PANAMA CITY – Guatemalan President Otto Perez Molina reaffirmed his stance on legalizing drugs in an interview with Efe, and said that the U.S. is now open to discuss this possibility as its position on the matter has become more flexible.
“From totally rejecting and avoiding the topic (of drug legalization), the U.S. has moved on to say that they are ready to discuss the issue even though they may not agree with it, which is a significant change,” the Guatemalan president said on Wednesday at the end of a 24-hour official visit to Panama.
“I am convinced that we have to do things differently from how they have been done over the last 50 years,” Perez Molina said, adding that “prohibition has not worked for us” in the battle against drug trafficking.
Guatemala’s stance, according to the president, is to seek “regulation, as some drugs have to be legalized, others have to be regulated and some have to be banned, while keeping in mind issues of public health and people’s rights.”
He argued “this can be a much more positive (step) from what we have been doing which has not worked.”
According to Perez Molina, “fortunately, the idea – that we have to be more creative and see what things we have to do differently – has been gaining more ground.”
The president lamented that so far the repressive fight against drugs “has made us lose human resources, which is most valuable, and has undermined the institutional structure of our countries.”
“They have not been able to win, after 50 years, nor even improve the conditions,” he emphasized, in reference to the war on drugs.
Perez Molina recalled that when he made “the first declaration – about the necessity to legalize drugs –, within 24 hours, the U.S. embassy repudiated (the declaration), indicating that they were against it and that it was not viable.”
According to the president, “it is going to take time,” but drug legalization “is a trend that cannot be stopped.”
He emphasized that the drug problem, inseparable from violence, along with poverty, hunger, inequality, the child immigration crisis and the chronic exclusion of the indigenous population were the most serious issues affecting his country.
Perez Molina said his government will complete its term in 2016 with the achievement of having noticeably reduced violence, poverty and inequality.
Within a period of two years and eight months, his government has been able to reduce the homicide rate for every 100,000 people from 40 to 30, which amounts to a reduction of 10 percent or 15 murders less per day.
Regarding the problem of illegal immigration to the United States, especially involving children, the president admitted that there is no definite agreement yet to resolve the issue with Washington.
However, “it is an achievement that the five affected countries have started talking about,” he added, while referring also to El Salvador, Honduras and Mexico.
“We made a proposal to create a plan for Central America but it remained on the table,” he remarked, regarding his last visit to Washington along with the presidents of El Salvador, Salvador Sanchez Ceren, and Honduras, Juan Orlando Hernandez.
“Our proposal is in line with the promotion of investments and generation of employment opportunities, besides cooperating on security matters,” he said.
Along these lines, he explained, “things have been progressing and we hope to have a more concrete plan by the end of next month. We are looking at the possibility of having another meeting with U.S. President Barack Obama at the time of the UN General Assembly meeting.”
Perez Molina admitted that the marginalization of Guatemala’s indigenous population was the result of “historic neglect.”
However, he asked these communities “not to confuse respect for traditions with backwardness” referring to their opposition to development projects within the territories they inhabit.
Opioid-related overdose deaths are a bleak public health issue in this country.
The percentage of patients who receive opioid prescriptions to treat noncancer pain has almost doubled in the past decade, but the number of overdose-related deaths for women have increased five times as much, according to the Centers for Disease Control and Prevention.
To put the nationwide stats in perspective, more women have died each year from drug overdoses than from motor vehicle-related injuries since 2007. For men in the past decade, the rate of opioid overdose deaths has increased three-fold. According to the CDC, women in particular are more likely to be prescribed opioid pain relievers than men, more likely to use them chronically, and more likely to be prescribed them in higher doses.
But what if medical marijuana, another option for treating chronic pain, could have an impact on these staggering statistics?
Research publised today in JAMA Internal Medicine found that states with medical marijuana laws before 2010 had 24.8 percent lower annual opioid overdose deaths on average when compared to states where medical marijuana was illegal.
Medical cannabis laws were associated in the study with lower overdose mortality rates that generally strengthened over time. In 2010, for instance, researchers noticed there were 1,729 fewer deaths in states where medical marijuana was legal.
