Saturday, January 31, 2009

The Future of Harm Reduction: The US and the countdown to Vienna

The latest on this story from Reuters (including transform quote) and more importantly, given the high level audience in the States, a New York Times editorial ( below).

Update: The Guardian 03.02.09: Rift with EU as US sticks to Bush line on 'war on drugs' (including Transform quote)

from Reuters

U.S. and Europe split over drugs policy

By Luke Baker

LONDON (Reuters) - U.N.-sponsored negotiations on a new global drugs strategy are close to breaking down, with profound divisions between Europe and the United States on key policy issues, participants at the talks in Vienna say.

The problem is that U.S. negotiators are trying to push through anti-drug programmes that were promoted during the former Bush administration but which are no longer advocated by President Barack Obama, they said .

Whereas former President George W. Bush believed in a zero-tolerance approach in the war on drugs, one of Obama's first moves was to back the lifting of a ban on federal funding for needle-exchange programmes. He also gave tacit support to so-called "harm-reduction" strategies that are seen as crucial in the fight against drug-related diseases such as HIV/Aids.

The Vienna stand-off, which threatens to scupper a March summit at which the new drug policy declaration is to be signed, has prompted Democrats in Congress to write to the new U.S. ambassador to the United Nations calling for intervention.

Drug policy campaigners say that without a change in the U.S. position, anti-drug strategies could be set back for the next decade and have a knock-on impact on the spread of HIV/Aids and other diseases.

"We understand that the U.S. delegation in Vienna has been actively blocking the efforts of some of our closest allies -- including the European Union -- to incorporate in the declaration reference to harm reduction measures, such as needle exchange," read the letter, sent to Susan Rice on Wednesday and signed by California Congressman Henry Waxman, among others.

The U.S. delegation should be given new instructions from the new administration, it said.

"Otherwise, we risk crafting a U.N. declaration that is at odds with our own national policies and interests, even as we needlessly alienate our nation's allies in Europe."

Officials close to the U.S. negotiators in Vienna denied that Bush-era policies were being "rammed through" but said instructions from Obama administration had not been received.

"We are currently hearing out proposals, keeping options open and Washington informed. Our new administration will continue to review and develop our negotiating positions," a spokeswoman for the U.S. mission in Vienna said:


The Vienna negotiations, under the auspices of the U.N. Office on Drugs and Crime, have been going on intermittently for several months but are due to wrap up before a summit on March 12-13 when the new declaration is due to be signed.

While the United States is the chief proponent of a zero-tolerance approach to the estimated $160 billion (111.9 billion pound) illegal drugs industry, it has support from Russia and Japan, neither of whom support 'harm reduction' policies, which can include medication-assisted therapy and drug legalisation.

The European Union's policy position is supported by Australia, Latin America and Iran, among others, all of whom favour policies that include harm-reduction measures.

Drug policy campaigners believe that if the United States could be brought closer to the European position, Japan, Russia and others including China and India would follow, potentially producing consensus on a new global drugs strategy.

"Time is very tight and the race is now on to change the instructions from U.S. officials before the ink dries on the previous administration's line," said Danny Kushlick, head of policy at Transform, a British drug policy foundation.

"The implications of changing the political line is enormous for those who have suffered under the U.S. administration's refusal to support basic harm reduction measures."

U.S. sources said that while it was not impossible that the negotiating position could be changed, it would only happen once new instructions were issued from Washington.

At the same time, while the Obama administration differs from Bush, it does not advocate all 'harm reduction' strategies, which can include drug consumption rooms, safe-injecting rooms, and providing heroin and needles in prisons.

(Additional reporting by Mark Heinrich in Vienna)

(Editing by Angus MacSwan)

from the New York Times:

Time lag in Vienna

"Programs that give drug addicts access to clean needles have been shown the world over to slow the spread of deadly diseases including H.I.V./AIDS and hepatitis. Public health experts were relieved when President Obama announced his support for ending a ban on federal funding for such programs.

Unfortunately, Mr. Obama’s message seems not to have reached the American delegation to a United Nations drug policy summit in Vienna, where progress is stalled on a plan that would guide global drug control and AIDS prevention efforts for years to come. The delegation has angered allies, especially the European Union, by blocking efforts to incorporate references to the concept of “harm reduction” — of which needle exchange is a prime example — into the plan.

State Department officials said that they were resisting the harm-reduction language because it could also be interpreted as endorsing legalized drugs or providing addicts with a place to inject drugs. But the Vienna plan does not require any country to adopt policies it finds inappropriate. And by resisting the harm-reduction language, the American delegation is alienating allies and sending precisely the wrong message to developing nations, which must do a lot more to control AIDS and other addiction-related diseases.

