Dean Becker (00:29) Well it gives me a great deal of satisfaction and pride actually, to be speaking with mr. [inaudible] tenacity. I believe I got that name right. He's the executive secretary with the global commission on drugs. And I want to welcome him to the show. Hello, Kaleel. Dr. Khalid Tenasti (01:06) Thank you, Dean. I'm very happy to be here with you. Dean Becker (01:08) Well, I, um, I've been following you guys, uh, for, well, I guess the 10 years or so that the global commission has been, uh, uh, in place. And if you will tell us a bit about the global commission on drug policy, what is it about? Dr. Khalid Tenasti: (01:23) Thank you very much, Dean. Actually, you're very right. The global commission has come out with its first report and has come out to the world in June, 2011 with its report called the war on drugs. And also the documentary movie that was going with a break into taboo. But if we really look into the origins of the global commission, they go back to 2000 to the end of 2007, when president Fernando Henrica DOSO of Brazil with presidents, former presidents is a DEO from Mexico and says that guy Vidya from Columbia came together to create the Latin American commission on drugs and democracy because of the risks that the response given to drugs has been putting on the institutions on democratization and empower in criminal organizations and in violence in cities and Latin and central America. And so these, these former presidents came together with a group of other intellectuals and offer former office holders and writers from Latin America to look into what are the issues and what recommendations they can come up with. Dr. Khalid Tenasti: (02:23) And that's when they looked out into Europe. And so that Europe, by implementing harm reduction responses, decriminalization models for personal use and possession have been more successful in, in managing basically the presence and the consumption of drugs among society, although it was banned to some basically. And so this is how the global commission came together. And it was the meeting between the Latin Americans who have really were behind, you know, given that leadership to this discussion and the Europeans who came in as well and joined them as well. Other people with also mr. Kofi Annan from Africa, et cetera, the global commission has came up with this first analysis report in 2011 of course was not the first to say we have a problem with drugs. And that problem is also related to the policies to the control policies we put in place, but it was the first time that such high level people that were themselves for many in office back at the United nations general assembly special session in 1998, who had said that by 2008 will have the world free of drugs. Dr. Khalid Tenasti: (03:25) So many of them were signatories and were in that meeting as representative of their countries as heads of States. And they have come up together for some of them who had been very good policies. And for some others who had really believed in prohibition to be able to help people came together to say, we have something that is wrong with the way we do it, because we, first of all, not achieving any of the results, consumption, trafficking, violence, um, production, you know, um, lack of rule of law corruption, uh, all sorts of, you know, infectious diseases, et cetera, are going up and really high up while we spend more and more on enforcement, et cetera. So there is a problem with maybe the use of drugs and that is something to be discussed in another area, but there is also a huge, huge consequences that add up in the way we do control policies. Dr. Khalid Tenasti: (04:15) And so just very to finish up on the global commission because we're very fortunate. It has been renewed for the last nine years. We had many, many new people joining from former president Ramos Horta from two more or less day. We had mr. Bereday from the, uh, uh, atomic agency that, uh, the former director that has joined us from Egypt. We had mrs. Helen Clark from New Zealand. So it really took this big global, um, trend. And so it is people coming up from every part of the world and come into the same conclusion that the war on drugs and the way we try to control drugs through the refreshing alone and a law enforcement focus is adding up a lot of harms. So this is in a nutshell, I mean, I can go way beyond on this and what we do. It's that true? Dean Becker (04:59) No, that touched a lot of the bases. I probably would have inquired about a good summation if you will. And I thank you for that now. I don't know if you had a chance to look at my website, the conscientious objector page. Did you have a chance to look at it? Well, your response to what I put forward there, just in general. Dr. Khalid Tenasti: (05:20) Yeah. I mean, well, in general, I mean, you have, I mean, when, when it is something, I mean, it is very difficult to object to the way you have looked into the issues and saying, what are the impacts of the way we look into or the way we try to control drugs or the way we control to make them disappear from society? I mean, we all agree of course, that there is a demand and there's a demand for psychosis, psychoactive substances through all over the world, the legal ones and the illegal ones. I mean, the whole system of saying what is legal and illegal is based on the potential of addictiveness of a, of a substance. Why do we live alcohol and tobacco outside of that and not have the same levels of control? So it is for sure to say that people look for psychoactive substances and there is a demand. Dr. Khalid Tenasti: (06:02) So the supply will always follow because it's also a sustained demand. And the fact of trying to, to hide that reality and trying to break that reality and, and trying to live in a parallel world does create many, many issues. First of all, I mean, everyone, even the United nations recognized that recognizes this since 2008. And as you said, it, one of the, what we call the unintended consequences of the regime of control, which are, I mean, they've been recognized since 2008 and they still considered unintended. So the first of them is, is the black market itself and the illegal market. And the fact that the policy choice was to leave it in the hands of criminals and not have authorities or regulators taken that market and regulated it's regulated, it's access, limiting it depending on the substance, et cetera, et cetera. So all the impact to speak about what is going on in Latin America, what is going on in terms of funding of different groups, of different criminal groups. Those also sometimes engaged in Tara, although the evidence there is less clear, it's also more about opportunistic relationships in certain areas of the world, et cetera. So that is a clear vision of the real impacts actually