In a bid to promote opiate maintenance therapy behind bars, the British government has begun installing methadone vending machines in the country's prisons. Justice Minister Phil Hope told parliament last week that 57 vending machines have been installed so far.
Reviewed: "Andean Cocaine: The Making of a Global Drug," by Paul Gootenberg (2008, University of North Carolina Press, 442 pp, $24.95 PB)
Regardless of what you may think about cocaine -- party favor or demon drug -- one thing is clear: Cocaine is big business. These days, the illicit cocaine industry generates dozens of billions of dollars in profits annually and, in addition to the millions of peasant families earning a living growing coca, employs hundreds of thousands of people in its Andean homeland and across Latin America, and hundreds of thousands more in trafficking and distribution networks across the globe.
In a break with the Bush administration, Justice Department officials called Wednesday for the first time for Congress to pass legislation that would undo the vast disparities in sentences for those convicted of crack and powder cocaine possession offenses. For years, drug reformers, civil rights groups, and even the US Sentencing Commission have called for the disparities to be undone, saying they have had a racially disproportionate impact on poor and minority communities.
President-elect Barack Obama met Monday with Mexican President Felipe Calderón to discuss bilateral issues of major importance for the two countries. In addition to NAFTA and immigration policy, Mexico's ongoing plague of prohibition-related violence was high on the agenda.
Ed. Note: The following is part of a recent blog entry giving the latest details on a fascinating local vs. federal battle over the question of whether or not we should have an open debate on the drug war, followed by a full article giving the full background to the story. Both pieces are from StoptheDrugWar.org
Amidst the continuing furor of anti-drug polemics and hysterics, it's easy to make the casual observer forget one of the basic realities of this issue: Most people who use drugs are okay. For most of the people who use drugs, it's OK that they are using drugs. We may legitimately worry about those who truly have problems with their drug use, and the people they may affect; we legitimately worry about the consequences of the illicit trade in drugs -- which is to say, the consequences of prohibition. And we would like to see the drug trade made less accessible to children.
But when one faces facts straight on, they say a simple thing: Most people who use drugs are okay. If results are what count, in most cases it's okay that people are using drugs. Not in all cases, to be sure. But in most cases.
Certain types of civil disobedience can illustrate the pointlessness of criminalization of drug use in a vivid enough way to be both noticed and understood. Members of the European Parliament Marco Cappato of Italy and Chris Davies of Great Britain accomplished this three years ago when they presented themselves to police in the London suburb of Manchester with minute quantities of marijuana attached to the back of a couple of postage stamps, getting arrested in the process. Cappato and Davies weren't even using the marijuana, it wasn't even enough to be used, they clearly were not menacing society in any way, they are highly respectable citizens. Yet it was enough to get them sent to jail in handcuffs. That is an effective demonstration of the pointlessness of criminalization.
Drug reformers in the formerly Communist nation of Hungary are doing something similar right now. Roughly 30 of them have turned themselves in as drug users to Budapest and other city police headquarters since the beginning of April. Among them was a famous novelist who is also grandmother -- clearly not a threat to society. Police are being forced to arrest these people and make the law look ridiculous in the process. It is fueling discussion, not only about casual use of marijuana but also how society deals with the truly problematic drug users. It is raising the issue of the unlucky ones who get caught and might not get a lenient sentence. It may well help to change the country's drug laws.
The criminalization of responsible drug users is only one of the many pointless aspects of drug prohibition. Criminalization of the trade in drugs itself is also pointless, though for more complex reasons that involve economics, public health and many other factors. But criminalization of users is pointless on its face. People may miss that obvious point a lot of the time. But they are capable of grasping it, without a lot of effort, if it is pointed out in a clear and compelling manner.
I believe they can understand the rest of it too. As New Mexico's former governor, Gary Johnson, has put it, support for the drug war is a mile wide but an inch deep. Our drug policies are so far off-base, with such serious consequences, it isn't that hard to get a lot of people, perhaps most, to understand at a minimum that some things are wrong. Prohibition is pointless, but our efforts to end it need not be.
