Iron Law of Prohibition at Work in Overdose Death Epidemic

72,000 overdose deaths is the latest Center for Disease Control estimate for 2017. It’s a huge number; more deaths than AIDS took in a single year. Beyond speaking of increasing support for vague “public health” measures, the New York Times story blamed substances more than policies for this painful failure.

But drug war opponents do blame criminal justice. It’s called the iron law of prohibition: the greater the intensity of law enforcement, the higher the potency of the drug. A former director of NORML in 1986, Richard Cowan, summed it up “the harder the enforcement, the harder the drugs.”

When alcohol was prohibited, beer and wine disappeared, and the bootleggers made gin often described with gallows humor as “bathtub gin” industrial alcohol mixed with flavoring in a tub that on occasion poisoned the drinkers.

Today the poison is fentanyl ordered on the internet from China and delivered in packages like the thousands of other items. Of course, if we had friendly relations with this emerging power we could negotiate restrictions, but under Trump such requests are impossible.

The kick this drug adds to heroin and lately to stimulants like methamphetamine and cocaine is an example of the iron law.  None of these drugs are made with any protection for the consumer. Different policies can produce different results.

In 2015, the European Monitoring Center for Drugs and Drug Addiction published comparative statistics for overdose fatalities. Portugal which decriminalized all drug use in 2001meaning drug users and their street level suppliers no longer fear arrest or police intrusions had 3 overdose deaths for every million citizens. The second lowest rate. Clearly decrim hadn’t caused the disaster of increased use and endangering children that the prohibitionist warns will happen if police are replaced by public health officials.

The European average overdose deaths per million was 17.3, the United Kingdom was way above average at 44.6, while for the Dutch it was 10.2

In the United States, using a different statistical base from the UN Office of Drug Control, in 2015 the death rate was 245.8 per million people between the age of 15 to 64 [https://www.statista.com/chart/9973/drug-related-deaths-and-mortality-rate-worldwide/].

August 31 is International Drug Overdose Awareness Day and the United States is pledged to increase treatment and access to overdose prevention medicines while also increasing police enforcement.

The iron law of prohibition suggests the increasing the intensity of law enforcement and implementing tolerant public health measures will conflict or an even create worst public health problem.

With desperate brevity, the current problem in the U.S. can be examined under this lens. In 2000 when doctor prescriptions for pharmaceutical opioids were high and before warnings spread that doctors oxycontin pills caused addiction, the pills were easily diverted. But 20-20 hind sight reveals opioid related overdoses were low during this unregulated era.  As restrictions on pharmaceutical supplies increased overdose deaths started to increase.

The overdose deaths examined in 2000 were traced to pharmaceutical pills, by 2010, pharmaceuticals were a declining cause while heroin was on its way up. People who formerly depended on pills had become injecting heroin users. In 2000 deaths from fentanyl were virtually non-existent by 2017 it was the major problem and what’s worse fentanyl is now mixed with meth and cocaine making these stimulants surprise killers. This is the paradox of the iron law, when pharmaceutical pills were easily found, there were overdoses, but history makes it clear the level of overdoses deaths were low, and public health measures could have kept this number down without any police involvement.

Today the drug war is renewed by alarm over overdose deaths, Sheila Vakharia Phd a Policy Manager at the Drug Policy Alliance reports that stimulants are a growing cause of overdose deaths. The CDC’s latest national overdose data [https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm] – for the period between December 2015 and December 2017, she wrote in an email, showed “cocaine-involved overdose deaths  went from 6,841 to 14,058 (over doubled) and methamphetamine-involved deaths went from 5,777 to 10,523 (80+% increase).” In NY state over the same period “cocaine-involved overdose deaths went from 354 to 690 (almost double- 95% increase) and methamphetamine went from 36 to 133 (269% increase!!).” This problem is not going away.

What should have been done around 2000 when it was discovered pharmaceuticals were being used by drug users was an intensive education campaign about how to recover from overdoses and instruction on how to minimize harm from using the pills.  A long-range strategy would also have looked at why these pills were becoming attractive to users while regulators attacked the false advertising of Purdue Pharma. One reason for the increase in addiction is that users thought pills were safer than injecting heroin.

This perception is correct but these pills being legal could also be controlled with relative ease and that is exactly what happened; the pills were cutback and users started injecting heroin and then dealers started cutting heroin with fentanyl and we really saw deaths explode reaching the 72,000 figure.

Enforcement also creates other problems. So-called synthetic marijuana, it’s plant matter that isn’t pot and why this is critical will become apparent shortly. What gets a person high is spraying a chemical, designed to mimic pot but never tested for safety, on the plant matter.

This is another way enforcement enters the picture. Synthetic marijuana is potent but cheap, $2/3 for a joint that can get a person high most of the day because one toke makes most people blasted. This makes it attractive to the homeless and it is also attractive to people on parole (who are often homeless) who are drug tested constantly, but because the chemical that is sprayed hasn’t been labeled illegal by the DEA and can be sold legally. And what this means if the parolee is drug tested, he or she is listed as clean. Surveillance of drug users follows the iron law, it makes user seek ever more dangerous and potent substances

Criminalizing a person’s intimate habits is a bad even fatal idea.

And let us conclude with a great leap of faith. Opposing the prosecution of users and their dealers is something that conventional politicians like Andrew Cuomo support reluctantly, while the inexperienced politicians like Cynthia Nixon and Zephyr Teachout are proving to be open minded about new methods of coping with drug use. From this perspective their inexperience becomes an asset.

Warren Demonstrating She is the Leading Candidate to Replace Trump

A Senator, whose reelection campaign is eclipsed by speculation about her running to replace Donald Trump breeds a certain impatience, a smart alec scoffing “what makes her so special.”

One way to meet this challenge is with oration, a deft presentation of ideas. This is what Elizabeth Warren did with a rousing speech to the democratic wing of the Democratic Party at the Netroots Convention. These activists support candidates who reject corporate money and are fed up with neo-liberalism and its failure to energize much less offer substantive benefits to the 99%.

Her remarks in New Orleans weren’t off the cuff, the speech was prepared — an optimistic program for uniting the left with their uneasy compatriots in the center.

