Tid til danske heroinforsøg og fixerum

Af Bo Asmus Kjeldgaard (SF),Familie- og Arbejdsmarkedsborgmester i København og Frank Hedegaard (SF), Medlem af Familie- og Arbejdsmarkedsudvalget.

De hollandske heroinforsøg viser, at de hårdest ramte stofmisbrugere får det langt bedre med lægeordineret heroin. Sundhedsministeriet offentliggjorde d. 12. marts en dansk undersøgelse om heroinforsøg.

Vi håber, at udspillet medfører, at regeringen vil arbejde for forslaget, så vi kan komme i gang med at hjælpe de hårdest ramte stofmisbrugere.

Det har længe været indlysende, at behandlingsindsatsen overfor stofmisbrugere ikke har virket tilstrækkeligt. Det er derfor også glædeligt at se den seneste tids debat, der viser, at flere politikere, fagfolk og organisationer nu ser positivt på, at lave forsøgsordninger med lægeordineret heroin herhjemme.

SF har længe peget på, at vi bliver nødt til at gå nye veje – eksempelvis med lægeordineret heroin og fixerum. Vi bliver nødt til at handle over for de hårdest ramte stofmisbrugere, som ikke kan hjælpes af nogle andre behandlingstilbud.

Forsøg i Schweiz har været fulgt nøje af WHO, og viste bemærkelsesværdige resultater. Nu viser også de hollandske forsøg, at lægeordineret heroin har en god effekt overfor denne gruppe.

Stofmisbrugerne får det mærkbart bedre både fysisk og psykisk og samtidig falder kriminaliteten. Nu mener vi, det er på høje tide, at Danmark følger efter. Nu må der handles.

Det er de hårdest ramte stofmisbrugere, der får gavn af heroinforsøg. Overordnet handler det om, at vi har en gruppe stofmisbrugere, som ikke har haft nogle gavn af hidtidige behandlingstilbud.

Efter mange år må vi konstatere, at der er nogle, som simpelthen ikke kan komme ud af stofmisbruget trods mange behandlingstilbud. Derfor er det nytteløst at fastholde det hidtidige mål om stoffrihed for denne gruppe. Ofte er resultatet, at de har et sidemisbrug ved siden af deres metadonbehandling. Det er til stor skade for deres helbred og velvære.

Det er derfor på høje tid, at regeringen gør det muligt at iværksætte et heroinforsøg i Danmark. Heroinforsøg der skal hjælpe gruppen af stofmisbrugere, som har været igennem talrige behandlingstilbud uden at få det bedre.

At lave heroinforsøg kræver, at vi gør det på en ordentlig og kontrolleret måde, så vi ved, hvordan vi bedst mulig kan hjælpe netop denne gruppe stofmisbrugere. Hvad er det, der giver den bedste effekt? –

Vi ved fra de hollandske forsøg, at det ikke alene handler om heroinen, men det overskud det giver dem, at de ikke skal ud at finde deres stoffer, og vi ved det handler om jævnlig kontakt med lægen og det social- og sundhedsfaglige personale.

De hollandske erfaringer kan ikke direkte overføres til Danmark. Dertil er der for store forskelle mellem den hollandske misbrugssituation og den danske. I Holland er flere stofmisbrugere i behandling end i Danmark.

De hollandske stofafhængige er tilsyneladende bedre fungerende end de danske. Der er en højere grad af social integration (flere er i arbejde), flere ryger i stedet for at sprøjte stoffet, de har en mindre dødelighed og der anvendes mindre metadondoser i behandling end herhjemme.

Man er således nødt til at gennemføre forsøg med heroin herhjemme, og vel at mærke ordentlige, kontrollerede forsøg, hvis man overvejer at anvende heroin supplerende til metadon.

Trods det at flere og flere bliver positive overfor at lave danske forsøg med lægeordineret heroin, er der også stadig modstandere. Men vi synes debatten om lægeordineret heroin til tider bygger på myter og fordomme.

Særligt er der en myte om, at det skulle medføre flere unge stofmisbrugere.

Men der skal ikke herske nogen tvivl om heroinforsøg ikke handler om fri heroin, som desværre er det ord man bruger, når medierne beskriver forslaget. Der er tale om forsøg for den gruppe stofmisbrugere, som igennem en lang årrække har været igennem alle øvrige forsøg med henblik på afvænning.

Der er tale om særligt dårligt stillede stofmisbrugere, der kan beskrives som: ældre patienter med en lang misbrugskarriere og hvor den psykosociale situation er perspektivløs og som gentagne gange og uden succes har deltaget i behandlingsprogrammer.

Dermed skulle vi meget gerne slå et syvtommer søm igennem myten om, at heroinforsøgene ender med at resultere i flere heroinmisbrugere.

