort for a limited time.
SMMGP POLICY UPDATE – Good Practice in Harm Reduction Report NTA (October 2008)

I would respectfully point out that the claim regarding reduction in drug related deaths fails to acknowledge the fact that there was an increase between 2003-4, largely accounted for by deaths involving heroin/methadone and morphine (1)

Your update also disregards the fact that drug related deaths are at their highest for 5 years.(2) In fact as you should be aware the total number of drug poisoning deaths in 2007 including a staggering 16 per cent rise in deaths involving heroin and morphine compared to 2006, increased to 2,640.

It is even more regrettable that you chose not to point out that deaths from heroin and morphine appear to be increasing year on year, or the fact that in 2007 there were 196 deaths involving cocaine, the highest recorded number of deaths involving cocaine since the ONS database began in 1993.

A further notable omission are the deaths relating to methadone, which increased by a wholly unacceptable increase of 35 percent over 2006 to 325 and once again the highest level since 1999.

An even more glaring omission is the fact that in males no less than 67 per cent of drug poisoning deaths were attributable to ‘drug misuse’.

In the light of the foregoing, I have to consider whether your update ‘Good practice in Harm Reduction’ is being unrealistically optimistic, or, like the title, misleading. I will reserve judgement pending your comments.

(1) Office of national Statistic in 2007s: April 2007

(2) Office of national Statistics: Health Quarterly Statistics autumn 2008.

Source: e-mail from Peter O’Loughlin, The Eden Lodge Practice.
Date: Fri, 6 Feb 2009

Drug treatment programmes are only successful for around half of the drug addicts who enrol on them, figures have shown.

Health minister, Dawn Primarolo, said just 35,441 patients out of 69,612 were given “successful discharges” from structured treatment programmes in 2007-08. This works out at about 51%.

That left 34,171 patients who failed to complete their treatment for drug misuse, figures released in a written parliamentary answer to shadow home secretary Dominic Grieve showed.

This included 19,591 – or 28% – who simply dropped out or left, with a 2,169 turning down the treatment and 2,078 having treatment withdrawn. A total of 4,240 (6%) failed to complete their course due to be admitted to prison.

Of the successful cases, only 11% were considered to be “completely free of using illegal drugs”. This totalled about 7,324 ex-users. The remainder were either using drugs in a “non-dependent way” or were referred on to other services.

Source: Nursing in Practice 15th Jan 2009

The United Nations’ crime and drug watchdog has indications that money made in illicit drug trade has been used to keep banks afloat in the global financial crisis, its head was quoted as saying on Sunday.
Vienna-based UNODC Executive Director Antonio Maria Costa said in an interview released by Austrian weekly Profil that drug money often became the only available capital when the crisis spiralled out of control last year.
“In many instances, drug money is currently the only liquid investment capital,” Costa was quoted as saying by Profil. “In the second half of 2008, liquidity was the banking system’s main problem and hence liquid capital became an important factor.”
The United Nations Office on Drugs and Crime had found evidence that “interbank loans were funded by money that originated from drug trade and other illegal activities,” Costa was quoted as saying. There were “signs that some banks were rescued in that way.”
Profil said Costa declined to identify countries or banks which may have received drug money and gave no indication how much cash might be involved. He only said Austria was not on top of his list, Profil said. (Reporting by Boris Groendahl; Editing by Charles Dick)
Source: Reuters 25th Jan. 2009

Last month this blog highlighted an article by Times columnist Libby Purves about late night policing in Ipswich and pointed out the lack of formal sanctions she saw being used while spending a shift with officers dealing mainly with pub and club goers. In particular, the following passage demonstrated the light touch policing method employed:
I question PC Rafferty about his interpretation of “drunk and disorderly”, since one in five of those around us is now, in my view, disorderly. If there were any peace they would be breaching it. He laughs: “Drunk and hopeless.” There aren’t enough cells, or time for the paperwork. The police merely contain the bingers, keep them friendly. By and large it works.
I then asked whether this did in fact ‘work’, and questioned if merely managing or containing drunken and disorderly behaviour was preferable to a more comprehensive solution.Another Times article a few days later by Anjana Ahuja outlined evidence from experiments which help confirm the ‘broken windows’ theory – that tolerating minor wrongdoing results in more serious crime and disorder. One of the experiments conducted was outlined thus:
Dr Keizer’s team left an envelope hanging out of a postbox; the stamped and addressed envelope had a window through which could clearly be seen a five-euro note. How would passers-by, or those posting a letter, react when they saw it? The vast majority (87 per cent) either left it alone, or pushed it into the postbox. Only 13 per cent took it away (this was regarded as stealing).

But roughing up the environment had a dramatic effect. When the postbox was tagged with graffiti, 27 per cent of people stole the letter. When the postbox was surrounded by rubbish (but not graffitied), 25 per cent pocketed the cash.

The academics, who reported their startling results last month in Science, suggest that disorder does indeed beget disorder; when one social or legal norm is obviously violated, we are tempted to loosen our grip on others.
The broken windows theory forms the basis for zero tolerance policing. But, as the experience of policing in Ipswich demonstrates, the reality on the ground is arguably nearer to zero enforcement than the more robust approach required by the science, which in turn perhaps provides some insight into why the UK has such a self-evident law and order problem.

Another important facet of this debate is how out of touch the powers that be – desk-bound senior police officers, politicians, councillors and public servants – are with what happens at the sharp end of policing, and the implications this has for policy-making. Yet another recent Times article provides some evidence relating to this. In a piece about drugs legislation and enforcement, Andy Hayman, an ex-assistant commissioner at Scotland Yard, argues that the reclassification of cannabis and ecstasy will make little difference to policing on the ground. In relation to the bureaucracy he says:
I used to serve on the [Advisory Council on the Misuse of Drugs] in my capacity as the leading police officer on drugs policy. By the end of my stint I felt that its detachment from grassroots reality had eroded its credibility. Its purpose seemed to be to generate endless rounds of meetings and glossy reports to send to ministers.

Up to 70 members – made up of representatives from all sorts of government and voluntary bodies – attended the unwieldy full meetings, which were supported by a plethora of smaller working groups and sub-committees. I was always struck by how the experience of those living in the thick of the drugs problem got lost among the grey suits having highbrow technical and medical discussions.
As regards enforcement and prosecution:
The council would be horrified to learn that its recommendations on drugs classification are not taken seriously. But that is the case. The public either don’t understand the process or are not interested in it. For the police, the advisory council is a sideshow; officers prefer to apply their professional discretion on whether to caution or arrest suspects.

Put bluntly, how a drug is classified doesn’t help police officers in their day-to-day duties. The first thought of an officer confronted by a user of an illegal drug is to weigh up whether the possession warrants anything more than a caution. To make an arrest and charge doesn’t guarantee a prosecution so it may be simpler to deal with it on the street. That decision is made regardless of the classification of the drug involved.

For the courts, categorising a drug does help to provide a tariff for punishment. But even that idea has become dated as the Crown Prosecution Service now tends to apply its own prosecution guidelines. In practice, the classification of a drug does not significantly change how the courts or police deal with drug offenders.
Of course, these examples are a mere microcosm of the bigger problem, but extrapolate them to policing and crime generally – not to mention the even bigger picture of government and the public services – and the implications are surely self-evident.
About this site
Planet Politics is about disillusionment with the political process.
Planet Politics has absolutely no links to any political party, pressure group or the press, and is best described as anti-politics rather than non-aligned.

Source: planet–politics.blogspot.com Feb 2009

Should cannabis be decriminalised or not? Should it be classifed as a class B or C drug? Debates are irrelevant while they are entrenched in misinformation and disinformation
This article by Deirdre Boyd appeared in Addiction Today, November 2000 – before the ACMD advised then Home Secretary David Blunkett to reclassify it downwards to a class C drug. On the urging of prime minister Gordon Brown, the ACMD is again hearing evidence this February. The facts here have not dated – in fact, more recent research validates them further.
The most noticeable factor in ongoing debates about cannabis is the vast foundation of ignorance on which people are basing the most emotive, entrenched arguments. The fewer facts people have, the more heated they seem to be. This country needs a strategy of health information about cannabis which is as available and comprehensive as that eventually offered by anti-tobacco campaigners.
Cigarette smoking started to reduce because people were – after a battle spanning decades – given the facts about its risks. Cannabis smokers also deserve the truth so that they can make informed decisions about their own health and that of their families.
For example, are the people – including government ministers – who argue that they took pot in the 1960s and 1970s without any harm aware that the pot/marijuana/cannabis of today is not the same substance they took back then? Like every other profitable product, cannabis has been refined over the decades so that it is now four to 12 times more potent than it was 20 years ago.
So, for the moment, let’s put to one side the legal and criminal ramifications and look at what studies show about the effects of cannabis on health.
IDENTIFIABLE SYMPTOMS
When asked by a teacher suspicious of wide swings in academic performance in some of his students what symptoms could help to identify a pupil using cannabis, Dr James West of the Betty Ford Center gave the following answer.
“Cannabis affects the cerebral, cardiovascular, pulmonary and neuroregulatory systems. Acute or chronic use leads to: euphoria, decreased mental functioning, faster pulse, decreased pulmonary function, exacerbation of asthma, conjunctival injection (red eyes), pharyngitis (sore throat), bronchitis, stuff nose, dry mouth, sinusitis, perceptual delusions, paranoia, mood shifts, sleepiness, sexual arousal, anxiety/panic, lethargy and lack of ambition, plus angina in a pre-existing heart disease.
“The symptoms of overdose are very rapid pulse, very high blood pressure, delusions, hallucinations, seizures in epileptics and acute mental changes including psychosis. There are also withdrawal signs for regular users who quit abruptly: irritability, restlessness, insomnia, mild tremors/ bouts of chills and sometimes a low-grade fever.”
CANCER
A report by the British Medical Association found that smoking a cannabis cigarette leads to three times more tar inhalation than from a tobacco cigarette – and long-term use can lead to lung cancer. Dr West states that cannabis contaiins four to five times the lung-cancer-producing hydrocarbons as does tobacco.
BRONCHITIS AND OTHER RESPIRATORY DISORDERS
Such disorders linked with smoking can also be caused by long-term use. It is unclear if there is more risk of these disorders than with tobacco. But cannabis users tend to inhale more deeply and the drug does contain more tar. “Cannabis irritates the respiratory system and obstructs smaller airways with a form of bronchitis-emphysema,” explains Dr West.
HEART PROBLEMS
The heart responds to cannabis with an increased heart rate proportional to the dose of the drug. Usually, after smoking pot, the heart rate increased by 20-40 beats per minute, and rapid rates of 140 beats per minute are not unusual. Chronic use can lead to angina in people with pre-existing heart problems.
ADDICTION
Although infamous for recommending the decriminalisation of cannabis, the Runciman Report states that “the number of people seeking help from drug agencies for problems with cannabis use has doubled from 1,400 in 1993 to 3,300 in 1998 (10% of the total seeking help). This is only the people who identified cannabis as their “main drug”.
Cannabis is addictive, concludes a survey by the US National Institute of Drug Abuse. It found that 75% of people who gave up cannabis had cravings for it, and 70% switched to tobacco in an attempt to stay off. Almost 50% said they became irritable and many were bored after giving up the drug.
And in more recent experiments with monkeys, a NIDA team warned that cannabis might be as addictive as heroin and cocaine.
A 1994 report from the Center on Addiction and Substance Abuse at Columbia University found that 60% of children who smoked pot before the age of 15 years moved on to cocaine, and 20% of those who first smoked pot after age 16 then used cocaine.
RELAXING QUALITIES versus DEMOTIVATION & DEPRESSION
Cannabis is best known as a relaxant. This can lead to lower blood pressure, increased appetite, feelings of relaxation, mild intoxication and increased sociability. Smokers usually feel its effects in minutes and they can last up to three hours. The effect is delayed when eating or drinking, so that it lasts longer and can be harder to control. And the relaxing effect can go too far. Research shows that cannabis affects almost ever bodily system, slowing down reaction times, causing drowsiness and confusion.
MEMORY LOSS
Because cannabis is absorbed into the brain cell wall, it is considered more destructive to brain tissue than opioids. Heavy use impairs general intellectual functioning such as memory and comprehension. Even in small doses, dope smoking is known to cause short-term memory loss.
ACCIDENTS
Even “casual use” of cannabis impairs psychomotor skills like those needed to drive a car. It increases the chance of a traffic accident or accidents while operating machinery.
LEARNING IMPAIRMENT
Studies sow that regular heavy use can cause nerve damage and affect learning.
HALLUCINATIONS, PARANOID DELUSIONS
These can result from even small doses. Anxiety and panic are common.
COORDINATION
This, too, is affected by cannabis.
COMA
High doses can cause coma. But we are not aware of any records of fatal overdose.
PSYCHOTIC ILLNESS
“It can have adverse psychic effects ranging from temporary distress, through transient psychosis, to the exacerbation of pre-existing mental illness,” the Runciman Report states about cannabis.
Dr Andrew Silski, consultant psychiatrist and medical director at Pembury Hospital in Tunbridge Wells, backs this. “I estimate taht 75% of the young people I see suffering psychotic illness have a history of cannabis abuse,” he revealed.
The drug contains hundreds of active ingredients, most importantly cannabinoids, which interfere with the chemical functioning of the brain. Its most serious effect seems to be depleting neurotransmitters – such as dopamine, which is linked with pleasure – and hindering electrical currents vital for brain function.
People with personality disorders can succumb to amotivational syndrome. They lose motivation, drive and willpower, leading to depression. This can damage education, work prospects and relationships.
“There is also an unknown number of people with a mental or chemical predisposition for psychotic illness,” states Wilski. “In them, cannabis can trigger altered moods, confusion, delusions or hallucinations. Cannabis also has a profoundly worrying effect on people with unspecific brain impairment or weakness, such as dyslexia. And it is no coincidence that some ethnic communities, in which cannabis use is endemic, suffer hugely increased levels of psychosis: six to 20 times greater than the norm.”
FALL IN FERTILITY
Abnormalities can occur in the reproductive systems of men and women. Cannabis can cause irregularities in the menstrual cycle. And studies of males have shown reduced sperm count and mobility as well as sperm of abnormal appearance. Sterility and infertility have occurred in users.
LEUKAEMIA IN CHILDREN OF USERS
Smoking pot in pregnancy has been found to be linked to a form of leukaemia in infants.
The facts are here. The choice is yours.
Source: Addiction Today, November 2000

In Britain, Europe’s biggest consumer of narcotics, the Home Office reckons that drugs are brought in by about 300 major importers, who pass them to 30,000 wholesalers and then to 70,000 street dealers. Cocaine, meaning both the sniffable powder and smokable “rocks” of crack cocaine (which can be made using a simple microwave), accounts for about half the value of this industry, being less widely taken than cannabis but much pricier.
Some rare light was shed on the business by a Home Office study in 2007, in which 222 drug-dealers were interviewed in prison by analysts from Matrix Knowledge Group, a consultancy, and the London School of Economics. One dealing partnership, based in London and Spain, bought cocaine from a Colombian importer in 10kg bundles, which they sold to retailers using an employee whom they paid £500 ($703) per transaction. A second employee, paid £250 a day, would collect money from the buyers and pass it to a third member of staff, who would count it (processing up to £220,000 each day). Other employees would pay the Colombians and smuggle the rest of the cash, on their bodies, back to Spain.
Most drug businesses are forced to stay small and simple to evade the police. Only one dealer claimed to be part of an organisation of more than 100 people, and a fifth were classified by researchers as sole traders. Fear of being uncovered also hampers recruitment: most dealers stuck to family and friends, and people from the same ethnic group, when hiring associates. Just like other businessmen, they carried out criminal-record background checks on potential employees—except that, in this case, a record was a good thing.
Kevin Marsh, an economist at Matrix Knowledge, argues that most players in the drug business have a poor knowledge of the market. “Shopping around for new wholesale suppliers is risky, so many retailers stick to the same one and pay over the odds,” he says. Most of the dealers interviewed knew little about the purity of what they were buying, and money laundering was usually fairly shambolic. Managing cashflow is one of dealers’ biggest weaknesses, according to one drug specialist at the Serious Organised Crime Agency (SOCA): “Supply of powder is the most resilient thing. To destroy the business, you have to go after the money.” That, and extradite foreign dealers, as America has long done. Britain is believed to be negotiating its first-ever extradition of a Colombian, on drug charges, at the moment.
Times may at last be getting harder for cocaine-dealers. Shortly before Christmas, the wholesale price in Britain shot up to £40,000 per kilo, the highest in years. Better policing was one cause; another was the slump of sterling. European retailers’ margins have been chipped away. To protect their profits, dealers are diluting what they sell. A decade ago, average street-level purity was about 60%; police say it is now nearer 30%. “People think there is a lot of cocaine around, but two thirds of it isn’t cocaine at all,” says one SOCA officer.
That would be fine if the remainder were talcum powder. But in the past few years dealers have turned to pharmaceutical cutting agents such as benzocaine, a topical anaesthetic, which mimic the effects of cocaine and may be more harmful. Dealers call such agents “magic” because of their effect on profits. “Grey traders”, who knowingly sell such chemicals to dealers, are starting to be convicted.
Educating drug-takers about what is getting up their noses may lower demand. But cutting raises bigger questions for drug policy. “We may have to say at some stage that taking heavily adulterated cocaine is more physically harmful to the user than taking cocaine that’s less adulterated,” a senior SOCA official says. “That is not the case at the moment. But we’ve got to keep asking the question. I’m aware that the health equation could one day say: Stop trying to stop cocaine coming in.”
Source: Economist.com 5 March 2009

Notwithstanding research carried out by the National Treatment Agency (NTA) which clearly established that the majority of those who have developed dependence, wish to become drug free; here in the UK, the focus for the past 10 years has been on ‘harm reduction’, rather than seeking to engage users into abstinence focused recovery. The outcome of this disastrous and misguided policy has been an escalation in drug related deaths which are at their highest for 5 years, 325 of which are attributed to methadone, the flagship of the harm reductionists, together with a devastating increase in the spread of blood born disease among Injecting Drug Users (IDUs) The statistics provided by the Health Protection Agency for England and Wales are as follows:

• The level of HIV infection among Injecting Drug Users (IDUs) in England and Wales is higher now than at the start of the decade.

• In London where the prevalence of HIV in IDUs is higher than elsewhere in England and Wales, 1 in 20 IDUs is infected.

• In the remainder of England and Wales HIV among IDUs has increased from approximately 1 in 400 in 2002 to around 1 in 150 in 2006.

• The prevalence of Hepatitis C among IDUs has increased from 33 percent in 2000 to 42 per cent in 2006.

• Approximately 1 in 5 IDUs has Hepatitis B infection, which extrapolates as an increase approaching 200 per cent since 1997.

The escalating increase in blood born disease has occurred despite the plethora of needle exchange facilities throughout England and Wales, and the growth of supervised drug consumption rooms

It is self evident from the foregoing that here in the UK at least, it is not the lack of harm reduction measures which is contributing to avoidable deaths and the epidemic of blood born disease being wreaked on our society, but the use of toxic psycho active substances.

It is not so called prohibition which has failed, but the encouragement by way of the tacit permission, and in many instances, the not so tacit encouraging of continued use, inherent in the harm reduction ideology, which has failed users and society so abysmally.

The supporters of Harm Reduction, under their various guises have never allowed the truth to interfere with their propaganda, or indeed their more covert agenda, to legalise drug use; the main beneficiaries of which would be the pharmaceutical industry. Such a move would be to inflict further incalculable harm on society, since it would result in a growth of use and addiction, similar, if not more widespread, to that seen in the late 1800’s when most of the drugs which are controlled today, were in fact legal.

The growth of drug use during that period was the direct result of concerted efforts by leading members of the medical profession in promoting drug use, many of whom were influenced by Sigmund Freud, who was so unethical in his dealings that he accepted separate commissions from two competeing, large pharmaceutical companies, both of whom are still in business today, to write papers extolling the benefits of that destructive substance, cocaine, not only as the ‘elixir of life’, but also as a cure for alcohol and morphine addiction. The rest as they say is history

One has to ask is it a coincidence that many of the bodies, who are pressing for an end to what they term as prohibition, receive ‘research grants’ from the pharmaceutical industry?
Source: Daily Dose; posted by Peter O’Loughlin on 13 Mar 2009 at 6:23 am

By Seth Freedman – Guardian columnist – 5th June 2009.

A simplistic advertising campaign masks the corrosive, corrupting nature of narcotics
Yesterday afternoon, I met Release’s spokeswoman Claudia Rubin outside Old Street station in London. In a perfect piece of vehicular choreography, the first bus to veer past us at the roundabout bore the slogan “Nice People Take Drugs”, the phrase Rubin coined for Release’s latest campaign to kickstart a drug-policy debate.
The advert’s minimalist design was, she told me, inspired by the atheist bus campaign which caused such a stir last year. Release’s version dispenses with pictures or logos, relying instead on bold, orange lettering to convey the four-word mantra to street level. As marketing strategies go, it is a stroke of genius – guaranteed to achieve maximum impact, and luring viewers towards Release’s website to pique their curiosity.
However, the brilliance of the way the message is marketed does not automatically render brilliant the message itself. The intention behind the campaign is to attempt to break the societal taboo on drugs. According to Release, “the public is tired of the artificial representation of drugs in society” – informing passers-by that “nice people take drugs” will help “de-stigmatise drug use”, says Rubin.
Which is all well and good, but the fact that “nice” people have their faults doesn’t mean that their failings should be decriminalised and tolerated by everyone else. Nice people also break the speed limit, download pirated music, and commit any number of apparently minor misdemeanours, but the law isn’t meant to bend to accommodate such immoral behaviour just because a critical mass of people partake in a certain activity.
Defining what makes a nice person is, of course, an utterly subjective matter – as Release knows full well – as is determining at what point a person’s misdeeds turn them from nice to nasty. On one level Release is right: Rubin and I have been friends since we were 12, and the circles in which we mixed would definitely have passed the “nice” test, despite the vast majority of us having done drugs throughout our teenage years.
That we all came, saw and conquered our own mini-addictions and vices without turning to crime or violence is testament to our triumph over temptation, but to pass off our drug use as simply part and parcel of life is to gloss over the darker side of our experiences. Using drugs as an escape route, or a quick fix to our problems, was not a “nice” way to behave. Implying that drug abuse is socially acceptable, as Release are doing via their adverts, is not a noble message to hurl at impressionable children and teenagers who are unable to spot the nuance and meaning behind the stark sloganeering.
To claim, simplistically, that “nice people take drugs” masks the corrosive, corrupting nature of narcotics, as well as the underlying void they fill in users’ lives. The desire to get wasted – to blot out reality and allow substances to numb one’s senses to the present – is a desperate urge, and one which has held vast swaths of society in a vice-like grip since time immemorial. Ridding people of that impulse would do wonders for both their mental and physical health; bowing to so-called public demand and sugar-coating the truth about the dangers of drugs simply passes off as acceptable a wholly insidious behavioural streak.
Release believes that “the current [proscriptive] system has brought us powerful drugs like crack cocaine, skunk, and methamphetamine”, suggesting that the ban on the underlying narcotics has prompted cartels to invent stronger and deadlier variants of the original product. Such a theory is backwards: the demand for more potent strains is what spurs suppliers into action, not the other way round. I smoked skunk with my friends to achieve a deeper and darker haze: the legal status of cannabis was neither here nor there, just as those addicted to high-grade whisky or vodka couldn’t care less whether or not 3% lager is authorised for sale or not.
Addiction is a disease that affects tens of thousands of people in every generation. Allowing greater access to drugs will, as with alcohol and tobacco, only put more vulnerable citizens in temptation’s way – which neither Release nor anyone else should want to happen. Just as speeding laws shouldn’t be changed despite their impact on those drivers able to safely handle a car at 100mph, so too must drugs remain illegal to prevent risking the lives of the majority of the population.
Of the four words in Release’s advert, two leave too much open to interpretation: “nice” and “drugs”. “Good people smoke crack” would be a far more blunt and direct way to make the same point, but whether their message would be so blithely tolerated by the advertising authorities or the public is another matter – highlighting the essential error of drugs campaigning in the first place.
Source: Guardian.co.uk 5th June 2009Seth Freedman is a writer living in Jerusalem. He grew up in Hampstead Garden Suburb and worked as a stockbroker in the City for six years, before moving to Israel. Seth Freedman has written articles published in The Guardian and The Times – 81 articles published in 14 news websites since April 2008. No email address known for Seth Freedman.

