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What's New At Drug War Facts, Vol. 3, No. 8, September 2013

The new Drug War Facts newsletter (Sept. 2013) is now online.

Issue In Focus: Marijuana Legalization

Senate Judiciary Committee to Discuss Marijuana Legalization Sept. 10

US Senator Patrick Leahy (D-VT) is chair of the Senate Judiciary Committee. Sen. Leahy has scheduled a hearing on "Conflicts between State and Federal Marijuana Laws" for Sept. 10, 2013. The witness list and other details are available via the Committee website at:
http://www.judiciary.senate.gov/hearings/hearing.cfm?id=094c28995d1f5bc4...

This hearing comes on the heels of the release of an official guidance memo from the Department of Justice to US Attorneys around the country clarifying the DOJ's position on successful marijuana legalization initiatives in Colorado and Washington as well as legalization efforts in other states. The news release announcing the memo is at
http://www.justice.gov/opa/pr/2013/August/13-opa-974.html

The guidance memo itself is available from
http://www.justice.gov/iso/opa/resources/3052013829132756857467.pdf

While the real impact of the DOJ's memo has yet to be seen, the fact that they have chosen to not interfere with or stop the implementation of marijuana regulation programs in Colorado and Washington is seen by most as a positive step toward real reform and an end to prohibition.

Basic data and other information regarding marijuana generally can be found at
http://www.drugwarfacts.org/cms/Marijuana

Basic data and other information regarding medical marijuana can be found at
http://www.drugwarfacts.org/cms/Medicinal_Cannabis

Issue In Focus 2: Drug Policies and HIV in the Russian Federation

The Russian Federation recently announced that it hopes to put billions of additional dollars into drug treatment. The publication Russia Beyond The Headlines reported on July 5, 2013:

"The Federal Narcotics Turnover Control Service (FSKN) has admitted that the state is facing an uphill battle against drug addiction and is planning to enlist help from private rehab centers. FSKN has requested a record 180 billion rubles ($5.4 billion) for the program.
"Russia’s state-owned, specialized rehabilitation clinics have only 1,730 beds. Meanwhile, FSKN statistics put the number of the nation’s drug addicts at 7-8 million, of whom some 600,000 are officially registered.
"The central idea behind the national rehabilitation system is to involve private institutions in treating addicts, because the state lacks the requisite resources. Almost 180 billion rubles ($5.4 billion) has been requested for the program.
"Around 500 organizations capable of accepting up to 20,000 patients can count on public cash, including faith-based centers, private clinics providing paid services, and public organizations.
"The money is supposed to reach addicts via special rehabilitation certificates. To obtain one, a potential program participant will have to sign a contract with an FSKN-certified rehab center and a state authority responsible for patronage (such as a social service agency or the police)

http://rbth.ru/society/2013/07/05/russia_to_spend_billions_to_help_recov...

Beyond the question of whether the requested funds will ever be made available, or whether the numbers are valid, the problem is that not all drug treatment is the same. Some methods are less successful than others, and the Russian Federation is notorious for its backward, ineffective approaches to drug treatment. The problems go well beyond the fact that substitution treatment with methadone or buprenorphine is banned in Russia. The Russian approach to drug treatment, called "Narcology," is brutal and harsh. The Eurasian Harm Reduction Network pointed out in 2012 that:

"The inaccessibility and poor quality of services pertaining to the treatment of drug dependence in Russia have been extensively documented. Treatment methods reported include flogging, beatings, punishment by starvation, long-term handcuffing to bed frames, 'coding' (hypnotherapy aimed at persuading the patient that drug use leads to death), electric shock, burying patients in the ground and xenoimplantation of guinea pig brains62. The practice and acceptance of such methods clearly indicate that the government’s approach does not correspond to international drug treatment guidelines.
"Such methods are not only cruel but ineffective. As the Russian Federal Drug Control Service has acknowledged, over 90% of drug treatment patients return to using illegal drugs within one year63. As a result of the ineffective government approach to drug treatment and care, Russia has one of the largest numbers of people who use drugs—government estimate reaches 5 million64, while UNODC’s 2009 World Drug Report estimated that 1.6 million people use opiates65. Meanwhile, the number of people living with HIV in Russia continues to rise; in 2010 alone, a total of 58,633 new HIV cases were officially registered in the country66. Injecting drug use has long been the predominant risk factor, with around 80% of all HIV cases registered in the country from 1987 to 2008 associated with the use of injecting drugs67. The government’s refusal to respond adequately to the main transmission risk means that most of the funding goes to the management of the consequences rather than prevention of new infections. It is clear that 3% of the entire budget cannot possibly reach the most vulnerable population in an effective manner, and even the 3% spent on prevention is spent inefficiently."
Source: Merkinaite, S. A war against people who use drugs: the costs. Eurasian Harm Reduction Network (EHRN), Vilnius: 2012, pp. 21-22.
- See more at: http://www.drugwarfacts.org/cms/?q=node/1245#sthash.cFLKW1xu.dpuf

As the US slowly begins to embrace harm reduction and drug policy reform we must keep sight of the fact that other nations may not be as advanced, so reformers need to work even harder to spread knowledge and get out the facts.