Her compelling argument for unity spells out left wing principles but with a presentation that commands the respect from more traditional Democrats. In this reading, she addresses how she would govern. It’s only a sketch but it displays a clarity that hold out the promise that would make her a leader of Congress and the nation

The Senator has close ties to these political geeks, she reminded her audience that Netroots pressed Congress to pass the Consumer Financial Protection Board, her brainchild as a Professor at Harvard Law School.  The scholarly article captured the popular imagination with this persuasive argument — consumer protection agencies safeguard children from dangerous toys or make cars safer for adults and children, but no agency protected the public from dangerous financial agreements.

The CFPB wasn’t created “just because a professor had a good idea.” Warren called it “an uphill fight. Wall Street spent more than $1 million a day lobbying against this agency.  They called in every favor, pulled every string, hired every lobbyist they could find, trying to stop us.”

“But we beat ‘em.”

“We built a broad coalition of people” and that is the grand object of her speech, creating a “broad coalition” that will turn the November midterm election into a blue wave putting Democrats back in power.

But her unity isn’t of “can’t-we-all-get-along” variety. In this era of Trump, she calls it a “fight.” The “question, hanging over people’s heads, determining their fate: Who does government work for?

“The powerful corporations – the banks, the credit card companies – that had ruined these families’ lives just to make a few extra bucks?  They were getting away with it because those who ran the government weren’t willing to stand up for working people.”

She promises that behind closed doors she will fight for the many not the few. A promise she kept with a new bill that requires America’s billion-dollar corporations to put employees on their board of director.

Her respect for the left and her opposition to corporate greed makes her different from Democrats who plead for unity and while asking the left to tone it down and be “realistic.”

Her message is the opposite, the people united can emerge victorious and wrest control from the rich and powerful.

Like Abraham Lincoln, who described his childhood as “the short and simple annals of the poor,” Warren has distilled her upbringing into the pithy phrase, “I grew up in Oklahoma on the ragged edge of the middle class.” Saving nickels, her family made the down payment on a home, and then her father’s heart attack left him too frail to earn a good wage in a strenuous job. The bills piled up, fear cast a pall over the family, foreclosure loomed, her mom at 50 went to work for a minimum wage.

The pain and tension of life on the “ragged edge” remains seared in Warren’s memory. One morning, she went into her parent’s bedroom, and “my mother had out her best black dress.  You know the dress. It’s the one that only came out for weddings, graduations, and funerals.  She was crying.  She kept saying: ‘We will not lose this house.  We will not lose this house.’ She was fifty years old.  She’d never had a regular job.”

One obstacle facing the Senator is uncertain black support. It is my opinion that Elizabeth Warren can go to any black church or meeting and tell this story and walk out having establish a bond with her audience. She evokes the fear, recognizes the courage it takes to overcome the helpless feeling as bills pile up faster than the paycheck. These are experiences that unite the races, experience common to millions of Americans.

She also joins hands with Black America and repeatedly damns “racist law enforcement” and its spawn the war on drugs. She ties her support for legal pot to larger changes in the criminal justice system.

From her life story Warren’s point of view shifts, “For a long time, I thought this was a story about my mother.  About her courage, and her grit.” But “I came to understand that story…is also a story about government. When I was a little girl, minimum wage was enough to cover the basics for a family of three.”

Warren brings the message home, it’s the left-wing version of Make America Great Again. “When I was a little girl, minimum wage was enough to cover the basics for a family of three.  Today, a full-time minimum wage doesn’t pay the rent on the median two-bedroom apartment in any state in America.” The job that “saved my family fifty years ago wouldn’t even keep a mama and her baby out of poverty today.”

It wasn’t that long ago the government, “the guys in Washington set the minimum wage based on what it would take to support a family.” Today “Republicans who run the show make decisions like that based on what would maximize the profits of the big corporation.”

Unlike Bernie her fellow lefty Presidential contender, she isn’t locking in a number–$15— as salvation, but a principal, a welfare state principal: a just society supports a family. There are many ways to get there—low rent housing, higher minimum wage, healthcare with no co-pays or insurance premium—financed with higher taxes but government must have a realistic plan for insuring that people earn enough to pay their basic bills. Bernie of course support these policies, but he focuses on grievances and anger.

Warren emphasizes policy and applaudes the courage to fight the influence exerted by the rich and powerful. By highlighting the goal of establishing a minimum income that supports a family she is giving Congress and bureaucrats a clear goal that voters can rally behind.  This is the mark of an effective executive.

Warren and Sanders will muster the moral force of the government on behalf of housing, feeding and dressing families. Bernie’s urge is to mobilize public opinion and bring about a revolution. He reflects the sound judgment that when the top 1% have as much wealth as the bottom 90% there is surplus wealth that should be taxed. This approach has the advantage of turning higher taxes into a social justice issue.

What feeds his revolution is focusing on how unfair it is that so few should have so much. Sanders appeals to people’s anger with the wealthy, Warren appeals to people’s courage urging them to fight back. And like Bernie, she reminds everybody if the electorate unites, “the high and the mighty” can be “beat.”

Warren is more artful and turns conservative arguments on their head. The Supreme Courts Citizen’s United decision held corporation are persons with rights including making campaign contributions, Warren adds theyh also have obligations. Her latest project is a bill requiring giant corporation be federally chartered to honor their obligations as citizens to employees, the environment, and social well-being.  This is an argument for the Accountable Capitalism Act. In an email blast, she reminds us this approach won’t cost the taxpayer a penny but it would give workers 40% of the seats on the Board of Directors of America’s largest corporations.

Bernie has a greater propensity to offend moderate Democrats who often turn to the rich for campaign contributions. What Warren understands and Sanders glosses over, no progress can be made unless both wings of the Democratic Party remain united.

It is here that Warren displays a knack that resembles Lincoln’s great accomplishment, he kept the Republican Party united by identifying a legal argument against slavery. The Federal Government had no authority to end bondage in the states, but its legal reach did extend to the West where no state governments had been created. This argument against slavery expansion kept the pro-Southern Republicans from New York City and the abolitionist working together and enabled the newly created Republican Party to take the White House

Creating a viable coalition is a critical task for any President and the Netroots speech demonstrated Warren’s appeal to the left wing of the Democratic Party even as she was making an appeal to moderate Democrats to stay loyal to the Party.