Resultaterne i de hollandske forsøg har været nævnt mange gange i den igangværende debat.

Resultatet er også utrolig interessant og giver positive perspektiver for fremtiden.

Næsten 2/3 af personerne i heroinforsøget opnåede en forbedring på det fysiske, psykiske og/eller det sociale område.

Med heroin kunne man hjælpe 25 % flere patienter end med metadon alene.

Forskellen må tilskrives forskellen i behandling og behandlingskontekst.

Behandlingen med heroin indebar en større kontakt mellem patienter og personale og mere struktur på dagen.

En anden interessant pointe i det hollandske forsøg er også, at mange af patienterne i kontrolgruppen, der kun fik metadon, fik tilsvarende mængder heroin som forsøgsgruppen, men de fik det bare illegalt.

Forskellen i behandlingsresultaterne er således ikke betinget af den farmakologiske virkning af heroin, men i den adfærdsregulering der ligger i, at får heroin ordineret legalt og i indtagelsen under kontrollerede forhold.

Det betyder overvejende, at stofmisbrugerne ikke tvinges ud for at skaffe penge til mere heroin, men i stedet får overskud til socialt samvær og til at spise. Og det giver en positiv kædereaktion.

I det hollandske forsøg ser man mærkbare forbedringer i både det fysiske og psykiske helbred og i den kriminelle aktivitet. I nogle tilfælde kunne man faktisk observere så væsentlige forbedringer i det fysiske og psykiske helbred, at deltagernes score på relevante spørgeskemaer nærmede sig normalbefolkningens.

På mange måder har de hollandske forsøg altså vist at have en god effekt såvel fysisk, psykisk og socialt.

Men som det også har været fremme i medierne, så har heroinforsøgene yderligere den gode sidegevinst, at stofmisbrugerne stort set slipper af med deres kriminelle adfærd.

Det er først og fremmest godt for stofmisbrugerne, der slipper for konstant at skaffe penge til stoffer og deraf følgende stress og nedværdigelser. Men det er naturligvis også en gevinst for samfundet generelt.

Hvor responderne tidligere i gennemsnit havde knap 15 kriminelle dage om måneden, så har de med den lægeordinerede heroin kun omtrent 2 kriminelle dage. Det er en mærkbar nedgang.

Fixerum på Vesterbro kræver en lovændring

Indlæg til Vesterbrobladet 5. oktober 2001
Af Sophie Hæstorp Andersen

Sommer og efterår 2001 har på Vesterbro været præget af, at salg af narkotika, samt øget prostitution er blomstret op i gaderne igen. Årsagerne hertil er flere – og mandag den 1. oktober lyttede overborgmesteren, socialborgmesteren og politiet på utilfredse beboere på Maria Kirkeplads og i Sommerstedsgade.

Jeg deltog selv i mødet, hvor snakken dels handlede om, hvordan politiet kan gøre en ekstra indsats for at fjerne pushere fra gaden; dels hvordan vi kan sikre et mere værdigt liv for narkomanerne på Maria Kirkeplads. Et sted, hvor narkomanerne ofte finder lukkede døre i kirken, og som derfor er henvist til at fixe sig direkte på pladsen under åben himmel.

Resultatet blev, at overborgmester Jens Kramer Mikkelsen efter mødet, nu bakker op om at etablere fixerum til narkomaner på Vesterbro. En stor sejr til Vesterbros beboere – der er bare lige et MEN.

I dag er fixerum nemlig ikke lovlige. Det kræver med andre ord en lovændring før fixerum kan blive en realitet på Vesterbro. En lovændring, der hidtil er blevet forhindret af flere partier på Christiansborg – herunder flere socialdemokrater, indrømmer jeg gerne. Men jeg vil det anderledes.

I mine øjne, findes der ingen universelle løsninger i bekæmpelsen af narkomisbrug – og der er altid brug for nytænkning. Vi kan lige så godt indse, at ingen narkomaner bliver stoffri fra den ene dag til den anden. Målet er stadig fuldstændig stoffrihed, men på længere sigt, mener jeg at København skal gå foran og lave forsøg med både fixerum og udlevering af fri heroin til de mest belastede misbrugere. Kun sådan kan vi komme den stress og de stikskader til livs, der i dag blokerer for, at narkomaner kan finde overskud til at gå i behandling – og endelig blive helt stoffri.

Forsøg med udlevering af fri heroin under ordnede lægefaglige forhold kan dog ikke rette op på, at vi fortsat har brug for en stor social indsats samtidig med behandlingen af narkomaner. Her kan Københavns Kommune hjælpe med sine erfaringer – men den sociale indsats kan ikke stå alene, som den gør i dag – med alt for få døgnbehandlingspladser og alt for mange på ambulante behandlinger med metadon.

