| February 11, 1998 #033 | ||||||||||||||||
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A DrugSense publication | ||||||||||||||||
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Table of Contents
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FEATURE ARTICLE (Top) | ||||||||||||||||
The Hepatitis C Epidemic- Implications for Drug Policy: Part I
~ by Tom O'Connell, M.D. and Joey Tranchina, M.A. | ||||||||||||||||
Hepatitis, literally "inflammation of the liver," is a term now reserved
for viral infections as opposed to inflammation caused by other agents,
such as bacteria, parasites, or chemicals. As with any illness, knowledge
of hepatitis has accumulated incrementally. After long suspecting a virus,
research initially identified two diseases caused by different viruses;
Hepatitis A (HVA) usually acquired through the intestinal tract and
Hepatitis B (HVB) usually acquired parenterally (by injection or
inoculation directly into tissues).Immunity to both viruses is usually
complete and both can be transmitted by sexual activity during the active
phase. The clinical course is similar, except that HCA is usually much
milder. Because some patients seemed to have a third form of hepatitis, a
third virus, referred to for years as "non A-non B," was suspected. That
suspicion was confirmed In 1989 by discovery of the Hepatitis C virus
(HCV). A number of variants or sub-types have since been identified.
Further research has characterized the disease complex caused by HCV more
completely; the accumulated information has great significance for not only
for injecting drug users, but all concerned with either public health or
drug policy. | ||||||||||||||||
HCV, the Illness | ||||||||||||||||
Most of the estimated 4,000,000 Americans with HCV face a far more
insidious illness than that produced by either A or B. While the initial
infection may be mild and without jaundice, recovery for 85% of patients is
incomplete and the virus establishes long-term residence in their blood,
liver, and other organs. The symptoms produced by this chronic infection
range from none at all to debilitating. There also seems to be increased
susceptibility to many other illnesses, particularly auto-immune diseases.
Finally, a significant percentage develop chronic active hepatitis, which
may lead eventually to cirrhosis (dense scarring) of the liver decades
later, particularly in heavy users of alcohol. Hepatitis C induced
cirrhosis is now the most frequent indication for liver transplantation in
the United States. A significant percentage also develop liver cancer
(hepatoma). | ||||||||||||||||
Spread of HCV | ||||||||||||||||
HCV is can be spread to susceptible patients by inoculation of contaminated
blood or tissue fluid. A collateral benefit of identifying HCV is that we
can now screen donor blood and have thus nearly eliminated spread via
transfusion or blood products. Spread to and from health workers is
possible, but is minimized when standard procedures (including gloves) are
used. Injecting drug users (IDUs), who now constitute the largest reservoir
of HCV in the general population, also represent the most important mode of
spread, although sexual and placental transmission occur rarely. Far
hardier than HIV and more abundant in host blood, HCV is much more easily
transmitted via contaminated needles and syringes. Most importantly, it can
be transmitted by seemingly trivial blood contamination occurring when
infected and non-infected drug users "shoot up" together, even though they
may not directly share either needles or syringes. | ||||||||||||||||
The implications of this latter observation are critical when it is realized that the prevalence of HCV infection among injection drug users (IDUs) in the United States has been tested at 100% in at least one group (Anchorage, AK) and is estimated to be over 80%, nationally. A Seattle study estimates that novice drug injectors face a 30% risk of HCV the first time they use, if assisted in any way by an established IDU. | ||||||||||||||||
Beyond injection, there is evidence that communal snorting of cocaine or
heroin, when sharing the device used for snorting, allows enough
blood-to-blood contact to transmit the disease. The risks of communal
snorting are not as great as communal injecting and haven't been
quantitatively assessed, but are significant. | ||||||||||||||||
Thus, the challenge is to educate two populations: established users and
potential users. All who have engaged in "risky behavior" at any time
should be tested and adapt their behavior accordingly, The degree to which
paraphernalia laws and non-availability of sterile equipment favor
transmission of HCV is obvious. The problem with HCV, as opposed to HIV is
more nearly one of quarantine, i.e. of confining the disease to those
already infected. | ||||||||||||||||