How is it that the few can command the many, she demanded? “What is it about our politics that prevents our government from working for working people?  How come the majority never gets to rule in Washington anymore?”

There is the power of money “because of Citizens United and the revolving door between industry and government, money doesn’t just talk in Washington.  Money shouts, money screams, money commands.  And a lot of politicians – on both sides of the aisle – follow the money.”  Let’s pause and focus what makes Warren different from other Democratic candidates: “politicians – on both sides of the aisle – follow the money.” She isn’t a Democrat who blames the Republicans for everything, and she implies that she would damn Democrats opposing her policies as unprincipled hirelings of the rich.

Another reason the wealthy impoverish working families, “Republicans have conspired to rig the rules of democracy itself – using everything from partisan gerrymandering to voter suppression to the census.  Thanks to their years of work, the system is badly tilted. The majority is cut out of government because Republicans create election districts only they can win.”

Democrats will “have to fight uphill the whole way.  But we are not without power.  We are not without hope.  And we are certainly not without motivation.”

The most immediate solution and the one that is cured by elections is getting working people united. “The rich and powerful learned that the best way to stop us from changing the system is to set working people against each other. So they’ve become experts at the politics of division.  Frankly, it might be the one thing Donald Trump is good at – well, that and kissing up to two-bit dictators.”

The politics of division, “Trump’s story” like the left’s maintains “working families keep getting the short end of the stick” but they never accept responsibility for “the decisions he and his pals are making every day in Washington. No, the problem is other working people.  People who are black or brown.  People who were born somewhere else.  People who don’t worship the same, dress the same, talk the same as Trump and his buddies.”

“They want us pointing fingers at each other, so we won’t notice their hand in our pockets!”

Warren is taking an early lead in the Presidential race because she has better ideas than the other candidates and promises to use the ideas to mobilize Congress and the voters.

 

 

 

 

New NYS Push Against Hepatitis C

BY NATHAN RILEY | Health advocates are making a concerted push to raise awareness of a disease about which many people are uniformed despite its growing prevalence: hepatitis C.

July 28 was World Hepatitis Day, with the World Health Organization focusing its efforts around the theme: “Test. Treat. Hepatitis.” And, now, New York State has started a Hepatitis C Elimination Task Force, announced July 27 by Governor Andrew Cuomo.

The outbreak in the state is gathering force, and the best practices advice is now that when you get tested for HIV, get tested for hep C, as well. That’s not because of any specific link between the two epidemics, but rather due to the ease of managing your health care. In fact, many people who don’t consider themselves at risk for HIV could be infected with hepatitis C. Right now, such testing requires that a person ask for it.

Cuomo responds to evidence treatable infection growing among young people

In 2016, an alarming 14,745 new HCV infections were reported in New York — more than five times the number of new HIV diagnoses for the same year.

There is no obvious warning; a person infected with HVC can be otherwise healthy. The virus can hang out in the liver for years and cause no obvious discomfort.

New York State is responding with a new plan to unravel a critical dilemma, with public health officials estimating that half the infected population doesn’t know it. That problem carries a two-fold risk. First, hep C is treatable, so a person not knowing their status can unnecessarily harm their health. Treatment simply involves completing a regimen of medication and the virus disappears. An untreated person can also spread the disease.

The success in combating hep C is remarkable for a disease that wasn’t even identified until 1989. HCV lurks in the body and the blood. It was even spread by blood transfusion before it was identified.

Until recently, public health officials focused on populations 45-65 and older, many of whom have now received treatment and so are not infecting others. The assumption was that HCV infection incidence was declining.

That optimistic scenario is now outdated. The disease has spread, and young people are testing positive for it.

There are many ways to become infected, but the activists from VOCAL-NY and Housing Works that prodded Governor Andrew Cuomo and the State Health Department to prioritize the battle against HCV are active in keeping drug users healthy, through needle exchanges and other interventions. Injecting drugs is clearly one path for new infections, but so are needles in badly run tattoo parlors and straws shared while snorting drugs. The delay in authorizing Safer Consumption Spaces, where drug users can inject under the supervision of health care workers who provide harm reduction information, is one of the stumbling blocks to effective prevention efforts.

HCV infections can’t always be traced to a particular behavior because, unlike HIV, the hep C virus can live outside the body. State health officials advise that it isn’t easily sexually transmitted, but risks increase if partners have tears in their skin. It is also possible that infection can result from something as simple as sharing a toothbrush, given the virus’ resiliency outside the body.

The bottom line: get tested, and the only way to get tested is to ask for it. Every city sexual health clinic will test you for free. Go and ask for the full complement of STD tests, including for HIV, and tell them to test for HCV also. No appointments are necessary. If you visit your doctor’s office, insurance will pay for the test. But, again, your doctor is unlikely to suggest the test. You need to ask for it.

On my last visit to the city’s Riverside sexual health clinic on West 100th Street following a syphilis contact, I was in and out in an hour.

The rise in infections among 18- to 29-year-olds is particularly worrisome, that group including as it does women of child-bearing age. Infected young people, if untreated, will face major health problems later in life. Left untreated, HCV infection can be fatal.

The cost of hep C treatment keeps falling, and in the face of the epidemic barriers to treatment are toppling. The new rule is that if you test positive, you get the treatment — patients must no longer demonstrate that their infection has become serious.

New York State is now taking the epidemic’s resurgence seriously, providing money to Medicaid to cover treatment costs and allowing needle exchanges and similar service providers to become part of the testing network.

The state plan is the first in the nation “to take up the challenge,” said Housing Works CEO Charles King. Referring to Cuomo, King said the plan is “very much in line with his commitment in 2014 to end AIDS as an epidemic in New York State.”

This is an epidemic that affects heterosexuals as much as members of the LGBTQ community. Getting tested and then taking the medicine will cure the disease and eliminate the risk of transmission. Word of mouth always helps battle epidemics, so passing the information along to friends is a positive step everyone should take.

This article was posted on GayCityNews.com on August 2, 2018

Racial Bias Found in Westchester Pot Arrests

BY NATHAN RILEY | The apple doesn’t fall far from the tree when it comes to marijuana enforcement in New York City’s suburbs.

Black and brown people are singled out for marijuana possession arrests in Westchester County, according to studies by the Drug Policy Alliance and suburban civil libertarians.

