02/06/19 Alex Wodak

Dr. Alex Wokak is a physician and the director of the Alcohol and Drug Service, at St Vincent's Hospital, in Sydney, Australia. Wodak is a notable advocate of drug reform laws. Wodak helped establish the National Drug and Alcohol Research Centre, the NSW Users AIDS Association, and the Australian Society of HIV Medicine. Wodak is President of the Australian Drug Law Reform Foundation and was President of the International Harm Reduction Association. Wodak also helped open Australia's first needle exchange programme and the first medically supervised injecting centre in Kings Cross

Program: 
Cultural Baggage Radio Show
Date: 
Wednesday, February 6, 2019
Guest: 
Alex Wodak
Download: Audio icon FDBCB020619.mp3
Share

Comments

CULTURAL BAGGAGE

FEBRUARY 6, 2019

TRANSCRIPT

DEAN BECKER: I am the Reverend Dean Becker, keeper of the moral high ground in the drug war for the world, and this is Cultural Baggage.

Hi, folks. I am Dean Becker, the Reverend Most High. You are listening to Cultural Baggage on the Drug Truth Network. Today, we're calling Australia.

We are speaking with Doctor Alex Wodak. He's a longtime investigator of the world's drug problems, the drug war problems, and he recently had an article, well, that referenced him, with news.com.au, and that he was talking about the need to reframe, realign, our, I would think he's talking about the world's drug perspective, and how we ought to move forward.

They paraphrased it to say an esteemed doctor and leading drug reform campaigner is calling for the illicit drug market to be handed to pharmacies, and I concur one hundred percent with that. I want to welcome Doctor Alex Wodak. How are you, sir?

ALEX WODAK, MD: Good, thank you, and thank you. And thank you for having me on your program.

DEAN BECKER: Yes, sir, I consider it an honor. I've been reading your thoughts over the past twenty years I've been delving into this drug war situation. I live in Houston, Texas, which for many years was the world's leading jailer, if you will. We would lock up people for any amount of drugs for as much time as we possibly could.

But that seems to be changing in my fair city, and changing incrementally around the world. Would you concur with that thought, sir?

ALEX WODAK, MD: Definitely, definitely. It's been, the pace is accelerating, it's -- not only is happening, but it's also happening faster in 2019 than it did in 2018 and faster in 2018 than it did in 2017, and so on.

DEAN BECKER: Yes sir.

ALEX WODAK, MD: So, this is a very important battle that's going on north, south, east, and west.

DEAN BECKER: Well, a couple of, well, I think it was six weeks or so ago, a friend of mine within Law Enforcement Action Partnership had a major article in the Boston Globe talking about the need to actually regulate and control the supposedly controlled substances.

The Guardian, the Observer, a lot of other papers in Great Britain have delved into this subject, and it seems that you folks in Australia have taken a new look at this as well.

ALEX WODAK, MD: Look, it's been a long battle, and I've been involved in it from the early 1980s, in Australia, and also did a lot of international work in this area, in a number of countries, all over the place, and it was a very lonely battle in the 1980s.

There weren't many of us who supported having a new look at the global problem of -- global position of drug prohibition. But, it accelerated in the 1990s, and George Soros, from your country, lent his support to this movement, and that accelerated things, and it's just kept on building and building.

And now, we also have the support of Helen Clark, who is a former prime minister of New Zealand and former third ranking position in the United Nations, and indeed, the current UN Secretary General, António Guterres, was the prime minister of Portugal in July 2001, when they decriminalized drugs, all drugs, and adopted a new and very successful approach to drug policy.

So, this movement is building and building, and we're getting more and more successes, more and more victories, and including especially in the United States, which for so long has been pushing the war on drugs. It helped design the war on drugs, and then it sold this policy right around the global, and now it's the United States which is also in the forefront of efforts to have more realistic, more pragmatic, more effective, cheaper, policies.

Drugs are always going to be a problem, but, it doesn't help by waging an ideological war against them.

