The botanical and medical origins of opiates are mostly European

Much of what I'm going to say is straight from an article by Mike Jay in the London Review of Books of 21 June. The book is "Opium: Reality's Dark Dream" by Thomas Dormandy (Yale, ISBN 978 0 300 175325), I recommend it to the serious student of the history of drug policy. It helps to explain how we got where we are today, or rather, why our seemingly sensible policies only seem to make things worse. Much of what I'll say next is pure plagiarism, but I hope LRB and the authors mentioned will see it as free advertising.

Opiates are thousands of years old. As a drug they haven't changed, nor has our metabolism. The difference between feeling good on it and being dead is uncomfortably small, hence the reluctance of many medical men in ages past to use it. This is supposedly why Philips II of Spain, Charles II of England, and Lois XIV were among the masses who in their time died of protracted and unnecessary agony (as millions still do in poor countries today, thanks to the moral casino known as the INCB). The agony was unnecessary because opium as a painkiller was well known at the time. But doctors always know best. A 12th century medical man noted that many visitors to Mecca were "dangerously obsessed with their craving", still a problem today if the Saudi police are to be believed. Avicenna warned about the addictive and euphoric effects, and advised to collect your fee before dosing the patient, etc.

It wasn't until the 19th century that society begins to see pain relief as a necessity rather than a luxury. The spread of TB in the middle classes helped. As Mike Jay says "Despite resistance from some medical and religious authorities who maintained that pain was a physical or spiritual necessity, the use of opium to relieve it came to seem no more than common kindness". Palliative treatment had arrived, at least in the rich world.

As production was increased to feed this market, prices dropped. Opium was often cheaper than alcohol (and did a lot less damage in a crudely industrialising world). The article gives a tantalising vignette of Britain's most notorious opium growing area, the "poppyland" of the East Anglian fens, an area I know well, and more traditionally English than that you can hardly get. "Shopkeepers on market days would line up tots of laudanum tincture on their counters for visiting farmers to drink on the spot, with...bottles and jars of pills to see them through the week". For anyone who knows this area of England the image is surreal.

Opium had been known in China for ages, but he article claims that it was introduced, at least on the scale that European colonial powers were behind it, as an additive to Dutch tobacco, hence the design of the opium pipe, offering a way of more efficient vaporisation, inhalation, and a more intense high (at a time when most Europeans were still drinking the stuff).The market-induced Chinese custom transformed the drug from a private medication into a a convivially shared intoxicant, giving it ultimately its decadent and sinister, alien image.

By 1860 morphine had been developed out of opium, vastly improving its effectiveness as an (addictive) painkiller. Just in time really: By that time the American Civil War (the biggest single war of the 19th century) had created 50.000 amputees (not to mention 620.000 dead). It had accounted for the distribution of  more than ten million doses of morphine. Morphine addiction becomes a fairly familiar phenomenon in the States and elsewhere. By 1885 the American physician J.B. Mattison is quoted in the article as claiming that a third of all New York Doctors are morphine addicts. This led to problems in the medical professions (and their families).

And here we get to today's conundrum. This is where, in the US, addiction begins to be seen as specifically "un-American", not just immoral but rendering people decadent and socially useless. The latter is important. Henri Bergeron, in "Sociologie de la Drogue" makes a similar point about the social/political issue with drug use: the effect of drugs takes the form of a withdrawal from society (unlike alcohol, normally) and removes the citizen as a social actor and tax payer, thus rendering the state irrelevant. Not something the French are keen on.

By WWI legislation was coming in in various countries, as millions of men were given morphine on the battlefields of Europe. The article mentions one of the first prosecutions under the new laws, against Harrods of London, for selling gift-wrapped packets of morphine for friends and loved ones at the front. It goes on to describe the rising tide of drug control legislation as the 20th century progresses, and the growling moral tone of some of those laws. In the US, the Harrison Narcotics Act of 1914 stated that addiction was not a disease but a "self-inlicted moral infirmity". Like today's multilateral system of drug control, those laws failed to address the issue with any success. Heroin makes its appearance and is sold in cough mixtures and other over-the-counter products until 1913. WWII's demobbed heroes included untold numbers of men and women with amphetamine addictions induced by liberal but official prescription by the military. By 1946 the mob begin to control the drugs market, and the rest his history.