A new study of Westchester arrests found racial disparities comparable to the ones that mar city enforcement and provide evidence that legalization of pot would provide real benefits to communities of color.

Suburban county’s law enforcement pattern mirrors NYC’s

Per 100,000 people in Westchester, 15 whites but 182 blacks and 84 Latinos were arrested for possessing pot. Some portion of those people of color arrested face the risk of deportation as the result of this enforcement pattern.

The study, prepared by Kathy Kaufman of the Westchester Coalition for Police Reform, found that between 2013 and 2017, one in 63 of Westchester’s black adult residents was arrested on a low-level marijuana possession charge — a probability of arrest for black people that was exceeded only by Suffolk County outside of New York City.

Young people of color were arrested more often than white youth, burdening them with a criminal record.

“Between 2013 and 2017, Westchester police arrested 1,059 youth under 20 years old for low level marijuana possession, accounting for nearly one in three (29 percent) arrests on that charge County-wide,” the study found. “Fifty-eight percent — a total of 2,322 people — arrested for low-level marijuana possession in Westchester County were 25 years old or younger.”

The report “Marijuana Arrests and Enforcement in Westchester County: A New York Story” sustains the argument recently advanced by the State Health Department that legalization would communities of color because an “emerging body of research” shows that “the risks to public health and social wellbeing of legalizing marijuana are smaller than previously thought” and the “the detrimental effects of the current marijuana enforcement regime” cause more harm than the alternative of making pot available for adult use.

The Westchester study was funded by the Drug Policy Alliance as it pushes for passage of laws to tax and regulate marijuana sales as is currently done in California, Colorado, and Massachusetts.

This story was posted on August 2, 2018 at GayCityNews.com

De Blasio Dithers on Marijuana

BY NATHAN RILEY | Public officials in the city and state should suspend marijuana enforcement until Albany resolves the pressing question of legalization.

A new consensus is gaining momentum that the risks of marijuana can be controlled by public health measures. At its recent State Convention, New York State Democrats supported legal adult sales of recreational marijuana, declaring that weed is “is less harmful than alcohol and tobacco.”

Meanwhile, top health officials in New York City and New York State have endorsed a tax and regulate model for adult recreational use. It is a new era where health issues need no longer hinder legalization, and the debate centers on how to implement a new approach to marijuana.

Mayor’s supposed “advance” will still lead to arrests

In a report to Governor Andrew Cuomo made public last week, Dr. Howard Zucker, the state health commissioner, said he doesn’t subscribe to the theory that marijuana represents a gateway to harder drugs. Zucker’s conclusion has been widely held by other public health officials for years. The National Institute of Drug Abuse points to some rodent studies that indicate early use of marijuana could make the brain susceptible to an appetite for other drugs. Studies like this agree with epidemiological data that show that use of drugs in early adolescents is correlated with abuse as adults. But then there is a big qualifier here: “the majority of people who use marijuana do not go on to use other, ‘harder’ substances.”

Moreover, NIDA notes “cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs.” This trio of drug are “typically used before a person progresses to other, more harmful substances.”

Given this pattern, NIDA offers “an alternative to the gateway-drug hypothesis.” Drug users “are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs.” You choose friends you are comfortable with and, in turn, you have shared activities.

From this perspective, the longstanding war on pot is not justified; use of marijuana may have a link to other drug use later in life, but it doesn’t necessarily cause it. Arrests are unwarranted, particularly given the high likelihood that legalization is on its way, but Mayor Bill de Blasio remains stubbornly resistant to this new reality.

With a great flourish, he recently announced that smoking in public would be greeted with a summons not arrests, arguing he was making a real concession.  But other member of the Democratic Party and advocates blasted his proposal.

The chairs of two criminal justice committees in the City Council joined advocates June 20 on the steps of City Hall attacking the mayor’s plan. Their critique burst de Blasio’s hopes of appearing progressive; the plan, they said, represented only the smallest of steps forward.

Queens Councilmember Rory Lancman, who heads up the Committee on the Justice System, blasted the mayor’s plan on the steps of City Hall and in a statement, saying, “No one should be arrested for smoking marijuana, period.” Calling the new plan a sham, he noted that a speeding ticket is a civil summons, but that de Blasio’s action on marijuana involves a criminal summons.

“The mayor’s policy does not attempt to reduce criminal summonses at all, still allows arrests in circumstances that cannot be justified by public safety,” Lancman said.

Then, in a thrust that must hurt a mayor whose political persona is defined by opposition to all forms of discrimination, Lancman predicted the plan “will likely make marijuana policing even more discriminatory toward people of color, continues to expose noncitizens to deportation, and takes no steps to eliminate the collateral consequences which are in the city’s control.”

Joining him was another Queens councilmember, Donovan Richards, who chairs the Committee on Public Safety that oversees the NYPD, as well as Brooklyn Councilmembers Antonio Reynoso and Jumaane Williams, the latter of whom is challenging Lieutenant Governor Kathy Hochul in the September Democratic primary and is aligned with Cynthia Nixon’s gubernatorial bid.

City Comptroller Scott Stringer, a likely candidate for mayor in 2021, joined the demonstrators, saying “too many live have been ruined, too many people of color have been targeted.” As he left the speaker’s podium, he reminded everyone that he is “the money guy. If you will legalize, you will actually create a $3 billion dollar industry” and tens of thousand new jobs. With more revenue, he said, “you will have an opportunity to invest more in the community.”

Kassandra Frederique, state director of the Drug Policy Alliance, called for a “clear-cut policy saying no arrests, no justification for putting people into the criminal system — period.”

Public defenders, organizations representing minority youth like Make the Road New York, and drug reformers like VOCAL-NY also stressed that New York must stop relying on criminal penalties.

Under the mayor’s plan, anybody stopped for marijuana who is not carrying identification can be arrested and fingerprinted and that could lead ICE to identify them for deportation, Legal Aid Society lawyers argued.

According to de Blasio, his plan will make things better because there will be fewer arrests.

But he avoids a basic ethical question. If marijuana will be legal in eight or nine months, how can enforcement be justified now? Campaigners for legal marijuana are eager to avoid any arrests for a drug that is less harmful than alcohol or tobacco. Keeping young people’s records clean means they can can qualify for better jobs and increase their earning potential — a factor particularly salient in low income neighborhoods and communities of color. This is one piece of the argument that legalization will be good for the state’s economy.

