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Drug Addiction In The Philippines

INTRODUCTION

This special issue of JDI has introduced its readers to several of the latest drug policy innovations taking place in Central and Western Europe at the beginning of the 21st century. The accounts provided in this collection of articles suggest that the traditional conservatism associated with drug policies nearly everywhere throughout most of the 20* century may be giving way to subtle new variations and adjustments, especially among member states of the rapidly expanding European Union (EU). As Europe becomes more powerful and centralized, it seems likely that many accepted practices generated under previous international alignments will be increasingly challenged.

These articles detail the latest approaches being undertaken in Europe to undo or minimize some of the harms associated with drugs themselves, as well as those caused by drug policy. Although there have been occasional passing references made to the U.S. and its interest in these matters, these have not been the foci of attention throughout the issue; but any meaningful discussion of contemporary international drug policy must also deal with the U.S. and its preferred approach to drug control. In this regard, the U.S. is the "elephant in the closet," in the sense that we are always aware of its presence, and it always exerts considerable influence, even when not at the center of the discussion. Yet the United States has played a key role in the evolution of drug control programs beyond its own borders that must be considered.

This final article concerns the United States' role in international drug policy making, past and present. The prohibitionist model that now dominates most domestic and international drug policies was first developed and then successfully promoted by the United States. Throughout the 20th century, the U.S. energetically pursued the establishment and subsequent elaboration of an international drug control regime that is now administered by the United Nations (UN), an organization that has by and large adopted wholesale the U.S.-defined prohibition model. The first section of this paper assesses the extent to which prohibitionists have succeeded in compromising the sovereignty of participants by restricting the freedom of individual nations to strike out on their own to innovate and develop alternative approaches, especially when the latter are seen as threatening or undermining the dominant approach.

The second section addresses the recent growth and development of harm reduction measures in Europe and elsewhere. We will find that these approaches are even being discussed and sometimes implemented within the U.S. with the support of local governments and the electorate, despite the efforts of U.S. government officials to thwart such innovations. The growth of these practices and the challenges they pose to the existing control regime suggest that the prohibition model is not only under attack in Europe, but in the U.S. as well. While it is premature to speculate about the eventual outcome of these disputes, their resolution is certain to be interesting. This essay assesses the hostile reactions of the government of the U.S. and the UN bureaucracy to harm reduction efforts such as those now being implemented in Europe by drawing on examples from four additional case studies, two from Europe (Holland and Switzerland) and two from other parts of the world (Australia and Canada).

The third and final section of the paper describes the extent to which the strict prohibition model has simply been set aside by the United States whenever it conflicted with other, more salient or compelling state interests. Thus, on many occasions the U.S. has overlooked, and sometimes condoned or at least tolerated, drug trafficking by governments, other groups, or individuals that offered some other important benefits. During the Cold War this typically involved a commitment to allying with the U.S. against communist influences; more recently it has involved a battle against Islamic fundamentalism and terrorism in Afghanistan and other places. This inconsistency, or hypocrisy, reveals that the United States only follows strict prohibitionist policies when it is convenient to do so, although other nations are severely criticized and taken to task for similar conduct. The writer refers to this as the "do as I say, but not as I do" phenomenon.

U.S. DOMINANCE OF INTERNATIONAL DRUG CONTROL EFFORTS

Drug legislation evolved in the 20th century largely as a product of the insistence of the United States that international agreements and controls must serve as the mechanism to interrupt the otherwise virtually unlimited flow of illicit substances from producers to consumers located throughout the world. Before 1912, the largest producers of opium, coca leaf, and cannabis plant substances were decidedly poor, nonindustrialized countries such as Iran, Iraq, Afghanistan, Turkey, Bolivia, Peru, and parts of Asia. These countries had no interest in, or reason to, restrict their exports of these commodities in the world markets. A second group was comprised of Western industrialized nations, especially the U.S., Germany, and Switzerland, the principal producers of refined drugs and synthetics, that wanted to protect their pharmaceutical industries' investments and assure future global sales (Kramer, 1971; Courtwright, 2001).

The laissez faire approach was first seen as posing a major problem shortly after the United States took control of the Philippines in 1898 following its victory in the Spanish-American War. While occupying those islands, the Americans soon discovered that they had inherited a legal distribution system that provided narcotics to addicted people, most of whom were Chinese immigrant workers, not indigenous Filipinos. This practice was viewed as a vice and moral concern, implying that its continuance would look bad for, and be repugnant to, American citizens and their values. Episcopal Bishop Brent of the Philippines was appointed by President Roosevelt to head a commission to investigate the existing drug distribution program and make recommendations as to what could be done about it (Musto, 1999, pp. 25-26).

The fruit of Brent's labors was the scheduling of the 1909 opium meetings held in Shanghai to address the worldwide "problem" of narcotics distribution. Attendees included 13 of the 14 invited countries (Turkey failed to send a representative), and the agenda was designed to address the concerns of the Americans as well as those raised repeatedly by China, a country that had suffered greatly as a direct result of English opium trafficking there throughout the 19th century. The British had literally forced opium produced in their Indian colonies on the Chinese population and went so far as to fabricate two wars to accomplish that end, utilizing the ruse that they were merely protecting their trade interests (Madancy, 2003 ; Inglis, 1975 ; Kramer, 1971; Trocki, 1999). The predictable outcome of these predatory acts was that the Chinese population suffered widespread addiction and its government's various efforts to ban, restrict, or control the trade all proved futile. Therefore, the Chinese situation was to be discussed as one of the centerpieces of this first international meeting. No binding resolution emerged from the Shanghai International Opium Commission, however, as Great Britain and The Netherlands made it a condition of their participation that this be a fact-finding body, not a lawmaking one. Thus, attendees made recommendations and resolved to consider the necessity of meeting in the future to draft appropriate legislation (Musto, 1999, pp. 35-36).

Given their limited success in this first attempt at fostering international controls over drug production and distribution, the United States' representatives quickly moved ahead by calling for further meetings and actions to consider the adoption of a worldwide system of controls that would be built on their preferred prohibition model. The Hague Conventions were byproducts of several meetings held in The Netherlands, the first in 1912 and the last in 1914(Kramer, 1971). On these occasions the United States called for an international control system that would limit production by establishing quotas for producer countries based on medical necessity (the amount estimated to be needed for legitimate medical purposes) and scientific research needs and then develop a system of oversight to assure adherence to these goals.

Understandably, a number of the attendees at the Hague meetings were reticent to sign the agreements; drug producing nations anticipated they would suffer a loss of revenues once international controls were put into place, especially if the licit quotas were set at very low levels. They also feared that unfair competition could result if they signed, while nonsignatory producer nations simply increased production, thereby increasing their market share at the expense of the signatory nations. Finally, the issue of national sovereignty was a major concern, as these agreements required a commitment to abiding by and cooperating with regulations that could ultimately undermine independence. Despite the fact that the treaty was never signed by all of those nations attending the first meeting in 1912,' the agreements were ratified and treated as valid international law.

The United States had been the prime mover of this early anti-drug legislation, relying on diplomatic pressure and arm twisting to forge a shaky consensus among nations that were generally much less convinced of the need for international controls. This American triumph signaled the beginning of nearly a century during which America literally dominated the direction of drug control and drug policy in the international arena. Given the nature of international treaties, however, no one nation can simply exert its will over others, regardless of how powerful it is. Consequently, all of these legislative enactments involved compromises, and U.S. representatives have often been unhappy with specific provisions that they believed were not strict enough.

Between 1912 and 1961 when the UN finally approved the Single Convention agreement, nine international drug control treaties had been proposed and approved, although not all had come into force (they had not been ratified by the requisite number of participants). The thrust of those commitments was that signatory nations were obligated to keep records of all transactions involving controlled substances and to submit these along with statistics on arrests and other related activities to the international governing body of the UN. One core proposition was that narcotics could only be used for legitimate medical purposes or for scientific studies; all other uses were considered illegal, and signatories were committed to their prohibition (Bewley-Taylor, 1999). One perceived weakness of these early treaties was that they provided no external means of forcing compliance; individual states were asked (and expected) to cooperate, but there was no means of compelling them to fulfill their pledges, other than through the exertion of political pressure.

THE 1961 UN SINGLE CONVENTION

The 1961 Single Convention agreement is the cornerstone of modern international drug control efforts. The convention came into existence because of growing frustration with previous agreements, which had led to calls to strengthen the existing control and monitoring apparatus and to tighten and extend some of the treaties' provisions. The first draft of the proposed treaty was prepared in the early 1950s; a second was completed in 1956; and a third in 1958 (Bewley-Taylor, 1999). The Plenipotentiary Conference for the adoption of the Single Convention on Narcotic Drugs was held in New York from January 24 to March 25, 1961, with a total of 73 nations in attendance (Sinha, 2001). The convention was approved during the sessions and then made available for signatures, eventually coming into force on December 13, 1964 (Chatterjee, 1981, p. 343). At the present time, 166 nations have signed and ratified the convention; only 26 states have refused to do so (Albrecht, 2001).

