Friday, June 27, 2008

“We don’t want to fight addicts; we want to fight addiction. We need to manage addiction.”

“We don’t want to fight addicts; we want to fight addiction. We need to manage addiction.” The credo of the drug policy of Iran, according to The New York Times.

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Monday, June 23, 2008

More Pain Relief Needed. Use Afghanistan's Opium.

On May 8, 2008, I met in Washington with a delegation of narcotics officers and prosecutors from Afghanistan who were guests of the United States Department of State to learn about American anti-drug policy.

In a tone that I hoped was sympathetic to the teachings of Islam, and the violence and political instability that surrounds the production of opium and heroin in Afghanistan, I criticized prohibition in general and American anti-drug policy in particular.

The delegation received my comments very favorably. In Q & A, I was asked about the requirement that the enormous quantities of opium seized by Afghani law enforcement must be destroyed. Why, I was asked, can the opium not be sold to legitimate pharmaceutical companies?

I noted that there is a global crisis of insufficient pain management. (The International Herald Tribune and The New York Times reported on the human suffering that this causes in September 2007). The World Health Organization has major efforts committed to address the cancer pain crisis.

I noted that the "Western powers" in the early 20th Century, as part of their economic domination of much of the rest of the world, created international legal organizations to determine which countries could grow opium and how much.

My recollection was that only India, Australia and Turkey are allowed to grow opium for the international trade. It is outrageous, I said, that the "Saudi Arabia of opium" can't sell its opium to international pharmaceutical firms at a time when there is an enormous unmet demand for pain relief, and Afghanistan's people and government need legitimate sources of revenue to rebuild their nation and establish security.

To my knowledge, the United Kingdom has not been a pharmaceutical opium producing country.
But according to the Daily Mail on June 23, 2008, the United Kingdom of Great Britain was recently permitted to start growing opium for the medical trade.

Why should this be permitted to the British farmers and not to Afghani farmers?
This new development should be seen by Afghanistan as a precedent to change the international agreements to permit Afghanistan to supply opium to the legitimate market.

Allowing such legal cultivation would be politically and economically devastating for the Taliban and their terrorist allies, al Qaeda. It would increase the supply of pain killers available to the seriously and terminally ill in the developing world. It would help restore peace and end hunger in Afghanistan. And it would also save lives of American and NATO soldiers in Afghanistan.

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Saturday, June 14, 2008

"Legal Drugs Kill Far More Than Illegal, Florida Says"

In Florida last year, there were 2,328 deaths due to "strong painkillers" like Vicodin(R) and Oxycontin(R), 743 deaths due to benzodiazepine-class drugs like Xanax(R) and Valium(R). Cocaine caused 843 deaths, methamphetamine caused 25 deaths, heroin caused 93 deaths, and marijuana zero deaths, according to the 2007 report by the Florida Medical Examiners Commission reported in The New York Times ("Legal Drugs Kill Far More Than Illegal, Florida Says," p. A10, June 14, 2008). "Drugs Identified in Deceased Persons by Florida Medical Examiners, 2007 Report" is 43 pages long.

Sounds like a public health problem, but the Times' Damien Cave can only quote law enforcement officials such as Sergeant Lisa McElhaney, in the Broward County Sheriff's Office, for her insight: "The abuse has reached epidemic proportions. It's just explosive."

However we should give the Times' Damien Cave a great deal of credit for taking the initiative to put the fact that marijuana caused zero deaths in the middle of story. That fact is obtained from the medical examiners' report only by deduction. It was not stated as a finding or a conclusion.

It is worth noting that the number of cocaine deaths has grown almost continuously from 821 in 1993 to 2179 in 2007.

Deaths among older drug users; and the political misrepresentation of who is dying
It is also significant that in 2007 the number of persons found with lethal levels of cocaine in their body under age 18 was 4, ages 18 to 25 was 96, and among persons older than 35 was 582.

Consider this fact and the mantra of politicians defending unjust laws such a mandatory minimums. This is Senator Hatch on PBS Frontline's "Snitch" in 1999:

Sen. ORRIN HATCH (R), Utah: Well, we found- the reason why we went to mandatory minimums is because of these soft-on-crime judges that we have in this society, judges who just will not get tough on crime, get tough especially on pushers of drugs that are killing our youth. And so that's why the mandatory minimums, so that we set some reasonable standards within which judges have to rule, rather than allowing them to just put people out on probation who otherwise are killing our kids.

