Nurses implore Canadian PM to keep supervised injecting facility open

To those nimbys, soap box moralisers and shameless political game players (yes, I mean you Brown, Smith and Coaker) who have systematically stymied attempts to set up supervised drug consumption facilities in the UK - I challenge you to watch this video. These are not 'pot-heads', 'junkies', or evil trojan-horse 'legalisers' making the case for Vancouver's pioneering Insite facility to remain open, these are leading nurses, researchers and public health experts imploring the Canadian Prime minister not to jeopardize a proven life-saving facility just because he thinks it is the politically expedient thing to do.



For those who have not been following developments in Canada you can read here about how Insite this week won a legal reprieve in the British Colombia Supreme Court to prevent its imminent closure. There has been massive international coverage of this story, and it has important implications for similar debates unfolding across the globe, not least in the UK.

more discussion of Insite's numerous impact assessments here

CBC radio on the Supreme Court ruling here (mp3).
Includes Interviews Liz Evans of PHS Community Services, who operate Insite, Comments from Dean Wilson of the Vancouver Area Network of Drug Users (VANDU) and Health Minister Tony Clement in response to questions from Vancouver East MP Libby Davies.

'The Government's questions relating to InSite's impact have effectively been answered'

While the UK is once again consumed by the drug policy endarkenment, deciding whether to symbolically increase prison sentences for cannabis smokers from 2-5 years, to our shame the debate on more important issues like supervised injecting rooms has fallen off the agenda completely with ministers claiming -100% incorrectly- that such policies would violate our commitments to the UN drug treaties. Notice that they never state that such facilities wouldn't deliver positive public health outcomes. No, as ever this is all about politics, with cowardly ministers fearful of critical headlines willing to sacrifice lives to satisfy their pollsters.


Well: elsewhere in the world the rational voices of public health and science are fighting back and standing up to the ideologues.....


Professor Neil Boyd, SFU Criminologist Speaks Out on InSite Research

OTTAWA - Professor Neil Boyd, a Criminologist at Simon Fraser University who was recently engaged by the Stephen Harper Government to conduct research on InSite, Vancouver's supervised injection site(SIS), addressed the Ottawa Press Gallery today outlining the benefits of the facility. These public comments are a blow to the Federal Government, as Professor Boyd is the Government's key "witness" in the ongoing BC Supreme Court case regarding InSite's legal status.

"There is no doubt that InSite has made a positive impact for the individuals who use InSite, the residents, service providers and business operators in the neighbourhood, and for the greater public health of the community," said Professor Boyd.

Boyd's research, compiled for an advisory committee specifically selected by the Stephen Harper Government, highlighted many positive impacts of InSite's work, including:

• InSite is strongly supported by business operators, service providers and residents in the neighbourhood surrounding the facility.
  
  
• An intentionally conservative cost-benefit analysis demonstrated that there are significant savings to tax-payers as a result of InSite's work.
  
  
• InSite has proven to have a positive impact in reducing the spread of HIV/AIDS, and the consequent costs of its treatment.
  
  
• InSite prevents drug overdose deaths.
  
  
• There have been no adverse effects from InSite on drug use patterns, crime, or public disorder.

"The research presented re-confirms the kinds of results obtained from the other Health Canada funded evaluation," said Professor Boyd. "Mr. Harper should respect science and its principles -- the findings are demonstrated consistently in independently peer-reviewed scientific journals."

"The Government's questions relating to InSite's impact have effectively been answered," added Professor Boyd.

In September, 2007 a letter was published in the scientific medical journal Open Medicine, signed by more that 130 prominent Canadian doctors and scientists urging Mr. Harper to refrain from placing ideology ahead of scientific evidence.


Media Contacts
Mark Townsend, cell: 604-720-3050 - PHS Community Services Society
Nathan Allen, cell: 604-833-0748 - InSite for Community Safety


BACKGROUND

"The Government's questions relating to InSite's impact have effectively been answered." - Professor Neil Boyd, Criminologist, Simon Fraser University

In May 2007, the Harper Government formed a politically-appointed advisory committee to re-explore questions relating to InSite's work. Simon Fraser University criminologist Neil Boyd was contracted through a Health Canada RFP process to relay findings from new research to the committee. On April 11, 2008, the Government released a report, Vancouver's INSITE service and other Supervised injection sites: What has been learned from research?, using Professor Boyd's data.

The new Health Canada funded research demonstrated that:

• Taxpayers receive $4 in benefits for every dollar spent on InSite, based on a conservative cost-benefit analysis. These tax savings do not take into account any potential cost benefits resulting from improved public health, or reduced stress on the criminal justice system.
  
  
• 80 per cent of police officers, business owners, residents and service providers interviewed in the area thought the service should be expanded or retained.
  
  
• More than half of the police officers interviewed in the survey shared the opinion InSite should remain open.
  
  
• Research on calls for service in the area indicated that InSite had not increased drug dealing or crime in the area.
  
  
• Self-reports from users of injection site service indicate that needle sharing decreases with increased use of injection site services, reducing the risk of contracting or spreading HIV and Hep C.
  