Vi må starte et sted. For mig er der ingen tvivl om, at vi ikke kan acceptere at så mange yngre mennesker hvert år dør som følge af et narkomisbrug. Det er tid til at foretage nogle utraditionelle valg, når det gælder behandling af narkomaner. Menneskelige valg – ikke dogmatiske. Det kræver en holdningsændring i Folketinget.

What is “Junkie-Apartheid”? Remember South Africa where the majority of people were segregated and controlled by the minority? That’s what’s happening to drug users here…We are segregated and persecuted…anybody who uses drugs is scared shitless these days and for good reason…our civil rights have vanished. To that end, I suggest the following dream list to keep in mind…Please feel free to add to this or subtract from it. – Vicki Jacobs

1. Decriminalization of All Drug Laws… hands off our bodies…like the abortion struggle, the principal is control over our bodies, not government control.

2. Clean Drugs With No Bullshit: Think about it…what other business is so unresponsive to consumers? Whatever happened to customer satisfaction? Would any other big business last this long while delivering such an inferior product? Demand testing of drugs for purity of content–not drug-testing of consumers!

3. Consumer-Controlled Junkie Services: detoxes where the client determines the method of treatment, rather than the provider…demand availability of the latest technological advances in detox including electro-stimulation machines and electro-acupuncture to reduce withdrawal symptoms. The people should control their own technology. Harm reduction therapy…drug-management therapy…these services are supposedly for the client, yet they are controlled solely by the system of “Junkie-Apartheid”.

4. Consumer-controlled Drug Maintenance: This means methadone clinics where the client determines the dosage and is not penalized for dirty urine, etc….demand the right to be treated with dignity…demand injectable methadone for shooters and heroin maintenance for those who prefer it (probably most of us).

5. Non-discrimination in health services: We all know too well what happens to drug-users in the health-care system…resulting in a well-founded reluctance to seek medical care…To most doctors, we’re just drug-seeking scum…demand respect.

6. Housing for Drug-Users: It’s nearly impossible to obtain any kind of decent housing for known drug-users, leaving the only options shelters -which ain’t nothin’ but de facto prisons- or the alienation of the streets. As citizens of the richest country on the planet, demand respect.

7. Jobs for Junkies: I.Q. testing of drug-prisoners in San Quentin found their IQs higher than the national average, yet known users are not hired or summarily fired. Demand an end to drug-testing; replace it with competency-testing for the job itself.

We’re talking basic civil rights here. We are a disenfranchised minority. Nobody will hand us our civil rights -we will have to fight for them, especially now when the battle lines are obvious. Let’s stop bickering and think, dream, and organize for our collective future.

Above Manifesto is dedicated to Rod Sorge, who I pray is watching over us from a better place. Rod, we miss you more than we can say…you gave your life for this cause…I hope we’re deserving of your sacrifice.

Vicki Jacobs is an acupuncturist at the Lower East Side Harm Reduction Center/Needle Exchange in NYC

“What percentage of countries in the world have drug prohibition? Is it 100 percent, 75 percent, 50 percent or 25 percent?”

I recently asked many people I know to guess the answer to this question. Most people, especially avid readers and the political aware, guess 25 or 50 percent. More suspicious people sometimes guess 75 percent.

The correct answer is 100 percent, but nobody guesses that. Most readers of this paragraph will not have previously heard that every country in the world has drug prohibition. Unusual as it seems, almost nobody knows about the existence of world-wide drug prohibition.

In the last decade of the 20th century, many people throughout the world became aware of national drug prohibition. They came to understand that the narcotic or drug policies of the United Sates and some other countries are properly termed “drug prohibition.” But even as this understanding spread, the fact that drug prohibition covers the entire world remained a kind of “hidden-in-plain-view” secret. Now, in the 21st century, that too may be changing.

“Global drug prohibition” (the term was first used in 1990) has begun losing some of its invisibility. And as it becomes more visible, it loses some of its other powers. This article briefly describes the varieties and uses of world-wide drug prohibition in the 20th century, and explores its prospects in the 21st century.

Every country in the world has drug prohibition. Every country in the world criminalizes the production and sale of cannabis, cocaine and opiates. In addition, most countries criminalize the production and sale of some other psychoactive substances, and they make exceptions for limited medical purposes, especially morphine for pre- and post operative pain management. Most countries also criminalize simple possession of small amounts of some of the prohibited substances, usually an ounce (28 grams) or less.

In Crack in America: Demon Drugs and Social Justice, Craig Reinarman and I suggested that the varieties of drug prohibition can be seen as a long continuum. The continuum extends from the most criminalized and punitive forms of drug prohibition, such as the crack cocaine policy of the United States of America, to the most decriminalized and regulated forms of drug prohibition, such as the cannabis policy of the Netherlands. In this article I want to suggest that the most criminalized and punitive end of the drug prohibition continuum be called “criminalized drug prohibition” and the other end be termed “decriminalized drug prohibition.”

