The Drug Policy Digest

Sunday, December 07, 2003
Rush to Judgement?
The New Republic Charges "The Orotond One" With Hyporcrisy

For those who haven't heard enough about Rush Limbaugh's drug addiction and early recovery, The New Republic's December 1, 2003 issue ("Notebook" section) does a pretty good job of summarizing his situation and a commentary on Rush's revisionist view of his drug use. An excerpt:

"People are saying that I am a hypocrite, as I was using drugs. Yet I was telling people to lead a moral life," Limbaugh explained. "[But] my behavior doesn't change right and wrong. ... There's no hypocrisy in this, because ... it didn't change the value of right and wrong simply because I didn't abide by it at a particular time." Umm, exactly. No one is arguing that Limbaugh's transgressions made taking drugs "right," merely that, as he himself admits, he was saying one thing and doing another--in a word, a hypocrite.

And, as readers of this column has heard before, The New Republic reports that Rush had held others to a higher standard than he held himself:

To take just a couple examples from his past, Limbaugh once opined, "We have alcoholics and drug addicts in our society, don't we? And what do we say about them? Well, they can't help it. ... [Y]eah, like that line of cocaine just happened to march into the hotel, go up to the athlete's room, and put itself right in front of him on his blotter." More to the point, he also once declared that "too many whites are getting away with drug use. ... The answer is to go out and find the ones who are getting away with it, convict them, and send them up the river." Now that Limbaugh himself has been found, however, conviction and a trip up the river do not appear to be the next steps in his personal program.

As he returned to his old style, Limbaugh returned to the familiar theme of liberal-bashing:

"[T]he problem with liberals," he explained, "is that they don't like themselves. ... All this phoniness, all this reaching out, all this: 'Please like me, please, we're not that bad, please, we don't want to hurt you, please get along with us.' It's not possible, my friends, because they don't like themselves. ... We're not trying to establish intimacy with [liberals]. We want to crush them."

Well, some people enter recovery and learn larger lessons about acceptance and tolerance, and some emerge with a renewed almost Puritanical desire to "crush" nonbelievers and others with divergent views.

Meanwhile, rumor has it that Limbaugh may be in for more scrutiny as federal investigators note that his bank withdrawals to support his illicit drug habit (amounts that seem to be designed to circumvent bank regulations to detect money laundering for, well .... illlicit drug commerce) show a disturbing and possibly illegal pattern of taking out money in amounts just below the "trip wire" reporting limit. More, I'm sure, will be revealed.

Stay tuned.

Sunday, November 23, 2003
After Limbaugh's Return, Listeners Get Conservatism from a "Recovery" Point of View
But Limbaugh Refuses to Discuss Possibility of Criminal Charges and "Pretends" He Doesn't Know Names of Painkillers

The New York Times story on Limbaugh's return to radio, gives some valuable insights into the ordeal he has been through in recent months, if not years. However, he may not be prepared to "come clean" on all aspects of his behavior.

NOTE: Click here for one cartoonist's view of the Limbaugh story: Rush Off Drugs.bmp

After emerging from a self-imposed exile in which he was treated for an addiction to painkillers, Rush Limbaugh returned to the air yesterday. Listeners who tuned in during the first few minutes of his radio show would have been forgiven if they thought they were hearing an Oprah-style self-help session.

"I have to admit that I am powerless over this addiction that I have," Mr. Limbaugh, speaking from a Manhattan studio, told his listeners, just after noon on the East Coast.

During a 16-minute opening monologue, Mr. Limbaugh, who has spoken in the past about the need to jail more drug abusers, instead borrowed liberally from the teachings of 12-step programs like Alcoholics Anonymous.

At times, he said, he even pretended that he did not recognize the names of painkillers mentioned by callers.

Though the early segments of his three-hour show were devoted to what Mr. Limbaugh had learned about himself in treatment, he still took time to practice his stock in trade, advancing the message of the right and lambasting the left.

"Many people feel and think that when you go to a rehabilitation center for addictions or other things, that the people in there turn you into a linguini-spined liberal, and that's not true," he said.

Among the problems with liberals, Mr. Limbaugh said he had discovered, is that "they don't like themselves."

Mr. Limbaugh said there was only one subject he would not talk about on the air: news reports suggesting that he had acquired drugs like the painkiller OxyContin without a prescription and that the matter was now the subject of an investigation.

Thursday, November 20, 2003
"Marijuana-Related" Death Cited
Victim Chokes on Plastic Bag of Pot

FORT WORTH, Texas -- an Associated Press report carreid by Salon Magazine says that a man changing a flat tire choked to death on a bag of marijuana he had stuffed down his throat in an apparent attempt to hide it from police who stopped to help him, authorities said.

Officers were unaware that the victim had drugs when they spotted him on the highway in Corinth, about 45 miles northeast of Fort Worth.