in the big, big impacts of what is going on in the world. So thank you. Thank you Dean Becker (07:17) Before that. Uh, and yeah, I, I've devoted 20 years of my life of 60 hours a week. Really. I I've, uh, I've uh, uh, we reached the age of 50 and decided I wanted to leave something more positive behind for future generations. And if I can help move this equation, this situation to one of less harm to do one of two quit empowering the cartels, at least, uh, I think the terrorists, they grow marijuana and opium over there in Afghanistan, Lebanon, and I'm sure ISIS and the Taliban get a cut now. And then if, if not, uh, uh, billions outright. But, um, we have in these United States, we have led the way we were the ones who insisted the United nations take up this banner to March with this war on drugs. And for years we, um, four and eight, we had a requirement that they had to join forces with the drug war. It was the United nations, excuse me, it was the U S that that forced this drug war at least to such a degree on the rest of the world. And it is my hope that the United States can begin to undo that process to demand less of other nations and, and to, uh, create a situation where logic and common sense can get back into this rather than paranoia and delusion your response to your colleagues. Dr. Khalid Tenasti: (08:40) Yeah, I mean, it is for certain, I mean, the United States has been the biggest, I mean, we can not limit the contribution. I mean, the, the contribution of the United States to, to the multilateral system and to the world and into spreading democracy, et cetera, is a huge one, but it goes in the war on drugs in the bad side. But I mean, it is a, it is everything. So maybe just to be less hard from the perspective of an international person and not to be less harsh, but just to neons the bit, I mean, the international drug system was built really. I mean, it is the conventions of drug policy are the very, almost the only ones that speak about an evil and evil of addiction. And so it was really built up in the sixties around when, when, when social hygiene, ism is a movement among doctors and politicians, teaching people how to, how to do not to catch infectious diseases, not to get to BRCA locis, to be cleaner, et cetera, not to get, you know, the basic, uh, infectious disease. Dr. Khalid Tenasti: (09:38) So it was still the belief that you could through policies really change human behavior. And the problem with that system is that it continued like this, but it worked in a world that is very different. It never take into account the end of the eighties. It never take into account. The fact that border control has changed with world globalization and that we no longer speak about, you know, the same controls of the borders that are closed, et cetera, with the quantities of the goods of the people that are going around. I mean, we see it today with the Kobe, then the spread and the very rapid spread because people are moving, et cetera, et cetera. And when you lock down is different. So there is no more way to control as we used to do before, or what was intended in the sixties. There's also the fact that the HIV response for instance, has changed how we do public health approaches. Dr. Khalid Tenasti: (10:22) You can no longer impose on a person. I mean, if we think about people that are dependent on any or another substance, you can no longer really impose on them a treatment or for them to adhere to a treatment, they have to choose it. And that was the case that was HIV brought about condoms are choice, and the patient becomes a partner and not someone you would tell to what to do. And it can actually, we continue it in the system because it fed so many different things and we've never had to change it now today. I mean, so I see that system as having been, you know, staying the same may be in the sixties. It was well-intended and it was to respond to a situation that was like that, but there is no renewable, there's no modernization of the tools when normally public policy has to evolve, of course, with scientific progress on human progress to adapt to the needs today. Dr. Khalid Tenasti: (11:11) So it is the, in that sense where the reforms are very much needed because we know much better how to control them to eliminate doesn't expand or to regulate them to eliminate. And obviously what makes it very hard in which we're trying not to speak about it, to stay in a rational discussion is that the casualties are people and their lives and currently, so, but we try to remain also as pragmatic in the discussion as possible. Now, when you say about the United States that to change and to change at the global level, that would be fantastic because the problem that is now existing at the multilateral level is that the five countries with a permanent seat in the security council do agree altogether on the prohibition as the way to go. And no one of them is carrying the ideas of the reform or the discussion of the reform that changes a lot because those countries not only have a financial power and do have, you know, a, a very strong political power within the system, but it is also countries that do have real diplomatic network around the world that can work on their priorities. Dr. Khalid Tenasti: (12:12) And that can work on this change little by little. I mean, this is something that will never happen overnight. We do have 50 years of something where everybody agreed where it was given to people as granted that this is evil, that people who use drugs are bad people, et cetera, et cetera, that elimination is the only way to say no to drugs, et cetera. So to undo all of that, to have a, it's almost a cultural shift that is needed to some extent, so it will take the time. And hopefully of course, when the reforms at the national level in the United States will evolve, we see it in different States trying so many different things to address the situations of the opiod crisis, but also the cannabis prohibition. And also sometimes, I mean, other substances being looked at, et cetera, when that will have also given the evidence on its function and et cetera, that performs we'll have to move up the ladder and hopefully until the international level. Yes. Thank you. Dean Becker (13:07) No, I, a couple of years back, I was able to go to Europe. I, uh, uh, and, and Lisbon Portugal, I was able to sit down with a doctor [inaudible] the, uh, the drugs are. And, uh, he and I had a great discussion. We just had another one last week as well for this production of, uh, seeking the moral high ground. And he has done something that is being emulated that is being copied around the world. That is the decriminalization of drugs, that there are no longer arrest for minor amounts of drugs that maybe you go for treatment. Maybe you go for a good talking