Last week witnessed the conclusion of a sad chapter in an ongoing saga; the sentencing of Dr. William Hurwitz, a well-known physician specializing in pain management, to 25 years in prison and a $2 million fine for purported drug dealing involvement.
Supporters of Dr. Hurwitz say that his decision to treat pain aggressively with opioids (narcotics), in the way he did, derived from an ethical principle applied to its logical conclusion. Physicians are obligated by their medical oath to properly treat pain, which in general means relieving to the best feasible extent. To deny a patient adequate pain treatment is "tantamount to torture," in Hurwitz' own words. If you treat pain, then some of the people seeking opioid prescriptions from you inevitably will turn out to be drug diverters or abusers. But it is unethical to punish actual pain patients -- to torture them by denying them medicine -- just because such people are out there. So Hurwitz chose to err on the side of prescribing for pain rather than not doing so. Because his ethics, and his interpretation of them, required him to do so, drug warriors notwithstanding.
I agree with those ethics. It may be that reasonable people can believe that some degree of non-treatment of real patients should be risked in order to "balance" that priority with the priority of diversion control. I don't agree with that -- partly because denial of pain treatment really is torture, in my opinion -- and partly because I understand that the economics of the drug trade and prohibition renders diversion control ineffective regardless. If we can get to a point where a debate on the issue is taking place at that level, I'm not going to call anyone unreasonable who is rationally and sincerely trying to sort it out. But I agree with Hurwitz on this point.
I also believe that Dr. Hurwitz is in fact innocent. No actual evidence was ever presented that he knew that any of his patients were diverting or abusing drugs. And as one of the few people in the world holding both a medical degree and a law degree, Hurwitz would have been readily able to earn millions of dollars per year; a financial motive for the crimes of which he was accused simply did not exist. But whether my faith in Dr. Hurwitz is on target or not, even that may ultimately only have secondary importance.
There are two primary issues at stake. One is that it should have been doctors who decided whether Hurwitz had acted properly, but was not. Russell Portenoy, one of the world's top pain specialists, moved the issued forward this week by saying as much to the Los Angeles Times.
The other is the sheer lack of ethics displayed by prosecutors, by their witnesses, and sadly even by the judge himself, Leonard Wexler. I have it on good authority that the prosecutor arguing for a life sentence yesterday lied repeatedly during his performance. The judge invoked a tape he claims he saw, but which was never entered into evidence, to justify harsh treatment of Hurwitz. For a variety of reasons this is not very plausible. But even if it turns out to be true, it would still conflict with the spirit (albeit not the letter, perhaps) of the Supreme Court's recent pronouncements on these issues.
A witness for the prosecution, an addict in recovery, told of how he squandered his whole inheritance on drugs, conjuring the image of hundreds of thousands of dollars if not millions down the drain. He didn't mention, nor did anyone, that it was a mere $20,000, a lot to him perhaps but not a lot. Prosecutors leveraged their power to prosecute that individual and others, in order to get them to testify against Hurwitz in exchange for leniency -- a practice that courts have called bribery, though the Supreme Court ultimately did not uphold that. But the unreliability of testimony made under such duress is clear, and it is unethical to use it or allow it.
Most seriously, the prosecution's medical witness gave testimony that six of the leading experts on pain treatment characterized as "misleading" and even "absurd" in a letter they sent to the judge. But that letter was never shown to the jurors. How dare Judge Wexler withhold exculpatory information of fundamental importance to the case from the jurors? It may be that sharing the letter with the jurors would have been unusual and something that courts don't like to do. But given who that letter came from and the nature of its content, I can conceive of no moral justification for withholding such information from jurors regardless of usual procedures. There must have been some appropriate way for Judge Wexler to get them that information, and that's what he ethically had to do, but did not do.
