Tuesday, December 19, 2006

The Ipswich murders and the drugs debate

The terrible murder of five street sex workers in Ipswich over the past fortnight has provoked a burst of media debate on the prohibitions of both drugs and sex work - and the potential impacts of our current criminal justice oriented policies that attempt to control the respective trades.

The media coverage has been fascinating and varied. There have been a number of opinion pieces that have argued directly for licensing of brothels and the prescribing of heroin.

Mary Ann Seighart in a Times article 'Drugs: why we should medicalise, not criminalise' writes that:

"Drug addiction is a medical condition; it should not be treated as a criminal offence. The crime that results from drug addiction is a direct result of the drugs’ illegality. The organised criminal gangs, with their violence, corruption and money laundering; the street gangs, with their gun crime, stabbings and intimidation; the muggers, burglars, car thieves and shoplifters, who steal to fund their habit; the dealers who try to create new addicts; and finally, the prostitutes who put their health and lives at risk; all this crime and suffering could be wiped out if the drugs were available, free, on prescription"

Transform, get a nod when she then goes on to say that

"In European cities, where heroin is available on prescription, property crimes by drug-users have dropped by as much as a half. And think of the effect that widespread prescribing would have on turf wars, gang violence, gun crime, street dealing and prostitution. An excellent report from the Transform drug policy foundation* also points out: “The largest single profit opportunity for organised crime would evaporate, and with it the largest single source of police corruption.”

Transform estimates that the prison population would fall by between a third and a half, ending overcrowding and the need to build more jails. Billions of pounds spent enforcing prohibition and coping with its consequences would be saved. Hundreds of thousands could be treated as patients rather than criminals. The number of drug-related deaths would fall dramatically. And desperate young women could be rescued from pimps, potential rapists and murderers."

A similar pro reform piece appeared by Deborah Orr in the Independent. She focuses on sex work, but has been a long time supporter of drug law reform. The Guardian, as mentioned in the previous blog entry has run online articles on both sides of the drugs debate, with Nick Davies, whose articles on heroin were so influential back in 2001, arguing for more heroin prescribing, and John Harris, who flags up the difficulties in making crack legally available. This week the Guardian printed a well argued piece by Simon Jenkins that focuses on the political cowardice getting in the way of reform.

Inevitably there has been a reaction to this talk of 'legalisation' from other opinion writers who see it very differently.

Will Self (who is Deborah Orr's husband) argued in the Evening Standard that the 'legalise' drugs and prostituion position was over-simplistic. This seems a bit harsh given that he appears to be basing this on other columnists without reading the detailed work done by people in the public health arena, academia and drug related NGOs. But there you go, journalists can be a bit lazy and opinionated. David Aaronavitch in the Times down a similar route but becomes a self appointed expert on the basis that he has read the Home Office consultation paper 'Paying the Price'.

Melanie Phillips has also inevitably stepped up to represent the reactionary moral-indignation position with a familiar sounding tirade against the evils of pragmatic drug law reform. As ever she studiously avoids the reality of widespread dug use and dodges well known facts (some pointed out in the online comments below her article) like; cannabis use has fallen since it was reclassified or; Holland has a far lower rate of cannabis and heroin than the UK. Her initial tack is to argue, strangely it must be said, that replacing criminal markets with legally regulated ones wouldn't reduce crime or get rid of illegal markets. Secondly she argues that legality would condone and encourage use - as if somehow prohibition has reduced/eliminated it. She assumes her self-appointed moral high ground by calling for the continuation and ramping up of policies that have, for decades, done the exact opposite of what she seeks. The reformers, we are told, would 'institutionalise harm and enslave millions in a post-moral degraded universe' - yet that is exactly what the criminal justice approach she advocates has already achieved.

There is something particularly troubling about those, like Phillips, who argue there is any moral justification for increasing harm to vulnerable individuals as a way of discouraging certain behaviours in others. Not only does the past 40 years provide no evidence that this is an effective strategy, but it is profoundly unethical.

Yet Phillips, for all her dodgey stats and intellectual wrongness, does at least make a good argument and attempt to see it through. This cannot be said for the utterly vile Richard Littlejohn who appears to deliberately court controversy by being as unpleasant as possible. In a recent Daily Mail piece Spare us the 'People's Prostitute' routine... his bile takes the familiar reactionary route of blaming the victims, but doesnt stop there. He then dances on their graves:

"the deaths of these five women is no great loss. They weren't going to discover a cure for cancer or embark on missionary work in Darfur. The only kind of missionary position they undertook was in the back seat of a car."

Despite a few grains of truth in the Littlejohn piece ('they did it for drugs'), he doesn't appear sophisticated enough to actually take his spleen venting to any sort of conclusion. He doesnt call for anything, or recommend any policy response - he just says vile things about some poor murdered women, and their families, and then levers in some unrelated insults at the Prime Minister.

So where does all this opinion lead us?

The media debate, despite emerging from tragedy and despite the efforts of some Mail columnists, has overall been a valuable and suprisingly mature one. It has provided a useful platform for those advocating pragmatic regulated alternatives to the illegal markets created by various prohibitions.