The driver, Nickolas Sandoval, 24, was pronounced dead at a hospital. Cause of death: "asphyxiation due to aspiration of plastic bag," according to a spokeswoman for the Tarrant County Medical Examiner's Office.

Sunday, November 16, 2003
UCLA Study Says Treatment Alternative to Jail Works

California's three-year-old addiction-treatment initiative finds that more people are getting help instead of being sent to jail, according to a UCLA 5-year study published in the latest edition of the journal Under California's Proposition 36, first-time, nonviolent drug offenders are sent to a treatment program rather than jail or prison.

The study found a sharp increase in the number of admissions to treatment programs in several of the state's major counties: Kern County, 27 percent, Riverside County, 21 percent, Sacramento County, 17 percent, and San Diego County, 16 percent.

San Francisco was the only county not to see an increase, because it already was using an ambitious diversion program for first time drug offenders.

The study says that existing drug programs are running into challenges with offenders with additional problems, such as mental illness, disability, or homelessness.

The study "Treating Drug-Abusing Offenders" was published in the October 2003 issue of Evaluation Review (Vol. 27 No. 5).

Wednesday, October 22, 2003
Washington Post Publishes Major Series on Internet Drug Suppliers
Series Examines Regulatory Loopholes and Impaired Physicians Facilitating Online Narcotic Sales

In response to the alleged widespread Internet availability of such drugs as Vicodin, Valium, "Diet Pills," and other controlled substances, The Washington Post and other papers have begun to investigate drug-related overdose deaths and increasing rates of substance abuse.

While online "patients" are typically required to fill out an extensive medical history and report what drugs they are currently taking, it is unusual for the medication requests (actually, orders for specific drugs) to be refused. Online pharmacies claim to have physicians who review each case before approving their orders and may request supplementary documentation of identity or even medical records, but authorities are increasingly convinced that these operations are merely sophisticated drug-dealing operations.

National surveys of high school students indicate that, after marijuana, the abuse of prescription medications (often painkillers, sedatives, and stimulants) are the second most popular form of illicit drug use. Because these drugs are taken by those not named on the prescription or for reasons other than prescribed, this use is regarded as "illicit" under federal surveys. The use of alcoholic beverages by persons under the age of 21 is also illicit but is not reported by these studies.

Details on the rates of prescription drug abuse can be found in such studies as the "Monitoring the Future" survey and the "National Survey on Drug Use & Health (NSDUH)" annual report (previously known as the "National Household Survey on Drug Abuse (NHSDA)."

The Washington Post's first report, "A Vast, Unregulated Shadow Market U.S. Prescription Drug System Under Attack" was published on Sunday, October 19th.

The second article, "How the Internet Became a Pipeline for Deadly Drugs: Internet Trafficking in Narcotics Has Surged" was printed in Monday's edition. And the third segment "Dangerous Doctors Online: Doctors Medicate Strangers on Web" was in Tuesday's edition (October 21st). Part Four "Lax System Allows Criminals To Invade the Supply Chain" is today's piece.

The Washington Post's reporting on this series involved some serious research and legwork, including "... more than 500 interviews and the analysis of 100,000 pages of court filings, regulatory cases, investigative reports and computer records."

Databases at state pharmacy and medical boards permitted The Post to track 50,000 prescriptions for narcotics from various Internet sites. "A breakdown by Zip codes revealed that the preponderance of those drugs flowed to small towns in states with known prescription-abuse problems." Using medical board records, the reporters documented the histories of some of the doctors writing for the online pharmacies, including drug and alcohol abuse, criminal convictions, medical incompetence and financial difficulties.

The Post reporters "reviewed more than 250 lawsuits and criminal cases involving illicit wholesalers, pharmacies, counterfeiters and online drugstores from New York to Los Angeles. To show how tainted medication is introduced into the legitimate distribution chain, reporters also obtained wholesalers' invoices and purchase orders and matched those against records provided by a dozen patients."

In addition, The Post says that "interviews were held with security investigators for drugmakers, state and federal regulators, law enforcement officers, hospital pharmacy buyers, victims of bad medicine, Internet pharmacy operators and felons convicted of drug diversion and Internet fraud. In all, reporters traveled to 12 states, Canada and Mexico. More than 50 Freedom of Information Act requests were also filed."

Thursday, October 16, 2003
Walgreens Accepts Blame in Methadone Error and Forgery Coverup
Pharmacy Dispensed Methadone Instead of Ritalin to 7-Year-Old - Causing Coma and Brain Damage

After having denied the mistake for two years, Walgreen Co. admitted earlier this month that one of its pharmacists mistakenly dispensed methadone tablets rather than Ritalin to a 7-year-old. After taking the medication for 3 days, the concentration of methadone built up in the boy's bloodstream and caused him to lapse into a coma. After six days in the coma, the boy recovered but was apparently left with permanent brain damage. The dispensing error may have been the result of a pharmacist having misread "methadone" for "methylphenidate" (the generic name for Ritalin).