The Hurwitz case is high profile. But such violations of decency occur all the time, in the countless more ordinary cases being thrust through the system every day. The courts have hence become institutions not to be respected, but rather feared and condemned. It is not good enough for the courts to do the right thing, to protect us from dangerous criminals and enact legitimate justice, but to do so only some of the time. The courts must make all reasonable efforts to maintain and enforce the highest moral and ethical standards at all times. But they lack the will, and perhaps the desire, to do so.
The courts are in a moral fog, unable to discern right and wrong in their own actions, while sitting in judgment on others. It is time not only to oppose and criticize injustice, but to stand against it. Ethics requires that of us too.
The Honorable Judge Leonard D. Wexler
United States District Court
Eastern District of Virginia, Alexandria Division
401 Courthouse Square
Alexandria, VA 22314
Re: United States v. William Eliot Hurwitz, 03-CR-467-ALL (LDW)
Dear Judge Wexler:
I am writing to express concern about comments made by Ralph Craft, foreman of the Hurwitz case jury, which appeared in the Dec. 21, 2004 edition of the The Washington Post. Mr. Craft's remarks indicate the jurors fundamentally misconstrued both the legal and medical issues involved in the case. I have observed the pain issue and worked with pain patients, physicians and their advocates for 10 years and am well versed in the issue.
Mr. Craft told the Post that, "legitimate doctors out there don't prescribe anywhere close to what Hurwitz did."
However, the dosage which, according to the Post, "astounded" Craft, 1,600 5mg oxycodone pills, adds up to 8 grams daily, of a medication equivalent in its potency to morphine. According to Dr. Russell Portenoy, Chairman of the Department of Pain Medicine and Palliative Care at Beth Israel Medical Center, "[i]n clinical practice, the range of opioid doses required by patients is enormous" and "[d]oses equivalent to more than 35g morphine per day have been reported in highly tolerant patients. ..."
The 35 grams Dr. Portenoy, one of the world's leading pain specialists, finds appropriate in some cases, is more than four times the dosage Mr. Craft and presumably other jurors believed was impossibly large -- a serious misconception that appears to have played a major role in the convictions.
Mr. Craft also told the Post that Dr. Hurwitz "wasn't running a criminal enterprise." However, the charges of which he and other jurors voted to convict Dr. Hurwitz are clearly intended to apply to persons involved in major criminal enterprises. That Mr. Craft and perhaps other jurors could understand that Dr. Hurwitz did not run a criminal enterprise and yet convict him for running a criminal enterprise, suggests they were either unable, unwilling, or inadequately prepared to properly interpret the charges on which they were deciding.
Given the multiple, fundamental errors made by jurors, I believe your legal and moral obligation is to reverse the convictions and release Dr. Hurwitz immediately. Short of that, I urge you at least to use the discretion afforded by the recent Booker/Fanfan Supreme Court ruling to sentence reasonably, and sentence Dr. Hurwitz to time served when he appears before you this week. Since the jurors themselves did not believe Dr. Hurwitz ran a criminal enterprise, it would be unreasonable to hand down a sentence Congress intended for leaders of criminal enterprises.
Thank you for taking my points into consideration. I will be attending the April 14 sentencing hearing in support of Dr. Hurwitz, pain patients, and all enlightened physicians who wish to treat them. I believe this is a matter of the utmost moral gravity and that history will watch and remember the actions you take that day.
It was the talk of the airwaves today: Congress held hearings on steroid use in professional baseball, with sports stars like Mark McGwire and Sammy Sosa subpoenaed to be there. Is steroid use wrong? Can baseball police itself? Are congressmen seeking the public good or just grandstanding? Should the issue lie within Congress' purview at all? Numerous participants in the public debate have opined on the issue, and it will no doubt continue to be talked about for months or more likely years to come.
The most emotion-laden argument heard is that of the superstar athlete as role model for the nation's youth. One of the witnesses at the hearing was a grieving father whose son committed suicide, it is believed, as a result of withdrawal from anabolic steroid use. If kids get the idea that steroids can make them excel at sports, maybe even make the major leagues, more kids will use them and more such tragedies will be the result, is the idea. There may or may not be a lot of truth to the notion – it is notably difficult to sort fact from fiction on matters involving drugs and especially drugs and kids. But let's assume for the sake of argument that there is at least some truth to it. There probably is at least a little.