The mode of transmission of HCV should be a powerful argument against novice experimentation with drug injection, but it's an argument which can only be made in a setting of knowledge endorsed my recognized public health authorities. So far, there has been no evidence of any such focused campaign even being considered by the federal government, despite recent allocation of $195 million for standard drug war propaganda. The price we are paying for doctrinaire paraphernalia laws is an opportunity to offer an intelligent reason to "just say no," as well as knowledge that would allow those who refuse to say "no" to at least change their behavior. | ||||||||||||||||
Readers are invited to apply the principles of harm reduction in an
epidemic of this nature. We will explore the changing roles for and
increased demands upon harm reduction/NEP in Part II. | ||||||||||||||||
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WEEKLY NEWS IN REVIEW (Top) | ||||||||||||||||
Domestic News | ||||||||||||||||
Medical Marijuana MEDICAL MARIJUANA: DOING THE SCIENCE | ||||||||||||||||
COMMENT: (Top) | ||||||||||||||||
Thanks to Carl Olsen, we have this informative interview,
originally published in Synapse in Nov. '97. It covers, in comprehensible
language, important insights underlying current research in the mechanisms
of cannabis modulation of pain. The entire interview should be downloaded
and archived. Hopefully, the last exchange between the interviewer and the
researcher (IM) may stimulate you to do this: | ||||||||||||||||
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IM: (laughs) A little bit. One part is people calling up wanting to
know how they can get this drug to help them, because there are a
lot of people with really severe chronic pain for whom nothing to
this point has worked. So we've gotten some calls like that. Then
you've got reporters calling, wanting to know how it affects the
whole political debate. | ||||||||||||||||
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IM: My line is that it should be legal. It definitely should be
legal for people who need it to help with an illness or a disease
like chronic pain or epilepsy. And cannabis can really help.
Basically the science is just showing that there are very specific
mechanisms by which the cannabis can help. People are taking this
as a medicine, and for very specific reasons. It's hard to get that
point through. | ||||||||||||||||
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IM: Absolutely... It's satisfying to really do the science. | ||||||||||||||||
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The Drug War | ||||||||||||||||
DRUG SEIZURE DROP WORRIES U.S. CUSTOMS | ||||||||||||||||
COMMENT: (Top) | ||||||||||||||||
This very interesting admission points up the intrinsic
irresponsibility of classic US drug policy and the shallow nature of its
doctrinal underpinnings. Even while acknowledging for years that
interdiction is ineffective as a strategy in preventing foreign drugs from
reaching US markets, we have continued to finance a major annual
interdiction effort. | ||||||||||||||||
Since no one is prepared to argue that the dramatic fall-off in the amount of drugs seized represents a drug war "victory," one is forced to conclude that these figures, combined with the startling increase in purity of drugs sold on the street represent both a new phase in the maturation of the criminal drug market and a new low in drug warrior efficiency. | ||||||||||||||||
Agency says 84% dip in 1997 may bring backlash from Congress. | ||||||||||||||||
Officials hope that a new interdiction strategy will improve
performance. | ||||||||||||||||
SAN DIEGO--The amount of cocaine seized at the commercial ports of entry along the U.S.-Mexico border plummeted 84% in 1997, forcing U.S. Customs Service officials to develop a new drug-fighting strategy and leaving them concerned about a backlash in Congress. | ||||||||||||||||
Bill Heffelsinger, assistant to acting customs Commissioner Samuel H. Banks, said Tuesday that inspectors working at the high-risk commercial ports on the Southwest border confiscated 2,383 pounds of cocaine last year, compared to 15,114 pounds in 1996. | ||||||||||||||||
Nationwide, the quantity of cocaine seized by the agency dropped
15% last year to 159,475 pounds, compared to 187,947 pounds in
1996, Heffelsinger added. The total number of seizures by customs
agents and inspectors of all kinds of drugs was a record 26,240
nationwide last year, authorities said. | ||||||||||||||||
[snip] | ||||||||||||||||
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JUST SAY NO TO PRISON DRUG TESTING | ||||||||||||||||
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COMMENT: (Top) | ||||||||||||||||
Sheriff Hennessey's earnest confusion leads him to endorse the
right idea- reject routine testing of prisoners- but for the wrong reason.