I leave you to read the book for the more constructive and well-founded conclusions, but this is an intelligent account of how the "disease model" of addiction is very imperfect to say the least. It tends to have much more support among policymakers than in the medical profession. So much for the evidence base. We still have a long way to go.

Carel Edwards

Shared irresponsibility

Europeans have lost the taste for armed conflict. They have been there and done that.
They don't like the war on drugs much either, which is why Europe has been a relatively civilised place in terms of drug issues for some years now, favoring harm reduction and tolerance over the sort of mass incarceration that we see in the US. 
We buy this peace for ourselves at the cost of keeping firmly out of the debate that increasingly desperate Latin American countries are trying to get us involved in. Last December's Tuxtla Declaration - and the Cartagena meeting that followed - clearly called on the consumer regions to experiment with market solutions, i.e. regulate the market in order to take it out of the hands of organised (and not so organised) crime. The Europeans are deaf to these pleas, that goes for the media as well as the governments. 
It seems that we are even beginning to prefer a "Stronger European response to drugs" (see previous posts on the EU Commission's Communication).  If words could solve problems we'd be home and dry, but studies done for the Commission itself have shown that it is very hard to find any reliable data that allow us to make a causal link between public policy and drug use in the first place. That goes for demand, but the situation is even worse for supply control; law enforcement does not like to be evaluated or scrutinised, certainly not by a bunch of bureaucrats in Brussels. As a result, we haven't a clue whether (very costly)  police intervention against drug trafficking is having any effect, but in this respect we are no different from any other major block or country. 

So where does this leave the European approach to drugs? More and more European countries are probably in breach of the UN Drug conventions today, at least by the standards of the now Inquisition-like INCB. If Europeans (and quite a few other countries) have no appetite for reviewing the conventions it is partly because they are afraid to open a Pandora's box (you might end up with something worse), and partly because they have a big economic crisis on their hands. But above all, I believe that it hasn't sunk in yet in the world's major drug consumer markets that the only way to take organised crime out of the market structure is for states to produce certain types of drugs themselves and to regulate the sale of them. This won't happen tomorrow; the idea is a vote killer and distasteful to large parts of public opinion, but growing pressure from Latin American countries, where states are crumbling under the effects of our inconsistent policies, may yet turn the tide. 


On 29 May, European members of the Global Commission on Drug Policy met in Brussels with members of the European Parliament and officials of the EU Commission and Council. They were Michel Kazatchkine, Executive Director of the Global Fund for AIDS, TB, and Malaria, and Pavel Bem, architect of the Czech drug policy and former Mayor of Prague. Both are medical doctors with extensive experience in political life. They called on the EU to strengthen its comprehensive and balanced approach, and to resist the siren voices of the new "tough" approach advocated by the EU Commission. To quote Pavel Bem: in politics, simple solutions to complex problems are the road to hell.


A full report on the Brussels meeting should appear soon on the website of IDPC and the Global Commission itself.  

Unleash the dogs of criminalisation.

The history of criminalisation is one of casting first stones, scapegoating and of tribes seeking safety in convention. It is an entirely understandable and necessary social reflex, but possibly the most abused of all. Much of criminalisation is indefensible by almost any moral standard; from the spuriously sadistic retributions threatened by the great religions, via heresy to witch burning, to castration of young inmates of church-run boarding schools (recently revealed to have taken place in the Netherlands in the '50s). And then there is the one recent example of potential decriminalisation that beats them all: the Moroccan law that allows a rapist to marry his victim in order to save her honour (sic). Yet, my friends from LEAP, who have spent much of their lives at the sharp end of criminalisation, have explained to me just how little time the average law enforcement officer gets to spend on dealing with "proper" crime, like murder, rape and arson, and how much time goes into controlling kids with "substances" in their pockets, never mind harassing respectable housewives with substances. Which must be one of the reasons why the US has the largest prison population in the world: a quarter of the world's prisoners for 5% of the world's population - more than China - and a rate seven times higher than Europe.