Comment by NDPA:

The publicity provoked by the ‘Bus Slogan’ campaign by Release talks of ‘opening the drug debate’. This debate has been on-going for at least thirty years – and every time those who want to legalise drugs, or change the existing laws, lose the argument. They lie low for a few months. Then up they rise like a phoenix and declare ‘we must have a debate about drugs’. What they actually mean is ‘we must keep on debating about drugs until we get the answer we want’. Release and others of that ilk persistently turn a blind eye to the fact that the vast majority of the public (in the UK and worldwide) do not use illegal drugs themselves and they do not want their families impacted by the use of drugs by others. Drugs are unhealthy, unlawful, antisocial and unnecessary. Nice policies don’t accept drugs.

No one wants others to suffer. That’s the “Chink in the Armor” that Serra talks of. There may be some maladies that can be helped by marijuana, even if it is only psychologically. Those who are ill have been catapulted into the middle of the debate … a war, by a heartless and cruel group of people who want to get high and those who will not go speechless to watch our loved ones become like them. There seems to be no middle ground for those on our side understand all too well what the wrong message and role-modeling wrong behavior means.
These days, people on both sides of an issue are so polarized they won’t talk to each other, much less listen. Our side, with some willing to listen and talk, allowed the legalizer’s side to take ground that didn’t belong to them and more of the youth and those ill, (the vulnerable) are being hurt because they are now addicted.
Talking with and listening is an important issue with me – one is often surprised where one finds truth.
A friend suggested I read Sun Tzu’s book for the perspective of “know your enemy”. Understanding this, plus at the prodding of those I work with against drug use, I began to learn about the legalizers – an interesting study.
And then tonight; it’s ironic sometimes what one stumbles upon, poking around on the net! I happened onto a site that offered schooling toward a Criminal Justice Degree. I paused as I perused it; something wasn’t right, but as I looked it over, I couldn’t figure out what it was. I was thinking their ad, offering a salary of $40,000 as a DEA agent, wasn’t much of a motivation – not much to put one’s life on the line for! Still, I couldn’t quite leave that site. That “something’s wrong feeling” was stronger every moment; maybe I was seeing it, but I couldn’t recognize it. As I decided to search for it, I found it, printed lightly – almost as if it were not meant to be noticed.
What I’d noticed was the logo of one of the five schools offering the degree, one I’d seen before, many times now in my study. Evidently this time, for me it had been subliminal . . . . the link probably won’t mean anything to someone who hasn’t studied the players in the legalization movement – “it’s near impossible to keep up on even most issues in this ‘age of information’. I wonder if the DEA knows about this?”, I thought as I shook my head and began to laugh. “I wonder if my prohibitionist friends know about this? Gotta be someone’s idea of a bad joke – a legalizer’s school teaching future DEA agents”, I told myself. “I’ll bet users have noticed, … some of them”.
The school offering the degree? It’s the University of Phoenix. The university’s founder is John Sperling – one of the three men in what I call the “Daddy Warbucks Cartel”, the three men most responsible for funding the ballot measures all across the nation for the legalization of marijuana. (no; they’re not local grass-roots [pun intended] campaigns.)
Another is Peter B. Lewis, of Progressive Insurance. Wouldn’t it seem fitting that the government require all the “medical marijuana users” who drive, to sign with Progressive for their auto insurance? Could be real revealing, couldn’t it? The third man, is George Soros – all three radical politicos.
Another interesting thing I found that ties in as well – on an OSI, Open Society Institute’s site, (one of Soros’ numerous non-profits), I listened to a panel discussion over the net – about how nations like Iran have been successful at shutting down communications and the internet – what works and what doesn’t in totalitarian nations.
I found it interesting that it’s just exactly how the government of Iran recently reacted, attempting to shut down the ability of the people to talk with each other after this fraudulent election. Does anyone else find it ironic that proponents of drug legalization are in bed with a man who (I believe) essentially plans to take away others’ freedom?
If all three groups won’t talk, won’t listen, won’t give, it’s a loose / loose / loose, for everyone! Again, our side gave up or lost too much ground here and all sides are willing to fight to the end.
Source: examiner.com June 18th 2009

More than 11,000 children under 16 years old were treated last year for addictions to alcohol and drugs, including heroin, according to new figures released this week.
The National Treatment Agency for Substance Misuse puts the total figure of children treated at 11,294. This includes 6,075 under-16s addicted to cannabis, of which 102 are under 12 years old.
More than 4,000 children received help for alcoholism, including 57 under-12s.
The children addicted to class A drugs included ten under-12s who were dependent on heroin, out of 93 under-16s. A further 323 children were treated for cocaine misuse, 165 for ecstasy, and 36 for crack.
Conservative Health Secretary Andrew Lansley said the government is neglecting a ‘forgotten generation’ of children. “It’s a sad indictment of our broken society that so many are turning to things like drug and alcohol abuse at such a young age” he said.
The Department of Health said the high figures were due to an increase in spending on treatment, a rise of £10million, from £15million to £25million in the past five years,
Funding for the government’s national anti-drug campaign which is aimed at teenagers has been cut by 41 per cent from £9.05million in 2006-7 to £5.35million today.
Charity Drugscope offered an optimistic approach to the figures, saying the overall numbers of young people using illegal drugs has fallen in recent years, especially cannabis.
Source: www.askamum.co.uk 8th July 2009

Resolutions agreed by the Executive Council will obviously be subject to change and augmentation as NDPA itself grows. Full listing of Resolutions is available on request, but this brief synopsis gives a good measure of NDPA’s current strategy:
• NDPA will campaign for Prevention’s potential to be fulfilled, especially for the very young: a rational and ‘seamless’ set of policies across all age ranges is the aim; these should ideally combine to form a ‘Systems Approach’ which unites and empowers all sections of society.
• Policies and programmes should have the aim of healthy lifestyles free of drug misuse. Policies that condone or encourage drug use based on ‘Harm Reduction’ are not acceptable. Treatment interventions seeking to limit damage with known individual drug users have their place, but must be accompanied by an unequivocal health-promoting message. (As National Strategy indicates).
• NDPA supports laws and justice systems which reinforce drug-free and wholly healthy lifestyles, and endorses efforts to maintain and improve this situation. NDPA seeks improved, more accurate public information and far more accuracy and balance in the media. NDPA supports adherence to scientific research standards and ethics prescribed by the world scientific community.

The use of the most dangerous Class A drugs has hit a 12 year-high as more people take cocaine, new figures show.
Drug misuse figures show that one in six of people of working age – 15.6 per cent – expect to have taken a Class A drug in their lifetimes. This compares with 9.6 per cent in 1996.
The document revealed, for the first time, an official acceptance that use of Class A drugs is on the increase. Analysis of the figures showed a “slight underlying upward trend” which is “significant over the long term” between 1996 and 2008, Home Office statisticians wrote.
The figures also revealed a sharp rise in cocaine use. The survey found that 9.4 per cent of adult expect to take the Class A drug in their lifetime – compared with just 3.1 per cent in 1996.
Three per cent of all adults admitted taking cocaine in the previous 12 months, up from 2.4 per cent – meaning that there are an estimated 974,000 users.
Figures from the British Crime Survey showed cocaine use by 16-24 year-olds went from 5.1 per cent to 6.6 per cent between 2007/8 and 2008/9.
Drug experts said the increases, particularly in the case of cocaine, were of “significant concern” and blamed falls in price and increased supply.
Martin Barnes, chief executive of charity DrugScope, said: “These figures show a marked and worrying increase in the use of cocaine powder, in the adult population as a whole and among 16 to 24-year-olds. While this is not necessarily a surprise given the drug’s decrease in price and increase in availability over recent years, it is of significant concern, particularly the rise in use among younger people.”
The figures also showed that a third of people – 31.1 per cent – now expect to have taken cannabis in their lifetimes, up from 23.5 per cent in 1996.
Chris Grayling, shadow Home Secretary, said: “Hardly a day goes by without yet another depressing set of statistics about the scale of Britain’s social problems under this Government. Drug addiction causes family breakdown, is linked to a substantial proportion of crime and causes long-term damage to people’s health. We have to turn this round.”
Home Office Minister Alan Campbell said: “We are not complacent. We are taking comprehensive action to tackle cocaine use, from increased enforcement to reduce the supply, along with effective treatment, education and early intervention for those most at risk.
“Police and their partner agencies are seizing record numbers of drugs and cocaine purity is recorded at an all-time low. When people think they are taking cocaine, in some instances the actual purity is as low as 4 per cent.”
Source: www.Telegraph.co.uk 23rd July 2009

History has valuable lessons to teach policy makers but it reveals its lessons only grudgingly. Close analyses of the facts and their relevance is required lest policy makers fall victim to the persuasive power of false analogies and are misled into imprudent judgments.¬ Just such a danger is posed by those who casually invoke “The lessons¬ of Prohibition” to argue for the legalization of drugs.What everyone “knows” about Prohibition is that it was a failure. It did not eliminate drinking; it did create a black market. That in turn spawned criminal syndicates and random violence. Corruption and widespread disrespect for law were incubated and, most tellingly, Prohibition was repealed only 14 years after it was enshrined in the Constitution.

The lesson drawn by commentators is that it is fruitless to allow moralists to use criminal law to control intoxicating substances. Many now say it is equally unwise to rely on the law to solve the nation’s drug problem.

But the conventional view of Prohibition is not supported by the facts.

First, the regime created in 1919 by the Volstead Act, which charged the Treasury Department with enforcement of the new restrictions, was far from all-embracing. The amendment prohibited the commercial manufacture and distribution of alcoholic beverages: it did not prohibit use, nor production for one’s own consumption. Moreover, the provisions did not take effect until a year after passage ¬– plenty of time for people to stockpile supplies.

Second, alcohol consumption de¬clined dramatically during Prohibition. Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to state mental hospitals for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928.

Arrests for public drunkenness and disorderly conduct declined 50 percent between 1916 and 1922. For the population as a whole, the best estimates are that consumption of alcohol declined by 30 percent to 50 percent.

Third, violent crime did not increase dramatically during Prohibition. Homicide rates rose dramatically from 1900 to 1910 but remained roughly constant during Prohibition’s 14 year rule. Organized crime may have become more visible and lurid during Prohibition, but it existed before and after.

Fourth, following the repeal of Prohibition, alcohol consumption increased. Today, alcohol is estimated to be the cause of more than 23,000 motor vehicle deaths and is implicated in more than half of the nation’s 20,000 homicides.

In contrast, drugs have not yet been persuasively linked to highway fatalities and are believed to account for 10 percent, and 10- 20 percent of homicides.

Prohibition did not end alcohol use. What is remarkable, however, Is that a relatively narrow political movement, relying on a relatively weak set of statutes, succeeded in reducing, by one-third, the consumption of a drug that had wide historical and popular sanction.

This is not to say that society was wrong to repeal Prohibition. A. democratic society may decide that recre¬ational drinking is worth the price¬ — traffic fatalities and other consequences. But the common claim that laws backed by morally motivated political movements cannot reduce drug use is wrong.

Not only are the facts of Prohibition misunderstood, but the lessons are ¬misapplied to the current situation.

The U.S. is in the early to middle stages of a potentially widespread cocaine epidemic. If the line is held now, we can prevent new users and increasing casualties. So this is exactly not the time to be considering a Liberalization of our laws on cocaine. We need a firm stand by society against cocaine use to extend and reinforce the messages that are being learned through painful personal experience and testimony.

The real lesson of Prohibition is that the society can, indeed, make a dent in the consumption of drugs through laws.

There is a price to be paid for such restrictions, of course. But for drugs such as heroin and cocaine, which are dangerous but currently largely unpopular, that price is small relative to the benefits.

Source: Mark H. Moore New York Times, October 16, 1989

Instead of fighting drug-related crime, we need to stop people taking drugs, says Iain Duncan SmithYesterday, the UK Drug Policy Commission recommended that the fight against drugs should focus on dealing with the criminal and anti-social elements that surround their sale. In other words, as long as drug dealers don’t start shooting each other, the police should turn a blind eye to their activities.

Yet the irony is that this plan has been followed all too often – with devastating consequences. In a notorious experiment in Brixton, dealers were left alone to sell cannabis, forcing local people to dodge them as they wandered up and down the streets, and to worry that their children would get caught up in the trade and the police would do nothing about it.

In Balsall Heath in Birmingham, the police also decided to leave the dealers to get on with their trade, preferring to monitor their activities. Residents saw front gardens became littered with needles, and prostitutes moved in. Thanks to the leadership of the sociologist Dick Atkinson, the community drove the dealers and the prostitutes out, and forced the police to treat them normally.

The truth is that the sort of communities where the police are being encouraged to adopt this approach are poor, with high deprivation, high crime and high levels of addiction – in other words, places that have already been written off, and which no one seems to care about. Just imagine the outrage if they suggested doing this to a middle-class suburb.

Yes, we have had a decade of failed drugs policy. But instead of more of the same, we should accept that the present policy has failed because it is centred on the wrong premise: that the purpose of our drugs strategy should be simply to minimise the harm that they do.

This approach is not only defeatist, but dangerous. It is a policy which seems to believe that so long as an addict doesn’t mug someone, kill them or rob their house, then that’s fine. It is a policy that parks addicts on methadone, entrenching addiction and ensuring that many of their children follow suit. It fails to address the problems of drugs and alcohol in terms of breaking the cycle of addiction, or in terms of recovery – which is why a significantly higher percentage of Britons are addicts than is the case with any of our neighbours. Rehabilitation treatment has been marginalised, with only a tiny number of addicts helped to get off drugs. The problem is made worse by the authorities’ failure to recognise that high levels of alcohol consumption among young people have a strong connection to the rise in the drugs culture.

Contrast this with Sweden, or even Holland. There, they understand that a successful drugs strategy needs to have a strong emphasis on clear laws, with the expectation they be policed. People are clear about what will happen if they are caught in possession of illegal drugs. In Holland, they spend three quarters of identifiable funding on law enforcement. Typically, this includes interdicting local production and trafficking. In the UK, the corresponding figure is far less, and there is little clarity about enforcement.

Second, these countries use the justice system to divert criminal drug users to care programmes, the purpose of which is to reduce reoffending and break the cycle of addiction. In Sweden, they tie successful involvement in such programmes to the expunging of the criminal record. Unlike in Britain, rehabilitation is seen as an integral part of the approach – and, unsurprisingly enough, the number of addicts as a proportion of the population is considerably lower than here.

What we need is not more rhetoric about a “war on drugs”, which is political nonsense. Instead, we must start a sustained process that aims to reduce drug-taking behaviour rather than containing it, and thus improves the quality of life for addicts, their families, and their communities.

Iain Duncan Smith is chairman of the Centre for Social Justice

Source: Telegraph UK. 30 July 2009

UK Advocates threatens legal action against health authorities providing drug-based treatments over rehabilitation. Alcohol dependency affects 1.1 million people
NHS authorities that offer alcoholics controlled drinking treatments relying on medication rather than total abstinence could face legal action from a patients’ organisation. UK Advocates, a pressure group campaigning for the wider availability of rehabilitation courses for addicts, is preparing to file claims against the Department of Health and local health services.
The charity maintains it has found evidence of thousands of patients with severe alcohol problems being given “psycho-active drugs” while they are still drinking. The combination, it is alleged, can be “potentially lethal” and is at odds with the manufacturer’s prescription advice and guidelines. “In many cases,” UK Advocates claims, “drugs and controlled drinking programmes are administered to sufferers without the doctor or clinicians involved having performed effective liver function tests to establish the extent of liver damage from excessive drinking.
“Treating alcoholics with drugs and on a basis of ‘moderation’ is similar to advising someone with lung cancer to cut down their smoking,” says Bob Beckett, founder of UK Advocates. “Controlled drinking programmes … hark back to the 1960s and 70s when we believed pharmaceuticals would cure everything, including addiction to alcohol. They simply have not worked.
“There are nearly one million people with alcohol problems taking up NHS beds. If we are serious about dealing with alcohol addiction then we have to look at cessation programmes, not drug-based detox, not hypnotherapy, but properly defined, intensive abstinence treatment.”
UK Advocates says its insistence on abstinence programmes follows guidelines adopted by the World Health Organisation (WHO). The organisation is now assessing whether programmes offered by primary care trusts (PCTs) meet “these statutory requirements as adopted by the European Union in accordance with WHO recommendations”. It says it will take “legal action against those it believes have been negligent by failing to offer day and residential abstinence treatments where clearly required”.
In May, the all-party parliamentary group on alcohol criticised “a general lack of capacity and variety in alcohol treatment services, due to poor levels of funding and, in some cases, a harm reduction agenda driven largely by crime and disorder rather than health considerations”. The committee found that although as many as 1.1 million people are classified as alcohol dependent nationally, only 1 in 18 enter any sort of specialist treatment each year. Spending on drug addiction outweighs that on alcohol dependency. UK Advocates says that it will issue proceedings in the administrative division of the high court “against PCTs and clinicians who may be proven to have acted negligently”.
Tom Gard, a spokesman for the group, said: “We have heard of someone who has been drinking two bottles of wine a day and has [only] been told to cut down to one and a half.” The charity claims that an audit of PCTs across the East Midlands and Yorkshire has revealed a picture, reflected nationwide, of many trusts offering no residential or intensive day abstinence treatment at all.
“In many areas those suffering from alcohol dependence are instead offered only ‘controlled drinking’ programmes, often without appropriate prior tests to establish whether or not the person needs to stop drinking completely to avoid developing serious physical and mental health problems.”
A Department of Health spokesperson said: “We have a comprehensive strategy to tackle health-related alcohol harm. The number of structured alcohol treatment places is increasing. Around 104,000 people were recorded as receiving treatment in 2007-08, against an estimated number of 63,000 in 2004.
“We have launched the alcohol improvement programme which assists PCTs in understanding local need and planning commissioning decisions. Most specialist alcohol services aim to help people reduce the harm associated with drinking. For those with moderate and severe dependence, this will usually involve advice and support to become abstinent, whether in the community or in-patient settings.
“Where a clinician considers medication would be the most appropriate treatment it is normal practice to discuss the effects and potential side-effects of the medication with the patient.”
Source: guardian.co.uk, Monday 3 August 2009

by Kathy Gyngell on Tuesday, 04 August 2009 09:51 Last week brought a new twist to the myth that law enforcement – hyperbolically designated as ‘prohibition’ by the pro drugs lobby – rather than drug use itself is the root of the country’s drug problem.

Tom Feiling, an advocate of legitimising of cocaine, a drug which pretty much he alone rates as neither dangerous nor addictive, started off the week’s drug debate. Plugging his new book, the equally hyperbolically titled, ‘The Candy Machine: how cocaine took over the world’, he pushed the view that pro drugs activists want us to buy – that you can’t stop people using drugs so don’t try. Conveniently bypassed was the fact that cocaine has only ‘taken over’ those countries where enforcement is weak and penalties and asset stripping are rarely or ineffectively imposed. He did not point out that the UK, far from being draconian in anything other than its imposition of methadone, is one such country – hence its rates of cocaine use 2 to 3 times higher than nearly every other country in Europe.

Not everyone bought into Tom’s take on the subject, Stuart Holmes, a medical student, for one. Expressing his horror at the impact of cocaine ‘on swathes of the population to whom the NHS directs so many of its resources’ he found ‘Tom Feiling’s tirade against the illegality of cocaine and other hard drugs a little galling.’ Instead of the balanced exposition of cocaine use in this country, discussion of the source of cocaine and the legal framework surrounding the drug here that he had expected, he found ‘a thinly veiled manifesto for the legalisation of hard drugs.’

Nor, did former Police Commander, Brian Paddick, he who infamously instigated the Brixton experiment of warning rather than arresting people found with cannabis (and many of the negative consequences that followed). Forcefully dissociating himself from Feiling on Sky News he stressed the total unacceptability of both cocaine and crack cocaine, outlining the violence and destruction of lives its use has led and does lead to, quite apart from that involved in its trafficking. He should know.

Nor, clearly, did he think much of the UK Drug Policy Commission’s (UKDPC) contribution to the debate also published this week disingenuously titled “Moving towards Real Impact Drug Enforcement”. When confronted with their innovatory contribution that some drug dealers but not others – the less violent ones – should officially be tolerated because (according to the UKDPC) arresting them ‘can increase violent crime’, he made clear this approach was both impracticable and wrong. His scepticism and his call for nothing less that a total change of social attitudes to a non acceptance of drug use – something singularly missing from any of the UKDPC reports – was an unexpected breath of fresh air. If we can change attitudes to smoking in a generation we can change them to drug use, he declared.