Some members of Congress are rightly angry about the impasse in Vienna. On Wednesday, three members fired off a letter to Susan Rice, the new American ambassador to the United Nations, urging that the United States’ delegation in Vienna be given new marching orders on the harm-reduction language. If that doesn’t happen, the letter warns, “we risk crafting a U.N. declaration that is at odds with our own national policies and interests, even as we needlessly alienate our nation’s allies in Europe.”

Thursday, January 29, 2009

Should caffeine be a made a class B drug?

The week before last witnessed the first decent media drug panic we’ve had in a while, although unusually this one was not about cannabis, ecstasy, or cocaine. It followed the publication of a paper (from Durham University’s department of psychology) titled ‘Caffeine, stress, and proneness to psychosis-like experiences: A preliminary investigation’ in a fairly obscure Journal called Personality and Individual Difference. The papers key finding was that heavy caffeine users were slightly more prone to hallucinations, but not to feeling persecuted.

Somewhat strangely the story received massive cross-media coverage, in almost all the UK daily’s, news agencies and major media outlets across the world. A google-news search finds 285 media hits ranging from Fox news (Lots ... and Lots of Coffee Linked to Hallucinations), and the Times of India (coffee can lead to hallucinations), to The Australian (Drink coffee, see dead people) and even Reuters with the ridiculous invent-a-quote headline 'Coffeeholics wake the dead'. But as so often with drug panics the actual research findings are rather underwhelming when compared to many of the shock headlines of the stories covering them.

Some dead people spotted outside Starbucks yesterday*

As deconstructed in the Guardian’s unfailingly brilliant Bad Science Column by Ben Goldacre (and the excellent NHS 'behind the headlines' page), the paper's findings, in actuality, showed a statistically significant but very weak correlation between high caffeine intake and proneness to hallucinate (different from actually hallucinating). Moreover The findings were based on weak observational data from a self selecting sample of students (who did an online questionnaire of often strange and ambiguously worded questions), confounding variables were not considered, and much of the media coverage quoted the finding that 7 cups of coffee a day is associated with a three times higher prevalence of hallucinations, a fact that emerged from the Durham University press release but is not supported by the actual research findings. There was also nothing in the paper about coffee making you see ghosts or dead people – a headline that evidently emerged by a process of Chinese whispers between the published paper (which mentions sensing people who were not there), the departmental press release, news agency coverage, and lazy headline writers.

So here, in the finest tradition of drug stories in the media, was a piece of not especially good research being very badly reported; a rather dull and ambiguous research finding sexed up by the headline writers to either fill up space on a quiet news day or shift units, depending on how you want to see it. You may well ask; So What? Nothing new here really.

But this rather sorry and un-illuminating tale does raise some more interesting issues when viewed alongside the longer running but not completely dissimilar cannabis panic. They are alike in key respects – journalistic hype, poor science reporting, the theme of young people in peril, drugs and mental health (specifically psychosis) and so on. But there are also some dramatic differences. The fact that the caffeine story revolved around the discovery that high levels of consumption could lead to psychotic-like symptoms notably failed to provoke any comment from any of the legions of politicians and opinion writers who pounced on every new research paper that mentioned ‘cannabis’ and ‘psychosis’ in the same sentence, before pontificating ad-nauseum about ‘sending out the wrong message’, ‘a mental health time bomb’, 'lethal skunk' (perhaps responsible for all the dead people seen by the coffee drinkers?) and all the rest.

Where was the Home Secretary telling us how the coffee young people are drinking today, the Starbucks' triple shot mega-chinos, are nothing like the innocent cups of Maxwell House that their parents used to drink in the 60s? Where was Melanie Phillips rallying against the moral depravity of Government-sanctioned caffeine-crazed child-zombies prowling our streets? Where was the Independent on Sunday reversing its support for caramel lattes because of the ten-fold increase in ghost sightings? Caffeine panic just doesn’t seem to fire up our legions of drug warriors. There’s no political mileage in it and of course, most of them spend much of the day drinking it. Even more than alcohol, its one drug that it’s OK to consume. A nice, safe drug. Our drug. Not really a drug at all.