  
• A private security company contracted by the Chinese Business Association reported reductions in crime in the Chinese business district in a surrounding area.
  
  
• InSite encourages users to seek counselling, detoxification and treatment. Such activities have contributed to an increased use of detoxification services and increased engagement in treatment.
  
  
• InSite staff have successfully intervened in over 336 overdose events since 2006 and no overdose deaths have occurred at the service. (868 OD events since InSite opened in 2003) Professor Neil Boyd's data re-affirms the substantial research undertaking already completed through previously funded evaluation funded by Health Canada.

The Federal Government has spent close to $2 Million to evaluate InSite, making it likely the most thoroughly researched primary health carefacility in history.

With funding from Health Canada, the BC Centre for Excellence in HIV/AIDS conducted a rigorous scientific assessment of InSite.

Laid out in 25 academic papers published in world renowned, independently peer-reviewed, scientific medical journals, the evaluation concluded the following:

• The SIS has been associated with reductions in public disorder related to injection drug use. There has been a 45% decrease in open drug use as a result of InSite. (Wood et al., Canadian Medical Association Journal, 2004 Petrar et al., Addictive Behaviors, Stoltz et al., Journal of Public Health, 2007)
  
  
• The SIS has attracted and retained a high-risk population of IDUs who are at heightened risk for HIV infection and overdose. (Wood et al.,Am. Jrnl. of Preventative Medicine, 2005 - Wood et al., Am. Jrnl. of Public Health, 2006)
  
  
• Use of the SIS has been associated with reductions in HIV risk behaviour (syringe sharing). (Kerr et al., The Lancet, 2005, Wood et al., American Journal of Infectious Diseases, 2005)
  
  
• SIS staff has successfully managed hundreds of overdoses - There have been 868 lives saved at InSite (Kerr et al., IJDP, 2006, Kerr et al.,IJDP, 2007)
  
  
• Many individuals at risk for HIV infection receive safer injection education at the SIS, and increases in safe micro-injecting practices have been observed (Wood et al., International Journal of Drug Policy, 2005, Stoltz et al., Journal of Public Health, 2007)
  
  
• Use of the SIS has been associated with increased uptake of detoxification services and other addiction treatments. There has been a 33% increase in use of addiction treatment as a result of contact with InSite. (Wood et al., New England Journal of Medicine, 2006, Wood et al.,Addiction, 2007)
  
  
• The establishment of the SIS has not prompted adverse changes in community drug use patterns. (Kerr et al., British Medical Journal, 2006)
  
  
• The establishment of the SIS has not prompted initiation into injection drug use. (Kerr et al., American Journal of Public Health, 2007)
  
  
• The establishment of the SIS has not led to increases in drug-related crime. (Wood et al., Substance Abuse Treatment. Prevention, and Policy, 2006)

In January 2006, following media remarks from Stephen Harper stating he was waiting to hear reports from the Royal Canadian Mounted Police before making his decision, the RCMP contracted two researchers, Irwin Cohen and Raymond Corrado, to independently review the research from the BC Centre for Excellence in HIV/AIDS.

Their respective papers, compiled for the RCMP, referenced the following:

• Reductions in public disorder including public drug use and prevalence of injection related litter was significant (R. Corrado, Analysis of the Research Literature on INSITE, 2006).
  
  
• There was a good likelihood that a reduction in the epidemic of blood-borne diseases was enhanced since a substantial number of InSite clients stopped syringe sharing. (R. Corrado, Analysis of the Research Literature on INSITE, 2006).
  
  
• It is necessary to develop policies that protect the public, educate about the harms of drug use, maintain public order, and reduce the risk of an epidemic from blood borne diseases. (I. Cohen, A Review of the Research Literature on Supervised Injection Sites, 2006)

Craig Jones speech from Vancouver UN beyond 2008 conference

Craig Jones, PhD, Executive Director, the John Howard Society of Canada

Context: The following was delivered on the morning of Feb 5. 2008 to a UN-sponsored Conference called "Beyond 2008" the theme of which was (roughly) "How can we, the UN, help you, the voluntary sector in Canada, more aggressively and effectively prosecute the global war on drugs?" - which assumptions provoked a good deal of ire and scorn, particularly from those NGOs who find themselves cleaning up the destruction of the war on drugs.

I held my peace for the first day, which featured a number of questions concerning process by which the NGO community and the UN might better collaborate on (eg) the eradication of cannabis in Canada, but delivered the following on the morning of the second day. I was the first speaker and when I finished I snapped my laptop shut and exited the conference centre . to rousing applause.

--

I did my homework last night and it re-affirmed in me my conviction that Canada ought to renounce the UN Drug Conventions.

The Conventions embody a particular model of human nature which presumes that human beings can be threatened or punished into good behaviour, that general deterrence works.

This model is a philosophical a priori: it cannot be refuted by evidence because it is grounded in late-Victorian ideology and carries with it all the classist, sexist and racist implications associated therewith.

