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14 September 2005

the Foot-Shooting Lost Never-Ending War on Drugs

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Structural diagram of the HIV virus, the cause of AIDS. In the USA, where criminal laws, state and federal prosecutors and law-enforcement officials forbid or oppose clean needle exchange programs and oral methadone therapy, one of the chief paths of HIV/AIDS infection is needle-drug addiction.

This is a typical heroin overdose death in America.The dying person's friends watch as he turns blue and starts to sunfish, but because possession of heroin is a felony crime with certain prison time, they're terrified to pick up the phone and dial 911 for an ambulance, or to drive their friend to a hospital emergency room. They know cops will arrest all of them and prosecutors will try to put them in prison -- even if their friend lives.

A drug called Narcan, when injected into an overdose victim promptly, is a very reliable antidote. Waiting around for an hour because you're (appropriately) terrified of prison is not prompt enough for Narcan.

In one state, New Mexico, police officers carry Narcan and are trained to inject it into an overdose victim on the spot. The person lives. Later come the judge and the jail. But at least the person lives when the cops show up. That's an improvement over the model that prevails in almost every other USA state.

I am not a big fan of heroin. But at its worst, heroin and heroin addiction are medical problems. When sirens and flashing lights get involved, doctors and paramedics should be there. Not cops. Cops are also not notoriously helpful in lowering the rate of hepatitis and HIV/AIDS from needle-drug addiction in the community. Medical professionals are helpful, and do actually lower the rate of transmission of these blood-borne diseases.

Note in this story: No Evil Drug Lords or Rich Drug Kingpins will go to prison. Just a couple of clueless addict kids who barely had enough money to buy the stuff. Drug Lords and Kingpins are hard to find, investigate, and convict. Kids and addicts shooting up smack are easy to find and convict. So police and prosecutors spend all their time on kids and addicts. These kids seem to be white; that's unusual. A wildly disproportionate number of victims of the War on Drugs are black and Hispanic. They're usually broke and have no money to put up any kind of vigorous legal defense.

Another target of the War on Drugs: The dead kid's parents, because they didn't know their son was overdosing on heroin, so they just put him to bed. Originally the District Attorney indicted the parents for manslaughter and tried to put them in prison, too.

The War on Drugs: War Without End, Amen. War against enemies who are our kids, our parents, our brothers and sisters, our neighbors.

There are other models. If some nice correspondent from Portugal would be kind enough to supply the accurate details, it is my understanding that Portugal is one of several European countries that no longer throws heroin addicts into prison. And I know Switzerland, at least in the past, has tried non-criminal models of dealing with heroin addiction. In Rotterdam, there's an Old Addicts Home -- the Netherlands has policies which are so oriented toward helping and healing rather than punishing and imprisoning and sickening that heroin addicts can get old there.


The Newark Star-Ledger (New Jersey USA)
Tuesday 13 September 2005

Pair admit role in heroin death
They waited an hour before getting help

Star-Ledger Staff

Two Hunterdon County women pleaded guilty yesterday to manslaughter charges in the July 2002 death of their friend, admitting they failed to seek help for more than an hour after they knew he was overdosing on heroin.

The plea deal struck with prosecutors calls for Erica Poch, 22, of Clinton Township and Christine Curtin, 24, of High Bridge to be sentenced to three years each in state prison. In exchange, a first- degree charge of strict liability in a drug-induced death, which carries a potential 20-year prison term, will be dropped.

Poch and Curtin admitted during separate appearances before Superior Court Judge Roger Mahon that they were with Leonardo DiPasquale, 18, of Califon on July 6 when he suggested they travel to Somerset County to buy heroin.

Curtin made the arrangements to get the drugs while Poch drove the three friends to make the purchase.

"Where did the money come from to get the heroin?" Curtin's lawyer, Robert Corbin, asked his client during the guilty plea hearing.

"Leo," Curtin replied.

Curtin and Poch admitted that it was obvious DiPasquale was suffering a drug overdose soon after he ingested the heroin.

"Did you drive around with him for an hour before anything was done?" Corbin asked.

"Yes," Curtin replied. Poch provided a similar account as she pleaded guilty to manslaughter before Mahon.

After an hour, they contacted DiPasquale's parents and arranged to meet them in a parking lot. They told his parents DiPasquale had taken a combination of Xanax and alcohol. DiPasquale's parents took him home and put him to bed. He was pronounced dead the next morning.

DiPasquale's parents were also indicted on manslaughter charges in their son's death based on allegations they were negligent for not immediately taking him to a hospital, but that case was dismissed in 2003.

Poch and Curtin are free on bail until their sentencing, which is scheduled for Nov. 4. Both women must serve at least two years and five months of their three-year terms before being eligible for parole.

Poch already has seven months of jail time credit from her initial arrest before she made bail, according to Assistant Hunterdon County Prosecutor Katharine Errickson.

At the time of DiPasquale's death, he was out on bail awaiting trial on drug charges linked to another heroin overdose death. DiPasquale was one of three people charged following the death of Gregory Baltz, 17, of High Bridge, in January 2002.

Brandon Scott Winters, of Phillipsburg, pleaded guilty to manslaughter in Baltz's death in exchange for a seven-year state prison term. He is serving his sentence at Bayside State Prison in Cumberland County. The third person pleaded guilty to a drug distribution charge.

Matthew J. Dowling may be reached at mdowling@starled or (908) 429-9925.

© 2005 The Star-Ledger


Blogger pat's pub said...

On what ground do you claim that herion addiction is, at worst, a "medical problem"??
As a nicotine addict and someone who has lost far too many friends on drugs I find it a bit naive that an addiction, any addiction could be reduced to a "medical problem". Of course it is easier and better to put the kids into detox, rehab, 12steps, a methadone program etc. in order to try to solve the "medical problem" instead of jail
But what after that?