to, uh, but, but nobody is arrested. And, and Canada is the police chiefs of Canada are wanting to copy that. Now the, uh, the head of the Canadian police chiefs came out and called for decriminalization of all drugs, uh, to follow suit to what Portugal has done. Dean Becker (13:59) And, uh, another topic that, uh, I, I went to Switzerland, I there met, uh, dr. Kristoff Berkey. He was one of the pioneers who designed their, uh, heroin injection program. They're now approaching 20 million injections of pure heroin. And, uh, they have had zero overdose deaths, which, which I think undoes the logic that we were talking about, what was created 50 years ago, drug users are bad and deserving of punishment. And I guess what I'm saying here is that changes a foot changes is being recognized as being of benefit, uh, and, and to do away with these old hysteria situations. I don't know if there's a question there other than it's a sign of progress is not. Dr. Khalid Tenasti: (14:52) It is, it is. I mean, just think about it. This is, I mean, if you look at the policy area, even the discussion discussions that are becoming now very much mainstream, I mean, I would just give two examples. The first one is that, I mean, really it is about one of the areas of policy areas where the wrongs are being repaired very quickly. I mean, it's very difficult. It's very hard, but if we look at it, I mean, really with disabilities, to some extent it is the issue that has moved so much in the last 10, 15 years. It did being on the number of debates on the fact that we can speak about it. I mean, who could have seen, uh, marijuana legalized in so many who has space for recreational use, et cetera, and growing, and in a country like Canada at the federal level, et cetera. Dr. Khalid Tenasti: (15:31) So that is one that has really, really very much evolved now. Um, I mean, the decriminalization is a way to move because there is absolutely no. Um, how do I say? Yeah, I mean, sorry, let me come back to the second example, because that was what was in my mind, I said two, I mean, the second one, if you compare now the coverage of the opioid crisis in the United States and the coverage of the crack crisis in the 1980s, I mean, the coverage is very different, even in the language and trying to look into what are the issues, et cetera. So it has indeed evolved. People will start understanding that addiction. I mean, we say dependence because we use the terminology of who, but addiction is the word in the United States that is still used, but here in Europe, we don't. So for us, addiction slash dependence is a chronic disease. Dr. Khalid Tenasti: (16:22) That includes, that includes a relapse. So to some extent, that's why the global commission on drug policy does not agree with the drug courts that sends people into rehabilitation treatment, because that does not take into account that people do relapse and they would go to prison. Otherwise, if they do relapse instead. And also the fact that, of course, no judge should be taken a decision of a doctor to some extent. So I wanted, yeah, I mean, to say these two example, they do really evolve. And in Switzerland, the program of diamorphine that you were speaking about is a program that is extremely controlled. It is a health approach. It is, but the idea there was to say, we have, I mean, the, the, the very pragmatic discussion was, first of all, let's put in place all the services and to save people and let's evaluate them and see if they work or not. Dr. Khalid Tenasti: (17:11) And of course, as you've said, there is a very strict monitoring and evaluation. That program is very difficult even to access because people have to have really a need of diamorphine and not be able to have the fin or methadone or other substitution treatments, then that's how they get there. But of course, now we have evaluation. You've spoken about Portugal, but there are so many different countries that have different models of, of decriminalization. Those commissions of this wage in the, in Portugal are a very, very interesting model because people still have to face somehow, you know, to talk to someone, to talk to many people and say, you know, and so they are conscious that this is not something that is easy. For example, in the Czech Republic is different. It's only a misdemeanor and you just get a fine, so there are many different models, but of course they have been proven. And I mean, there's evidence and there's evaluation. Dean Becker (17:58) Now. Um, the other news coming out of Canada, uh, a dr. Perry, Kendall, uh, he has 20 years experience as the British Columbia commissioner on substance abuse, something some titled to that effect, and he's now retiring, but he wants to start up a company to acquire heroin cheaply and to provide it cheaply to the users in Canada, uh, to kind of parallel, I guess what they've done in Switzerland. It's another sign of intelligence from my perspective, because in the U S I don't know, I think it was just over 70,000 people died last year from drug overdoses, because I closed my radio show with this side because of prohibition. You don't know what's in that bag, please be careful. And there's just so much truth. And I think heart in that phrase, your response here, Kaleo. Dr. Khalid Tenasti: (18:51) Yeah. I mean, for us, I mean, those are two really. I mean, just to be again, Dean, I think that you are, of course this is, I mean, I haven't heard specifically about this idea of opening. I mean, they do have a heroin program that is not really a diamorphine programs. One Canada is not working very well, but nevertheless, I mean, those are two issues. So as far as the global commission is really concerned, I mean, diamorphine, if we take the example in Switzerland, it is a very medical program. I mean, this is with very much rules, regulations. People have to try at least twice and other substitution treatment. And it's really for people that are heavily dependent on the substance. So just for the people listening to know that this is something that is very medical and it is a medical procedure. So people go to a day clinic, you know, to get the diamorphine et cetera, which was fantastic because you're in COVID since people who inject drugs were considered as people that are vulnerable to COBIT infection. Dr. Khalid Tenasti: (19:35) I mean, there were some very exceptions to deliver to their homes. The diamorphine, it was a great innovation to keep people alive here during the COVID lockdowns. Um, now on when we say, and, and you touched up on something that is so important, which is about the quality of what people buy or even knowing what they buy, if they are buying the right substance or not. But that is for us, this is the difficulty with this ideological difficulty against a harm reduction, because I mean, drug testing, et