Criminalized drug prohibition uses criminal laws, police, and imprisonment to punish people who use specific psychoactive substances, even in minute quantities. In the U.S., drug laws prohibit even supervised medical use of cannabis by terminally ill cancer and AIDS patients. U.S. drug prohibition gives long, mandatory prison sentences for possession, use, and small-scale distribution of forbidden drugs. U.S. drug laws require mandatory prison sentences that increase for repeated drug offenses. Most U.S. drug laws explicitly remove sentencing discretion from judges, and do not allow for probation or parole. The United States now has nearly half a million men and women in prison for violating its drug laws. Most of these people are poor and from racial minorities. Most of them have been imprisoned just for possessing an illicit drug, or “intending” to sell small amounts of it. The mandatory federal penalty for possessing five grams of crack cocaine, for a first offense, is five years in prison, with no possibility of parole. Criminalized prohibition is the harshest form of drug prohibition.

The cannabis policy of the Netherlands is the best known example of the other end of the drug prohibition spectrum — of a decriminalized and regulated form of drug prohibition. Several United Nations drug treaties — especially the “Single Convention on Narcotics” of 1961 — require the government of the Netherlands to have specific laws prohibiting the production and sale of particular drugs. Therefore Dutch law explicitly prohibits growing or selling cannabis. This is still formally drug prohibition, and the Netherlands does prosecute larger growers, dealers and importers (or smugglers) as required by the U.N. treaties. But in the Netherlands national legislation and policy limits the prosecution of certain cafes, snack bars and pubs (called “coffee shops”) that are licensed to sell small quantities of cannabis for personal use. The coffee shops are permitted to operate as long as they are orderly and stay within well-defined limits that are monitored and enforced by the police. The coffee shops are not allow to advertise cannabis in any way, and they may sell only very small amounts to adults. Like other formally illegal activities, cannabis sales are not taxed. Without a change in the Single Convention and other international treaties, this is probably as far as any country can go within the current structures of world-wide drug prohibition.

The prohibition policies of all other western countries fall in between the heavily criminalized crack cocaine policies of the U.S. and the decriminalized and regulated cannabis prohibition of the Netherlands. No western country, nor most third world countries, have ever had forms of drug prohibition as criminalized and punitive as the United States. And in the last five to ten years, drug policy in Europe, Canada, Australia and elsewhere appears to be shifting even further away from the criminalized end of the prohibition continuum. But all these countries are required by international treaties to have — and still do have — real, formal, legal, national drug prohibition.

Drug prohibition is a world-wide system of state power. Global drug prohibition is a “social fact,” it is a “thing” (to use the terms of the great sociologist Emile Durkheim). Drug prohibition exists whether or not we recognize it, and it has real effects, real consequences.
For many decades, public officials, journalists and academics rarely identified any form of U.S. drug law as “prohibition.” Instead, public officials, journalists, and academics referred to a national and international “narcotics policy.” The international organization that created and still runs global drug prohibition is called the “International Narcotics Control Board.”
National drug prohibition began in the 1920s in the United States as a subset of national alcohol prohibition. The first U.S. drug prohibition enforcement agents were alcohol prohibition agents assigned to handle “narcotics.” American prohibitionists had always worked hard to convince other nations to adopt alcohol prohibition laws; during the 1920s, some savvy prohibitionists (notably an obscure U.S. Prohibition Commissioner named Harry A. Anslinger) realized that the success of U.S. alcohol prohibition depended on support from other countries. However, the campaign to spread American alcohol prohibition to other nations was an utter failure. In 1933, the U.S. repealed its own national alcohol prohibition laws — the 18th Amendment to the Constitution and the Volstead Act — and returned the question of alcohol policy to state and local governments to do with as they wished.
The story of drug prohibition took an entirely different course. Since the early 20th century, the U.S. had found European governments far more willing to consider anti-narcotics legislation than anti-alcohol laws. The founding Convenant of the League of Nations explicitly mentioned the control of “dangerous drugs” as one of the organization’s concerns. In 1930, the U.S. Congress separated drug prohibition from the increasingly disreputable alcohol prohibition and created a new federal drug prohibition agency: the Federal Bureau of Narcotics, headed by the committed alcohol prohibitionist Harry A. Anslinger. In the 1930s, the U.S. helped write and gain acceptance for two international anti-drug conventions or treaties aimed at “suppressing” narcotics and “dangerous drugs.” In 1948, the new United Nations made drug prohibition one of its priorities, and the U.N. Single Convention of 1961, and a series of subsequent anti-drug treaties, established the current system of global drug prohibition.
In the last eighty years, nearly every political persuasion and type of government has endorsed drug prohibition. Capitalist democracies took up drug prohibition, and so did authoritarian governments. German Nazis and Italian Fascists embraced drug prohibition, just as American politicians had. Various Soviet regimes enforced drug prohibition, as have its successors. In China, mandarins, militarists, capitalists, and communists all enforced drug prohibition regimes. Populist generals in Latin American and anti-colonialist intellectuals in Africa embraced drug prohibition. Over the course of the 20th century, drug prohibition was supported by liberal prime ministers, moderate monarchs, military strongmen, and Maoists. It was supported by prominent archbishops and radical priests, by nationalist heroes and imperialist puppets, by labor union leaders and sweat shop owners, by socialists, social workers, social scientists, and socialites — by all varieties of politicians, practicing all brands of politics, in all political systems.
Over the last eighty years, every government in the world eventually adopted drug prohibition. National drug prohibition was one of the most widely accepted, reputable, legitimate government policies of the entire 20th century. Why? Why should this be so?