DEAN BECKER: No sir, it does not. Now, in concurrence with what you said about the US kind of switching over a bit here, many of the presidential candidates on the Democratic side have begun to talk about the need to legalize marijuana federally. They've begun to talk about ending the drug war.

Not a lot of specifics coming forward from them as yet, but to at least mention those words, to stack them together, and to broach this subject.

Just recently, the, president Trump issued his new national drug control report. Used to be a couple hundred pages, it's down to about 20 now, but basically it says just to do the same old same old that we've been doing, and that we'll look at it again in five more years to see if we've made any progress. Your response to that thought please, sir.

ALEX WODAK, MD: Well, this is part of the decline of the prohibition side, and we see the United States has really withdrawn from the international contest of ideas on this subject at an official level.

The top US government official in this area, now retired, William Brownfield, said about five or six years ago that the international treaties were up to being interpreted by each country, a position that the United States has trenchantly opposed for decades, and now he says that it was up to each country to make their own judgment about what the treaties meant.

The old order is collapsing. It hasn't collapsed yet, we don't exactly know what's going to replace it. I expect that each country will be able to make its own mind up about the best way of -- it thinks of responding to the particular situation in that country.

But I think where we're heading is in -- there are going to be five elements to it. Firstly, drugs are going to be redefined as primarily a health and social problem, not primarily a law enforcement problem. That's the threshold question, terribly important.

Once you make that decision, that it's primarily a health and social problem, a whole lot of other things follow automatically.

Second thing that needs to happen is that drug treatment needs to be raised to the same high quality level as the rest of the health care system at the moment. It's terribly poor, underfunded, and ideologically driven down a path where it can't succeed. It needs to be treated like breast cancer, diabetes, heart disease, whatever.

What we do should be based on evidence. There should be enough funding so that everybody who wants help can get help.

The third thing we need to do is that we need to take a leaf out of Portugal's book and scrap all the penalties for personal possession of drugs. So there need to be a definition of what personal possession means for heroin or cocaine, or amphetamines, or whatever the drug is, cannabis, whatever the drug is, and that will be a different quantity for each drug.

And then if you're below that level and you come to the attention of law enforcement, you get help, but you don't get thrown in jail or prison. You get help. If above that level, the law takes its own course, as it does now.

The fourth thing we need to do is, we need to, and this is the only controversial bit, we need to regulate as much of the drug market as possible. Now, that may seem bizarre to some, but think about it, we're already doing that. The methadone program, which you have in the United States, first country in the world with it, you got that in 1964.

That really is already regulating part of the heroin market. We need to do more of that. The needle and syringe program that the United States and many other countries, about 80, 90 countries around the world provide to slow the spread of HIV among and from people who inject drugs, that's also part of it.

Medically supervised injecting centers, there are going to be some in the United States, there aren't any at the moment. There are plenty in Canada, they're building lots more, and about a hundred of these medically supervised injecting centers in about a dozen countries -- excuse me -- around the world.

And then the fifth thing that we need to do is that we need to make life for young people better so that they feel optimistic about the future, they don't worry about growing up in a world of irreversible climate change, of mass unemployment, they can really look at the future and feel confident, they don't have to take drugs. They can get on with their lives, have great lives, without taking drugs.

So, these are -- this is the kind of platform that I think we need to fight for all over the world.

DEAN BECKER: Thank you. Folks, once again, we're speaking with Doctor Alex Wodak. He's emeritus consultant, alcohol and drug service at St. Vincent's Hospital, and president of the Australian Drug Law Reform Foundation.

Doctor Wodak, I want to go in the thought here, I spent a couple of weeks this spring, I should say, last spring, in 2018, touring some sites in Portugal. I had a great, long interview with Doctor João Goulão, and we talked about morality.

We talked about the fact that prior to these advents in Portugal, and in Switzerland and elsewhere, it was all based on morals, that drug users were, you know, satan worshipers, et cetera.

And much of that propaganda, that reefer madness, if you will, still lingers here in these United States. Many of the politicians that stand in the way of change talk about, you know, it's going to lead people to hell, basically, if we use these drugs.