The Single Convention was designed to modernize the previous system of controls by codifying the drug conventions, simplifying the international control structures, extending the system of control that already applied to opium and poppy straw to cannabis and coca leaves as well, and encouraging the adoption of appropriate treatment and rehabilitation measures for users (Chatterjee, 1981, pp. 343-344). Since the various nations in attendance had quite different interests and concerns that often put them at odds with one another, they made compromises that were reflected in the final agreement. One scholar who has become a specialist on this treaty, McAllister ( 1992), identified several quite distinct interest groups among the participants, each of which had a different agenda and which promoted more or less strict controls on different classes of drugs. For example, the organic states consisted of those nations that had established themselves as producers of plant substances like opium and/or coca; they preferred weak controls and sought compensation for any losses suffered because of the agreements. A second group was comprised of drug manufacturing nations, mostly Western industrialized nations; they lobbied for strict controls on the first group, but not on themselves. Other groups were less directly involved in the drug trade, but they too tried to steer the policy decisions in a direction that would work in their best interests (McAllister).

In the end, the powerful states representing drug manufacturing interests dominated the deliberations, and they pushed for strong measures that would primarily impact producers of organic plant-based substances, while protecting their own self-interests by minimizing controls over manufactured drugs and the pharmaceutical firms that produced them. One unique feature of the 1961 convention was that its signatories agreed to work toward the total elimination of indigenous use of particular organic drug substances - especially coca leaf and cannabis - in those countries where these practices occurred and called for the gradual outlawing of these traditional practices over a 25 year phase-out period. This feature of the treaty was also directed at Third World producer nations where these practices had been commonplace for many hundreds, if not thousands, of years, and where they had not posed any serious problems for local or national governments.

Following its drafting and ratification, the Single Convention has served as the basis for all modern international drug policy. Despite Commissioner Anslinger's disdain for the final version of the treaty as too weak,2 its prohibitionist language and provisions were the result of U.S. efforts to bring all nations under the same control agenda. This meant that any future radical innovations in drug policy would virtually be stymied, due to the restrictive language of the agreements committing signatories to adhere to the prohibition model.

THE 1971 CONVENTION ON PSYCHOTROPIC SUBSTANCES

The second major international drug convention, the 1971 Convention on Psychotropic Substances, was held in Vienna on July 11, 1971. Its purpose was to introduce controls similar to those found in the Single Convention for a variety of substances that had not been included in the earlier agreement (Sinha, 2001). Specifically, synthetic stimulants, sedatives, and so-called hallucinogens, all drugs that had been popularized during and after World War II were now to be scheduled and regulated, just as opiates, cocaine, and cannabis had been by the Single Convention.

Once again, the U.S. led the international community in the promotion of this legislation. Several years earlier, in 1965, the United States passed a domestic Comprehensive Drug Abuse and Control Act to extend federal government controls over non-narcotic depressants, stimulants, and hallucinogens (Lindesmith, 1965). This act was later strengthened in 1968. The 1971 UN convention was very similar to the U.S. legislation that preceded it.

In his analysis of the 1971 Convention, Sinha (2001) argues that there were two major schisms evident among the participants: on the one hand, the developed nations of the world - the "manufacturing group" - pushed for weak controls, recognition and respect for national sovereignty and national rather than international solutions in the way of controls; a second constituency comprised of developing states and socialist countries pressed for rigid controls and international oversight, much like those they had been forced to accept under the earlier Single Convention. Predictably, the latter group was not successful in its efforts to mandate strict controls over the manufacturers, however, as the U.S. and other powerful synthetic drug producing nations succeeded in watering down both the language of the agreement and its control provisions. On this occasion, for example, there was little discussion of addiction, which had figured prominently in discussions leading up to the Single Convention (and the drugs that it controlled). Instead, the practical utility of these drugs in the practice of medicine was emphasized. It was asserted that the use of psychotropic substances for medical and scientific purposes is necessary and that there should be no excessive restrictions on their availability (Sinha, 2001 ).

In its final form, the 1971 legislation is considerably weaker than its predecessor for several reasons. First, the drugs that were now added to the control list were not placed in the most restrictive scheduling categories, and the burden of proof in the scheduling process was reversed from what it had been before; now "substantial proof would be required before a substance would be considered harmful, whereas earlier all were considered harmful unless proven otherwise. Secondly, the restrictions imposed on the substances controlled in 1971 do not apply to their salts, derivatives, and the like, as did the Single Convention. This meant that the controls only applied to the actual drugs named in the legislation; all others remained uncontrolled. Thirdly, there is no requirement that annual figures be provided regarding the amounts of these drugs needed in the practice of medicine, which means that manufacturers are not restricted in their production amounts by the international controls. Finally, the World Health Organization (WHO), which served as the authoritative body that determined schedules for the drugs controlled under the Single Convention, was not relegated to an advisory role only. This provision makes it very difficult to have a new substance controlled under the 1971 legislation (Sinha, 2001). Each of these factors then contributed to a much weaker control agreement under the Psychotropics Convention than was found under the Single Convention.

The marked disparity between the powerful players and those who were less so was amply illustrated with the terms of the 1971 agreements, as the former stakeholders protected their nations' economic interests from the threat of potential restrictions and rigorous monitoring of synthetic drugs, while sustaining the differential treatment of, and strict controls over, those nations that were producers of organic plant-based substances.

One progressive aspect of the Psychotropics Convention was that it paid more attention to demand-side problems than its predecessor had. The text of the agreement includes references to treatment, educational efforts, rehabilitation and even social reintegration, albeit with the understanding that these would be utilized in addition to imprisonment, rather than in lieu of it.

THE 1988 CONVENTIONAGAINST ILLICIT TRAFFICKING IN NARCOTIC DRUGS AND PSYCHOTROPIC SUBSTANCES

The last major international treaty was designed to tighten controls over illicit trafficking. Between November 25 and December 20, 1988, 106 nations met to draft the convention. Its major thrust was to have been to harmonize the varied policies and drug laws that existed in different nations; in actuality, however, the document criminalized specific related behaviors and adopted criminal punishments for transgressors. Moreover, it urged participants to criminalize users as well as producers and traffickers in psychoactive substances and called for mandatory penalties for possession and other offenses.

In spite of the strict controls that were embedded in the new convention, several nations adopted stances that placed them in direct confrontation with the U.S. and its UN strict prohibition backers (Jelsma, 2003). Various countries including Belgium, Poland, The Netherlands, Germany, and Denmark had all opted to effectively decriminalize "soft drugs" such as marijuana and hashish. More recently, Canada carefully considered similar legislation, as did Great Britain. In each of these nations, the decision was made not to enforce the criminal penalties that the violation calls for in the national statute or to decriminalize possession of small amounts that are perceived as posing little danger to individual users. In most instances, monetary fines replaced the previous criminal sanctions. Note that all of this has been accomplished within the framework of the existing UN conventions, and that is why the offenses typically retain their formal criminal status, rather than being truly decriminalized.

OTHER UN ACTIONS

In addition to the three conventions discussed above, there have been several other important changes in the international community's approach to the regulation and control of psychoactive substances. In 1971, for example, the UN established a new agency, the UN Fund for Drug Abuse Control (UNFDAC), to carry out the organization's mandate. Then in 1972, the United States requested a protocol to strengthen the provisions of the Single Convention. This included the requirement that nations receive prior authorization for cultivation, production, and manufacture of controlled substances. On the demand side, treatment was called for, although it was only to occur following imprisonment for drug offenses (Bewley-Taylor, 1999). In 1987 a UN conference was held to develop strategies for convincing those nations that had not yet signed the existing conventions of their legitimacy and utility.

Several interesting developments occurred in the early 1990s that played out throughout that decade. For the first time in recent history, serious questions were raised regarding the UN drug control strategy; this occurred when Mexico submitted a critical letter in 1993 that called for a careful reconsideration of the existing approaches. In it they observed the obvious failure of these earlier efforts to curtail cultivation, production and trafficking, also noting the rapid growth and expansion of criminal organizations to meet growing demand. At the same time, the letter raised concerns about the relative absence of demand-side strategies; the international body had long stressed supply-side actions, while neglecting demandside issues. Finally, they criticized the United States' efforts to unilaterally dictate anti-narcotics operations in Mexico itself, and its "certification program"3 (Jelsma, 2003, p. 181).

These concerns were shared by many other disadvantaged nations, and the 1993 General Assembly meeting included a groundbreaking discussion of the entire legalization debate, in response to a complaint charging that the Dutch cannabis policies violated the conventions. The question was whether the organization would recognize any form of nonmedical use of controlled substances as legitimate, although a majority ultimately determined that doing so would undermine the existing system (Jelsma, 2003, p. 183). During the discussions, prohibition defenders objected to any suggestions that the present system was not working, and either implied or stated directly that "legalizers" were behind the calls for reform. Representatives of Denmark, Australia, The Netherlands, Canada, and Portugal all raised questions about the traditional control approaches and called for critical review, experimentation with new strategies, and a thorough evaluation of all that had been done in the way of past practices. An expert committee comprised of 10 members was appointed to study these issues and make recommendations to the larger body, but the group's participants were carefully selected by the dominant prohibitionist powers, and no dissidents were included. Predictably, the report that was issued by them in 1994 concluded that the calls for legalization had been misplaced and that the claims that the existing control system had failed were inaccurate.