cetera, do exist. And those need to be allowed to be implemented at all levels at city level, at state level, at the federal level. Now there is also the issues of, um, I mean, a city like Amsterdam, or even here in Geneva, for example, where people who inject drugs and are dependent on drugs that go to services like safe injection facilities that go into, you know, different services, those people, they, if there is a problem, they can be caught very quickly and they could report what substance, what they bought it. Dr. Khalid Tenasti: (20:31) And so the analysis goes very quickly and the services of the city, even in Amsterdam, they even put like ads in the street saying something is going on in the black market, do not buy this substance. And even here in Switzerland, for example, in Geneva and the communities, because they see what is going on at the safe injection room when they see people arriving. Because, but this is because people are not afraid to come forward because the cops are not going to be called because they're considered patients because they're given the services of harm reduction services, which allow people then to be sent to the doctors. If they have problems to see also the factors or to go into treatment, you know, people send them, so they do testing also for infectious diseases, et cetera, to send them afterwards to the hospital, to have it a regular treatment regimen. Dr. Khalid Tenasti: (21:13) I mean, not for drugs, but if there's any other issue or if they want to enter into a cycle of treatment, because here we also have, the fact of everything is offered to people have to choose. They could choose the substitution treatment as maintenance for forever. If they can not get out of it, they could use it for a certain period. They can go to rehabilitation and abstinence. I mean, it really is about a therapeutic contract between the doctor and the patient. So it is not about imposing to people what they have to do, it's to help them choose how they get out of their difficult situation. And here again, we're talking only about people with heavy dependence that go to the services, et cetera. We're not talking about the vast majority, which is a recreational, which has no issues. And we don't see. So yeah, I mean, this is the fact of, that's why decriminalization is very interesting so that people can come forward so that the authorities have the information of what is going on in the market. Dr. Khalid Tenasti: (21:55) And for example, some cities can just be in the United States saying like, we have, we have so many fentanyl on the streets, be careful of not buying this, et cetera, et cetera. And those are messages of prevention of course, and keeping people alive. Yeah. But that, that's very hard to do in a repressive environment where people are afraid of law enforcement everywhere in the world, you know, and I will, I think it's more, more powerful. The, the stigma here in the United States that, uh, I mean, you probably heard the phrase, you, if you're getting busted for drugs, you can no longer get a job, credited housing, an education. Uh, there are so many roadblocks put in your way. So many court fees and fines and other obstacles to creating a new life, a new process. And I guess what I'm saying here is that what you guys are doing in Europe and elsewhere, it shows intelligence. Dr. Khalid Tenasti: (22:51) It shows that this is still a human being. It's still a life worthy of respect. And second chances, third chances, more chances. And, and here in the U S as well, once you get that stigma of a druggie, your life is facing a lot of obstacles. Well, I, there's also, I mean, that is, I totally agree with you. And there is no way, no way, no way to minimize the impacts of stigma and discrimination on people's lives. And most certainly on people that are in the most difficult situation to start with. Right. But I mean, and that stigma is more related. It's not only about drugs. I mean, let's be honest. It's about a lot of things. Drugs are cross-cutting issue. They touch upon so many wrong things in our societies. It also falls. I mean, even the implementation of drug laws is so arbitrary people that can afford to do it behind high walls that no one sees they do. Dr. Khalid Tenasti: (23:43) And they don't, they're not impacted to get arrested, et cetera. They get people to deliver to their homes, et cetera, whatever they need. So it is also that nature of arbitrary that makes it very difficult. And it goes also again to all the populations, but I mean, people are starting to get aggressive with death and we are getting out of marijuana because, um, I don't know if this is positive or negative, but I saw the, um, uh, author of the wire, you know, the TV show. And he was speaking about Colorado in their experiment of the marijuana legalization. He was saying that he was worried because in an interview and he was saying, he was worried to some extent, because we are getting out the people that have the political voice, the college white college students, we're getting them out of this, of the prohibition, if we legalize cannabis, because in my want, because that's their substance and what is going to be the issue with other people that use other drugs and do not have that same voice that do not have that same social status and class, and that do not have that same presence in the public debate. Dr. Khalid Tenasti: (24:35) So it is so drugs are used a lot as a bond for a lot of things as well, but those are also issues that are related to the socioeconomic, to the ethnic et cetera issues. And that is not only in the United States, that is the case in the United Kingdom. That is the case in France. That is the case in the Russian Federation, where more people that are arrested do not have Slavic names. They have other names. This is the case everywhere. You know, I mean, you can look at it in every perspective and countries of the South countries of the North, the rich countries, et cetera, when you have something that is, that has been so stigmatized and built being built. That's why I said the convention speak about addiction as evil. So this is the state of spirit that we have since the very beginning into this discussion at the time, also to remember that, of course, as I said, maybe the intentions were good, maybe not, but to some extent at the time Europe was in reconstruction, um, the many countries in the South we're getting there, we're getting there decolonized. Dr. Khalid Tenasti: (25:29) This is where to thinking about the sixties. I mean, most of Africa has been getting its independence in 1960, et cetera. And of course the United States was becoming the cultural hedge amount around the world, et cetera. And so that was what, the kind of spirit that went everywhere that went everywhere, which is really funny because