Further adding to the tragedy of this story is the admission by Walgreens that a forged prescription was substituted in the pharmacy records in a clumsy attempt to cover-up the error. Originally, Walgreens' defense claimed that their pharmacy was not missing any methadone and could account for all medication dispensed. However, when the records were produced in court, lawyers quickly became suspicious of the pharmacy's books. They saw that the "inventory log," which appeared to account for all of the methadone pills, had many entries that were crossed out and written over. New Mexico, where the pharmacy is located, is one of 18 states that the DEA says have some form of advanced prescription monitoring program (sometimes called "triplicate" programs) that provide greatly enhanced surveillance of the prescribing and dispensing of highly controlled drugs like methadone and Ritalin. The New Mexico program is not mature yet, and it is designed to prevent illicit "diversion" of controlled drugs by drug abusers and addicts, rather than misreading of a legitimate prescription.

While it is not unheard of for a patient to receive the wrong medication (due to physician error, pharmacy error, or hospital staff error), the lengths to which this pharmacist went to conceal her culpability is shocking, and a clear violation of a number of criminal laws and codes of professional conduct.

The U.S. Food and Drug Administration (FDA) alerted pharmacies last year that six similar incidents had occurred in recent years due to confusing the two drugs. One case resulted in the death of an 8-year-old boy in 1999.

The full story can be read here (*). But be wary of descriptions of methadone as "prescription heroin" (see the Houston Chronicle story) and other misinformation about this medication. Methadone is a valuable painkiller that can be prescribed by any physician who might order Percocet or other strong painkillers for relief of suffering. Like OxyContin, methadone has been unfairly stigmatized in the press due to its use in addiction treatment and its abuse potential -- factors that should not prevent the aggressive use of these medications in patients where they are indicated.

Tuesday, October 07, 2003
Drug Use in Baghdad at "Crisis" Proportions Says BBC Report
Hallucinogenics, Valium, and "Huffing" Said to be Widespread

A report in the World Edition of BBC News says that there is widespread use of hallucinogenic tablets, sedatives, and the "huffing" (inhalation by mouth) of paint thinner or correction fluid (such as White-Out). An atmosphere of "anarchy" is blamed, as is the pre-war release of most of Iraq's prisoners. The consumption of sedative tablets is said to have been popular in the prison system.

Iraqi Youth "Huffing" Paint Thinner

The report says that among the hallucinogens, some 10 to 15 varieties are available. One tablet is known simply as "Lebanon/" A user interviewed said that "When I take it, I see Lebanon, I've never been there. but it's in the tablet." Although marijuana is available, it is said to be very expensive.

Some police officials claim that, two years ago, very cheap hallucinogenic tablets were coming into Iraq as part of a "sabotage" operation from another country. The story gives no details about the chemical composition of the hallucinogens. Read the story here (*).

Friday, October 03, 2003
Arnold and/on Steroids
Can Schwarzenegger's Behavior Be Explained by his History of Steroid Use?

Those watching the California recall race must be fascinated by Arnold Schwarzenegger's emergence as a front-runner. More interesting are the recent allegations of boorish behavior towards women (groping and other "bad behavior") and, largely overlooked, towards men. In short, he seems to be an aggressive man without regard for social norms.

Can his behavior be explained by his (admitted) extensive abuse of anabolic steroids? Read Andrew Sullivan's post on his own experience with "supplemental" testosterone (which he uses under a doctor's supervision for a legitimate illness) and Salon's take on the issue for some valuable perspective. Steve Sailer, who refers to Sullivan as "AndroGel Andrew," also has some insights. AndroGel is the trade name of a transdermal prescription preparation of testosterone.

As to his allegedly pro-Hitler remarks of some 20+ years ago, well I won't judge the man by his father's sins (in this case, actual membership in the Nazi Party), but people under the influence of steroids or other mind-altering drugs have been known to say some very strange things. Just think of Rush Limbaugh for a moment.

Limbaugh, called the "moralizing motormouth" by the New York Daily News, has been implicated in scheme wherein he is said to have used his housekeeper to obtain large quantities of OxyContin and other opiate painkillers for his own use. Before getting too gleeful about this turn of events, see Mark Kleiman's site for some thoughts. Kleiman, who is generally skeptical about such things, says that "having a horrible disease" is nothing to poke fun at. For Mark's view on Limbaugh and the disease of addiction, see his post and follow a few of his links.