It would be wrong to suggest that a particular law or policy is directly 'to blame' for the murders. Clearly the killer could have targetted women in brothels who were legally recieveing drugs on prescribtion had he chosen to. However, these events have focused attention on the way the laws on drugs and prostitution drives these markets underground and far from eradicating the problems, makes them far worse, fuelling crime and maximising riskes for the people involved - in this case putting vulnerable women directly in harms way. So whilst not directly to blame, it is unarguable that wrongheaded prohibitions can create high risk environments that make violence more likely, and the reporting of this story has made this point very clear.

The Government has not emerged with any credit whatsoever, in particular regarding its shelving some of pragmatic recommendations made by a long and detailed Home Office consulation on prostitution that reported in 2004. The Observer front page headline concerned the fact that No 10 'blocked move to legalise prostitution' because of fears about the media reaction to such moves. Quite revealing, and one suspects, not disimilar to No.10s reaction the the drugs report produced by No.10's own Strategy Unit in 2003 (which they tried not to publish).

There is something going on here with this debate that suggest progress to me. The concept being promoted by the Government and the likes of Melanie Phillips is that drugs and sex work are morally unacceptable and on that basis alone their prohibitions are justified. On the other hand there appears to be a growing public and media awareness that policy needs to be pragmatic, accepting of reality, and be based on evidence of effectiveness rather than just moral indignation. The latter position appears to have come out on top this time round, and just for once, the Government are being portrayed as irresponsible for not legalising something.

Paying the Price - Home Office consultation document
Paying the price - final report

Monday, December 18, 2006

Guardian Comments On Prohibition

This pithy comment from the Guardian divides the prohibitionist camp into the ignorant and the political.
Whereas this second comment from the Guardian says the legalisation argument flounders on the extremity of dangers imposed on society by crack.

Friday, December 15, 2006

Australian Justice Minister Seeks to Ban Language

This story highlights the control freakery of those in power in Australia. Prior to a crisis meeting on ice, the justice minister, Chris Ellison, has called for the use of the terms "party drugs" and "recreational drugs" to be outlawed. So it's no surprise that he is against injecting rooms despite the fact that these have proved to be effective in reducing crime and rates of addiction as has been amply demonstrated in the Canton of Zurich.

Tuesday, December 12, 2006

End Drugs Prohibition and Sign Our Petition

This petition goes directly to Downing Street, so please sign up and make our case for ending prohibition heard!

At last! polonium 210 in cigarettes hits the news

I have been researching this story for a number of years – that cigarettes contain radioactive polonium and lead – but never made any progress getting it into the news. A few times I have contacted science correspondents and never received a reply. I guess it just seemed like too much of a wacko-conspiracy theory, a bit like exploding cigars and Fidel Castro.

And then… the Litvinenko murder happens and polonium appears in the news as a major story, for the first (and probably last) time ever. And now the story I have been twittering on about to my generally disbelieving colleagues for years hits the news - at long last.

So what’s it all about?

Basically there has been various research done over the past 30 years or so to show that there is radioactive polonium-210 and lead-210 present in cigarettes. This fact whilst little known, is well acknowledged in the scientific community and beyond dispute.

There is a lot of debate about the possible health impacts of this radioactive content but it is clear that it does enter the lungs in smoke and there is a reasonable case made by a number of authors that this is the direct cause of some, possibly even most, smoking related lung cancer. It is important to note that there is considerable controversy about the extent of the carcinogenic effect of the radioactive content of the cigarettes as this exchange of letters in New England Journal of Medicine from 1982 clearly demonstrates.

Various estimates put the level of radiation absorbed by a pack-and-a-half a day smoker at the equivalent of 300 (Maryland Department of Health & Mental Hygiene) to 800 (The Office of Radiation, Chemical & Biological Safety at Michigan State University) chest X-rays every year – other reports suggest it is much higher, some up to 22,000.

High profile figures have got involved in this debate over the years: The US Surgeon General C Everett Koop stated publicly in 1990 that tobacco radiation is probably responsible for 90% of tobacco-related cancer.

Researchers have induced cancer in animal test subjects that inhaled polonium 210, (Yuille, CL; Berke, HL; Hull, T. 'Lung cancer following Pb210 inhalation in rats.' Radiation Res, 1967. 31:760-774) but were unable to cause cancer through the inhalation of any of the non-radioactive chemical carcinogens found in tobacco.

Some researchers suggest that the radioactive particles are relatively low risk if the exposure is averaged out over the entire exposed surface – but that with inhaled smoke the particles are concentrated in localised regions, the bronchial epithelium (points where the lung airways divide) exposing small numbers of cells to comparatively high levels of radiation – magnifying the carcinogenic effect.