There is no doubt that governments throughout the world have accepted drug prohibition because of enormous pressure from the United States government and a few powerful allies. But U.S. power alone cannot explain the global acceptance of drug prohibition. Governments of all types, all over the world, have also found drug prohibition useful for their own purposes. There are several reasons for this.

Drug prohibition has given all kinds of governments additional police and military powers that they have been freer to deploy than other kinds of police powers. Police and military narcotics units can legitimately go undercover anywhere and investigate anyone — anybody could be in the drug business. Most of the undercover police in the United States are in narcotics squads (no other crimes require so much undercover manpower). The CIA can only legally operate beyond U.S. borders, and the FBI only within the U.S., but the DEA (the Drug Enforcement Administration) is free to independently stage covert operations domestically and in other counties. Anti-drug units within city, county and state police departments have unparalleled freedom of movement. Police anti-drug units have regular contact with informers and spies; they can make secret recordings and photographs of anyone, and they have cash for buying drugs and information. In the United States, police anti-drug units are sometimes allowed to keep money, cars, houses and other property they seize. Top politicians and government officials in many countries may have believed deeply in the cause of drug prohibition. But other health-oriented causes could not have produced for them so much police, coast guard and military power.
Government officials throughout the world have used anti-drug squads to conduct surveillance operations and military raids that they would not otherwise have been able to justify. Many times these anti-drug forces have been deployed against targets other than drug dealers and users — as was the case with U.S. President Richard Nixon’s own special White House anti-drug team, led by former CIA agents, which later became famous as the Watergate burglars. Nixon was brought down by his squad’s mistakes. But over the years, government anti-drug forces all over the world have carried out countless successful non-drug operations.
Sometimes this use of “anti-drug” justifications for diverse military and police activities has been fairly obvious. The U.S. has long justified the military support provided to anti-democratic governments and factions it favored in Latin America by asserting that the military hardware was being given to “fight drugs.” Nearly everyone who writes seriously about U.S. foreign policy takes it for granted that the “anti-drug” justifications have been transparent but politically useful cover stories.