So where have the UKDPC’s ideas come from? They are premised on a variant of the discredited policy idea that only some drug use is harmful which, in this wishful two world view of drug use, can be isolated. That this lobby should make the tactical switch of applying their ideas to enforcement now their preferred but ethically dubious policy of applying liquid handcuffs to so called HHCU’s (high harm causing users) to stop their acquisitive crime has so categorically failed, is perhaps not surprising. After all if you believe that most drug use is non harmful then you are bound to have to think that most dealing is not harmful either – or only if the strong arm of the law comes down on it.

Unbelievably this is the gist of the UKDPC’s Alice in Wonderland view of the illicit drug trade – that the violence that ensues is a function of police actions/enforcement not of the trade – so good dealers can be tolerated while only bad (i.e. violent) dealers will be targeted. Well that’s all right then – all dealers can no doubt be ‘good’ if no one gets in their way. But heaven protect the children, families and communities exposed to the plying of a sanction less trade on their doorsteps with no police to support or protect them. To say nothing of how such a policy would make the UK an even softer target, turn us into an even larger market and encourage more use and incremental damage.

This is political correctness or liberalism taken too far. Will we be blaming the police action as opposed to inaction for murder and robbery next?

Yet startlingly in all the prime time coverage respectfully devoted by the BBC’s Today programme to the report – summaries thoughout the morning each with Home Affairs Editor Mark Easton’s imprimatur – none of these points were raised. The premise of the report was uncritically accepted. Yet as well as being numbingly illogical the report is nothing less than a formula for the backdoor legalisation of drugs’ trafficking – ‘a harm reduction stepping stone to legalisation’, as drugs policy expert, Professor Neil McKeganey, has called it.

According to McKeganey, “the form of policing UKDPC are advocating would in reality give rise to the creation of areas of our cities and our rural communities in which drug use had effectively become legalised. Such a policy raises the frankly idiotic scenario in which we are punishing drug users in some areas and accepting them in others (hardly a sound basis for English law).”

For my own part I would like to see Roger Howard (CEO of the UKDPC) or Dame Ruth Runciman (its Chairman) going to those communities they would designate as suffering minimal harm from drug dealing and which, as a result of their counsel, would be forced to accept the existence of local drug markets. My guess is that these are unlikely be the ones in which they themselves reside.

To judge by the reported comments of Bill Hughes, the agency director of SOCA, following the report’s publication, the thinking of some of those currently involved in senior drug enforcement positions may be equally muddled. He, it would seem, accepts the idea that the report asserts that we focus too much on seizures and arrests, has abdicated the idea of vigorous enforcement and is misguidedly advocating this implausible approach. The UK’s already declining drug seizures and arrests, seen in this context, are even more revealing (see my report, The Phoney War on Drugs) not least by contrast with Holland’s rising cocaine seizures and drug arrests.

The need for smarter enforcement is undeniable. But not of the UKDPC’s interpretation of the concept. Nothing less than a top to bottom rethink – a new, committed and well resourced national strategy with local action to protect our borders, to hit middle and local markets, keeping operations flexible, adaptable and most importantly ongoing – is called for.

This, not the UKDPC’s policy of quasi legalisation, will protect Antonia Senior’s daughter as she grows up; and not her mother’s appallingly ill thought ideas in the Times second ‘legalising’ article in 5 days; the one which brought this particular week’s drug debate offerings to an exhausting end.
Category: prisons and addiction
Comments
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Backdoor legalisation
John J. Coleman, PhD, presiden 2009-08-04 13:22:17
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An excellent commentary that exposes the illogical premise that more of a bad thing is good for us. It is not the poor of the world who beg for the legalisation of drugs but the elite who can afford to destroy the lives of the poor to preserve their own self-indulgent mandarinic lifestyle. Have they no shame in calling up the hallowed symbols of liberty and compassion to justify their drug lust? The tyrant always seeks to convince the innocent that the effect is causal and not the other way around. To understand this, one only needs to look at the level of violence wherever weak, corrupt, or non-existent government intervention in the drugs trade has produced de facto legalization.
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Professor
Neil McKegney 2009-08-04 15:24:29
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The UKDPC have called for enforcement resources to be targetted at those areas within which the drugs trade has caused greatest harm. This is a variant of the current drug policy that is focussed on the most harmful drugs (heroin and cocaine) and which by implication increasingly accepts other forms of drug use. However enforcement needs to tackle the fledgling drug markets with as much vigour as it tackles the well developed drug markets if it is to offer an effective deterrent to drug use and drug dealing. The idea that enforcement agencies increasingly desert those communities where drug use is occurring but not yet reaching the level of harm of other communities is simply a recipe for enforcement failure. What one wonders would the UKDPC say to any community that was seeking enforcement protection but which did not yet reach the bar of high harm that the UKDPC envisages? Communities need protection from the drugs trade and that more than anything else is what enforcement needs to provide. The idea of triaging enforcement resources and concentrating on the most harmed areas may sound attractive on paper but in reality may amount to no more than an abrogation of our responsibility to protect all of the communities affected by the drugs trade.
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UKDPC-Alice in Wonderland policies
David Raynes 2009-08-04 17:18:23
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If the ideas of UKDPC on allowing drug dealing/trafficking in some places but not others were to be followed (and Bill Hughes of SOCA apparently & allegedly gave it some positive consideration!)-the limited current system of control would be further undermined. Is that what UKDPC want? Actually this idea and the adverse consequences were demonstrated in several recent episodes of “The Wire”. Of course it is necessary to prioritise, THAT is a different thing from what is being suggested.

Give some dealers/traffickers (even relatively) safe passage in some areas
of activity by location or by methods and experienced law enforcers KNOW, dealers will gravitate there and expand their activity there and grow operations through that ignored system/location/method.
The objective of enforcement policy should be to make dealing and
trafficking a risky business and UK Plc a hard target rather than a soft target for external traffickers, most especially for those who are not British based. Internally to the UK, the objective of enforcement policy should be to make dealing/traficking a risky and unpredictable
business-everywhere. A clear secondary objective is to deter new entrants to the business. To suggest otherwise, as is simply nonesense. It is very much against the experience and evidence of the last 35 years of enforcement and of course would further undermine the current very weak overall UK Plc efforts. Seizures & arrests are not always the answer but they certainly help. Attrition and deterrence without those measures eg by seizing cash & assets can be undertaken but it has not been wonderfully effective so far. Local addict dealers can be persuaded into treatment by making their efforts non viable. Police need to work in partnership with other agencies to achieve this. Of course there has to BE some treatment available!

Containment of traficking IS possible, especially for an island nation. It needs, in the UK, much better coordination of effort between the Border Agency/Customs, SOCA & Constabularies. Does the Home Office understand why this has not happenned? Who was tasked to lead this? Was anyone? If not, why not?
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Drugs & Law Enforcement
Terry Byrne 2009-08-04 21:39:07
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UKDPC is right – but only so far as it calls for smarter law enforcement and says that law enforcement cannot eradicate drugs markets. Beyond that, UKDPC shows a low understanding and no sensible ideas about focusing law enforcement effort that is only matched by Bill Hughes of SOCA it would seem. Law enforcement can, at best, only provide a framework of deterrence and prevention so that other vital factors – parents, families and communities, schools, public figures, employers and health agencies – can secure and maintain our UK society’s rejection of drug misuse.
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correcting a number of errors and misconceptions
Steve Rolles 2009-08-04 22:03:50
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“the myth that law enforcement – hyperbolically designated as ‘prohibition’ by the pro drugs lobby – rather than drug use itself is the root of the country’s drug problem.”

- ‘prohibition’ is a term in wide use to describe the current approach to drug control – in contrast to regulated markets or free markets. There is no controversy over this and nothing ‘hyperbolic’ about it; it is a purely descriptive term – one used by the UK Government in drug strategies, and by the UNODC.

- ‘The pro-drugs lobby’ is an deliberately derogatory term based on the absurd premise that because you determine your views as anti-drug, those who disagree with you must be ‘pro-drug’. This is a classic example of a false binary, ignoring the obvious reality of many people who are passionately anti-drug but also support reform of ineffective and unjust policy and law – including a debate on legal regulation. Transform’ supporters include bereaved parents, religious leaders and public health professionals. Law Enforcement Against Prohibition is made up of over 10,000 serving and enforcement professionals – are they ALL pro drug? Please stop using this offensive and childish slur.

- finally, the central point of your opening sentence is wrong. Reform advocates such as Transform make a clear distinction between harms created by drug use – for which we advocate a public health response (treatment, education, prevention) and harms created or exacerbated by prohibition/ illicit markets – for which we advocate a rational exploration of regulated market alternatives. You should be aware of this from our meetings, and our publications in which it is clearly stated and which you have referenced.

Regarding Tom Feiling’s piece – it was clearly an opinion piece, and he is entitled to his opinion, just as you are . The reality of cocaine use/demand is a fact – it is the idea that an enforcement response can eradicate it that is delusional, as evidenced by the past 40 or so years. You, again, provide no evidence that increased enforcement is a key variable in decreased use (there is little/none as the WHO found in a massive global research project published last year to which I have directed you previously), beyond your cherry picked examples. Interesting that you again bypass the US experience again re cocaine use and enforcement spend / punitiveness.

Paddick’s views, like Cameron’s, seem to have shifted since he moved into the political mainstream, but clash with those of another met commander you have failed to mention, who responded in the Times this week: http://www.timesonline.co.uk/tol/comment/letters/a rticle6736613.ece
likewise Eddie Ellison former head of the met drug squad, and numerous other police (www.LEAP.cc’ etc).

I don’t have time to deconstruct your analysis of the UKDPC report, beyond highlighting that you have confused legalisation (legal regulation of markets and supply) with de-facto decriminlisation through tolerant policing of certain activities (use or low level dealing). The two are entirely different propositions, the UKDPC having made great efforts to distance itself from the former, whatever conspiratorial silliness you appear to be implying.

Again you provide no evidence that increased enforcement reduces use or more importantly (as a pragamatist) reduces harms, and fail to engage with the overwhelming evidence that enforcement has been largely counterproductive.
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Drug Free Scotland
Bill Cameron 2009-08-04 22:47:13
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As a parent for whom the jargon and politics of the battling “pro” and “anti” lobbies is confusing, the latest suggestion from UKDPC to allow drug dealing in certain areas and not in others, merely adds to our confusion. Surely some member of UKDPC can imagine the scenario from a parent’s point of view and conclude that the dealers will expand their activity in the areas relatively ignored by law enforcement. Current drug policy does not, as it seems to have been accepted, focus on only the most harmful drugs and dismisses any other form of drug misuse. UKDPC would be hard pressed to single out one area in Scotland where the uncontested violence and corruption due to drug abuse does not exist.
Why are parents lulled into a false sense of “ your kids are going to use drugs anyway, so just let’s stop trying to stop them”? Rubbish! – not in my home – and anyway who told you that? And are we also to ignore the effects of drugs: stealing; violence; corruption; family breakdown; illness’ death? Certainly not – sorry boys, the two go together.
No one wishes legalisation but currently the state exists where at one side of the street a young person can be lifted for possession of Cannabis (even perhaps for his parent’s M.S.) and at the other side of the street there are lines of young addicts waiting to collect their kit from a needle exchange (no exchange of needles ever evident) after which the go home to use Cocaine or Heroin – legally?
Smarter enforcement? Cooler catching? There is no argument that we require countrywide change across the board, adequately resourced to squash local drug markets. In my own unhappy and tiresome experience that has ever happened.
I am told it was Antonia Senior who quoted “Drugs are evil. Legalise them now” and who went on to protest her fear that her daughter would join the “addict” club. I would advise her to speak to a parent whose child is already a paid up member of that elite club.
Harm reduction, legalisation – call it what you like – is a paraphrase or extension of what the snake said to Eve. “You will surely NOT die……………..(implied) for I will teach you how to sin safely!”
So let’s get smart and expose such things so that social thinking people are able to promote their human rights in their own society. Everything else has not failed. It has not happened yet!
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The effect of increased enforcement
David Raynes 2009-08-04 23:08:18
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Steve Rolles you say:
“no evidence that increased enforcement is a key variable in decreased use”.

There is plenty of evidence & well founded suspicion that REDUCED enforcement in the UK has been a variable in increased use of drugs and pecifically certain drugs.

Some recent examples:-

Post 1999, Customs stopped targetting the main importers of cannabis, (though still acting aginst it when found), the market became flooded and in the words of one academic analyst “mature”. That led on to-may indeed have influenced- the unwise declassifying of cannabis, the weird “Lambeth experiment” (wider drug dealing effects conveniently forgotten by UKDPC?) and also the ubiquity of supply and use that we experienced around 2003/4. (Though just maybe I agree, use is falling a little now in older, better educated age groups as a result of increased publicity about harms and reclassification upwards). Even that conclusion is uncertain, cannabis may just have become unfashionable, in favour of cocaine, crack and other drugs.

At the end of the 1990s Customs to a certain extent, ignored or were by what was considered THEN, as pragmatic prioritisation choice, under-active against the organisers of cocaine courier traffic targetted into black communities. This was done in favour of targetting larger bulk consignments. It was significant in effect because the courier traffic was quite suddenly, in mid to late 90s, feeding a crack explosion. This crack explosion-forcast at the end of the 80s by Bob Stutman had been succesfully held off for nearly ten years.

More recently SOCA has focussed on “upstream disruption” and been noticeably unsuccsessful against both heroin and cocaine, direct, UK imports. SOCA has also often neglected to service Customs/Border Agency cold finds (having taken in the resources that previously did that work). They may have learned from that major error though by now and are changing their approach. SOCA is to date, much less successful against serious drugs traficking into the UK than the agencies that operated before it was formed. Cocaine is now ubiquitous in a way it was not, even five years ago. Seizures are down, arrests are down, interdiction of direct smuggling by boat is ata 15 year low.

I do not expect you to know about these things, they are not within your experience nor are they easy to understand from published sources but if you leap in to defend the silliness of UKDPC you ought to make a better effort to understand the history.

There is no defence for the utter garbage of what UKDPC are trying to suggest. Nature abhors a vacuum, so self-evidently does crime. Without a reasonable level of enforcement against any type of organised & profitable criminality it is highly likely to increase. For your evidence look at societies where the power of the state breaks down or the writ of the limited authority that exists, does not run.

It is not just the experience in the examples I have given you, I could give you many more.

Are you supporting UKDPC because legalisation of drugs is what you campaign for and because, having failed to persuade the public and the two relevant dominant political parties, you see causing a creeping breakdown of the present system as your best way forward?

Observers are entitled to be suspicious of both your motives and those of UKDPC. Neither of you in my opinion, are likely to be part of any solution to the UKs worsening drug problems. You have been part of the paid advocacy for liberalisation/legalisation, about which I so often complain and which I suggest has been part of the mixed messages about drugs which has so worsened the UK position in comparison with some neighbours.
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Steve Rolles 2009-08-05 09:41:11
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David – none of the examples you cite demonstrate that enforcement has a major impact on overall use, misuse or harm. Its impacts – when they do occur – will largely be displacement – between regions, or criminal networks(or occasionally between drugs) – this is true from producer country activity through to domestic street dealing. I think you identify the real issue re cannabis when you note that the fall in use was probably due to a shift in fashion. Determinants of drug use are largely social, cultural and economic, not enforcement/punishment related.

The fact that there is no international correlation between levels of enforcement and levels of availability and use is an inconvenient reality that you and Kathy both choose to avoid, instead cherry picking examples that support a link (eg sweden)and ignoring those that don’t (eg the US). Neither of you has ever cited or responded to the WHO study I have repeatedly flagged up.

Re UKDPC – we support their call for better evidence and I have personally been impressed with some of the research and analysis they have commissioned and published. We have, however, been publicly critical of much of their analysis (I had a critique of a previous report published in the Guardian – and a recent blog critiqued their new crime report – search the blog for UKDPC), where we disagree with it or feel it misses the point. This is as it should be and is no different from our engagement with Kathy’s work or anyone else’s.
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to enforce or not…
simon aalders 2009-08-05 10:05:44
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For the UKDPC to arrive at the conclusion that we should hand over communities to drug dealing, to avoid conflict between gangs was what i heard in the report, is astounding.
As has been stated, if the UKDPC think this is a good idea perhaps they should live in an area blighted by drug dealing and gang culture, or talk to the families trying to bring up children and live fulfilling lives in those areas before making such crass public statements.

There are numerous failed examples of apeasement to criminal gangs across the globe we do not need another failed experiment in the UK. The victims would not be shown on TV, nor gain the headlines as they struggle through the consequences of increased criminal activity. Those that propagate such policies will be long gone and deffinitely nowhere near any of those areas.

In my local area the community praise the Police for sustained enforcement activity, they want the public services to act vigourously to deal with drug/gang culture, and they want drug addicts treated properly – by that I mean taken off drugs to give them the best opportunity to turn their lives around.

They don’t want society to throw up it’s hands and say we give up, it’s too hard.

If the UKDPC have run out of steam and this idea tells me they have, there are plenty of others out here actually making a difference for communities.

Legalisation is no solution.
Decriminalistaion is not a solution.

Proper treatment, enforcement and community involement are.
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Displacement of criminal activity
David Raynes 2009-08-05 10:10:06
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Steve Rolles you say :
“Its impacts – when they do occur – will largely be displacement – between regions, or criminal networks(or occasionally between drugs) – this is true from producer country activity through to domestic street dealing”.

Well exactly. You make my very point. THAT is why UKDPC are fundamentally not just misguided, they are categorically wrong. They demonstrate no understanding of how crime operates. What they suggest is intellectually unsound. Displacement quite obviously operates in both directions. It was once said, I think by Da Costa, that countries get the drug problems they deserve. The UK has one of the worst drug problems in Europe now, it was not always thus (my historical view on high level traficking extends back 40 years) and it has got worse at an accelerating rate in the last 15 years compared to some of our neighbours. Precisely the period during which those at the top of UKDPC (Ruth Runciman & Roger Howard) have been most influential on policy and most active proselytising. Correlation is not causality but it is certainly a starting place for analysis. It should cause policy makers in the Home Office to think more clearly about why we are where we are and the history. They should do that and you should not ignore it.
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Good and bad drug dealers
Derek 2009-08-05 10:31:34
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Kathy wrote:

“Unbelievably this is the gist of the UKDPC’s Alice in Wonderland view of the illicit drug trade – that the violence that ensues is a function of police actions/enforcement not of the trade…”

So the likes of Al Capone were not a function of alcohol prohibition then? How come the off licence down the road here in Norwich isn’t run by the mob? It is, after all, the same drug being sold and only the regime it’s sold under is different.

Likewise whilst we’re discussing drug harms was not the existence of moonshine or bathtub gin down to the prohibition laws? Quite clearly they were Kathy. Quite clearly the prohibition law creates problems all of its own and these are in addition to any harms drugs can cause.

To deny any connection between the violence and other harms of the illegal drugs supply side with the application of prohibition is surely to deny reality and worse, to ignore the lessons of history.

Almost worse is to write that “law enforcement – hyperbolically designated as ‘prohibition’ by the pro drugs lobby”. Please Kathy, call a spade a spade. What we have is prohibition and is correctly called prohibition. Defend it by all means, but please don’t pretend it’s something else.

It’s interesting also that you claim cocaine use has become established in countries with liberal regimes whilst ignoring the situation in the USA, the leader of the war on drugs and hardly a “liberal” regime. Actually the most compelling reason for the growth of the Euro zone cocaine market is probably the Euro with its usefully high denominations.

It’s very telling though that after all this time the issue of drug law reform not only hasn’t gone away but is again gaining ground. The fact that it’s gaining ground not only here, but in the home of prohibition the USA is most illuminating.
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Corrigendum
ukdpc 2009-08-05 11:13:07
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We would like to correct some of the misreading of the UKDPC review on enforcement which Kathy and others have made.

In fact the review is all about making the best use of enforcement resources. It is thus about targeting supply side interventions more effectively, not giving up on enforcement as some have suggested. The thrust of our approach is about using a focus on the wide range of harms that individuals and communites experience from drug markets to stimulate innovation and to encourage assessment of impact to ensure that the maximum benefit is achieved.

We would urge people to read the reports themselves rather than assume that all that is written about them in the media or on blogs is accurate. The full reports can be found on our website at

http://www.ukdpc.org.uk/publications.shtml

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Drug enforcement and Drug Prevalence
Neil McKeganey 2009-08-05 11:56:15
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It is puzzling that UKDPC having authored the report on enforcement have not contributed to its blog discussions. However taking up the point made by Steve Rolles that there is no evidence of a link between enforcement and drug consumption. Quite the reverse is indeed the case since none of the currently illegal drugs are consumed at the same level as the legal drugs (tobacco and alcohol). The experience with these two legalised drugs is powerful evidence of the potential level of consumption of the illegal drugs were they to be legalised. As I have pointed out to Steve Rolles before in China at the time of the opium wars an estimated 20% of the population were thought to be addicted to opium. This shows us that there is nothing in the drugs themselves that necessarily limits their appeal to only a tiny minority of the population. If organisations like Transform truly believe that enforcement has no evident impact on level of use one wonders why they spend so much time lobbying for a change in drug laws and enforcement practices.
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Prohibition
Alison Hughes 2009-08-05 11:58:00
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If prohibition is so good – why isn’t Kathy Gyngell campaigning for the prohibition of the two most dangerous drugs in th UK – alcohol and nicotine? Instead she focuses her attention on an emotional and ill-informed attack on methadone, which is a useful treatment in helping people come off street drugs and changing their lives around. This does happen and a lot of people do eventually come off methadone but it takes a long time.
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legalisation and drug prevalence
Neil McKeganey 2009-08-05 12:00:18
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Taking up the point made by Steve Rolles that there is no evidence of a link between enforcement and drug consumption. Quite the reverse is indeed the case since none of the currently illegal drugs are consumed at the same level as the legal drugs (tobacco and alcohol). The experience with these two legalised drugs is powerful evidence of the potential level of consumption of the illegal drugs were they to be legalised. As I have pointed out to Steve Rolles before in China at the time of the opium wars an estimated 20% of the population were thought to be addicted to opium. This shows us that there is nothing in the drugs themselves that necessarily limits their appeal to only a tiny minority of the population. If organisations like Transform truly believe that enforcement has no evident impact on level of use one wonders why they spend so much time lobbying for a change in drug laws and enforcement practices
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legalisation and drug prevalence
Derek Williams 2009-08-05 13:04:16
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Neil McKeganey wrote: “none of the currently illegal drugs are consumed at the same level as the legal drugs (tobacco and alcohol)”.