THE 1998 UNGASS MEETINGS

In 1998 the UN's General Assembly Special Session on drugs was held from June 8 through June 10. At those meetings a consensus was achieved that called for the elimination of, or a significant reduction in, the illegal cultivation of coca, cannabis, and the opium poppy by the year 2008. A similar plan had been initiated with the Single Convention agreement that had called for the elimination of these coca and cannabis crops by 1988. Despite the total failure of that earlier effort, the UN now wanted to accomplish the same thing, only this time in 10 rather than 25 years.

This brief historical summary has provided the reader with essential facts regarding the development and refinement of drug laws and drug controls as international phenomena, as opposed to strictly state concerns. The evidence presented suggests that the United States and its prohibition allies in the UN have effectively created and sustained a worldwide system of controls that features a strong emphasis on policies that deal with supply-side issues (production, distribution, and sales), and a much weaker commitment to demand-side features (prevention, treatment, and education). Moreover, the entire model is built upon the assumption that the criminal justice approach is both necessary and beneficial in combating the various harms that drugs visit on societies. Alternative models such as public health approaches have been downgraded by prohibition enthusiasts who feel that these methods "coddle" users and serve as dangerous social experiments that can easily lead to the ultimate disaster - the legalization of all substances. In the following section we will explore the recent (re)emergence4 of these public health alternatives, as well as the responses they have drawn from defenders of the criminal justice orientation.

THE EMERGENCE OF HARM REDUCTION IN EUROPE

During the last 15 years or so, the term "harm reduction" has come into widespread use among those with a professional interest in this field; the concept refers to drug intervention approaches that are designed to minimize the individual and societal harms associated with problematic use. Despite its apparent recency, the harm reduction idea has an earlier history. In the U.S., for example, the 1971 Schafer Commission report, Marihuana: A Signal of Misunderstanding (National Commission on Marihuana and Drug Abuse [NCMDA], 1972), may be seen as an archetype of harm reduction thinking. That document concluded that marihuana was a drug whose use should not call for serious criminal penalties. In fact, the commission recommended decriminalization (but not legalization), stating, "marihuana's relative potential for harm to the vast majority of individual users and its actual impact on society does not justify a social policy designed to seek out and firmly punish those who use it" (NCMDA, p. 130). In Canada similar harm reduction ideas were disseminated in a 1972 publication known as the Le Dain report (Le Dain, 1972). During this same time period, the Dutch initiated a social experiment in which "approved dealers" in youth centers were allowed to sell small amounts of cannabis to the clientele, as long as there was no hard drug dealing, no sales to those below a certain threshold age, no advertising, and no violence. The consistency of the findings from these different studies document that during the 1970s drug policy reform was being seriously considered in a number of otherwise very different places. Moreover, we will find that many of the particular strategies that were recommended then are now being rediscovered as "typical" harm reduction methods.

There is potential ambiguity in the term "harm reduction," as even prohibitionists claim to be motivated by the desire to reduce harms associated with drug use. Thus, it can be argued that harm reduction is being accomplished in the United States through aggressive law enforcement actions targeting users. A person imprisoned for drug activities can no longer consume drugs, it is argued, and therefore the harms are reduced. Of course, this ignores the harm done to the individual and his or her family and friends resulting from incarceration itself. If this overly broad conceptualization of harm reduction is permitted, the term no longer retains any significant meaning, and all sides can truly argue that they are pursuing the same policy, regardless of what they do. In what follows we put forward a core set of ideas that cohere to provide a distinct definition of the harm reduction approach. American prohibitionism does not qualify; indeed, it is the counterpoint.

At the heart of harm reduction thinking is the belief that drug use is omnipresent, regardless of moral and normative questions regarding its social desirability. This means that there can be no realistic effort to eliminate such use, as all of human history suggests that drugs, having been used in all countries and at all times, are permanent features of human life. A derivative of this insight is that the purpose of drug policy is to develop methods to reduce use wherever possible, and to minimize the various harms that arise from extreme use, or abuse. Many harm reduction methods have been purposely directed at the relatively small group of users who are addicted to or dependent on substances that are both dangerous to their health and survival. Much less attention has been paid to recreational drug use, especially to the casual use of so-called "soft drugs" (cannabis and hashish), although there are prevention programs underway that encourage regular users of these substances to reduce frequency of use, and/or to choose methods of ingestion that reduce health risks.

Underlying all harm reduction approaches is a public health model, one that sees many drug-related problems as most appropriately falling within the ambit and expertise of the health care system rather than the criminal justice system. Adherents generally do not distinguish between licit and illicit substances, but view all drugs as having potential for doing good or ill. Therefore, the most popular drugs, tobacco and alcohol, are incorporated in public health discussions on substances. Due to their popularity and frequency of use, these licit drugs are featured in any harm reduction descriptions of drug toxicity and health effects related to their use. The disease metaphor is frequently invoked for both licit and illicit substances, and medical doctors, therapists, and epidemiologists are seen as playing key roles in establishing and implementing appropriate systems of monitoring and control. The overarching concern is how to assure that public health is protected from the potential harms associated with drug use, and whenever possible to do so without resorting to the punitive system of criminal justice, except for those involved in illegal production, trafficking, sales, and the like. In some places, civil commitment (involuntary commitment) of hard-core users is utilized as a quasi-health measure, although this practice comes closer to criminal justice methods and seldom includes any medical treatment whatsoever.

Arguably, the single most powerful influence on the rediscovery of harm reduction methods in the late 1980s was the worldwide AIDS crisis. With the emergence of the HIV/AIDS pandemic, early research demonstrated unequivocally that injection drug users were a particularly susceptible group, second only to gay men in terms of their percentages among these diseased populations, and that they were rapidly spreading the virus throughout society. Once this connection was made, health care workers and government officials in many places, including the United States and Western Europe, determined that something must be done to minimize the harmful effects of unprotected sex and injection drug use. The urgency of the situation was such that a wide variety of techniques were undertaken experimentally, even in the absence of any scientific knowledge of their utility; there was no time to await the results of carefully designed, controlled studies.

Given the sense of concern shared by health workers in all nations, it was perhaps inevitable that information networks would be rapidly established to provide for the rapid exchange of information about what works, in order that new approaches showing some promise could be swiftly replicated elsewhere. The end result of these interactions was that a very sophisticated professional coterie of experts emerged, persons who shared a sense of common responsibility to head off HIV and AIDS before they advanced even further into the at-risk and general populations. Once in place, this formidable system served as a conduit for the latest advances in the study and treatment of blood-borne diseases such as AIDS and hepatitis C, information that could be easily accessed and applied by interested parties anywhere in the world.

In reviewing the actual implementation of harm reduction strategies for drug problems in Western nations during the last 15 years or so, it seems quite clear that the pace of their adoption has quickened, and often remarkably so. When they were first introduced, there was much hesitation and strong resistance from prohibition factions, which had a chilling effect on the spread of harm reduction strategies. Over time, however, an increasing number of jurisdictions have expressed frustration over the inflexibility of, and restrictions imposed by, the prohibitionists that interfere with efforts to contain these problems. The government of the United States, however, has opposed these innovations not only within the fifty states, but also in other nations.

Below the writer provides four illustrations of U.S. reactions to other nations' attempts to alter their drug policies or sponsor experiments that were seen as "liberal," thereby threatening the status quo prohibitionist stance. The examples were chosen from among many possibilities, as these efforts to restrict any deviations from the standard methods have been applied throughout the world, and for a long period of time. In the cases presented here, however, the precipitating events are of quite recent origin, making these particular instances especially timely. Two of the illustrations involve European nations (Holland and Switzerland). The other two involve Australia and Canada; it is not just Europe that is scrutinized by U.S. interests trying to maintain the existing regime.

DUTCH LIBERALISM

For many years, prohibition forces led by the United States have had much to say about The Netherlands' drug policies. The reasons for this hostility are not hard to find; the Dutch were the first modern nation to challenge the accepted set of assumptions associated with prohibitionism and then to chart new territory by finding their own way, albeit within the restrictions imposed by the dominant model articulated in UN treaties.5

Beginning in the early 1970s, the Dutch government first explored the possibility of adjusting their previously inflexible, punishment-oriented policies regarding illicit drugs. The impetus for this reconsideration was the fact that many Dutch youth had been experimenting with illegal substances and were facing serious consequences. The presumed deterrent effect associated with stigmatization through the criminal law was clearly not sufficient to constrain young people from treading on dangerous ground and thwarting the authorities, regardless of the legal and personal consequences. Rather than simply "crack down" on the deviants, the reasoned Dutch response was to study the problem and then to try and find a way to adjust their laws to accommodate the new reality.