The case against arrests is implicit in the Democratic Party’s recent resolution. “Marijuana laws have not had a significant impact on marijuana availability,” the statement reads. If the law fails to curb use, then no individuals, much less poor black and brown youth, should be criminally punished in a futile exercise. That is why enforcement should be suspended and the Legislature be given time to create a new policy.

The mayor’s “advance,” meanwhile, continues major injustices. As Gothamist headlined its story about de Blasio’s announcement: “NYPD Will Stop Arresting SOME People For Smoking Pot.” Among those who will be arrested are parolees. It is hard to think of a crueler outcome for getting high than going back to prison after enjoying freedom. In fact, according to the Daily News, some federal judges are refusing to play along with this. Judge Jack Weinstein, a liberal lion on the federal bench in Brooklyn, made the news with “a remarkable 42-page ruling explaining why he would not send 22-year-old Tyran Trotter back to prison for three years — longer than his original sentence! — for smoking pot, a technical violation of his post-release terms,” according to the Daily News.”

In his years as mayor, de Blasio has displayed an uncanny talent for isolating himself politically. His ties to the drug reform movement were already frayed by his long delay in supporting safer consumption spaces that offer medical support to drug users during their time of greatest peril in the minutes after they inject. His months-long stall on the issue is now being followed by Cuomo’s own foot-dragging in giving the state’s go-ahead.

If de Blasio were to advocate for complete suspension of marijuana law enforcement pending action in Albany, he would become a leader with a national constituency and polish his fading progressive image. Instead, he is allied with the police, which will always show more loyalty to Cuomo than to him in any event. At a time when the mayor needs allies and a chance to reignite the initial enthusiasm he stirred, he is increasing his troubles by standing pat rather than making a bold move forward.

This article was posted on GayCityNews.com on July 19, 2018

State Health Commish Gives Pot a Go

A report from Dr. Howard Zucker, the state health commissioner, has blessed the legalization of marijuana. | NYS DEPARTMENT OF HEALTH

BY NATHAN RILEY | In a report that will be read by public health officials across the country, the New York State Health Department has declared that legalizing marijuana would bring positive benefits; the “pros outweigh the cons,” opined Dr. Howard Zucker, the state health commissioner.

The report, which went public last week, makes it clear that legalization will improve health outcomes. After reading the report, it would be easy to conclude pot smokers are no different from the rest of the population. The report emphasizes that consumer safety will improve with laboratory-tested pot, its potency carefully labeled and customers able to pick the plant that brings the most satisfaction. Here health and pleasure form a useful synergy, and regulations reduce risks.

The risk that an emancipation effect will spur a sudden surge in use is low. By age 18, 52 percent of New Yorkers have tried marijuana. Under the current system, there is no shortage of supply, and the report suggests that limiting sales to licensed stores will make it more difficult for those under 21 to find pot.

Dr. Howard Zucker’s report finds improved health outcomes, economic benefits

Current law fails to restrict supply, and that means arresting users and suppliers accomplishes little. The report implies pot busts are cruel and pointless.

Sustaining these penalties are scare stories about marijuana that create fear but lack merit. A big lie is enshrined in federal law; it declares marijuana is a Schedule 1 drug with “no medical use” and a high potential for abuse. The problem of abuse can better be addressed after legalization when its use will be regulated. The report expresses the hope that legalizing pot will reduce the use of opioids.

Some studies have indicated that in places with medical marijuana there are fewer opioid overdose deaths. New York State has seen a 180 percent increase in overdose death between 2010 and 2016 to more than 3,000 a year, and every year more people die than the year before.

Occasionally a dry wit is displayed in Zucker’s report. During a discussion about marijuana causing a loss of motivation, it is described as a “temporary transient state,” not a permanent condition. Findings like these lead to the conclusion that marijuana is less harmful than alcohol or tobacco and undermine the rationale for its prohibition under federal law.

The exaggerated claims about harm from marijuana have been accompanied by a vicious enforcement policy. “Statewide, New York’s marijuana arrest rate of 535 arrests per 100,000 people was the highest of any state in 2010 and double the national average” with 103,698 arrests for possession, according to the report.

“The impact of low level marijuana offenses extends” beyond expenditure of criminal justice resources, the report notes. “Individuals who have a criminal record often face challenges throughout their lives.” It disproportionately criminalized black and brown residents. In 2017, the problem persisted, the reporting finding that “86 percent of the people arrested for marijuana possession in the fifth degree in 2017 were people of color; 48 percent were Black, and 38 percent were Hispanic. Only nine percent were White.” And the black and brown defendants received tougher punishment than whites.

Strikingly, “It is rare that these arrests lead to the discovery of guns or violent crimes,” the report stated.

And arrests have a health impact: Arrests and incarceration disrupt families, hindering access to education and health care, and increasing poverty “particularly in low-income communities of color where arrests are concentrated despite equivalent rates of marijuana use across racial groups,” the report stated. “Incarceration of family members destabilizes families and is considered an adverse childhood experience (ACE).” Incarceration also has “an impact on community health in many areas (including teenage pregnancies and sexually transmitted infections).”

Legalization will bring improvements in community health for low-income neighborhoods, the report concluded.

To rectify past harms, the report recommends that “NYS expunge the criminal records of individuals with marijuana-related offenses.”

Meanwhile, developing tests for driving while using marijuana will improve once tax revenues from pot sales can finance this research.

Legalization will create a new industry in New York State. The report estimates that at “an average retail price of $270 per ounce, the market for marijuana is estimated to be approximately $1.7 billion; at $340 per ounce, the market is estimated to be approximately $3.5 billion.” Estimated tax revenues could fall between $248 million and $677 million, but the goal of raising taxes conflicts with the public policy imperative of ending the illegal market. The more expensive legal marijuana is, the greater the likelihood that the unregulated market will continue.

Preliminary data from Colorado suggests that legalization did not bring “statistically different” vehicular crash rates — though studies of marijuana impacts on traffic accidents are funded only sporadically and the data is imperfect.

The State Health Department’s “Assessment of the Potential Impact of the Regulated Market in Marijuana for New York State” argues that legalization improves public health and recommends that its licensing be separate from alcohol and tobacco. The details are not spelled out in the report but will be debated during the coming year. Health is no longer the issue; the hows and wheres are what are left to be decided.