The research team, lead by Dr. Marcus A. Bachhuber at the Philadelphia Veterans Affairs Medical Center, examined state medical marijuana laws and opioid overdose deaths using death certificate data from 1999 to 2010.
California, Oregon, and Washington had medical marijuana laws effective before 1999. Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont had medical marijuana laws effective between 1999 and 2010. Both of these groups of states were included in the research.
Nine states, including Massachusetts, enacted medical marijuana laws after the study concluded in 2010, so data from these states’ recent legislation changes wasn’t analyzed. As of July 2014, 23 states had enacted medical marijuana legislation, primarily to treat chronic or severe pain, but research has not yet been done to analyze whether these states had similar trends.
In Massachusetts, where Governor Deval Patrick has declared a “public health emergency,” the number of deaths due to opioid overdoses has increased by 90 percent from 2000 to 2013, according to data from the Massachusetts Department of Public Health. But voters legalized medical marijuana in a November 2012 ballot initiative. Is our state a contradiction?
Researchers warn that more research is necessary before research like theirs inform policy.
“In summary, although we found a lower mean annual rate of opioid analgesic mortality in states with medical cannabis laws, a direct causal link cannot be established,” wrote the authors in the study. “If the relationship between medical cannabis laws and opioid analgesic overdose mortality is substantiated in further work, enactment of laws to allow for use of medical cannabis may be advocated as part of a comprehensive package of policies to reduce the population risk of opioid analgesics.”
In a related review and commentaryof the research, also published in JAMA Internal Medicine, Dr. Marie J. Hayes, Dr. Mark S. Brown write:
“If medical marijuana laws afford a protective effect, it is not clear why. If the decline in opioid analgesic-related overdose deaths is explained, as claimed by the authors, by increased access to medical marijuana as an adjuvant medication for patients taking prescription opioids, does this mean that marijuana provides improved pain control that decreases opioid dosing to safer levels?”
“The potential protective role of medical marijuana in opioid analgesic-associated mortality and its implication for public policy is a fruitful area for future work,” they conclude.
How much benefit can we expect from drug legalization?
For the past few years, John McWhorter has been making powerful arguments that we should end the drug war that has fueled so many problems in the black community: the horrendous relations with law enforcement; the lucrative black market that lures unskilled young men away from education and legitimate jobs; the violence as drug dealers use guns in lieu of legal protection for their businesses. As longtime readers know, I am in sympathy with all those arguments. I support legalization of all Schedule I and Schedule II drugs, even at the risk of substantially increasing the number of people who abuse them.
At the same time, I want to be realistic about the potential benefits. If we legalize drugs, will the gangs, and all the attendant costs of the drug war, really go away?
Here’s one optimistic piece of evidence: The murder rate in America seems to have plummeted dramatically since the end of Prohibition.
SOURCE: JUSTICE RESEARCH AND STATISTICS ASSOCIATION
The U.S. could certainly use a lower murder rate and fewer people behind bars, so that’s a pretty powerful argument in favor of legalization.
On the other hand, it’s not as if the Mafia went away as soon as its liquor profits did. Instead, it expanded into other areas: gambling, vice, narcotics, extortion and “racketeering”: infiltrating unions and legitimate businesses and using the threat of violence to make excess profits.
That makes it hard for me to believe that the criminal enterprises running the drug markets will simply go softly into that good night of legalization. I’m not saying that the Crips and the Bloods will take over the Service Employees International Union. But I have no doubt they’ll try to take over something. I doubt anyone in 1932 would have predicted that the next stop for the Five Families was the Longshoremen or the waste-management industry. But I bet a lot of people thought the Mafia would just have to fold up its tents or go back to being small, local organizations that could easily be crushed by the law -- and they were obviously wrong.
If we never had Prohibition, the Mafia would probably never have gotten very powerful. But once we had it, we produced a large number of rich people with a vested interest in keeping things going. In other words, the growth of criminal gangs is “path-dependent” -- just because you could have gotten a very good outcome if you’d stopped something before it started doesn’t mean that you can get the same great outcome by ceasing now.
