The Week Online with DRCNet
ISSUE #37, 4/10/98

Table of Contents

1. DRCNet Exclusive: Syringe Exchange Funding Ban Decision to be Released Within Two Weeks
2. Oakland Asset Forfeiture Law Challenged -- and, Federal Forfeiture Update
3. Senate Would Extend Marijuana Prohibition to Include Medical Research
4. Felony Charges for Woman Cultivating Marijuana for Ukiah Cannabis Buyers' Club
5. "It's the Pain, Stupid": Kevorkian, Pain, and the DEA
6. Vaclav Havel Vetoes Bill Criminalizing Drug Possession
7. Update on Drug and Harm Reduction Policies in Central and Eastern Europe and the Newly Independent States
8. German Doctors Vote in Favor of Heroin Prescription
9. Drug Policy Letter Focuses on Women and Drugs
10. Medical and Public Health Organizations Oppose Criminalization of Pregnant Addicts
11. Editorial: Vaclav Havel's Second Prague Spring

(visit last week's Week Online)

1. DRCNET EXCLUSIVE: SYRINGE EXCHANGE FUNDING BAN DECISION TO BE RELEASED WITHIN TWO WEEKS

The Presidential Advisory Commission on HIV/AIDS was all set to vote (4/9) on a resolution which would have demanded that the President direct Secretary of Health and Human Services Donna Shalala either make a determination regarding the ban on federal funding for syringe exchange, or resign. That vote, however, has been put on hold in the wake of information that a decision is forthcoming.

Sources familiar with the situation told the Week Online that President Clinton's Chief of Staff, Erskine Bowles, called commission chairman Dr. Scott Hitt on the eve of the vote to tell him that Secretary Shalala is "supportive of the issue" of exchange, and that HHS' internal review would be complete and a decision announced within two weeks. While the White House has not guaranteed what the decision would be, the Commission has decided to table any action on the resolution pending prompt action by Shalala.

The Department of Health and Human Services did not return calls for comment.

In a letter that was leaked to Congress and the New York Times last week in which Drug Czar Barry McCaffrey indicated his opposition to lifting the ban, McCaffrey pointed to two Canadian studies as evidence that syringe exchange does not necessarily prevent, and may actually increase HIV transmission. Syringe exchange opponents in Congress also pointed to the studies as evidence mitigating against lifting the ban. On Thursday, April 9, however, Drs. Julie Bruneau and Martin T. Schechter, the authors of the studies, published an op-ed in the Times claiming that the officials had misinterpreted the research and that factors such as the population sample, the type of drugs injected (cocaine, which is generally injected far more frequently by users than heroin) and the under-provision of exchange services were responsible for the high transmission rates that the studies reported.

2. OAKLAND ASSET FORFEITURE LAW CHALLENGED -- AND, FEDERAL FORFEITURE UPDATE

The American Civil Liberties of Northern California sent a letter last week to the Oakland City Council, notifying them of a recent opinion issued by the Legislative Counsel of California which concluded that the City of Oakland's vehicle seizure and forfeiture ordinance "is void as contradictory to state law."

At issue is an ordinance titled "Operation Beat Feet", which the Oakland Police Department has utilized to seize and sell automobiles allegedly used to solicit acts of prostitution or acquire illegal drugs -- even when there is no criminal conviction. State law prohibits forfeiture in such cases, except when following conviction and proof of guilt beyond a reasonable doubt. For more info on the Oakland issue, visit http://www.aclunc.org/pressrel/980331-seizure.html.

On the national front, Forfeiture Endangers American Rights (FEAR) reports that HR 1965, a bill that would have further increased federal powers and weakened citizens' protections against property seizure, has been abandoned by its sponsor, Rep. Henry Hyde.

Hyde's support for HR 1965, a bill drafted in close consultation with the Dept. of Justice, was considered by forfeiture reform advocates to be odd, given his formerly strong advocacy on behalf of reform, including authoring of a book, "Forfeiting Our Property Rights: Is Your Property Safe from Seizure?", published by the Cato Institute, endorsed in a press conference by the ACLU, and his sponsorship of HR 1835, a decent forfeiture reform bill supported by advocates. Hyde's apparently contradictory positions led to speculation (unconfirmed) that he may have been misled by staff members, or that the illness and death of his wife may have been a contributing factor in his misjudging DOJ's bill.