The John Howard Society - on the basis of our long experience working to re-integrate former prisoners - finds this ideology unpersuasive, counter-productive, destructive and contradicted by evidence and experience.

In Canada, controls or legislation introduced to fulfill the obligations of the Conventions have been a disaster for people with mental health and/or addictions.

Adherence to their punitive requirements has brought about the unnecessary criminalization of thousands of non-violent young persons - many with mental illness -- and the resulting incarceration has negatively affected these persons, their families and communities.

Thousands of otherwise law-abiding persons must live out their lives with the stigma of a criminal record -- which stigma is far more damaging for the future course of their life than any experience with psycho-tropic drugs.

The Conventions have, however, been good for organized crime, nationally, regionally and globally and its symbiotic twin, law enforcement. When organized crime thrives, so do the bureaucratic interests of the law enforcement apparatus. To the extent that Canada's drug control strategies have historically inclined toward supply suppression, the Conventions have been good for this symbiotic alliance.

For NGOs, the impact of the conventions varies according to whether an NGO either draws resources and legitimacy from the Conventions - and the war on drugs generally - or works to clean up the social and human destruction caused by the drug war's utopian pursuit of the unachievable.

The negative impacts of the Conventions tend to fall heaviest upon people who are largely voiceless, illiterate, incarcerated, mentally ill or who - in many cases - simply had the temerity to chose bad parents.

The obligations of the Conventions are un-realizable in practice, a fact acknowledged even by those who publicly endorse them. Prohibition and criminal stigmatization makes the best the enemy of the good. The attempt to make the Conventions work amplifies the harm that is already associated with drug use and abuse by turning manageable public health issues into expensive and intractable criminal justice issues.

The "discretionary measures . provided for in the convention" are emasculated by the overarching principle of prohibition and criminalization. Where available discretionary measures are starved for resources or maintained on a short leash and under the unrelentingly hostile scrutiny of the INCB, the White House Drug Czar and associated apparatus.

Where most urgent - in Canada's prisons where HIV and Hep C are epidemic - evidence-based harm reduction measures, permitted by the Conventions, are thwarted by a deficit of political courage.

We need to re-regulate the production, distribution and consumption of currently illicit drugs. Starting with cannabis - which is 75% of the global war on drugs - we need to take the regulation of all illicit drugs under the direct control of the state rather than - as we currently do - delegating it to the contest between organized crime and police agencies of the state and international system.

Prohibition, as required by the Conventions, is a policy choice to criminalize large numbers of otherwise law-abiding people and to thereby provoke into flourishing a global criminal underworld.

It is the cure that is worse than the disease.

Prohibition is not a law of nature - like gravity -- it's a dysfunctional and destructive form of harm maximization that benefits only organized crime and police agencies.

Thank you.

--
Craig Jones, Ph.D.
Executive Director
The John Howard Society of Canada
809 Blackburn Mews, Kingston, Ontario, K7P 2N6
email: cjones-at-johnhoward.ca
http://www.johnhoward.ca/
--

"A politician is a man who thinks of the next election; while the statesman thinks of the next generation." ~ James Freeman Clarke (1810-1888)

Support for reform: The Unusual Suspects

Drug law reform is often pigeonholed as the preserve of Guardian reading liberal-lefty types. The reality, as a recent blog post on the Canadian shotgun blog (part of the Western Standard) highlights, is that there are many more unusual suspects - of conservative political leaning - who also have strongly held and often vocal views in support of drug policy and law reform. The shotgun blog provides a interesting list of some of these, including individuals such prominent conservative commentator William F Buckley, conservative newspaper the Ottawa Citizen, and conservative think tank the Cato institute.

The list also includes a quote from the late Nobel Laureate Milton Friedman.

‘There is, in my opinion, no government policy that is as immoral as drug prohibition...’
(Friedman and Freedom, March 15, 2002). Whilst he arguably came more from a libertarian than conservative perspective his stance, about which he wrote many times still surprises many. (Friedman’s views on drug prohibition are considered in this piece by Johann Hari in the Independent from 2006 posted on the blog)

America’s Cato Institute, a public policy think tank, is yet another supporter of reform.

‘In spite of the greatest anti-drug enforcement effort in U.S. history, the drug problem is worse than ever. What should be done now? ... The status quo is intolerable--everyone agrees on that. But there are only two alternatives: further escalate the war on drugs, or legalize them. Once the public grasps the consequences of escalation, legalization may win out by default.’ (Thinking about drug legalization, May 25, 1989)

Back in the UK we also have number of supporters from possibly surprising corners of the political and intellectual map.

The Economist, a UK publication with a circulation of 1.2 million (over half being in the US) is respected and widely read by those with a serious interest in economics around the world from all political persuasions, despite its generally right leaning economic perspective. It has been and outspoken advocate of legally regulated drug markets for decades.

“The role of government should be to prevent the most chaotic drug users from harming others – by robbing or by driving while drugged, for instance – and to regulate drug markets to ensure minimum quality and safe distribution. The first task is hard if law enforcers are preoccupied with stopping all drug use; the second, impossible as long as drugs are illegal."

The Economist, editorial. From Issue entitled: ‘Time to legalise all drugs’ – 28/06/01

In stark contrast to the populist drug war rhetoric regularly deployed by current shadow Home Secretary David Davis, the now Conservative party leader David Cameron was a member of the Home Affairs Select Committee in 2002 during its detailed inquiry into UK drug policy and supported the recommendation that:

“the Government initiates a discussion within the [UN] Commission on Narcotic Drugs of alternative ways—including the possibility of legalisation and regulation—to tackle the global drugs dilemma” (paragraph 267).

He also, notably given the current political shenanigans, supported the calls for reclassification of cannabis from B to C, and ecstasy from A to B.

Conservative front bencher and former cabinet member Alan Duncan MP, is also a proponent of reform:

"The only completely effective way to ameliorate the drug problem, and especially the crime which results from it, is to bring the industry into the open by legalising the distribution and consumption of all dangerous drugs, or at the very least by decriminalising their consumption."

‘The Legalisation of Drugs' in ‘Saturn's Children'. Read the complete chapter here.

Of course support for a more rational approach to drug strategy can be seen across the political spectrum. There are in fact supporters of pragmatic reform from all parties.

Clearly the reform argument does not fit easily into either the right/left political divide nor an libertarian/authoritarian one. Some of the false assumptions about the political fault lines in this debate are explored in Transform’s recent publication ‘After the War on Drugs Tools for Debate’:

‘Some advocates of reform envisage replacing prohibition with a libertarian regime, others with more draconian forms of social control. The reform argument itself is non-partisan – it is simply a pragmatic position led by evidence of effectiveness and public health/harm reduction principles. Calling for legally regulated drugs markets is actually the rational and moderate position between the ideological poles of absolute prohibition and free market libertarianism.’

How enforcing prohibition creates street crime

Researchers at the University of British Columbia have made a compelling case that drug prohibition and backwards welfare rules increase criminal activity.

A team led by Kora DeBeck and Thomas Kerr surveyed injection drug users in the Vancouver area. They asked, "If you didn't need the money to pay for your drug use, are there any sources of income in the last 30 days that you would eliminate?"

In that study, 62 percent of sex workers and 41 percent of drug dealers said that they would cease their criminal activities if they did not need the extra income for drugs.

It may seem obvious that streetwalkers don't like their jobs. However, a scientific study like this is exactly the sort of evidence that is necessary to change public policy. The researchers were able to eloquently use their findings to highlight the shortcomings of Canadian laws and social services. That critique, and the results of their survey, will appear in an upcoming issue of the journal Drug and Alcohol Dependence .

DeBeck and Kerr began with a simple argument; seizures and arrests by law enforcement agencies raise drug prices. This makes it hard for serious addicts to afford their habits without resorting to prostitution, drug dealing, panhandling, binning, and other illegal activities.

By disrupting drug markets and increasing risks involved in producing and distributing illegal substances, prohibition-based drug enforcement policies play a role in inflating drug prices, which in turn induces active IDU (injection drug users) with high intensity addictions to engage in prohibited income generating behavior to finance their drug use. While the ultimate objective of inducing high drug prices is to deter drug use, this analysis and a growing body of research indicates that the unintended consequences of these enforcement-based policies produce significant harm for drug using individuals and broader society.

Here is the biggest policy dilemma: people that receive financial assistance from the government will lose their support if they earn more than a minuscule amount from legitimate sources. This standard, intended to keep checks out of the hands of people that don't need them, may also strongly discourage the rightful recipients from pursuing normal work. Since there are no records of the illegal transactions, the drug dealers and sex workers can have their cake and eat it too.

Furthermore, the current structure of social assistance in Canada is such that recipients will lose their income benefits if they begin to earn above $400 per month through legitimate work, leaving this population with limited income generating options beyond resorting to prohibited sources.

At the end of their report, the scholars offered several more ways to keep problematic dependent users out of trouble: increase the availability of low-end jobs, make heroin available by prescription, and offer methadone or stimulant substitutes for free.

One method of trying to reduce engagement in prohibited income generation among drug user populations with severe addictions is to expand their economic opportunities. This would involve supporting the development of legitimate means of earning income through various low threshold employment opportunities and skill building measures. A recent intervention designed to economically empower drug addicted sex trade workers to develop alternative legitimate sources of income has been shown to have a positive influence on reducing involvement in the sex trade industry. Alternatively, policy makers could intervene by providing addiction prescription and substitution therapies to individuals with markers of serious addiction to decrease their reliance on, and subsequent need to purchase, street drugs. This could be achieved in part through heroin prescription programs and by expanding substitution therapies including methadone maintenance.

this is an edited version of guest article on Respectacle by Aaron Rowe

Canada: Free speech goes up in smoke at school

Below is copied a story chronicling just the latest installment of drug war madness in North America, this time from Canada. Discussing the relative risks of illegal drugs alongside legal ones in the wrong environment, a school for example, and apparently you are sending out 'pro-drug' messages. So another triumph of misplaced moral posturing over science and reason then. It is admittedly worse over there than here in the UK, but not by much if the recent furore over cannabis reclassification and 'sending out messages' is anything to go by. I wonder how the distinguished authors of the recent Lancet paper, that made the same point as young Kieran regards relative drug harms, would feel about this?

Young people need to know the risks and dangers of all drugs they may encounter, regardless of legal status. Actually, now I think about it, arguably illegal status is one of the potential harms they need to be warned about aswell, as a criminal record will often cause more harm than the use of the drug itself.

The free speech issues in this story also echo the very wierd 'Bong Hits for Jesus' saga, which recently reached the US supreme court.

Free speech goes up in smoke at school

Saskatchewan student's marijuana research spurs lock down and suspension

JOE FRIESEN

From Wednesday's Globe and Mail

June 20, 2007

WINNIPEG — It started months ago when Kieran King's high-school class heard a presentation about the dangers of drug use.

Kieran, a 15-year-old Grade 10 student in tiny Wawota, Sask., population 600, thought the presentation lacked credibility, so he did some research on the relative health risks of alcohol, tobacco and cannabis.

When he told some of his fellow students that cannabis seemed the least hazardous of the three, he set in motion a series of events that led to a school lockdown, a threat assessment involving the RCMP, a suspension and failing grades on his exams.

"It's all a bit overwhelming," his mother, Jo Anne Euler, said. "It's just totally bizarre."

She explained that her son is a compulsive researcher who tends to go on at length about what he reads on the Internet.

One student at Wawota Parkland School didn't want to hear Kieran's thoughts about marijuana, and complained to principal Susan Wilson.

The principal then called Kieran's mother because she was concerned he was advocating drug use, Ms. Euler said.

Ms. Euler told the principal her son is an A student who doesn't go out, doesn't smoke or drink, and isn't pushing drugs on other kids.

"She said 'Well, if he talks about it again, I will be calling the police,' " Ms. Euler said. "I told Kieran that and he said 'Mom, all I'm doing is sharing the facts.' "

Kieran felt his right to free speech was being trampled, so he enlisted the help of the Saskatchewan Marijuana Party.

Together they planned a school walkout for free speech, scheduled for 11 a.m. last Tuesday, where free chocolate chip hemp seed cookies would be handed out.

But just before 11 that day, the principal announced that the school was a closed campus and that no one was allowed outside.

When several students tried to leave anyway, teachers barred the doors and ordered them back to class, Ms. Euler said. Kieran and his younger brother Lucas defied and joined a ragtag group of five protesters standing across from the school holding placards.

The principal then ordered a lockdown to ensure the safety of students. The RCMP raced to the scene, only to find a small, peaceful protest.

Kieran's mother was again called to the school and told that both her sons had been suspended for three days. Later that day, the school conducted a threat assessment on Kieran with the help of the RCMP and school division counsellors, Ms. Euler said............

read the rest of this sorry tale here

------

Now its cannabis and gay incest

Here's one we haven't seen before. Throughout the long history of reefer madness this one has to be the weirdest yet. A new short for MTV Canada, reported in the Toronto star attempts to dissuade young people from driving stoned. Itself a perfectly laudable goal, but the new ad's approach is to present an every day cautionary tale suggesting that your judgment after smoking a bong will be so compromised you will engage in a homoerotic kiss with your same sex sibling. And if you're so wasted you're snogging your brother, well obviously you really shouldn't be driving.

watch it here

You'd be forgiven for asking what the hell this is about. I feel fairly certain that a search of Pubmed will show no papers linking cannabis and gay incest. No - this is a classic attempt at the modern art of viral Internet marketing. In terms of exposure, it clearly works - I'm blogging it, your reading about it and probably watching it, some of you will tell others about it, and on it goes. The film makers, none other than uber-agency Satchi and Satchi, are not a stupid bunch. They've thought this through; they know you can massively magnify an ad's exposure by including enough controversy or shock value to ensure the ad itself becomes the story. So far, so cynical.

But, you have to ask - will the ad, either in its original TV slot or in its Internet afterlife, achieve anything more than lots of viral exposure. The so-clever-it-hurts Satchi execs clearly know all about exposure, but do they know how to reduce the level of driving under the influence? Do they measure outcomes? Do they care? Anti-drink driving campaigns have been highly effective in the past, so its not as if the film makers had nothing to base this pathetic effort on.

The obvious problem with the film is that it's completely ridiculous, and fails so spectacularly to chime with reality or the experiences of its target audience that the possibility then exists of its safe driving message actually being undermined. 'Kids' don't like being patronised, and we have long and rather tragic history of failed anti-drug campaigns devised by 'grown-ups' to prove it.

UN INCB is 'obstacle' to HIV prevention and drug treatment programs

A report published today by the Canadian HIV/AIDS Legal Network (part of the Open Society Institute Public Health Program), titled 'Closed to Reason: the International Narcotic Control Board and HIV / AIDS' strongly criticises the INCB, the nominal enforcement body for the UN drug conventions. It accuses the INCB of becoming 'an obstacle to effective programs to prevent and treat HIV and chemical dependence' . The bizarre politics and machinations of this strange UN entity make for often shocking reading. The summary findings and recommendations are copied below. They should be of immediate and urgent concern to all members states:

Key findings and recommendations

The role of drug policy has been transformed since the era in which the International Narcotics Control Board (INCB), the 13-member body responsible for monitoring compliance with the United Nations drug conventions, was conceived. In a time when an estimated 30 percent of infections outside of Africa are due to injection drug use, drug policy is fundamental to the success or failure of the international response to HIV/AIDS. A significant body of scientific evidence has shown the importance of measures such as effective treatment for chemical dependence and provision of sterile syringes in preventing HIV. The INCB, which emphasizes its impartiality, independence and reliance on evidence, has an historic opportunity to help stop the injection-driven HIV epidemics now emerging and exploding in much of the world.

Instead, the Board has become an obstacle to effective programs to prevent and treat HIV and chemical dependence. INCB annual reports are rife with omissions and misrepresentations and lack both scientific documentation and justification for legal opinions. Country visits by INCB representatives fail to highlight law enforcement patterns that accelerate HIV transmission and represent clear human rights violations. Although the Board is responsible for ensuring the global availability of legal opiates, it has not acted to help countries accurately estimate their need for the opiate substitution treatment shown to be effective in reducing HIV risk and increasing adherence to antiretroviral medications.

The Board stresses the drug control aspects of its mandate. Its annual report for 2005, however, refers 18 times to the role of drug use in accelerating HIV transmission in various countries. Tellingly, that report, like other INCB documents, fails to urge countries to pursue proven strategies to reduce HIV transmission among people who inject drugs. While the UN drug conventions clearly mandate treatment for drug users, the INCB has remained silent on the shortage of effective chemical dependence programs, and the abuses committed in the name of drug treatment and rehabilitation.

The United Nations system as a whole is committed to reducing HIV among people who inject drugs, to safeguarding the human rights of people who use drugs, and to increasing accountability and civil society involvement. In this context, the INCB is an anomaly: a closed body, accountable to no one, that focuses on drug control at the expense of public health and that urges national governments to do the same.

INCB members contradict or seek to thwart evidence-based recommendations of other UN bodies and representatives.

• INCB members have spoken out against sterile syringe programs and opiate substitution treatment, despite findings by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organization, the United Nations Office on Drugs and Crime (UNODC) and the INCB itself that these measures are effective and important components of HIV prevention.

• In 2002, the president of the INCB claimed, erroneously, that distribution of sterile syringes contravened the UN drug conventions. In 2005, a memorandum signed by an INCB member from Russia included numerous misstatements of fact meant to discredit the use of methadone as a treatment for opiate addiction.

• The Board has sought to silence UN representatives who support a fuller range of HIV prevention approaches. In 2006, for example, Stephen Lewis, the UN Secretary-General’s Special Envoy for HIV/AIDS in Africa, commented favorably on Canadian data showing that a Vancouver safer injection facility had reduced HIV risk. The next day, he received an angry telephone call from the INCB Secretariat and a promise that the Board would write to the Secretary-General to urge that Lewis be censured for support of “opium dens.” In that letter, the INCB president expressed disbelief that “any officer of the United Nation [sic] could have made such statements,” and demanded that Lewis recant.

INCB reports praise governments that violate human rights.

• A Board delegation visited Thailand in 2004, several months after police forces began a “war on drugs” in which human rights experts documented extrajudicial executions, arrest quotas, use of blacklists, and the internment of tens of thousands of people, including many with no history of drug use. In its report issued after the visit, the Board did not condemn the mass arrests; instead, it expressed appreciation for the Thai government’s efforts to investigate the killings, despite findings by human rights groups that the government had failed to allow any independent investigations.

• In 2004, after Bulgaria mandated imprisonment for possession of any amount of any illicit drug, fear of arrest caused rates of drug injection and syringe sharing to increase sharply. INCB representatives visited Bulgaria in 2005, but the Board’s report made no mention of the harsh drug law or its impact, noting instead that national drug control legislation was “well-developed.”

• In Russia, authorities in 2005 moved to reverse a reform that had reduced the numbers imprisoned for very small amounts of drugs. Wholesale and prolonged incarceration had been recognized as contributing to both penitentiary overcrowding and the fact that Russia’s HIV epidemic was among the fastest growing in the world. INCB representatives visited Russia during this debate, but the Board’s subsequent report made no mention of any discussion of the issue or of concern about the human rights implications of the policy. Instead, the INCB expressed concern about the extent of drug abuse in Russia, and encouraged coordination and cooperation between HIV and drug treatment services.

• Since 1990, China has marked the UN’s International Day Against Drug Abuse and Illicit Drug Trafficking with show trials in which drug dealers are sentenced to death, sometimes as crowds chant “kill, kill.” Scores have been executed. Despite professed support for sensitive policing, the INCB has failed to criticize either this practice or the police harassment of those seeking to obtain sterile injection equipment, whether in China or in other countries visited by the Board.