By the mid-1970s, the first experimental programs in relaxing the cannabis enforcement practices had proven viable, and the revised 1976 drug law reflected this assessment. Now, nonprosecution of possession cases involving 30 grams or fewer was to be the rule. Moreover, efforts were made to structure a policy that would effectively separate "soft" (cannabis and hashish) and "hard" (all other illicit substances) drug markets, so that purchasers of the former would not be forced to obtain their drugs from persons selling more dangerous products as well.

Any serious historical analysis of the Dutch drug control methods and policy must lead to the conclusion that, despite some claims to the contrary, this approach was - especially in the 1970s and early 1980s - a hit-or-miss affair and not based on any very specific coherent analysis or plan. There has been a tendency by some sympathetic scholars to "rationalize" the entire matter, implying that those who developed these strategies knew in advance exactly what they were doing and what the outcomes would be. However, this appears to be a post-factum construction designed to buttress the preferences of those making such arguments. In actuality, the early Dutch approach was largely based on guessworkbut featured a willingness to try alternative approaches in order to produce more desirable results than strict prohibition had provided.

Since those early beginnings, the Dutch system has evolved into a comprehensive, thoughtful approach based largely on research assessments of what works best within the framework of that society. They have taken on drug use as a serious social problem that first needs to be addressed as a public health question, and only secondarily as a criminal justice one. This is not to say that the Dutch have advocated the same for everyone else. In fact, they have been involuntarily thrust into an antiprohibitionist leadership role because outsiders dissatisfied with the results achieved under the dominant regime look to them for direction, due to widespread beliefs that the methods they adopted have worked so well. This phenomenon has made them the lightning rods for those agitated by any threats to the prohibition model.

There can be little question that the United States government's past actions directed at The Netherlands and its drug policy have been extreme, perhaps demonstrating the outer limits of such recriminations as they have been applied to Western nations.6 For many years, U.S. political leaders and policy makers have identified the Dutch approach to drugs as anathema to their own prohibition preferences. More than that, these have not been portrayed as simple differences of opinion between enlightened adversaries, but rather as deep-seated ideological disputes that can have significant repercussions for much of the rest of the world (Marshall & van de Bunt, 2001). These outbursts are often presented in the language of catastrophism, as if Dutch policies could have disastrous effects on many other nations, producing a domino effect that could only make an already bad situation much worse.

Perhaps a sampling of some of this colorful language would be helpful in illustrating the point. While he served as U.S. drug czar in the Clinton administration, General Barry McCaffrey was a particularly outspoken critic of Dutch drug policies. He repeatedly called attention to the "liberal" methods that were embedded in The Netherlands' policies and suggested that they had proven to be reckless social experiments that had actually worsened the drug situation there as well as caused problems for others because they indirectly encouraged Dutch entrepreneurs to sell their wares on the world market. While on a fact-finding tour of Europe in 1998, McCaffrey spoke out about the Dutch approach, saying, "The overall crime rate in Holland is probably 40 percent higher than the United States...That's (due to) drugs." In making this claim, he stated that the Dutch murder rate was 17.5 per 100,000, compared to a rate of 8.2 in the United States, although he was mistaken in these figures, as the actual Dutch rate is 1.8, less than one fourth ofthat found in the U.S. After McCaffrey's mistaken figure was corrected by a Dutch official (he had confused attempted murder numbers with actual homicides), his assistant, James McDonough (the current state drug czar in Florida) commented, "Let's say she's right. What you are left with is that they are a much more violent society and more inept (at murder), and that's not much too brag about" (Office of National Drug Control Policy, 1998).

A second example of U.S. rhetoric addressed to the Dutch approach is provided by John Walters, the current director of the White House Office of National Drug Control Strategy (ONDCP). Walters (and others) have repeatedly argued that the Dutch methods are misguided and ineffective and that they produce harmful spillover or collateral effects on other nations. In October of 2003, Walters complained that the Dutch were not "serious enough" in their efforts to close down clandestine ecstasy labs, facilities that were shipping tons of synthetic drugs to the U.S. and other nations. He suggested that The Netherlands was the primary source of ecstasy and other synthetic drugs throughout the world and referred to Dutch policies as "fundamentally irrational." Moreover, he was critical of a number of European countries for "their view that it's an appropriate policy to be more free about allowing drug use," referring to this as "a fundamentally irrational health policy and social policy.... If the Dutch government would take this seriously and take the steps necessary, this would change dramatically" (Baltimore Sun, 2003).

A third example is provided by an article appearing in Foreign Affairs, authored by Larry Collins (1999). In this account, Collins argues that the alleged Dutch successes are actually not that at all. Rather, the policy has been a disaster, he says, leading to all sorts of intractable problems. The article is filled with innuendo, "expert opinions" provided by Dutch police and treatment officials who agree with the author's negative assessment and scrupulously avoids all contrary evidence. After reading such an article, a noncritical person would assume the worst about the drug policy of The Netherlands. This account makes no effort to present a balanced view; rather, the author implies that his assessment is based on incontrovertible evidence. However, the evidence he presents consists solely of the sympathetic accounts of those who agree with his critical evaluation.

Finally, an article appearing in the October 18, 1996, International Herald Tribune featured an editorial by Joseph Califano, Jr., former Secretary of Health, Education, and Welfare. Califano currently heads the Center on Addiction and Substance Abuse (CASA), a New York City anti-drug organization. The editorial launched an attack on an official of the European Union for her advocacy of Dutchstyle cannabis policies for other EU countries. According to Reinarman (1997),

Instead of responding to her evidence and arguments about Dutch drug policy, Califano crudely paraphrases Bonino's position, asserting that it consisted of pernicious "myths." To counter these, he offers what he called "facts" purporting to show that "legalization would be a disaster for European children and teenagers." However, Califano's article itself consists of myths which distort both the substance of Bonino's critique of drug prohibition and the nature of Dutch drug policy, (p. 1)

Fortunately, there is a rich research literature assessing the outcome of the Dutch approach, and this material quickly dispels many, if not most of the claims being made about the Dutch "failure."

SWITZERLAND'S HEROIN TRIALS

A second illustration of the intolerance of the U.S. to alternative drug policies is provided by Switzerland's recent experiments with heroin maintenance. The program began during the early 1990s and has become an accepted feature of Swiss drug policy, as the method is believed to have proven to be effective for a cadre of hardcore users (those who have used for a long time and who have been unable to succeed in other treatment efforts). Nevertheless, there have been many criticisms of the heroin experiment, especially from the UN's International Narcotics Control Board (INCB), which only reluctantly allowed the researchers to receive a legal supply of pharmaceutical heroin (that body controls the legal supplies of the drug for scientific experimentation). Given that the 1961 Single Convention allows for exceptions to the otherwise total ban on this drug for legitimate medical use and for scientific experiments and research, there was no legal basis for refusing the request, even though the INCB disapproved of the experiment and publicly expressed these sentiments.

Switzerland has often been featured in international news stories with regard to its vaunted drug problems and liberal policy. The Swiss rate of addiction is among the highest in Europe, a statistical fact that has been known since at least the early 1980s (MacCoun & Reuter, 2001, p. 278). There are an estimated 30,000 heroin addicts in the country, and this group has experienced high rates of HIV/AIDS. The national and cantonal governments have taken very active roles in attempting to curtail these problems and in doing so have proven willing to "think outside of the box."

Perhaps the most notorious example of liberal Swiss policy occurred in Zurich between 1987 and 1992. At the time the police and local officials had been experiencing great difficulty managing the large addict population, a highly visible group that was believed to have contributed inordinately to a high crime rate. In addition, there were frequent public outcries over the users' behaviors, such as shooting their drugs openly in public places. A decision was made to relax police pressures on users and small time dealers, so long as they confined their activities to one particular park, the Platzspitz, which was located in close proximity to the central train station. Local addicts soon began to gather at this location to purchase and openly inject their drugs, doing so without fear of police intervention or arrest. In a short time the numbers of users who frequented the park escalated precipitously, so much so that other citizens were effectively excluded from this public park and encouraged to avoid it by the police.

Over time the Platzspitz became an internationally known example of the excesses of drug "legalization." A number of news stories were published about the place, and one in particular, a CBS 60 Minutes special that aired on January 14, 1990, drew a great deal of unwanted attention. Ultimately this bad publicity eventually proved to be fatal. Dubbed "Needle Park" in the CBS account, the seamiest side of the Platzspitz was featured in the presentation, revealing the degraded condition of the addicts who hung out there and the apparent failure of the tolerant policy. In 1992 the park was closed to further use for this purpose, and the addicts were forced to move elsewhere. While the authorities had hoped that many of these persons would leave the city, most simply continued their behaviors, only now these were no longer contained in one known locale, but were spread throughout the city. In addition, addict overdose rates began to increase once again.

