Posts Tagged ‘ legalisation ’

The ACMD in meltdown: a brief history

The Advisory Council on the Misuse of Drugs (ACMD) was established under the Misuse of Drugs Act (1971) to give scientific advice to the government regarding drug harms, and specifically on the classification of drugs under the act. The resignation of a seventh member in just a few months is yet another damning indictment of the government’s attitude towards the role of scientific advice in making drug policy decisions.

One can argue that relationships between the ACMD and the Home Office first got onto rocky ground when in January 2009, the then chairman Prof. David Nutt released his “Equasy” paper comparing the harms of horse-riding (with 1 serious event in every 350 exposures) to taking MDMA (with 1 serious event in every 10,000 exposures). He was criticised by the then Home Secretary Jacqui Smith, who demanded an apology for his comments.

Things got heated once again in July 2009, when Nutt gave a lecture repeating his view that drug policy should reflect the harms of the drugs in question, according to present scientific understanding. Nutt objected to the reclassification of cannabis from Class C to Class B, as it lacked scientific reasoning or evidence to back it up. When a pamphlet containing the lecture notes was published in October, the Home Secretary Alan Johnston sacked Nutt, with Johnston stating in a letter: “I can’t have public confusion between scientific advice and policy”. This, as you can quite imagine, opened up a can of worms.

Nutt’s dismissal trailed a wake of protest; pickets of Downing Street by Students for Sensible Drug Policy, outcry from the scientific community and resignations from the ACMD. Dr. Les King, the senior chemist on the council, was the first to resign, followed by Marion Walker, the Royal Pharmaceutical Society’s representative. King was later to say in an interview that “[the council’s principles] had been distorted by the government to their purposes”.

The ACMD then met with government officials to discuss the role of scientific advise in policy making. Home Office officials did little to reassure the ACMD, and a further 3 members resigned – Simon Campbell, Dr John Marsden and Dr Ian Ragan. The Home Office set to revise its guidelines and principles on how it expected its scientific advisors to behave, which set out to give sanctions to advisors who the Home Office did not share “mutual trust” with, regardless of whether the advisor had broken any of the official Codes of Practice. Shortly afterwards Dr. Polly Taylor resigned from the council saying that she ‘lacks confidence’ in the way the government will treat the ACMD’s advice and that she felt “that there is little more we can do to describe the importance of ensuring that advice is not subjected to a desire to please ministers or the mood of the day’s press”.

On April 1st,  another member of the ACMD, Eric Carlin, resigned. Disillusioned with the lack of emphasis placed upon harm reduction efforts and the Home Office pushing through the ban of mephedrone under pressure from corporate media before the ACMD had chance to properly discuss the matter, he said in his resignation letter: “I am not prepared to continue to be part of a body which, as its main activity, works to facilitate the potential criminalisation of increasing numbers of young people”, and that the ACMD’s recent decision regarding mephedrone was “unduly based on media and political pressure”.

In the next few weeks, as politicians try to push through that mephedrone ban, it is likely that more members of the ACMD will resign in protest. The ACMD cannot legally operate with less than 20 members, and the ACMD recently appointed 3 new members; Hew Mathewson (a dentist), Gillian Arr-Jones (a pharmacist) and Prof. Simon Gibbons (a phytochemist). This has been construed by some as a cynical attempt to keep the ACMD functioning with the increasing threat of more resignations.

The ACMD is in meltdown. We must ask ourselves; does the government have any scientific credibility anymore? If drug policy isnt badsed on scientific evidence then what is it based on?

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Mephedrone: A little perspective?

Calls to ban the legal high mephedrone (or meow meow, mcat, etc.) have increased since the recent, tragic deaths of teenagers Nick Smith and Louis Wainwright after taking the drug.  I want to focus on the harms associated with the drug, and a bit about what we can do legally and socially to reduce those harms.

Lets get this straight, mephedrone has very real harms. Whilst we can’t fully know the cause of Nick Smith and Louis Wainwright’s deaths until the toxicology reports are released, it is likely that mephedrone had some part to play in their death, along with the alcohol they had drank. Whilst the media have previously misrepresented mephedrone’s role in some deaths*, the harms associated with mephedrone cannot be ignored. They should, however, be placed in context.