All the more reason Congress was wrong to do what it did this week. If there were any young people in America who didn't know that steroids can enhance one's athleticism, they almost certainly know it now. Along with thinking about the policy and social issues, some young people are now thinking, more than they were before, about whether or not to take steroids. It is an inevitable chain of events whenever politicians or the media draw attention to a drug. Though I do not know whether steroid use will increase as a result of the hearings, I would not be surprised by that. Whereas I would be surprised if the hearings directly or indirectly caused steroid use to drop. That's just not the way these things tend to work out.
Anyone interested in this issue should read "How To Launch a Nationwide Drug Menace", chapter 44 of the 1972 classic, The Consumers Union Report on Licit and Illicit Drugs. The chapter traces the evolution of glue sniffing from an obscure habit in 1959 to a major national phenomenon by the early 1960s. Anyone hurt or concerned by the harms wrought by drugs on some of their users ought to be disheartened by that story's similarities to today's steroid brouhaha. Will publicity from Congress' unintended advertising of steroid use serve to drive use up?
Time will tell, but if history is any guide, the answer is probably yes. And I for one was not interested in yet another demonstration of what not to do. Unfortunately, history likes to repeat itself. One more nationwide drug menace in the making.
Years after candidate George Bush's non-answers to questions about his possible drug past fueled controversy and a sense that he indeed had such a past, proof for some of it at least has at last emerged. Taped excerpts from a conversation, released by the author of a new book, reveal the future president essentially admitting to past marijuana use and explaining why he would never acknowledge it in public.
On one level, the educated reaction to this news is something along the lines of, "So what?" Tens of millions of Americans have used marijuana during their lives. It wasn't a big deal for most of them. Even the more dangerous drugs aren't a problem for most of their users – that's not the strongest argument for legalization of them, but it's true. All the more so for marijuana. Bill Clinton used marijuana. Al Gore used marijuana. It did not and should not have disqualified them from the nation's top job. Nor does it disqualify George Bush.
On other levels, however, the information is troubling, for two reasons. One is that candidate Bush criticized his opponent, Al Gore, not for having used marijuana but for having admitted to it. "I want to lead," he explained on the tapes, and "I don't want some little kid doing what I tried." He couldn't criticize Gore for having used drugs because he had also used drugs. So instead he criticized him for being open and truthful.
There is a level on which one could legitimately hold that it is counterproductive for kids to be keenly focused on the drug use of famous role models; this is an area on which reasonable people can hold varying points of view. But the way to accomplish that would be through legalization and treating private drug use as not a big deal. And that is not what George Bush has advocated.
Which leads us to the second reason, one of hard policy. As governor, Mr. Bush escalated sentences for some drug offenses, putting other people in prison for longer time periods for things that he himself had done or supported. As president, under his authority the federal government has targeted medical marijuana cooperatives, escalated the war on pain doctors, campaigned against drug policy reform initiatives or legislation, promoted drug testing and vastly overreaching drugged-driving laws, gone to court against any reform to drug policy that it could no matter how modest.
So if marijuana use in the distant past is not relevant to judging the president, hypocrisy on the drug issue is very relevant. And if not being open or candid about one's own youth is not exactly the same as lying to children, it verges on that. Not to suggest that his predecessor and failed opponents have stellar records on the issue by any means; they most certainly don't. But they're not president right now.
So if it is unimportant that George Bush used marijuana, it is kind of sad that he opposes honesty about it. And it is very sad that he continues to support cruel and repressive drug policies – policies which could have ruined his life if they had been in place back then, but realistically only in theory.
I am glad, therefore, that now there is proof of George Bush's drug use. If only by providing one more bit of rhetorical ammunition, it will make it slightly harder for the drug warriors to continue to escalate their pogrom against the American people.