Further highlighting this peculiar conceptual dis-juncture that exists in the minds of the media, public and politicians alike, between illegal and legal drugs, some of the media coverage was unintentionally hilarious; like the interview on the Radio 1 website with a woman, who after drinking several bottles of diet cola, says that: "I can act weird and I talk weird, as if you are high on drugs". And notable in the media coverage was the almost complete absence of the word 'psychosis', even though it was in the title of the research paper being reported on, and psychotic symptoms were the paper's primary subject, and indeed primary findings. Did the uncomfortable echoes of the cannabis/psychosis media narrative lead to the word being unconsciously deleted from the coverage?.

We shouldn’t forget that the key stated motivation for the recent reclassification of cannabis from C back to B was the potent new strains of ‘skunk’ cannabis and its effects on mental health , specifically the danger of inducing psychosis (the widely misunderstood and rarely explained word, endlessly repeated in the media). Compared to the caffeine story there was certainly a wide array of political forces marshaling behind the skunk/psychosis panic; the tabloids and opposition politicians trying to score points by hyping the panic to make the Government look irresponsible, and a new Prime Minister wanting to assert his moral credentials with a few judicious policy U-turns on third-rail type issues. There is more and arguably better research too, both on increasing potency and mental health risks of cannabis, but in the froth of hype, panic, moral grandstanding and political posturing, any grasp on reality or objective science and harm assessments was lost (chronicled on this blog in almost gruesome detail over the last couple of years).

Another lesson then, from this latest caffeine mini-panic, is that the media clearly doesn’t even need the sorts of partisan politics and culture-wars tedium that swilled around the cannabis debate to fall back on bad science reporting of drug stories. They will evidently do that completely unprompted. Understanding of and reporting on statistics in the media is almost universally poor. Combine this fact with the need to produce sexy drug-shock type headlines (usually produced by generalist, crime or home affairs reporters with no science or stats background) and you have a recipe for a seemingly endless tide of poor drug coverage. It may give bloggers something to sound off about, but in policy terms the impacts of this phenomenon are almost all bad.

By way of epilogue consider some of the recent coverage of caffeine in the Daily Mail, the long time standard bearer for hysterical bad-science drug reporting. A Mail story from the 26th of January is headlined: ‘Coffee may raise child cancer risk: New evidence that caffeine could damage babies'' DNA'. With this effort the Mail threatens to become a self-parodying laughing stock, so luminous is its idiocy. Behold; they have managed to conjure a drug shock headline of classic DNA-melting drug-baby vintage, reporting on scary ‘new evidence’ from research that is not only unpublished, but has yet to even begin.

Is this the beginning of a Daily Mail push for caffeine to be classified as a Class B drug? Are they groping around for something new to be outraged about now the cannabis 'problem' has been solved with an additional three years on prison sentences? Probably not, but I almost hope it is – it would expose the contradictions and hypocrisy in the media's drugs reporting.

See also:
the caffeine wikipedia page
NHS caffeine advice

*photo thanks to

Tuesday, January 27, 2009

When rats were placed in an environment ideally suited to their needs, they no longer showed interest in puhsing levers for rewards of morphine.

'The globalisation of addiction' by Bruce Alexander

review by Mike Jay

Bruce Alexander is best known - though deserves to be much better known - for the 'Rat Park' experiments he conducted in 1981. As an addiction psychologist, much of the data with which he worked was drawn from laboratory trials with rats and monkeys: the 'addictiveness' of drugs such as opiates and cocaine was established by observing how frequently caged animals would push levers to obtain doses. But Alexander's observations of addicts at the clinic where he worked in Vancouver suggested powerfully to him that the root cause of addiction was not so much the pharmacology of these particular drugs as the environmental stressors with which his addicts were trying to cope.

To test his hunch he designed Rat Park, an alternative laboratory environment constructed around the need of the subjects rather than the experimenters. A colony of rats, who are naturally gregarious, were allowed to roam together in a large vivarium enriched with wheels, balls and other playthings, on a deep bed of aromatic cedar shavings and with plenty of space for breeding and private interactions. Pleasant woodland vistas were even painted on the surrounding walls. In this situation, the rats' responses to drugs such as opiates were transformed. They no longer showed interest in pressing levers for rewards of morphine: even if forcibly addicted, they would suffer withdrawals rather than maintaining their dependence. Even a sugar solution could not tempt them to the morphine water (though they would choose this if naloxone was added to block the opiate effects). It seemed that the standard experiments were measuring not the addictiveness of opiates but the cruelty of the stresses inflicted on lab rats caged in solitary confinement, shaved, catheterised and with probes inserted into their median forebrain bundles.