Mephedrone has been associated with relatively few deaths in the UK and worldwide, especially when compared with other drugs. The few deaths associated with mephedrone pale in comparison when compared to the 22,000 deaths a year caused as a direct result of drinking alcohol, or the 106,000 deaths a year from smoking. Whilst the sheer numbers of deaths due to these ‘culturally acceptable’ drugs should be shocking, they don’t experience the same sensationalist reporting given to mephedrone. Why? Partly because alcohol and tobacco are culturally acceptable; we’re ‘used’ to it killing people. Partly because mephedrone is new, and partly, I think, to some sort of cultural snobbery – people finding the idea of putting things up your nose distasteful.

We know very little about mephedrone, because it is so new, little research has been done on how it reacts with our bodies and what effects it might have. One thing we do know is that it can cause vasoconstriction – the narrowing of the blood vessels – which can put increased pressure on the heart. Vasoconstriction also makes you go pale, make your feet and hands cold, and is the reason many people find it difficult to get an erection on mephedrone (for info on erections and meph, go to the comments section after you have read the rest)  Vasoconstriction as a result of taking mephedrone is unlikely to kill someone on its own, however, so other contributing factors such as underlying medical problems and the effects of other drugs (such as alcohol) taken at the same time are probably significant. There might also be some effects of mephedrone that we simply don’t know about yet.

Banning mephedrone would be a backwards step, for obvious reasons; putting a popular but potentially harmful substance in the hands of unaccountable dealers can only be a bad thing. The legal high market isn’t perfect**, but at least product purity (and so dosage) is something users can rely on. Banning mephedrone would only mean that users would be putting mephedrone + crushed glass up their noses on a night out.

What we need to focus on is getting some good harm reduction information out there about mephedrone. All drug taking involves a certain amount of risk, but there are ways of reducing the risks associated with drug use. So, the safest way of using mephedrone is not to go there. Failing that, avoiding poly-drug use (which seems to be implicated in most of the cases I have read about), doing mephedrone in a safe environment and keeping an eye on how much you are using are all good ideas. It is probably preferable to ‘bomb’ – take it orally – rather than snort, as snorting can damage the nasal membranes. If you are snorting, however, make sure you don’t shart tubes, and don’t use notes. Make sure you keep warm, too, as mephedrone can make you a tad cold. If anyone else has any decent harm reduction advice, please feel free to comment.

*Like the death of Gabrielle Price, which the Daily Mail, The Sun and The Telegraph attributed to mephedrone whilst toxicology reports revealed that she died from broncho-pneumonia from an infection.

** The legal high market is far from perfect. Legal highs are often more dangerous than illicit highs and in the most part severely under-researched. Legal high manufacturers should be able to give out harm reduction information, but in the most cases are restricted in doing so by the law, as giving out such information would be somehow encouraging people to use a substance as a drug and not as a plant fertiliser or a ‘research chemical’. Still, purity and quantity is guaranteed which is a big leap from the illicit drugs market. Hopefully one day both markets will be regulated intelligently, and harm reduction information given out with each purchase.

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Exploring the Mexican Drug War

On the 1st of February, 14 young people were killed in the Mexican border city of Juarez, caught in the cross-fire between the Mexican War on Drugs.
The victims, barely older than children in some cases, were at a birthday party when gunmen drove up to the house and opened fire. 14 people were killed, and 20 more injured. Young people were seen climbing over fences in order to escape. Mexican authorities suspect the murders were enacted by the “La Linea” cartel, who mistakenly believed the address to be associated with a rival cartel. This tragedy comes in a time of increasing violence associated with the government/drug cartels conflict in Mexico.
Mexican President Felipe Calderon effectively declared his own “War on Drugs”, when in 2006, just 10 days after he was elected, he sent 65,000 troops into Michoacán, cracking down on drug cartels in the area. Since Calderon came to power, violence has escalated massively; a total of 18,095 people being killed in this ‘Drug War’ since Calderon came to power, the numbers increasing every year. 7726 people were killed last year, and so far 1118 people have been killed this year.
Mexican drug cartels have become more powerful in recent years due to the effects of American interference in the Columbian drugs trade increasing the amount of drugs that trafficked through Mexico into America. The “Plan Columbia” initiative instigated by President Andres Arango and the US government has caused much devastation in Columbia; an increase in drug related violence, regional political instability, and massive environmental and social destruction associated with US fumigation of coca plantations (and anything else in the surrounding area) with powerful herbicides. The collapse of the Columbian Medellin and Cali Cartels also had a massive impact on pushing more trade through Mexico.
When looking at how aggressive interventionist tactics such as “Plan Columbia” and Calderon’s self declared “War on Drugs” have had on combating the harms associated with drugs we must first ask ourselves 2 questions:
1. Have the harms associated with the drugs trade decreased?
Clearly, the answer in both these cases is no. Calderon escalated violence in the area by giving drug cartels a new enemy to fight against. Whilst it might seem like every gain for the Mexican government in the ‘War on Drugs’ is a good thing, this is often not the case, every cartel leader removed from power means more factional in-fighting as to who replaces them, increasing violence further.
2. Has the drugs trade decreased in output?
No, at least not in the long term. Supply channels have just moved to compensate for American aggression. The ‘Plan Columbia’ initiative caused more drugs to be trafficked via Mexico and the Caribbean, taking the harms associated with the illicit drug trade into new areas. The actual quality of the substances, however, is likely to decrease, increasing the harm to consumers on the American side of the border.
The “War on Drugs” is clearly counter-productive. What we need is a “War on Harm”; where we take into account that an illegal drugs trade will always exist whilst prohibitive laws are in place. Take steps to reduce the harms associated with drugs; regulate their trade so cartels don’t get a look in. Spend the money that would be spent on guns on education. Be proactive rather than reactive.
An organisation that I’m involved in is holding an online vigil and discussion on Thursday 11th, between 9 and 11pm (GMT). We are also asking people to take photos of themselves holding their own vigils at home (think candles) and sending them to mexico@ssdp.org.uk to show solidarity. Come join us at http://www.ssdp.org.uk
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Why I support Release’s “Nice People Take Drugs” Campaign