The consequence of social misclassification of the problem
In covering this report, could the reporter have asked doctors, public health specialists or health educators about the meaning of such data and what could be done about it? No.

Michael Aldrich, Ph.D., explained very cogently -- about four years ago in San Francisco -- that for the society a tragic consequence of misclassifying the "problem" of drug misuse as a criminal problem has meant that for decades we have consulted the wrong "experts," such as police sergeants. In general, our police "drug experts" are untrained, unqualified, and fundamentally ignorant about the causes of these kinds of deaths and the various means that a public health expert might suggest to address the problem.

What could we do to reduce these deaths?
I'm not a doctor or a public health expert. But I would ask such professionals, "Is it possible that we could save lives and prevent some of these deaths by educating drug users on safer drug use practices?"

Could family practitioners talk with teenagers and young adults in a way that acknowledges that they might be using "legal" drugs socially and not medically, and that non judgmentally advises them about how to minimize the dangers? Not in the current drug paradigm. Such counsel would risk prosecution and loss of medical licenses for "sending an inconsistent, don't do drugs message."

When a physician prescribes Xanax or Oxycontin to a person, might it make sense for the physician to call in all the family members aged 14 and older to talk about the risks to family members and guests having such a drug sitting in a parental medicine cabinet?

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Blind to prejudice, you can say or hear "Infested by the druggies" and not blink

The Saturday Profile in The New York Times on June 14, 2008 is of Fadela Amara, the French Secretary of State for Urban Policy in the government of President Nicolas Sarkozy. Amara is a strong advocate for the immigrants in France, many of them Muslim. She tells of her radicalization at age 14 when her 5-year old brother was killed by a drunk driver, and the police used racist remarks toward her parents.
In Steven Erlanger's profile, Ms. Amara is working with a street theater group, the Company of Contrarians. The founder of the company, Neusa Thomasi, 46, was born in Brazil. Ms. Thomasi says, as quoted by the Times reporter,

"Immigrants understand the problems of immigrants," . . . describing the need, echosed by Ms. Amara, "to reoccupy public spaces infested by the druggies and the criminals."
"Infested by the druggies." How is this term different from a racist slur?

Ms. Amara says,
Our tenets defend equality, condemn cultural relativism and combat archaic traditions. . .This is why I claim the heritage of the French Revolution. I'm universalist. I believe strongly in the values of the republic -- liberty, equality, fraternity -- and secularism.
I wonder, how do Ms. Amara and other self-proclaimed claimants to the values of the French republic -- liberty, equality and fraternity -- think the families of drug users hear the phrase "infested by the druggies"?

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Wednesday, June 11, 2008

U.S. - Mexico Anti-Drug Blah Blah

Monday, U.S. and Mexican customs officials "unveiled a cooperative effort," to fight the "escalating levels of violence that have turned parts of Mexico into war zones and spread as far as North Texas," reports the Dallas Morning News. The headline: "U.S., Mexico launch unprecedented effort to disrupt cross-border weapons smuggling." (emphasis added).

Will Customs' (ICE) efforts to stop the flow of guns from the U.S. to Mexico be any more successful than the interdiction of cocaine, heroin, marijuana and methamphetamine from Mexico to the U.S.?

I have no confidence it will. What continues to strike me how the news media and Members of Congress remain blind to the incompetent and half-hearted nature of America's anti-drug effort. It is as though if they looked at how the money is being wasted by ICE, the DEA and the Justice Department by not doing what they are supposed to be doing, they might have to think about the logic of the effort, too.

Texas has four Federal judicial districts. Close to the border, we should expect that the federal drug investigators and prosecutors would be focused on the high-level trafficking organizations that operate along the Rio Grande.

Because of the racial disparity in the Federal government's cocaine prosecutions and the fact that so many of the crack defendants are minor participants in penny ante drug organizations, my July 2006 White Paper was successful in calling upon the Sentencing Commission to look at degree to which small scale cases dominate the federal investigations.