Whilst this may be true, illegal drugs aren’t (or haven’t been) advertised and promoted. This is especially true for alcohol of course which is marketed ruthless at young people with designer drinks and drug speak advertising. Tobacco use in recent years has dropped considerably partly due to advertising bans and suchlike.

Regarding illegal drugs, we don’t really know how many people take them of course. The number of people who use cannabis is of a comparable order to the number who smoke tobacco and no-one would pretend the estimates for that number are anything better than an underestimate.

If the law was so effective, how are the high levels of use in the US explained? Or come to that the success of the Portuguese regime?

And please, we are all agreed that despite what Kathy might think, what we have out there is prohibition, isn’t it?
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Your Times letter 30/07/09
John Watson 2009-08-05 15:00:28
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Kathy,

In your letter to The Times 30/07/09, you say: “As cannabis use rises so, too, does psychosis.”

I have been looking for statistics that show this, as it would be almost certain proof that cannabis causes psychosis. However, I have been unable to do so.

I have found “Assessing the impact of cannabis use on trends in diagnosed schizophrenia in the United Kingdom from 1996 to 2005.” (PubMed: http://www.ncbi.nlm.nih.gov/pubmed/19560900 ), “Between 1996 and 2005 the incidence and prevalence of schizophrenia and psychoses were either stable or declining. [...] In conclusion, this study did not find any evidence of increasing schizophrenia or psychoses in the general population from 1996 to 2005.”

Which seems to contradict your statement.

Where did your statistics come from, please?
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Director Crew 2000
John Arthur 2009-08-05 17:18:05
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‘If we were starting with a blank canvas which drugs would be legal and which illegal’ is a well practiced tool in substance use training (attitudes to substance use) which we have used with professionals, young people and community groups for many years now. It is amazing how many would put alcohol in the illegal bracket and allow many of the currently illegal drugs to be sold ‘under regulation’. This is not people who are ‘pro drugs’ or indeed soley people who have suffered alcohol or other drug probems themselves or in their family, but a wide range of professionals across health, social work, police and the justice system. Kathy, as someone who has lost a lot of family & friends through addiction and dependency and who thinks that there are serious flaws in our present system I am saddened by your Bush-esque like pronouncement that everyone who is not happy with the present drug laws and think there may be other solutions must be ‘pro drugs’. Nothing could be further from the truth and I’d like you to at least take that comment back and consider your rhetoric in the future. Of course you are entitled to your opinion as we all are, how else are we to achieve consensus as a society, however your remarks are at best often ill considered and increasingly appear to be deliberately provocative and insulting. To what ends I can only imagine.
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Steve Rolles 2009-08-05 18:52:32
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I await – from Kathy, David, Neil, or anyone, some evidence showing a statistically significant link between enforcement spend or punitiveness of enforcement and levels of use or drug harm between states (or regions), or some comment on the WHO (not pro-drug crazies) study last year the headline conclusion of which was;

“Globally, drug use is not distributed evenly and is not simply related to drug
policy, since countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones.”

Degenhard et al, World Health Organisation, 2008 ‘Toward a Global View of Alcohol, Tobacco,
Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys’

Available in full online
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Drug harm and enforcement
Neil McKeganey 2009-08-06 06:24:28
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Steve an absolutely fundamental assumption of the legalisation position adopted by Transform and other organisations is that the greatest harm associated with drug use arises from the enforcement and what you call punitive drug policies. It is that assumption which in essence underpins your arguments for legalisation as being the most effective means of reducing drug harm. But where is the quantitative evidence that shows enforcement is a greater source of drug harm than drug use itself?
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drug harms vs policy harms
Steve Rolles 2009-08-06 10:47:47
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Its more complicated than that Neil. The nature of the drugs used, the way in which they are used and the environments in which they are used – are all negatively impacted by prohibition and the illicit anarchic underground culture controlled by criminal entrepreneurs it has created. So drug use itself becomes more harmful under prohibition than it would under a regulated system controlled by the appropriate state authorities, one in which a regulatory environment could progressively encourage a shift in culture towards safer products, behaviours (including abstinence), and using environments.

This is quite aside from the secondary harms created by prohibition in terms of crime, corruption, destabilisation of producer countries, conflict, environmental damage, human rights abuses, erosion of respect for authority and so on. I have made this argument very clearly in a number of publications comparing a user of illicit heroin to one on a heroin prescription.

Which causes more harm is impossible to gleam in this context – its the wrong question. More important is that harm is greater under the current regime than it would be under alternative approaches – which is the core of our argument – (something that in no way makes us ‘pro-drug’ as Kathy, Costa, David and others -but not you Im pleased to say- continue to childishly parrot). We also argue that the political nature of prohibition interferes with the development of evidence based responses, by immunizing the policy from scrutiny and diverting resources away from proven public health interventions into demonstrably counterproductive enforcement ones.

I’m wary of blaming enforcement per se, as that appears to put the blame on the police/army, when in fact they are merely the expression of a political program or ideology – ie prohibition; which is punitive by its very nature (it establishes a set of rules and punishements for breaking them) and place within the criminal justice system (not something I have determined). Would you say prohibition was non punitive, and if so how would you describe it?

And meanwhile, how about an answer to my other questions?

Kathy – why do you never get involved in the blog discussions that follow your comment pieces? I think you are possibly missing the point of blogs – which are supposed to be about dialogue.
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Drug Harm and Enforcement
Neil McKeganey 2009-08-06 17:54:24
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Steve I take your point that the ways in which drug use may be harmful are many and varied but in essence you must surely be operating with some notion of the amount of harm associated with the legal position of certain drugs relative to the quantity of harm associated with the consumption of those drugs in whatever legal context. If you are not then the prospect arises that you may well be arguing for the legalisation of substances that are substantially harmful in their own right and where the quantity of harm associated with their use may be only minimaly reduced by a change in their legal status. My sense is that the legalisation position has to assume that harm would be very substantially rather than minimally reduced by a change in the legal status of the drugs concerned. But the question remains as to what you base that assumption on. In the combined article you wrote with Danny K you said that:

The question is not whether human rights or public health comes first. Rather it is whether we collude with a policy that invariably degrades and sometimes destroys our clients and the communities in which they live, or whether we speak out against it, both as individuals and organisationally…More importan(t) is the question of how organisations can most effectively challenge the status quo, terminate prohibition and replace it with an effective system that is effective, just and humane (Kushlick and Rolles 2004:245).

That extract rather assumes that the health harms associated with drug use come a long way second to what you regard as the harms arising from the illegal status of the drugs concerned. If that is indeed you view then surely you need to make clear what your assessment of relative harm is actually based upon.
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Steve Rolles 2009-08-06 19:00:43
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We assume that harms to individual users would diminish (as argued above and in the CBA paper we discussed recently), and that harms associated with illegal markets would diminish (for obvious reasons). I don’t think even the UK government or UNODC would disagree with this.
I understand your argument (and theirs) that these gains would be more than outweighed by an increase in health harms associated with an increase in use were drug markets legally regulated – but I don’t agree with your assumptions that underpin this argument – and i also dont think you understand the sort of regulation we are calling for. I find the Chinese peasant opium use in the 19th century a particularly non-useful parallel for modern drug culture in urban Britain, and also do not agree that the experience with alcohol and tobacco supports your contention. Not only are alcohol (which is a deeply culturally embedded food and beverage, as well as drug)and tobacco (which does not intoxicate like most drugs – so does not seem to raise the same degree of moral indignation, despite its awful public health impacts)qualitatively different from most drugs we are concerned about (particularly problematic use of heroin and cocaine), they have also been subject to decades, even centuries, of aggressive marketing (something that would be forbidden under the regulatory models we advocate for other drugs), and had few of the other controls over product, price, vendors, outlets, users etc that we are calling for. Where such have been begun to belatedly implemented use has fallen without resorting to blanket prohibitions – e.g. tobacco in the UK – use of which continues to fall whilst cocaine (7 years in prison for possession, billions spent annually on interdiction) continues to rise.

We have, from the outset, called for better, indeed stricter, regulation of alcohol and tobacco as well – something entirely consistent with finding the optimum regulatory models, re outcomes, for all drugs. The reason we do not focus on these issues more is because there are plenty of agencies (Alcohol concern, ASH, the royal colleges etc) who already do it very well.
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Legalisation and Drug Harm
Neil McKeganey 2009-08-06 20:14:51
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Steve where is the template (evidence) for successfully regulated drug markets that Transform clearly aspire to extend to other currently illegal substances? I can see why you do not want to accept the Chinese opium situation fostered by the UK against the expressed wishes of the Chinese government because it does indeed indicate a level of opium consumption that Transform would rather discount as an impossibility within a developed “regulated”heroin market. But of course these awkward historical events are not se easily dismissed simply because they do not mesh with ones preferred view of hisotry and future drug policy and in that sense the examples do have to be considered for their possible relevance to current discussions.
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Steve rolles 2009-08-06 21:30:42
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surely a more relevant ‘awkward historical event’ (than opium use in peasant china 150 years ago) for you to respond to would be the steady increase in drug availability, use, misuse, crime, and overall harms (by any measure) under prohibition in the modern world – despite ever increasing resources being thrown at its enforcement. Wheres *your* evidence base for the policy we have now, and how much failure do you think is required before alternatives are regulatory are meaningfully explored. its fine to keep throwing questions at me but what about answering a few of mine?

I obviously cant produce an evidence base for the regulation we are advocating as it has not happened yet – beyond limited and often flawed/problematic models (coffee shops, heroin prescribing etc) or equally problematic – although useful paralell examples (e.g. regulation of gambling, and sex work), so you will always win on that front – I cant provide evidence from the future. I can only speculate with the evidence we have, whilst pushing for more to be gathered.

The problem is that, perhaps uniquely in health and social policy, an entire avenue of policy options has been closed down in perpetuity, on ideological grounds not evidential ones, not just re implementation – but even experimentation and research. This is particularly peverse and anomalous given that regulating risky commodities and and activities is absolutely the social policy norm, indeed it is one of the primary functions of Governments.

To be able to have flexible policy options in almost all aspects, except one; legal regulation of production and supply – is intellectually offensive and profoundly anti-science. Are archaic drug laws create an arbitrary line in the sand that should be an affront to everyone in public health or social policy. By all means make the evidential case for prohibition (and ill argue with you), but not on the basis of preventing others from exploring the alternatives. For ever.
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Drugs and Enforcement
Neil McKeganey 2009-08-07 09:32:20
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Steve although you cite the continuing use of illegal drugs as a failure of existing drug laws surely the fact that the level of use of those drugs is not comparable in any country to the level of use of the legal drugs in all countries is the clearest evidence there could ever be that existing drug laws have indeed succeeded in limiting the use of certain substances. I don’t know of any scientific study that could in any way provide evidence on a par with the consistent international pattern of illegal drug use consumption falling a long way short of the level of consumption of the legal drugs. However to argue for a change in our existing drug laws surely has to be based on something more than an ill-defined belief that in some vague ways things would be better under a legalised or regulated regime- better for whom, by how much and for how long? and with what unintended consequences? The standard response that organisations arguing for legalisation provide is to ask for the evidence of success of our current drug laws and then to claim that the failure of drug laws to entirely cease such drug use is a sign of their inevitable failure. This of course is a deeply ironic position for a legalisation group to adopt since illegal drug consumption is not something that they themselves wish to cease anyway. However your point that there is some kind of international policy conspiracy stopping the experimentation with different types of drug laws including legally regulated markets seems a bit strong to be honest since there are many countries that could be cast as having experimented with widely different drug laws including those that have adopted heroin prescribing safe injecting centres lower level penalties for drug possession etc.

Our debate started with the UKDPC publication of their report on evidence and Kathy Gyngell’s blog on that report I still think that it is strange that an organisation such as UKDPC that is clearly wanting to make a contribution to public and policy debate on the drugs issue is so reticent at contributing to this debate leaving you largely on your own as it were to argue for the position they have set out in their paper on harm reduction focussed drug enforcement.
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steve rolles 2009-08-07 13:49:06
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(im not arguing for the UKDPC position – which, I repeat, is distinctly NOT legalisation / regulation – this debate took a different turn)

I think you ignore the fact that there are plenty of legal drugs that are not so widely used (inhalants for example), and that amongst illegal drugs some are used far more than others – cocaine use is about ten times that of heroin for example, but it is equally illegal. This – along with the fact that trends in drugs go up and down apparently independtly of legal changes and even price, suggests that people’s drug choices are primarily determined by factors other than legality/punitive sanctions and related deterrence. The evidence base for a deterrent effect is incredibly poor – and just repeating alcohol and tobacco does not fill this yawing evidential abyss at the heart of entire prohibitionist paradigm.

There is no conspiracy against experimenting with legal regulatory options for supply – there are 3 UN conventions that that specifically prevent it, the single convention in particular (much of which was drafted in the 40s) tying states into a system that is no longer relevant to the world today. Challenging the conventions would raise unacceptable political and diplomatic costs (largely in terms of US pressure – but also potentially undermining the valuable aspects of the drug treaty system, and indeed the wider treaty system). Countries can experiment with decrim of possession and medical prescription models but decrim does not involve supply and prescription only covers a tiny proportion of users and the illicit market. Wider exploration of regulated legal supply remains undeniably off limits. The brief experiment with BZP in New Zealand is the only one I am aware of anywhere in the world; whilst not a total disaster, the regulation was inadequate and it has been reversed when the political pressure got too hot (and BZP is also not covered by the Conventions).

Trying to establish a link in international comparisons between levels of enforcement/punitiveness and levels of use is reasonable if done with appropriate methodological caveats (indeed it is something that many people, including Kathy and Costa, like to do – albeit in a cherry picked methodologically laughable fashion -in comparing UK and Sweden – the whole thing about ‘getting the drug problem you deserve’). The WHO did it more systematically and found no link (still waiting for a comment on this).

Significant correlations have, however, been found between levels of use/misuse and income inequality (Wilkinson/Pickett) . I doubt Kathy would want to push on that fascinating finding and see where it leads, but for me it once again highlights the key role in social, economic and cultural factors in determining the contours of drug culture, and relative marginal nature of enforcement policy.

The critique of prohibition’s failure on its own terms (reducing availability,use) is surely legitimate, as is highlighting the unintended consequences. Long term failure of this policy is not the only reason to explore alternatives but it is a perfectly rational and reasonable catalyst. We want to see reduced overall harm (to users and the wider community) and maximised health and wellbeing (rather than obsessing over reduced use). This obviously does not preclude reduced demand, but pragmatically focuses on reducing problematic use (which the UNODC interestingly acknowledges says is only 5% of total illicit use). Reducing non-problematic use is not the priority because it is, well, not problematic (unless one sees it as a issue of personal morality in which case it is a different debate to the pragmatic public health policy and law one).

Professor Susan GreenfieldIt is folly to legalise a drug that is known to leave users with permanent damage to their ability to reason, argues Susan Greenfield, the distinguished expert on brain processes (Sunday August 18 2002, The Observer) now that those anxious to look cool can puff cannabis freely in without fear of arrest, perhaps those of us who have argued that
relaxing the laws on cannabis is irresponsible and dangerous should
retreat gracefully behind our chintz curtains. Yet the downgrading of
the classification of cannabis perpetuates the same tired old myths
and the same serious problems.

Take the myth that cannabis is ‘just the same as’ alcohol. A glib yet logical riposte might be that if the drugs are truly identical why not just stick with the booze? What is the distinct appeal of cannabis that can be ignored in equating the two drugs? Such sophistry is inappropriate because alcohol and cannabis work on the brain and body in very different ways. Alcohol has a range of non-specific actions that affect the tiny electrical signals between one brain cell and another; cannabis has its own specialised chemical targets, so far less has a more potent effect.
Moreover, although drinking in excess can lead to terrible
consequences, there are guidelines for the amount of alcohol that
constitutes a ‘safe’ intake. Such a calculation is possible because we
know alcohol is eliminated relatively quickly from the body.

With cannabis, it is a different story. The drug will accumulate in
your body for days, if not weeks, so, as you roll your next spliff,
you never know how much is already working away inside you. I
challenge any advocate of cannabis to state what a ‘safe’ dose is.
Until they do, surely it is irresponsible to send out positive
signals, however muted? Another notion is that cannabis is less
harmful than cigarettes. I’m not sure how this idea came about,
certainly not as the results of any scientific papers. We do know
cannabis smoke contains the same constituents as that of tobacco:
however, it is now thought that three to four cannabis cigarettes a
day are equivalent to 20 or more tobacco cigarettes, regarding damage
to the lining of the bronchus, while the concentration of carcinogens
in cannabis smoke is actually higher than in cigarettes. And if
cannabis were ‘just the same’ as alcohol and cigarettes, why are
people not taking those already legal drugs for the much-lauded
pain-relief effects? After all, another case for the relaxation of the
laws on cannabis is the ‘medical’ one that it is an effective
analgesic. But there is a world of difference between medication
prescribed in a hospital, where the cost-benefit balance tips in
favour of pain relief, compared to a healthy person endangering their
brain and body needlessly. Even the most loony of liberals has not
suggested tolerance for morphine or heroin abuse, because they
are prescribed clinically as potent painkillers. And think about it:
if cannabis brings effective relief from pain, then how does it do so?
Clearly by a large-scale action on the central nervous system.
Further wishful thinking is that, because cannabis doesn’t
actually kill you, it is OK to send out less negative legal signals,
even though the Home Secretary admits that the drug is dangerous.
Leaving aside the issue that cannabis could indeed be lethal, in that
the impaired driving it can trigger could well kill, there is more to
life than death. It is widely accepted that there is a link between
cannabis and schizophrenia: as many as 50 per cent of young people
attending psychiatric clinics may be regular or occasional cannabis
users. The drug can also precipitate psychotic attacks, even in those
with no previous psychiatric history. Moreover, there appears to be a
severe impairment in attention span and cognitive performance in
regular cannabis users, even after the habit has been relinquished.
All these observations testify to a strong, long-lasting action on the
brain. Some attempts have been made in laboratories to work out
what cannabis could actually be doing to brain cells. So far,
some data have suggested that there can be damage to neurons, and at doses comparable to those taken on the street.

None the less, others argue that the experimental scenario of isolated neurons growing in a lab dish are hardly a natural situation, and that such data have to be interpreted with caution. But absence of evidence is not evidence of absence. The effects on the brain in real life are most probably
subtle and therefore hard to monitor: it’s not so much that cannabis
will create great holes in your brain, or deplete you wholesale of all
your best neurons. Instead, by acting on its own special little
chemical targets (and because it will therefore work as an impostor to
a naturally occurring transmitter), the drug is likely to modify the
configuration of the networks of brain cell connections. These
configurations of connections make you the unique person you are, since they usually reflect your particular experiences. So a change
will be hard to register from one person to another, and certainly
from one slice of rat brain to another: but still, it will make you
see the world in a different way – characteristically one depleted of
motivation.

It is hard for me, as a neuroscientist, to accept that a
drug that has the biochemical actions that it does, that hangs
around in the brain and body, and that has dramatic effects on brain
function and dysfunction, could not be leaving its mark, literally, on
how our neurons are wired up and work together. It is argued that
we will never stamp out cannabis use, and therefore we should
give up trying. But we will not stamp out murder or house break-ins or mugging, yet I’ve never heard an argument for freeing up police time
by liberalising the law on these acts. Laws, it is said, are
only enforceable when the majority wants them enforced, yet the
arguments used for easing up on cannabis apply equally to promoting
ecstasy or other mind-bending substances.
Do we really want a drug-culture lifestyle in the UK? Cynically, one could argue that it is politically expedient to court the youth vote, to open up the
inevitable prospect of revenue from a new source of taxes and to help
the ailing tobacco industry prosper from a great new product of
readymade packets of spliffs. The condoning of chemical consolation
also distracts from other problems. We have failed our young
people in providing homes and jobs and, by giving them an easy route into a chilled-out oblivion, have turned our backs on the far more challenging prospect of initiating policies to help them realise their
potential and live better and more fulfilling lives. They are paying a
high price for cool.