Of course, we have more tools to fight organized crime than we used to. And extortion has gotten a lot harder than it used to be, as this"Sopranos" episode hilariously illustrated. But desperate people can be very creative. And for all its good effects, drug legalization would produce a lot of desperate criminals looking for ideas.
I still support legalization, to be sure. But while it might help, we should remember that it might not be sufficient to erase all the pathologies that the War on Drugs has helped to create.
To contact the writer of this article: Megan McArdle at mmcardle3@bloomberg.net.
To contact the editor responsible for this article: Brooke Sample at bsample1@bloomberg.net.
That the war on drugs, in its current form, is a failure is obvious to all but the most blinkered observers. But the proper response to this failure is a matter of contention. Pope Francis, for instance, recently suggested we address the underlying causes of drug abuse (without ending prohibition). Others recommend treatment-based approaches. The more libertarian among us are likely to back complete legalization of all drugs.
I would like to recommend a policy that does not reject any of the above as possibly the ultimate answer to this failure, but takes a measured, experimental step that, while running little risk of making matters significantly worse, holds out, I think, great hope for improving them.
With marijuana, the question is apparently being decided in favor of gradual, piecemeal legalization. But heroin and cocaine legalization has far less support, and with good reason: these drugs are far more addictive than pot. (I am not saying that therefore they should not be legalized, merely that is understandable that people might be more sanguine about marijuana legalization than about legalizing harder drugs.) I wish to suggest a halfway sort of legalization that I feel offers several potential upsides: let us try legalizing the milder substances from which cocaine and heroin are derived, namely, coca leaves and opium.
Perhaps if we could simply make cocaine and heroin disappear by wishing it were so, it would be the best of all possible solutions. But basing policy on fantasy is generally a poor choice. (Please see the second Iraq war for evidence.) And the current policy of strict prohibition has fueled organized crime and led to the increasing militarization of our police forces. My proposal offers the following advantages over the current situation:
It allows us to test the waters of just how socially damaging full cocaine or heroin legalization might be, without simply plunging in head first. If simply legalizing coca leaves and opium produces droves of drugged-out zombies (which I don’t think it would), we could rule out full cocaine and heroin legalization, and even consider repealing this halfway legalization. If the effects are that bad, we can be sure that they would have been worse if we had legalized the harder forms of these drugs.
A strong libertarian argument for full legalization (I say ”strong,” and not “decisive,” because I think there are significant counter-arguments here), is that many people are able to use these drugs in moderation without destroying their lives. (See the work of Jacob Sullum if you doubt this is true.) “Why,” the libertarian asks, ”should these people be denied legal access to them simply because others will abuse them? (And note: while such usage is often referred to as “recreational,” it might often more accurately be described as”medicinal”: such moderate users may suffer from problems in focusing, and find that a mild dose of cocaine alleviates this difficulty, or be in chronic pain, and find that a mild dose of heroin offers them the best relief.) Well, these moderate, responsible users ought to find a milder, safer, and legal form of the drug they use to be a very welcome thing indeed. They could avoid the risk of arrest, of unregulated and adulterated street products that may contain dangerous additives, of job loss, and would enjoy a much greater ability to control their dosage.
The considerations in point number two indicate what I think would be the greatest potential upside of this idea: its impact upon the economics of the trade in hard drugs. The shift in consumption predicted above would greatly lessen the demand for the more dangerous forms of these drugs. But it is not only the demand-side that would be affected: suppliers would face dramatically altered incentives as well. Today, many poor farmers are able to eek out a living for their family by growing coca opium poppies that will ultimately be used to produce cocaine or heroin. To think that they will abandon this production with no viable alternative on the horizon is dreamworld thinking. But what if they had a legal outlet for their crops? What if they no longer had to sell their produce to violent criminals, but could sell it legally to legitimate businesses? What if they no longer had to risk arrest or a complete loss of their crop at the hand of their government? How many of them would rush into this new, safer market, and abandon their only current outlet or their product?