But we Europeans like to learn from our American friends: the recent violent life and death of Mohammed Merah, in France, has prompted President (and candidate) Sarkozy to promise criminalisation of such things as visiting Jihad web sites, going to areas like eastern Afghanistan for no good reason , etc. Law enforcement officers and judges take note: when that woman from Médecins sans Frontières with the North African features (because her Algerian grandfather fought in the French army) checks into Charles de Gaulle  off a flight from Kabul, pull her out of the queue.  OK, it's election time, but we already have crazy laws, like the one making it an offence to deny the holocaust. Not that I believe denial of historical facts should be encouraged, but the holocaust is one of history's most documented and undisputed facts, and those who do deny it are usually so implausible (or mad) that they strengthen the holocaust case every time they open their mouths. I also get this queasy feelings sometimes about the 900,000 or so Germans who died in the allied bombing of their cities in WW II, most of them civilians, their memory unprotected by laws criminalising denial or even trivialisation of what happened to them.

The act of criminalisation always raises the issue of what is permissible in lawmaking when judging those who are not like yourself. "Otherness" (l'altérité" in french) is a familiar concept in sociology and anthropology. It is the mainspring of tribal and racial conflict which can lead to the sort of massacres I have mentioned. It was probably the greatest single factor in anti-semitism throughout the ages (that and owing money to Jews). It is one of the toxic by-products of immigration, not because immigrants are bad, but because today many (European) host countries  park their immigrant communities in no-hope housing with no-hope education, keeping them quiet with welfare but making it extremely difficult for them to belong, even if they do get through the social barriers. This doesn't justify shooting Jewish school kids or former soldiers, nor for that matter, cutting Theo van Gogh's throat or planting bombs on the London tube, but it should warn us that this may have to be dealt with in other ways than criminalisation. Killing people is already a crime.

THE INCB's CLOTHES

The International Narcotics Control Board has now repeatedly attacked Bolivia since it denounced the 1961 Convention, indicating its intention to re-accede with a reservation allowing for the traditional use of coca leaf. Bolivia has been acting within the normal procedures of international law and its own constitution on this matter. The squeals of protest it has met with from its European, American, and other "friends" have contained little in the way of argument other than INCB's recent contention that "the integrity of the international drug control system would be undermined".

It is interesting to see a body like the INCB overstepping the mark of its own powers under the UN treaties by playing God, with little regard for the inviolability of the national laws and cultures that are the bedrock of the UN system. “The INCB response is another clear sign that the UN drug control regime is under strain and that the cracks in the so-called ‘Vienna consensus’ are approaching a breaking point,” according to TNI’s Martin Jelsma. “It is a sign that its principal guardian, the INCB, is in distress and no longer capable of responding to challenges in a rational manner.”


Why this persistent refusal on the part of the multilateral system of drugs control to enter into a meaningful dialogue on reform of the Conventions? A South American diplomat recently put in the following terms: back in the 16th century, when the Catholic church was no longer capable of reform, it spawned the Reformation and lost its monopoly over Christianity. Without dramatising current events, the multilateral drug control system is showing its age and revealing the sclerosis of the institutions created to implement it. The tabloid tone of the INCB's latest report is a sign of this.

Last December, Presidents and other political leaders of ten Latin American countries from the so called Tuxtla Mechanism for Dialogue effectively called on the rich drug consumer markets, primarily the US and Europe, to begin with experimenting regulation models for what we still call illicit drugs. US and European media largely ignored this declaration. These countries made this call because they are being destroyed by organised crime. The UN Drug Conventions have not created this crime, but they have created a global framework in which it prospers almost by default. The struggle against such crime is turning into a slaughter house for ordinary people, particularly in Central America, with no end in sight.

If the church will not reform then let us put our faith in a reformation and support the Tuxtla appeal. As a European, I hope that Europe will not yet again be trumped by the Americans in getting us out of a hole. It may not look likely at the moment, but 16 US states have enacted laws that allow for the sale of "medical marijuana, and at least there is a lively debate going on there, whereas EU leaders are firmly looking the other way and the Brussels administration has quite lost its way. Sooner or later though, our governments will have to grasp the nettle of organising this regulated market. If there is one lesson to be learned from the tobacco and alcohol models it is that it should not be left to purely commercial interests.

Watch this space.