Source: www.guardian.co.uk/science Aug.2002

“Britain’s rehab services are facing collapse. No fewer than 15 of the UK’s 100 rehab centres have closed in the past 15 months, despite an increase in the number of people seeking help for addictions.
Because of changes in government health policy, private rehab centres are finding fewer and fewer health authorities are willing to foot the bill for addicts to have residential treatment, despite that fact that it is much more effective in getting them off drugs, according to the Addiction Recovery Foundation.
The Independent on Sunday learnt this weekend that a flagship rehab centre – £26m Winthrop Hall in Kent – is preparing to shut after only one year of operation.
According to the latest Department of Health figures, 202,660 drug users were seen by addiction services in England in 2007-08.
The National Treatment Agency (NTA) has spent millions of pounds getting thousands more drug users into contact with addiction services since it was set up in 2001. Yet last year only 3 per cent of cases were referred to a residential rehab service, while two-thirds were prescribed heroin-substitute medication by GPs and NHS doctors working in addiction services.
Critics claim there are few long-term benefits of this medication-centred approach. The majority of rehab services use a version of the 12-step programme, and abstinence – becoming drug free – is the goal after four to six weeks of intense therapy. Clinics are run by large companies such as The Priory or small charitable organisations such as the Providence Projects in Bournemouth.
Up to now, rehab has been paid for by the drug abusers themselves or their local health service. But, increasingly, government policy supports putting as many addicts as possible into methadone-substitute programmes because they are cheaper.
As a result, rehab clinics such as Winthrop Hall have become reliant on private clients. The hotel-style addiction clinic was opened in October 2007 by Jon Moulton, a venture capitalist and millionaire, to provide specialist treatment in luxury surroundings for high-flying City executives. But yesterday, staff confirmed that the £32,000-a-year clinic is no longer accepting new patients.
Advocates of rehab say that the closure encapsulates the problem with government thinking on rehab. They point to research by the University of Glasgow, which found drug users who go through residential rehab are seven times more likely to be drug-free after three years than those who go to methadone clinics.
The Health Care Commission last week identified the low use of residential rehab services as a weakness.
Dr David Best, from the Department of Psychiatry at the University of Birmingham, said: “Commissioners have spent bigger and bigger slices of the pie on harm reduction services at the expense of rehab, despite the evidence that rehab works. Users now have to jump through so many hoops to get there, it has become much harder, and rehab centres have closed as a result. It’s not because we don’t need these services but the system has become saturated in methadone clinics, which are a much cheaper and easier way to ‘treat’ people.”
Professor Neil McKeganey, director of the Centre for Drug Misuse in Glasgow, said: “When we stop patting ourselves on the back and look back on this period, we will see that this was a shameful dereliction of our responsibility and we failed the majority of drug users by keeping them locked into addiction. Drug services fail addicts, contrary to official figures which report overwhelming success. Our research shows that those lucky enough to get residential rehab are seven times more likely to be drug free after three years. This is an inconvenient finding for politicians and civil servants who have preferred to support cheaper services that deal with large numbers of people.”
Anecdotal evidence suggests addicts who want to come off drugs are often met with reluctance from drug workers. In some areas, primary care trusts will only pay for rehab if the individual’s health or public safety is deemed to be in imminent danger because of their chaotic drug use. And there are growing reports of desperate addicts committing crimes as they try to convince the authorities to pay for rehab.
The not-for-profit Providence Projects in Bournemouth was forced to open its doors to private clients in 2005 after a drop in NHS referrals pushed it close to ruin. Paul Spanjar, the treatment director, said: “We get calls on a regular basis from friends and relatives who are desperate because the user’s primary care trust will not pay for rehab. Don’t get me wrong, there are great NHS trusts, but in some areas it is impossible for an addict to get funding.”
The NTA points to research that shows substitute prescribing reduces dangerous injecting and crime rates among addicts. It also claims that overcoming dependence is the ultimate goal of all treatment it supports. Paul Hayes, the NTA’s chief executive, disputes the number of rehab closures and believes the proportion referred to rehab is closer to 8 per cent.
ROAD TO REHAB: “YOU MUST LEARN WHY YOU’RE AN ADDICT”
Andy Hayden, 40, a former addict, lives and works with ex-offenders in Weymouth, Dorset. He has been clean for five years.
“I started on alcohol, glue and gas when I was 12, but within a few years I’d progressed on to anything I could get my hands on. At my worst, my girlfriend and I spent £600 a day on crack and heroin. Eventually I ended up living on the streets, picking food up off the floor, and was in and out of hospital with abscesses and cellulitis.
“About six years ago I suddenly realised that if I didn’t do something I was going to die. I went to the local methadone clinic and was immediately prescribed 50ml ‘maintenance’ a day. This was enough, but I told them I needed more so they doubled my dose. I still had no idea what was wrong with me; we never talked about that. So I kept stealing to buy drugs because while methadone stops you feeling ill, it doesn’t give you a high. When the clinic threw me out for using extras, my addiction was even worse. Methadone is a horrible drug to come off, much harder than heroin.
“In 2003 I heard about a project that sent prolific offenders into rehab. I was so desperate by this point that I made up loads of offences, just so that I’d get in. I was eventually referred to the Providence Projects in Bournemouth and have never looked back since. I know rehab is more expensive, but you have to learn why you’re an addict before you can stop.” ”
Source: The Independent Feb.1st 2009

Deterrence is preferable to encouraging marijuana use, which would follow alcohol and tobacco in soaring costs to society.Last month, Gov. Arnold Schwarzenegger reignited a heated debate when he called for a civilized discussion on the merits of marijuana legalization. Indeed, the governor was responding to new public opinion polls showing greater interest in the policy idea — and with the mounting problems associated with the drug trade in Mexico and here at home, it is hard to blame anyone for suggesting that we at least consider all potential policy solutions.

One major justification for legalization remains tempting: the money. Unfortunately, however, the financial costs of marijuana legalization would never outweigh its benefits. Yes, the marijuana market seems like an attractive target for taxation — Abt Associates, a research firm, estimates that the industry is worth roughly $10 billion a year — and California could certainly use a chunk of that cash to offset its budget woes in the current economic climate.

What is rarely discussed, however, is that the likely increase in marijuana prevalence resulting from legalization would probably increase the already high costs of marijuana use in society. Accidents would increase, healthcare costs would rise and productivity would suffer. Legal alcohol serves as a good example: The $8 billion in tax revenue generated from that widely used drug does little to offset the nearly $200 billion in social costs attributed to its use.

In fact, both of our two already legal drugs — alcohol and tobacco — offer chilling illustrations of how an open market fuels greater harms. They are cheap and easy to obtain. Commercialization glamorizes their use and furthers their social acceptance. High profits make aggressive marketing worthwhile for sellers. Addiction is simply the price of doing business.

Would marijuana use rise in a legal market for the drug? Admittedly, marijuana is not very difficult to obtain currently, but a legal market would make getting the drug that much easier. Tobacco and alcohol are used regularly by 30% and 65% of the population, respectively, while all illegal drugs combined are used by about 6% of Americans. In the Netherlands, where marijuana is de facto legalized, lifetime use “increased consistently and sharply” after this policy shift triggered commercialization, tripling among young adults, according to data analysis from the Rand Corp. We might expect a similar or worse result here in America’s ad-driven culture.
An honest debate on marijuana policy also carefully considers the costs of our current approach. Arrest rates for marijuana are relatively high, reaching about 800,000 last year. Though these numbers are technically recorded under the category of “possession,” the story that is seldom told is that hardly any of these possession arrests result in jail time (that is why former New York City Mayor Rudolph Giuliani made headlines when he aggressively arrested public marijuana users and detained them for 12 to 24 hours in the 1990s).

One of the most astute minds in the field of drug policy, Carnegie Mellon’s Jonathan Caulkins, formerly the co-director of Rand’s drug policy research center, found that more than 85% of people in prison for all drug-law violations were clearly involved in drug distribution, and that the records of most of the remaining prisoners had at least some suggestion of distribution involvement (many prisoners plea down from more serious charges to possession in exchange for information about the drug trade). Only about half a percent of the total prison population was there for marijuana possession, he found. He noted that this figure was consistent with other mainstream estimates but not with estimates from the Marijuana Policy Project (a legalization interest group), which, according to Caulkins, “naively … assumes that all inmates convicted of possession were not involved in trafficking.” Caulkins concluded that “an implication of the new figure is that marijuana decriminalization would have almost no impact on prison populations.” This is not meant to imply that marijuana arrests do not have costs, but rather, that these concerns have been highly exaggerated.

Finally, legalizing marijuana would in no way ensure that the most vicious drug-related problems — violence, economic-related crime, street gang activity — would disappear. Most of those problems stem from the cocaine, heroin and methamphetamine markets. Marijuana’s share of the black market is modest (the cocaine market is three times larger), and the money that is spent on the drug is spread over so many users and distributors that few are working with amounts that motivate or encourage high levels of crime.

Moving beyond the simplistic and unrealistic option of legalization, what can we do to reduce marijuana use and the costly harms it brings? Increasing the ferocity of enforcement isn’t the answer, but increasing its potential for effectiveness through deterrent methods might be. Programs like Project HOPE in Hawaii, which perform regular, random drug testing on probationers and others and implement reliable, swift (but short) sanctions for positive screens, have shown remarkable success. Innovative solutions, grounded in sound research on prevention, treatment and enforcement, present the shortest route out of marijuana-related costs. But an open market for the stuff? That doesn’t pass the giggle test.

Kevin A. Sabet worked at the Office of National Drug Control Policy in the Clinton and Bush administrations. He is currently a consultant in private practice.

Source: LA Times Sunday 7th June 2009

Despite this government spending £10billion – £1.5billion a year – on its drugs policy, the numbers emerging from government treatment programmes are the same as if there had been no treatment at all, revealed Kathy Gyngell in a recent document from the apolitical Centre for Policy Studies. We share its seminal factsThis summer saw the release of The Phoney War on Drugs by researcher Kathy Gyngell, chair of the Centre for Policy Studies’ Prisons and Addictions forum and editor of the 400-page Addictions section of Breakthrough Britain. It is a devastating critique of the failure of the UK’s drugs policy, the waste of valuable resources and lives.

Many experts implementing good practice will have witnessed the reality of the conclusions Gyngell arrives at, but perhaps not known the exact statistics. Truth gives power. Not only might counterproductive policies and practices be reduced, but Gyngell offers some tried-and-tested solutions. The UK is compared with Sweden and the Netherlands throughout The Phoney War. Both countries were chosen because they have adopted drug policies which are markedly different to
those of the UK and their drug use is lower. It is noteworthy that, despite the perception that the Netherlands has a liberal drugs policy, 76% of Dutch municipalities now operate local zero tolerance drug policies. Coffee shops are now increasingly tightly regulated and policed. A third have been closed in recent years. Sweden and the Netherlands also have more effective prevention strategies.

BLIGHTING THE NEXT GENERATION.

“Trae-blue Lane had just turned three when she died from an overdose of methadone, the heroin substitute supplied to her mother,” reported the Sunday Telegraph in January 2009. A Channel 4 Freedom of Information request found that between 2005-2006 police caught over 6,000 children selling drugs from class-A substances to cannabis, and caught a further 53,497 children in possession of drugs.

The deaths of infants are small windows on the UK’s worsening and chaotic drugs culture which Labour’s drug policy has, inadvertently, promoted. Consider these trends:

Adaption by James Bradbury of an article from Forreal.org
You may have seen this mysterious number in the form of logos, on TV shows and in films, perhaps without knowing what it means or even noticing it. Few people currently know what this number represents.

Simply put, 420 is a symbol of cannabis and its culture. It’s a “nudge-nudge wink” for pot users akin to the popular euphemism “I like to party”. It means they can speak openly about cannabis use by way of a code so that non-users will remain ignorant of their meaning. Somehow it leaked out into the mainstream and onto commercial clothing and other merchandise. Despite its prevalence, many parents and some teens are still unaware of what 420 means.

Nobody is certain why the number 420 became associated with cannabis culture, but numerous theories exist. Some people believe that it was originally a police code signalling cannabis use, while others think it came from the number of chemicals found in cannabis. As it happens there are over 400 chemicals found in cannabis, many of them carcinogenic, but the exact number and proportions vary widely between plants. Yet another idea is that 4:20 was the time a group of guys met after school to smoke cannabis. In any case, the number has been significant for cannabis users and promoters since the 1970’s.

When you see the symbol 420, be aware of what it represents. The person or organisation behind it is probably advocating cannabis use, its legalisation and possibly that of other drugs. Remember that the use of cannabis frequently leads users into using other drugs due to a variety of physical, psychological and social factors.

Those who make use of the 420 symbol may imply that cannabis use is commonplace, or even normal. This is certainly not true, as over 80% of young people do not use drugs more than once or twice, while 50% never try them at all. For more information about the physical, psychological and social dangers of cannabis, see our Cannabis Information page.

Thanks to Forreal.org for the use of material for this article.

By Roger Morgan. Californians for Drug-Free Schools

Marsha Rosenbaum is a self professed drug abuse expert, whose research was funded for 18 years by the National Institute on Drug Abuse. If the contents of her booklet called ‘SAFETY FIRST, a Reality- Based approach to TEENS, DRUGS, and Drug Education’ is reflective of her research, we should demand our tax dollars back. If ever she was a professional, she has now reduced herself to a snake oil salesman.

The worst thing about it is that 30,000 copies of ‘SAFETY FIRST’ were printed and distributed by her employer, The Drug Policy Alliance (DPA), and copies were given to every school in the nation. That should kill more than a few kids, and keep the supply lines open for drugs …. the mission of her employer. Her affiliation with the DPA alone is enough to expose her true intent.

As a parent who lost two step children to drug addiction twenty five years ago, and a very active drug prevention activist for the last 7 or 8 years, I have searched for solutions with no pre-conceived ideas of what it took to keep kids off drugs. Just about everything I have learned flies in the face of her advice. If she has any expertise with drugs, she certainly exhibits none as a drug prevention expert.

One of our cherished rights is freedom of speech. As reflected in ‘SAFETY FIRST’, the ability to propagate false information for specials interests, whatever they may be, also suggests it is one of the flaws. Ms. Rosenbaum’s special wisdom seems to be gained mostly from kids versus the scientific community: For example, she states:

‘They know there are differences between experimentation, abuse and addiction: and that the use of one drug does not inevitably lead to the use of another.

Yet, conventional drug education programs focus predominantly on abstinence-only messages and are shaped by problematic myths:

Myth #1: Experimentation with drugs is not a common part of teenage culture.

Myth #2: Drug use is the same as drug abuse;

Myth #3: Marijuana is the gateway to drugs such as heroin and cocaine; and

Myth #4: Exaggerating risks will deter young people from experimentation.”

First of all, there is profound evidence that one drug often leads to the use of another. It normally starts with cigarettes, then alcohol and then pot. Experimentation with drugs is a common part of teenage culture only because we allow it. We can stop most of it by doing what we have done to stop it with adults: random drug testing.

There should be no level of drug use that is acceptable for teens, because they are physiologically more susceptible to harm and addiction than adults, and their brains aren’t fully developed until their late teens or early twenties. No responsible adult would say just teach them how to do it responsibility.

With regard to telling kids the truth, there is no reason to exaggerate the risks of drugs. The truth alone should be sufficient for anyone with average intellect who is seeking the truth. However, these are children we are talking about. The reason they can’t vote is that they haven’t gained the cognitive skills to make mature decisions, including making the healthy decisions about their activities as teenagers. Most of us weren’t any smarter at that age, so it’s not a slight. Just a reality.

Ms. Rosenbaum states “. . . Our current efforts lack harm reduction education for those students who won’t “just say no”. In order to prevent drug abuse and drug problems among teenagers who do experiment, we need a fallback strategy that puts safety first.”

How about a program that just keeps them off drugs, Ms Rosenbaum, like random drug testing? For those who will become addicted because of permissive practices, we do need treatment. But treatment doesn’t work most of the time. As you stated, 80% to 90% of kids don’t have a problem. But 10% to 20% do, and many more don’t just come out whole. They aren’t totally unscathed. They are damaged, many of whom will never achieve their full potential, even if they aren’t complete addicts.

Harm reduction is the myth; the mantra of the DPA and other druggies and organizations that want to legalize and proliferate the use of drugs. Any self respecting drug abuse expert would know that some kids have a genetic pre-disposition to addiction of alcohol and drugs. Experimentation for them generally leads to addiction, and addiction to death or destruction. Harm elimination by getting kids to adulthood prior to first significant use, by whatever means possible, is the best harm reduction policy. Science says if we can get kids to adulthood intact they should never have a problem. Neither will society.

Ms. Rosenbaum myopically proposes that we teach children responsible use of drugs; and that we call on parents to have coherent conversations with their children, like her “Dear Johnny” letter, which will convince them to be responsible when they are using drugs or alcohol – evidence enough that she lives on a different planet.

Kids experimenting with drugs and alcohol don’t tend to be responsible. What do you tell them? Just smoke a little bit of pot and don’t get high? Don’t drink and use pot at the same time? Don’t drink or do drugs and drive? If someone offers you heroin, meth or cocaine, a drug that will give you a new high, just say thanks, “I’ll lumber along with pot?”

Her “MOTHER’S ADVICE” to son Johnny is naïve, and myopic in view of today’s family situation. Apparently Ms. Rosenbaum hasn’t noticed that our nation has a 49% divorce rate; single parenting; two parents working; drug using parents; child abuse, et. al. There is a reason why 60% of Americans are at moderate to high risk of using drugs and alcohol. There is a reason why schools are the safety net.

Parents are number one in terms of at-risk behaviour, followed by school environment. Even those parents who try, need help. Rosenbaum suggest parents “ find creative ways to open a dialogue, then listen, listen, listen.”

Ms Rosenbaum, if the kid is already using, you’re whistling Dixie. If he or she is just weighing the options, then parents need to carefully weigh their persuasive skills against peer pressure, the need for a teenager to be accepted, the chance of a genetic propensity to become addicted, and the forceful, deliberate attempt of a $600 billion illicit drug trade focused on getting their child hooked on their insidious products before adulthood, when science says they are safe.

To illustrate that marijuana is not a gateway drug, she states “… For every 100 people who have tried marijuana, only one percent is a current user of cocaine.” The reality is for every 100 people who use cocaine, meth, heroin and other drugs, all 100% probably started with marijuana. Rosenbaum states “there is no credible research evidence demonstrating that using one drugs causes the use of another.” That is simply a lie. There is plenty of research to show the relationship that one drug leads to others. Marijuana is a gateway drug, and it is dangerous in its own right. Over 60% of the young people in rehab programs are there for addiction to pot. Marijuana also has a very debilitating effect on short term memory, adversely affects motivation, retards the maturation process and leads to a multitude of physiological problems, including mental illness. Teaching children there is a safe, responsible level of marijuana use is blasphemous.

If there was any question of her maligned motives, her published responses to seminars presented by the ONDCP promoting random student drug testing in the spring of 2004 laid the matter to rest.

She said research and experience tells us “random drug testing does not deter drug use”. That is simply another lie. In every case where it has been done properly, it has dramatically reduced drug use. Schools in Oregon have shown that drug use by kids were in a school which tested was only 25% of the level in schools that did not test. At Hunterton Central Regional schools in New Jersey, after 2 years drug use was reduced in 20 of 28 categories. At De La Salle High School in New Orleans, which the kids had nicknamed “De La Drugs”, drug use has all but been eliminated by use of hair analyses. Ball State University did a study that showed 73% of High School Principals reported a reduction in drug use among students subject to drug testing, while 2% reported an increase. The big question seems to be is Marsha afraid it will work? And why?

She said testing athletes “can deter them from participating.” Research has shown that not to be true in general, and only for a few. If they are using drugs, they should not be competing in athletics. It is dangerous, for them and others. So, kids – a choice.

The biggest lie of all was that random drug testing is “expensive and inefficient”. She cites school administrators in Dublin, Ohio who curtailed their random drug testing program because they calculated their expenses at $35,000 a year for 1,473 students, at $24 a piece, because they only got 11 positive results, a cost of $3,200 per “positive” test.

We know Ms. Rosenbaum isn’t very knowledgeable on drug prevention, but apparently neither she nor the folks in Dublin are very good at math either. Since random drug testing is a deterrent, the correct way to measure the program would be to divide the cost of $35,000 by the 1,462 kids that didn’t do drugs, which would yield a cost of a little less that $24 per student. That’s cheap insurance! And not that Ms. Rosenbaum wants to confuse herself with facts, but with on-site drug test kits that cost as little as $2.50, all 1,473 kids could be tested today for $3,683. If the school can’t afford that, there are Federal Funds available to help pay for it, and if they only tested 10% of the students they could get the desired deterrent effect.

Under the guise of being a drug abuse expert from 18 years of shabby research, Ms. Rosenbaum has foregone any objectivity and professional integrity that should flow from independent research, and sold her soul to one of the most dangerous organizations in America: The Drug Policy Alliance (DPA), funded in large part by George Soros. The DPA’s mission is to legalize and proliferate the use of drugs. In joining their organization and advocating against the best known drug use deterrent, random drug testing, she has essentially defected to the other side.

Rosenbaum is not credible, and neither her motives or advice can be trusted.

As we set sail for another round of political buffoonery revolving around the drug problem here in Vancouver, there is a lone cry from the crow’s nest. Sadly, there were 14 more drug OD deaths in Vancouver during the first year of operation of the ‘Supervised (formerly ‘Safe’) Injection Site’ (50 in 2003; 64 in 2004 as per the attached documents). I have seen more tragedy down here in the skids (and elsewhere across Canada) than I care to, or possibly can, remember. I do sense that the tide will be changing here soon (I hope) as we are currently drifting in dangerous and uncharted waters.

Tonight I am taking out a Global TV reporter and her camera crew at the request of our good Inspector John McKAY, a worthy seaman who is bolding taking a stand against all of this pro-drug legalization nonsense that is deeply muddying up the waters. I have been policing these barren waters since the mid 80′s and the surface is as choppy as it ever was. It is time to high time say that the “Emperor has no clothes on” and set a new, healthy and prosperous course. The efforts behind the ‘Four Pillars Model’ (prevention, treatment, enforcement, and harm reduction) have been in vain, if you pardon the pun, because there has been too much emphasis on the so-called harm ‘reduction’ components.

Let’s look at it this way. Ask yourself this simple but defining question: Which of the four pillars are anti-drug and which are pro-drug? The answer to this belies why we are veering off course and into shark-infested waters. The drug legalizers are pirates who have hijacked the harm reduction pillar, which they have neatly and quietly whittled down into a harm reduction rudder in order to ‘safely’ steer the ship while the passengers and the crew sleep.

I find it a bit ironic that the warning of ‘ice’ being sighted from the crow’s-nest is being taken seriously, given the death and damage that other drugs have wreaked in our society. One of crystal meth’s nicknames is ‘ice’. Society is waking up to the fact that there needs to be a ‘war on ice’. But what will sink S.S. Society is the 90% of raw destructive power that is below the waterline: the foundation on which this drug is allowed to sit (injection sites, heroin trials, ‘medicinal’ marijuana, legalization attempts, weak drug laws and sentencing, etc.). I can show you a picture of a drug addict that is now largely a waste of human potential. Was this due to ravages of heroin, coke, or meth? What drug was used first: nicotine, alcohol, or pot? Does it really matter? The end result is the same.

The passenger infirmary list is getting longer by the day. If those of us who are deck hands are not to be believed, and if the attached stats are somehow skewed, then let’s just go ashore and ask the store owners and non-drug using citizens about the highly touted success (by Mayors Campbell and ex-Mayor Owen) of the ‘Four Pillars’ (“One pillar and three toothpicks” as one astute politician commented on the overabundance of the HR efforts). No one seems to ask for the opinions of the stalwart deck hands of this ‘success’, none of whom are throwing up their hats in the air in celebration of these joyous announcements. Those in the thriving ‘junkie industry’ are tossing lifesavers made out of blood-soaked meat to the hapless victims who have gone overboard with their drug ‘experimentation’ in shark infested waters. All this is done under the banner of compassion mind you, as we must not take away the freedom of choice. I would argue that to a large degree, the addict is unable to soberly choose what is right for them anymore. Their loss of dignity speaks to that.

Meanwhile the sharks circle below hungrily awaiting for the Captain to declare the water safe for swimming.

What is not a laughing matter is the strong movement afoot to legalize all drugs (‘market regulation’ is the buzz phrase). The sham of “legalization though harm reduction” is at last being exposed here in Vancouver. I hope that the police are not willing to be used as pawns in the legalization game by speaking into their hats. The Vancouver Agreement has been contorted beyond its initial shape and scope. I feel that it is time to speak up or forever live with the shame and further social destruction that drug legalization will bring.

