Tag: drugs

Bureaucratic politics 101: the U.S. adjusts its position on the drug treaties

INL’s Shawshank Redemption: thanks to cannabis legalization in WA and CO, the US now finds “flexibility” in the drug control treaties.

Historically, the United States was the chief architect of the prohibition-oriented international drug control regime, and among the most “hawkish” of the signatories (along with Sweden, France, Russia, Japan, and Singapore, and much of the Arab world). The U.S. did a bunch of finger-wagging at the Dutch for their relatively liberal policies. And the Bureau of International Narcotics and Law Enforcement in the State Department (“INL” in Alphabet-speak, informally “Drugs and Thugs”) has long been one of the more hawkish players in internal drug-policy debates.

The treaties, on their face, require the criminalization of not only drug dealing but drug use. One of the arguments made against the tax-and-regulation approaches adopted by initiative in Colorado and Washington State was that their adoption would put the country out of compliance with its treaty obligations. There are legal loopholes: the treaties acknowledge that their obligations apply to each signatory only insofar as consistent with its domestic institutional arrangements. Since the U.S. federal government, the party bound by the treaties, lacks the constitutional power to require criminalization at the state level, it’s not clear that the actions by Colorado and Washington State voters can be said to have been illegal under international law.

Uruguay has gone further, legalizing at the national level. The Uruguayan government argues that even that is allowed by the treaties, because the treaties recite the reduction of illegal drug trafficking and the protection of public health among their stated goals, and the Uruguayan law is designed to accomplish those goals. Whatever the merits of that argument legally - personally, I don’t think it passes the giggle test, though as a policy matter I’m glad Uruguay is making the experiment and hope it succeeds - it is one that the United States could once have been counted on to scorn.

And yet, when the U.N. Commission on Narcotic drugs met in Vienna last month, and some member countries got up to criticize the Uruguayan move (which the International Narcotics Control Board, the referee set up by the treaties, promptly denounced) the U.S. had no comment on that issue.

In part that reflects changing U.S. public opinion about cannabis, and the more liberal stance of the Obama Administration compared to its predecessors. But in part it reflects the fact that INCB also blasted Colorado and Washington State, putting INL in the position of having to defend the permissibility under international law of those regimes and of the accommodating stance toward them adopted by the Justice Department. So the voters in those two states in effect forced a change in our national stance in international fora.

Here’s Ambassador William Brownfield, the Assistant Secretary of State in charge of INL, explaining the new stance: the treaties, we are now told, are “living documents,” allowing “flexibility” in how different nations choose to meet their obligations, and we should seek a new consensus about what that means.

Obvious, once it’s happened. (It might not have happened in, say, the Romney Administration.) But, as far as I know, not predicted in advance by anyone, least of all by me.

Footnote It would be easier to take more seriously the self-appointed “Global Commission on Drug Policy” if spokespeople such as Michel Kazaktchine didn’t insist on making nonsensical claims, such as that minor drug offenses account for half of U.S. incarceration (the actual figure is more like 20% for all drug offenses) and that prohibition has failed to reduce consumption (compared to what?) and that alcohol and tobacco control via taxation and regulation have been more successful (by what measure).

The Dramatic Arrival of Health-Oriented Drug Policy

Health care for addiction in the United States has been forever transformed by three new pieces of legislation

Given how often some people demand “health-oriented drug policy” from the Obama Administration it is more than a little peculiar how one of the biggest reforms in history didn’t attract more attention and draw more praise in the blogosphere. With the Administration’s declaration that treatment of mental health and substance use disorders are essential health care benefits, to be provided not only in the state health insurance exchanges but in all new individual and small-market health insurance plans, over 60 million Americans just got better insurance coverage for these disorders. The graphic below is from HHS:

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That isn’t the end of the good news. The more than 100 million Americans who receive coverage under large-group plans are also getting better coverage due to the Mental Health Parity and Addiction Equity Act. Passed in the waning days of the G.W. Bush Administration with the regulations being written by the Obama Administration, the law mandates that any offered benefits for addiction and mental health must be comparable to those offered for other conditions.

But wait there’s more: Medicare, which enrolls almost 50 million people, has long had inferior coverage for addiction and mental health outpatient care, reimbursing only 50% of costs versus 80% of those for other forms of medical care. Thanks to a provision in the 2008 Medicare Improvements for Patients and Providers Act (again, give it up for the 110th Congress and President Bush), this disparity in reimbursement is being phased out and will be entirely eliminated by January 1 of next year.