In 1994, the now famous heroin maintenance trials were initiated in Zurich. The experimental project was to be conducted over a three-year period and would be closely managed and evaluated to determine the efficacy of heroin as a form of chemotherapy. In the experiment, three groups of addicts were to compared: one would receive injectable heroin; a second would get morphine; and the third group would receive methadone - all in maintenance doses. Selection criterion limited participants to those who had been using for some time and who had failed at earlier treatment efforts. The study subjects were allowed to self-medicate at the dose level they preferred in order to curtail extracurricular drug seeking. They were allowed to inject up to three times per day in the center, but could not take their drug with them when they left. A variety of support activities were offered to assist the participants to find and retain employment, correct any health problems, improve their family relations, and the like.

At the end of the three-year period, the experiment was labeled a success by its evaluators (Gutzwiller & Uchtenhagen, 1997; also see Killias & Uchtenhagen, 1996). The researchers found that the group receiving heroin had improved their health, employment, and social situations while committing less crime than before, leading the evaluators to conclude that the program should be continued and expanded. Subsequently, similar programs were opened all over the country that could accommodate as many as 15% of the nation's 30,000 addicts.

Responding to these early reports, the U.S. Congressional Subcommittee on National Security, International Affairs, and Criminal Justice criticized Swiss health officials for supporting the experiment. According to Bewley-Taylor (1999),

The chairman of the subcommittee, J. Dennis Hastert (R-IL), commented that "this is a real national security issue" and that he opposed the "immoral act of giving away heroin and expanding the risk of even higher drug abuse." His views were forcibly supported by Bob Barr (R-GA), who said that he had visited Switzerland to see how these heroin "giveaway" clinics worked, and was "shocked" that so "civilized" a nation would be "flirting with disaster and gambling with the future they pass on to their children." (p. 216)

A 1995 Wall Street Journal article echoed these sentiments. Its author, Rachel Ehrenfeld, had visited Switzerland to observe the program and claimed that it had proven to be a failure, that addicts were in fact diverting legal supplies of heroin to the street, supplementing their legal heroin supply with illegal drugs, refusing to work, and being encouraged by project staff to adopt "alternative lifestyles"(Ehrenfeld, 1995).

Other U.S. experts more sympathetic to harm reduction methods were less critical of these same clinical trials. In an article written for the National Review, Ethan Nadelman, the director of the Lindesmith Center and a long-term advocate for drug policy reform, argued that the Swiss program had been a great success and could serve as a model of sensible, science-based reform that others would be wise to follow (Nadelmann, 1995). He found the data convincing and concluded that the Swiss were on the right track in developing practical harm reduction methods that could work with an especially difficult group of addicts.

Despite the criticisms directed at the program, the Swiss government decided to move ahead with its expansion. The Swiss drug policy innovations of the last 30 years or so serve as incontrovertible proof that it is possible to develop and implement a policy guided by harm reduction principles and to do so within the restrictions imposed by the international treaties, regardless of the popularity of this choice in the international arena.

THE AUSTRALIAN CAPITAL TERRITORY(ACT) HEROIN TRIAL

Beginning in 1991, Australian medical officials and other drug experts were alarmed by rapidly growing rates of HIV/AIDS among injection drug users there. They responded to the epidemic by calling for a feasibility study that would consider the logistics and potential of supplying a variety of different pharmacological agents, including heroin, to active users in an experimental setting. The feasibility study was funded, and a final report was issued in 1995, recommending two pilot programs that would be followed by a full-scale clinical trial if the former proved successful. These proposals were debated for two years. In 1997, having won the support of the Ministerial Council on Drug Strategy, the entire program was scrapped by the Federal Government, which refused to fund the study or to amend national legislation that would allow for the importation of heroin to be used in the trial. What happened between the initial decision to consider heroin treatment as an option for long-term users who had failed in other treatment attempts and the final decision to reject the proposal involves a classic case of contested ideologies, with evidence-based decision making losing out to prohibitionist fears.

The Australian feasibility study was a scientifically sound piece of work. The study group consulted with more than 100 experts, representing a range of disciplines including anthropology, health care, criminology, demography, and economics, along with many others who provided their opinions through survey results, public meetings, and the like (Bammer & Douglas, 1996). The resulting plan called for an initial pilot study that would include 40 addicts: half were to be recruited from existing methadone programs and half from dropouts of such programs. The research subjects were to be given either heroin, heroin in conjunction with oral methadone, or methadone. They would be allowed to inject up to three times a day in the clinic setting. A second stage experiment would have broadened the number of participants to 250, using the treatment options of oral methadone by itself or the subject's choice of treatments. Finally, if these pilot studies showed promise, a full-scale clinical trial was to be conducted with 1,000 addicts living in three Australian cities. The latter was to have been a two-year study that would provide evidence regarding the feasibility of heroin maintenance as a treatment, as well as the particular conditions under which it worked, and the personal characteristics of those who responded positively to it (Bammer, 1993; also see Bammer, Stevens, Dance, Ostini, & Crawford, 1995).

In this instance, the feasibility study's recommendations sparked a fierce debate about whether to pursue the matter further, and these considerations were complicated by the outside interference of the United States and the UN. According to Bewley-Taylor (1999), pressure was being brought simultaneously on Switzerland (which was already funding a similar study) and Australia, but with very different results. He states,

...officials in Canberra appear to be more susceptible to direct U.S. coercion. The Australian Achilles heel is the legal opium-growing industry of Tasmania. This highly profitable enterprise exists and prospers only with approval from the UN's ESfCB and the United States. Evidence suggests that the USA is applying pressure unilaterally and through the INCB upon Canberra to halt the socalled ACT heroin trials. The loss of the A$80 million a year Tasmanian opium business seems to be a significant inducement encouraging the Australian authorities to follow the prohibitive line dictated by Washington, and maintained by the global prohibition regime, (p. 216)

In Australia, a number of local officials and medical experts also rejected the study "on its own merits." For example, in a letter to the editor of the MedicalJournal of Australia, Christopher Alroe, a senior consultant with the Queensland Branch of the Australian Medical Association, states,

Wodak and the trial's supporters appear to believe that liberal use of free heroin would threaten the profits of drug traffickers, but for that to be so heroin would have to be widely available in the community. Thus, the purpose of the trial was not to determine efficacy, as the authors of the trial, like Wodak, knew the outcome - the introduction of free heroin throughout Australia. (Alroe, 1998, p. 527)

Here again, the the internationalization of drug policy through the UN conventions has had a chilling effect on individual nations with regard to their ability to customize domestic policy to local conditions. The belief that all nations must subscribe to the same approach has effectively curtailed innovation, at least among most of the UN signatories. Had these dominant policies achieved any measurable degree of success, perhaps this inflexibility would be more understandable and defensible. Given their notorious failure, however, the efforts to curtail any alternative view seem misplaced and counterproductive.

CANADA'S SOFTENING POLICIES ON CANNABIS

Our final example of contemporary drug policy innovations stymied by the U.S. and its international experts involves the recent decision by the Canadian government to alter its traditional hard-line stance toward cannabis, and to do so in light of the latest scientific knowledge about the drug and its effects. These changes drew the attention of top policy officials in the United States who responded with threats and charges of irresponsible policy making in an attempt to prevent their implementation.

It is important to note that for many years, Canadian drug policy was virtually undifferentiated from that found in the United States. The policy assumed the deterrent value of criminal stigma and penalties, both in reducing usage rates and in effectively dealing with those who trade in the illegal substances. For many years, Harry J. Anslinger counted on the support of his Canadian counterpart, Colonel Clement Sharman, in his many battles on behalf of international drug prohibition. According to Bewley-Taylor (1999), an assessment of the mens' correspondence indicates that Sharman was "one of Anslinger's staunchest supporters...he and Anslinger saw eye to eye on most problems and collaborated very closely" (p. 69). Given Anslinger's influence in the development of international drug policies, this alliance helped him to convince, cajole, and force other nations to accept the prohibition model as their own. The recent (September 2002) Report of the Senate Special Committee on Illegal Drugs in Canada commented on this early period of drug policy making, noting that,

Early drug legislation was largely based on a moral panic, racist sentiment and a notorious absence of debate; Drug legislation often contained particularly severe provisions, such as reverse onus and cruel and unusual sentences; and the work of the Le Dain Commission laid the foundation for a more rational approach to illegal drug policy by attempting to rely on research data. (Cannabis: Our position for a Canadian public policy. Report of the Senate special committee on illegal drugs [summary report], p. 24)

The Canadian approach to drugs began to change during the 1960s and 1970s, just as it was changing in the United States at that time. A major investigation of cannabis was reported by the Le Dain Commission in 1972, and its findings echoed the sentiments of the Schafer Commission here in the U.S. In both of these accounts, earlier cannabis legislation was said to have been misguided because it was not evidence-based. Rather it was the product of innuendo and false claims and promoted fears that youth would be ruined by the substance. According to the commission, an abundance of research evidence indicated that none of these former claims could be substantiated and that the drug was apparently not nearly as harmful as alcohol and tobacco products. Despite these findings, little was done either in Canada or the U.S. to alter traditional prohibitionist drug policies, and things remained much as they were.