Drug prohibition has also been useful for governments and politicians of all types because it has required at least some anti-drug crusades and what is properly called drug demonization. Anti-drug crusades articulate a moral ideology that depicts “drugs” as extremely dangerous and destructive substances. Under drug prohibition, police, the media, and religious and health authorities tend to describe the risks and problems of drug use in extreme and exaggerated terms. “Drugs” are dangerous enemies. “Drugs” are called evil, vile, threatening, and powerfully addicting. Politicians and governments crusade against them, declare war on them, and blame them for many unhappy conditions and events. Anti-drug crusades and drug scares popularize images of “drugs” as highly contagious invading evils. Words like plague, epidemic, scourge, and pestilence are used to describe psychoactive substances, drug use, and moderate, recreational drug users.
Government officials, politicians, the media and other authorities have found that the enemies described in the language of drug demonization can be very useful. These enemies can be blamed by almost anyone at any time for long-standing problems, recent problems, and the worsening of almost anything. Theft, robbery, rape, malingering, fraud, corruption, physical violence against men, women or children, disrespect, juvenile delinquency, sloth, sloppiness, sexual promiscuity, low productivity, and all around irresponsibility — anything at all — can be and has been blamed on “drugs.” Almost any social problem is said to be made worse — often much worse — by “drugs.”
Consider the case of crack cocaine and the still active U.S. “War on Drugs.” In the 1980s, the Reagan and Bush administrations helped popularize the image of crack cocaine as “the most addicting drug known to man.” They then used that image to explain the deteriorating conditions in America’s impoverished city neighborhoods and schools, and they warned that crack addiction was rapidly spreading to the suburbs. In effect, Presidents Reagan and Bush said: “Our economic and social policies did not make those urban problems worse, addiction to crack cocaine did, and now crack is spreading to young people in the suburbs.” Democrats in Congress happily joined with Republicans and voted major increases in funding for police, prisons, and military to fight the War on Drugs.
Even if crack was as bad as Republicans, Democrats, and the media said, it probably still could not have caused all the enduring problems they blamed on it. But the truth about crack cocaine is even more startling than the myths. Crack cocaine, “the most addicting drug known to man,” turned out to be a drug that almost nobody liked to keep using. Many Americans tried crack, but very few people continued using it heavily for a long time. Mainly this is because most people cannot physically tolerate, much less enjoy, frequent encounters with crack’s brutally brief, extreme up and down effects. Crack use in America is now so low that the U.S. government does not even include crack use in its press releases about the prevalence of drug use. Nor has crack become popular anywhere in the world. Heavy, long-term crack smoking appeals only to a small number of deeply troubled people, most of whom are also impoverished. Because frequent bingeing on the drug is so unappealing, there was never any danger of an epidemic of crack addiction spreading across America, especially not to middle-class families in the suburbs.
Nonetheless, the contradictions between the drug war’s myths about crack and the reality of crack cocaine’s very limited appeal have not affected the credibility and legitimacy of the War on Drugs. Most politicians have not regretted spending hundreds of billions of dollars to save America’s children from addiction to crack cocaine and other drugs by running an expensive, punitive, utopian crusade to make America “drug free.” In the presidential election of 2000, both George W. Bush and Al Gore promised more funding and more prisons to make America “drug free.” Here in the 21st century, U.S. politicians continue to justify the enormous expenditures and imprisonment; they still insist that less criminalized and punitive drug policies will lead to a mass epidemic of drug addiction and substantially increase every social and economic problem. In this respect, drug war propaganda is like the propaganda from other wars: many otherwise reasonable people continue to believe in it even when the drug demonization and pro-drug war claims are patently false, or do not make logical sense.
Drug demonization also endures because it is useful to at least some important individuals and institutions. In a war on “drugs,” as in other wars, defining the enemy necessarily involves defining and teaching about morality, ethics, and the good things to be defended. This content varies somewhat by place and time, but in the U.S. anti-drug messages, especially those aimed at children and their parents, have recognizable themes. Currently these include messages about: individual responsibility for health and economic success, respect for police, the value of providing the police with information about drugs, resisting peer-group pressure, sexual abstinence outside of marriage for health reasons, the value of God or a higher power in recovering from drug abuse, parents knowing where their children are, sports and exercise as alternatives to drug use, why sports heroes should be drug tested, low grades as evidence of behavioral problems including drug use, and parents setting good examples for their children. Almost anyone can find some value that can be defended or taught while attacking “drugs.”
In the U.S., newspapers, magazines and other media have long found that supporting anti-drug campaigns is good for public relations; they have also found that anti-drug stories are good for their business — they attract customers. The media regularly editorially endorse government anti-drug campaigns and favorably cover anti-drug efforts as a “public service.” For doing so, they are praised by government officials and prominent organizations. There is no doubt that many U.S. publishers and editors have believed in the War on Drugs and in defending the criminalized, prison-centered tradition of U.S. drug policies. But only some of the causes that people in the media believe in can be shaped into compelling “read all about it” and “more details at eleven” type news stories. Only some causes can be turned into scary front page stories that are simultaneously good for public relations and very good for business.
For many decades, the top editors in the news media have clearly recognized, as an economic fact of their business, that a scary front page drug story will increase sales of magazines and newspapers — especially when it is about a potential drug epidemic threatening to destroy middle-class teenagers, families and neighborhoods. Editors know that a scary story about a new, tempting, addicting drug attracts more TV viewers and radio listeners than most other kinds of news stories, including non-scary drug stories. In short, whatever their personal values, publishers, editors and journalists give prominent space to frightening drug articles because they know the stories attract customers.
When one demon drug loses its ability to scare people, then politicians, the media, and drug enforcement agencies shift to another. At this moment (the spring and summer of 2001), they are focusing on prescription narcotics, methamphetamine, and ecstasy. Each demon drug comes with its own distinctive story about the ruin it causes including brain damage, psychological destruction, moral collapse, and sometimes death. The many anti-drug news stories and public education campaigns implicitly (and sometimes explicitly) suggest that nearly all social problems can be reduced at least somewhat by attacking “drugs.” And to a remarkable extent, pro-drug war politicians in the U.S. have an easier time getting elected, and expensive anti-drug programs pass without much debate. In the U.S., during economic good times and bad, funding grows for “anti-drug” courts, police, prisons, and military operations, while schools, housing, medical care, and other social services are under-funded or cut back.
Because U.S.-style criminalized prohibition is so extreme, it allows us to see the continuing political usefulness and viability of prohibitionist policies and anti-drug campaigns for governments in third world countries, and for many governments in Western democracies (including currently for Blair, Clinton and Gore “third way” politicians). Drug prohibition has powerful sources of support because of its usefulness to politicians, to the media, and to many other important institutions and constituencies. As a result, in the coming years, “drugs” will continue to be attacked with guns, soldiers, police, courts, and prisons in the U.S. and many other countries. “Drugs” will also be attacked with words, pictures, grave commentary, editorials, and uncountable anti-drug stories and ads on TV and radio, in newspapers and magazines, and in videos, movie trailers, and glossy booklets taught to children in school. All of this will further help justify drug prohibition, and help maintain public support, especially for the more criminalized and punitive varieties of drug prohibition.