at the same time, alcohol and tobacco were glorified and were sold and pushed through marketing, et cetera. So, and this is the spirit that was still fine today, almost everywhere. It is the case in the United States versus very sad because the United States, of course, I mean, people have more access to education, to information more easily, et cetera. And they should get a little bit more informed on the issues to understand also, I mean, I mean, problematic drug use is not far away from anyone's life. Anyone can fall into different circumstances, you know? Dr. Khalid Tenasti: (26:15) And so people have to look at it into a perspective from a societal societal perspective. What kind of societies do we want is these injustices that are not very far from anyone and the opiod crisis shows it. I mean, people from all social classes die, people suffer from everywhere, et cetera. So it is about getting informed about what kind of societies will want together. This is why the global commission has always called since the very beginning for, um, net for local national stay, you know, consultations people around the table, talking get in parents of children, getting the police, getting school teachers, getting people who use drugs, get in, uh, health workers, social workers, uh, prosecutors, everyone around the table so that everyone can hear the concerns of everyone. I mean, this is a one society. People have to sit together and find the issue. And this is what happened in Switzerland actually to prepare the national policy of the four pillars, which is a prevention treatment harm reduction repression. Dr. Khalid Tenasti: (27:11) So this is how drug policy is handled here is the four pillars. And so that was based on many, many, many federal kind of tonal because it's also here, a federal country, fentanyl and local, uh, consultations and discussions where people would come in and say their issues about Lake, you know, the neighborhoods with, with the syringes in the street, uh, people being afraid because the syringes are near the parks where the children play the perspective of the police, the perspective of the prosecutors. And, you know, so everyone has to come together to find a consensus, to some extent and advance the issues little by little. But I mean, again, just to say, it's been 50 years of, you know, making the same nod and it's so big now that it has to be done a little by little by little by little, because whenever you try to do something so quick, the unintended consequences become very big because drug policy is so cross cut into so many other issues to health, to housing, to employment, you know, it is with a person. So it touches upon everything. Dean Becker (28:11) What you bring forward there. I want to kind of delve into, and that is the cantons I guess, are the sub governmental agencies and whatever, but we haven't United States. We have the 50 States, we've got cities counties. And then, then we have, uh, governors versus state congresses, et cetera, people battling on this issue. But what, what, uh, where the changes are being made are on the local level cities deciding they're not going to enforce a law as vigorously or in the same way as they did before my city of Houston being a prime example, um, you can have up to four ounces of marijuana now and not be arrested. You get a ticket and you got to take a class and that's in essence, contrary to state law, or I dunno, skirts the state law in some fashion. And I guess what I want to bring forward is that at the national level, the federal level, we have just a handful of people. Dean Becker (29:15) The, the U S attorney general, the head of the DEA, the head of the office of national drug control policy, a few others who have this quote authority whose pronouncements ensure that these drug laws continue forever because they, they quote have the moral authority. They know what in the heck they're doing. And I would love the opportunity to have five minutes to show. They don't have a clue what they're doing because they, they, they don't care how many people die. How, how many kids have access, how many gangs and terrorists are funded. They just do not care about that. They have a mandate that's as you say, that started out 50 years ago as being, you know, sanctified and pure, but it has been shown to be nothing but madness from my perspective, you know, your responsibility. Dr. Khalid Tenasti: (30:05) Well, I mean, the impacts are the impacts of the prohibition on the war, on drugs and being very repressive can not be concealed. dtnadmin Sat, 11/07/2020 - 07:11 Permalink TRANSCRIPT Dean Becker (00:29) Well it gives me a great deal of satisfaction and pride actually, to be speaking with mr. [inaudible] tenacity. I believe I got that name right. He's the executive secretary with the global commission on drugs. And I want to welcome him to the show. Hello, Kaleel. Dr. Khalid Tenasti (01:06) Thank you, Dean. I'm very happy to be here with you. Dean Becker (01:08) Well, I, um, I've been following you guys, uh, for, well, I guess the 10 years or so that the global commission has been, uh, uh, in place. And if you will tell us a bit about the global commission on drug policy, what is it about? Dr. Khalid Tenasti: (01:23) Thank you very much, Dean. Actually, you're very right. The global commission has come out with its first report and has come out to the world in June, 2011 with its report called the war on drugs. And also the documentary movie that was going with a break into taboo. But if we really look into the origins of the global commission, they go back to 2000 to the end of 2007, when president Fernando Henrica DOSO of Brazil with presidents, former presidents is a DEO from Mexico and says that guy Vidya from Columbia came together to create the Latin American commission on drugs and democracy because of the risks that the response given to drugs has been putting on the institutions on democratization and empower in criminal organizations and in violence in cities and Latin and central America. And so these, these former presidents came together with a group of other intellectuals and offer former office holders and writers from Latin America to look into what are the issues and what recommendations they can come up with. Dr. Khalid Tenasti: (02:23) And that's when they looked out into Europe. And so that Europe, by implementing harm reduction responses, decriminalization models for personal use and possession have been more successful in, in managing basically the presence and the consumption of drugs among society, although it was banned to some basically. And so this is how the global commission came together. And it was the meeting between the Latin Americans who have really were behind, you know, given that leadership to this discussion and the Europeans who came in as well and