Drug Policy Question of the Week – 1-22-11

As answered by Mary Jane Borden, Editor of Drug War Facts for the Drug Truth Network on 1-22-11. http://www.drugtruth.net/cms/node/3238

Question of the Week: Does the National Drug Control Strategy achieve its goals?

A 2008 Congressional Research Service report describes a document released annually by the Office of National Drug Control Policy:

“Since 1999, the Administration has developed an annual National Drug Control Strategy, which describes the total budget for drug control programs and outlines U.S. strategic goals for stemming drug supply and demand.”

Goals have varied. The 1999 Strategy proposed

“a ten-year conceptual framework to reduce illegal drug use and availability 50 percent by the year 2007.”

The 2002 to 2005 Goals were roughly the same, with the 2003 Strategy calling for a two-year goal of

“A 10 percent reduction in current use of illegal drugs by 8th, 10th, and 12th graders,”

and a five-year goal of

“A 25 percent reduction in current use of illegal drugs by adults age 18 and older.”

The source for the first percent was to reference a Monitoring the Future survey, which found that current use of illegal drugs by 8th, 10th, and 12th graders for the two years following 2003 declined by –5.2%. The other source, the National Survey on Drug Use and Health, reported that illicit drug use by adults age 12 and older during the five years following 2003 grew by +4.3%. By 2009, the increase was +9.7%.

The National Drug Control Strategy 2010 revised the goals slightly to

“Decrease the 30-day prevalence of drug use among 12–17 year olds by 15%,”

and to

“Reduce the number of chronic drug users by 15%.”

The National Drug Control Strategy FY 2011 Budget Summary says,

“The President’s Fiscal Year (FY) 2011 National Drug Control Budget requests $15.5 billion to reduce drug use…”

These facts and others like them can be found in the Drug Usage and United States policy chapters of Drug War Facts at www.drugwarfacts.org.

Questions concerning these or other facts concerning drug policy can be e-mailed to [email protected]

Drug Policy Question of the Week – 1-10-11

As answered by Mary Jane Borden, Editor of Drug War Facts for the Drug Truth Network on 1-10-11. http://www.drugtruth.net/cms/node/3220

Question of the Week: What are NAOMI and SALOME?

NAOMI stands for the “North American Opiate Medication Initiative.” It is a,

“two-centre, parallel, open-label randomized controlled trial aimed at testing whether heroin assisted treatment offers benefits over and above optimized methadone therapy in the treatment of individuals with chronic addiction who continue to use heroin despite having tried conventional treatments in the past.”

The NAOMI trials took place in Vancouver and Montreal, Canada.

SALOME stands for the “Study to Assess Longer-term Opioid Medication Effectiveness,” and is defined as a,

“clinical trial that will test whether diacetylmorphine, the active ingredient of heroin, is as good as hydromorphone (also known as Dilaudid), a licensed medication, in benefiting people suffering from chronic opioid addiction who are not benefiting sufficiently from other treatments.” The SALOME trial is taking place in Vancouver.

NAOMI and SALOME are among a number of heroin maintenance clinical trials that have also occurred in Switzerland, the Netherlands, Germany, and Spain. According to a 2006 article in the Harm Reduction Journal, the outcomes of these trials were “unequivocally positive.” The article concluded that “prescribing heroin produces substantial declines both in illicit drug use and in criminal activity” and that it was “feasible to conduct a program that made heroin medically available.”

Like its European counterparts, the NAOMI trial found that, “Heroin-assisted therapy proved to be a safe and highly effective treatment for people with chronic, treatment-refractory heroin addiction. Marked improvements were observed including decreased use of illicit “street” heroin, decreased criminal activity, decreased money spent on drugs, and improved physical and psychological health.”

The SALOME trial was scheduled to begin in January 2010. Results would likely be available later this year.

These facts and others like them can be found in the Heroin Maintenance chapter of Drug War Facts at http://www.drugwarfacts.org.

Questions concerning these or other facts concerning drug policy can be e-mailed to [email protected]

Drug Policy Question of the Week – 12-18-10

As answered by Mary Jane Borden, Editor of Drug War Facts for the Drug Truth Network on 12-18-10. http://www.drugtruth.net/cms/node/3189

Question of the Week: Which are the most harmful drugs?

Title 21, Chapter 13, Section 812 of the U.S. Code contains the Controlled Substances Act of 1970 that established five drug “schedules” presumably based on harm. Schedule I are said to the most dangerous. The other four schedules suggest gradually less harm. The United Kingdom has a similar classification system using the letters A, B, and C. Neither includes alcohol or tobacco.

Several studies have compared the harms of various drugs. A famous New York Times article from 1994 looked at nicotine, heroin, cocaine, alcohol, cocaine, and marijuana and found heroin to be the most dangerous, followed closely by alcohol. Cannabis and caffeine were deemed to be least dangerous.

The American Scientist magazine analyzed drug dependence and concluded,

“Heroin and methamphetamine are the most addictive … Cocaine, pentobarbital, nicotine and alcohol are next, followed by marijuana and possibly caffeine. Some hallucinogens—notably LSD, mescaline and psilocybin—have little or no potential for creating dependence.”