Release, the human rights charity that gives advice and campaigns on drug policy are running a campaign simply
called “Nice People Take Drugs”. In June 2009, they paid for the slogan to be plastered on the side of London
buses, which were pulled a few days later by advertising regulators even though no complaints about the slogan
or the adverts were received by members of the public.

The slogan itself was designed to challenge the moralistic way many people view drugs and drug-users, and to
try and foster an atmosphere where an open dabate on drug policy can held. In a world where drug-users are demonised
by the press, ‘Nice People Take Drugs’ is a powerful thought-provoker, encouraging the public to view drug users as
human beings, instead of rabid criminals out to recruit your children.

The advertising regulator responsible for pulling the ad told Release that they would have to amend the slogan to
“Nice people ALSO take drugs” or “Nice people take drugs TOO”. I suppose the argument is that “Nice people take drugs”
could somehow be conflated as “In order to be ‘nice’, you must take drugs”. I think the general public need to be
credited with more intelligence than that, especially in a world where every other message is saying “Drug takers are
innately evil”.

Whilst the conventional media use easy soundbites about drug harms to justify their reactionary veiwpoints, making
an argument for drug law reform and harm minimisation requires a more nuanced approach. Explaining why control and regulation
of drugs is the best way of dealing with the harms they cause to society and the individual today is complex and often requires
several footnotes to back up your point. But, in a world where the soundbite in the media rules, and a world where politicians
gain from accusing eachother of being ‘soft of drugs’ for taking a progressive approach, that argument is hard to access
through conventional ways. Whilst we as drug law reformers can (and do) win the scientific, moral, social, environmental and economic
arguments, when in a fair debate; the press and legal system is set against us. The slogan “Nice people take drugs”, as much as
a soundbite as any government official could produce, is refreshing. Were now playing them at the same game, and when it comes down to
it, if people actually look at the arguments, were winning.

To find out more about Release visit: http://www.release.org.uk/
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What about heroin?

Originally posted as a facebook note way back when.

Yep. “What about heroin?” is *the* first thing that anyone asks when you talk about decriminalising drugs. Its a hard question, as, according to the Parliamentary Select Committee on science, heroin is the most harmful drug. (For reference, alcohol (legal) is the fifth, tobacco (legal) is the ninth, cannabis (class B) 12th, LSD (class A) 15th, and MDMA (class A) 19th out of the drugs investigated).

So, what to do with the world’s most harmful drug when we decriminalise drugs? It’s a hard question, and it’s important to look at the facts. Heroin use was prohibited in the 70′s when the Misuse of Drugs act came into force. Since then, all drug use in the UK has shot up by 300%, but heroin in particular has shot up by 1000%. Heroin, because it is highly addictive, expensive, and impure due to an unregulated, illegal market, means that the harms associated with its use are many.

I’m a firm believer in a harm reduction approach. I feel that if a policy should be pragmatic, and seek to reduce the number of people harmed by drug use, and minimise the intensity of that harm should it occur. So here are my steps to harm reduction. Im first going to focus on the experiences of heroin users, and then society as a whole.