When you consider that addictions almost always evidence themselves in adolescence or early adulthood, it becomes clear that the ACA provision allowing parents to keep children on their insurance until age 26 adds yet another layer of protection for the population.

Some people of course have coverage from more than one of the above sources, but even granting that overlap, over 200 million Americans have gotten improved insurance coverage for treatment of drug and alcohol problems (and mental health disorders as well). This includes many people who were starting with nothing, as well as a large population that had a benefit of inferior quality.

This is the biggest expansion to access to care for addiction in at least 40 years and probably in American history. In financial terms, it is certainly the biggest commitment of public and private resources to the health care of people with substance use disorders in U.S. History. Congratulations are in order to countless grassroots advocates, civil servants, political appointees, members of Congress and two U.S. President for transforming the face of health care for addiction.

Weekend Film Recommendation: Layer Cake

Given that I am in London and sitting in the very chair you see pictured here, it is only natural that I make this weekend’s film recommendation the movie in which it appears: Matthew Vaughn’s stylish and brutal Layer Cake. That’s obviously not me pictured, but the magnificent Sir Michael Gambon. He plays wily drug kingpin Eddie Temple in one of the great British gangster films (which is saying something, they have been making outstanding movies about guns and geezers over here for three quarters of a century).

The film centers on cocaine middleman “Mr. X”, played convincingly by a pre-James Bond Daniel Craig. One of the many things the film gets right about the illegal drug trade is that it includes people like Mr. X who think they can make big money while remaining untouched by the damage that drugs do downstream and the violence and immorality of the kingpins who call the shots upstream. Mr. X tells himself he is just a businessman whose commodity happens to be illegal, and that he will simply leave the drug trade behind him when he is financially secure. But when drug honcho Jimmy Price (Kenneth Cranham) gives him an unusual assignment, his assumptions are shattered and he quickly gets in way, way over his head. Meanwhile, he develops a serious case of the hots for a low-level gangster wannabe’s girlfriend (played by Siena Miller…rumor has it that she and Craig prepared for their sex scenes together Lee Strasberg-style).

The supporting cast is uniformly strong, especially Colm Meaney as a long-time gangster. There are some over-the-top camera shots by Vaughn which some people found self-conscious and annoying, but they work well given the kinetic story line. And Gambon’s soliloquy on “the facts of life” is as quotable and as well-delivered as anyone could ask.

p.s. This film is rated R with an exclamation point, so by all means don’t bring the kids.
p.p.s. Vaughn shot three different endings for this movie, all of which I’ve watched and he definitely picked the right one.

Calling b.s. on UN drug numbers

Alejandro Hope shreds the latest drug numbers invented by the UN.

Alejandro Hope, until recently in charge of organized-crime analysis at CISEN (the Mexican intelligence service) shreds the latest nonsense numbers from the UN Office on Drugs and Crime.

Part of the problem with drug policymaking at every level is its almost complete detachment from reality. In particular, statistics about drug volumes and revenues are more or less invented at random, then passed around like bad pennies.

I have this flagged under “Lying in Politics,” but “lying” isn’t really the mot juste. This is more what Harry Frankfort calls “bullsh*tting”: the statements are false, but not really intended to deceive. Stating them, and citing them, are ritual gestures: socially meaningful, but essentially content-free. (And debunking them is one of the central themes Jon Caulkins, Angela Hawken, and I pursue in Drugs and Drug Policy, whose subtitle should really be, not “what everyone needs to know,” but “what everyone needs to stop believing.”


Translation below the fold.

Footnote More from Alejandro at his new blog (mentioned earlier by Keith). It’s called “Plata o plomo” (“Silver or lead”), the proverbial choice offered to law enforcement officials by Latin American drug traffickers: take our money or face our bullets.

Continue reading “Calling b.s. on UN drug numbers”

Mapping the Revenue of Mexico’s Organized Crime Organizations

Starting tomorrow, Stanford’s Center for International Security and Cooperation will host a two-day conference on violence, drugs and governance in Mexico. In preparing for the event (at which Mark Kleiman will also be in attendance), I decided to try to estimate the current revenue streams of the Mexican organized crime organizations (MOCOs). I leaned heavily on RAND research and on the analyses of colleagues in Mexico to generate my estimates, so credit for whatever is correct in these charts goes to them whereas any errors are solely on my own head.