Basic economic reasoning from incentives, therefore, indicates that adoption of this proposal would produce a dramatic decrease in both the demand for and the supply of cocaine and heroin, something that decades of drug war have been unable to achieve.
My proposal may not meet anyone’s vision of an ideal solution to the problem we currently face. But economics teaches us that we live in a world of trade-offs, and that perfect solutions to social problems are largely chimeras. To the libertarian who complains that my proposal does not go far enough, I will point out that it does not present any barrier to full legalization of all drugs at a later point in time. To the drug warrior who would complain that it is a surrender, I note that it would be very likely to achieve a goal the drug war has been wholly unable to achieve, and could always be undone later if its effects proved too pernicious. To those who want more resources devoted to treatment or to addressing underlying causes, I reply that my proposal would free up many resources currently being devoted to prohibition for such purposes.
Sometimes, a stop in a halfway house is an important step on the road to recovery.
WASHINGTON, DC - DECEMBER 3: Colombian President Juan Manuel Santos speaks during a meeting with U.S. President Barack Obama in the Oval Office of the White House December 3, 2013 in Washington, DC. Obama and Santos commented on last year's free trade accord among other subjects. (Photo by Andrew Harrer-Pool/Getty Images) (2013 GETTY IMAGES)
BOGOTÁ.COLOMBIA (AP) – President Juan Manuel Santos on Thursday endorsed newly introduced legislation that would legalize marijuana for medicinal and therapeutic use in this drug war-afflicted Andean nation.
Santos, a proponent of rethinking prohibitionist drug policies, made the announcement at a drug policy forum Thursday in Colombia's capital, Bogotá. It was his first major drug policy statement since he won re-election in June.
The bill introduced last month by a governing coalition senator is "a practical, compassionate measure to reduce the pain (and) anxiety of patients with terminal illnesses, but also a way of beginning to strip from the hands of criminals the role of intermediary between the patient and the substance that allows them to relieve their suffering," Santos said.
In the Americas, Uruguay has approved legal pot and Jamaica's justice minister announced in June plans to legalize the drug for religious and medical purposes and decriminalize the possession of amounts up to 2 ounces (57 grams).
Possession of no more than 20 grams of marijuana for personal use is currently legal in Colombia.
The medicinal-use bill was introduced by Sen. Juan Manuel Galan, whose father was assassinated in 1989 by cocaine traffickers. He told The Associated Press that other countries in the region considering similar measures include Argentina, Brazil and Chile.
Galan said his hope is to have his bill, which would put the distribution of medical marijuana under government control, gain final legislative approval next June.
Ethan Nadelmann, director of the New York-based Drug Policy Alliance, said some U.S. states as well as countries including Israel and Canada are well advanced in offering government-administered legal medical marijuana, while a bill was introduced last week in the Central American nation of Costa Rica.
In Colombia, marijuana plantations help enrich leftist rebels and right-wing paramilitary bands alike, although cocaine is a bigger business for them.
The commander of Colombia's counterdrug police, Gen. Ricardo Restrepo, told the AP that the country currently has about 1.5 square miles (390 hectares) of marijuana fields and that a pound costs about $230.
Colombia is the world's No. 2 cocaine-producing country after Peru, according to the United Nations and U.S. Drug Enforcement Administration. It was the global leader until 2012.
A two-decade U.S.-backed crackdown on Colombia's drug cartels and extensive aerial eradication of coca crops has somewhat diminished and compartmentalized the trade. Critics say the campaign has simply shifted trafficking to countries with less effective law enforcement and legal systems.
The human cost of the fight against illegal drugs has been terrible for Colombia and other supply and transit countries, Santos told the forum.
"We have spent billions of dollars on an ineffective war that has claimed more than 60,000 lives in Mexico alone in the last six years," he said.
Nearly four years ago, Dr. Sue Sisley, a psychiatrist at the University of Arizona, sought federal approval to study marijuana’s effectiveness in treating military veterans with post-traumatic stress disorder. She had no idea how difficult it would be.