This article was added to GayCityNews.com on July 19, 2018

Safe Consumption Delay Prompts City Hall Sit-In

 

BY NATHAN RILEY | Chanting “no more overdoses,” 75 angry New Yorkers packed the steps of City Hall on April 5 and then a smaller group staged a sit-in at the gates leading to Mayor Bill de Blasio’s office, forcing police to eject them. The demonstrators were making an emotional plea to the mayor that he release a feasibility study about safe consumption facilities that give drug users medical supervision while they are getting high.

In such spaces, users consume product they buy on the street under the watchful eye of an overdose prevention worker. Should a user slip into unconsciousness, these workers are only steps away and can administer naloxone, a public health wonder drug that reverses overdoses and restores normal breathing. There have been thousands of overdoses at such facilities in cities like Frankfurt, Sydney, and Vancouver, but nobody — as in zero — has ever died.

On February 5, Dr. Mary Bassett, the city health commissioner told a City Council budget hearing that “the public health literature is clear.” Despite that definitive statement, de Blasio has kept the health department study under wraps. Yesterday’s City Hall protesters charged that in the 59 days since Bassett’s testimony, there have been approximately 236 overdose deaths in New York.

Advocates demand de Blasio release study of facilities where drug users have medical support

Charles King, the CEO of Housing Works, an AIDS services group, opened the protest on a personal note.

“Today marks the 14th anniversary of the death of Keith Cylar, one of the co-founders of Housing Works and my life partner for some 15 years,” he said.

Then adding that he was speaking “not just on behalf of people living with AIDS and HIV, but also on behalf of people who use drugs,” King said, “Keith spoke with particular passion and urgency. He was not only a black gay man living with AIDS, he was also addicted to drugs his entire adult life. And whether it was long-term degeneration caused by AIDS or long time use of cocaine that caused his cardiomyopathy, and whether the heart attack would have happened anyway or was triggered by the crack he smoked that night, his death certificate says he died of a drug overdose. I will go to my grave knowing that if someone had been with him at that moment who knew how to intervene, he might well be standing here with us today.”

Also in impassioned remarks, Kassandra Frederique, the New York State director of the Drug Policy Alliance, said, “Safe consumption spaces are critical to saving lives. We don’t need a report to tell us what we already know, what we need is leadership.”

The mayor, she added, isn’t “leading the parade, he’s following it.”

As other speakers addressed the crowd, King and about a dozen others went inside City Hall and tried to enter de Blasio’s suite of offices. When refused at the gate leading to the mayor’s wing of the building, they sat down chanting “no more overdoses.” Police approached a limp Charles King and, with some difficulty, dragged him out of the building. Some others among the demonstrators were also carried out, while some stood up on their own. Police made no arrests either inside or out, and the rally on the steps lasted an hour and a half.

The mayor, arriving at City Hall in the middle of the demonstration, decided against walking through the protest.

In 2016, Corey Johnson, an out gay city councilmember who then chaired the Health Committee and is now Council speaker, put a $100,000 appropriation into the health department budget to pay for the safe consumption space feasibility study, at a time when overdose deaths in the city had reached 1,300 a year, more than the combined total from vehicle accidents, homicides, and suicides.

King said the report was finished in December, but the mayor has so far declined to release it publicly.

In an email, Johanne Morne, director of the AIDS Institute in the State Department of Health, said flatly, “Safe Consumption Spaces have shown success in other countries.” The idea, she continued, should be “an item of consideration” for “interventions in response to the opioid epidemic.”

In a strongly argued editorial in February, the New York Times declared the safe consumption space approach a “rigorously tested harm-reduction method” that has “proved incredibly effective at slashing overdose deaths.”

Councilmembers Mark Levine of Manhattan, chair of the Council Health Committee, and Stephen Levin of Brooklyn, chair of the General Welfare Committee, support the program.

The citywide coalition of treatment providers, medical professionals, and harm reduction activists are boiling over with anger at a delay that prevents drug users from gaining timely access to a life-saving medicine.

A drug user overdosing is helpless and depends on another person to help them regain normal breathing. Safe consumption spaces are specifically designed to meet this emergency and also allow health professionals to begin a constructive engagement with users about other means of reducing the harm caused by their drug habit.

This article was posted on GayCityNews.com on April 6, 2018

Progressive Hell’s Kitchen Club Sticks with Cuomo

BY NATHAN RILEY | Right in Cynthia Nixon’s backyard, just weeks after the actor and activist announced her Democratic primary challenge to Andrew Cuomo, the Hell’s Kitchen Democrats — a progressive newcomer on the local political club scene — voted Thursday night to endorse the two-term governor for reelection.

The club held its first endorsement meeting for statewide offices April 5, and elected officials showed up to make personal pleas for support. State Comptroller Tom DiNapoli appeared and described the duties of his office, talking about leveraging his office’s control of the state employees’ pension funds to insist that corporations hire women and minorities for their boards of directors. He also talked about working with shareholder activists to press corporate America to abide by the Paris Agreement on climate change, despite President Donald Trump’s withdrawal of the US from it.

Club members had the chance to compare Lieutenant Governor Kathy Hochul and her primary opponent, Brooklyn City Councilmember Jumaane Williams. Hochul, who appeared on behalf of the governor, emphasized her record of supporting women’s issues including the right to choose in Republican districts in western New York State. She also argued that she and Cuomo are steadfast supporters of the long-stalled Gender Expression Non-Discrimination Act, a transgender civil rights measure, despite what she said was opposition from many upstate New Yorkers.

West Side’s newest Democratic organization supports all incumbents except IDC’s Marisol Alcantara

“I am laser focused on bringing our country back” from Trump’s reactionary policies, said Hochul, who reminded the club that 2018 is the 100th anniversary of the first time women voted in New York State elections.

Williams, for his part, promised to turn the lieutenant governor’s office into the state equivalent of the city’s public advocate role.

“I will speak against the governor,” he promised. “The emperor has no clothes” he argued, citing corruption and high rents as failures of the current administration in Albany. When questioned about a City Council bill that made it easier for transgender New Yorkers to change their birth certificates, however, Williams acknowledged that he abstained from voting on that citing concerns he had about a specific portion of the language in the measure. [Editor’s note: The original posting of this story incorrectly reported that Williams had voted “no” on the bill.]