Thus there is interesting data that reveals the small quantities involved in Federal cocaine cases nationwide, compiled by the U.S. Sentencing Commission. The average weight of crack involved in a federal crack case (examining all of the 4,262 federal crack cases brought in FY 2006) was 51 grams. This is just one gram more than the 50 grams that trigger a mandatory minimum sentence of 10 years. How little is 51 grams? It is the weight of a common candy bar, nothing that a major dealer would waste their time with. It is too tiny an amount to make into a Federal case when cocaine is smuggled into the country by the metric ton (1,000,000 grams), that is, too tiny an amount if your head is screwed on right!

Shockingly, nationwide, 35.1 percent of all crack cases involve less than 25 grams.

In FY 2006, the federal prosecutors in Texas were largely wasting their time (and our money):
In Western Texas, there were 127 crack cases, 61 less than 25 grams -- 48.0 percent.
In Eastern Texas, there were 94 crack cases, 44 less than 25 grams -- 46.8 percent.
In Southern Texas, there were 70 crack cases, 31 less than 25 grams -- 44.3 percent.
In Northern Texas, there were 67 crack cases, 21, less than 25 grams -- 31.1 percent.

Remember, the State of Texas knows how to investigate, prosecute and punish drug dealers. They certainly can investigate and prosecute neighborhood crack dealers. And Texas has one of the largest prison systems in the United States, indeed one of the largest prison systems in the world.

Yet in FY 2006, federal prosecutors in Northern and Eastern Texas actually brought more crack cases than powder cocaine cases. They spent more time in federal court with candy bar crack cases than with Mexican cartel leaders. And that means that more minor players fill federal prison cells than cartel leaders. What a waste of the federal effort!

Unfortunately there is no comparable data for marijuana, heroin, and methamphetamine. We are unable to see whether ICE, the DEA and Justice Department are especially incompetent and wasteful fighting cocaine by focusing on local crack cases, or if this misfocus is the case with other major drugs of abuse.

Is it any wonder the violent Mexican cartels feel they can operate with impunity in Mexico, and the United States?

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Monday, June 09, 2008

Where is the crime? Where are the votes? Where are the ads?

Paul Krugman writes June 9 that Senator Obama's nomination indicates that America has changed enormously. In 1966 and 1968, fear about crime -- and "the associated fear that fair housing laws would let dangerous blacks move into white neighborhoods," says Krugman -- was a winning issue for the Republicans. Krugman adds, " I don’t think a politician today could get away with running the infamous 1988 Willie Horton ad."

Krugman may be just too optimistic:
A conservative activist is attacking Obama as soft on crime, reports Richard B. Schmitt of the Los Angeles Times. Floyd Brown, the creator of the Willie Horton ad of 1988, has created

On June 9, the FBI released preliminary Uniform Crime Reports for 2007 that show violent crime was down 1.4 percent overall. But murder is up in small and mid-sized cities.

Some very disturbing research in Memphis, TN suggests that the strategy to free poor Blacks from the crime and dysfunction of housing projects is spreading crime to the formerly safe neighborhoods to which they move, according to reporting by Hannah Rosin in The Atlantic Monthly for July-August.

Ted Gest at Criminal Justice Journalists reports on the June 9 FBI release.

Violent, Property Crimes Down In 2007: FBI Preliminary Totals
Reports of both violent and property crimes in the U.S. declined in 2007 from the previous year, the FBI said today. In a preliminary report, the bureau said the number of violent crimes declined by 1.4 percent from 2006, reversing two years of rising violent crime numbers. Property crimes were down 2.1 percent last year from the previous year. The largest declines were in vehicle theft, down 8.9 percent and in rape, down 4.3 percent and murder, down 2.7 percent, the Associated Press reports.

Murders were down in cities of more than 250,000, including a sharp 9.8 percent drop in cities of more than a million residents. Murders were up 3.7 percent in cities of 50,000 to 100,000, up 1.9 percent in cities of 100,000 to 250,000, and up 1.8 percent in cities under 10,000. Historically, murder trends began in the largest cities and moved over several years to smaller ones.

Federal Bureau of Investigation

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Wednesday, June 04, 2008

Troop 1500: Girl Scouts Beyond Bars

Troop 1500: Girl Scouts Beyond Bars is an excellent documentary about women in prison and their daughters.