Ed Broadbent (leader of the New Democratic Party from 1975 to 1989 and human rights champion) stated recently that “Human rights are based on the inherent dignity of the human being” (June 16, 2005, ‘CBC One’ radio). Drugs have been robbing that dignity from tens of thousands of people. If some blackguards were killing and torturing people in the high seas as drugs do, then it would be an obvious human rights issue and the purveyors of powdered death and destruction would be forced to walk the plank, be keel-hauled, or thrown into the brig.

Drugs sap the potential of our youth. We owe them a better legacy than drug dependency, for it is very well-established that as the perception of the harms done by drugs decreases, drug use increases, and that is simply unacceptable and completely unconscionable.

The havoc that we have witnessed with drugs in our society to date is but the tip of the iceberg if the drug legalization movement is left unchecked.

Of course these comments are my own and do not necessarily reflect those of the VPD, but watch and see if they in fact are…Al

Al Arsenault, President
Odd Squad Productions Society
Box 1107, 516 Abbott St.,
Vancouver, B.C. CANADA,V6B 6N7
 www.oddsquad.com
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Ben Mitchell argues that drugs should not be legalised.
In the UK, the social and economic costs of drug misuse account for between £10 billion and £18 billion a year. Around 250000 problematic drug users’ contribute to 99% of these costs.1 These addicts spend around £16,500 a year each to feed their habits, with most of this coming from the proceeds of crime2. Hard drug users, who indulge in heroin, crack cocaine and powder cocaine, are responsible for 50% of all crimes3.
On the one side, them are proponents of harm reduction’. In the case of heroin, they want to see persistent users prescribed heroin under the N US.
Opponents compare the Dutch and Swedish approach to drugs over the last 25 years, and point out that drug use in the Netherlands, which has adopted a policy of ‘harm reduction, has seen use of cannabis amongst the young more than double, with use of ecstasy and cocaine by l5 year olds rising significantly4.
By contrast, in Sweden, the goal has been to create a ‘drugs free society,’ with everyone from the police to schools working towards such a strategy. As a result, overall lifetime prevalence of drug abuse, amongst 15-16 year-olds. is 8% in Sweden, compared to 29% in the Netherlands. In 1998, only 496kg of cannabis were seized in Sweden, compared to 118 in the Netherlands, now described as the drugs capital of Western Europe5 . This is because in Sweden drug use is seen as inimical to a civilised, tolerant society, whereas in the Netherlands drugs have been accepted as a ‘way of life’ and have contributed hugely to crime.
The UK’s approach to drugs is deeply flawed. with the government sending out confusing and misleading messages. Cannabis has been downgraded from a class B to class C drug; yet many people widely believe that cannabis has been decriminalised,
The ‘Lambeth Experiment’, which led the way to reclassification, caused an explosion in the number of drug dealers preying upon the area6. The experiment has to all intents and purposes ‘allowed’ people to smoke cannabis publicly. But, the moral and ethical question still remains: is it acceptable to tolerate something which is proven to damage both the health and judgement of individuals, and can also affect relationships with families, friends and the wider society?
There are now several experiments being conducted across Europe in an effort to contain heroin addiction. In Switzerland, since 1994, 1,000 of the country’s 33 heroin addicts have been prescribed pure heroin. The aim is to stabilise the health of addicts and prevent them from using heroin in public, thus taking their habit away from the black market.
Swiss officials claim that the experiment is working because crime is down, However, addicts are now becoming dependent on prescription heroin and hopes of weaning them off the substance have quickly faded.7
The Police Federation disputes that legalisation would cut crime. This assumes that the powerful international drug cartels would simply fade away into the night. More likely scenarios are that they would fight to maintain their lucrative street trading8.
Notes
1. The Government Reply to the Third Report from the Home Affairs Committee Session 2001-02: The Government Drug Policy: Is it working?, p.5
2. Home Affairs Third Report: The Government Drug Policy. Is it working?, Illegal Drugs, Drugs-related property crime. no.36
3.The Government Reply to the Third Report from the Home Affairs Committee session 2001-02: The Government Drug Policy. Is it working?, p.5
4 .Home Affairs Select Committee Report: The Government Drug Policy. Is it Working? Memoranda of Evidence – no.16 (submitted by the Criminal Justice Association)
5. Risk of Legalising Cannabis Underestimated: A Comparison of Dutch and Swedish Drug Policy. Criminal Justice Association, February 2002
6. The Dealers Think They’re Untouchable Now’, The Observer, 24 February 2002 and ‘London’s Drug Crime Hotspots Revealed. Evening Standard. 28 May 2003
7. Better Ways’. The Economist, 26 July 2001
8. Quoted in Home Affairs Select Committee Third Report: The Government ‘s Drugs Policy. Is
Working’., no.60 Source:CIVITAS; Institute for the Study of Civil Society
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Dear Peter,

Tony Blair’s call for mandatory drug testing for people arrested for criminal offences Is Me more than cynical rhetoric aimed at pandering to the law and order lobby. This is policy formation on the hoot there has been no consultation with practitioners or government departmental specialists to assess the effectiveness or repercussions of pursuing this initiative.

Of course there is a clear link between illegal drug use and acquisitive crime. But the under lying reason for this is the high price of illegal drugs on the unregulated market. Lets not forget that there is little if any property crme associated with tobacco addiction. Why? Purely because the price is low.

Suddenly the talk is of a ‘War on drugs”. Why no ‘War on alcohol”, by far the most important precursor to violent offending? Or a war on tobacco, by far the biggest killer?

It seems as if Tony Blairris marking his political territory like a tom cat. Apart from causing a stink, this will do nothing to address the underlying reasons for drug misuse that he claims others have ducked for so long.

What problematic illegal drug users need and want is access to effective treatment options before their offending even begins. This latest initiative flies in the face of more progressive measures that this government has been instrumental in developing up to now.
Yours sincerely, Danny Kushlick Director, Transform: The Campaign for an Effective Drug Policy

Dear Danny,

Conference rhetoric or no, drug misuse and related crime needs to move up the agenda. Mention of mandatory testing is, of course, akin to waving a red rag at a bull, but it can have a positive side: it may give more heroin and cocaine users a helpful shove into intervention or treatment But it follows, of course, that these services must be in place now.

Even If it were true and it isn’t that all drug crime is acquisitive, relaxing drug laws would not necessarily bring drugs within economic reach. Many legalisers foresee heavy taxation and, of course, changes in the law don’t increase the personal income of users. Many would still end up funding their lifestyles with crime.

You ask where the “war” on tobacco and alcohol has been. I ask: where have you been if you haven’t noticed the massive health promotion campaigns? And Labour are hardly monopolising the drug platform, as you imply: senior Tory and Lib Dem politicians alike have set out their stalls over the fast month. All party support for the national strategy continues.

That strategy calls for more treatment resources, as you do. Me, too but if you really want to reduce offending, prevention is the only way forward. Sadly, that notion gets abused as much as drugs do. Yours sincerely,
Peter Stoker Director, National Drug Prevention Alliance

Dear Peter,

I’m pleased to hear that you support the call for more treatment services. In my area, Avon, dependent users have to wait a year for a detox bed or a rehab place which means that those people who want help are effectively being denied it.

There are more than 250,000 dependent illegal drug users in the UK right now, and they are responsible for

Between a third and a half of all property crime. There are 12m dependent tobacco users and they’re responsible for none of it.

Our organisation Is not calling for a relaxation of the drug laws. Quite the opposite: the illegal drug market is the most “relaxed” and lucrative on the planet. It constitutes 8% of international trade and is subject to no control or regulation whatsoever. Transform would like to see this trade brought back into a regulated framework where it can be controlled through prescription and licensing.

There’s little we can do to “prevent” the activities of the millions of people already using and misusing drugs in the UK. However, we can make sure that those who do use drugs cause as few problems as possible for those who do not. We could begin by making free treatment available immediately for anyone with a legal or illegal drug problem and reallocating resources from the criminal justice budget towards social initiatives. Or we could just “shove”dependenttusers into non existent programmes. Yours sincerely, Danny

Dear Danny,

Yes, waiting lists for treatment are too long but they’d be an awful lot longer if we were to swallow your notion. “Regulating” supply means legalising or decrminalising the stuff, no matter how you play with words. This would mean a significant relaxation of the law, which would boost the use of dangerous drugs. The experience of every country which has tried this including Holland has been negative enough to provoke massive back pedalling.

Sweden had a major problem, and, at first, it tried to “regulate” it. They relaxed the laws, gave out harm reduction advice and the like only to find a major escalation of use and attendant problems. Then they switched to firmer laws, much better prevention resources, a range of social initiatives and mandatory intervention and treatment. The prevalence of drug misuse in Sweden is now a fraction of ours.

I don’t subscribe to the view that punishment should be the sole response to any crime, but we do need a system which intercepts and improves the situation. Your system merely appeases by accommodating the user at the expense of everyone else.
Yours sincerely, Peter

Dear Peter,

The illegal drugs market is worth a billion dollars a day and is currently controlled and regulated by organised crime. Yes, Peter, Transform campaigns ultimately for legalisation as the best way to regulate and control the drugs market. The average age of heroin users in the Netherlands is 39 and rising. In the UK its 26 and failing. Enough said?

The Blair Straw initiative to drug test people arrested for criminal offences flies in the face of the governments own studies, one of which showed that £1 spent on treatment saves £3 in criminal justice costs. One can only wonder how refusing bail fits in with this evidence. Liberty, the civil liberties group, has also suggested that the idea may breach the European Convention on Human Rights.

Let us hope that Mr Blair’s speech was intended as Daily Mail fodder only. God forbid that he should actually attempt to put it into practice. In the US they don’t do rhetoric; acting “tough on drugs” there has helped raise the prison population to nearly 2 million. One in 35 adults in the land of the free are either in prison, on probation or on parole.

Transform’s millennium prediction is that this kind of mandatory drug testing will mean more prisoners, less treatment,’ more social exclusion, less freedom and little reduction in crime. How about a drug policy that’s tough on organised crime, not tough on socially deprived individuals?
Yours sincerely, Danny

Dear Danny,

It seems, after all, that the kind of treatment you are proposing for illegal drug misusers is to treat them with impunity. If they steal to buy drugs this is, you say, because they are socially deprived. Ergo, one crime is the justification for another. And your proposal for beating crime is to legalise it.

I’ll join you in tackling social injustice, and in pressing for more and better drug services, but all our research

and observation, inter nationally, shows your stance on drug laws to be profoundly mistaken. We don’t want to regulate the misuse of drugs, we want to minimise it whether the drug is illegal or not. Findings to date argue for a sensitive and flexible mix of justice systems, appropriate interventions (because not every user is an addict) and community wide prevention.

The rights and responsibilities of drug misusers should be balanced against those of non users, who rarely get a mention but are often the consequential victims.

Whether these latest ideas of mandatory testing and the withholding of bail will prove a bridge too far will become clear with time. But they do not invalidate the general strategic approach, which anyone genuinely interested in improving the situation for all including the drug misusers should support.
Yours, Peter

Source: Society Guardian.co.uk Guardian Newspapers Limited , Saturday October 2, 1999

Questions of medicine are for the FDA to answer – not special interest groups, not individuals, not public opinion. Our medical system relies on proven scientific research. Smoked marijuana as medicine has been rejected by the American Medical Association, the National Multiple Sclerosis Society, the American Glaucoma Society, the American Academy of Opthalmology and the American Cancer Society.1 Recently, the federal Institute of Medicine also conducted research on this issue and they see “little future in smoked marijuana as a medicine.” 2

The major reason the national medical organizations and the FDA reject crude smoked marijuana is that numerous safe and effective FDA approved medicines are available for all the conditions that smoked marijuana allegedly helps. Marijuana legalization advocates would have you incorrectly believe that smoking marijuana is the only alternative for cancer sufferers who are going untreated for the nausea associated with chemotherapy, and for all those who suffer from glaucoma, multiple sclerosis, and other ailments. However, numerous effective medications are currently available for these illnesses. 3

Before the passage of the Pure Food and Drug Act in 1907, our nation was exposed to a host of patent medicine and “folk remedies.” The major drug in most of these “cures” was alcohol. This is why people reported that they “felt better” as they do with marijuana. Needless to say, these claimed benefits were erratic and not reproducible. Marijuana is intoxicating, so it’s not surprising that sincere people report relief of their symptoms when they smoke it. They may be feeling better – but they are not actually getting better and they may be getting worse due to the effects of marijuana.

Americans have the world’s safest and most effective system of medical practice built on a process of scientific research, testing and oversight. Our investment in medical science is at risk if we do not defend the proven process by which medicines are brought to the market. All drugs must undergo rigorous clinical trials before a drug can be released for public use. Smoked marijuana has not met that test. We should not approve any drug that has not proven to be safe and effective.

Scientific literature shows that use of marijuana is a major risk factor in the development of addiction and drug use among our school children. The efforts to confuse the public about marijuana have contributed to the drop in school children’s perception of marijuana’s harm which results in marijuana and other drug use among school children. Of the nearly 182,000 kids in treatment today, 48% were admitted for abuse or addiction to marijuana while only 19.3% for alcohol and 2.9% for cocaine, 2.4% for methamphetamine and 2.3% for heroin. It is no coincidence that those states with medical marijuana initiatives have among the highest levels of drug use and drug addiction. 4

References:

1. Bonner, R., Marijuana Rescheduling Petitions, 57 Federal Register 10499-10508; Alliance for Cannabis Therapeutics v. DEA and NORML v. DEA, 15 F.3d 1131 (D.C. Cir 1994)

2. John A. Benson, Jr., Co-Principal Investigator, in releasing Marijuana and Medicine: Assessing the Science Base, Institute of Medicine, National Academy of Sciences, 1999.

3. Eric Voth, M.D., FACP, “Medicinal Applications of Marijuana”, Institute on Global Drug Policy of the Drug-Free America Foundation, St. Petersburg, FL. WWW.DFAF.ORG; 2004 Physicians’ Desk Reference, page 3241

4. Clayton, R.R., and Leukefeld, C.G., The prevention of drug use among youth; implications of “legalization”. Journal of Primary Prevention. 1992:12:289-302.; “Non-medical Marijuana: Rite of Passage or Russian Roulette?” July 1999 obtained at website WWW.CASACOLUMBIA.ORG/PUBLICATIONS

More research has been published on the effects of drug courts than on virtually all other interventions for drug-abusing offenders combined. How, then, can the field continue to be in serious dispute about whether drug courts “work”? How is it possible for some reputable scholars to conclude that the success of drug courts has been definitively established (e.g., Meyer & Ritter, 2002), whereas others insist that drug courts are little more than a sham perpetuated by irrational believers (e.g., Anderson, 2001; Hoffman, 2002).

The answer is at least three-fold. First, the more extensive the literature on an intervention, the greater the likelihood that it will contain conflicting findings that can lead researchers to different conclusions. To preserve unanimity, one should conduct a single study, declare victory, and then spread the word — which happens all too frequently in the substance-abuse and criminal-justice fields. Like the old adage, “no good deed goes unpunished,” if a field takes seriously its responsibility to carefully study its operations and impacts, it will almost certainly turn up some damning evidence.

Second, the more studies that are conducted on an intervention, the greater is the probability that some of the studies will have been poorly implemented, the data poorly analyzed, or the implications overstated. This leaves proponents open to the charge that they are relying on “junk science.” Even if some well-designed studies do support the utility of the intervention, those studies may become unfairly tainted in the minds of critics, by association with poorer studies that reached the same conclusion or were mentioned in the same review papers.

Third, there are different standards of proof for establishing the efficacy of an intervention as opposed to its effectiveness. Efficacy refers to whether the intervention can be successful when it is properly implemented under controlled conditions, whereas effectiveness refers to whether the intervention typically is successful in actual clinical practice (e.g., Howard et al., 1996). Efficacy is a necessary, but not sufficient, condition for effectiveness, and is ideally established through randomized, controlled, experimental studies (e.g., Campbell & Stanley, 1966).

These three factors shed light on the most recent iteration of the drug court controversy being discussed on Join Together Online. In an August 2004 commentary, Kevin Whiteacre took to task the National Drug Court Institute (NDCI) and the White House Office of National Drug Control Policy for their “National Report Card” on drug courts in the U.S. (Huddleston et al., 2004). Mr. Whiteacre pointed out, correctly, that (1) the majority of drug-court program evaluations have used either no comparison group, or a biased comparison group such as offenders who refused or failed the drug-court program; (2) the majority of evaluations reported analyses only for program graduates (i.e., the most successful cases) as opposed to the original “intent-to-treat” cohort; and (3) the GAO has issued reports faulting the data-collection methods used in the drug-court grantee self-report surveys administered by the former Drug Courts Program Office (DCPO).

These are valid points that have been echoed by other drug-court researchers, including my colleagues and myself at the Treatment Research Institute (Belenko, 1998, 1999, 2001, 2002; Marlowe, DeMatteo, & Festinger, 2003). Unfortunately, Mr. Whiteacre went beyond these appropriate criticisms to conclude that the “jury’s still out” on the impact of drug courts. On this latter point, I believe he is mistaken.

It is true that many drug-court program evaluations are of such poor quality that the results cannot be interpreted from a scientific perspective. However, there are at least three randomized, controlled, experimental studies published in peer-reviewed journals reporting superior results for drug courts over traditional probationary conditions. These studies were conducted in the Maricopa County (Ariz.) Drug Court (Turner et al., 1999), the Baltimore City Drug Treatment Court (Gottfredson & Exum, 2002; Gottfredson et al., 2003), and the Las Cruces (N.M.) DWI Court (Breckenridge et al., 2000). Among other positive findings, these studies revealed significant reductions in post-program criminal recidivism for drug-court participants lasting up to two and three years post-admission. A fourth experimental study of the Summit County (Ohio) Juvenile Drug Court also provided evidence for the superiority of drug court over standard adjudication; however, the small sample sizes in that study rendered the findings preliminary.

There have also been several “parametric” studies that are beginning to isolate the effects of the various “key components” (NADCP, 1997) of drug courts. For instance, using a randomized, controlled design, Adele Harrell, John Roman, and their colleagues at The Urban Institute have demonstrated that imposing graduated sanctions for positive urine drug-screens improved outcomes over standard pre-trial drug-court supervision (Harrell, Cavanagh, & Roman, 1998). Further, in a series of experimental studies, our research group demonstrated that frequent judicial status hearings improved outcomes for high-risk drug offenders who had more severe drug-use histories or a comorbid diagnosis of antisocial personality disorder (Festinger et al., 2002; Marlowe, Festinger, & Lee, 2003, 2004; Marlowe, Festinger, Lee, et al., 2003). These findings were replicated in three different jurisdictions, located in both urban and rural communities and serving both misdemeanor and felony drug offenders.

The latter studies are particularly relevant for establishing the efficacy of drug courts. It is very difficult to conduct the type of randomized studies with no-treatment control conditions that are necessary to scientifically prove the efficacy of an intervention. An alternative approach, however, to assessing the efficacy of drug court is to evaluate the effects of manipulating its core ingredients. Demonstrating that judicial status hearings have a significant bearing on drug-court outcomes establishes that drug courts have a unique mechanism of action. This provides scientific support for the utility of drug courts, and perhaps the only practicably obtainable evidence that the GAO and other stakeholders would be willing to accept.

Taken together, the results of these experimental studies prove the efficacy of drug courts beyond peradventure. The Food and Drug Administration (1998) requires only two experimental clinical trials to establish the efficacy of a new medication. It makes little sense to hold drug courts to a higher standard of scientific proof than we hold, say, cancer medicines. The fact that some program evaluation studies have been poorly implemented does nothing to detract from the scientific integrity of these well-designed studies. It may, however, raise questions about the effectiveness, nationally, of drug courts in day-to-day practice. Dozens of well-designed program evaluations have demonstrated the effectiveness of particular drug-court programs; however, the vast majority of drug courts in this country are not collecting the data elements necessary to document their services or outcomes.

The responsibility now falls to the drug-court field to establish performance benchmarks and best practices for drug-court programs, and to develop accreditation procedures that can be used to document whether a particular program is in compliance with professionally accepted standards of practice. Failing to do so would be a potential waste of money and a breach of consumers’ trust. It would not, however, detract from the scientific evidence favoring the efficacy of drug courts. In short, the jury may still be out on how the universe of drug-court programs in this country is operating in practice, but the verdict is long overdue on the efficacy of drug courts.

Editor’s Note: Doug Marlowe is the director of law and ethics research at the Treatment Research Institute at the University of Pennsylvania.

References

Anderson, J. F. (2001). What to do about “much ado” about drug courts? International Journal of Drug Policy, 12, 469-475.

Belenko, S. (1998). Research on drug courts: A critical review. National Drug Court Institute Review, 1, 1-42.

Belenko, S. (1999). Research on drug courts: A critical review: 1999 update. National Drug Court Institute Review, 2(2), 1-58.

Belenko, S. (2001). Research on drug courts: A critical review: 2001 update. New York: National Center on Addiction and Substance Abuse at Columbia University.

Belenko, S. (2002). Drug courts. In C. G. Leukefeld, F. Tims, & D. Farabee (Eds.), Treatment of drug offenders: Policies and issues (pp. 301-318). New York: Springer.

Breckenridge, J. F., Winfree, L. T., Maupin, J. R., & Clason, D. L. (2000). Drunk drivers, DWI “drug court” treatment, and recidivism: Who fails? Justice Research & Policy, 2, 87-105.

Campbell, D. T., & Stanley, J. C. (1966). Experimental and quasi-experimental designs for research. Chicago: Rand McNally.

Festinger, D. S., Marlowe, D. B., Lee, P. A., Kirby, K. C., Bovasso, G., & McLellan, A. T. (2002). Status hearings in drug court: When more is less and less is more. Drug and Alcohol Dependence, 68, 151-157.

Food and Drug Administration. (1998, May). Guidance for industry: Providing clinical evidence of effectiveness for human drug and biological products. Rockville, MD: Center for Drug Evaluation and Research, U.S. Dept. of Health & Human Services.

Gottfredson, D. C., & Exum, M. L. (2002). The Baltimore City Drug Court: One-year results from a randomized study. Journal of Research on Crime and Delinquency, 39, 337-356.

Gottfredson, D. C., Najaka, S. S., Kearley, B. (2003). Effectiveness of drug treatment courts: Evidence from a randomized trial. Criminology & Public Policy, 2, 171-196.

Harrell, A., Cavanagh, S., & Roman, J. (1998). Final report: Findings from the evaluation of the D.C. Superior Court Drug Intervention Program. Washington, DC: The Urban Institute.