Hochul, DiNapoli, and State Attorney General Eric Schneiderman, the only other statewide elected officials besides Cuomo, also received the club’s nod. Specific tallies from the secret ballot were not announced.

Despite the announcement this week that the renegade Independent Democratic Conference in the State Senate would abandon its alliance with the Republicans who control that chamber and rejoin the regular Democratic Conference, the Hell’s Kitchen Dems vowed to continue opposing IDC members facing primary challenges in September. The club endorsed former City Councilmember Robert Jackson in his challenge to Marisol Alcantara, who immediately joined the IDC after her 2016 election to a Senate seat representing the West Side. Jackson lost to Alcantara two years ago and is eagerly preparing for a rematch.

The club also endorsed four local state legislative incumbents — Assemblymembers Richard Gottfried and Linda Rosenthal and Senators Liz Krueger and out gay Brad Hoylman. Gottfried, Rosenthal, and Krueger each addressed the club.

This was posted on GayCityNews.com on April 6, 2018

Nixon’s Working Family Coup

BY NATHAN RILEY | It’s official, Cynthia Nixon is no longer merely the actress from “Sex in the City,” but now the official candidate of the Working Families Party, with the opportunity to stay on that ballot line in the November election.

The candidate damned for being “inexperienced” and even an “unqualified lesbian” outmaneuvered Governor Andrew Cuomo in a game of insider baseball. Cuomo suffered an abject defeat, and then lashed out by strong-arming unions to stop contributing to and supporting the WFP.

Nixon is now the candidate of a united left disgusted with what activists see as “corporate” Democrats who compromise their principles to avoid taxing the ultra-wealthy. Also meeting on Saturday, April 14, in Albany was an affiliate of Bernie Sanders’ Our Revolution, the New York Progressive Action Network, which endorsed Nixon, as well. Ken Lovett at the New York Daily News reported the local affiliate will press the national organization to give Nixon the nod.

NEWS ANALYSIS: With new posture on drugs, justice, challenger rallies the left

Sanders, careful about getting involved in primaries where one Democrat feuds with another, has made it clear that Nixon will have to prove she is capable of ousting Cuomo before he would get involved.

The critical challenge facing the WFP candidate is making New Yorkers care if they vote for Cuomo or her. How would she make life different by being governor and would that matter to the voters?

Given that everyone is being told that Donald Trump is the problem, why does it matter if Nixon or Cuomo is elected? Nixon can expect decent media coverage until the final weeks before the Democratic primary, at which point attention usually bends in favor of the incumbent, especially an incumbent like Cuomo who nurtures wealthy support.

But Nixon is already changing policy in the state. On the same day Cuomo gave up on seeking WFP support, he conceded that New York would legalize pot at some point. Possibly, he would even push a legalization bill in the final weeks of the legislative session. With Senate Republicans likely having continued control over the agenda, they and Cuomo could enact a cramped, restrictive bill comparable to their narrow medical marijuana bill that in two years has registered 49,780 patients, though the state is unable to say how many actively use the program. It allows certain patients for specified illness to obtain drinkable solutions and pills that alleviate specific symptoms. But no patient is allowed to smoke pot or enjoy the euphoria that comes from its high. That is prohibited in New York.

Other states that enacted medical marijuana by referendum like California created programs that gave pot to virtually anyone who sought it: have a bad back, a person could buy pot. Depressed and having a bad reaction to HIV meds, ditto — pot was available. Cuomo and many New Yorkers mocked this permissive approach. But its real purpose was to educate consumers and give them a mindset where they thought about what they wanted from using marijuana.

Public health advocates are trying to change people’s mind about how to use marijuana. They want to get away from the hipster belief that’s it’s for getting high and present pot as a drug as like Prozac — a substance that makes a patient happy and able to function. The positive experience with medical pot was undoubtedly a reason that California voters in 2016 endorsed legalizing it for adult recreational use.

New York’s medical marijuana program is having no impact on public perceptions on pot use. Instead, racist enforcement of the existing recreational prohibition has continued for decades. Mayor Bill de Blasio softened the policing policy but did not end it. Nixon has pounced on this issue, and persuading black women that she cares about racial justice is critical to her electoral success. She is the only one taking a principled position — if it’s racist, it has to stop.

The battle between drug reformers and prohibitionists revolves around stigma and autonomy. Reformers, citing human rights and notions of dignity, say a user has to decide to give up their drugs and often compare the struggle to dieting where some people succeed and control their weight while others wrestle with the problem for years. This position enjoys broad medical support. Dr. Mary Bassett, the city health commissioner, has tweeted, “We fail people every time we say they have to ‘get clean.’ There is nothing dirty about addiction.”

This dynamic is familiar to the LGBTQ community because of debates of discussion about HIV and stigma.

The prohibitionists are convinced psychoactive drugs used without a physician’s guidance are bad and are willing to jail or threaten jail to users who don’t get “clean.” Reformers who object on civil liberties grounds are quick to respond that many users wait until their parole or probation period is over and immediately get high again. This is a group of users at risk for overdosing. They can be overwhelmed by taking high doses of a drug after a long abstinence.

The medical community recognizes this problem and prefers medically assisted treatment. It alleviates the craving for drugs and lets the patient decide if and when to taper off.

Nixon is for more than simply legalizing pot, she brings a new attitude toward drug use that is perhaps unintelligible to Cuomo. Drug reformers argue we can live with people who use drugs — that a friend or family member who gets high is no more of a problem than that a person is gay or straight. We know that people all over the world in many different cultures use psychoactive drugs. The US will never be drug-free and should learn to live peacefully with drug users. Most drug users are conventional people living productive lives. Others who have more serious problems with drugs can recover and then live conventional productive lives.

The difference between the left Democrats and the corporate Democrats are large and will be the subject of controversy. Even if Nixon loses the election, she will have mobilized a progressive base that will stay and work to grow larger. Rome wasn’t build in a day nor will a progressive political party’s future be decided by one election.

This article was posted on GayCityNews.com  on April 29, 2018

De Blasio Moves on Safer Consumption Spaces to Curb Overdoses

BY NATHAN RILEY | A multi-year push in New York City to offer drug users a safe place for consuming their drugs seems destined for success after Mayor Bill de Blasio announced his support for “overdose prevention centers.”