The proposal, which has the support of veterans groups, was hung up at several regulatory stages, requiring the research’s private sponsor to resubmit multiple times. After the proposed study received final approval in March from federal health officials, the lone federal supplier of research marijuana said it did not have the strains the study needed and would have to grow more — potentially delaying the project until at least early next year.
Then, in June, the university fired Dr. Sisley, later citing funding and reorganization issues. But Dr. Sisley is convinced the real reason was her outspoken support for marijuana research.
“They could never get comfortable with the idea of this controversial, high-profile research happening on campus,” she said.
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Dr. Sue Sisley said the University of Arizona had fired her because of her outspoken support for marijuana research.CreditLaura Segall for The New York Times
Dr. Sisley’s case is an extreme example of the obstacles and frustrations scientists face in trying to study the medical uses of marijuana. Dating back to 1999, the Department of Health and Human Services has indicated it does not see much potential for developing marijuana in smoked form into an approved prescription drug. In guidelines issued that year for research on medical marijuana, the agency quoted from an accompanying report that stated, “If there is any future for marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives.”
Scientists say this position has had a chilling effect on marijuana research.
Though more than one million people are thought to use the drug to treat ailments ranging from cancer to seizures to hepatitis C and chronic pain, there are few rigorous studies showing whether the drug is a fruitful treatment for those or any other conditions.
A major reason is this: The federal government categorizes marijuana as a Schedule 1 drug, the most restrictive of five groups established by the Controlled Substances Act of 1970. Drugs in this category — including heroin, LSD, peyote and Ecstasy — are considered to have no accepted medical use in the United States and a high potential for abuse, and are subject to tight restrictions on scientific study.
In the case of marijuana, those restrictions are even greater than for other controlled substances. (Marijuana remains illegal under federal law, though nearly half the states and the District of Columbia allow its medical use and two, Colorado and Washington, have legalized its recreational use.)
To obtain the drug legally, researchers like Dr. Sisley must apply to the Food and Drug Administration, the Drug Enforcement Administration and the National Institute on Drug Abuse — which, citing a 1961 treaty obligation, administers the only legal source of the drug for federally sanctioned research, at the University of Mississippi. Dr. Sisley’s proposed study also had to undergo an additional layer of review from the Public Health Service that is not required for other controlled substances.
The process is so cumbersome that a growing number of elected state officials, medical experts and members of Congress have started calling for loosening the restrictions. In June, a letter signed by 30 House members, including four Republicans, called the extra scrutiny of marijuana projects “unnecessary,” saying that research “has often been hampered by federal barriers.”
“It defies logic in this day and age that marijuana is still in Schedule 1 alongside heroin and LSD when there is so much testimony to what relief medical marijuana can bring,” Gov. Lincoln Chafee of Rhode Island said in an interview. In late 2011, he and the governor of Washington at the time, Christine O. Gregoire, filed a petition asking the federal government to place the drug in a lower category. The petition is still pending with the D.E.A.
Yet despite the mounting push, there is little evidence that either Congress or the Obama administration is interested in changing marijuana’s status. And in public statements, D.E.A. officials have made their displeasure known about states’ legalizing medical and recreational marijuana.
The agency’s position seems at odds with that of President Obama, whose Justice Department has allowed states to legalize either medical or recreational marijuana as long as they follow certain federal priorities, such as not allowing sales to juveniles. Mr. Obama has also said that he believes marijuana is no more dangerous than alcohol and that he is bothered by the disproportionate number of minorities incarcerated for possession of the drug.
Asked if there was an inconsistency between the president’s stance and that of the Drug Enforcement Administration, a White House spokesman, Matt Lehrich, said: “The administration’s policy continues to be that while the prosecution of drug traffickers remains an important priority, targeting individual marijuana users is not the best allocation of federal law enforcement resources. The D.E.A. is carrying out that policy.”
There are signs, though, of a possible shift in attitude within the federal government. In May, the D.E.A. issued new rules to increase the government’s production of marijuana for research this year to 650,000 grams from 21,000 grams.