Much more recently, Canada has begun to liberalize its approach to drugs, and this change has been viewed with alarm by U.S. drug enforcement officials. At issue has been the Canadian toleration of heroin injection rooms in Vancouver, the production and marketing of high quality cannabis in British Columbia, the provision of medical cannabis to patients suffering from a variety of diseases, and, most recently, discussions about dramatically altering the practices with regard to cannabis law enforcement directed against users (but not that aimed at dealers and traffickers). All of the above can be seen as reflecting a new interest in health-based harm reduction policies and elevating such concerns over those of traditional, punitive methods. The reasons for the shift are not hard to discern, for the cannabis investigation cited above stated them quite succinctly in its report:

The series of international agreements concluded since 1912 have failed to achieve their ostensible aim of reducing the supply of drugs; The international conventions constitute a two-tier system that regulates the synthetic substances produced by the North and prohibits the organic substances produced by the South, while ignoring the real danger the substances represent for public health7; When cannabis was included in the international conventions in 1925, there was no knowledge of its effects; The international classifications of drugs are arbitrary and do not reflect the level of danger they represent to health or to society; Canada should inform the international community of the conclusions of our report and officially request the declassification of cannabis and its derivatives, (p. 35 of the summary report)

This group was well aware that its findings would cause some consternation among those who continued to support traditional law enforcement approaches to the drug problem. For example, the summary report contained the following:

The Committee is well aware that were Canada to choose the rational approach to regulating cannabis we have recommended, it would be in contravention of the provisions of the various international conventions and treaties governing drugs. We are also fully aware of the diplomatic implications of this approach, in particular in relation to the United States.

We are keen to avoid replicating, at the Canada - U.S. border, the problems that marked relations between the Netherlands, France, Belgium and Germany over the issue of drug tourism between 1985 and 1995. This is one of the reasons that justifies restricting the distribution of cannabis for recreational purposes to Canadian residents.

We are aware of the fact that a proportion of the cannabis produced in Canada is exported, mainly to the United States. We are also aware that a considerable proportion of heroin and cocaine comes into Canada via the United States. We are particularly cognisant of the fact that Canadian cannabis does not explain the increase in cannabis use in the United States. It is up to each country to get its own house in order before criticizing its neighbour

Internationally, Canada will either have to temporarily withdraw from the conventions and treaties or accept that it will be in temporary contravention until the international community accedes to its request to amend them...In addition, we have seen that international treaties foster the imbalanced relationship between the northern and southern hemispheres by prohibiting access to plants, including cannabis, produced in the southern hemisphere, while at the same time developing a regulatory system for medication manufactured by the pharmaceutical industry in the northern hemisphere. Canada could use this imbalanced situation to urge the international community to review existing treaties and conventions on psychoactive substances, (pp. 50-51)

As predicted, these efforts by the Canadian government to reconsider their traditional adherence to the prohibition model did in fact attract a great deal of criticism from their southern neighbor. U.S. spokesmen quickly attacked the proposed changes in cannabis policy, for example, suggesting that if they proceeded with the decriminalization plan, they (the U.S.) would be forced to take steps to prevent collateral effects in the United States. The U.S. drug czar, John Walters, accused the Canadian government of allowing the shipment of "poison" to America's youth. "You expect your friends to stop the movement of poison to your neighborhood.. .And that is what is going on here. If we were sending toxic substances to your young people, you would be and should be upset" (Harper, 2003). He also suggested that this change would lead to the "crack equivalent of marijuana," potent bio-engineered strains of the drug, finding its way into the United States (Campbell, 2003). Walters suggested that it would be necessary to slow down border crossings in order to stem the tide of cannabis that was sure to find its way into the United States. It would be "regrettable" to see the "loss of the mutual co-operative partnership we've had with the Canadians regarding our borders, regarding the integrity of the hemisphere, regarding our commerce, regarding the implications of trade and value to ourselves" (Campbell). Similarly, David Murray, who works for Walters, suggested that he "doesn't want to tread on another country's sovereignty, but warned there would be consequences if Canada proceeds with a plan to decriminalize the possession of marijuana" (CBC News, May 2, 2003). In other accounts, Walters claimed Canada's drug problem was "out of control" and that there had been a five-fold increase in border seizures. "Right now we're being inundated with high potency marijuana." (BBC News, May 27,2003). Pn summarizing Canada's proposed changes and the hostile U.S. response, Robert MacCoun states,

Why then does the Bush administration take this Canadian initiative so seriously? The most likely explanation is symbolic politics. The real threat is that Canada's actions will aid and abet American marijuana reformers by legitimizing their position. That is also a likely explanation for the vehemence of federal opposition to state medical marijuana laws in any other light. There has been no evidence to date that medical exemptions have led to increased marijuana use. Medical marijuana is seen as the Trojan horse for commercial legalization, a view made more credible by the prominence of drug-policy reform organizations rather than patient groups. (MacCoun, 2003)

In this section of the paper we have observed the typical responses by the United States and its ideological partners in support of prohibitionist approaches whenever other nations have undertaken changes that might undermine that model. In doing so we looked only at cases involving modern, industrialized nations in order to illustrate the methods by which the U.S. constrains and inhibits deviations in the drug policies of other prosperous countries. The discussion also suggested that the poorer, less industrialized, nations are in a much worse position, as they have little bargaining power and are much more dependent on the powerful nations for their very survival. In the next section we note with irony that this seemingly consistent, ironclad commitment to prohibition principles has been conveniently waived at home whenever the U.S. government found that it had other more pressing interests at stake.

U.S. AMBIGUITY REGARDING PROHIBITION POLICY

Given what has been said thus far, it may surprise readers to learn that the strident efforts by the United States first to develop and then to administer worldwide drug controls based on a seemingly inflexible prohibition model have been set aside whenever other more pressing domestic concerns conflicted with these goals. That is, strict controls were simply set aside in certain situations involving U.S. national security interests. These circumstances led American drug enforcers to overlook the indiscretions of certain allies who were viewed as crucial to American interests. While there have been many historical examples that could be cited to illustrate this inconsistency, only a few are presented below.

The emergence and long lasting success of Harry J. Anslinger as head of the Federal Bureau of Narcotics from its formation in 1930 until his retirement in 1962 is one of the Cinderella stories of federal bureaucrats. Few others could match his record, as differing political administrations generally choose to appoint their own to office rather than relying on an incumbent manager held over from a previous administration. Yet Anslinger, J. Edgar Hoover, and a few others survived many changes in government. There can be little question but that Anslinger was an outspoken proponent - some would say the architect - of drug prohibition as the only realistic means of achieving drug control. He conceived a system that could be applied throughout the world to accomplish that goal, and left a record of accomplishments in this regard that would be difficult to exceed.

Although Anslinger was an unabashed prohibitionist, he was silenced by his superiors on a number of occasions when his outbursts became an embarrassment or got in the way of State Department interests. As noted earlier, this occurred with regard to the early deliberations regarding the proposed Single Convention agreement. In that instance, Anslinger worked surreptitiously to undermine the convention, knowing that if it were ratified an earlier piece of international legislation, the 1953 Opium Protocol (which would have been more restrictive), would never come into effect8 (Bewley-Taylor, 1999). Ultimately he was overruled, however, and forced to accept the fact that his own government thought differently about the matter.

For many years, especially throughout the 1950s, anti-communism blended into prohibitionist policies. Anslinger and Hoover were especially vocal in this regard, with both men repeatedly charging that the People's Republic of China was flooding the U.S. with cheap, high quality heroin in order to destabilize the country. According to the New York Times, Anslinger claimed the People's Republic wanted to "demoralize the free people of the world" and that "fanatical Communist traffickers have resorted to the extreme measures of cutting off the ears of small time sellers who reveal the identity of the suppliers in Communist China" (quoted in BewleyTaylor, 1999,p. 110). One of his agents later said (in 1971), "everywhere Anslinger spoke, he said the same thing - that Chicoms are flooding the world with dope to corrupt the youth of America. There was no evidence for Anslinger's accusations but that never stopped him" (Bewley-Taylor, p. 113). After U.S. policy changed toward China following that nation's border disputes with Russia, a State Department official reported, "There is no reliable evidence that the Communist Chinese have ever engaged in or sanctioned the illicit export of opium or its derivatives. Nor is there any evidence of that country exercising any control over or participating in the Southeast Asia opium trade" (Bewley-Taylor, p. 113).

While claiming that the Communist Chinese were poisoning the youth of America, the U.S. provided prodigious amounts of support to Chaing Kai-Shek, whom Anslinger claimed was working to eliminate the drug traffic in that part of the world. In reality, however, Chaing's army, the Kuomintang (KMT), was itself involved in the drug trade in order to finance arms and their field operations. This was not the first nor the last time the U.S. would actively support nations and leaders who were involved in the illegal drug trade.