Instead of ineffective coerced "treatment" of inmates, Hennessey favors
equally ineffective coerced "treatment" of different segments of the
population more transiently under the control of the criminal justice
system. This is a classic example focusing on the deck chairs while the
iceberg looms. What else is new? | ||||||||||||||||
The "unbearable taxpayer costs" the Sheriff refers to could be avoided
altogether by not incarcerating drug users. | ||||||||||||||||
By Michael Hennessey | ||||||||||||||||
A couple of weeks ago, front page headlines said,"President Clinton to
Reduce Drug Use in Prison." The president's policy calls for states to drug
test inmates and to report annually on drug use in prisons. This policy
might sound good, but it is misguided and it doesn't enhance public safety.
It may even hurt crime prevention by diverting funds from more effective
programs, such as drug treatment. Getting people to stop using drugs in
prison is not nearly as important as stopping them from using drugs outside
of prison. | ||||||||||||||||
The White House contends that"coerced abstinence" while in prison will reduce the addicts's demand for drugs after release. Ricdiculous! Does the absence of heterosexual relationships in prison lessen a prisoner's interest in sex after release from prison? I don't think so.[snip] | ||||||||||||||||
The National District Attorney's Association, commenting on the Califano
Report, stated: "Simply warehousing prisoners, without regard to addressing
and dealing with the underlying problem of substance abuse, produces
unbearable taxpayer costs."[snip] | ||||||||||||||||
Michael Hennessey is the sheriff of the City and County of San Francisco.
His pioneering efforts to rehabilitate prisoners include education and
substance abuse recovery programs. | ||||||||||||||||
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OPIOIDS DEATHS FROM HEROIN OVERDOSE ARE PREVENTABLE | ||||||||||||||||
COMMENT: (Top) | ||||||||||||||||
The harm reduction implications of this study are inescapable:
Not only would relaxed paraphernalia laws reduce the spread of AIDS from
injection drug use, easier access to Narcan would save many people who
currently die of heroin overdose. | ||||||||||||||||
A thousand deaths from heroin overdose each year could be prevented in Britain if emergency resuscitation drugs were supplied to addicts and their close contacts, according to a report presented to the Royal College of Psychiatrists' winter meeting last week. | ||||||||||||||||
Professor John Strang, director of the National Addiction Centre at the Maudsley Hospital in London, suggested that premature deaths from drug overdoses account for the increased mortality among opiate addicts. A survey of heroin addicts in south London showed that over half of those undergoing treatment had overdosed in the past. These overdoses, however, were rarely suicide attempts. | ||||||||||||||||
[snip] | ||||||||||||||||
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COCAINE | ||||||||||||||||
FETAL 'CRACK' EXPOSURE: EFFECTS QUESTIONED | ||||||||||||||||
COMMENT: (Top) | ||||||||||||||||
This news article concludes that the original "crack baby" scare stories were greatly exaggerated, but holds out the possibility that intrauterine exposure might have subtle detrimental effects which haven't yet become clear. By implication, these effects would have to be less that those of alcohol and tobacco which have already been well documented. As usual. there is reluctance to emphasize the relatively good news about a demonized drug along with the need to emphasize potential bad news. | ||||||||||||||||
NEW YORK (Reuters) -- Initial reports of permanently damaged "crack
babies" may have been greatly exaggerated, according to pediatric
researchers. However, they caution that the long-term impact of
fetal cocaine exposure upon child development still remains largely
unknown. | ||||||||||||||||
Research involving over 300 newborns led experts at the University
of Florida in Gainesville, to conclude that "we have few data to
warrant the alarm that grew out of earlier reports, often fueled by
the media, of the possible devastating effects of prenatal
cocaine-exposure." [snip] | ||||||||||||||||
Standard psychological testing revealed no significant differences
in overall intellectual performance among the two groups of
newborns. However, according to Eyler, more subtle behavioral
differences emerged during subsequent testing.[snip] | ||||||||||||||||
International News | ||||||||||||||||
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MEXICO | ||||||||||||||||
CIA LINKS MEXICO'S INTERIOR MINISTER TO DRUG LORDS | ||||||||||||||||
COMMENT: (Top) | ||||||||||||||||
Given the profound depths of the corruption already (grudgingly)
revealed to affect the Mexican bureaucracy, it's doubtful that anyone who
has risen to a responsible level in the Mexican government remains above
suspicion. Still, McCaffrey, in his role as chief spokesman for the drug
war, can be counted upon to rush down to the border on cue and heap lavish
praise on the next stooge they come up with. | ||||||||||||||||
It's ironic that the CIA should be the source of these charges. Is the kettle getting a chance to play the role of pot for a change? | ||||||||||||||||
Mexico's new interior minister, the second-most-powerful official
in the country and a likely candidate for the presidency, has been
linked by the CIA to international narcotics traffickers.