Yet despite (or perhaps because of) their radical implications for the data that underpin addiction psychology, the Rat Park experiments attracted little attention. Alexander's paper was rejected by major journals including Science and Nature, and eventually published only in the respectable but minor Pharmacology, Biochemistry and Behavior. Although the experiments have subsequently been replicated and extended, they still inform the science of addiction only at its margins. The Globalisation of Addiction is Alexander's attempt to draw out their full implications for our understanding of addiction, and to chart a course towards forms of treatment that can transform their findings into practice.

His analysis begins with a radical reconception of addiction itself. Throughout the 20th century, as the science and treatment of addiction have developed into vast academic and professional industries, its underlying nature has stubbornly refused to coalesce into any sort of consensus. Is it a physiological condition marked by metabolic responses such as tolerance and withdrawal, a condition produced simply by exposure to 'addictive' drugs? Or is it a psychological affliction, the product of an 'addictive personality' - or, alternatively, a moral weakness, a failure of willpower and abrogation of social responsibilities? And how do these clinical views of addiction relate to the ever-expanding meanings of the term in the wider culture?

For Alexander, all these seemingly disparate accounts are united by their focus on the individual addict; but even a cursory historical and cultural survey reveals that the incidence of addiction is essentially a social phenomenon. Many historical and indigenous cultures have lacked even the concept of addiction - but many of these same cultures, once their traditional structures have been disrupted by conquest or colonisation, have been destroyed by it. All across the Americas, the Pacific and Australia, hundreds of 'demoralised' cultures have descended into vicious spirals of addiction, usually to alcohol, in many tragic cases wiping themselves out entirely. The root causes of addiction, then, must run deeper than any individual pathology: they must be sought in a larger story of cultural malaise and 'poverty of the spirit' that forces individuals, often en masse, into desperate and dysfunctional coping strategies.

Once addiction is recognised as a consequence of broader social currents, it becomes clear that the problem is far more widespread than the professional focus on drugs allows. Uncontrolled and chaotic appetites are extensively diagnosed across our culture not merely for illicit drugs, alcohol and nicotine but for other substances (food), other consumer activities (shopping, gambling), and other sources of emotional support such as romantic love. 'Addictive' is a slogan of enticement used to sell online gaming, exercise programmes and women's magazines. Even successful and high-functioning individuals can often be accurately described as addicted to money, power or status. Throughout the 20th century, these extensions of the concept of addiction were typically marginalised on the grounds that, unlike illicit drugs, these were mainstream activities that generated dysfunctional behaviour only in a minority of subjects. But alcohol has always been both mainstream and addictive, and it is increasingly clear that illicit drugs are used widely without necessarily generating addiction. Any attempt to get to the root of the problem must recognise that addiction is rampant not merely among a subculture of problem drug users but across society at large.

Alexander's search for the drivers behind the modern explosion in addiction leads him to consider the parallel spread of free market societies. Along with their obvious economic benefits, free markets also bring a widespread increase in what he terms cultural 'dislocation'. What were once elaborately reciprocated cultural transactions are reduced to simple commercial exchanges, and 'the competitive marketplace becomes the matrix of human existence'. Social fabrics are loosened as economic winners and losers polarise into their respective ghettoes, and traditional networks of trust are replaced by often brutal demarcations between neighbourhoods and social classes. It is our now endemic culture of competitive, zero-sum individualism that has, in the phrase of Alexander's title, globalised addiction over the last 50 years.

It is, he acknowledges, too simplistic to blame capitalism itself: the fundamental problem, dislocation, can equally be generated by feudalism , communism or any other political system. Nevertheless, a consumer society systemically erodes the sovereign remedy against addiction which, following Erik Erikson, Alexander terms 'psychosocial integration'. This has long been recognised as a necessity for social functioning: even Charles Darwin, whose theory is typically used to support competitive free market ideology, insisted that generating 'social and moral qualities' was a crucial factor in human evolutionary success. Psychosocial integration eliminates the hyperfocused pursuit of individual gratification that manifests as addictive behaviour, and balances individual autonomy with social belonging. Dislocation, though its effects are concentrated among the poor and socially excluded, has pervasive effects on society as a whole, which is why levels of happiness and wellbeing stubbornly refuse to rise in proportion with purchasing power. The greatest modern triumph over drug addiction, in China during Mao's Great Leap Forward from 1949-1955, took place against a background of material poverty but intense social cooperation in rebuilding a shattered society.