The most difficult thing about getting current revenue streams correct is estimating how much the MOCOs are making from non-drug-related activities (e.g., smuggling immigrants across the border, pirating videos, kidnapping, extortion). Everyone I read or talked to agrees that this line of MOCO revenue is growing, but estimates of how large it is were divergent. The first chart here uses the low-end estimate among experts of 15% non-drug revenue. If this estimate is correct, the MOCOs are still largely one dimensional drug trafficking organizations, with principal profit coming for cocaine. Note that were we mapping drug markets more generally, cocaine would be a much larger share of the pie but because much of that money is made by Colombian gangs, the share for the MOCOs is smaller.

The drug-related pie slices are all based on the national U.S. market revenue, with one exception. Because California had a ballot proposition to legalize marijuana, I have broken out the California marijuana revenue stream separately. It’s about a seventh of the total. Continue reading “Mapping the Revenue of Mexico’s Organized Crime Organizations”

[Wordless shriek of rage and frustration]

Most of the news in the new household survey on drug abuse is good: cocaine and meth use are down, meth initiations are way down. There’s an uptick in cannabis use, especially among young adults. So why is the official press release headlined “National Survey Shows a Rise in Illicit Drug Use”?

Over the past four years, the number of people self-reporting as methamphetamine users on the big household survey is down by half, and meth initiation rates - a leading indicator, and therefore the one to watch - by 60%. The number of people self-reporting cocaine use is down by a third. Middle-school rates of drinking and smoking are also down, though less dramatically. Initiation to non-medical pain relievers remains high, but off its peak in the early 2000s, reached after a decade that saw initiation rise tenfold.

Oh, yes, and cannnabis use is up some (almost 20% from the 2007 trough, from ), especially among young adults (18-25). Cannabis use among those under 18 is flat. Mean age at first use is up from 17 to 18.4: that’s the direction you want to see it going.

So the on-one-foot summary of the results is “Nothing exciting, but basically good news.”

But if you were really, really, really stupid - or had a job that required you to pretend to be that way - you might just treat all use of illicit drugs as alike and simply count the number of users. In that case, the modest rise in cannabis use would swamp all the other results, because cannabis is by far the mostly widely used illicit drug, and a report mostly full of pretty good news would come out as “National Survey Shows a Rise in Illicit Drug Use,” complete with silly viewing-with-alarm quotes from officials.

(No, dammit, we are not “at a crossroads”! Next year is mostly going to look like this year.)

Even after 30 years in the business, it’s hard to get used to how plain damned dumb the official (and journalistic) discourse on this topic is. The household survey (aptly named NS-DUH, where DUH is pronouned “duhhhhhhhhh”) doesn’t get at what’s really interesting: the number of problem users, and especially criminally-active problem users. But it does contain some useful information. Too bad the people running the show mostly ignore that information and concentrate on fluff.

Mexico’s drug problem, and ours

The latest Foreign Affair has my essay offering some ideas about drug policy, at right angles to the drug warrior/legalizer debate.

The latest Foreign Affairs has my essay offering some ideas about drug policy, at right angles to the drug warrior/legalizer debate. It’s behind a paywall, but I can supply a .pdf on request.

Coincidence

The Drug Policy Alliance has such great regard for the truth that its reports dole out the precious substance with a sparing hand.

This morning, I got an email from a friend who isn’t involved in the War About Drugs but knows a great deal both about drug abuse and about my views on the topic. Like me, he is neither a hard-core warrior nor a flat-out legalizer. He had just received a fund-raising pitch for the Drug Policy Alliance, signed by George Soros. (I should note that Soros is one of my heroes; I can’t think of an individual in our lifetimes whose philanthropy - especially in the former Soviet Bloc - has created more value for the world.)

My friend wrote, “It looks good. Is it?”

I wrote back “In a word, no. DPA is the main drug-legalization group. They’re not very forthcoming about their actual aims.”

Of course, that’s the point; DPA sounds much more reasonable on paper than it is in practice. You might not guess that its announced goal of “drug policies based on science, compassion, health and human rights” means in practice opposition to any effective form of drug abuse control.

Then, when I got to work, I found in my mail a slick (in both senses) report on drug courts from DPA. It’s unsigned, which I would say reflected prudence on the part of the author or authors; it is not the sort of document anyone with any scholarly self-respect would want his name attached to.

Now, I’m not a fan of drug courts as they currently exist - they enroll too many low-level offenders without severe drug problems who would have done better with a good leaving-alone - so many of the report’s criticisms of drug courts seem on target to me. But the level of sleaze in the argumentation is truly breathtaking.

Continue reading “Coincidence”