Hoffman, M. B. (2002). The rehabilitative ideal and the drug court reality. Federal Sentencing Reporter, 14, 172-178

Howard, K. I., Moras, K., Brill, P. L., Martinovich, Z., & Lutz, W. (1996). Evaluation of psychotherapy: Efficacy, effectiveness, and patient progress. American Psychologist, 51, 1059-1064.

Huddleston, C. W., Freeman-Wilson, K., & Boone, D. L. (2004). Painting the picture: A national report card on drug courts and other problem-solving court programs in the United States. Alexandria, VA: National Drug Court Institute, and Bureau of Justice Assistance.

Marlowe, D. B., DeMatteo, D. S., & Festinger, D. S. (2003). A sober assessment of drug courts. Federal Sentencing Reporter, 16, 153-157.

Marlowe, D. B., Festinger, D. S., & Lee, P. A. (2004). The judge is a key component of drug court. Drug Court Review, 4,1-34.

Marlowe, D. B., Festinger, D. S., & Lee, P. A. (2003). The role of judicial status hearings in drug court. Offender Substance Abuse Report, 3, 33-46.

Marlowe, D. B., Festinger, D. S., Lee, P. A., Schepise, M. M., Hazzard, J. E. R., Merrill, J. C., Mulvaney, F. D., & McLellan, A. T. (2003). Are judicial status hearings a key component of drug court? During-treatment data from a randomized trial. Criminal Justice & Behavior, 30, 141-162.

Meyer, W. G., & Ritter, A. W. (2002). Drug courts work. Federal Sentencing Reporter, 14, 179-185.

National Association of Drug Court Professionals. (1997). Defining drug courts: The key components. Washington, DC: Office of Justice Programs, U.S. Dept. of Justice.

Turner, S., Greenwood, P., Fain, T., & Deschenes, E. (1999). Perceptions of drug court: How offenders view ease of program completion, strengths and weaknesses, and the impact on their lives. National Drug Court Institute Review, 2, 61-85.

Today in Atlanta, concerned parents will meet with regional school officials, drug prevention specialists and student assistance professionals to discuss the promise of a powerful new tool to fight drug use among America’s youth.

Building on the 11 percent decline in teen drug use America has witnessed in the past two years, random student drug testing — locally controlled, nonpunitive and designed to get help for those in trouble — can help consolidate and further our progress.

Addiction is a paediatric-onset disease that needs a public health response. In much the same way that school tuberculosis tests identify children who are sick and can spread a dangerous disease, student drug testing helps identify kids who have a problem with drugs and prevents the spread of the disease of addiction.

Each child prevented from using drugs means there is one fewer child able to pass the disease of addiction to his or her peers, and we know that if we can prevent children from using drugs in their teen years, they are much less likely to go on and use drugs later in life.

In the past decade, the nation’s acceptance of student drug testing has increased, hastened by the U.S. Supreme Court’s 2002 ruling that drug testing students in extracurricular activities is constitutionally protected.

President Bush highlighted this policy as an effective prevention and intervention instrument during his State of the Union speech in January, and backed up his position with a call for increased federal funds for schools that would like to start these programs. This momentum in favour of student drug testing is based on the demonstrated effectiveness of random testing programs to deter use, and a more educated public understanding that student drug test results can only be used confidentially to help students, not to punish them.

Random drug testing of students in extracurricular activities is effective because it demonstrates that a community has set a serious standard for its youth. In addition to creating a culture of disapproval toward drugs, student drug testing also achieves three public health goals:

• It deters children from initiating drug use;

• It identifies children who have just started using drugs so that parents and counsellors can intervene early;

• It helps identify children who have a dependency on drugs so that they can be referred to effective drug treatment.

According to a study in the Journal of Adolescent Health, a school in Oregon that randomly drug tested student athletes had a rate of drug use that was one-quarter that of a comparable school with no drug testing policy.

After two years of a drug testing program, Hunterdon Central Regional High School in New Jersey saw significant reductions in 20 of 28 drug use categories, including a drop in cocaine use by seniors from 13 percent to 4 percent. The U.S. military saw drug use rates drop from 27 percent in 1981 to 3 percent today, thanks to the introduction of random drug testing.

BYLINE: DR. KEVIN COSTELLO
Published on August 9,  2004- The Press Democrat PAGE: B9

Marijuana … what harm can a little dope do? The short answer is: Plenty.
First, is marijuana addictive? You bet it is. About one in eight people exposed to marijuana will become dependent on it. This makes it a little more addictive than alcohol. How do I define addiction? There’s a fancy medical definition or a more simple one: If you use marijuana every day you are probably addicted to it, especially if you have been doing this for a few months or more.So, let’s say you smoke marijuana every day. Isn’t that your business? Maybe yes, but most likely, no. When you are addicted to a substance your relationships in life are with that substance — not with other people.

In addiction medicine we have found that it is often best to ask the family members of the dependent individual how they feel. Frequently, there is a deep resentment and embitterment about the lack of support or the lack of emotional contact and empathy. A patient of mine was once asked by his wife to stop smoking marijuana for a few weeks, because her father was dying and she needed his support.

He managed to stop for a while, only to return to the addiction after his father-in-law died. It is remarkable how strong the dependency on marijuana can be.

Let’s say you don’t care about anyone else or that all your friends smoke or your significant other is tired of you and just as happy to have you stoned all the time.

What’s wrong with that?

There was an article in the Journal of the American Medical Association a few years ago, that looked at patients who used marijuana at least daily. The authors found that even 19 hours after stopping marijuana, these chronic users were not able to think as well (or memorize, or calculate, or analyze or perform other mental functions). In other words, if you smoke marijuana daily, you are always affected or “stoned” to a certain degree. You will not be able to realize your full intellectual capacity. This is especially important to high school and college students whose futures are determined by how well they do during that critically important eight-year window of academic opportunity.

Marijuana can also affect people in mid-career. A former patient of mine who was a Honda mechanic told me that he would read the shop manuals that came out every year seven or eight times. Despite the repetitive reviews, he was still not able to master the material. After stopping marijuana — which he had been using since high school — he found he only needed to read the manuals once.

One further caveat: some people seem to function very well on marijuana. They hold responsible positions and continue to perform relatively well. These folks are probably very bright and are able to accommodate the decrease in mental capacity. They may not, however, be the people you want performing brain surgery or negotiating an important contract.

Let’s say you really don’t care about any of the things that I’ve mentioned above. All you want is to smoke a little dope. A recent article, also in the Journal of the American Medical Association, showed that people who were using cocaine and methamphetamine (nasty stuff — there is a lot of evidence suggesting that these stimulants cause permanent brain injury) frequently followed a pattern of smoking cigarettes at a young age, then drinking alcohol, smoking marijuana and finally, progressing to harder drugs. The authors concluded that marijuana was not only a “gateway drug,” but seemed to actually precipitate the progression to the stimulants (cocaine and methamphetamine) and even to heroin, in certain individuals. So, you still don’t care. Well, I’ve saved the worst for last. The following is a partial list of the complications associated with the chronic use of marijuana: toxic psychosis (in susceptible individuals), increased heart rate and pain, decreased lung function, impaired fetal growth and development, decreased immune function (important for fighting infections and cancers), weight gain, bronchitis, and more.

Finally, a brief word about “medical marijuana.” The medical marijuana initiative passed by California voters, basically provides for the legalization of marijuana. This is because the initiative states that in addition to several serious illnesses, marijuana may be prescribed for “any other illness for which marijuana provides relief.” There was also no restriction on the age of the patient. Many physicians have no problem with the administration of marijuana to a patient with a terminal illness — but did the people of California really intend (as one United States Supreme Court justice put it) that marijuana be used for “anyone with a stomach ache” or for any reason at all?

I, for one, am not willing to sacrifice the one in eight individuals who are now at increased risk for developing an addiction to this drug due to its significantly increased availability.

I know that this article will raise deeply felt issues with some people. It is not my intention to offend anyone. I have attempted to provide factual information that can be reviewed, and hopefully, help you formulate an opinion about the use of marijuana. If you think that you have an addiction to marijuana, or you have further questions about it, the folks at Marijuana Anonymous can be an excellent source of information and assistance. You could also consult with a specialist in chemical dependency or one of the many local chemical dependency programs.

Dr. Kevin Costello is the chief of the medical division of Chemical Dependency Services for Kaiser in Santa Rosa.

By Jim McDonough Malcolm

The marijuana normalizers – as in, “let’s make marijuana use normal, or acceptable” – loved it; so did some of the press. Both were quick to misportray the study, so much so that the author of the study himself was dismayed.

Andrew Morral of RAND believes he did everything he could to explain he did not disprove the gateway theory but, as he told me, “The story about it misrepresented both our findings and my comments about the relevance of our findings to US drug policy. RAND and I have taken pains to emphasize that we do not believe we have disproved the gateway theory.”

The study did say that a high incidence of progression from marijuana to heroin and cocaine use is apparent; that the younger you are when you start using marijuana, the more likely you are to end up using cocaine and heroin; that the more often you use marijuana, the more likely you will use cocaine and heroin.

In short, the study shows the correlation between marijuana and other drug abuse to be high.

Indeed, the study accepts previous studies that have demonstrated the probability that heroin and cocaine use increases 85 times for marijuana users when compared with those who are not marijuana users; that early teen use of marijuana is even more highly correlated with other drug use than late teen marijuana use; and that the more puffs of marijuana you take, the more likely you move on to injections and snorting of even more dangerous drugs.

But here’s where the misunderstanding begins. The study says that maybe these terrible things happen because the people who use all these nasty drugs do it because they have a propensity for drug use, and marijuana is the first illegal drug to present itself to the young.

Dr. Morral calls that the “common factor” theory.

In other words, all drug users like all drugs; marijuana just comes along first. He suggests that this theory might be more accurate than the gateway theory.

But is a gateway not a gateway because it happens to present itself in front of where you want to go?

Perhaps this study’s findings appear trivial. They aren’t. If marijuana is merely the door through which those inclined to use drugs pass because it is convenient, all the more reason to keep that door locked.

I’m convinced that’s the best way to view Morrall’s findings, because the pro-marijuana lobby and much of what the press missed in this study, as well as other careful studies, were findings that suggest:

• There is a strong correlation between marijuana and other drug abuse, with marijuana almost always occurring first.
• Marijuana, all by itself, is a dangerous drug.
• There is a strong correlation between marijuana use and schizophrenia.
• Marijuana itself is addictive.
• Youth marijuana use correlates highly with violence, truancy, and other behavioral problems.
• The younger the marijuana user, the more psychological and physiological damage done, and the more likely that other drugs will follow.
• Smoking three marijuana joints a day can cause the equivalent respiratory damage associated with 20 cigarettes a day. Marijuana smokers show significantly more respiratory symptoms than people who don’t smoke it.
• Prolonged use can cause attention deficit and deterioration in memory.

As we do more studies, we might turn to these people for insight.

So what of the utility of the “common factor” theory over the “gateway” theory? A weed by any other name still smells the same.

* Jim McDonough is director of the Florida Office of Drug Control. He previously served as director of strategic planning at the Office of National Drug Control Policy.

Source: Christian Science Monitor December 16, 2002

By Malcolm Ritter, Associated Press

NEW YORK — Can Prozac help you kick cocaine? Can Ritalin? How about a blood pressure pill or medicine for muscle spasms?

If you’re an alcoholic, could you get help staying sober by taking an anti-nausea drug used by cancer patients?

Scientists are exploring those questions right now. In fact, in the field of addiction medicine, one of the hottest sources of new drugs is … old drugs.

Despite years of research, there is no drug approved in the United States for treating cocaine dependence. To find such a treatment, the National Institute on Drug Abuse is sponsoring human studies of 21 medicines already on the market for something else. That’s about two-thirds of all the potential cocaine drugs being tested in people, says Frank Vocci, director of NIDA’s pharmacotherapy division.

Over at the National Institute on Alcohol Abuse and Alcoholism, nearly all the potential alcoholism drugs tested in people under institute sponsorship over the past 10 years were previously approved for some other use, says Raye Litten, co-leader of the institute’s medications development team.

While the strategy is hardly new, “it’s been going on maybe just a bit below the radar screen” for most of the public, Vocci said.

It can certainly work. In 1997, for example, the government approved a stop-smoking pill called Zyban, which was in fact the older antidepressant Wellbutrin.

To be sure, experts haven’t given up on developing new drugs. Most NIAAA-funded drug studies for alcoholism that are in early-stage testing — not yet tried on people — are brand-new drugs, Litten said.

But the notion of examining current drugs for addiction-breaking potential holds several advantages. It’s a lot cheaper to get federal approval for a new use of an old drug than to bring a completely new medicine to market. And experience with an existing drug gives an idea of its safety and dose range for possible anti-addiction effects, Vocci said.

He and others caution that people who happen to have medications on hand that show promise in such studies shouldn’t give them to friends and family with addiction problems. That must be left to professionals. Experts also say that even effective anti-addiction medicines usually can’t work by themselves, but must be used along with nondrug therapy.

The most straightforward approach to testing an existing drug is to follow its approved purpose, but in a different way. For example, some scientists are studying how to prolong the effects of naltrexone, now usually given as a daily pill for treating dependence on alcohol or opiates like heroin and morphine.

Dr. David Gastfriend of Massachusetts General Hospital and Harvard Medical School and other researchers recently reported that specially formulated naltrexone helped alcoholic men cut down on their drinking for a month when they received the drug as a shot in the buttocks.

Why is a monthly visit to a doctor better than just taking a pill every day?

“The pill requires a daily awareness that this is a dangerous disease and a rational decision to take the pill,” Gastfriend said. “The problem with this illness is that on any given day, a person can feel, No, it would be better if I could drink. So you take the pill the first day and you have to make 29 more decisions” the rest of the month.

“But if you received an injection the first day, those 29 decisions have already been made,” said Gastfriend, a paid consultant to Alkermes Inc., which is developing the formulation he studied, called Vivitrex.

More striking than just reformulating a drug is finding a new and apparently unrelated use for it. Here, scientists are guided by emerging knowledge about how addiction hijacks the brain.

Addicts apparently suffer from a combination of unusually strong desire for a drug and a weak inhibition against using it, Vocci said.

“These people essentially have a revved-up engine and thin brake pads,” he said.

In the brain, scientists have found that cocaine produces euphoria by stimulating nerve circuits that communicate with a substance called dopamine. So they’ve looked for medications that can affect the activity of this dopamine system.

One is a decades-old old drug called Baclofen (pronounced BAK-loe-fen), used to treat spasms, cramps and muscle tightness in people with multiple sclerosis or spinal problems. Steven Shoptaw, a researcher at the University of California, Los Angeles, recently published a preliminary, federally funded study that suggested it can cut cocaine use in addicts. A much larger study is now under way to confirm that, but for now the drug looks promising, Shoptaw said.

Other drugs that work in a similar way and that are being tested in cocaine addicts include the anti-seizure medications tiagabine, topiramate and a drug sold overseas as Vigabatrin.

Cocaine withdrawal symptoms might be eased by boosting the brain’s depleted dopamine levels. So scientists are studying dopamine-boosting drugs like Ritalin, used for attention deficit hyperactivity disorder, and amantadine, used for flu and Parkinson’s disease.

But addiction is complicated enough to involve many brain circuits, which in turn provide many targets for anti-addiction drugs. Inderal, a blood-pressure medicine, may reduce cocaine craving during early abstinence by interfering with the actions of another brain substance, norepinephrine. The antidepressants Prozac and Effexor, which boost levels of yet another brain chemical called serotonin, are also under study in cocaine dependence.

Then there’s Ondansetron (pronounced on-DAN-se-tron), which is normally used to prevent nausea and vomiting after cancer chemotherapy or surgery. Scientists are studying it for both cocaine and alcohol abuse, again for its action in the serotonin circuitry.

It might seem logical that a single drug could help in multiple kinds of addiction, but even that situation can come with a twist. Consider Antabuse, the anti-alcohol drug that works by making users sick if they drink alcohol. Scientists recently found, unexpectedly, that Antabuse also helps cocaine-dependent people cut back on cocaine, though not by making them sick.

Just how it does that isn’t clear, says researcher Dr. Thomas Kosten of Yale University. Antabuse hampers the normal breakdown of cocaine by the body, and boosts dopamine levels while reducing norepinephrine levels, he said. The net effect may be to reduce both withdrawal symptoms and desire to seek cocaine, he said.

Shoptaw thinks that, within the next five years, some drug will win approval for treating cocaine dependence. Baclofen, Topiramate and Antabuse lead his list of candidates. Each may find a use in a different phase of cocaine dependence, such as getting off the drug or staying off, he said.

And addiction specialists are eagerly looking beyond today’s medicine cabinet toward a drug that isn’t approved for anything in the United States yet. Rimonabant blazed into the headlines in March when researchers reported evidence that it might help people battle both cigarette smoking and obesity.

But why stop there?

Rimonabant blocks the brain’s docking sites for its own marijuana-like substances, part of the “cannabinoid” system that might play a role in addictions beyond food and nicotine, says Dr. Herbert Kleber of Columbia University.

Once the drug is approved for either smoking or obesity, he expects researchers will jump in and test it for things like heroin and cocaine.

And the strategy of squeezing new uses of out existing drugs may score another success. Inside here are some medicines being studied for their potential to stop drug addiction. They are already on the market for these uses:

Prozac and Effexor; prescribed for depression.

Amantadine; flu and Parkinson’s disease.

Baclofen; spasms, cramps and muscle tightness in people with multiple sclerosis or spinal problems.

Ritalin; attention deficit hyperactivity disorder.

Ondansetron; prevention of nausea and vomiting after cancer chemotherapy or surgery.

Tiagabine, Topiramate and a drug sold overseas as Vigabatrin; seizures.

Source:http://www.dailynews.com/Stories/0,1413,200~20954~2380825,00.html

By Susan Greenfield

Oxford, England — Across Europe and America, the legalization of cannabis for personal use generates intense debate.

Britain has, to all intents and purposes, practically decriminalized marijuana usage.

As a neuroscientist, I am concerned. One common justification for legalization or decriminalization of cannabis centres around the idea that it does not involve a victim. At least four reports in major medical journals — Ramstrom (1998), Moskowitz (1985), Chesher (1995) and Ashton (2001) — show the contrary.

Costs to the community include accidents at work or at home, educational under-attainment, impaired work performance and health-budget costs.

Another argument is over that cannabis is nonaddictive. Of course, defining addiction is hard. But if one regards it as an inability to give up, then there is strong evidence that cannabis incites dependence. Recent scientific papers report many users in the United States, United Kingdom and New Zealand now seek treatment for dependence. Other papers show that 10 percent of users want to stop or cut down but have difficulty doing so. A paper in 1998 reported that 10 to 15 percent of users become dependent on pot.

It was shown recently that withdrawal symptoms were experienced after only three days of light use. Heavy users confront a worse situation. Dr. Bryan Wells, a rehabilitation expert, says that for the first time he’s beginning to see in heavy cannabis users the withdrawal symptoms produced by hard drugs.

Another argument is the beneficial effect of marijuana on pain. So far, that evidence is anecdotal; it is hard to exclude placebo effects. The results from clinical trials are awaited.

But distinctions should be drawn between recreational drugs and medicines, as they are for opiates. If cannabis is a painkiller, then it must have a huge impact on the physical brain.

Indeed, widespread reports exist of the impact of cannabis on the brain, in particular areas concerned with memory (hippocampus), emotion (mesolimbic system) and movement (basal ganglia). Cannabis affects a variety of chemical systems and it works via its own receptor — its own molecular target.

The fact that there is a naturally occurring analogue of cannabis in the body, as there is for morphine, provides a basic reason to differentiate it from alcohol.

For an agent that affects a variety of transmitter systems, it is as though it were a transmitter itself. This is not surprising, for cannabis has a clear effect on psychology. Not only does it produce euphoria, but the effects, often overlooked, may also include anxiety, panic and paranoia. Disorders in psychological performance, attention impairments and memory deficits are well known.

More disturbing — and less frequently acknowledged — is the fact that these effects can be long-term.

In one recent study, the attention spans of ex-users were compared to those of current users, short-term and long-term. The abstainers, who had been users for at least nine years, had quit from three months to six years before the study. Of the current users, one group had at least 10 years of dependence; the other, about three years. Everyone in the study had used cannabis from 10 to 19 days per month.

Although the quitters did better than users, all had attention impairments in comparison with nonusers in a control group. The impairment was related to the duration of use. Most disturbing was the fact that no improvement in performance occurred with increasing abstinence.

It was no surprise, then, that because these long-term effects seem to be irreversible, there is an effect on brain pathology. Because much of this data comes from work with isolated systems, and therefore on all brains, an obvious criticism is that you can’t extrapolate from such data. Yet, the evidence suggests that the long-term effects must have a physical basis. Is there a safe dose of cannabis, with no effect on the brain? Even a dose comparable to one joint, and analogous levels of the active THC ingredient to that in plasma, can kill 50 percent of neurons in the hippocampus (an area related to memory) within six days. People are unaware that the THC in cannabis remains in the body for more than five days. For someone using cannabis routinely, the dose carried in the body is higher than they imagine. It is easy to underestimate the dose because of the wide range in the strength of cannabis. Individual variations in body fat and, worryingly, variations in one’s disposition to psychosis, mean that you cannot predict how much cannabis will affect any person at any time.

Cannabis could well be having a serious effect on the mind, which I define as the personalization of brain circuits that reflect an individual’s experiences. A transmitterlike substance, with such powerful effects, must affect those circuits. So blowing your mind might be exactly what marijuana users are doing.

Source: San Francisco Chronicle (CA): Pubdate: Sun, 6 Jan 2002

Note: Susan A. Greenfield, the Fullerian Professor of Physiology at Oxford University, is director of the Royal Institution of Great Britain. This article was written for Project Syndicate, based in Prague.

By Joel Becker, Associate Editor

As methamphetamine makes a larger impact in western Wisconsin, more and more people are making an effort to find out just how bad the drug really is.

As a part of an Elk Mound inservice for school staff, Tim Schultz of the Division of Narcotics Enforcement gave a presentation to those 60 staff members and another 160 or so community members.

Schultz’ presentation wasn’t something that was humorous or entertaining. Rather it was more apropos for a Halloween spook show.

In fact, portions of the presentation, that included videos and photos, were simply gruesome.

Schultz told the audience that he gives the same presentation to high school students and some find it too graphic.

Early in the presentation on meth, Schultz showed a video with pictures of a 4-year-old girl who had been slowly bloodied, scarred and burned before being scalded to death in a bathtub by her parents who were meth users and cookers.