joined them as well. Other people with also mr. Kofi Annan from Africa, et cetera, the global commission has came up with this first analysis report in 2011 of course was not the first to say we have a problem with drugs. And that problem is also related to the policies to the control policies we put in place, but it was the first time that such high level people that were themselves for many in office back at the United nations general assembly special session in 1998, who had said that by 2008 will have the world free of drugs. Dr. Khalid Tenasti: (03:25) So many of them were signatories and were in that meeting as representative of their countries as heads of States. And they have come up together for some of them who had been very good policies. And for some others who had really believed in prohibition to be able to help people came together to say, we have something that is wrong with the way we do it, because we, first of all, not achieving any of the results, consumption, trafficking, violence, um, production, you know, um, lack of rule of law corruption, uh, all sorts of, you know, infectious diseases, et cetera, are going up and really high up while we spend more and more on enforcement, et cetera. So there is a problem with maybe the use of drugs and that is something to be discussed in another area, but there is also a huge, huge consequences that add up in the way we do control policies. Dr. Khalid Tenasti: (04:15) And so just very to finish up on the global commission because we're very fortunate. It has been renewed for the last nine years. We had many, many new people joining from former president Ramos Horta from two more or less day. We had mr. Bereday from the, uh, uh, atomic agency that, uh, the former director that has joined us from Egypt. We had mrs. Helen Clark from New Zealand. So it really took this big global, um, trend. And so it is people coming up from every part of the world and come into the same conclusion that the war on drugs and the way we try to control drugs through the refreshing alone and a law enforcement focus is adding up a lot of harms. So this is in a nutshell, I mean, I can go way beyond on this and what we do. It's that true? Dean Becker (04:59) No, that touched a lot of the bases. I probably would have inquired about a good summation if you will. And I thank you for that now. I don't know if you had a chance to look at my website, the conscientious objector page. Did you have a chance to look at it? Well, your response to what I put forward there, just in general. Dr. Khalid Tenasti: (05:20) Yeah. I mean, well, in general, I mean, you have, I mean, when, when it is something, I mean, it is very difficult to object to the way you have looked into the issues and saying, what are the impacts of the way we look into or the way we try to control drugs or the way we control to make them disappear from society? I mean, we all agree of course, that there is a demand and there's a demand for psychosis, psychoactive substances through all over the world, the legal ones and the illegal ones. I mean, the whole system of saying what is legal and illegal is based on the potential of addictiveness of a, of a substance. Why do we live alcohol and tobacco outside of that and not have the same levels of control? So it is for sure to say that people look for psychoactive substances and there is a demand. Dr. Khalid Tenasti: (06:02) So the supply will always follow because it's also a sustained demand. And the fact of trying to, to hide that reality and trying to break that reality and, and trying to live in a parallel world does create many, many issues. First of all, I mean, everyone, even the United nations recognized that recognizes this since 2008. And as you said, it, one of the, what we call the unintended consequences of the regime of control, which are, I mean, they've been recognized since 2008 and they still considered unintended. So the first of them is, is the black market itself and the illegal market. And the fact that the policy choice was to leave it in the hands of criminals and not have authorities or regulators taken that market and regulated it's regulated, it's access, limiting it depending on the substance, et cetera, et cetera. So all the impact to speak about what is going on in Latin America, what is going on in terms of funding of different groups, of different criminal groups. Those also sometimes engaged in Tara, although the evidence there is less clear, it's also more about opportunistic relationships in certain areas of the world, et cetera. So that is a clear vision of the real impacts actually in the big, big impacts of what is going on in the world. So thank you. Thank you Dean Becker (07:17) Before that. Uh, and yeah, I, I've devoted 20 years of my life of 60 hours a week. Really. I I've, uh, I've uh, uh, we reached the age of 50 and decided I wanted to leave something more positive behind for future generations. And if I can help move this equation, this situation to one of less harm to do one of two quit empowering the cartels, at least, uh, I think the terrorists, they grow marijuana and opium over there in Afghanistan, Lebanon, and I'm sure ISIS and the Taliban get a cut now. And then if, if not, uh, uh, billions outright. But, um, we have in these United States, we have led the way we were the ones who insisted the United nations take up this banner to March with this war on drugs. And for years we, um, four and eight, we had a requirement that they had to join forces with the drug war. It was the United nations, excuse me, it was the U S that that forced this drug war at least to such a degree on the rest of the world. And it is my hope that the United States can begin to undo that process to demand less of other nations and, and to, uh, create a situation where logic and common sense can get back into this rather than paranoia and delusion your response to your colleagues. Dr. Khalid Tenasti: (08:40) Yeah, I mean, it is for certain, I mean, the United States has been the biggest, I mean, we can not limit the contribution. I mean, the, the contribution of the United States to, to the multilateral system and to the world and into spreading democracy, et cetera, is a huge one, but it goes in the war on drugs in the bad side. But I mean, it is a, it is everything. So maybe just to be less hard from the perspective of an international person and not to be less harsh, but just to neons the bit, I mean, the international drug system was built really. I mean, it is the conventions of drug policy are the very, almost the only ones that speak about an evil and evil of addiction. And so it was really built up in the sixties around when, when, when social hygiene, ism is a movement among doctors and politicians, teaching people how to, how to do not to catch infectious diseases, not to get to BRCA