Tuesday, September 02, 2003
Marijuana Again Legal in Alaska Homes, Court Says
Possession for Personal Use in Home is Protected by Alaska's Right to Privacy - Remains Illegal Under Federal Law

An article in the August 29th issue of the Juneau Daily News
says that a ruling by the Alaska Court of Appeals (a state court) has re-legalized the use of marijuana by adults in private homes.

The court handed down its decision Friday and directed the state Attorney General to review the findings and make recommendations on how the state should proceed.

In its decision released Friday, the Court says Alaska citizens have the right to posses less than 4 ounces of marijuana in their home for personal use. The court cited the Alaska Supreme Courts' Raven decision in 1975, that the state Constitution protects possession of marijuana by adults for personal use in one's own home. In 1972, with financial and legal support from NORML (the National Organisation for the Reform of Marijuana Laws), a young lawyer, Raven appealed to the Alaskan Supreme Court following arrest for possession of marijuana; he declared his arrest violated his private rights. In 1975 the Supreme Court ruled by five to one in favour of Raven. In 1990, Alaskans approved a ballot proposition that re-criminalized the possession of any amount of marijuana by making possession of less than a pound of cannabis a Class B Misdemeanor. but the impact of this measure remains cloudy.

Subsequent court rulings have upheld the earlier 1975 decision, but the state's highest court has not ruled on the matter, so the law remains ambiguous.

NORML still lists Alaska as having decriminalized cannabis. According to NORML, this means users are treated leniently even though possession of less than 227 grams may be punishable by up to 90 days in jail and a fine up to $1,000.

Watch the Drug Policy Digest for more developments on Alaska's sudden shift in cannabis policy.

Monday, September 01, 2003
Justice Department Web Site "Preserving Life & Liberty" Defends Patriot Act Against Critics
Also, Clarification on the Federal Death Penalty for Drug Trafficers

Briefly off topic, the United States Department of Justice has launched a web site called "Preserving Life & Liberty" at that defends the U.S.A. Patriot Act (Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism) against those who claim the measure is.... overly ambitious. The appearance of the site in the wake of press reports that "Patriot Act II" or "Son of the Patriot Act" is about to be rushed through Congress, as some claim its predecessor was. For those interested in this type of thing, a draft of Patriot Act II, referred to in the text as the "Domestic Security Enhancement Act of 2003" (dated January 9,2003) is available here.

And, while we're on the subject, some have asked about the federal death penalty and its application to drug policy. It seems that capital punishment under federal jurisdiction is based upon two legislative acts: the Anti-Drug Abuse Act of 1988 and the Federal Death Penalty Act of 1994. Federal law now permits the death penalty in a range of crimes involving murder and at least 4 crimes that do not involve murder: espionage, treason, "attempting, authorizing or advising the killing of any officer, juror,or witness" in the course of a case involving an alleged "Continuing Criminal Enterprise" -- whether or not an actual killing or attempted killing results, and "Trafficking in large quantities of drugs." It turns out that the provision of the Linbergh Law that permitted the death penalty for kidnapping (with or without death to the victim) was nullified by the Supreme Court in 1968.

For more on the use of the death penalty in drug offenses, lawyers may wish to consult Title 18 USC, Section 3591(b) for more details.

Sunday, August 17, 2003
New York Times Article Lauds Potential of Buprenorphine in Treatment of Heroin Addiction and Other Dependencies
2000 Physicians Already Using the "New" Treatment

In an August 11th New York Times piece entitled New Drug Promises Shift in Treatment for Heroin Addicts by Richard Perez-Pena, the article discusses addicts who take buprenorphine, a drug "newly approved" by federal regulators (it's been at least ten months, now) to treat addiction to heroin and other opiates, including addiction to prescription drugs like Vicodin and OxyContin.

According to the Times, experts and addicts say it has several advantages over methadone, and the most important may be that a patient can get a supply, not merely a dose, with a visit to a doctor and pharmacy.

Like methadone, buprenorphine (pronounced byoo-pre-NOR-feen) is addictive, but the risk of overdose is much lower. Unlike methadone, buprenorphine will not give an addict more than a mild high no matter how large the dose, and it cannot be combined with opiates or other narcotics to get higher still. Users suffer fewer unpleasant side effects, and milder withdrawal symptoms when they stop taking it.

Other highlights of the article:

* The relative ease with which a supply of buprenorphine can be obtained is a radical departure from the use of methadone, which is tightly controlled by federal law and can be given only one daily dose at a time, in licensed clinics where space is limited. Experts say the advent of buprenorphine could triple the number of people in treatment for heroin addiction.

* Some experts see the change as more evolutionary than revolutionary, warning that much remains to be learned about buprenorphine, and that methadone, too, was once seen as a wonder drug. But they are enthusiastic, saying that since doctors began prescribing buprenorphine in October, the experience has been overwhelmingly positive.