And the most disturbing portion of the presentation were pictures of people who couldn’t escape their homes when their meth labs exploded.

Schultz touched on marijuana as a gateway drug, but focused on meth because “that is the biggest problem we have right now.”

Schultz has been a presenter for 17 years and said the Polk and Barron county areas are the worst places for methamphetamine in the state of Wisconsin.

He said 90 percent of crime in those counties can be attributed to meth use as users search for ways to acquire the money they need to keep up their habit.

He noted that meth is different from any other drug out there because every other drug is natural. Meth is totally manmade and is the most potent drug there is.

When smoked or injected, he cited a report that said that 90 out of 100 users will become addicts by the second time they use.

“There’s no such thing as a recreational meth user,” Schultz said.

He said people start to use meth (crystal, crank, speed, lith-fluff, ice, glass shards) for a couple of reasons. Schultz said people use it because meth causes dramatic weight loss. It gives users incredible energy and keeps them awake for days or weeks at a time.

It also gives the user a euphoria beyond anything else because it forces the brain to release all of its dopamine, the body’s feel-good drug (except that with all of the dopamine in use, the feeling is 40,000 times stronger than any release the body gives naturally). The brain usually recycles the dopamine, but meth keeps the dopamine in the system for a long high (four to 16 hours) and eventually destroys it.

So no high is as good as the first, but the addict will continually try to recreate that feeling, destroying all dopamine in the body, which meth then simulates. The person can have no feeling of pleasure on their own after continued abuse and rely on meth to feel good.

But, as Schultz said in the nearly two-hour presentation, addicts basically turn into paranoid schizophrenics. He said the “meth monsters” make addicts unable to grasp reality.

Schultz told stories of how addicts believe law enforcement officers were always watching them and out to get them. They even believed they could see them peeking in their windows or watching them with night-vision goggles from a roof across the street.

Another user said he thought he was driving 60 miles an hour in his car and saw a relative running along side, so he opened his door to let him in.

Addicts also get “crank bugs,” which cause them to scratch and pick at their skin.

The cuts and scabs are just one indication of a meth user. They also usually have bad teeth and gums, bad breath, body odor, sunken in eyes, gaunt faces and a haggard appearance.

Since methamphetamine is relatively new in Wisconsin (there’s more in Polk and Barron counties than in Madison and Milwaukee combined) Schultz said the recently-enacted law that puts pseudophedrine (a key meth ingredient) behind the counter will have little affect. Thirty-seven states have similar laws.

When the law was enacted in Iowa, meth-related arrests dropped 70 percent. But Schultz says 90 percent of the meth in Wisconsin comes from Mexicans, much of which comes from Mexico.

Though every meth addict is a victim, children are the innocent victims.

“Meth users care more about the drug than their children,” Schultz said.

Children are constantly exposed to the chemicals necessary to making meth and are often harmed by the toxins or die in meth lab fires.

“Living in a home with a meth lab is like living in a toxic waste dump,” he said.

Schultz said those trying to recover often reoffend. He said the only way for users to break the meth habit is by participating in a long-term program.

 Source: www.dunnconnect.con Nov. 2005

By Janet C. Greenblatt

Introduction

The National Household Survey on Drug Abuse (NHSDA), sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services, has shown that since 1992, the rate of past month marijuana use among youth has more than doubled, going from 3.4 % in 1992 to 7.1 % in 1996. Similar trends are evident among both boys and girls; among whites, blacks and Hispanics; and in metropolitan and non metropolitan areas (SAMHSA 1997a). Other studies have also shown a doubling of marijuana use between 1992 and 1995 among 8th graders, and significant increases among 10th and 12th graders (NIDA 1997). At the same time, the rate of 12 to 17 year olds perceiving great risk in using marijuana has decreased. In the 1992 NHSDA, 39% of youths reported that smoking marijuana once a month is of great risk to people compared with 33% in 1996. Similarly, in 1992, 64% of youths reported smoking marijuana once or twice a week was of great risk to people compared with 57% in 1996 (SAMHSA 1997b).

The National Institute on Drug Abuse (NIDA) has reported that marijuana can be harmful both from immediate effects and damage to health over time. Specifically, studies have shown that marijuana can hinder the users’ short term memory and ability to handle difficult tasks (Schwartz et al. 1989). Students may find it difficult to study and learn. While many of the long-term effects of marijuana use are not yet known, studies have shown that daily marijuana smokers who did not use tobacco had more sick days and doctor visits for respiratory problems than a similar group who did not smoke either substance. A person who smokes marijuana regularly may have many of the same respiratory problems that tobacco smokers have (Tashkin et al. 1987). Other studies have shown that the regular use of marijuana may play a role in cancer and problems of the respiratory, immune and reproductive systems. Heavy marijuana use can affect hormones in both males and females. Both animal and human studies have shown that marijuana impairs the ability of T-cells in the lungs’ immune defense system to fight off some infections. Because of the drug’s effects on perceptions and reaction time, users could be involved in automobile accidents (NIDA 1995). According to the 1996 NHSDA, nearly one million 16-18 year olds (11%) reported driving at least once within two hours of using an illicit drug in the past year (most often marijuana) (SAMHSA 1998).

Although it is not yet known how the use of marijuana relates to mental illness, some scientists maintain that regular marijuana use can lead to chronic anxiety, personality disturbances, and depression (NIDA 1995). Some frequent long-term marijuana users show signs of lack of motivation and tend to perform poorly in school (Pope 1996). A recent study demonstrated similarities between marijuana’s effect on the brain and those produced by such addictive drugs as cocaine, heroin, alcohol, and nicotine (Volkow 1996).

There is substantial interest in the co-occurrence in the general population of illicit drug use with other kinds of behavioral patterns, mental syndromes, and psychiatric disorders (Bourden et al. 1992, Kandel et al. 1997, Kessler et al. 1996, SAMHSA 1996). A number of descriptive studies have demonstrated that people who use drugs are more likely to have mental disorders, physical health problems, and family problems (NIDA 1991). In addition, a recent study (Crowley 1998) was conducted with 165 boys and 64 girls between the ages of 13 and 19 who had been referred by social service or criminal justice agencies to a university-based treatment program for delinquent substance-involved adolescents. Based on interviews, medical examinations, social history, and psychological evaluations, the study showed that marijuana use by teenagers who have prior serious antisocial problems can quickly lead to dependence on the drug. Most of the youths reported that their behavioral problems predated, and were not initially caused by, their drug use.

The 1994, 1995, and 1996 NHSDA incorporated the widely used Youth Self-Report (YSR) Checklist which ranks adolescents on a variety of clinically validated scales of behavioral and emotional problem behaviors (Achenbach 1991). In this paper, the relationship between marijuana use among those age 12-17 and various problem measures, as reported on the YSR, is shown. This paper concentrates primarily on the reported frequency of marijuana use and its relationship with self-reported behaviors.

Methods

The NHSDA, currently conducted by SAMHSA, has provided estimates of the prevalence, consequences, and patterns of drug use and abuse in the United States periodically since 1971. It is the primary source of statistical information on the use of illegal drugs by the United States population age 12 and older. The survey collects data by administering questionnaires to a representative sample of persons living in the U.S. (SAMHSA, 1998).

The respondent universe includes residents of non institutional group quarters such as shelters, rooming houses, dormitories and residents of civilian housing on military bases. Persons excluded from the universe include the homeless not found in shelters, residents of institutional quarters, such as jails and hospitals, and active military personnel. The survey employs a multistage area probability sample design that includes over-sampling of young people, African-Americans, and Hispanics. In 1993, 1994, and 1995, cigarette smokers age 18-34 were also over-sampled.

The household interview takes about an hour to complete, and includes a combination of interviewer-administered and self-administered questions. With this procedure, the answers to sensitive questions (such as those on illicit drug use) are recorded on separate answer sheets by the respondent and are not seen by the interviewer. After the answer sheets are completed, they are placed by the respondent in an envelope, which is sealed and mailed with no name or address information included.

A concern of NHSDA data users is that the data are based on self-reports of drug use, and their value depends on respondents’ truthfulness and memory. Although many studies have generally established the validity of self-report data and the NHSDA procedures were designed to encourage honesty and recall, some underreporting may have taken place (Harrell 1986). The methodology used in the NHSDA has been shown to produce more valid results than other self-report methods such as interviews by telephone (Turner et al. 1992). However, comparisons of NHSDA data with data from surveys conducted in classrooms suggest that underreporting of drug use by youths in their homes may be substantial (Gfroerer 1997).

For this study, data from the 1994, 1995, and 1996 NHSDA datasets were combined, dividing the analytic weights by 3 to produce average annual yearly estimates for the combined dataset. Questionnaires and data collection and estimation methodologies were essentially the same in those three years. The household screening completion rate for the 1994-6 surveys was 94%. This study is restricted to those age 12-17. In 1994, 83% of sample persons age 12-17 completed the interview resulting in a sample size of 4,698. The 1995 NHSDA achieved a response rate of 85% for the 4,595 respondents age 12-17; the 1996 response rate was 82 % for a sample size of 4,538. Three-fourths of the interviews (in the combined dataset) among those age 12-17 were completed in complete privacy or with minor distractions.

In 1994, SAMHSA began collecting mental health data on the NHSDA. A youth mental health module for the age group 12-17 was adopted from work by Thomas M. Achenbach and colleagues (1991a) to obtain youths’ reports of their competencies and problems in a standardized format. The module was designed to measure depression, anxiety, social withdrawal, somatic complains, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior during the past 6 months. Psycho-social problem behaviors in the past 6 months were measured using a module composed of 118 items from the Youth Self-Report (YSR) which has been used extensively in studies of adolescents. Scores that sum up responses to the YSR have been shown to distinguish adolescents typically seen in clinical settings for counselling or psychotherapy from those seldom referred for treatment, in other words, to identify individuals who are likely to have clinically significant levels of functional, cognitive, or emotional problems. For this study, the responses to each of the 118 items were analyzed separately.

Results

Characteristics of Past Year Marijuana Users Age 12-17

Youths were asked how often in the past 12 months they used marijuana (Table 1). The majority of 12, 13, and 14 year olds (64%, 59%, and 52%, respectively) who used marijuana used less often than monthly (1-11 days in the past year) compared with 47% of 15 year olds and 39% of 16-17 year olds. More than 27% of users age 16 to 17 used marijuana 1 to 7 days a week in the past year compared with 12% of 12 year old users and 21-24% of 13-15 year old users.

The teenagers using monthly or more often were more likely to be older (age 16 to 17). The monthly or more often users were also more likely to be male than those who used less frequently. Those who used monthly or more often were more likely than less frequent users to live in the West and to have moved 2 or more times in the past year. The weekly users were 1.7 times more likely than nonusers to be living in other than a 2-parent family (55% and 33% respectively). As the frequency of use increased, the % of 12-17 year olds living in a 2-parent family decreased.

Self-reported Problem Behaviors Associated With Marijuana Use

In completing the YSR, youths were asked to read the list of 118 statements and indicate if the statement was not true, somewhat or sometimes true, or very or often true for them. Although causal conclusions about the relationship between substance use and problems cannot be drawn from the NHSDA data alone, these data provide a useful complement to other studies. While the reported behaviors are not necessarily caused by the use of marijuana or, conversely, the cause of marijuana use, there appears to be a strong positive correlation between the reporting of certain behaviors and reported frequency of marijuana use. The more frequent the use, the more likely the 12-17 year olds were to report problem behaviors.

Withdrawal:

There were 7 measures that comprised the withdrawal category .+ There was a strong correlation between the reporting of withdrawal items and the frequency of reported marijuana use. Those who used marijuana on 1-7 days a week in the past year were nearly twice as likely as non-users to report they refuse to talk (25% vs. 16%), they don’t have much energy (47% vs. 25%), and they are unhappy, sad or depressed (40% vs. 23%). Those who used marijuana at least monthly in the past year reported being more likely than nonusers to say they were secretive or kept things to themselves.

Somatic Complaints:

Those age 12 to 17 who used marijuana in the past year were more likely than nonusers to report feeling dizzy, overtired, and nauseous or sick. There appeared to be little correlation between frequency of marijuana use and certain reported somatic complaints with the more frequent users being as likely as less frequent users to report symptoms such as having headaches, rashes or other skin problems.

Anxiety/Depression:

Those who used marijuana at least once a month in the past year were nearly 3 times as likely as nonusers to say they think about killing themselves (24% vs. 8%). Those who used marijuana in the past year were more likely than nonusers to report that they deliberately try to hurt or kill themselves, feel lonely and that no one loves them, that other people are out to get them, and they are worthless and inferior. For some items, as the frequency of use increased, the % of adolescents reporting these feelings also increased. For example, weekly users were more likely than less frequent users to feel “others are out to get me”, “I am worthless or inferior” or “I am unhappy or sad”.

Social Problems:

Those who used marijuana in the past year were more likely than nonusers to report that they do not get along with other kids and weekly users were nearly twice as likely as nonusers to report this (33% vs 19%) . The weekly users were less likely than nonusers to report they act too young for their age (27% vs. 36%), they prefer younger kids as friends (15% vs. 22%), and they get teased a lot (17% vs. 25%). However, weekly users were more likely than nonusers to say they are not liked by other kids (25% vs. 18%).

Thought Problems:

Past year marijuana users age 12 to 17 were more likely than nonusers to report four thought problems: “I can not get my mind off certain thoughts”, “I repeat certain actions over and over”, “I do things other people think are strange”, and “I have thoughts people would think are strange”. In addition, monthly or more often users were more likely than nonusers to say they see and hear things that other people think are not there.

Attention Problems:

Those who used marijuana in the past year were more likely than nonusers to report they have trouble concentrating (72% vs. 51%), they feel confused or in a fog (41% vs. 24%), they daydream a lot (68% vs. 52%), they act without stopping to think (63% vs. 44%), and their school work is poor (59% vs. 30%) . As before, the % of those reporting attention problems generally increased with frequency of use.

Delinquent Behavior:

Differences of the greatest magnitude between users and nonusers were found in measures of delinquent behavior . Those who used marijuana weekly were 9 times as likely as nonusers to say they use alcohol or drugs for nonmedical purposes (76% vs. 8%), 6 times as likely to say they had run away from home (24% vs. 4%), nearly 6 times as likely to say they had cut classes or skipped school (60% vs. 11%), 5 times as likely to say they stole from places other than home (34% vs. 6%), and 3 times as likely to say they steal at home (17% vs. 5%). Moreover, a higher proportion of past year marijuana users reported these behaviors than did nonusers. Past year users were also more likely than nonusers to report they do not feel guilty after doing something they shouldn’t, they hang around with kids who get into trouble, and they lie and cheat. As noted elsewhere, the proportion saying these statements were somewhat, very or often true about them generally increased with frequency of marijuana use. For example, weekly marijuana users were about twice as likely as those who used fewer than 12 times in the past year to say they had run away from home or they had cut classes or skipped school in the past 6 months.

Aggressive Behavior:

Past year marijuana users were more likely than nonusers to report all aggressive behaviors . For many items, the percentage reporting the behavior increased as frequency of use increased. Weekly users were nearly 4 times as likely as nonusers to report they physically attack people (26% vs. 7%), and 3 times as likely to report they destroy things that belong to others (22% vs. 7%), they threaten to hurt people (38% vs. 13%), and they get in many fights (37% vs. 14%). The weekly users were also twice as likely as nonusers to report they disobey at school (59% vs. 24%) and they destroy their own things (22% vs. 10%). On average, past year marijuana users, regardless of frequency of use, were twice as likely as nonusers to report they destroy things that belong to others, they disobey at school, they get in many fights, and they threaten to hurt people.

Criminal Behavior:

In addition to the YSR module, the NHSDA included questions about some past-year activities that may have been illegal. In each comparison adolescents age 12 to 17 who used marijuana in the past year were 3 or more times more likely than nonusers to report past-year involvement in these activities. Past year marijuana users were more likely than nonusers to report that in the past year, they were on probation, and they had 1) taken something from a store without paying, 2) purposely damaged property that wasn’t theirs, 3) driven under the influence of alcohol or drugs, 4) hurt someone enough to need a bandage, and 5) sold illegal drugs. As before, in most cases, the %age reporting these behavioral problems increased with the frequency of marijuana use. In particular, weekly users of marijuana were more than 5 times as likely as those who used only 1 to 11 times in the past year to have driven under the influence of drugs (29% vs. 4%) or to have sold illegal drugs in the past year (29% vs. 6%). Weekly users were also 2-3 times more likely than those who used less often than monthly to be on probation (20% vs. 7%), to have driven under the influence of alcohol (20% vs. 9%), or to have purposely damaged property that was not theirs (35% vs. 18%).

Conclusion

This report shows that among those age 12-17, past year marijuana users were more likely than nonusers to report problem behaviors in the past 6 months. Further, for the majority of items measured, the more frequent the use, the more likely the youths were to report problem behaviors.

The more frequent users were more likely to be the older youths (6 out of 10 were age 16-17), white, male, to live in a metropolitan area and the West. They were more likely than less frequent users to have moved in the past year and are less likely to live in a 2-parent family. Frequent marijuana users were more likely than less frequent users to report delinquent behaviors such as running away from home, stealing, and cutting classes or skipping school. They were also more likely than less frequent users to report aggressive behaviors such as destroying things that belong to others and physically attacking people. Monthly or more often users were more likely than less frequent users to have driven under the influence of alcohol or drugs or sold illegal drugs in the past year. From a psychological view, youths who used marijuana in the past year reported many behaviors symptomatic of anxiety and depression. Users were 2 to 4 times more likely than nonusers to report they think about killing themselves or that they deliberately try to hurt or kill themselves. They were more likely than nonusers to say they were unhappy, sad or depressed and that they feel “no one loves me”. The users were more likely than nonusers to report that “others are out to get me” and “I am suspicious”.

Regardless of whether the problem behaviors preceded marijuana use or marijuana use preceded the behaviors (which we are not able to ascertain from the NHSDA), it is apparent from these data that the marijuana users are exhibiting many signs of anxiety and depression and exhibiting delinquent and aggressive behaviors far in excess of the nonusers. Further, there appears to be a high correlation between the presence of many of these reported behaviors and the frequency of marijuana use.

These findings strengthen the argument that marijuana is not a benign substance. Not only can it be associated with many destructive and aggressive behaviors, it can also be associated with severe symptoms of anxiety and depression. Longitudinal studies are needed to determine if the symptoms and behaviors preceded the marijuana use or vice versa. Whether this can be determined or not, this report shows the importance of preventing the use of marijuana in youths and the need for treatment for marijuana use in conjunction with treatment for co-morbid mental disorders.

References

1)Substance Abuse and Mental Health Services Administration (1997a). Drug Abuse Series: H-3. Preliminary Estimates from the 1996 National Household Survey on Drug Abuse. Office of Applied Studies, July 1997.

2)National Institute on Drug Abuse (1997). Press Release for the Monitoring the Future Study, The University of Michigan Institute for Social Research, December 1997.

3)Substance Abuse and Mental Health Services Administration (1997b). 1996 National Household Survey on Drug Abuse: Preliminary Tables (Unpublished). Office of Applied Studies, June 1997.

4)Schwartz, R.H., Gruenewald, P.J., Klitzner, M., and Fedio, P. (1989) Short-term memory impairment in cannabis-dependent adolescents. American J. of Diseases of the Child 1989; 143:1214-1219.

5)Tashkin, D.P., Coulson, A.H., Clark, V.A., et al. Respiratory system and lung function in habitual, heavy smokers of marijuana alone, smokers of marijuana and tobacco, smokers of tobacco alone, and nonsmokers. Am Rev Respir Dis 1987; 135:209-216.

6)National Institute on Drug Abuse (1995) Marijuana: Facts Parents Should know. Booklet NCADI #PHD712, GPO#017-024-01570-0.

7)Substance Abuse and Mental Health Services Administration (1998). Drug Abuse Series: H-5. National Household Survey on Drug Abuse Main Findings 1996, Office of Applied Studies, May 1998.

8)Pope, HG Jr, Yurgelun-Todd,D. The residual cognitive effects of heavy marijuana use in college students. JAMA 1996 Feb 21; 275(7): 521-7.

9)Volkow, N.D., Ding, Y.-S., Fowler, J.S., & Wang, G.-J. 1996. Cocaine Addiction: Hypothesis Derived from Imaging Studies with PET. J. Addictive Diseases, 1996.

10)Bourden, H., Rae, D., Narrow, W., Manderscheid, R., and Regier, D., National Prevalence and Treatment of Mental and Addictive Disorders, Mental Health, United States, Center for Mental Health Services, DHHS Pub. No. (SMA)92-1942 (1992).

11)Kandel, D.B., Johnson, J.G., Bird, H.R., Canino, G., Goodman, S.H., Lahey, B.B., Regier, D.A., and Schwab-Stone, M. Psychiatric Disorders Associated with Substance Use Among Children and Adolescents: Findings from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Journal of Abnormal Child Psychology 1997, 25(2), pp. 121-132.

12)Kessler, R.C., Nelson, C.B., McGongle, K.A., Edlund, M.J., Frank, R.G., and Leaf, P.J., The Epidemiology of Co-occurring Addictive and Mental Disorders in the National ComorbiditySurvey: Implications for Prevention and Service Utilization. American Journal of Orthopsychiatry 66:17-31 (1996).

13)Substance Abuse and Mental Health Services Administration (1996). Advance Report 15. Mental Health Estimates from the 1994 National Household Survey on Drug Abuse. Office of Applied Studies, July 1996.

14)Crowley, T (1998). Troubled Teens Risk Rapid Dependence on Marijuana. Drug and Alcohol Dependence 50:1.

15)Achenbach, T.M., (1991) Manual for the youth Self-Report and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.

16)Harrell, A.V., Kapsak, K.A., Cisin, I.H., and Wirtz, P.W. (1986). The Validity of Self-Reported Drug Use Data: The Accuracy of Responses on Confidential Self-Administered Answer Sheets. Prepared for the National Institute on Drug Abuse, Contract Number 271-85-8305.

17)Turner, C.F., Lessler, J.T., and Gfroerer, J.C. (1992). Survey Measurement of Drug Use: Methodological Studies. National Institute on Drug Abuse. DHHS Pub No. (ADM) 92-1929..

18)Gfroerer, J.C. (1997). Prevalence of youth substance use: the impact of methodological differences between two national surveys. Drug and Alcohol Dependence 47 (1997) 19-30.

Table 1:Percentage Distribution of Past Year Frequency of Marijuana Use Among Past Year Users by Age, 1994-96

Source:Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse