Drug Policy Reform Research Articles

Report of TNI/IDPC Expert Seminar on the Future of the UN Drug Conventions

As the debate on drug policy and law reform gathers momentum on the international stage, the failings of the three UN drug control conventions (1961, 1971 and 1988) have come into stark relief. Criticisms of the global drug control regime established by the drug treaties have now entered the mainstream public discourse and political debate. The discussions around treaty reform that would allow or facilitate a wider spectrum of approaches to drugs are assuming a degree of urgency. The technicalities of convention reform form an important part of the discussion but arguably subservient to the wider political discourse. Until sufficient political will exists, substantive reform of the UN drug conventions will not be possible, despite growing recognition that the current drug control regime is not working. For this to occur the political calculus will need to shift so that the cost-benefit analysis for individual States moves decisively in favour of proactive engagement. This expert seminar is the fifth in a series of expert discussions on drug policy funded by the European Commission Drug Prevention and Information Programme and the Open Society Institute. The report of this seminar has been divided up under key headings that reflect the structure of the days’ discussions, with a summary of key points and conclusions at the end. Exploring the technical and bureaucratic dimension of convention reform The political calculus: Dealing with sub-optimality How to constructively frame the debate on convention reform Potential drivers of change / avenues for progress Lessons from Latin America Lessons from Bolivia The role of Europe Discussion and Conclusions

Pharmacists: First responders

Pharmacists: First responders

Drug Policy reform refuseniks, and the discrepancy between the arguments for prohibition, the evidence base and the changing need for service provision

Drug Policy reform refuseniks, and the discrepancy between the arguments for prohibition, the evidence base and the changing need for service provision

EX3 A Evaluation of the Effects from China Drug Policy Reform During 2009-2011: Some Success, Many Unintended Effects

EX3 A Evaluation of the Effects from China Drug Policy Reform During 2009-2011: Some Success, Many Unintended Effects

Drug policy in the Americas – a new set of Latin American policy proposals

PurposeThis article aims to give some background information about the debate around drug policies in Latin America and to provide a view on a possible future direction of the developing debate.Design/methodology/approachRecently increasing signs coming from the highest political level indicate that current strategies are perceived as failed, and incentives for a debate on alternatives to prohibition should be discussed. The article reflects on the origin and conditions in which this debate is taking place, and the ideas, options and projection into the political institutions that are designed for that purpose. The article describes the process using existing and new materials and insights produced by scholars and participants in the Latin American drug policy debate.FindingsThe article finds that the impetus given to the drug policy reform debate has now reached a level, that it can no longer be avoided to talk openly at the highest political level, about alternatives to current drug policy strategies, based mainly on prohibition.Originality/valueThe article connects recent drug policy debates into a historical perspective, and helps to underscore the need for these reforms, as a solution for the problems faced by Latin American countries, such as increased levels of violence related to the drugs market.

The Real Dope: Social, Legal, and Historical Perspectives on the Regulation of Drugs in Canada, edited by Edgar-Andre? Montigny (Toronto:University of Toronto Press, 2011)

In The Real Dope: Social, Legal, and Historical Perspectives on the Regulation of Drugs in Canada, Edgar-Andre? Montigny brings together a broad range of recent writing on a wide variety of drugs. The collection is well worth reading for the insights it provides into Canada’s socio-legal historical experience of the regulation of different psychoactive substances and for its documentation of the wealth of expertise coalescing in this area of research. This subject matter has inspired much critical analysis and scholarly debate about the role of academics in informing policy discussions about drug use and support for liberal drug policy reform. The present contribution is unique in its broad coverage of different “types” of drugs in different eras, and in its accessible, coherent presentation of historical material. Each chapter stands both alone and as an asset to its larger contemporary relevance, as interpreted by authors drawn from a variety of disciplinary backgrounds.

Modernising the Global Drug Control System: Can Europe Lead - A Civil Society Perspective

On the afternoon of 29th May 2012, a number of representatives from civil society organisations from across Europe gathered to discuss the role of the European Union (EU) in leading the debates around reforming the international drug control system. This meeting comes at a time when the EU is drafting its new Drug Strategy for 2013-2020, and when a number of government officials in many regions of the world are calling for a paradigm shift on drug control.On the morning of 29th May, the International Drug Policy Consortium (IDPC) and the Global Commission on Drug Policy organised a seminar directed at Members of the European Parliament (MEPs) to discuss the issue, with the participation of two Global Commissioners – Michel Kazatchkine, physician and former Executive Director of the Global Fund, and Pavel Bem, psychiatrist and mayor of Prague, who has played a leading role in designing the current Czech drug policy. The seminar reflected the fact that a number of MEPs, as well as the European External Action Service, now seem interested in drug policy reform. On the other hand, there are signs that the European Commission and the DG-Justice seem more reluctant to support a debate on the drugs issue. The afternoon session focused on the conclusions of the report of the Global Commission on Drug Policy and its implication for Europe. The discussions touched upon issues related to the willingness of the EU to engage in meaningful debate around drug policy reform and harm reduction, and strategies that could be implemented to encourage more leadership among EU institutions.

Drug Policy Reform – From Evidence to Practice: Session Report

The last of the series of Correlation Conferences, entitled ‘Getting out of the margins – Changing realities and making the difference’, took place from 12th to 14th December 2011 in Ljubljana, Slovenia. This report is an account of the discussions that took place during the final session of the Conference, ‘Drug policy reform – From evidence to practice’. Thanks are due to Thanasis Apostolou, from Diogenis, Drug Policy Dialogue in South East Europe, for chairing the session.Much discussion is currently taking place about the ineffectiveness of drug law enforcement practices and of the role of the criminal justice system and prisons in controlling the illicit drug market.Improvements can be observed in terms of general attitudes towards people who use drugs. For instance, human rights now constitute an important aspect of the drug policy agenda and governments have started considering drug dependence differently, shifting from a criminal approach to a health-oriented one.Within this framework of discussion, national governments and international bodies, NGOs and other stakeholders are requested to provide effective answers to the emergence of new drugs, changes in consumption patterns and existing behaviours.It seems clear that drug policies based on law enforcement and punishment are outdated and that new responses need to be found to tackle drugs issues. The panellists of this session informed the audience about current drug policy developments worldwide, both at the national, European and international level. The objective of this panel discussion was to comment upon new drug policy trends, and to propose concrete steps to improve drug policy.The panel was composed of the following drug policy experts: Martin Jelsma, Coordinator of the Drugs and Democracy Programme of the Transnational Institute (TNI) Ann Fordham, Executive Director of the International Drug Policy Consortium (IDPC) Jindrich Voboril, National Drug Coordinator in the Czech Republic Frederik Polak, Member of the European Coalition for Just and Effective Drug Policies (ENCOD) Eliot Albers, Acting Director of the International Network of People who Use Drugs (INPUD) Nikolaos Takis, Psychiatrist at the detoxification unit of the Psychiatric Hospital in Athens, Greece (replaced Meni Malliori, the Greek Drug Coordinator, who was excused)

A resounding success or a disastrous failure: Re‐examining the interpretation of evidence on the Portuguese decriminalisation of illicit drugs

In this Harm Reduction Digest two observers and scholars of the 2001 Portuguese drug policy reform consider divergent accounts of the reform which viewed it as a 'resounding success' or a 'disastrous failure'. Acknowledging from their own experience the inherent difficulties in studying drug law reform, Caitlin Hughes and Alex Stevens take the central competing claims of the protagonists and consider them against the available data. They remind us of the way all sides of the drug policy debates call upon and alternatively use or misuse 'evidence' to feed into discussions of the worth, efficacy and desirability of different illicit drug policies. In doing so they provide pause for thought for those of us who operate as drug policy researchers and drug policy advocates.

IDPC-GCDP Report: Modernising the Global Drug Control System – Can Europe Lead?