But, the fact of the matter is, from my perspective, sir, we already have these drugs. They're already in play, they're made by untrained chemists, they're cut with all kinds of bull stuff, and it has no real logic to the current policy, that, in Switzerland, they've had twenty million injections of pure heroin and nobody's died from that, because they were taking care of their people.

Your response to that whole bailiwick, please.

ALEX WODAK, MD: Yes, well, anybody who's watched The Wire, or seen Breaking Bad, it's pretty obvious that what we're doing doesn't work, and that's the starting point of this debate.

I was -- took part in a debate in your city in the James A. Baker III Institute at Rice University in Houston, and it was staggering how deeply entrenched people were, this was about ten years ago, in the war on drugs. Those people still exist, but what's happening now is that younger people, and particularly people from law enforcement, are leading the charge to try and have a more informed, more thoughtful, and more realistic, frankly, approach.

And, that involves the elements that I said before, and one of the things we have to realize is that when we do provide prescription heroin, it's now provided in almost a dozen countries around the world, there have been trials in seven countries involving seventeen hundred people, and the results are very positive.

The people who were treated with these heroin assisted assisted programs were people with very severe problems who had multiple different types of treatment before and hadn't benefited from any of them. And these are the people who benefit from the heroin assisted treatment.

And, they went back to, took a while, they were pretty damaged, many of them, that started the program, but, when they were -- when they responded to the treatment they went back to leading fairly normal, conventional lives, holding down jobs, looking after their partner, looking after their parents, looking after their children.

They went back to paying taxes. They went back to being like everybody else in the community. And some of them were continued on the heroin treatment for a while, some of them switched back to methadone, but their lives were improved. They got their lives back, and the community got them back.

And that's really what we need to do. It's a demonstration, really, a very powerful demonstration that when the state regulates the supply of illicit drugs, and provides that to citizens who can't manage without it, it's a win-win for everybody.

But when the same drug is distributed by the black market, by motorcycle gangs, it's a disaster for everyone, a disaster for the people who use the drugs, their families, and their community.

And this is what we should be doing more and more. It's not for all drugs, not for all people. And you've started that with recreational cannabis now in ten out of the fifty states of the Union, and that's going to increase over the future, starting of course with Colorado and Washington states in 2012 voting for that, and then starting their programs in 2014, and it's now spread.

New York, New Jersey will be the next to come on line, and it's a good thing, too. Canada started October 2018, New Zealand will have a referendum on the personal cannabis regulation next year, in 2010. Half a dozen Caribbean countries are starting to do this, and Luxembourg will be the first country in the European Union to start doing this as well.

So this is an idea whose time has come, and we should all get behind it, and try and help the people who are bringing in drug law reform around the world.

DEAN BECKER: You are listening to Cultural Baggage on Pacifica Radio and the Drug Truth Network. We're speaking with Doctor Alex Wodak, and we'll be back in just a few seconds.

It's time to play Name That Drug By Its Side Effects! Hives, fainting, pain, swelling, tiredness, headache, fever, nausea, dizziness, vomiting, itching, bruising, stomach ache, shortness of breath, chest pain, swollen glands, weakness, tiredness, seizure, blood clots, and death. Time's up! The answer, from Merck and Company: Gardasil, which may help prevent cervical cancer in your teenage daughter.

Quick reminder: we are speaking with Australian doctor, drug reformer, Alex Wodak.

You know, I think about current news. I think in the last day or two the World Health Organization has come out in favor of in essence legalizing marijuana. There are, I mentioned earlier, there are politicians that are starting to speak more boldly, et cetera.

And I guess what I'm leading to here, sir, is that, I think even at the local level, sheriffs, district attorneys, you name it, legislators, they all know much of this truth. They all know that we are off track. What do you think it will take to get them on track, to develop the courage to speak for the need for change that will improve all the lives in the ways you've been talking about? Your thought there, Doctor Wodak.

