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Friday, February 20, 2009

Harm reduction may be coming to America with new drug czar

The Boston Globe is reporting today that President Obama may choose a drug policy reformer as his new drug czar:

While the appointment is still not official, White House officials have said President Obama has chosen as his drug czar the police chief of Seattle, a city with enlightened policies on drug-law enforcement. Gil Kerlikowske did not originate those policies, but he has maintained them and seen their benefits during his nine years as chief. He should be an effective advocate for Obama's own less punitive positions.

After his Senate confirmation, Kerlikowske should get to work putting flesh on Obama's campaign promise to "focus more on a public-health approach" to drug abuse. Step one will be to get Congress to lift the ban on federal spending for needle-exchange programs, a proven method of limiting the spread of infectious diseases like HIV/AIDS and hepatitis C. Candidate Obama said he favored lifting the ban.

A public-health approach to drug policy is part of a harm reduction philosophy, an excellent example of which is the Four Pillars Drug Strategy employed by the City of Vancouver to reduce drug-related harm. The “Four Pillars" includes:

Harm reduction - reducing the spread of deadly communicable diseases, preventing drug overdose deaths, increasing substance users’ contact with health care services and drug treatment programs, and reducing consumption of drugs in the street;

Prevention - using a variety of strategies to help people understand substance misuse, the negative health impacts and legal risks associated with substance use and abuse, encouraging people to make healthy choices, and providing opportunities to help reduce the likelihood of substance abuse, including affordable housing, employment training and jobs, recreation and long-term economic development;

Treatment - offering individuals access to services that help people come to terms with substance misuse and lead healthier lives, including outpatient and peer-based counseling, methadone programs, daytime and residential treatment, housing support, and ongoing medical care; and,

Enforcement - recognizing the need for peace and quiet, public order and safety in the Downtown Eastside and other Vancouver neighborhoods by targeting organized crime, drug dealing, drug houses, problem businesses involved in the drug trade, and improving coordination with health services and other agencies that link drug users to withdrawal management (detox), treatment, counseling and prevention services.

Libertarian critics of the “Four Pillars” model argue that legalization is the simpliest and best harm reduction strategy. In a recent interview with the Western Standard on the occasion of National Addictions Awareness Week, for instance, libertarian author and psychiatrist Dr. Thomas Szasz wrote:

Cui bono? Who benefits? The aim of National Addictions Awareness Week, albeit unacknowledged, is to benefit the “addiction treatment” industry, a government sponsored racket. Addiction is a stigmatizing pseudo-medical “diagnosis”...a label, not a disease like breast cancer. “Addicts” possess free will to stop taking drugs.

Our so-called drug problem is a matter of individual liberty and personal responsibility. Instead, we treat it as a medical matter. So long as we do, we shall have more and more of the kinds of “drug problems” we now have.

Posted by Matthew Johnston

Posted by westernstandard on February 20, 2009 | Permalink


Except that the "four pillars" approach has been tried in the Downtown Eastside, along with needle exchanges and safe-injection sites, and there hasn't been a bit of difference. Hard numbers about the safe-injection site are particularly hard to come by, despite its proponents' loud insistence that it has won glowing reviews from numerous "peer-reviewed" papers and journals. The line most often trotted out in its defence is, "It hasn't made things any worse."

Oh, and did I mention that the HIV infection rate among IV drug users in the DE is 40%, compared to only 3% for Seattle?

For some reason, Obama and Crew seem determined to revisit the failed policies of Pierre Trudeau and Jimmy Carter. If that is "enlightenment," I'll take the Dark Ages any day. A year from now a lot of people are going to wish they had Bush back.

Posted by: Shane Matthews | 2009-02-20 6:12:08 PM

Wait, the war on drugs is a waste of tax dollars. Yet, I'm supposed to pay for some drug addicts clean needles. Better yet, maybe I should just pay for the addict to take their methadone or some other drug at a supposed treatment center(do it Vancouver style and just roll over). I keep hearing how libertarians should oppose the war on drugs. However, now you think I should pay for some lowlife's needles. Bull! You want to let the scumbags shoot up fine. However, if they are threatening any law-abiding citizens then maybe people should have a right to deal with them in an appropriate manner without police involvement. I hear many sentiments on this site about drug legalization. I wonder how much is the result of following a pure libertarian belief system and how much is about making a quick buck off of legalized drugs?

Posted by: Art | 2009-02-20 6:22:54 PM

sending in the UN to drug producing nations and knocking down their party drug infrastructure would reduce the harm of schedule 1 and schedule 2 type drugs.

The best before date for the four pillars approach of harm reduction was 15 years ago - It's way way way too late to apply appeasement.

So we guess its on with the Drug War till the wipeheads have no drugs

Posted by: 419 | 2009-02-20 6:34:09 PM

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