Notable New Facts

(Prevalence of Current Illicit Drug Use in the US, 2012)
"• In 2012, an estimated 23.9 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 9.2 percent of the population aged 12 or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically.
"• The rate of current illicit drug use among persons aged 12 or older increased from 8.1 percent
in 2008 to 9.2 percent in 2012. The rate in 2012 was similar to the rates in 2009 to 2011
(ranging from 8.7 to 8.9 percent), but it was higher than the rates in the years from 2002 to
2008 (ranging from 7.9 to 8.3 percent)."
Source: Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 1.
- See more at: http://www.drugwarfacts.org/cms/node/2593#sthash.uNPHiJSE.dpuf

(Prevalence of Injection Drug Use in Russia, 2012) "Russia has the largest population of injecting drug users (IDUs) in the world — an estimated 1·8 million people. More than a third have HIV; in some regions, the proportion is nearer to three-quarters. Astonishingly, an estimated 90% of Russian IDUs have hepatitis C, and most patients co-infected with HIV and tuberculosis in Russia are drug-dependent."
Source: Talha Burki, "Russia’s drug policy fuels infectious disease epidemics," The Lancet, Vol. 12, April 2012, p. 275.
- See more at: http://www.drugwarfacts.org/cms/node/3425#sthash.UV7UqfBU.dpuf

(Russian Antidrug Strategy) "In June 2012, the government launched the 'State Counternarcotics Strategy until 2020' that calls all agencies and all levels of government to join in the fight against illicit drugs. The Strategy urges improvements in supply and demand reduction, and outlines new legislation aimed at deterring drug trafficking. An important development in implementing the Strategy in 2012 was the signing in March by then-President Medvedev of a law stipulating life sentences for trafficking large quantities of drugs. Previously, the maximum sentence was 20 years. The law also allows for the confiscation of property and money obtained by drug dealing."
Source: United States Department of State Bureau for International Narcotics and Law Enforcement Affairs, "International Narcotics Control Strategy Report: Volume I: Drug and Chemical Control (Washington, DC: March 2013), p. 277.
- See more at: http://www.drugwarfacts.org/cms/node/3013#sthash.ROXjtzpR.dpuf

(Russian Policing Practices Violate Health and Individual Rights) "In the three Russian cities participating in this study, we found policing practices targeting injecting drug users (IDUs) to violate health, as well as individual rights. The brutality of police practices violate health directly, but also indirectly through the reproduction of day-to-day social suffering, which in turn can be internalized as self-blame, lack of self-worth, and fatalism regarding risk. These findings illustrate how law enforcement practices, particularly extrajudicial practices, generate an atmosphere of fear and terror, which shapes everyday practices of risk avoidance and survival among IDUs. Policing practices contribute to the reproduction and experience of stigma, and linked to this, a sense of fatalistic acceptance of risk, which may become crucial in shaping health behaviour, including HIV prevention. Yet we also identify nonconforming cases of resistance to such oppression, characterised by strategies to preserve dignity and hope. This leads us to consider how hope for change provides an important resource of risk reduction as well as escape, if only temporarily, from the pervasiveness of social suffering."
Source: Sarang, Anya, Rhodes, Tim, Sheon, Nicolas, and Page, Kimberly, "Policing Drug Users in Russia: Risk, Fear, and Structural Violence." Subst Use Misuse. 2010 May; 45(6): 813–864. doi: 10.3109/10826081003590938
- See more at: http://www.drugwarfacts.org/cms/node/1245#sthash.6TGwMdM1.dpuf

(Deficiencies in Russian Demand Reduction and Treatment Services) "The Russian government addresses demand reduction and drug abuse prevention in the State Counternarcotics Strategy. The Strategy outlines ongoing deficiencies in the demand reduction system, including insufficient medical treatment and social rehabilitation services, a shortage of specialized workers (doctors and social workers) and a shortage of centers serving drug abusers. At present, there exist only four state-run and 70 non-governmental organization (NGO) centers for rehabilitation of drug addicts. The few government-supported drug addiction treatment programs that do exist are generally ineffective, with high rates of recidivism. Most drug replacement therapies, such as methadone, are illegal in Russia, although treatment centers in St. Petersburg and Orenburg are implementing a few new models of cognitive therapy which expand the breadth of substance abuse programs and rehabilitation. A new medication-assisted therapy study on Naltrexone abuse, supported by the United States and Russian governments, is ready for publication. The Russian Orthodox Church continues to operate approximately 40 faith-based rehabilitation centers."
Source: United States Department of State Bureau for International Narcotics and Law Enforcement Affairs, "International Narcotics Control Strategy Report: Volume I: Drug and Chemical Control (Washington, DC: March 2013), p. 278.
- See more at: http://www.drugwarfacts.org/cms/node/1245#sthash.6TGwMdM1.dpuf