In many countries, popular support for drug prohibition also has been rooted in the uniquely 20th-century faith in the capacity of the state to penetrate and benevolently control many aspects of daily life for the “common good.” The hope of global drug prohibition, of the people who created the system, was the hope of using the powers of a nearly omnipotent state to do good and suppress evil. This romantic vision itself was very much part of a distinctly 20th century utopian hope or dream. Unlike, say, the “founding fathers” who wrote the U.S. Constitution and Bill of Rights, and unlike many political movements in the 19th century, in the 20th century liberals, conservatives, fascists, communists, socialists, populists, right-wingers and left-wingers usually shared this romantic vision of the benevolent state. Twentieth-century political movements disagreed violently about how the state should be used. Drug prohibition was one of the few things they could all agree upon. Drug prohibition was part of what I think it is appropriate to call the 20th century’s “romance with the state.”
Because politicians in many countries, from one end of the political spectrum to the other, shared this positive, romantic view of the powerful, state, they could agree on drug prohibition as good non-partisan government policy. In the U.S. during the 1980s and the 1990s, Democrats feared and detested Presidents Reagan and Bush, and Republicans feared and detested President Clinton, but the parties united to fight the “War on Drugs.” They even competed to enact more punitive anti-drug laws, build more prisons, hire more drug police, expand anti-drug military forces, and fund many more government sponsored anti-drug messages and “drug-free” crusades. Opposing political parties around the world have fought about many things, but until recently they have often endorsed efforts to fight “drugs.”
Finally, drug prohibition has enjoyed widespread support and legitimacy because the United States has used the United Nations as the international agency to create, spread, and supervise world-wide prohibition. Other than the government of the U.S., the U.N. has done more to defend and extend drug prohibition than any other organization in the world. The U.N. currently identifies the goal of its anti-drug efforts as “a drug-free world.”

In the 20th century, drug prohibition spread from the U.S. to every country in the world. I have suggested a number of reasons this. First, drug prohibition has spread so successfully because of the enormous political influence and economic power of the United States. Second, many different kinds of governments throughout the world have supported drug prohibition because they have found that drug prohibition’s covert and open police and military powers can be used for many non-drug related activities. Third, drug prohibition has also gained substantial popular support in many countries because its drug demonization crusades and anti-drug ideology have been rhetorically, politically and even financially useful to many politicians, the media, schools, the police, the military, religious institutions, and some elements of the medical profession. Fourth, the spread of drug prohibition has been aided by the 20th century’s romantic or utopian ideologies about coercive state power, making the fight against “drugs” the one topic about which politicians of all stripes could usually agree. Finally, drug prohibition has gained great legitimacy throughout the world because it is seen as project of the United Nations.
All forms of drug prohibition, from the most criminalized to the most decriminalized, have probably involved at least some explicit drug demonizing. In general, drug demonization and drug prohibition reinforce each other. But it is important to recognize that drug demonization existed before global drug prohibition, and drug demonization will certainly continue long after world-wide drug prohibition has passed away.

New Study: Punishing Drug Users Does More Harm Than Good

Friday, October 19, 2001.

New research suggests that punishing drug users could increase the likelihood that they will continue using drugs. Howard B. Kaplan, a sociologist and director of the Laboratory for Social Deviance at Texas A&M University, said that punishment lowers self-esteem, thus increasing the likelihood of continued deviant behavior.

“When a person is punished by society for a deviant behavior such as drug abuse, he or she is stigmatized and alienated, and this increases the likelihood of that person becoming motivated to act against social conventions,” said Kaplan.

He explained that when people are subjected to “negative social sanctions,” such as arrests or expulsions from school, they feel isolated from conventional society. As a result, they become unable to escape their past.

The low self esteem caused by such stigmatization, Kaplan notes, increases a person’s likelihood of continued deviant behavior. As a result of experiencing self-rejection, a person loses motivation to follow the rules of the society that has condemned him or her. Not only is there this loss of motivation, but there is a gain of motivation to continue deviant behavior, he explains.

Kaplan, whose research is funded by the National Institute on Drug Abuse, says even as stigmatized people experience self-rejection, the need for them to feel good about themselves is always present and causes them to redefine their deviant behavior as acceptable, or even good, he explains. In what social scientists refer to as “secondary deviance,” the person continues to behave in the deviant manner as a means of defense against the societal reaction to the initial behavior, he adds.