The Board stresses drug control at the expense of public health, expressing concern about diversion rather than praise for scientifically proven measures that reduce HIV and other harms.

• While acknowledging that WHO added methadone and buprenorphine to its Model List of Essential Medicines in 2005, the Board has made no public effort to promote opiate substitution treatment (OST) in countries where large numbers of people inject drugs. It also has failed to highlight OST as an essential tool in HIV care or treatment. Although Ukraine, China, Malaysia and Iran have moved in recent years to expand OST programs and/or needle exchange programs to contain HIV, INCB reports have not expressed appreciation for or satisfaction with these developments. Instead, the Board has expressed concern about diversion of methadone and buprenorphine, and urged WHO to advocate for tightened controls on these medications.

The Board issues interpretations of law and pronouncements on harm reduction, despite a lack of expertise in international law and HIV policy.

• According to their published biographies, none of the Board’s 13 members has formal training in international law, despite the importance of such credentials in interpreting treaty provisions. In the case of substitution treatment, needle exchange, and safer injection facilities, the pronouncements of INCB members have contravened the fi ndings of the Board’s own legal advisors and national experts.
  
  
• Despite the centrality of drug use to HIV transmission, none of the Board members has published in peer-reviewed journals on HIV/AIDS, and few list any experience of HIV treatment or prevention in their biographies.
  

The Board conducts operations in secret, and without mechanisms for accountability.

• INCB meetings are closed to observers, and no minutes are available.
  
  
• INCB members have used their Board affiliation when making misstatements of fact, yet no public mechanism exists for member states or community organizations to contest claims, seek clarification, or offer amendments.
  
  
• Sources are selectively and inconsistently documented in INCB reports.
  
  
• The INCB does not publicize country visits in advance or convene public hearings or other opportunities for input.
  
  
• Despite the UN Secretary-General’s call for greater transparency and interaction with civil society at the UN, the INCB’s website includes no information on the Board’s budget or staff.
  
  
• The INCB Secretariat — paid for by the UN — is unresponsive to requests for information from affected communities or non-governmental organizations.

Recommendations

• To improve accountability, address the HIV epidemic, and meet its mandate to assess compliance with the UN drug conventions, the INCB must change.
  
  
• The INCB should regularly assess the supply and adequacy of treatment for chemical
  dependence. It should provide technical assistance to help countries accurately estimate the need for opiate substitution treatment, support governments that are striving to scale up such treatment, and encourage governments that have yet to provide these life-saving therapies to find safe and effective ways to do so.
  
  
• The INCB should cite scientific evidence for its observations about drug use and health, and legal grounds for its interpretation of law. It should provide sources of information for its annual reports, and opportunities for UN member states and civil society groups to offer corrections or additional information.
  
  
• The INCB should provide greater opportunity for exchange with UN member states, UN
  agencies with relevant mandates, civil society, and HIV/AIDS experts. INCB country missions should include greater opportunities for engagement with these groups.
  
  
• The World Health Organization, the UN Economic and Social Council (ECOSOC) and UN member states should ensure that INCB members include persons with expertise in HIV/AIDS policy and international law.
  
  
• The INCB should articulate, and ECOSOC should evaluate, public guidelines to clarify when INCB members are speaking for the Board, and how misstatements of fact can be corrected.
  
  
• The UN Secretary-General should commission an independent evaluation of the INCB, including a scientific evaluation of the Board’s statements on health, and an examination of Board members’ independence and expertise, with particular attention to HIV, international law and human rights.

US Drugs Tsar gets a frosty reception in Canada

The US Drugs Tsar is currently on tour in Canada, part of his ongoing mission to export and entrench the disastrous 'War on Drugs' around the world, whilst simultaneously condemning and undermining moves toward such dangerous concepts as 'harm reduction'.

Canada has little or nothing to learn from the US' beyond how not to do it. This was made abundently clear at a press cnference organised by the Canadian Foundation for Drug Policy which included the following line up of top-draw speakers:

*Larry W. Campbell, Senator, former Mayor of Vancouver, former RCMP Drug Squad member, and former Chief Coroner of British Columbia.
*Ethan Nadelmann, director of the Drug Policy Alliance, the leading organisation in the US promoting alternatives to the war on drugs, former Princeton University professor and author of several books and articles on policing, crime control and drug policy
*Professor Line Beauchesne, Department of Criminology, University of Ottawa, the author of several books on drug policy, and co-founder, Canadian Foundation for Drug Policy.
*Dr David Marsh, former preseident of the Canadian Society for Addiction Medicine

hosted by: Eugene Oscapella, Ottawa lawyer, co-founder, Canadian Foundation for Drug Policy, and lecturer on drug policy in the Department of Criminology, University of Ottawa.