Public health advocates voiced enthusiasm as the news spread on May 3 that the administration had reached out to Dr. Howard Zucker, the state health commissioner, for a go-ahead to open four Safer Consumption Spaces in the Bronx, Manhattan, and Brooklyn.

Brooklyn City Councilmember Stephen Levin, the chair of the General Welfare Committee who was arrested the day before in a sit-in on Lower Broadway opposite City Hall to push de Blasio to act, tweeted: “Where others look down upon our most vulnerable we will show love and a path towards recovery.”

Thanking the mayor, Levin added, “This will save lives.”

After months of protests, mayor rolls out plan with significant political, health institution support

De Blasio’s action came in the wake of a city health department study of this approach toward curbing drug overdoses funded by the City Council in 2016 and completed this past December.

The mayor set conditions that likely will easily be satisfied. He sought support from the city’s district attorneys, and Manhattan DA Cyrus Vance, Jr., and Brooklyn DA Eric Gonzalez immediately signaled their endorsements via Twitter.

“In the midst of an overdose crisis, we cannot sit by and let ppl die when there are proven interventions that can save live,” Gonzalez wrote, while Vance said, “We are proud to support the Mayor’s proposal to establish Overdose Prevention Centers. Thanks for your leadership.”

Darcel Clark, the Bronx DA, has held meetings on the intervention but remains hesitant unlike her peers, saying only that she has an “open mind.” Clark faces the voters for reelection in 2019, while Vance and Gonzalez won four year terms this past November.

In a written statement, Corey Johnson, the City Council speaker who initially pushed the proposal in 2016 when he chaired the Health Committee and got $100,00 put into the budget to have the health department carry out the study, said, “We thank Mayor de Blasio for taking this brave, important, and necessary step.”

Johnson, who is gay and HIV-positive, often expresses sympathy for those who have died from drug overdoses, mentioning his own history with alcohol and drug use, from which he has been in recovery for years.

“Too many people have died from opioids and heroin,” he said. “These sites will save lives and connect addicts with treatment options and trained professionals that could lead them to recovery. This is an issue that has deep personal significance to me.”

The US Justice Department has issued quasi-official opinions that Safer Consumption Spaces are illegal, but the mayor, by establishing the sites as temporary research programs, believes Zucker has the legal authority to approve their operation.

In the de Blasio administration’s letter to Zucker, Dr. Herminia Palacio, the deputy mayor for health and human services, asked “for immediate steps under Public Health Law to license a pilot research study.” The license would “include the possession of controlled substances.” She cited as precedent the pilot research that authorized needle exchanges whose distribution of sterile syringes brought dramatic reductions in new HIV infections among injection drug users.

In examining the city’s request, Zucker can count on the strong support of Chelsea State Assemblymember Richard Gottfried, who chairs the Health Committee.

“The Mayor’s announcement is an important step and a testament to the hard work of public health advocates on this issue,” Gottfried said in an email to Gay City News, adding, “Supervised injection facilities are an effective harm reduction strategy and a place where people can be connected with appropriate health care and social services.”

A letter to de Blasio from Charles King, president of Housing Works, the AIDS services group, demonstrates the quiet persuasion — that was coupled with loud protests from advocates, as well — that got city leaders behind this project. King was writing in his capacity as chair of Research for a Safer New York, Inc., a consortium of syringe exchanges that have found themselves treating overdoses and assisting clients who have injected in their facilities’ bathrooms.

This consortium will be the contractor managing the overdose prevention centers, with Dr. Holly Hagan, an epidemiologist at NYU, overseeing the research effort. NYU has agreed to have its Institutional Review Board evaluate the study design.

The mayor acted after the four city councilmembers where the initial four overdose prevention centers will be sited had already endorsed the idea. Johnson and Levin, in particular, had voiced considerable frustration with de Blasio’s slow pace of acting on the issue.

In Upper Manhattan, the Washington Heights Corner Project has agreed to sign a contract with the consortium. Liz Evans, a founder of the Vancouver Needle Exchange in Canada that opened in 2003, is on staff there. Mark Levine, the chair of the City Council Health Committee and a supporter of SCS, represents the district that includes the Corner Project.

St. Ann’s Corner of Harm Reduction, where this writer was formerly chair of the board, participated in the Bronx Opioid Community Summit on April 21. At the meeting, Councilmember Rafael Salamanca, who represents the district where St. Ann’s is located, gave a moving talk about growing up in the Bronx where drug use was common and visible. He emphasized the opportunity to bring change to people’s lives through love and compassion. His remarks, which included his endorsement of Safer Consumption Spaces, drew a standing ovation.

The other participating needle exchanges are run by Housing Works, in Midtown West, in Johnson’s district, and VOCAL-NY, which has space within walking distance of Atlantic Avenue-Barclay Center subway complex. Levin is the councilmember for that district.

In testimony before the Council’s Budget Committee in February, Dr. Mary Bassett, the city health commissioner, said the scientific evidence that these facilities stop fatal overdoses is “clear.”

Drug users, especially those taking opioids, frequently overdose, but in Safer Consumption Spaces they receive assistance in breathing with doses of naloxone, a public health wonder drug. A plastic nozzle is used to squirt the medication into a user’s nostril and the opioid is inhibited and normal breathing is restored. In Safer Consumption Spaces worldwide — located in more than 100 cities — there have been no reported fatalities.

In upstate Ithaca, Mayor Svante Myrick and the City Council have already approved a Safer Consumption Space. Philadelphia and San Francisco are also moving forward on this approach, though no such facility is yet in operation in the US.

According to Politico, the number of overdose deaths in New York City hit a record 1,441 in 2017, with 80 percent of them from opioids.

Even as Housing Works’ King lauded de Blasio, he expressed frustration about how long it took to get to this day.

“Housing Works is thrilled that Mayor de Blasio has stepped up to do the right thing, and given the skyrocketing rates of overdose in New York City, we only wish this administration’s support for an intervention that we have long known to save lives had come sooner,” he said in a written statement, adding, “One thing we have learned from years of fighting the AIDS epidemic is that harm reduction works.”

This article was posted on GayCityNews.com  on May 4, 2018