It is clear that the radioactive polonium and lead is present in cigarettes, is being consumed, and a risk – potentially a very serious one - does exist. Marmorstein, J. ('Lung cancer: is the increasing incidence due to radioactive polonium in cigarettes?' South Medical Journal, February 1986. 79(2):145-50), notes that In 1930 the lung cancer death rate for white US males was 3.8 per 100,000 people. By 1956 the rate had increased almost tenfold, to 31 per 100,000.13 Between 1938 and 1960, the level of polonium 210 in American tobacco tripled, commensurate with the increased use of chemical fertilizers. Whilst this is not an established causal link, given the terrifying extent of the death rates, It is amazing that this issue hasn’t received more attention.

It now gets more interesting conspiracy fans.

The key source of the radioactive content in tobacco is thought to be phosphate fertilisers. The radioactivity is concentrated in the plant, particularly the tiny sticky hairs on tobacco leaves, as the water is drawn from the soil and evaporates. The radioactivity is also present in lots of farmed foods but it is when the tobacco leaves are smoked and inhaled that the particular lung cancer risk emerges.

This was apparently known to major tobacco companies as far back as 1974, and by 1980 a means to remove the radioactive content was also known – by using ammonium phosphate as a fertilizer, instead of calcium phosphate. This idea is rejected on the basis of expense. This is clearly revealed in the two publically available leaked ‘smoking gun’ memos (reproduced below from the www.tobaccofreedom.com website) from Philip Morris in 1980.

The key quotes are:

"210- Pb and 210 -Po are present in tobacco and smoke."

..."For alpha particles from Po-210 to be the cause of lung cancers in unlikely due to the amount of radioactivity of a particular energy necessary of induction. Evidence to date, however, does not allow one to state this is an impossibility."

“The recommendation of using ammonium phosphate instead of calcium phosphate is probably a valid but expensive point”

So what can we conclude from all this?

Well, obviously tobacco companies primary concern is not public health, they are motivated purely by profits. If there is a model for irresponsible corporations – they are it. No surprise there. They denied tobacco was linked to lung cancer despite overwhelming evidence for years.

More worryingly perhaps is that Government’s in the UK, the US and everywhere else have failed to act on this – either by commissioning the appropriate research or by banning the use of the offending fertilisers. Ultimately it is the governments responsibility to monitoir these issues. They have had 20 years since this has been in the public domain and done nothing. Only now when some unrelated Russian political murder brings this obscure substance into the public eye are we beginning to get a hint of a debate and the potential for change. Lets be under no illusions, this saga is a grotesque failing of our public health infrastructure and a total scandal and disgrace for all governments concerned.

On a broader front serious issues are raised about tobacco control generally and why it has historically been so lax. Things are now improving – with long overdue controls on advertising and smoking in public spaces - and the public health impacts of smoking beginning to fall from their post war high. This is the result of more effective public health education and better legal regulation – something that should obviously underpin effective policy on all drugs. Cigarette tobacco can still have up to 15% non tobacco content and there are 400 or so permitted additives, most of them pretty obnoxious looking (the list is available from the Tobacco Manufacturers Association). Tobacco products should have ingredients listings the same as any other product we put in our bodies:


Similar lessons need to be applied to alcohol control, still far too unregulated, particularly regards marketing and packaging, contributing to the rapid current rise in alcohol related ill health. Why no health warnings on alcohol products? why no ingredients listings? why do we so rarely see alcohol content in units on alcohol products?

Organic tobacco is fairly widely available which apparently doesn’t use the offending fertilisers. Its not good for you but may be marginally less bad. Alternatively, you could go all Swedish and use ‘snus’ or ‘bandits’ – tobacco which you hold in you mouth rather than smoke. It can give you mouth cancer but is generally far less risky (they have half our level of smoked tobacco in Sweden and half the level of lung cancer).

It is incumbent on the Government to regulate dangerous drugs properly. This must include basic harm reduction measures such as making sure tobacco full of radioactive carcinogens isnt being consumed by millions of people on a daily basis.

LATEST: 12.12.06

In a rather depressing development, apparently a government TV ad that highlights the fact that cigarettes contain polonium-210 has been pulled because of...wait for it...sensitivities to the Litvinenko family. How totally ridiculous. Just as we are about to be told something that has been known for decades, they decide to pull the ad for the most absurd of reasons.

Surely the sensitivities of the tens of 1000s of who have lost relatives to lung cancer, or may do in the future, are more important. Im quite sure Litvinenko would not want this ad being pulled as part of his legacy, and nor would his family. The Litvinenko story is an opportunity to broadcast this story and achieve something positive, not squirrel it away.

(mock cigarette packet photo from www.adbusters.org)

Monday, December 11, 2006

Losing Hearts and Minds in the War in Afghanistan

Despite widespread popular distrust of the use of herbicides in Afghanistan ("Afghans are deeply opposed to spraying poppies"), John Walters, the director of the U.S. Office of National Drug Control Policy is pressing the Afghan government to use the ground-sprayed herbicide, Roundup, on the illegal poppy crops. No mention is made in this article of any recompense or alternative crops which the Afghans might grow as profitably as opium nor of the inflammatory effect that wiping out people's livelihoods tends to create. Perhaps this will come later.