Francisco Labastida Ochoa has "long-standing ties" to drug dealers
since serving as governor of the state of Sinaloa for six years,
according to a report labeled "top secret" that was obtained by The
Washington Times from agency sources. | ||||||||||||||||
[snip] | ||||||||||||||||
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US - MEXICO REACH AGREEMENT ON DRUG FIGHT
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COMMENT: (Top) | ||||||||||||||||
Whoops! As noted in the comment on the other article, | ||||||||||||||||
WASHINGTON -- The United States and Mexico announced an agreement
Friday that administration officials and outside analysts said
would help to ensure continued U.S. certification of the Mexican
anti-drug effort. | ||||||||||||||||
Coming after nearly a year of negotiation, the pact outlines broad areas of cooperation between the governments. But it lacks specific commitments and is unlikely to silence the sharp congressional criticism of Mexico's commitment, one skeptic said Friday.[snip] | ||||||||||||||||
Colombia ranks as the largest producer of cocaine that makes its
way to the United States, while Mexico serves as the leading
transportation pipeline, according to U.S. analysts. The Clinton
administration has given Colombia a failing grade the past two
years, which cost the country some U.S. financial aid. | ||||||||||||||||
The administration, however, approved Mexico's efforts despite
widespread reports of corruption among top-ranking Mexican
officials. | ||||||||||||||||
[snip] | ||||||||||||||||
McCaffrey on Friday endorsed another Mexican official who was accused of associating with traffickers. ``The Washington Times'' this week said a CIA report fingered Mexico's new interior minister, Francisco Labastida Ochoa, with ``long-standing ties'' to drug dealers when he was governor of the Mexican state of Sinaloa. | ||||||||||||||||
``I personally have no evidence of allegations of this nature that I would find compelling, and we have no intention of going to the Mexican government about allegations of this nature on this gentleman,'' McCaffrey said. ``We intend to work with him.'' | ||||||||||||||||
[snip] | ||||||||||||||||
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U. K. | ||||||||||||||||
THE DRUGS WORLD WAR - WHAT WENT WRONG? | ||||||||||||||||
In this second of a three part series, Knightley provides a valuable international overview and analysis of US drug war policy. His citing of the action of State Department Undersecretary Gelbard in scuttling the recently attempted heroin trial in Australia is far more accurate and perceptive than anything I have seen in the mainstream American media. | ||||||||||||||||
This whole series should be archived on everyone's hard drive. It should
also be circulated by fax, or by printing and mailing it to your most
resistantly Luddite friends and acquaintaces. | ||||||||||||||||
Part Two | ||||||||||||||||
The fight against drugs has been lost. Yet the US right continues
to squander vital resources on a worldwide, irrational crusade to
rein in the 'evil perpetrators' By Phillip Knightley | ||||||||||||||||
THE 25-year-old war against drugs has been lost but there are still
bitter-enders on both sides of the Atlantic who want to fight on.