1. Decriminalise.

From talking to a friend of mine who is a drugs worker in Wakefield, there seems to be much anecdotal evidence of overdosing heroin users being left by friends and associates out of fear of legal recriminations, when the ambulance comes. This has reduced somewhat locally in West Yorkshire when the police made the decision to not go out in response to these emergency calls, but people still die unnecessarily out of fear of the police. Whilst i haven’t got any stats for the UK, in America, only 10% of ambulances are called when someone dying of a heroin overdose is still alive, something that could be avoided by decriminalising heroin possession

2. Active Education

Provide adequate education for drug users and their friends on how to recognise a heroin overdose (see the end for information on what an heroin overdose looks like) so an ambulance can be called earlier. At the moment, the drugs education system takes a similar to ‘abstinence only sex education’, and as such is failing the third of us, who choose to do illegal drugs, by not providing us with information on harm reduction and danger signs.

3. Quality Control

If the market for heroin was quality controlled, which is likely to happen in a decriminalised market, many of the health risks associated with heroin use would decrease. Quite a lot of the medical issues heroin users face are caused not by using heroin itself, but by the impurities present in the drug. The impurities are only there because of the government’s policy of prohibition, putting the supply into hands of unaccountable dealers.

4. Sort out needle exchanges.

In this country, our needle exchanges are relatively good. However, not all needle exchanges distribute the essential ‘accessories’ for safe IV drug use, such as filters, sterile water, stericups, and vitamin c. A study also showed that there is a big difference between Scotland and England, with Scotland less likely to give away some accoutrements, and England less likely to give away swabs and wipes, etc. Scotland also has a cap on the amount of needles they can give away to one user in a session, which seems silly as many users may be collecting for others and this could lead to people having to share needles. England are more likely to ‘intervene’ and refuse to give you needles if you are/look under 18, which is horrendous, as this is a likely cause of people under 18 having to share needles – putting our youth disproportionately at risk.

5.. First Aid Training

Train drug users and their friend’s basic first aid such as CPR so the victim of an overdose is likely to get vital help before the ambulance comes. Also, the more IV users know about first aid, especially the importance of sterility and not sharing bodily fluids, the better.

6. Naxolone Provision

Give out naxoline in emergency kits to users and drug workers, and others likely to come into contact with people overdosing on heroin (much like the system with people prone to having anaphylactic shock carrying epi-pens). Naloxone is a drug which has anti-opiod effects, it combats the effects of a heroin overdose when administered to a patient. The dissemination of this drug could save many lives. It also has other interesting properties, which I will come to later.

7. Heroin Maintenance

Methadone maintenance is undoubtedly a good thing, but it is prone to certain problems. The success rate of methadone maintenance programmes are lowered simply because in many cases, people don’t enter them voluntarily, but are coerced (i.e. they are given the choice of either going to prison or going through methadone treatment). So many people in methadone treatment either don’t want to be there, or don’t feel the need to give up heroin. Another problem is that methadone is still a highly addictive drug, which is potentially harmful (especially in its street form), so programme dropouts are put back onto the street with another addiction, often making their problems worse. One solution to these problems would be to actually administer quality controlled heroin to patients. This has all the benefits of methadone treatment (reduction in crime, reduction in the harms associated with an individual’s drug use, increased chance of getting sober, etc.) with a lot less negatives.

8. Expansion of methadone+ treatment

As I mentioned before, methadone treatment is currently one of the best treatment programmes offered at the moment. Studies on heroin maintenance programmes in Switzerland show that quite a lot of people passing through the system end up opting on to methadone or abstinence treatment after a while (showing that after a period of heroin maintenance and emotional therapy, many feel able to start kicking the habit). It is essential that methadone treatment carries on being available. The feasibility of using other maintenance drugs such as Buprenorphine or naloxone (see above) which have the same effect but need administering less often (once every 3 days rather than once a day), which should in theory decrease the cost of these programmes. It is also suggested by some sources that a maintenance programme that requires the patient to be in the clinic less, increases chances of recovery.

9. LSD/ Ibogaine therapy

LSD and Ibogaine are drugs that can, under clinical supervision, break addictions relatively quickly. The main reason why LSD and ibogaine are not used in addiction treatment is because they are currently illegal (because they also happen to make you high, although it isn’t physically possible to be addicted to either drug), and having ‘official acceptance’ of a drugs therapeutical effects calls into question the legitimacy of the illegal status. And so, the drugs remain unused for treating addicts, and remain illegal. Another issue with Ibogaine is that in huge quantities it is neuro-toxic, which is a barrier to its use in treatment. However, a derivative of ibogaine, 18-methoxycoronaridine has no side effects in terms of getting you high, or in terms of toxicity. It is essential that we at least explore further the use of these drugs in treatment of addicts.