Two examples come to mind immediately. The first involved the Panamanian strongman, Manuel Noriega, who was well thought of in U.S. State Department circles for many years. Noriega's known involvement in the drug trade was ignored because of his cooperation with the U.S. in its efforts to suppress communism in Central and South America. Later, when his friendship was no longer required because communism had ceased to pose a realistic threat, the U.S. invaded Panama and forcibly deposed Noriega, eventually imprisoning him here. A second example may be found in the U.S. support of Osama bin Laden and the Afghan mujahadeen in their resistance to the Russian occupation during the 1990s. The Afghan rebels supported themselves through opium smuggling activities, which were overlooked by their American friends. Later, the Taliban banned all opium production in Afghanistan and there was a dramatic reduction in that region's involvement in the drug trade. Following the U.S. removal of the Taliban, however, Afghanistan opium has once again flooded the market, with that nation now being identified as one of the largest producer countries in the world.

Although there had been many previous allegations, historian Aired McCoy (2003) was the first to prove that U. S. agents'actions supported drug smuggling operations by allies. McCoy learned that the KMT and American CIA were running drugs out of Southeast Asia throughout the American involvement in the Vietnamese conflict. These actions obviously had to have high-level government approval, and it was forces friendly with the U.S., anti-communist forces, that were the ones conducting the dirty business, not the other way around. McCoy (2003) argues:

These alliances with drug dealers and drug lords were not just an aberration, an expedient born of the cold war. During the U.S. invasion of Afghanistan in October 2001, the CIA recruited warlords as the main U.S. ground force for an attack on the Taliban, and then encouraged them to seize local power once the Taliban regime was defeated. Since these warlords were also the country's top drug lords, Afghanistan 's opium cultivation and heroin production soon revived to dominate the world market..... Simply put, criminal liaisons are an integral part of the CIA's covert operational capacity, (p. 531)

CONCLUSIONS

What we have shown in this paper, I think, is that despite some hypocritical inconsistency, the U.S. has been a moving force fostering suppression of harm reduction innovations throughout the world. This is the sense in which the U.S. is the elephant in the closet in all of the cases discussed in this article and throughout the special issue. The discussion of international drug policy, or even more narrowly European drug policy, can only be comprehended with attention to pressures generated by U.S. prohibitionists. It seems likely that prohibition will continue to reign as the dominant form of drug control well into the 21st century.

Furthermore, no strong movement exists to totally abandon prohibitionist ideals, although there have been some modest moves in that direction. Harm reduction initiatives serve as examples of changes in drug policy that seem achievable under the present system by focusing on the demand side of the drug equation, while retaining a criminal justice orientation toward the trafficking and sales of these substances. Their foci have been the alleviation of some of the worst problems associated with a firm reliance on criminal justice methods for all aspects of drug control, especially those matters that primarily impact users, while retaining harsh methods for supply side concerns. In accomplishing these ends, harm reductionists have promoted a wide variety of interventions that include a major expansion of treatment options; methadone availability for addicts; heroin maintenance for addicts who have failed in previous treatment attempts; safe injection rooms for users to avoid some of the health hazards associated with street use; free availability of syringes, condoms, and drug information materials; aggressive drug prevention and health protection campaigns; and decriminalization of use for all or for selected drugs. As we have seen, each of these options can be implemented within the constraints imposed by the prohibition model, by selectively, though legally, easing some of the strict methods that have been applied to users in the past. Indeed, as Levme(1999) states:

Since the early 1980s, harm reduction workers and activists in Europe, and increasingly throughout the world, have sought to provide drug users and addicts with a range of services aimed at reducing the harmful effects of drug use...Even the United Nations agencies that supervise world-wide drug prohibition have come to recognize the public health benefits of harm reduction services within current drug prohibition regimes.... I want to suggest that harm reduction is a movement within drug prohibition that shifts drug policies from the criminalized and punitive end to the more decriminalized and openly regulated end of the drug policy continuum. Harm reduction is the name of the movement within drug prohibition that in effect (though not always in intent) moves drug policies away from punishment, coercion, and repression, and toward tolerance, regulation and public health. Harm reduction is not inherently an enemy of drug prohibition, (pp. 127128)

Although these strategies are feasible under the existing system of control, hardcore supporters of prohibition policy have treated harm reduction advocates as if their proposals are likely to threaten the safety and even survival of the free world. That is, they suggest that these methods are all actually designed to bring about legalization of all drugs and that discussions of HIV/ADDS, medicinal marijuana for cancer patients, and other reforms are all subterfuges to divert our attention from that end. We have seen that any nation that challenges the status quo with regard to drug policy initiatives may be subject to extreme criticism by prohibition's defenders, especially the United States and its UN allies. More than that, the latter have worked diligently to see to it that any reform efforts will be greeted with economic disincentives and other undesirable repercussions.

It appears, however, that threats of this order will no longer suffice to stifle drug policy reform. As is made clear in the articles prepared for this issue, many European nations have refined existing harm reduction methods or are beginning to explore these possibilities as they seek more satisfactory solutions to emerging drug problems. We have emphasized that these changes have been relatively slow-paced and carefully planned and executed in order to avoid major difficulties should they prove to be ill conceived or counterproductive. None suggest an ironclad commitment to any particular approach that would be adhered to without regard to its results. Rather, these changes have been responsibly prepared and carefully evaluated; evidence-based assessments are commonplace among them and serve to guide modifications, including the abandonment of any that prove to be of questionable utility or that are clearly unsuccessful. The documentation of these facts should lead one to question the charges of "irresponsible" or "reckless" policy making that have been directed at the innovators by U.S. or UN spokespersons; they are, in fact, the opposite of that.

The evidence suggests that, given the restrictions imposed on all signatories by current international treaties, it is not likely that there will be any dramatic shift in drug policies in the foreseeable future. Instead, the harm reduction methods we have described have been introduced and refined within the structure of the existing commitments and as such are perfectly legal and acceptable under the present arrangements. The limits of the agreements are being tested in some instances, but generally these methods clearly fall within the accepted range of possibilities that is written into the conventions. It is apparent that some "wiggle room" has been found, as regards the decriminalization of cannabis, for example, or in the heroin maintenance experiments taking place in a number of European countries.

It is important to note that no nation has shown an inclination to radically alter its drug policies in the direction of legalization of all substances. In that sense, all remain somewhat conservative and restrict the possibilities for change to a limited number of options. The dangers associated with un trammeled access to powerful drugs are well known, and few believe there is any reason to entertain notions of a world, or nation, without some form of restrictive drug laws. As noted in the earlier article by Uitermark, even the Dutch may now be in the process of readjusting their liberal policies and moving in a more conservative direction.

In assessing these matters, one interesting, though unlikely, possibility is that, like the former Soviet empire, international drug prohibitionism could simply collapse, imploding because of its contradictions and long term failure to deliver on its promises. This in turn would result in a return of sovereignty to individual nations to develop their own strategies, which would foster the discovery of local solutions to these concerns. The unevenness of the problems suggest that this may be highly desirable in order to maximize flexibility and responsiveness to contextually unique conditions. At the same time, however, it will create even more problems for those who wish to continue along the old established path, in their preference for the failed "one size fits all" model.

NOTES

1 The attendees at this first meeting reached a consensus that no agreement would be valid unless all participants agreed to it. This would protect the signatory nations from one another in terms of unfair competition. Since the treaty was never ratified by some of those attendees, it should never have come into force.

2 In his role as United States' representative, Anslinger felt that the Single Convention was too weak and clandestinely worked to urge other nations not to sign it. He eventually lost this battle when the U.S. State Department overruled him.

3 The program was initiated by Congress in 1985 in response to the tortureslaying of U.S. drug agent Enrique Camarena in Mexico. Each year the President must certify that source nations are cooperating with U.S. drug control efforts or they lose foreign aid and other support. The program has been the cause of much acrimony, especially between Latin nations and the United States (MacCoun and Reuter, 2001).

4 I say "re" emergence because the public health approach was preferred in some countries, such as England, for a lengthy period of time, even though it was undermined there and suffered a loss of commitment during the closing decades of the twentieth century. In the United States too, public health approaches have enjoyed considerable popularity as alternatives to prohibitionism during particular periods, such as the late 1960s and early 1970s.

5 Readers interested in general reference works on the Dutch approach to drug control are encouraged to look at Bullington (1995), Korf (1995), Leuw & Marshall (1994, and van de Wijngaart (1991).

6 There is much evidence that less developed nations, and especially those that grow the drug plants consumed in the United States, suffer much more strident rebuffs and public threats than do any of the Western countries, regardless of the latter's differences vis a vis U.S. preferences. Because of their dependence on foreign aid, the former are also much more likely to suffer real economic sanctions if they refuse to accommodate these demands.

7 This refers to a recent disagreement voiced in appropriate UN bodies about their long- term emphasis on control policies that mostly impact developing Southern plant-based drug producing countries with lengthy histories of traditional use of these substances, while ignoring or downplaying the significance of those nations that produce manufactured drugs - the Northern group. As noted earlier, Mexico was the first to file the complaint with that organization in 1993 (see Jelsma, 2003, p. 182).