Like American generals in Vietnam, they believe they see a light at
the end of the tunnel. Realists know that, rightly or wrongly, the
campaign is over. | ||||||||||||||||
Imagine a courtroom scene in Oklahoma. The prosecutor is suggesting
to the jury the sentence it should recommend for a man who has been
found guilty of possession of cannabis. "Two hundred years, two
thousand years . Just pick a number and see how many zeros you can
add on," he says. "Put this druggie away and God will bless you
all." | ||||||||||||||||
They did, and Will Foster, a computer software consultant, married with two children, is now serving 93 years for growing marijuana plants for cigarettes to relieve his chronic rheumatoid arthritis. | ||||||||||||||||
[snip] | ||||||||||||||||
What is behind the irrational passion that the United States brings
to the war on drugs? What is it that motivates one American
anti-drugs campaigner, William Bennett, to call for the beheading
of drug dealers, and the former police chief of Los Angeles to
suggest that even casual users should be taken out of the courtroom
after conviction and immediately shot? | ||||||||||||||||
[snip] | ||||||||||||||||
Ethan A Nadelmann, director of the Lindesmith Center, a New York drug-policy research institute, says: "The only reason for the failure to prescribe adequate doses of pain-relieving opiates is the "opiaphobia" that causes doctors to ignore the medical evidence, nurses to turn away from their patients' cries of pain, and some patients themselves elect to suffer debilitating and demoralizing pain rather than submit to a proper dose of drugs." | ||||||||||||||||
Such is the moral conviction of the drugs war warriors that it is
difficult to engage them in rational debate. Dr Thomas Szasz of the
department of Psychiatry at Syracuse University suggests that it is
a waste of time presenting facts to the anti-drug lobby to convince
them that the war is lost. | ||||||||||||||||
He says that the war on drugs is a mass movement characterized by
the demonising of certain objects and persons - "drugs", "addicts",
"traffickers" - as the incarnations of evil. Hence it is foolish to
dwell on the drug prohibitionist's failure to attain his avowed
aims. "Since he wages war on evil, his very effort is synonymous
with success." | ||||||||||||||||
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THE DRUGS WORLD WAR - WHAT DO WE DO NOW? | ||||||||||||||||
COMMENT: (Top) | ||||||||||||||||
This is the third and last article in an extraordinary series
printed by the Independent. Again, DrugSense readers are urged to download
and archive all three (the URLs are listed below). | ||||||||||||||||
This segment looks at the drug war as an economic phenomenon and examines some little-appreciated ways in which illegal drug money is folded back into the legal economy. It then cites several examples of modern youth ignoring false drug war doctrine and explodes, one after the other, the conventional justifications for retaining an illegal market. | ||||||||||||||||
The series ends on a weak note: although concluding that the drug war is
irretrievably lost, no coherent post prohibition model is suggested, nor is
there any mechanism suggested for forcing the ruling power structure to
acknowledge the failure of its policy or any scenario as to how this might
come about. | ||||||||||||||||
Part 3 | ||||||||||||||||
While governments wage unwinnable war against drugs, ordinary people are
facing the truth: the 'enemy' is already among us and, accepted if not
yet acceptable, is here to stay. | ||||||||||||||||
THE world war on drugs has been lost because everyone | ||||||||||||||||
At any given time some $5bn made from drugs is sloshing around the
international monetary system. Inevitably, some of it filters into
the world of legitimate finance. | ||||||||||||||||
[snip] | ||||||||||||||||
But elsewhere in Europe, experts say that City institutions
actually relish the flood of dirty money pouring in from places
such as Russia. They say, further, that it may be safer in the
long-term that drugs money is laundered and goes into legitimate
financing, rather than moving unaccountably through the black
economy. | ||||||||||||||||
[snip] | ||||||||||||||||
And then there are others with an interest in the war continuing -
the prison builders, the drug-testing companies, the professional
anti-drugs education programmes, the extra police and parole
officers called up for the battle. Not to mention those who have
been corrupted, | ||||||||||||||||
[snip] | ||||||||||||||||
SINCE THE WAR on drugs has been lost, it is logical that we should be planning what to do next. There is no chance in the immediate future of such a discussion taking place in the United States. | ||||||||||||||||
[snip] | ||||||||||||||||
But both agree that the war on drugs has failed, and that there
should be a movement towards legalisation. | ||||||||||||||||
[snip] | ||||||||||||||||