Hyde is again supporting HR 1835, but forfeiture reform is still very much an uphill battle. For further information on forfeiture and how to get involved in reform efforts, visit FEAR's web site at http://www.fear.org.

(Two important books on asset forfeiture are Henry Hyde's book, mentioned above, and A License to Steal: The Forfeiture of Property, by Leonard W. Levy, professor of law at the University of North Carolina. Both books can be purchased from amazon.com by following these links. DRCNet will earn 15% of your purchase price on Levy's book but not Hyde's. The Hyde book can also be purchased directly from the Cato Institute, http://www.cato.org.)

3. SENATE WOULD EXTEND MARIJUANA PROHIBITION TO INCLUDE MEDICAL RESEARCH

- adapted from NORML weekly news, http://www.norml.org

The Senate approved a "sense of the Senate" resolution on April 3 denying funding for any future medical marijuana research projects. The amendment, introduced by Sen. Gordon Smith (R-OR), is included in Senate Concurrent Resolution 86, a measure outlining Congressional budgets for the next five years. Although the amendment is not legally binding, the resolution may influence Congress when determining funding levels for health and research programs. NORML Executive Director R. Keith Stroup said:,"This amendment is a slap in the face to respected scientific and medical institutions such as the National Institutes of Health, the American Medical Association, the National Academy of Sciences, the American Cancer Society, and others -- all of which have recently urged the federal government to facilitate clinical trials to better determine marijuana's therapeutic potential." Senate Amendment 2180 states that "no funds appropriated by Congress should be used to... fund or support, or to compel any individual, institution, or government entity to... support any item, good, benefit, program, or service, for the purpose of marijuana for medicinal purposes." Smith argued that his amendment will help ensure that America's children are not sent mixed messages on drug use."

Currently, all scientific protocols to examine marijuana's medical potential must receive federal funds. According to Rick Doblin �- head of the Multidisciplinary Association for Psychedelic Studies -- this is because the only legal supplier of marijuana for research purposes remains the National Institute on Drug Abuse, and that agency will only consider providing marijuana to projects that have passed the NIH grant review process. NIH is currently funding only one study regarding marijuana's medical potential. Senate Con. Res. 86 now goes to the House for consideration.

For more information, contact either Paul Armentano or Keith Stroup of NORML at (202) 483-5500.

4. FELONY CHARGES FOR WOMAN CULTIVATING MARIJUANA FOR UKIAH CANNABIS BUYERS' CLUB

- Troy Dayton for DRCNet

On April 2, Lake County, California district attorney Stephen Hedstrom slapped Yvette Rubio with felony counts of possession and cultivation of marijuana for sale. Rubio was arrested last fall. Rubio was supplying marijuana to Cherrie Lovett, medical marijuana patient and founder of the Ukiah Cannabis Buyers' Club. Rubio cultivated the plants assuming she was covered by Proposition 215, the 1996 initiative legalizing the medicinal use of marijuana.

The 51 plants were surrounded by fences with copies of a contract identifying the crop as a supply for a cannabis buyers club. If convicted, Yvette Rubio could face three years in state prison.

Rubio's property lies on the border between Lake County and Mendocino County. Mendocino County's Board of Supervisors has written letters and passed resolutions denouncing federal opposition to the Ukiah CBC. Evidently, Lake County does not feel the same way.

Marvin Lehrman, Director of the Ukiah CBC told the Week Online, "This is a big step backward. We were moving in the other direction. People in need are getting relief from this plant. I can't understand why anyone would want our potential suppliers prosecuted. Luckily, for our patients, we were able to find other sources." Rubio, however, is not as lucky.

According to the Santa Rosa Press Democrat, Lake County district attorney Stephen Hedstrom maintains that his actions are within the guidelines of Prop. 215. According to Hedstrom, the recent ruling against Dennis Peron of the San Francisco Cannabis Cultivators Club makes it clear that marijuana cannot be grown as a commercial enterprise. Hedstrom claims he waited for the outcome of the Peron case before deciding whether to prosecute Rubio.

"We are not a commercial enterprise. We are a volunteer, not-for-profit organization, dedicated to providing patients with safe, affordable marijuana in a safe environment under a law passed by the majority of Californians," said Lehrman.