Blogger Bob Merkin said...

Ah. Oh. Okay. Excellent question.

Because the USA has been regarding heroin addiction as an entirely Criminal/Prison Problem for almost a century.

Now we got more prisoners than any nation on Earth, more than Russia, more than China.

And we got far more heroin and far more heroin addicts than we had when heroin was legal and could be purchased just for the asking from the local pharmacist. Sears & Roebuck would sell you the syringe from its famous old mail-order catalog.

So actually I'm not any kind of True Believer in the Medical Problem Kult.

I just am living here in this USA with PROOF that when the government declares its a Serious Criminal Problem, and all heroin addicts must go to Prison -- that's a total catastrophe.

So I would like the USA just to EXPERIMENT for the next ten years with treating heroin addiction with Doctors, Nurses, Pharmacists, etc. and then see what happens.

Well, okay, I confess: I am a True Believer. I am CONVINCED much better and healthier things would happen than have happened since the USA made heroin illegal.

Now can you tell me a few On-The-Ground Details about heroin and Switzerland's laws and situation?

Blogger pat's pub said...

After a record high in heroin-relatet deaths in 1992 (419) something had to change. Back then it was not unusual to walk through town and pass the open drug scene where people dealt ans shot up. Because of an acclaimed Methadone program based on the dutch model, drug and AIDS prevention campaings, Public Rooms where people could shoot up and special pharmacies where you can actually test all your drugs the number has dropped to 187 in 2004. We got so liberal in our drug policy that I clearly remember a lad rolling and smoking a reefer iside a train and nobody was saying a word.
But things are, unfortunetly, changing.
In 2002 the Swiss Parliament had to react to a Petition (singed by yours truly as well) that demanded the legalisation of soft drugs like Pot. Conservatives and the religious right bastards voted it down and because those arfin bastards won the last election things are not looking good for a tolerant drug policy.
The other problem is the change in behaviour in drug use. According to the statitics I have seen the number in drug-related felonies (posession, dealing, trafficking etc) is rising rapidly again.
Europe ist currently flooded with cheap Cocaine (take a good guess where it's coming from...)and designer drugs like eckies, Thai Pills, poppers seem to be very hip right now, even amongst people you would not consider your usual drug addict (secretaries, shift workers, etc). Crack and Free Base never really made it in Europe, thank good.
And since nicotine is a highly addictive substance as well (some scientists claim that it has the same addiction level as herion) let me give you a quick wrapup of whats going on in the War Against Tobacco. Smoking will be prohbited on all public transports effective Dec 12. Experiments to ban smoking from pubs, bars etc are currently running.
I hope they fail. I really do.

Time for a ciggie and maybe a can of Old Vleeptron Draught.

Blogger Adam Scavone said...

We got so liberal in our drug policy that I clearly remember a lad rolling and smoking a reefer iside a train and nobody was saying a word.

That was me!

I lived in Switzerland for about five months, from January-May 2001, outside of Geneva in the town of Givrins, and people smoked reefer on the train quite frequently. I saw on the news once when I was there that they were giving tickets for those caught smoking on the train, but the conventional wisdom was that it was only on local trains that the enforcement was taking place. I smoked on trains all over the country, and never had any problem with police or conductors.

One instance that particularly stands out was the day I went with some friends to Zurich, and we got into a car that was filled with many Swiss Army guys, and even they were smoking reefer (the Swiss Army is very different than the American Army, for the Americans reading this. The Swiss Army is quasi-compulsory, yet their "appearance code," for instance, didn't mandate that hair be short, so there were long-hair Army guys, who no doubt were quite capable of repelling any invading force regardless of their hair length).

Anyway, as for Swiss heroin, there is a recent study out ("Mortality in heroin-assisted treatment in Switzerland, 1994-2000," Drug and Alcohol Dependence August 2005, 79(2) p.137-143) that's worth reading if you can get your hands on it (email me if you're interested at adamscavone AT gmail DOT com). While I'd like to see the data on arrest rates for other drugs, the Swiss heroin program is no longer just an "experiment" (as it started as) but is now semi-permanent part of Swiss drug control, based on the "Four Pillars" approach.

Arrest rates on the rise do not necessarily reflect rising drug use, and are often the result of changing police policies and/or the result of a repressive political environment. That kind of thing happens from time to time. While dissuading drug abuse is a good idea, coercive prohibition certainly seems to have a "forbidden fruit" effect that encourages some use.

The most important thing is that, at the end of the night, nobody is dead or seriously hurt, and the Swiss approach to heroin abuse is a prime example of a non-coercive, high-engagement approach that works with high-risk users in order to keep them alive and functioning (and by all accounts, the Swiss heroin program has helped not only in reducing mortality, but also in other areas as well - reducing homelessness, joblessness, improving personal relationships and interpersonal functioning). It's really a cool and innovative program that acknowledges that drug abuse is not going to simply go away, any more than alcoholism or gambling addictions, compulsive sexual behaviors, or any other "risky" and rewarding behavior (however fleeting or ultimately painfully consequential the reward).

Another point: Jacob Sullum makes it forcefully in his book, Saying Yes: In Defense of Drug Use, it's not clear that "addictiveness" is a property of drugs. The vast majority of people who use even the most "addictive" drugs use them sparingly and will never develop problems with them. The vast majority of users will never steal or cheat or rob or anything else to get drugs. That's not to say "addiction" doesn't exist, but the mounting evidence points toward the abusive users rather than the demonized drugs. See Stanton Peele for a grounded assessment of what addiction is, how it works, and what we can do about it.


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