The war against drugs is part of the last great authoritarian campaign of this century - the attempt to tell us what one can and cannot do to one's own body. The debate is raging over abortion and euthanasia, but not drugs. It cannot be too early to discuss what we should do when the crusaders against drugs finally admit defeat. | ||||||||||||||||
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HOT OFF THE 'NET (Top) | ||||||||||||||||
DRUGSENSE TO OPEN UNIVERSITY DRUG POLICY FORUM | ||||||||||||||||
DrugSense will sponsor an e-mail discussion group to provide university
students and faculty with a national forum in which to discuss drug policy
and related issues. | ||||||||||||||||
Josh Sinoway, a second year political science student at the University of California at Santa Cruz, will be the host. Josh comes by his interest in drug policy in 2 ways: first, as son of Ron Sinoway, long time reform activist and second as a survivor of the quasi-military helicopter interdiction campaign waged for years against all residents of California's "Emerald Triangle," whether they are pot growers or not. | ||||||||||||||||
Josh will bring an unabashedly reformist attitude to the forum, and has the ultimate goal of organizing nationwide reform projects involving students. | ||||||||||||||||
His e-mail address is: | ||||||||||||||||
Check here next week for details. | ||||||||||||||||
TIP OF THE WEEK | ||||||||||||||||
MAPTalk - There is an email list called MAPTalk where letter writers and
readers of the DrugSense Weekly share ideas. We hope that you will either
join MAPTalk or forward a copy of your letters to so that
they can be shared with other interested reformers. | ||||||||||||||||
We get occasional requests from people who want to subscribe or unsubscribe
from MAP or other reform lists. Here are step by step "canned"
instructions. Please save them. | ||||||||||||||||
Two ways to un subscribe and subscribe to or from MAP, DRC, and other
reform mailing lists: | ||||||||||||||||
WAY ONE http://www.mapinc.org/lists/ | ||||||||||||||||
The easiest way, by far, to subscribe or unsubscribe to a whole pile of
reform mailing lists is the MAP web page. If you are able to get on the
Internet go to http://www.mapinc.org/ and click (with your mouse) on
"Mailing Lists" (at the bottom of the home page) select MAP Mailing lists,
DRC, or whatever. Next click on "Subscribe/Unsubscribe." Now click on the
little arrow on subscribe and then click on subscribe or unsubscribe.
Click on the little down arrow next to the various list names and select
which list you want to get on or off. Fill in your name and email address,
send and you're done. This is a wonderful way for busy people like you to
quickly and easily log on or off lists and occasionally "look in." It takes
just a minute or two and eliminates having to remember all the various
commands and addresses. | ||||||||||||||||
While you're on the MAP web page look around at the wonderful enhancements
such as our activist database sign up form (under "Sign me up") and the
incredible list of LTEs we've had published in the last few months (under
"MAP gets Published") | ||||||||||||||||
If you don't know how to "surf the net" Here are the instructions: | ||||||||||||||||
WAY TWO FOR THE "INTERNET CHALLENGED" | ||||||||||||||||
To subscribe to MAPTalk send a message to For DRC lists send to put _subscribe MAPTalk (or DRCTalk etc.) firstname lastname_ (The name is optional for MAP but mandatory for DRC) in the body of the message (insert your first name and last name - no dashes). You will receive a confirmation that you are subscribed. | ||||||||||||||||
| ||||||||||||||||
To unsubscribe from DRC lists send a message to with
unsubscribe (list name) in the body of the message. You will receive a
confirmation that you are unsubscribed. | ||||||||||||||||
| ||||||||||||||||
To un subscribe from MAP lists send a message to with
un subscribe (list name) in the body of the message. You will receive a
confirmation that you are unsubscribed. | ||||||||||||||||
| ||||||||||||||||
This works for DRCTalk, other DRC lists (like the MMJ list WWW list) and
many other lists as well. | ||||||||||||||||
Again make your life easier and use the web page above. It is a gift from
the gods. Hope this helps. | ||||||||||||||||
WAY THREE the MAP database | ||||||||||||||||
To be added to the MAP database (IE to receive or stop receiving FOCUS
alerts or the newsletter) do the following: | ||||||||||||||||
To be added go to http://www.mapinc.org/join.htm and fill out the form.
Alternately, if you are in a hurry, you can go to | ||||||||||||||||
Visit http://www.drugsense.org/unsub.htm to be removed from our database
and/or unsubscribe from the Drugnews-Digest, DrugSense Weekly Newsletter
and weekly Focus Alerts. | ||||||||||||||||
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DS Weekly is one of the many free educational services DrugSense offers
our members. Watch this feature to learn more about what DrugSense can
do for you. | ||||||||||||||||
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We wish to thank our contributors. | ||||||||||||||||
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Mark Greer () |