Rubio's attorney, David Nelson, told the Press Democrat, "What we don't like is the felony prosecution. She's got plans in her life. She wants to go to school. It's a killer."

5. "IT'S THE PAIN, STUPID": KEVORKIAN, PAIN AND THE DEA

A March 16 Boston Globe article reported that Bill Connaughton of West Roxbury, Massachusetts, known as "BostonBill" in the online chat rooms that he organized for people with fibromyalgia, became the 98th client of Dr. Kevorkian. BostonBill was active to the end, providing advice, encouragement and support to his fellow patients through the net. Hence, his sudden end was a shock to the online patient community.

The Globe article, which can be accessed by visiting http://www.boston.com and going to keyword "BostonBill", discussed and quoted extensively from the ensuing online debate over physician-assisted suicide (though in a letter distributed posthumously, BostonBill explained that he considered it to be submitting to euthanasia, rather than suicide, considered a sin in his religion, Catholicism.

A side of the issue not discussed, however, was the reason so many chronic pain patients consider the suicide option: undertreatment of pain. In a post on the Usenet titled "It's the Pain, Stupid", an individual, perhaps another patient, wrote:

"I just feel I need to shout out how sad it is that a fibromyalgia patient has to resort to Dr. Kevorkian for relief from his pain. If we didn't have so many doctors scared to prescribe the medicine necessary to relieve the pain, BostonBill would still be alive today, helping others in need and advancing the cause to find a cure for this DD. I think it is just about criminal to let patients suffer when there are meds available."

In 1996 DRCNet reported on the case of Dr. William Hurwitz, a Virginia physician whose license was revoked for pain treatment practices that were lauded by experts but considered controversial by the state's Board of Medicine (see http://www.drcnet.org/guide10-96/pain.html to read about the incident and the harassment suffered by some of his former patients at the hands of DEA agents). Hurwitz followed the principle that the appropriate dose of medication for a pain patient is the dose that relieves the patient's pain.

In a dramatic turnaround last year, the board, with many of the same members, restored Hurwitz's license to practice medicine and prescribe controlled substances, and voiced their approval of Hurwitz's general method of pain control. Hurwitz is still not back in business, however, as the DEA has continued to withhold his federal controlled substances license, leading some pain patient advocates to conclude that the DEA is the enemy in the fight for pain relief. Skip Baker, President of the American Society for Action on Pain (ASAP), commented, "that pain could have been controlled if Dr. Hurwitz was permitted by the DEA to do his life saving work the DEA is now blocking... It's not a matter of physician assisted suicide, it's a matter of no pain control in America making physician assisted suicide necessary!"

ASAP is a patient support network advocating for adequate use of opioids (narcotics) in pain treatment. Check them out at http://www.actiononpain.org and read about ASAP's March on Washington this June.

6. VACLAV HAVEL VETOES BILL CRIMINALIZING DRUG POSSESSION

Vaclav Havel, legendary fighter for freedom and human rights and now President of the Czech Republic, has vetoed a bill this week (4/6/98) which would have banned possession of drugs for personal use in that country. Havel cited human rights concerns. Spokesman Ladislav Spacek told Reuter's News Service, "The President reached the opinion that the law would lead to the prosecution of victims rather than culprits." Reuter's also reports that experts have warned the Czech president that such a law would drive up drug prices, fueling crime, and that criminalized addicts would be less likely to seek treatment.

(See this week's editorial for commentary.)

7. UPDATE ON DRUG AND HARM REDUCTION POLICIES IN CENTRAL AND EASTERN EUROPE AND THE NEWLY INDEPENDENT STATES

- Jean Paul Grund for DRCNet

These are interesting times for drug policy in Central and Eastern Europe (CEE) and the Newly Independent States (NIS). In the Russian federation, rather draconian drug laws have recently been passed which will turn providers of needle exchange or substitution treatment into criminals -- even discussing safer drug use practices with an injection drug user could be construed as "inciting to use drugs" under the new law -- and have disastrous consequences for the prevention of AIDS and Hepatitis C. Meanwhile, we are witnessing the dawn of an explosive HIV epidemic in Russia, which will make the epidemic in the U.S. look futile. On the other hand, countries like Poland, Hungary, and Lithuania seem bound on a more pragmatic path. All three countries recently introduced legislation which allows for (increasing) substitution treatment with methadone, and, in Lithuania, other opioid agonists. In the Czech Republic and Slovakia, methadone treatment was introduced in 1997. This treatment is also available in Croatia, Slovenia, Macedonia, Latvia and Estonia. While Poland recently criminalized possession of drugs, it exempted small quantities for personal use. In the Ukraine, which is confronted with an immense injection-related HIV epidemic, the Deputy Minister of Justice recently signed a statement that harm reduction interventions are not in contradiction with the national legislation of the country.