Once a month the troop drives to the Hilltop Unit, a women's prison about an hour from Austin, TX, where the girls get to spend the afternoon with their mothers, assisted by the troop leaders/social workers. The Girl Scouts are equipped with camera, and one of their major projects is to interview their mothers, and record other aspects of their lives.

Troop 1500 is a real Girl Scout troop designed as "an intervention" for girls whose mothers are imprisoned in Texas for typical crimes: drug dealing, drug possession, aggravated assault, robbery. The troop has to address the intense emotions that surround prison visits. The joy and the anger.

Some mothers have been to prison several times. Over time, the parole hearings for the mothers get closer and closer, and the intense question is which moms will be released. And if released, will they be able to stay clean and out of trouble. One mother, in her interview with her daughter, notes that with her record, if she screws up, she is sure to go back to prison with a life sentence. You see her daughter's face as she says this.

The girls learn that one mother has been kicked out of the program, even though her daughter stays in it. We learned the mother is writing a book about her life. But she has asked volunteers for money to buy a typewriter and supplies. The institution examines her prison account which shows that she used the money to buy candy and they charge her with extortion. She gets two more years added to her sentence.

In another case, a daughter's caregiver has got a job in Colorado, and she is leaving her mom in prison and her friends in the troop behind.

One mother is not realistically going to see parole any time soon. She was a nurse, married with three children. She admits that she euthanized an elderly patient which she thought was a kindness at the time. She was sentenced to 50 years. She won't be eligible for parole until 25 years have passed. Yet her daughter keeps visiting her. At one point, the daughter brings a DVD with home movies of the mom as a child and speaking as her school valedictorian, and other movies of the girl and her siblings as infants and toddlers. She is not a drug user, a robber, but a healer who made a tragic mistake of compassion.

Some of the mothers talk about their lives -- drinking and using drugs at a very early age, or having children when they are very young. One mom was a crack dealer. She wonders what her life can be like after release if she is only earning a few hundred dollars a week, when that sum was her earnings for a few minutes during her criminal career. Another mom graduated from shoplifting to armed robbery to buy drugs.

The warden of the prison has reservations about the Girl Scouts. She fears that the girls will not see prison as the horror that it is. She talks about the selfish choices the mothers made.

The interviews and the prison visits are interspersed with the ordinary activities of the daughters as Girl Scouts -- going to camp, canoeing, making projects, playing, singing Girl Scout songs. These are lovely girls.

Very powerfully the movie makes clear that some of the mothers were profoundly self-centered. One mother took her young daughter along on her drug deals. One mother notes how every mother worries that others might hurt their children and observes how her crimes and her imprisonment have hurt her children far more than anyone else ever did or could.

My daughter is in Girl Scout Troop 4334. I've escorted her on her cookie sales for three winters. Last year, I helped to lead a canoe trip for the troop, teaching paddling techniques. Two days ago, on June 2, I led a hike for Troop 4334. We walked from their school into Rock Creek Park's urban forest and then along the creek. We were on our way to the troops' Flying Up ceremony in which Brownies become junior Girl Scouts at "Candy Cane City."

We stopped along the creek bank so the girls could throw rocks across the stream and into the water. At one point, I answered a question about what a sandbar was and how a sandbar is formed. We heard birds singing to mark their territory. Of course, we were on the lookout for poison ivy. The girls are just like the girls in Troop 1500, except that the girls in Troop 1500 are uniformly poor.

On Monday, our troop leader made a lovely speech marking the Flying Up, and noting how she could see one of our girls as a U.S. Senator or another girl as Member of Congress (goals you get when you live 7 miles from the Capitol).

The girls in Troop 1500 are great kids -- wise for their years, playful, compassionate. You see them brimming with potential and responding to love and nurture. And as you watch the girls and their mothers, you have to wonder, does our society have the right ideas about what to do about crime? Are the right ideas being applied in our prisons? Does our correctional system make sense for American families? Who is benefiting from our correctional system, and in what ways?

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Monday, June 02, 2008

Crack cocaine injustice and failed policy

Sunday's The Washington Post Magazine (June 1, 2008) has an excellent article by Vanessa Gezari about Michael Short. Short received a rare presidential commutation of sentence in December 2007 from President Bush. His 19 year prison sentence was cut to 15 years, 8 months for his minor role in a crack cocaine organization in Washington, DC.

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