locis, to be cleaner, et cetera, not to get, you know, the basic, uh, infectious disease. Dr. Khalid Tenasti: (09:38) So it was still the belief that you could through policies really change human behavior. And the problem with that system is that it continued like this, but it worked in a world that is very different. It never take into account the end of the eighties. It never take into account. The fact that border control has changed with world globalization and that we no longer speak about, you know, the same controls of the borders that are closed, et cetera, with the quantities of the goods of the people that are going around. I mean, we see it today with the Kobe, then the spread and the very rapid spread because people are moving, et cetera, et cetera. And when you lock down is different. So there is no more way to control as we used to do before, or what was intended in the sixties. There's also the fact that the HIV response for instance, has changed how we do public health approaches. Dr. Khalid Tenasti: (10:22) You can no longer impose on a person. I mean, if we think about people that are dependent on any or another substance, you can no longer really impose on them a treatment or for them to adhere to a treatment, they have to choose it. And that was the case that was HIV brought about condoms are choice, and the patient becomes a partner and not someone you would tell to what to do. And it can actually, we continue it in the system because it fed so many different things and we've never had to change it now today. I mean, so I see that system as having been, you know, staying the same may be in the sixties. It was well-intended and it was to respond to a situation that was like that, but there is no renewable, there's no modernization of the tools when normally public policy has to evolve, of course, with scientific progress on human progress to adapt to the needs today. Dr. Khalid Tenasti: (11:11) So it is the, in that sense where the reforms are very much needed because we know much better how to control them to eliminate doesn't expand or to regulate them to eliminate. And obviously what makes it very hard in which we're trying not to speak about it, to stay in a rational discussion is that the casualties are people and their lives and currently, so, but we try to remain also as pragmatic in the discussion as possible. Now, when you say about the United States that to change and to change at the global level, that would be fantastic because the problem that is now existing at the multilateral level is that the five countries with a permanent seat in the security council do agree altogether on the prohibition as the way to go. And no one of them is carrying the ideas of the reform or the discussion of the reform that changes a lot because those countries not only have a financial power and do have, you know, a, a very strong political power within the system, but it is also countries that do have real diplomatic network around the world that can work on their priorities. Dr. Khalid Tenasti: (12:12) And that can work on this change little by little. I mean, this is something that will never happen overnight. We do have 50 years of something where everybody agreed where it was given to people as granted that this is evil, that people who use drugs are bad people, et cetera, et cetera, that elimination is the only way to say no to drugs, et cetera. So to undo all of that, to have a, it's almost a cultural shift that is needed to some extent, so it will take the time. And hopefully of course, when the reforms at the national level in the United States will evolve, we see it in different States trying so many different things to address the situations of the opiod crisis, but also the cannabis prohibition. And also sometimes, I mean, other substances being looked at, et cetera, when that will have also given the evidence on its function and et cetera, that performs we'll have to move up the ladder and hopefully until the international level. Yes. Thank you. Dean Becker (13:07) No, I, a couple of years back, I was able to go to Europe. I, uh, uh, and, and Lisbon Portugal, I was able to sit down with a doctor [inaudible] the, uh, the drugs are. And, uh, he and I had a great discussion. We just had another one last week as well for this production of, uh, seeking the moral high ground. And he has done something that is being emulated that is being copied around the world. That is the decriminalization of drugs, that there are no longer arrest for minor amounts of drugs that maybe you go for treatment. Maybe you go for a good talking to, uh, but, but nobody is arrested. And, and Canada is the police chiefs of Canada are wanting to copy that. Now the, uh, the head of the Canadian police chiefs came out and called for decriminalization of all drugs, uh, to follow suit to what Portugal has done. Dean Becker (13:59) And, uh, another topic that, uh, I, I went to Switzerland, I there met, uh, dr. Kristoff Berkey. He was one of the pioneers who designed their, uh, heroin injection program. They're now approaching 20 million injections of pure heroin. And, uh, they have had zero overdose deaths, which, which I think undoes the logic that we were talking about, what was created 50 years ago, drug users are bad and deserving of punishment. And I guess what I'm saying here is that changes a foot changes is being recognized as being of benefit, uh, and, and to do away with these old hysteria situations. I don't know if there's a question there other than it's a sign of progress is not. Dr. Khalid Tenasti: (14:52) It is, it is. I mean, just think about it. This is, I mean, if you look at the policy area, even the discussion discussions that are becoming now very much mainstream, I mean, I would just give two examples. The first one is that, I mean, really it is about one of the areas of policy areas where the wrongs are being repaired very quickly. I mean, it's very difficult. It's very hard, but if we look at it, I mean, really with disabilities, to some extent it is the issue that has moved so much in the last 10, 15 years. It did being on the number of debates on the fact that we can speak about it. I mean, who could have seen, uh, marijuana legalized in so many who has space for recreational use, et cetera, and growing, and in a country like Canada at the federal level, et cetera. Dr. Khalid Tenasti: (15:31) So that is one that has really, really very much evolved now. Um, I mean, the decriminalization is a way to move because there is absolutely no. Um, how do I say? Yeah, I mean, sorry, let me come back to the second example, because that was what was in my mind, I said two, I mean, the second one, if you compare now the coverage of the opioid crisis in the United States and the coverage of the crack crisis in the 1980s, I mean, the coverage is very