The seminar entitled “Modernising the global drug control system – Can Europe lead?” was organised in the European Parliament by the International Drug Policy Consortium (IDPC), and the Global Commission on Drug Policy, and co-hosted by the Member of European Parliament (MEP) Nikos Chrysogelos.The event aimed to present the recommendations of the Global Commission and discuss the role that the European Union (EU) could play in current drug policy reform debates taking place within Europe and around the world. The seminar also comes at a time when the EU is working on drafting a new Drug Strategy to replace the one that will expire at the end of 2012.Two Global Commissioners participated in the panel discussion - Michel Kazatchkine, physician and former Executive Director of the Global Fund, and Pavel Bem, psychiatrist, who has played a leading role in designing Czech Drug policy and is the former mayor of Prague. To continue reading, please find the report below.On the same afternoon, IDPC and the Global Commission collaborated again to hold a civil society seminar on a similar issue. Please click here to learn more about the event.

Global Commission on drug policy reform calls for urgent reforms to drug policy

Global Commission on drug policy reform calls for urgent reforms to drug policy

The Obama Administration’s Drug Control Policy on Auto-Pilot

In a widely watched You Tube video, U.S. President Barack Obama is asked whether or not the drug war may in fact be counterproductive. Instead of the resounding NO that would have come from any of his recent predecessors, Obama responded: “I think this is an entirely legitimate topic for debate.” He then qualified his remarks by adding, “I am not in favor of legalization.” Nonetheless, even acknowledging the legitimacy of debate on U.S. drug policy is a significant shift from the past, when successive administrations stifled discussion and routinely labeled anyone promoting alternative approaches to the so-called U.S. “war on drugs” as dangerous and surreptitiously promoting massive drug use and poisoning America’s youth. With over two years in office, the Obama administration has had time to begin to make its mark on the government’s domestic and international drug policies. But has the welcome change in tone been matched by a change in policies? The track record to date is disappointing, with far more continuity than change. The Obama administration, apparently less fearful of being criticized as “soft on drugs,” has ratcheted down the rhetoric and has placed greater emphasis on the problem of demand and problematic drug use. Some necessary but modest changes have also taken place with respect to domestic drug policy. Yet broader drug policy reforms at the domestic level remain elusive and in the international sphere the U.S. “war on drugs” continues apace.

IDPC Briefing Paper- Cannabis in Mexico: An Open Debate

In August 2010, before a meeting of academics and representatives of civil society organizations, Mexican President Felipe Calderon declared that the legalization of illicit drugs could contribute to reducing the power held by organized crime. He quickly added, however, that this was not an option that would be considered by his own administration.His statements unleashed a series of comments from politicians, the media and many sectors of Mexican society that had until then remained silent. Among noticeable politicians’ remarks was the statement by former President Vicente Fox, who declared that the only way to solve the serious security problems faced by Mexico was to legalize illicit drugs. As such, he joined his own predecessor, Ernesto Zedillo, who, as a member of the Latin American Commission on Drugs and Democracy, has pushed for drug policy reform in the region, particularly with regards to cannabis.As we shall see in this paper, the drugs debate in Mexico is not a new topic for the political agenda. This document presents a general overview and analysis of the cannabis debate in Mexico.

Border Crossing to Inject Drugs in Mexico Among Injection Drug Users in San Diego, California

We examined correlates of ever injecting drugs in Mexico among residents of San Diego, California. From 2007 to 2010, injecting drug users (IDUs) in San Diego underwent an interviewer-administered survey. Logistic regression identified correlates of injection drug use in Mexico. Of 302 IDUs, 38% were Hispanic, 72% male and median age was 37; 27% ever injected in Mexico; 43% reported distributive syringe sharing there. Factors independently associated with ever injecting drugs in Mexico included being younger at first injection, injecting heroin, distributive syringe sharing at least half of the time, and transporting drugs over the last 6 months. One-quarter of IDUs reported ever injecting drugs in Mexico, among whom syringe sharing was common, suggesting possible mixing between IDUs in the Mexico-US border region. Prospective studies should monitor trends in cross-border drug use in light of recent Mexican drug policy reforms partially decriminalizing drug possession.

The ‘War on Drugs’ has failed. It's time for a war on drugs

Ewan Hoyle is founder of the pressure group, Liberal Democrats for Drug Policy Reform.