A similar analysis recently appeared in the British medical journal, The Lancet that found,

“… heroin, crack cocaine, and metamfetamine were the most harmful drugs to individuals, whereas alcohol, heroin, and crack cocaine were the most harmful to others.”

A table from another Lancet analysis now appears on Drug War Facts. This study ranked 20 drugs by physical-, dependence-, and socially-related harms. The table also shows their legal classifications in the U.K. and U.S.

Of the top five drugs rated as most harmful, only one – heroin – is a Schedule I drug in the U.S. Of the nine drugs that had ranking among the least harmful, four including cannabis are Schedule I.

These facts and others like them can be found in the Crime and Addictive Properties of Drugs chapters of Drug War Facts at http://www.drugwarfacts.org.

Questions concerning these or other facts concerning drug policy can be e-mailed to [email protected]

^{Notes:
– United Kingdom drug classes were initially assigned based on Table 2 in The Lancet report. However, since then, two drugs have been reclassified:
– Methamphetamine was moved from class B to class A in 2006.
– Although Cannabis was downgraded from class B to class C in 2004, it was subsequently upgraded to class B in 2009.
– “n/s” = no scheduling}

A printer-ready “From the Chapters of Drug War Facts” fact sheet in PDF format can be found at: http://drugwarfacts.org/cms/files/Drug-Rankings-by-Harm.pdf

Drug Policy Question of the Week – 12-6-10

As answered by Mary Jane Borden, Editor of Drug War Facts for the Drug Truth Network on 12-6-10. http://www.drugtruth.net/cms/node/3175

Harm Reduction is a term often mentioned in conjunction with drug policy. A recent report from the International Federation of Red Cross and Red Crescent Societies entitled, “Out of Harm’s Way: injecting drug user and harm reduction,” defined Harm Reduction as:

“… a range of pragmatic and evidence-based public health policies and practices aimed at reducing the negative consequences associated with drug use and other related risk factors such as HIV and AIDS. These interventions exemplify human rights in action by seeking to alleviate hazards faced by the injecting drug users, where needed, without distinction and without judgement.”

The Red Cross concluded that,

“Harm reduction is pragmatic, cost-effective and evidence-based. From a public health perspective, it safeguards the well-being of drug users by allowing them to minimize harm to themselves and others”

It went on to say that,

“Changing policies and reforming the justice system are central to harm reduction. Injecting drug use should not be seen as a criminal act but as a major public health issue.”

Another recent report from the International Harm Reduction Association called, “Three cents a day is not enough: Resourcing HIV-related Harm Reduction on a global basis,” supports Red Cross, stating,

“Prevention of HIV is also cheaper than treatment of HIV/AIDS. For example, in Asia it is estimated that the comprehensive package of HIV-related harm reduction interventions costs $39 per disability-adjusted life-year saved, whereas antiretroviral treatment costs approximately $2,000 per life-year saved. Such figures demonstrate that harm reduction is a low-cost, high-impact intervention.”

The IHRA’s conclusion in this report was a simple one,

“More money is needed for harm reduction, and it is needed now.”

These facts and others like them can be found in the HIV/AIDS chapter of Drug War Facts at www.drugwarfacts.org.

Questions concerning these or other facts concerning drug policy can be e-mailed to [email protected]

Drug Policy Question of the Week – 11-17-10

As answered by Mary Jane Borden, Editor of Drug War Facts for the Drug Truth Network on 11-17-10. http://www.drugtruth.net/cms/node/3151

Question of the Week: Is drug classification accurate?

The National Institute on Drug Abuse has named this week, November 8th through November 14th, National Drug Facts Week.

NIDA “encourage(s) teens to get factual answers from scientific experts about drugs and drug abuse.”

NIDA’s publication for this event entitled, “Drugs: Shatter the Myths,” contains “Facts” for marijuana, tobacco, methamphetamine, prescription drugs, and “huffing.” A search of it for “alcohol” finds no fact for this substance that is used monthly by 10 million American teens aged 12-20. This publication also omitted facts concerning heroin, cocaine, and crack.

Last week, the prestigious medical journal, The Lancet, published an article entitled, “Drug harms in the UK: a multicriteria decision analysis.” A panel of experts used this analysis technique to rate 20 different drugs on 16 total criteria of harm to the individual and harm to others.

This study found alcohol to be the most harmful drug. Its harm to others was rated as almost twice that for heroin and crack cocaine that placed second and third in this category. Heroin, crack cocaine, and methamphetamine were scored as most harmful to the individual. Still, alcohol’s overall harm score was 50% higher than that for runners up heroin and cocaine, dwarfing the scores of the seventeen other drugs evaluated.

It appears that the three drugs deemed to be most harmful in one of the most prestigious scientific journals — alcohol, crack cocaine, and heroin — were overlooked in NIDA’s official publication for National Drug Facts Week.

The Lancet article sums up this omission concluding,

“the present drug classification systems have little relation to the evidence of harm.”

These facts and others like them can be found in the Drug Usage and Addictive Properties of Drugs chapters of Drug War Facts at www.drugwarfacts.org.

Questions concerning these or other facts concerning drug policy can be e-mailed to [email protected]