The latest decision of President Vaclav Havel to veto the law banning possession of drugs for personal use, citing human rights concerns, is definitively a victory for common sense and pragmatic drug policy. This is a very promising action, especially when taken by a revered man such as Havel, but it does not come totally out of the blue. While the prohibitionist forces are definitively part of the policy spectrum in the Czech Republic, it seems that at present drug policy is made by people with pragmatic and harm reduction oriented attitudes. Pavel Bem, for example, the chairman of the national drug commission (the Czech drug czar), is a young psychiatrist and a very sophisticated thinker. Likewise, drug services in Prague are increasingly working with harm reduction models and cannabis use seems to be tolerated and not a reason for major concern.

During my recent visit to the Czech Republic I witnessed rather open use of this drug in several music clubs. In my view the drug policy situation in the Czech Republic resembles the situation in the Netherlands in the 1980s. Perhaps the country can become an example for sensible and pragmatic drug policy for the whole CEE region. I don't know what it's worth as an indicator, but until now, there is hardly any injecting related HIV reported in the Czech republic.

(Jean-Paul C. Grund, Ph.D. is Director of International Harm Reduction Development for the Lindesmith Center, a project of the Open Society Institute. You can find them on the web at http://www.lindesmith.org.)

8. GERMAN DOCTORS VOTE IN FAVOR OF HEROIN PRESCRIPTION

The British Medical Journal (4/4) reported that the German Medical Council has voted unanimously in favor of allowing heroin to be prescribed to long-term addicts. The issue will now go to the Minister of Justice, with the Council's recommendation, for approval. Council member Dr. Ingo Flenker told the BMJ that the doctors were influenced by the results of the Swiss maintenance trials, in which over 1,000 addicts were given access to the drug over a three year period. The results of that experiment are considered by the Swiss to be overwhelmingly positive, with marked improvement in housing, employment, admissions to treatment, health and mortality among participants.

The BMJ further reports that a poll, taken by the German newspaper Die Woche, found that 55% of Germans support making the drug available to hard core addicts under a doctor's supervision.

Dr. Ethan Nadelmann, Director of the Lindesmith Center, a drug policy think tank, told the Week Online, "The Swiss experiment proved that heroin maintenance can be a successful part of an overall policy aimed at reducing the harms of substance abuse both to the user and to society. It is truly encouraging that the German Medical Council has followed the science, rather than ideology in making this recommendation. With more and more countries, Australia, the Netherlands, Denmark, Luxembourg and now Germany expressing interest in replicating the Swiss model, and assuming that the results of future trials are similar to what we have already seen, it's going to be difficult for countries like the U.S. to continue to denigrate this modality and to dismiss it out of hand."

(The First International Conference on Heroin Maintenance will take place on June 6, at the New York Academy of Medicine, 5th Ave. and 103rd St. in Manhattan. For information, contact the Lindesmith Center at (212) 548-0695 or e-mail [email protected].)

If you missed our story on how Swiss voters overwhelmingly approved of heroin maintenance, check it out at http://www.drcnet.org/rapid/1997/9-28-1.html#switzerland. And if you missed our story on back-door U.S. pressure on Australia to not conduct a similar trial, check it out at http://www.drcnet.org/rapid/1997/7-24-1.html#blackmail.

9. DRUG POLICY LETTER FOCUSES ON WOMEN AND DRUGS

The current issue of the Drug Policy Letter, publication of the Drug Policy Foundation, focuses on the topic "Women and Drugs". Articles include "Women and Treatment", by Marsha Rosenbaum, discussing the biases and shortcomings faced by women seeking treatment; "Dorothy Gaines: Guilt by Association", by Rob Stewart, the story of an innocent woman serving a 19-year, 7-month sentence for conspiracy to distribute crack cocaine; "Caught in the Crossfire", by Robin Lloyd, chair of the Drug Policy Committee of the Women's International League for Peace and Freedom, on the Colombian women's movement opposing aerial fumigation of coca fields and the increasing presence of the Colombian military; "The Price of Principle", statement of Sherry Hearn, a former high school teacher in Chatham County, Georgia who was subjected to persecution after criticizing the school and local police's random, lockdown searches in the schools; an essay by Scott Ehlers on the women's repeal movement, based on a book by Kenneth D. Rose, American Women and the Repeal of Prohibition.