Wasting the citizen's time

In English law there is a criminal offence known as "wasting police time". I wonder if this applies in other countries. It covers things like knowingly making a false report that creates apprehension for the safety of any person or property. A good thing then that the INCB and the UNODC are based in Vienna and not in  London. Except of course that the UK is one of the 144 or so signatories to the single convention. So that's all right then. The police can waste citizens' time. It is quite common in London for a young person to get stopped for a routine drug search. It happens regularly to the student son of a friend of mine, who is a member of the House of Lords. We can all feel safe knowing that young aristocrats are being kept on a short leash these days.

"Towards a stronger European response to drugs" - third and last post.

The original EU text can be found at http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=COM:2011:0689:FIN:EN:PDF

In the previous two posts I have tried to demonstrate that this policy announcement by the EU Commission has more to do with political testosterone than with a sensible assessment of the past. This is certainly true for the tired old penal and prohibitionist ideas that dominate this paper. The merit of Commissioner Reding's predecessors responsible for drug policy was that they at least understood the need to submit law enforcement to some form of assessment. At the moment, we don't know how successful the world's police forces and judiciaries are in fighting drug crime. If this is what "success" looks like, heaven preserve us from failure. The development by the Commission of "key indicators" to measure drugs markets and drug supply reduction (para 2) is a welcome initiative; it was however started before Mrs Reding was appointed and has consistently met with a very unenthusiastic response from law enforcement and judiciary circles in the EU, so we are still years away from an assessment as to whether our money is being wasted or not by running after drug criminals who are usually a few steps ahead of the law and doing very well. And if one day we have these key indicators worked out and adopted across the EU, imagine the task of getting precise data on national law enforcement performance out of the 27 Home Affairs ministries across the EU.

Although we should welcome anything in this Communication that at least tries to hold up the balanced approach that used to be the Commission's hallmark on drug policy, no specific policy measures are announced beyond supporting measures to reduce health and social harms. The demand reduction part of the Communication (para 6) reflects ongoing health initiatives on HIV/AIDS and various existing funding programmes. It fails to mention that the Commission's current Drug Prevention and Information (funding)  Programme is destined to become a pure "justice" programme in 2013 and will loose its demand reduction and wider policy aspects. Mrs Reding is on record as saying that health aspects are not a Commission competence under the EU Treaty and that she leaves that up to Member States. So much for the balanced approach.

The initiative on "drugged driving" has been in the making for some years. It is a promising initiative.... in the field of road safety, not drug policy.

Para 8 - on International Cooperation - is again the usual line-up of supply reduction-related measures. There is a passage on the "comprehensive" nature of external EU policy, and on the (major) effort by the Commission in terms of providing alternative livelihoods in production and transit countries. This is of course the work of the Commission's EU External Action Service now and the Commission's Directorate General for Development. The former is in disarray and has just had a written warning from 14 EU Foreign Ministers to pull its socks up; the latter has no mandate on drugs policy but will implement policy directives on this from Brussels.

Conclusion

Evaluations made at the request of the Commission in recent years (particularly the so called Reuter/Trautmann report:  http://ec.europa.eu/justice_home/doc_centre/drugs/studies/doc_drugs_studies_en.htm, a joint publication by Rand and the Trimbos Institute) clearly suggest that the punitive, law enforcement driven approach of the world's current multilateral control system has not led to a reduction in use or trafficking, and that demand rarely responds to arrests and punishment. What we do know is that harm reduction and treatment strategies reduce crime and other social problems and reduce public health problems too.

This Commission announcement seems to ignore the lessons of the past 15 years, lessons which are not crackpot ideas from extreme pro-drugs groups, but evidence-based conclusions from its own services, from most Member States, and from serious bodies financed by the European Commission itself, such as the EU's  drugs monitoring agency, the EMCDDA.

It also comes at a rather odd moment: i.e. before the Commission's own services have completed their evaluation of the EU Drugs Srategy 2004-2012, and before the Commission's Civil Society Forum on Drugs has had the time to table its recommendations for the next Drugs Strategy.