Tackling HIV and drug addiction in Mexico

Mexico serves as a major producer of heroin, marijuana and methamphetamine and a trans-shipment route for cocaine destined for U.S markets, which has profound effects on the health of its people. Since 2007, over 20,000 drug-related fatalities occurred nation-wide in association with warring drug trafficking organizations. Social, political and economic forces coupled with wide economic disparities between Mexico and the U.S have created major corridors for drug trafficking and migration through northern border states, such as Baja California and Chihuahua, which now face twin epidemics of HIV and drug addiction.1 Baja California has the second highest cumulative AIDS incidence among Mexico’s 32 states.2 In Tijuana, a city of 1.5 million people adjacent to San Diego, CA, up to 1 in 116 persons aged 15–49 was HIV-infected in 2006.3 Among female drug injectors, HIV prevalence is 12%.4 Compared to Mexico overall where 0.2% injected any drug in 2008, 4.8% injected drugs in Baja California, and rates of methamphetamine use were highest in the country.5 Methamphetamine use was independently associated with HIV infection among the city’s female sex workers and their clients, among whom HIV prevalence is nearly identical (5–6%).6 Until recently, Mexico’s response to its drug problem mirrored that of the U.S., emphasizing supply reduction and interdiction. Harm reduction was initially limited to grassroots efforts of local non-governmental organizations (NGOs) in Ciudad Juarez and Tijuana. There was only one publicly funded methadone program in the country, in Ciudad Juarez. However, with growing recognition that rising HIV rates were linked to drug abuse in these cities and others, harm reduction became officially embraced, both in Baja California7 and nation-wide.8 In scaling up its response to HIV prevention, Mexico’s Federal Ministry of Health mobilized the Centro Nacional para la Prevencion y el Control del VIH/SIDA and state health officials to implement mobile clinics (‘condonetas’), delivering condoms, rapid HIV testing, educational materials and syringe exchange to high risk neighborhoods in border cities like Tijuana and other Mexican cities.9 By 2010, syringe exchanges were operating in nine Mexican states. Mexico has also embarked upon drug policy reform. On August 24, 2009, Mexican President Felipe Calderon approved an unprecedented law that deregulates possession of small, specified amounts of cocaine, heroin, methamphetamine and marijuana for personal use.10 The law specifies that police apprehending persons possessing these drugs in equal or lesser amounts will receive no penal action until a third apprehension, whereupon they will be required to enter drug treatment or jail. This law, to be enacted in August 2010, is intended to re-direct law enforcement to drug dealers and traffickers, while moving towards a harm reduction approach for drug dependence. A nation-wide expansion to expand opioid substitution treatment programs is underway under the direction of the Consejo Nacional contras las Adicciones, placing appropriate emphasis on demand reduction. These bold steps to addressing Mexico’s drug problem reflect a shift away from the ‘war on drugs’ philosophy that many deem to have failed,11 towards a more balanced approach. Other countries in Latin America (e.g., Ecuador, Argentina, Brazil) and elsewhere (e.g., Portugal) have also embarked upon drug policy reforms that involve some degree of decriminalizing drug possession.11 Mexican health officials, NGOs and researchers from Mexico and the U.S. are working in partnership to implement and evaluate the health and societal outcomes of these initiatives, and a new police education program focused on demand reduction, harm reduction and human rights being introduced in Baja California and Chihuahua. These initiatives will help ensure that Mexico’s health and drug policies are grounded in empirical evidence and the right to health for all people.

News and Notes

News and Notes

News and Notes

News and Notes

Happy Pills in America: From Miltown to Prozac (review)