* New York City has an estimated 200,000 heroin addicts, and only 38,000 methadone program slots. Nationally, there are 800,000 to one million heroin addicts and about 180,000 methadone clinic spaces, and addicts outside major cities often live nowhere near clinics. Experts say that for every heroin addict, there are two people addicted to prescription opiates, drugs like oxycodone, hydrocodone, codeine and morphine, and that buprenorphine can be effective for them, as well.

* Buprenorphine will not work for all addicts, and will not completely replace methadone. Some people simply will not respond well to it, which is true of almost any drug.

* Buprenorphine has been used as a painkiller for many years, and a few researchers, including Dr. Kleber, were permitted to make limited use of it for addiction treatment. In general, though, for decades federal law has prohibited use of any drug but methadone for heroin addiction.

* After a long lobbying campaign by treatment advocates, Congress loosened the law in 2000, and last October, the Food and Drug Administration ruled that doctors could prescribe buprenorphine in their offices for addiction treatment. To prescribe it, a doctor must first take an eight-hour course and register with the federal Drug Enforcement Administration. Because buprenorphine is addictive and has a potential black market, federal law prohibits a doctor from prescribing to more than 30 patients at a time.

* Since October, about 2,000 doctors nationally have been cleared to prescribe buprenorphine for drug treatment, including 218 in New York State and 62 in New Jersey. People in the drug treatment field say there are no more than a few thousand people around the country taking buprenorphine.

* New York State has decided that Medicaid, the health plan for the poor, will cover buprenorphine, but most states and most private insurance plans do not. Doctors say the retail cost is $5 to $10 a day.

* France allowed general practitioners to prescribe buprenorphine in 1996, and has reported a sharp drop in fatal overdoses. New York City alone has about 200 heroin overdose deaths each year.

* Buprenorphine latches onto the same receptors in the brain as heroin, methadone and other opiates, but more aggressively and effectively. A person already on buprenorphine who took another opiate would feel no effect, because the second drug would be unable to push the buprenorphine out of the way and latch on. Buprenorphine stays in the system longer, so many people can take it every other day, rather than every day.

* Buprenorphine is also unlike the others in having a "ceiling effect;" that is, beyond a certain dosage, taking more does not make the person any higher, or depress breathing any more. That reduces the risk of both abuse and overdose.

The withdrawal from buprenorphine ("bupe" as the article refers to it) is less serious than coming off of heroin or methadone.

Buprenorphine's debut as a treatment modality for addiction may have an important significant symbolic value, since it is the first opiate in decades that has been approved to be prescribed or administered in a physician's office. Many of us can recall when this was a criminal offense and doctors were imprisoned for trying to assist addicts.

Click Here to find a physician near you who is approved to use buprenorphine as an adjunct to recovery. There are about 175 such doctors in California as of August 2003.

Read the complete article here. Physicians interested in obtaining certification for using buprenorphine in their practice should see the Health and Human Services Buprenorphine site for information on training and waivers. Note that, like methadone, buprenorphine remains available for use in treating pain and other symptoms associated with organic disease processes. It may not be used for addiction treatment without special physician certification and a DEA endorsement to one's current DEA license. SPECIAL NOTE: Buprenorphine is *NOT* a Schedule V (exempt) controlled substance as stated in some parts of the DEA website. It is currently a Schedule III drug and all rules pertaining to the prescribing of these medications apply to this drug, in addition to the special provisions for using it as a treatment for addiction.

For more information about this medication and its use in addiction treatment, see The Australian Drug Foundation (ADF) web site for details.

Saturday, August 16, 2003
Kicking the (Heroin) Habit in Myanmar (Burma)
Country Moves Away from Opium and Heroin to Gambling and Prostitution - This is Progress?

In a recent article in The Los Angeles Times, "Myanmar Tries to Kick Its Habit" by Mitchell Koss, the author describes a forthcoming (this winter) documentary on the Golden Triangle by Mitchell Koss and Laura Ling will be presented this winter by the National Asian American Telecommunications Association.

Some excerpts:

In the late 1980s, the government of Myanmar ceded a region where a fifth of the country's opium is produced, dubbed Special Region #2, to the United Wa State Army. The area was granted autonomy in exchange for an end to its decades-long war against the Burmese majority to the south.
Our army guide took us to a newly opened "casino," a rough barn-like structure where the gamblers ran away when he walked up to a table. He then led us to a shed-like karaoke bar staffed by very young women imported from across the border in China. There, my colleague, encouraged by our enthusiastic host, sang John Lennon's "Imagine."

Our real reason for wanting to see the region, though, was to check out a U.N.-run voluntary opium-reduction program being run in several hundred Special Region #2 villages, funded in large part by the United States. Farmers here traditionally grow opium for cash to buy food because they usually can't grow enough food for a whole year. Everywhere, fields of largely white flowers climbed the steep sides of the green mountains.