"In Their Own Words", by Whitney Taylor, features conversations with members of the Bridgeport Needle Exchange Program's Women's Group, a group of 50 women in various stages of use, recovery and abstinence. Insights shared by members of the group, gained from their real-world experience, verify the claims made by reformers and medical and public health groups that fear of the system drives pregnant women drug users away from the treatment services and prenatal and other health care that they and their children need. "Here in Connecticut," says a woman named Kathy, "if a woman is pregnant and she has a heroin habit and she going into the hospital to have her child, they will take her children away... It is making them go further and further out into the street. They're afraid."

"The United Nations & the Taliban", by Karynn Fish, describes the unholy alliance between the United Nations Drug Control Program and the extremist religious group that has seized control of two-thirds of Afghanistan and has institutionalized a system of extreme discrimination against women (see http://drcnet.org/rapid/1997/12-5-1.html#taleban for background). The UNDCP's plan to fund the barbaric Taliban is one of the issues to be protested during the Global Days Against the Drug War this June 6-8 -- see http://www.stopthedrugwar.org/globalcoalition/ for more information and to sign on.

To join the Drug Policy Foundation and subscribe to the Drug Policy Letter, send $25 or more for annual membership dues to: DPF, 4455 Connecticut Ave., NW, Suite B-500, Washington, DC 20008, or sign up online at http://www.dpf.org, or write or call (202) 537-5005 for a sample copy.

10. MEDICAL AND PUBLIC HEALTH ORGANIZATIONS OPPOSE CRIMINALIZATION OF PREGNANT ADDICTS

Last November we reported that the South Carolina Supreme Court had upheld an 8-year prison sentence for a woman whose newborn child tested positive for cocaine from her cocaine use. This week, a coalition of physicians, health advocacy groups and drug treatment providers filed a "friend of the court" brief with the U.S. Supreme Court today opposing Whitner v State, a South Carolina Supreme Court decision which allows a woman to be criminally prosecuted for conduct during her pregnancy.

According to Margaret W. Crawford, Board Chair of The Alliance for South Carolina's Children, "This case is about ensuring newborns a healthy future. South Carolina's Attorney General Charles Condon thinks jail will deter substance abuse. However, treatment centers are already reporting that far fewer women are seeking treatment and prenatal care due to this policy -- causing further harm to women, children and families."

Daniel Abrahamson, Director of Legal Affairs for The Lindesmith Center, stated, "Mr. Condon has ignored the countless pleas of physicians and alcohol and drug treatment providers to treat, not prosecute, pregnant women suffering from chemical dependence. Now, the women and children most in need of help are suffering horribly as a result of Mr. Condon's misguided and draconian policies."

Among the medical groups and public health organizations submitting the brief are the American College of Obstetricians and Gynecologists, the American Nurses Association and the American Medical Women's Association. For the full list of signatories, a fact sheet on the Whitner case, a fact sheet on cocaine and pregnancy, and selected news articles about the case, visit the Lindesmith Center's Office of Legal Affairs web site at http://www.lindesmith.org/about_tlc/legal.html.

11. EDITORIAL: Vaclav Havel's Second Prague Spring

In the Czech Republic last week, Vaclav Havel, true to his history, took a courageous stand for liberty, human rights, and the rational ordering of society when he vetoed a bill which would have criminalized the possession of drugs for personal use. In doing so, he cited not only the cruelty of punishing the victim, but also the absurdity of driving up prices, fostering crime and empowering the forces of the black market. Havel, a writer and intellectual, played an active role in the democratization and renewal of culture that took place in 1968, helping to usher in a brief moment of freedom in Czechoslovakia before the Soviet tanks rolled in to reassert their dominance and put an end to that now-legendary Prague Spring.