(Legal and Policy Barriers to Harm Reduction and Disease Prevention Services in Russia) "The main reasons cited for restricting the opportunity of drug users to obtain medical and social aid, including prevention services, are the legislative barriers and official policy course that emphasizes reducing supply through law enforcement and reducing demand by promotion of 'healthy lifestyle'. The Strategy of the Anti-Narcotic Policy of the Russian Federation until 202061 and the plan to implement the strategy reaffirmed that approach. The 10-year plan restricts all activities and advocacy associated with harm reduction and other evidence-based services for people who use drugs. OST [Opioid Substitution Treatment] and NSPs [Needle and Syringe Exchange Programs] are considered antithetical to the strategy because they are 'attempts to legalize substitution therapy with use of narcotic drugs and promotion of drug use under pretext of syringe replacement'. Non-governmental organizations (NGOs) are prohibited from providing information on OST and other treatment and prevention measures opposed by the government. Such restrictive policies clearly indicate that the punishment and social isolation of people who inject drugs is the basis of state’s strategic approach to drug demand reduction. These policies have high financial and social costs."
Source: Merkinaite, S. A war against people who use drugs: the costs. Eurasian Harm Reduction Network (EHRN), Vilnius: 2012, p. 21.
- See more at: http://www.drugwarfacts.org/cms/node/1245#sthash.OBIf3hne.dpuf

(Global Burden of Disease, Mental Health, and Substance Use Disorders) "In 2010, mental and substance use disorders accounted for 183·9 million DALYs [Disability-Adjusted Life Years] (95% UI 153·5 million–216·7 million), or 7·4% (6·2–8·6) of all DALYs worldwide. Such disorders accounted for 8·6 million YLLs [Years of Life Lost] (6∙5 million–12∙1 million; 0·5% [0·4–0·7] of all YLLs) and 175∙3 million YLDs [Years Lived with Disability] (144∙5 million–207∙8 million; 22·9% [18·6–27·2] of all YLDs). Mental and substance use disorders were the leading cause of YLDs worldwide. Depressive disorders accounted for 40·5% (31·7–49·2) of DALYs caused by mental and substance use disorders, with anxiety disorders accounting for 14·6% (11·2–18·4), illicit drug use disorders for 10·9% (8·9–13·2), alcohol use disorders for 9·6% (7·7–11·8), schizophrenia for 7·4% (5·0–9·8), bipolar disorder for 7·0% (4·4–10·3), pervasive developmental disorders for 4·2% (3·2–5·3), childhood behavioural disorders for 3·4% (2·2–4·7), and eating disorders for 1·2% (0·9–1·5). DALYs varied by age and sex, with the highest proportion of total DALYs occurring in people aged 10–29 years. The burden of mental and substance use disorders increased by 37·6% between 1990 and 2010, which for most disorders was driven by population growth and ageing."
Source: Harvey A Whiteford, Louisa Degenhardt, Jürgen Rehm, Amanda J Baxter, Alize J Ferrari, Holly E Erskine, Fiona J Charlson, Rosana E Norman, Abraham D Flaxman, Nicole Johns, Roy Burstein, Christopher JL Murray, and Theo Vos, "Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010," The Lancet, 29 August 2013(Article in Press DOI: 10.1016/S0140-6736(13)61611-6).
- See more at: http://www.drugwarfacts.org/cms/node/3458#sthash.pBuFdwcq.dpuf

Notable New Sources

Source: Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.

Talha Burki, "Russia’s drug policy fuels infectious disease epidemics," The Lancet, Vol. 12, April 2012.

Sarang, Anya, Rhodes, Tim, Sheon, Nicolas, and Page, Kimberly, "Policing Drug Users in Russia: Risk, Fear, and Structural Violence." Subst Use Misuse. 2010 May; 45(6): 813–864. doi: 10.3109/10826081003590938.

Merkinaite, S. A war against people who use drugs: the costs. Eurasian Harm Reduction Network (EHRN), Vilnius: 2012.

Harvey A Whiteford, Louisa Degenhardt, Jürgen Rehm, Amanda J Baxter, Alize J Ferrari, Holly E Erskine, Fiona J Charlson, Rosana E Norman, Abraham D Flaxman, Nicole Johns, Roy Burstein, Christopher JL Murray, Theo Vos, "Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010," The Lancet, 29 August 2013 (Article in Press DOI: 10.1016/S0140-6736(13)61611-6).

Media

Drug Truth Media: DWF Editor Doug McVay wrote and produced video and audio segments for DrugTruth Network this past month:
Audio:
Century Of Lies show, Aug 25, 2013 - Hempfest Special written and produced by Doug McVay
http://www.drugtruth.net/cms/node/4481
420 Drug News, September 3, 2013 - Commentary on DOJ's guidance memo regarding marijuana legalization by states http://www.drugtruth.net/cms/node/4512
Video:
Unvarnished Truth #17: http://youtu.be/gPeJC6Amym8?t=55m23s

Doug McVay was also quoted in this article from Huffingtonpost: War On Drugs Failure Gives Way To Treatment In States, Cities, Aug 22, 2013
http://www.huffingtonpost.com/2013/08/22/war-on-drugs-treatment_n_379244...

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