10. Questioning 12-step programmes

12 step programmes such as Alcoholics Anonymous and Narcotics Anonymous frankly make me rather uneasy. I know their members feel strongly about the benefits of the programmes, so I’m not going to be too critical here. However, they do seem to be based around a belief in G-d, most of the steps mention G-d or some other sort of moral code. The NA produces literature similar to daily prayer books, and encourage recruitment or in their words “planting the seed of recovery in the minds of others”. 12 step programmes have a relatively low success rate of 10%, which makes them an inferior route to recovery than the above options. However, one of the reasons why they are so popular is the community based around them, something that groups like Rational Recovery, which don’t subscribe to pseudo-religious bs, can provide.

11. Changing Attitudes towards heroin use

One of the most important changes that needs to happen is one of attitude. As a society, we view heroin users as losers, dropouts, scumbags. In reality, all we are seeing is only a section of heroin users, the less privileged ones. Drug use here is fundamentally a class issues. Often people with money and privilege can obtain a steady supply of relatively good quality opiates (especially if one works in the medical profession), whereas what the people who we associate with heroin users are the less prividged, those who cannot always afford a steady, good quality supply, and often have to resort to crime to feed their habit. The fact of the matter is that the man who is credited as being the ‘Father of modern surgery’, Dr. William Halsted, was using quite heavily all through his eminent career with most of his colleagues not noticing. He managed not only to hold down a steady job, but to rise to the top of his profession. Why? Because he had access to a steady supply of good quality drugs, something which heroin maintenance treatment would provide.

12. Shooting Galleries

Kind of related to Heroin Maintenance, but Shooting Galleries are basically places where people can go to have supervised injection facilities. This massivley reduces the harm associated with IV drug use (such as HIV, collapsing veins, etc.), and can often simultaneously serve as needle exchanges.

Cost Implications

The implementation of the above steps could involve a lot of money. Just where is this money going to come from? Should tax payers stump up the cash for selfish drug users?

The answer is YES. Currently, we spend a hell of a lot of money on punishing drug users. It costs between 5 and 6 times as much money to put a keep a person in jail, opposed to the cost of providing a heroin user with maintenance treatment. Out of the 105,570 people arrested in 2004 for drug offenses in England and Wales, 85% of the were arrested for simple possession. 11% of those were given a custodial sentance. That equates to around 9900 people in prison for possession of drugs.[1] As the average cost of housing someone in prison is £32,358 [2], so we would save £320,344,200 in one fell swoop. If we decriminalised drugs and allowed regulate businesses to take the place of street dealers, we would save another £52,606,924 just from not having to put the dealers in jail. If you think of the VAST amount of money that we would save from not having to waste police time and resources on drug offenses, that would make a massive saving. According to Transform, the cost of drug motivated crime in Britain as a result of prohibition is costing the taxpayer £19 billion, a third of all UK crime cost.
So, it seems the money is there.

Social Effects of Decriminalsation.

1. Less Crime

Obviously, taking drugs out of the hands of dealers and into the hands of accountable businesses would massively reduce crime, especially violent crime as a result of dealers squabbling to control illicit markets. In fact, harsh prohibitionary ‘crack downs’ on drug crime actually are associated with creating more crime, moving crime to a different areas and initiating territorial disputes which often get violent.
In terms of heroin, crime is reduced massively in an area where heroin prescription/maintenance is present, as people no longer have to find the money to pay dealers. A swiss study found that in the areas where Swiss heroin maintenance programmes were readily available, drug dealing was low, as was property crimes lower than average and possession of other (non-heroin) drugs by the participants.

2. Less Drugs
Many people would imagine that legalising heroin would cause more people to use it, but the ‘medicalisation’ of heroin seems to have had the opposite effect in Switzerland, where the average age of people popping up on the radar for using heroin is getting lower, and the age of those people getting higher, suggesting that less new people are getting into drugs as a result of its medicalisation/decriminalisation.

3 Less Harm
I think the above steps showing harm reduction techniques adequately show that the harm associate with heroin (and other drug) use can be greatly reduced if drugs were decriminalised.

[1] – Home office Statistical bulletin, 2004, Drug offenders in England and wales
[2] National Prison Service Figures

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