Europe has had a bad year on the world stage. It's credibility is at a low ebb while that same world is loosing the battle against illicit drugs because the system the Western countries put into place 50 years ago in the form of UN Conventions and institutions have failed. Today, they are little more than a dysfunctional, scandal-ridden irrelevance, but capable of supporting extreme levels of violence against populations in the weaker countries. Presidents from a number of Latin American states, including Mexico and Colombia, have recently signed the Tuxtla Declaration, calling on  drug consuming countries to explore "all possible options, including market alternatives", i.e. forms of legalisation or regulation. The recently retired Secretary-General of the Council of Ministers and EU High Representative for the EU's external and security policy, Xavier Solana, is a member of the Global Commission on Drug Policy, which is calling for the same thing. The global drugs problem has reached a stage where serious and difficult policy changes are being debated. Not, it would seem, in the European Commission.

The Commission's policy statement is an embarrassment to intelligent European policy makers and people working in this field. It is also a comfort to the enemy, i.e. the criminals who makes a profit out of the huge illegal market the system provides them with. It is however also a comfort to those individuals, organisations, and countries - from dodgy bible-thumping preachers to the Kingdom of Sweden - who want to stick with the current  prohibitionist system if it kills them. The problem is, it just might, but do we want to go down with them?

Good luck

“Towards a stronger European approach to drugs Part II” – More on the EU Commission’s Communication on drug policy.

As we saw in the last post, this Communication ( http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=COM:2011:0689:FIN:EN:PDF ) quickly homes in on supply reduction and control issues. In fact, they make up the bulk of the text in a way that I had hoped we would not see in Europe again, not after more than a decade of groping our way towards an evidence-based understanding of the futility of non-smart law-enforcement approaches, and the growing – if politically incorrect – doubt about the effectiveness of a punitive control system in the first place. 

Parts two to five: drug trafficking, drug (chemical) precursors, confiscation and recovery of criminal assets, and new psychoactive substances.

The measures proposed by the Commission under these four headings all suffer from the same flaw: they admit that the illicit drugs trade has been too clever and adaptable for EU justice and law enforcement agencies to have any real effect on the flow of drugs into Europe. Some singularly ineffectual “pacts” against drug trafficking – little known beyond surreal debates in Brussels – are quoted. The fact that existing EU rules on the definition of sanctions have been largely ignored by the member states is correctly identified. Yet no conclusions are drawn from any of this other than that tougher rules in the same vein are needed.

There is no sign that the poor record of control and interdiction of drug trafficking into the EU (or into any other region for that matter) has been subjected to any objective analysis, as was called for by the Commission’s own mid-term evaluation of the current EU Drug Strategy in 2008. The good news is that the Commission, with Europol and the EMCDDA, will provide key indicators for the monitoring of drug markets, drug-related crime, and drug supply reduction. We also know that a Commission evaluation of EU drug markets, carried out by Rand/Trimbos/King’s College is still in the making. The bad news remains that it would surely have been more logical to have waited for the results of these initiatives and to have analysed first the actual performance of European law enforcement and justice systems in the drugs field before rushing into this macho legislative programme.

What we see here, then, is conviction politics of the worst order. I strongly object to naming names in these discussions, but Mrs. Reding, the member of the EU Commission responsible for (civil and criminal) justice, is not a civil servant but fills a political appointment and – like all Commission members – has her own web site. Let me quote then what she said before the House of Lords Select Committee on the European Union, last November: “I am more an action person than a strategy person. If necessary, I can also propose a strategy, but that will not prevent me from taking action, because actions are what is needed”.  Are we to understand that she will not be hampered by analysis but will run up a strategy for us if we really insist?

At one point she gets surprisingly close to evidence-based policy, when she refers to the Rand/Trimbos report on global drug markets, saying that it identified “…a lack of evidence that controls can reduce total global production. The same applies to trafficking”. She doesn’t follow this up however, nor does it seem at all incompatible to her with the course the Commission, under her leadership, is now following.

When asked what she thinks about the report by the Global Commission on Drug Policy or the debate on reviewing the conventions she literally refuses to answer the question and says so. (The transcript can be found on http://www.parliament.uk/documents/lords-committees/eu-sub-com-f/EU%20DS/ucEUF28.11.11ev7.pdf )

The stricter control of trade in chemical precursors (also) used for making drugs, and the proposals for more effective criminal asset recovery should be given a chance to show what they’re worth. Crime has to be fought and the encroachment of the black economy on the "white" economy is a serious issue. In the next post we will look at the remaining parts of this Communication (demand reduction, drugged driving, and international cooperation), and we will try to draw some conclusions as to where all this leaves the European debate on drug policy.

Good luck