This analysis has helped Alexander to understand the successes and failures of treatment programmes in his professional world in Vancouver, where alcoholism and violence remain an intractable problem among many native Canadian Indians. Dislocation, rather than poverty, is their ultimate cause: communities resettled on unfamiliar land can be subsidised to the point where a 4x4 sits in every drive and a satellite dish on every roof, but still manifest higher levels of addiction than those which are allowed to remain in their homelands and follow their traditional subsistence strategies. In the arresting motto adopted by British Columbia's successful aboriginal community projects, 'Culture is Treatment'.

Once addiction is reconceived as a symptom of the dislocation embedded in modern cultures, the practical measures required to manage it become vast in scope. Treatment of addicts needs to become more holistic, and interwoven into a far wider spectrum of social programmes. Education and treatment need to lose their narrow focus on illicit drugs and alcohol, and to encompass addiction in all its forms. Although the prohibition of drugs is a major contributor to social dislocation, legalisation is far from a panacea: the majority of addictions, after all, are to legally available products. (The greatest benefit of legalisation, perhaps, would be to allow communities to determine their own drug policies, thereby providing a crucial lever for increasing psychosocial integration.) Faith-based treatments, whether Christian or more broadly spiritual, have an important role to play: St. Augustine's Confessions remains a powerful template for the addiction recovery narrative, and membership of faith groups can provide an effective antidote to dislocation. Political activism, both global and local, is a tool of social empowerment that can benefit addicts and addiction professionals alike.

All these strategies are eminently sensible, but remain hard to patch into the treatment of addiction as currently constituted. We may accept Alexander's persuasive case that drug addiction, properly understood, is a scapegoat for broader social dysfunction, but it is by no means obvious how to respond effectively. Like it or not, treatment remains focused on individuals, for whom his analysis holds limited explanatory power. Alexander does not deny the existence of personal tendencies to addiction, which may include genetics and neurochemistry, but maintains that they are often marginal factors and poor predictors of individual risk: overall, interventions are more effective at the social level than the personal. But these underlying causes are far easier to identify than to address. Our societies are profoundly structured around the need for individual autonomy; and personal freedom must, on some levels, always include the freedom to become addicted.

The Globalisation of Addiction is a considerable work, highly ambitious in its scope, impressive in its multidisciplinary scholarship, clear in its structure and generous in its references. It is both its strength and its weakness that it integrates addiction so convincingly into broader issues of social and political reform. Like Rat Park, it offers a fundamental critique of the 20th century view of addiction, but also demonstrates how dominant are the processes and structures that drive it.

Published with permission from Mike Jay. Mike is a writer and historian (See ) and a trustee of Transform Drug Policy Foundation.

Originally published on
Article copyright 2009 Mike Jay

The Globalisation of Addiction is available on Amazon with a readable excerpt.

Thursday, January 22, 2009

Lords debate alternatives to drug prohibition

update: debate transcript below

Transform Drug Policy Foundation

Media release 20/01/09

No embargo

Lords to debate alternatives to drug prohibition

The House of Lords will be debating ‘the United Nations Declaration on countering the world drug problem’, in the Main Chamber, January 21st at 11am. The debate is led by Baroness Meacher (cross bench) who will call on the Government to follow the recommendation of the 2002 Home Affairs Select Committee to debate alternatives to prohibition at UN level (see notes to editors below) at this year’s upcoming 10 year review of UN drug policy in Vienna.

Baroness Meacher said:

“Criminalising drug users has clearly not reduced the problems we face, and has only served to exacerbate the harm caused by drugs. It is time for policy makers at all levels, including the UN drug agencies, to move away from the failings of drug war ideology and embrace a new approach guided by sound evidence and public health principles. There is now an urgent need for and mature and balanced exploration of policy alternatives, including the potential legal regulation of some or all currently illegal drugs”.


Notes to editors:

Home Affairs Select Committee Report: “The Government's Drugs Policy: Is it Working?”

Recommendation 24:

"That the Government initiates a discussion within the Commission on Narcotic Drugs of alternative ways - including the possibility of legalisation and regulation - to tackle the global drugs dilemma."


Read the debate transcript here

Media coverage:

Guardian news in brief

Wednesday, January 21, 2009

Obama lifts federal ban on funding needle exchanges

The Obama White House has launched its new website, Under the header "The Agenda - Civil Rights", the site highlights various relevant issues including; homophobia and its affect on HIV/AIDS, contraception (including in prisons), the need to empower women to prevent the spread of HIV, and notably: needle exchange. The relevant text is below. Aside from a small mention for drug courts and eliminating the cocaine/crack sentencing disparity there isn't much else about drug policy yet, but lifting the disgraceful needle exchange funding ban is a good start considering we are only in day one - and the generally pragmatic tone bodes well. Can we be cautiously optimistic? Yes we can.