8 The Opium Protocol had never been ratified by a sufficient number of countries, largely because of the severe restrictions it imposed on opium producing nations. Anslinger desperately sought to obtain the required signatures to bring this into force, while simultaneously working to derail the Single Convention.

REFERENCES

Albrecht, Jorg-Hans

2001 The international system of drug control: Developments and trends. In Jurg Gerber and Eric L. Jensen (Eds.), Drug war American style: The internationalization of failed policy and its alternatives (pp. 49-60). New York and London: Garland Publishing.

Alroe, Christopher

1998 Public health and politics: The demise of the ACT heroin trial. Medical Journal of Australia, 168, 527.

Baltimore Sun

2003 U.S. official takes Dutch to task on ecstasy. September 28. Retrieved August 19,2004, iromhttp:/www.mapinc.org/drugnews/v03/nl480/a09.html.

Bammer, Gabriele

1993 Should the controlled provision of heroin be a treatment option? Australian feasibility considerations. Addict, 88, 467 - 475.

Bammer, Gabriele, Stevens, ?., Dance, P., Ostini, R., & Crawford, D.A.

1995 Controlled heroin availability in Australia? How and to what end? International Journal of Addictions, 30, 991 - 1007.

Bammer, Gabriele, & Douglas, Robert M.

1996 The ACT heroin trial proposal : An overview. Medical Journal of Australia, 164, 690 - 692.

BBC News

2003 Canada seeks to change drug law. May 27.

Bewley-Taylor, David R.

1999 The United States and international drug control: 1909 - 1997. New York: Continuum, 1999.

Bullington, Bruce

1995 War and peace: Drug policy in the United States and The Netherlands. Crime, Law and Social Change, 22(3), 213-238.

Campbell, Deborah

2003 Being there: Pot tourism. San Francisco Bay Guardian (October 2). Retrieved August 24, 2004, from http://www.sfbg.com/38/01/ x_being_there .html

Canadian Senate Special Subcommittee on Illegal Drugs

2002 Cannabis: Our position for a Canadian public policy. Report of the Senate Special Committee on Illegal Drugs. September 2.

CBC News

2003 U.S. warns Canada against easing pot laws. May 2.

Chang, Iris

2003 The Chinese in America. New York: Penguin Books, 2003.

Chatterjee, S.K.

1981 Legal aspects of international drug control. The Hague: Martinus Nijhoff Publishers.

Collins, Larry

1999 Holland's half-baked drug experiment. Foreign Affairs, 78(3), 82-98.

Courtwright, David T.

2001 Forces of habit: Drugs and the making of the modern world. Cambridge, Mass: Harvard University Press.

Ehrenfeld, Rachel

1995 Selling syringes: The Swiss experiment. Wall Street Journal, September 6, p.A18.

Erickson, Patricia, Riley, Diane, Chang, Yuet, & O'Hare, Pat (Eds)

1997 Harm reduction: A new direction for drug policies and programs. Toronto: University of Toronto Press.

Gutzwiller, F., & Uchtenhagen, Ambros

1997 Heroin substitution : Part of the fight against drug dependency. In D. Lewis, C. Gear, L.M. Laubli and D. Langencik-Cartwright (Eds.) The Medial prescription of narcotics: Scientific foundations and practical experiences (pp. 295-300). Seattle: Hogrefe and Huber Publishers.

Hall, W., Room, R., & Bondy, S.

1995 WHO project on health implications of cannabis use: A comparative appraisal of the health and psychological consequences of alcohol, cannabis, nicotine and opiate use. Toronto: National Drug and Alcohol Research Centre, University of New South Wales, and Addiction Research Foundation.

Harper, Tim

2003 Pot plan puts U.S. noses out of joint: Trade at risk, warns drug czar; decriminalization called a mistake. Toronto Star, May 3.

Inglis, Brian

1975 The forbidden game: A social history of drugs. New York: Scribner.

Jelsma, Martin

2003 Drugs in the UN system: The unwritten history of the 1998 United Nations General Assembly Special Session on Drugs. The International Journal of Drug Policy, 14, 181-195.

Killias, Martin, & Uchtenhagen, Ambros

1996 Does medical prescription reduce delinquency among drug-addicts? On the evaluation of the Swiss heroin prescription projects and it methodology. Studies on Crime and Crime Prevention, 5, 245-256.

Korf, Dirk

1995 Dutch treat: Formal control and illicit drug use in the Netherlands. Amsterdam: Thesis Publishers.

Krajewski, Krzysztof

1999 How flexible are the United Nations drug conventions? International Journal of Drug Policy, 10, 329-338.

Kramer, John

1971 Controlling Drugs in America: Part One: The Early Background. Drug Forum, 1(1), 51-69.

Le Dain Commission

1972 A report of the commission of inquiry into the non-medical use of drugs. 1972. Ottawa: Information Canada.

Leuw, Ed, & Marshall, Ineke

1994 Between prohibition and legalization: The Dutch experiment in drug policy. Amsterdam: Kugler Publications.

Levine, Harry G.

1999 When policies collide: Market reform, market prohibition, and the narcotization of the Mexican economy. In H. Richard Friman and Peter Andreas (Eds.), The global economy and state power (pp. 127-128). New York: Roman and Littlefield.

Lindesmith, Alfred

1965 The addict and the law. Bloomington: Indiana University Press.

MacCoun, Robert

2003 American laws, foreign lands. O cannabis! Pot decriminalization in Canada highlights U.S. isolation. San Francisco Chronicle, June 11, A27.

MacCoun, Robert J., & Reuter, Peter

2001 Drug war heresies: Learning from other vices, times and places. Cambridge: Cambridge University Press.

Madancy, Joyce A.

2003 The troublesome legacy of Commissioner Lin: The opium trade and opium suppression in Jufian Province, 1820s to 1920s. Cambridge and London: Harvard University Press.

Marshall, Ineke, & van de Bunt, Henk

2001 Exporting the drug war to the Netherlands and Dutch alternatives. In Jurg Gerber and Eric L. Jensen (Eds.), Drug war American style: The internationalization of failed policy and its alternatives. New York and London: Garland Publishing.

McAllistser, William B.

1992 Conflicts of interest in the international drug control system. In William O. Walker (Ed.), Drug control policy: Essays in historical and comparative perspective (pp. 143-166). University Park, Pennsylvania; Pennsylvania State University Press.

McCoy, Alfred

2003 The politics of heroin: CIA complicity in the global drug trade. Chicago: Lawrence Hill Books.

Musto, David

1999 The American disease: Origins of narcotics control. New York: Oxford University Press.

Nadelman, Ethan

1995 Switzerland's heroin experiment. National Review, July 10, 46-47.

National Commission on Marihuana and Drug Abuse

1972 Marihuana: A signal of misunderstanding. First report. Washington, DC, U.S. Government Printing Office.

Office of National Drug Control Policy

1998 "Drug czar" McCaffrey, attacking Dutch Drug policy, misrepresents murder rate on European tour. Retrieved August 19,2004, from http:/www.ndsn.org/ julaug98/intll.html.

Reinarman, Craig

1997 The drug policy debate in Europe: The case of Califano vs. The Netherlands, International Journal of Drug Policy, 8(3). Retrieved August 24, 2004, from http://www.cedro-uva.org/lib/reinarman.califano.html.

Room, Robin

1999 The rhetoric of international drug control. Substance Use and Misuse, 34(12), 1689-1707.

World Health Organization

1999 Harm reduction approaches-and drug and alcohol policies and laws. In William J. Curran (Ed.), Drug and alcohol dependence policies, legislation and programmes for treatment and rehabilitation. Geneva: World Health Organization, Substance Abuse Department.

World Health Organization

1997 Harm reduction, human rights and the WHO expert committee on drug dependence. In E. Patricia, R. Diane, C. Yuet, & O' H. Pat (Eds.) Harm reduction: A new direction for drug policies and programs (pp. 119130). Toronto: University of Toronto Press.

Sinha, Jay

2001 The history and development of the leading international drug control conventions. Prepared for the Senate Special Committee on Illegal Drugs. Ottawa: Parliamentary Research Branch, Library of Parliament.

Thoumi, Francisco

2002 Can the United Nations support "objective" and unhampered illicit drug policy research? A testimony of a UN funded researcher. Crime, Law and Social Change, 38, 161-183.

Trocki, Carl A.

1999 Opium, empire and the global political economy: A study of the Asian opium trade 1750 - 1950. London and New York: Routledge Publishers,

van de Wijngaart, Go vert

1991 Competing perspectives on drug use: The Dutch experience. Amsterdam: Swets and Zeitlinger Inc.

Bruce Bullington, Ph.D., is editor of the Journal of Drug Issues. Dr. Bullington's interests are wide-ranging, often transporting him well beyond the usual boundaries of criminology and criminal justice. Within these disciplines, however, he is currently working on research related to drug policy, and especially the evolving policies found among European nations. He also studies Native American justice issues, qualitative research methods, the philosophy of science, and the historical development of crime theories.

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