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Rick Doblin is the founder and director of an organization sponsoring Dr. Sisley’s studies.CreditGretchen Ertl for The New York Times
And at the National Institute on Drug Abuse, for instance, records show that at the beginning of this year there were 28 active grants for research into the possible medical benefits of marijuana in six disease categories. Most of the studies focus on the potential therapeutic uses of individual cannabinoid chemicals from marijuana or synthetic versions and not the plant itself. Furthermore, a dozen or so of those studies are being conducted with animals and not humans.
Additionally, other National Institutes of Health entities have been supporting marijuana research. As for independently funded marijuana research, the federal government has cleared 16 projects since 1999, 13 of them at the University of California, San Diego.
Moving the drug to a less restrictive category could do more than reduce some obstacles to research, proponents say. It would be a significant step toward allowing doctors around the country to prescribe the drug. Federal lawmakers say it could also permit medical marijuana operations that are legal at the state level to take business deductions on their federal taxes.
Dr. Sisley’s predicament shows that even in states like Arizona, where medical marijuana is legal, the matter remains politically volatile. Last month, Arizona authorized the use of marijuana for patients undergoing conventional treatments for post-traumatic stress disorder under certain circumstances. Dr. Sisley’s study is supposed to use five different strains of marijuana that would be smoked or vaporized by 70 veterans. The goal is to develop a marijuana drug, in plant form that would be smoked and vaporized, approved by the Food and Drug Administration.
Her firing seemed to stem from a fight over money. In March, the Arizona House passed a Republican-sponsored bill designed to provide her project with some funding from fees collected in the state’s medical marijuana program. But the measure died when State Senator Kimberly Yee, a Republican who is the chairwoman of the Education Committee, refused to put the legislation on the panel’s agenda. Ms. Yee said at the time that she preferred the funds be used for antidrug education.
Angry about her opposition to the bill, a group of veterans began a recall effort against Ms. Yee. Some of those veterans had been treated by Dr. Sisley in the past, and Senate leaders concluded that Dr. Sisley herself was involved in the campaign.
The State Senate president, Andrew Biggs, called the university’s chief lobbyist, Tim Bee, to complain that Dr. Sisley seemed to be lobbying too aggressively and inappropriately.
“Tim said he would call me back after he found out more,” Mr. Biggs said in an interview. “And then he did and told me, ‘This will not be a problem going forward.’ ”
In April, a university vice president, who said he was calling on behalf of the president, Ann Weaver Hart, told Dr. Sisley that Mr. Biggs thought she should resign, Dr. Sisley recounted. In June, she received a letter from the university saying her annual employment contract would not be renewed as of Sept. 26.
Dr. Sisley denied participating in the recall effort. She acknowledged talking to senators and their aides about funding, but as a member of the Arizona Medical Association.
“The university could not take the political heat from the hyperconservative legislators and fired me and deserted all these veterans who have been fighting alongside me for years,” she said.
A university spokesman, Chris W. Sigurdson, said that while university policy prevented him from discussing specifics about Dr. Sisley’s case, the school had not been pressured to fire her. (Mr. Biggs also denied trying to get her fired.) He added that the university had proposed that another faculty member take over the project as lead investigator.
Late last month, the university notified Dr. Sisley that it had denied her appeal for reinstatement. Rick Doblin, founder and executive director of the Multidisciplinary Association for Psychedelic Studies, which is sponsoring Dr. Sisley’s research, said he would now try to persuade the Arizona Board of Regents to allow the study to continue at another state institute with Dr. Sisley as the lead investigator.
Mr. Doblin said he was committed to staying with her as the lead investigator and would help her look for an alternate research location. A switch to a new study location would require further regulatory review for the proposed research, which still needs another approval from the D.E.A., Mr. Doblin said.
PANAMA CITY – Guatemalan President Otto Perez Molina reaffirmed his stance on legalizing drugs in an interview with Efe, and said that the U.S. is now open to discuss this possibility as its position on the matter has become more flexible.