"*Promote AIDS Prevention: In the first year of his presidency, President Obama will develop and begin to implement a comprehensive national HIV/AIDS strategy that includes all federal agencies. The strategy will be designed to reduce HIV infections, increase access to care and reduce HIV-related health disparities. The President will support common sense approaches including age-appropriate sex education that includes information about contraception, combating infection within our prison population through education and contraception, and distributing contraceptives through our public health system. The President also supports lifting the federal ban on needle exchange, which could dramatically reduce rates of infection among drug users. President Obama has also been willing to confront the stigma -- too often tied to homophobia -- that continues to surround HIV/AIDS.

* Empower Women to Prevent HIV/AIDS: In the United States, the percentage of women diagnosed with AIDS has quadrupled over the last 20 years. Today, women account for more than one quarter of all new HIV/AIDS diagnoses. President Obama introduced the Microbicide Development Act, which will accelerate the development of products that empower women in the battle against AIDS. Microbicides are a class of products currently under development that women apply topically to prevent transmission of HIV and other infections."

See also:

Monday, January 12, 2009

Mexican Drug War – El Paso raises debate on prohibition

As the UN member state delegations gather their forces for the upcoming UN drug strategy review, it is vitally important to recognise the value of local activity in raising the debate on alternatives to global prohibition.

In response to the Mexican drug war taking place on their border, El Paso City Council, Texas, has taken the courageous step of calling on Congress to discuss drug legalisation as an option for ending the damage caused by prohibition.

Last Tuesday the Council voted 8-0 on a resolution drafted by the city's Border Relations Committee, outlining 11 steps the U.S. and Mexican governments can take to help El Paso's "beleaguered and besieged sister city."

All city representatives also supported an amendment by South-West city Rep. Beto O'Rourke that added a 12th step: the encouragement of the U.S. federal government to start a "serious debate" on the legalization of drugs.

See O'Rourke in action in this video, making a hell of a lot of sense.

Followed by more coverage:here, here, here, and here

Why not send a message of support to the Council.

The El Paso initiative shows how a city-wide initiative can impact internationally. This was the case when London Borough of Camden Council recommended legal regulation to the Home Affairs Select Committee drugs inquiry of 2001:

"Given the failure over several years, and across numerous agencies and countries, to have any significant effect on the supply side of the drug market, we feel it is time to consider seriously the option of undercutting the illicit market with a regulated legal market."
And, given that the drug war is creating havoc everywhere, why not contact your local council representative and try and start something like this near you. Here is one of our trustees, Gary Wallace, doing just that in his local paper: The drugs debate

Camden Council's was one of the submissions (that included Transform's), that influenced the Committee in making its final recommendation, calling for a debate on legalisation and regulation. And is worthy of note in the run up to the UN drug strategy review in March this year.
"We recommend that the Government initiates a discussion within the Commission on Narcotic Drugs of alternative ways—including the possibility of legalisation and regulation—to tackle the global drugs dilemma."
David Cameron, perhaps our next Prime Minister, then a back bench MP, was a member of the committee and voted for this recommendation. You may want to drop him a line too...

The El Paso initiative is in advance of talks that will take place between President-elect Obama and Mexican President Calderon that will focus on the Mexican drug war. For more on the way that the drug war horrors have escalated in Mexico over the last few months see:

Experts and public figures in the U.S. and Latin America offer a range of views, from stepped-up policing to legalization. And drug war created havoc continues as the knock on effect takes place:

And, just to bring the story home to us, here in the US of England, Lily Allen told the Mail: 'Drugs won't kill you', insists Lily Allen ('and yes, I've given up')
"Lily Allen was condemned last night for suggesting that the risks of cocaine are overstated. The 24-year-old singer said: 'The only story is that drugs are bad and they will kill you - you will become a prostitute, a rapist or a dealer. But that's not true. 'I know lots of people that take cocaine three nights a week and get up and go to work everyday, no problem at all."
I was called for a comment on the Lily Allen story. I suggested that the furore was about a culture clash, whereby drug use is normalised in certain subcultures. Whilst, to the outsider this behaviour appears aberrant and worthy only of condemnation. I went on to say that the most important point was to accept the reality that millions use drugs and that the priority was to keep users safe. Predictably they preferred Dominic Grieve of the Tory Party and David Raynes from the National Drug Party Prevention Alliance.