ALEX WODAK, MD: Well, I think what's been happening over the last thirty years is going to keep on happening, except that the pace is accelerating, and so it's not going to be like a fall of the Berlin Wall, where from one day to the next, the Berlin Wall comes down. It's not going to be like that.

It's going to be like going in slow motion, and it's already happening in slow motion. We're seeing community attitudes change in your country. The Gallup Poll in 1969, to the question do you support the legalization of marijuana, twelve percent support that. And in 2018, that was up to 66 percent.

Fifty-one percent of people who said they voted Republican said yes to that question, do you support the legalization of marijuana. If you look at the graph -- if you type Gallup Poll legalization of marijuana into your search engine on your computer, this image will come up and you will see that from 1969 to about 2000, support was slowly, slowly increasing from year to year, but very, very slowly and then sometimes it would go backwards, but overall there was a trend line going up.

And really, since 2000, up until now, the support has increased very much more rapidly. That's happening for many other questions apart from that question of legalization of marijuana, but the reform movement is on its way, and we saw in the elections in your country, around the world we watched, of course we all watch US elections very closely, and in your elections on November Sixth in 2018, we saw in about a dozen places, we saw major victories for drug law reform at the ballot box.

With the exception being the voters in Ohio didn't support a proposition which would have made it a little bit less difficult to fight a terrible opioid overdose epidemic that's striking your country.

Seventy-two thousand drug overdose deaths in 2017, and 30,000 of those 72,000 deaths were from drugs contaminated with fentanyl. What better illustration could we have of the failure and futility of trying to fight a war on drugs?

What's happened is that it's enabled the drug traffickers to contaminate their supplies with fentanyl, a much more potent opioid, made in this case in China, illegally, and somehow it gets into the drug supply in the United States and ends up killing 30,000 of your countrymen and women. Tragic, and that's also happening now in Canada, to some extent also in UK, and this is really the -- it illustrates why this war can't be won, it can only be lost.

And it's time that we adjusted to that, and people are adjusting to it. I saw the new governor of California a few years ago, when he was lieutenant governor of California, now he's the governor, and it's clear, he's a young man, dynamic man, he's obviously going to have a great career in politics, and he speaks like you or I do on this issue.

Many of the younger politicians in the United States and around the world speak in the same vein.

DEAN BECKER: Yes, sir. And it's wonderful to hear, it's music to my ears, I guarantee. Now, once again, we're speaking with Doctor Alex Wodak. Doctor Wodak, you mentioned fentanyl, and I think it was, I don't know, yesterday, couple of days ago, they announced the largest fentanyl bust, coming through a port of entry here in these United States, and I'm sure you've heard of the hoopla over the need for a wall, got to have a wall, wall wall wall.

And the fact of the matter is, is that, you know, they've got submarines, airplanes, they've got tunnels, they've got all kinds of ways to get the major loads across, into the United States.

And I guess my thought, sir, I heard that carfentanyl, which is an elephant tranquilizer, even stronger than fentanyl, that it's five thousand times stronger than heroin, and that much of the heroin being bought in the United States these days is not even heroin, it's a mixture of these fentanyl and carfentanyl drugs, with some magic white powder.

I guess I'm just concurring with your thought. We keep chasing this situation, and it's just going to get worse, and worse, if we keep it up. Your thought.

ALEX WODAK, MD: Well, exactly. That's -- in the 1980s, the people came up with the term "the iron law of prohibition," and it's a very good, snappy description of what actually happens.

If you apply a lot of law enforcement pressure to an illegal drug market, what happens is that the more dangerous drugs push out the less dangerous drugs. You saw that in the United States in 1920, when alcohol was prohibited, the first thing that happened was that beer disappeared, and in 1933, after alcohol prohibition was repealed, the first thing that happened was beer came back.

In Asia, the 1970s, we saw one country after another ban the smoking of opium. Now, opium smoking's not completely benign. It's not terribly dangerous, but it's not benign, either. Anyway, that disappeared after it was banned from one country after another. Old men used to smoke it, predominantly.