Once, in the mountains above Neiva, Colombia, in February 1999, I was caught by insurgents from the Revolutionary Armed Forces of Colombia while filming poppy fields for a documentary and was lucky to be let go with a warning. But in Special Region #2, the opium harvesters are not camera-shy. Barefoot women, some of them teenagers with babies on their backs, laboriously scored the poppy buds to draw out the opium gum, while others scraped the dried opium off buds that had been cut the day before. But unlike opium or coca farmers I've seen in Colombia and Bolivia — where an illicit crop can bring enough wealth to buy a pickup truck and a satellite dish — the average Golden Triangle family makes only $200 per year from its opium, according to the United Nations.

As I watched the women harvesting opium, I noticed that one woman's baby was covered with scabs; another's was going blind from conjunctivitis — "pinkeye," a common illness here but one that's easily cured with antibiotics. In Special Region #2, it is a common cause of blindness. The Wa have little access to health care or medication, other than opium. Indeed, smoking opium to alleviate malaria, TB or any of the other endemic diseases results in a high rate of addiction in the villages.

The region's extreme poverty is summarized by what passes for progress. The U.N. took us to a couple of model villages where the newest innovations were pit toilets and clothes for children.

On market day in the newly electrified town of Mong Pawk, we watched villagers bring their opium to Chinese women sitting by small scales. The opium buyers were a little more camera-shy and wouldn't answer questions. But the U.N. told us that a kilo of opium in Myanmar fetches only $120, about a fifth of what an ounce of high-quality Vancouver-grown marijuana — "B.C. Bud" — can retail for in New York City.

From the Mong Pawk market, the opium goes global. The distance separating Special Region #2 from Yunnan province, China, across the river, is literally a stone's throw (I made it on my sixth try). According to the U.N., in the early 1990s, globalization gave rise to mainland Chinese organized crime syndicates that challenged the supremacy of the old Hong Kong/Taiwan smuggling groups, just as Shanghai now challenges Hong Kong as a business capital. When mainland Chinese syndicates began turning Myanmar's opium into heroin and smuggling it out, 60% of the drug began crossing China. And some of it began staying there.

About the time heroin began crossing over, so did HIV. In the Mong Pawk market we watched as U.N. workers demonstrated how to put a condom on a model penis (ignored by the passing karaoke girls). Some studies estimate that Myanmar has the second-highest HIV rate in Asia, after Cambodia. So now China, with 1 million to 2 million intravenous heroin users, is facing the possibility of 10 million HIV cases by the end of the decade.
On the journey back out of Special Region #2, we stopped for the night in the city of Mong Lar, in the adjoining Special Region #4. Compared to where we'd just been, Mong Lar looked like a metropolis. It has eliminated opium production. Taking advantage of the nearness to China, Mong Lar has switched from opium to large casinos. Unlike the makeshift Wa casinos, Mong Lar's gambling palaces light up the night sky and draw thousands of Chinese visitors. Around the casinos are streets of brothels staffed by young women from all over China.

Suddenly, it all clicked. We understood why the Wa leaders had taken us to those would-be casinos and karaoke bars — they were showing how they planned to get rid of opium. They want to go into the tourism business.

Perhaps the Wa would try harder to stay in the opium business if it were more lucrative. They seem lately to be embracing methamphetamine production. In that, they are like many residents of California, who risk long federal prison sentences to maintain our state's status as the Golden Triangle of illegal methamphetamine production.

But the U.N. is hoping that eventually Myanmar's leg of the Golden Triangle will become more like Thailand's leg, where opium production is largely a thing of the past. It cautions that this is still a distant goal. But according to its survey released this June, poppy cultivation in Myanmar is down 24% from last year, and down 60% from 1996.

Unfortunately for the world, the global market still offers plenty of other sources of opium. The defeat of the Taliban in Afghanistan ended that group's ban on opium production, and now the Afghans have regained the No. 1 spot in world opium production. And according to the Drug Enforcement Administration, most of the heroin used in the U.S. now comes from Colombia and Mexico.

Read the entire article on the Los Angeles Times site or here.

Friday, August 01, 2003
Look Out For Bears; And Opium Fields !
Report Says There's Opium in Those Hills!

Press reports say that a hiker discovered 40,000 lavender-hued opium poppies growing in the Sierra National Forest, south of Yosemite. The plants, enough to yield 40 lbs. of raw opium, were in a clearing on a 3,000-ft.-high slope scorched by a forest fire two years ago.

Three men in camouflage outfits were in the process of scoring the poppy pods and squeezing out the raw opium for harvest when they were surprised by law-enforcement personnel. They fled into the woods and, although one "Asian" man was briefly detained after authorities found him with scratches on his face and a "brown substance" on his hands, nobody was arrested.