Reviewed by: Happy Pills in America: From Miltown to Prozac Nicolas Rasmussen David Herzberg. Happy Pills in America: From Miltown to Prozac. Baltimore: Johns Hopkins University Press, 2009. x + 279 pp. Ill. $45.00 (ISBN-10: 0-8018-9030-6, ISBN-13: 978-0-8018-9030-7). Amid the current flurry of interest in the history of pharmaceuticals, minor tranquilizers hold a special fascination, possibly due to the present resonance of controversies surrounding them a generation ago. In Happy Pills in America: From Miltown to Prozac, David Herzberg sets out to describe, through a focus on the rise and fall of tranquilizers from the late 1950s to the late 1970s, the advent of mass-consumption psychiatric drugs. That is, the book describes the commodification of “happiness” as a medical product. Focusing on popular and political discourse, Herzberg takes a cultural history approach, and throughout the book, his main sources are mass media and medical journal advertisements. These are supplemented in places by congressional records, memoirs, and some medical journal articles. The narrative begins with the introduction of Miltown (meprobamate) as a tranquilizer in the mid-1950s—it is cast not only as the first widely prescribed mental health pharmaceutical but “the first blockbuster drug”—and ends with the return of “happy pills” in the 1990s in the form of Prozac (fluoxetine). While this simple “psychotropic revolution” framing has long been a staple in the history of psychiatry, Herzberg departs refreshingly from the standard narrative by treating the marketing of the tranquilizers to physicians and the popular reception of the drugs as a single phenomenon. Drug companies in the 1950s, he points out, worked hard to violate the spirit of ethical advertising rules even as they honored the letter, for example hiring public relations firms to place pharmaceutical stories in mass media and providing free copies of popular magazines in a “special physician edition” that contained prescription drug ads (ideal for the waiting room). Thus popular late-1950s controversies about the problem of overcivilization-induced anxiety, conformable with Freudian psychiatry and potentially treatable by tranquilizers, and the clashing Cold War discourse of a crisis in masculinity that was implicitly hostile at least to men’s use of tranquilizers, not only affected pharmaceutical marketing (as Jonathan Metzl has pointed out in his 2003 Prozac on the Couch) but also must be regarded as a battlefield in which drug companies actively and directly influenced popular perceptions. According to Herzberg, in perhaps the book’s nicest insight, the outcome of this 1950s struggle over masculinity, anxiety, and drugs was not only new tranquilizer advertising to [End Page 637] physicians that cast potential male patients as hypermasculine cave men, but the now-infamous female bias in tranquilizer prescribing. Herzberg goes on to recount two major political controversies of the late 1960s and 1970s in which minor tranquilizers were embroiled: the middle-class feminist attack on Valium as a symbol of patriarchial oppression, which eventually brought down the drugs, and the charged debates surrounding drug addiction policy. The second of these discussions suffers from an overly narrow focus on tranquilizers and heroin, with major aspects of 1960s cultural conflict, like Vietnam, winning scarcely a mention and, still more surprisingly, youthful “hippies” with their distinctive marijuana, psychedelic, and amphetamine usage pattern winning no mention at all. The treatment of the feminist movement is more compelling, and here Herzberg makes another important observation that, in political contexts like congressional hearings, middle-class feminists actually undermined drug policy reformers aiming at what is now called “harm reduction” by emphasizing the role of middle-class women as innocent victims of tranquilizer makers and prescribers, thus hardening the contrast between medicines and “street drugs” wilfully taken for pleasure by deviants. The book admirably achieves its main aim: describing the reception of tranquilizers in the popular imagination of postwar America. It also draws attention to the important issue of happiness as an increasingly medicalized commodity in that context, although the tranquilizer story hardly exhausts that topic. It does not delve into the role of psychiatric medicine in actually redefining “happiness” in theory and, with drugs, materially shaping the consciousness of the postwar subject as consumer. Nor does the book feature any systematic...

Marketing a Policy Idea: Elite Frame Selection and Development in Ballot Initiative Campaigns

The importance of issue framing is well documented in public opinion and policy literature. While many analyze the impact of frames at the policy subsystem or public opinion level, this article identifies factors that influence frame selection and development in drug policy reform initiative campaigns. This study investigates why policy entrepreneurs choose to sponsor and advance medical marijuana ballot initiatives and draws on campaign literature, advertisements, and interviews to analyze the role of three forces that affect elite frame development: receptivity of public opinion, access to financial and media resources, and availability and credibility of spokespersons. These conditions influenced medical marijuana proponents' emphasis on patient rights, treatment options, and compassion as well as opponents' arguments about lack of evidence of medical effectiveness, the broader agenda of advocates, and conflicts with federal law. The case of drug control policy lends insight into the factors that shape elite frame selection and dissemination and points to avenues for future research.