Much has changed since 1968. Havel, who was jailed by the Communists as a dissident, is now the President of the Czech Republic. And although its dominance over Havel and his compatriots lasted for another twenty-one years, the Soviet Empire, unable to maintain their control over information in an age in which walls could no longer keep out words, is no more. But in vetoing that bill, in refusing to subvert the rights and the well-being of people to the dictates of ideology, Havel, and the world, may very well find that it is 1968 once again, and that the tanks are gathering at the gates, preparing to crush a rising rebellion.

Across the globe, the movement to end the Drug War is growing. And just as Alexander Dubcek, Vaclav Havel and a generation of Czechs were responding to the failures and the oppression of Communist rule, so too today's dissidents are responding to the failures and oppression of the Drug War. But now as then there is much at stake for the ideologues: money, careers, power, control. And now as then, dissent itself poses a real threat to an ideology without intellectual or moral legitimacy.

In June, the United Nations will hold its first-ever Special Session on Narcotics. Far from an open discussion of the impact and effectiveness of the global war, the agenda will be tightly controlled. Its mission, as stated, is to encourage greater international cooperation and wider participation in the war effort. Vaclav Havel's writings during his years under Communist rule often spoke to the intellectual contortions of people striving to function under an obviously flawed and illogical system. At the UN, a similar display is in the offing as the Session's attendees attempt to ignore the fact that the enemies in their war -- a global criminal network, legions of corrupted officials and institutions, and the proliferation of dangerous and addictive substances -- have all been either exacerbated or created entirely by the very system that the session is designed to perpetuate.

Ironically, it is the United States, arch-enemy of the old Soviet empire, that is the driving force behind the global Drug War. Domestically, the war has made the U.S. the world's number one per capita incarcerator, highlighted by an astounding one in three young African-American males under criminal justice supervision. That such oppression has failed to reduce the availability of drugs has only made the prohibitionists more determined. According to America's Republican Congressional leadership, legislation will be introduced this spring which will outline "a World War II-style" effort to replace the "half-hearted" and "weak" status quo. Internationally, the prosecution of the war has led the U.S. to steadily increase its military involvement in Latin America, including arms and personnel sent into a 35 year-old Colombian civil war -- a war which has grown exponentially as the native coca crop has been alchemized by prohibition -- and a planned "Hemispheric Anti-Narcotics" military base in Panama.

It is illustrative that Drug War dissenters within the U.S. have often faced Soviet-style silencing. In 1993, Surgeon General Jocelyn Elders was first marginalized, and ultimately forced to resign after suggesting that the legalization of drugs be studied. In 1994, Representative Gerald Solomon sponsored a bill which would have stripped the tax-exempt status of any non-profit organization advocating the legalization of drugs. In 1996, California Attorney General Dan Lungren held a press conference to urge that the nation's newspapers refuse to run a Doonesbury comic strip supportive of a state medical marijuana initiative. And over the past two years, Barry McCaffrey, dispensing the powers of the aptly named office of the "Drug Czar", has met several times with American media executives to lay out the government's views on the proper and improper depiction of drugs and the people who use them.

Despite, or rather because of the escalating and heavy-handed methods of the U.S.-led Drug War, voices of dissent are rising up not only in America but around the world. It is becoming quite apparent that this dissent, and the obvious failure to which it points, have made the prohibitionists desperate to prove that their system can work. Their only possible response, given their lack of success at the current level of repression, and their steadfast support of the prohibitionist model, will be to escalate.

This week, Vaclav Havel stood up once again for the rights, the freedoms and the dignity of Man. As in 1968, his action comes amidst a growing spirit of reform, and a sense of hope that an age of repression is ending. But now as then the ideologues cannot allow the reform movement to grow, and the forces of repression, this time American-led, will undoubtedly respond. But instead of the Czechs, standing in the path of the coming onslaught will be the peoples of Central and South America, of Central Asia, of the United States, and of any nation that follows her lead.

Make no mistake, the current ascendancy of reform is but another Prague Spring, and the tanks are even now gathering at the gates. But unlike the last time, Vaclav Havel and the rest of the world will not have to suffer for a generation before the ideologues fall. Because this is 1998. And today, unlike thirty years ago, we are living in an age of electronic communication and the free flow of information. And information is the single most potent weapon in the fight against repression. Just ask the Soviets.

Adam J. Smith
Associate Director

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