And, within ten years, opium smoking had been replaced by heroin injecting, and now it was the young and sexually active men who were injecting heroin. And this prepared the -- exactly the perfect conditions for the spread of HIV in the most populous region of the world.

Again, another demonstration of the iron law of prohibition. And we see that again and again, here with fentanyl, and now with carfentanyl in the United States.

Another example of the iron law of prohibition, going from white powder cocaine to crack cocaine is another illustration of the same phenomenon.

So, if you want highly potent and very dangerous drugs available at ever-low prices, then drug prohibition is a policy to use. But if you want your young people to be able to live to middle age, and every age in safety, enjoying their lives, then we have to come to something that is more effective, more rational, respects human rights, and is also more cost effective.

It's, I have to say that the early supporters of this kind of approach in the United States were particularly from the conservative wing of US politics. So, Barry Goldwater, the former senator from Arizona, a presidential candidate in '64. There was Milton Friedman, a Nobel Prize winner in economics. Thomas Szasz, a psychiatrist. William F. Buckley.

So, people from the far right of the American political spectrum, they were among the early supporters. And now, it goes across the political spectrum. The conservatives see it as a way of reducing taxes, reducing wasteful government expenditure. The people on the left of politics see this as a very important way of improving social justice, recognizing that the main victims of the war on drugs have always been the lower socio-economic groups, the disadvantaged, the vulnerable members in our community.

And, so it's now -- it's increasingly embraced by the left, by the right, by the center, and it's going to win. It is winning, and the more people who support this, the better.

DEAN BECKER: Thank you. Again, we're speaking with Doctor Alex Wodak. We've got just a couple of minutes left here.

ALEX WODAK, MD: Look how fast we can win this victory, to get more realistic, more humane, more effective approaches. That's an important question of strategy. I think it's important to recognize that there are many different reasons why we want to see more effective drug policies.

Firstly, what we have been doing clearly hasn't worked. It's consumed a lot of money, and it's been an expensive way of making bad problems worse.

Secondly, it's becoming clearer and clearer that there are better ways of managing this difficult problem than the way we're doing at the moment, relying heavily on law enforcement. And Portugal's an example of that. So too is Switzerland, many other countries now around the world are switching to more effective ways of managing this problem.

But, a third argument I think we have to pay more and more attention to, and that is that it's basically also these laws are unfair. They expect that the majority of us who generally like alcohol, caffeine, tobacco maybe, that we will punish people who have a minority preference for drugs: heroin, cocaine, cannabis.

And, when you think about it, if they're not harming anybody, and most of them don't harm anybody, they leave everyone alone, if they're not harming anyone, where's the fairness in punishing these people because they like a drug that or I don't like? That's also a very important element in this.

But, look, there are different arguments for different people. There are arguments that appeal to people from the conservative side of politics, there are people who, on the other side of politics, who will listen to different arguments, and there are people in the middle, and this is not really an argument about people who like drugs.

These arguments that you and I are discussing now are supported by people who like drugs, they're also supported by people who hate drugs, and they're also supported by people who don't give a damn about drugs. They're just right because they're right. What we're doing doesn't work. Let's do something that's more effective.

DEAN BECKER: Profound words. Thank you. Again, we've been speaking with Doctor Alex Wodak, he's president of the Australian Drug Law Reform Foundation.

ALEX WODAK, MD: Well, I think, in the United States, the Drug Policy Alliance is the organization I've worked with, mainly, and they've got an excellent website. The fact that we've got this richness of material is helping us, and it's very readily accessible, it's helping us to win this debate. It's a very difficult debate, let's get on with it.

DEAN BECKER: All right, once again, that was Australian Doctor Alex Wodak. And again I remind you, because of prohibition you don't know what's in that bag. Please, be careful.

Drug Truth Network transcripts are stored at the James A. Baker III Institute, more than 7,000 radio programs are at DrugTruth.net, and we are all still tap dancing on the edge of an abyss.