A new, domestic, source of materials for heroin manufacture? Not likely, say those interviewed. The area where the plants were found is about 40 miles from Fresno where smoking opium is said to still be prevalent among the area's Southeast Asian immigrant population.

Nothing truly new, opium cultivation is simple -- it is the California State Flower, after all. Actually, there are over 200 different species of poppy and the "opium poppy" (papaver somniferum) is illegal to grow anywhere in the United States, although vast quantities of opium are imported for medical purposes and as many as 108 nations are known to be growing the poppy for one purpose or another. India, for one, produces at least 46, 000 tons of the poppy seed alone. Opium is also a strategic material -- stockpiled in the event of war -- painkillers are going to be in high demand if, for example, North Korea lobs one of those "low yield" A-Bombs at California.

In April of this year, two Iowa University students were arrested after police found (among other proscribed items) 100 poppy pods that had been allegedly grown in their domicile.

Given that the 40 pounds of raw opium contains only about 0.4 to 0.9 percent morphine (the "active ingredient"), the best a heroin producer could yield from this crop would be less than half a pound of heroin. A nice chunk of change, but heroin is too easy to smuggle into the United States to make this a likely source of competition for the Mexican and Colombian brands.

Despite its illegal status, it is not at all unusual to find papaver somniferum seeds onbagelss and other pastry. In addition, the seeds and even the seed pods can be purchased from various quasi-legal sources in the United States. And, no, I won't tell you where.

Monday, July 28, 2003
New Justice Department Report Highlights Growth of U.S. Inmate Population
Mandatory sentences, especially for nonviolent drug offenders, are a major cause of increase despite crime drop

CNN reported yesterday that America's prison population grew again in 2002, despite a decrease in the crime rate. Some 2.1 million Americans were inmates in Federal, State, or local prison or jail facilities at the end of 2002 -- a 2.6 percent increase over the previous year. The Bureau of Justice Statistics released the report Prisoners in 2002 -- the latest in a series of reports on the nation's penal system. Preliminary FBI statistics showed a 0.2 percent drop in overall crime during the same period.

About 1 in 143 Americans was incarcerated on December 31, 2002. The prison system remained overloaded -- with state prisons operating at between 1 and 16 percent over capacity at year end. Some observers stated that the growth was due, in part, to mandatory sentences given to nonviolent drug offenders, while others attributed the increase to tough "three strikes" sentencing requirements. The Justice Department, for example, this year ordered the Bureau of Prisons to stop sending nonviolent and white-collar offenders to halfway houses.

More detailed analysis of prisoner characteristics is still pending, but drug offenders accounted for 20.4 percent of state inmates in 2001 and 55 percent of federal inmates that year. Violent offenders account for the largest increase in both jurisdictions. Blacks at 45.1 percent are the most represented group, while Whites at 34.2 percent and Hispanics at 18.1 percent accounted for all but 2.6 percent ("other") of the racial composition of the inmate population.

Read the entire report at the Bureau of Justice Statistics site. Detailed tables are also available for download.

Thursday, July 24, 2003
UCLA Report Shows Proposition 36 Saving of $275 Million in First Year of Operation
Most Participants are White and Report Methamphetamine Use

UCLA's Integrated Substance Abuse Programs (ISAP), part of UCLA's Neuropsychiatric Institute, has released its first report on California's "Treatment Alternative to Incarceration" or Proposition 36 and the first reports are encouraging.

In the first year of operation, almost 54,000 California residents were determined to be eligible for participation in Proposition 36 after an arrest for drug use or possession. Of the total, about 44,000 (82 percent) chose to take the treatment alternative under SACPA ("The Substance Abuse and Crime Prevention Act" or Proposition 36). The rest either wound up in traditional drug court or "opted for routine criminal justice processing," according to the report.

Among those who chose SACPA, 85 percent (37,495) completed assessment and 81 percent (30,469) entered treatment. Overall, 69 percent of those who chose the treatment option in court entered treatment. The report states that this "show" rate compares favorably with other studies of those entering treatment from criminal justice or other avenues.

About 50 percent of those who participated in the program reported methamphetamine as their primary drug of abuse - reflecting the drug's increasing popularity. Primary users of heroin and marijuana users were 11 percent and 12 percent of the entire group. About 50 percent of those in the program were non-Hispanic Whites.

For the entire report, see ISAP's UCLA web site for the report: "Evaluation of the Substance Abuse and Crime Prevention Act - 2002 Report."

"How to Get a Security Clearance Despite a History of Drug Use" ... Well, Some Marijuana Use, Anyway.
Washington Post Column Describes Process in Detail

An article in today's Washington Post describes the process for obtaining a security clearance and suggests that marijuana use, if infrequent and not recent, may not be an absolute disqualifier for a Top Secret clearance. Financial problems may disqualify an applicant, but the article states: "It is important to remember that many financially motivated crimes are committed out of simple greed, not need, and that most people with financial difficulties are not inclined to commit illegal acts at all. Financial need is the norm for a large segment of the population."