The press conference has been filmed and posted on youtube. The first installment, featuring Ethan Nadleman and Eugene Oscapella can be viewed below (the quality isn't going to win any awards but it perfectly watchable):



to see the following sections click:

Part 2 - Eugene Oscapella & Senator Larry Campbell
Part 3 - Eugene Oscapella & Line Beauchesne
Part 4: Eugene Oscapella & Dr. David Marsh
Part 5: Q&A from reporters
Part 6: Q&A continued
Part 7: Q&A continued

The following article by Ethan Nadleman, summing up a lot of these sentiments, appeared in the Ottawa Citizen:

Canada must not follow the U.S. on drug policy

Ethan Nadelmann
Citizen Special

Thursday, February 22, 2007

The U.S. drug czar, John Walters, is in Ottawa today, trying his best to put a positive spin on one of the greatest disasters in U.S. foreign and domestic policy. Part of his agenda is to persuade Canada to follow in U.S. footsteps, which can only happen if Canadians ignore science, compassion, health and human rights.

The United States ranks first in the world in per-capita incarceration, with roughly five per cent of the earth's population but 25 per cent of the total incarcerated population. Russia and China simply can't keep up. Among the 2.2 million people behind bars today in the United States, roughly half a million are locked up for drug-law violations, and hundreds of thousands more for other "drug-related" offences. The U.S. "war on drugs" costs at least $40 billion U.S. a year in direct costs, and tens of billions more in indirect costs.

It's all useful information for Canadians to keep in mind when being encouraged to further toughen their drug laws to bring them in line with those of the United States.

What's most remarkable about U.S. drug policy is the way it endures despite persistent evidence that it is ineffective, costly and counterproductive. One report after another -- by the U.S. General Accountability Office, the National Academy of Sciences, independent agencies and even the Bush administration itself -- consistently fault federal drug-control programs for failing to achieve their objectives.

But funding nonetheless persists. The DARE (Drug Abuse Resistance
Education) program, which relies on police to "educate" young people about drugs, keeps being funded despite an impressive run of studies demonstrating no effect on adolescent drug use. Ditto for the government's border interdiction and anti-drug ad campaigns, and its funding of federal-state anti-drug task forces, and much else.

Drug-policy reformers in the United States have been cheered by Canada's willingness -- at least until now -- to look to Europe rather than the United States for drug-control models. When HIV/AIDS started spreading a generation ago among people who inject drugs, both Europe and Canada were quick to implement needle exchanges and other harm-reduction programs, even as the United States opted instead to allow hundreds of thousands to become infected and die needlessly.

Heroin-prescription trials are now underway in Montreal and Vancouver, trying to determine whether what worked so well in Switzerland, Germany, The Netherlands and other countries can also work in Canada. The same is true of supervised injection sites, which have proven effective in reducing fatal overdoses, transmission of infectious diseases and drug-related nuisance. And most recently, Vancouver's mayor, Sam Sullivan, has broken new ground by proposing that cocaine and methamphetamine addicts be prescribed legal substitutes.

But I wonder whether Canada just can't help following in U.S. footsteps. DARE survives in Canada too, notwithstanding evidence of its lack of efficacy. Almost three quarters of Canadian federal drug-strategy spending is for law-enforcement initiatives, few of which demonstrate any success in reducing drug problems. "While harm-reduction interventions supported through the drug strategy are being held to an extraordinary standard of proof," the director of the B.C. Centre for Excellence in HIV/AIDS, Dr. Julio Montaner, recently observed, "those receiving the greatest proportion of funding remain under-evaluated or have already proven to be ineffective."

The survival of Vancouver's supervised-injection facility is currently at risk, for reasons having everything to do with politics and nothing with science or health, while federal drug-enforcement authorities know that all they need to do to preserve funding is make arrests and avoid scandal.

What matters most to U.S. drug czar John Walters, though, is cannabis, which he occasionally, and absurdly, describes as the most dangerous of all drugs. Seventy per cent of Americans say cannabis should be legal for medical purposes, and one study after another points to its efficacy and safety as a medicine. A similar percentage also think personal possession of marijuana should be decriminalized (i.e., resulting in fines rather than arrest and incarceration) and 40 per cent say it should be taxed, controlled and regulated, more or less like alcohol.

But Mr. Walters will have none of it. He travels the country, railing against cannabis and urging schools to drug test all students, without cause -- and without any scientific evidence that testing will work. And when he visits or talks about Canada, it's typically to complain -- erroneously -- that Canada is a major supplier of marijuana for the U.S., never mind the fact that Americans now produce most of the marijuana consumed in the United States.

Canada needs to lead, not follow, the United States when it comes to dealing sensibly with drugs. Mr. Walters's Canadian hosts today should remind him of the 2002 report of the Canadian Senate Special Committee on Illegal Drugs, chaired by Conservative Senator Pierre-Claude Nolin.

It's probably the best, most comprehensive, most evidence-based report on drug policy produced by any government in the past 30 years. And its recommendations are all about dealing with drugs as if politics were an afterthought, and all that mattered were reducing the harms associated with both drug use and failed drug policies. Imagine that.