Kaplan recommended that sanctions be created that include a component emphasizing societal acceptance. He explained that sanctions must be imposed in a context where giving up deviance, such as drug use, will be rewarded by conventional society

U.S. NARCOTICS CAMPAIGN COSTS MORE THAN GULF WAR

National Post (Canada)

19 Apr 2001

By Peter Morton

Effectiveness Unknown

WASHINGTON – Governments in the United States spend twice as much each year
on combating illegal drugs as the country spent on the 1991 Gulf War, a
White House-ordered report says.

But despite the US$30-billion annual cost to federal, state and municipal
governments, there is little research on whether the crackdown on illegal
drugs is effective, said the National Research Council, which did the study.

“It’s pretty distressing,” said Charles Manski, a professor of economics at
Northwestern University who was chairman of the study committee.

“Neither the necessary data systems nor the research infrastructure to
gauge the usefulness of drug-control enforcement policies exists,” he said
yesterday.

“It is unconscionable for this country to continue to carry out a public
policy of this magnitude and cost without any way of knowing whether, and
to what extent, it is having the desired result.”

The United States began its crackdown on drug trafficking and usage about
20 years ago, launching such programs as “zero tolerance” and DARE, an
acronym for Drug Abuse Resistance Education. It has also stepped up
eradication programs in such drug-producing countries as Colombia, where it
has pledged US$7.5-billion to try to wipe out coca production.

Federal government spending alone has increased tenfold since 1981 to
US$19-billion a year, resulting in 1.6 million people being arrested for
drug use in 1999, triple the number in 1980. Another 289,000 drug offenders
were sent to state prisons, 12 times the number in 1980.

But Mr. Manski said little effort is made to establish whether
incarcerating drug users and traffickers is an effective deterrent.
“Prevention is always better than incarceration, but no one knows whether
anyone was dissuaded from using drugs because of the current penalties,” he
said.

Only 15% of the US$780-million spent on researching drug policy goes toward
examining the effectiveness of imprisonment, says the report, which has yet
to be released.

Simple research such as comparing unemployment rates to the proliferation
of drug dealers in inner cities has yet to be done. “Do teenagers sell
drugs because they don’t have other jobs?” Mr. Manski said. “No one knows.”

The committee found existing drug-use monitoring programs somewhat useful,
but “strikingly inadequate to support the full range of policy decisions
that the nation must make.”

It found little work — and little government money — is being used to
understand drug use. As well, there is very little information on drug
pricing, although one of the goals of increased enforcement is to drive up
drug prices to make them too expensive.

There is even less known about some of the high-profile drug prevention
programs launched during the presidency of Ronald Reagan. No research has
been done, the report found, on whether “zero tolerance” drug enforcement
programs have had an effect on slowing drug shipments into the country.
What little research was done found the DARE program has had little impact
on illegal drug use, it added.

DEBATTEN om SFs forslag om at lade læger ordinere he-roin til de hårdest belastede narkomaner slingrer frem og tilbage.
Også modstanden i Folketinget er mildest talt diffus og bygger meget langt hen af vejen på højtflyvende moral-ske principper.

Det er let nok, at sidde i de plysbetrukne stole og være moralsk og bedrevidende, men det er blandt andet for-an Mariakirken i København det virkelige liv og den virkeli-ge død foregår. Det er en verden som de færreste har kendskab til og bør gøre sig kloge på.

Jeg tror det er vigtigt at lægge mærke til, at en markant støtte kommer fra Brugerforeningen af Aktive Nar-komaner. Altså fra folk der har et indgående kendskab til konsekvenserne af et misbrug.

Der er bare en ting galt med debatten. Og der er, at medens de kloge diskuterer og videnskabsmændene for-sker, så lever og navnlig dør mennesker i Danmark under forhold som ville være forbudt PA et svineslagteri.

DET ER RIGTIGT, at videnskaben ikke kender nok til virkningerne af heroin.
Men findes der overhove-det nogen der tør påstå, at det er bedre at sprøjte stoffet blandet op med vaskepulver, i en møgbeskidt port med en kanyle inficeret med hepati-tis, hiv og andre sygdom-me?
Så hvis valget står mellem to onder (og det gør det), så må det være et spørgsmål om at redde menneskeliv.
Så må den høje moral kom-me i anden række.
Jeg tror ikke, at én eneste tilhænger ville modsætte sig at fjerne den lægeordinerede heroin i samme øjeblik der dukker et videnskabeligt underbygget alternativ op der virker.
Men medens vi venter på miraklet, må og skal vi koncentrere os om i det mindste at holde de belastede i live og give dem så tålelige levevilkår som overhovedet muligt.