For insight into why certain factors weigh more heavily than others, the article suggests: "Of recent spies who betrayed their country for financial gain, about half were motivated by some real or perceived urgent financial need, and about half by personal greed."

On the other hand, dual-citizenship (United States/Irish or United States/Israel, for example) may be a problem due to "questions of loyalty." See the complete article for more information or click here for a list of web sites that contain information on seeking employment in the defense or security sectors.

Monday, July 21, 2003
Rolling Stone to Retain Stephen Glass to Report on Canadian Cannabis Developments
Glass Had Previously Fabricated Story in RS on D.A.R.E. Program, Says Intelligencer

New York Magazine's Intelligencer column, written by Marc S. Malkin, says in the July 28th issue, that discredited writer Stephen Glass will write again for Jann Wenner's magazine. Before anyone heard of New York Times reporter Jason Blair, The New Republic publicly apologized for Glass's fabrications and dismissed him five years ago as one of the magazine's associate editors. Glass recently (May 2003) published The Fabulist, a novel about a character who fabricates stories for a respected journal of culture and arts.

Glass will be reporting on the revolutionary developments in Canada regarding cannabis policy - - both for medical and "recreational" purposes. Watch this site for more on Canada's policy change.

Sunday, July 20, 2003
New York Times Story Highlights Addiction Among Executives

Today's New York Times has a fairly thorough and insightful article about the perils of addiction as they apply to CEOs and CEO "wanna-be's." It is worth a look, see "Dealing With Addiction and What Comes After" by Melinda Ligos.

Thursday, July 03, 2003
More on Ephedra...
Two Firms to Pay for Deceptive Advertising

The Los Angeles Times reported today that 2 Firms will have to repay customers $370,000 to resolve a case involving commercial ephedra preparations. Ephedrine is the active constituent of ephedra preparations - although many commercial products include other ingredients, including caffeine.

Excerpted L.A. Times report: WASHINGTON: Two companies that promoted ephedra dietary supplements with promises of safe and miraculous weight loss have agreed to repay customers $370,000 to resolve federal charges of deceptive advertising, regulators said Tuesday.

The Federal Trade Commission also is taking to court an operation based in California and Canada that it says made unsupported claims for weight-loss products and arthritis cures.

Health Laboratories North America Inc. and USA Pharmacal Sales Inc. agreed to pay $370,000 to consumers to redress charges that they falsely claimed their dietary supplements would cause rapid weight loss without exercise, the FTC said. The companies also agreed to warn consumers about the health risks of ephedra, the agency said.

Read the entire story here. Or read the recently released (May 2003) RAND study on Ephedra here --> Preponderance of Evidence - Judging What to Do About Ephedra.

The actions taken above were initiated by the Federal Trade Commision (FDC), while The RAND report was commissioned for the FDA -- read the executive summary here, or see the complete report - Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects - at the FDA site here.

Bottom line from the RAND study:

Regarding weight loss, we found enough evidence to conclude that the short-term use of either ephedrine alone, ephedrine and caffeine combined, ephedra alone, or ephedra with herbs containing caffeine all promote weight loss in selected patient populations. However, all but three of the trials lasted for less than six months. Ideally, the trials should assess not only the results of a full year of treatment but also what happens after the treatment is discontinued.

Caffeine clearly adds additional efficacy to ephedrine in promoting weight loss. The effects of ephedrine and caffeine together are roughly equal to the effects of ephedra with or without herbs containing caffeine. Each results in about two pounds per month of weight loss over four months.

To put these pounds in context, though, competing FDA-approved weight loss drugs have been shown to be about equally as effective. The drugs sibutramine (Meridia) and orlistat (Xenical) have both resulted in average weight loss of 6-10 pounds over 6-12 months, and the drug phentermine (often used in combination with fenfluramine as "phen-fen") has resulted in average weight loss of 16 pounds over 9 months.

* Regarding athletic performance, the few trials of ephedrine that we identified did not study the drug as used by the general population?—that is, repeated use. Therefore, the effect of ephedra or ephedrine to enhance athletic performance over the long term is completely unknown.

* Regarding safety, we conclude from the clinical trials that ephedrine and ephedra are associated with two to three times the odds of experiencing psychiatric symptoms, autonomic symptoms, upper gastrointestinal symptoms, and palpitations. It is not possible to separate out the effect that caffeine may contribute to these events.

Monday, June 23, 2003
In Case You Missed It...
For those who were too busy to read the comics section of the paper yesterday, take a look at yesterday's column.