different, even in the language and trying to look into what are the issues, et cetera. So it has indeed evolved. People will start understanding that addiction. I mean, we say dependence because we use the terminology of who, but addiction is the word in the United States that is still used, but here in Europe, we don't. So for us, addiction slash dependence is a chronic disease. Dr. Khalid Tenasti: (16:22) That includes, that includes a relapse. So to some extent, that's why the global commission on drug policy does not agree with the drug courts that sends people into rehabilitation treatment, because that does not take into account that people do relapse and they would go to prison. Otherwise, if they do relapse instead. And also the fact that, of course, no judge should be taken a decision of a doctor to some extent. So I wanted, yeah, I mean, to say these two example, they do really evolve. And in Switzerland, the program of diamorphine that you were speaking about is a program that is extremely controlled. It is a health approach. It is, but the idea there was to say, we have, I mean, the, the, the very pragmatic discussion was, first of all, let's put in place all the services and to save people and let's evaluate them and see if they work or not. Dr. Khalid Tenasti: (17:11) And of course, as you've said, there is a very strict monitoring and evaluation. That program is very difficult even to access because people have to have really a need of diamorphine and not be able to have the fin or methadone or other substitution treatments, then that's how they get there. But of course, now we have evaluation. You've spoken about Portugal, but there are so many different countries that have different models of, of decriminalization. Those commissions of this wage in the, in Portugal are a very, very interesting model because people still have to face somehow, you know, to talk to someone, to talk to many people and say, you know, and so they are conscious that this is not something that is easy. For example, in the Czech Republic is different. It's only a misdemeanor and you just get a fine, so there are many different models, but of course they have been proven. And I mean, there's evidence and there's evaluation. Dean Becker (17:58) Now. Um, the other news coming out of Canada, uh, a dr. Perry, Kendall, uh, he has 20 years experience as the British Columbia commissioner on substance abuse, something some titled to that effect, and he's now retiring, but he wants to start up a company to acquire heroin cheaply and to provide it cheaply to the users in Canada, uh, to kind of parallel, I guess what they've done in Switzerland. It's another sign of intelligence from my perspective, because in the U S I don't know, I think it was just over 70,000 people died last year from drug overdoses, because I closed my radio show with this side because of prohibition. You don't know what's in that bag, please be careful. And there's just so much truth. And I think heart in that phrase, your response here, Kaleo. Dr. Khalid Tenasti: (18:51) Yeah. I mean, for us, I mean, those are two really. I mean, just to be again, Dean, I think that you are, of course this is, I mean, I haven't heard specifically about this idea of opening. I mean, they do have a heroin program that is not really a diamorphine programs. One Canada is not working very well, but nevertheless, I mean, those are two issues. So as far as the global commission is really concerned, I mean, diamorphine, if we take the example in Switzerland, it is a very medical program. I mean, this is with very much rules, regulations. People have to try at least twice and other substitution treatment. And it's really for people that are heavily dependent on the substance. So just for the people listening to know that this is something that is very medical and it is a medical procedure. So people go to a day clinic, you know, to get the diamorphine et cetera, which was fantastic because you're in COVID since people who inject drugs were considered as people that are vulnerable to COBIT infection. Dr. Khalid Tenasti: (19:35) I mean, there were some very exceptions to deliver to their homes. The diamorphine, it was a great innovation to keep people alive here during the COVID lockdowns. Um, now on when we say, and, and you touched up on something that is so important, which is about the quality of what people buy or even knowing what they buy, if they are buying the right substance or not. But that is for us, this is the difficulty with this ideological difficulty against a harm reduction, because I mean, drug testing, et cetera, do exist. And those need to be allowed to be implemented at all levels at city level, at state level, at the federal level. Now there is also the issues of, um, I mean, a city like Amsterdam, or even here in Geneva, for example, where people who inject drugs and are dependent on drugs that go to services like safe injection facilities that go into, you know, different services, those people, they, if there is a problem, they can be caught very quickly and they could report what substance, what they bought it. Dr. Khalid Tenasti: (20:31) And so the analysis goes very quickly and the services of the city, even in Amsterdam, they even put like ads in the street saying something is going on in the black market, do not buy this substance. And even here in Switzerland, for example, in Geneva and the communities, because they see what is going on at the safe injection room when they see people arriving. Because, but this is because people are not afraid to come forward because the cops are not going to be called because they're considered patients because they're given the services of harm reduction services, which allow people then to be sent to the doctors. If they have problems to see also the factors or to go into treatment, you know, people send them, so they do testing also for infectious diseases, et cetera, to send them afterwards to the hospital, to have it a regular treatment regimen. Dr. Khalid Tenasti: (21:13) I mean, not for drugs, but if there's any other issue or if they want to enter into a cycle of treatment, because here we also have, the fact of everything is offered to people have to choose. They could choose the substitution treatment as maintenance for forever. If they can not get out of it, they could use it for a certain period. They can go to rehabilitation and abstinence. I mean, it really is about a therapeutic contract between the doctor and the patient. So it is not about imposing to people what they have to do, it's to help them choose how they get out of their difficult situation. And here again, we're talking only about people with heavy dependence that go to the services, et cetera. We're not talking about the vast majority, which is a recreational, which has no issues. And we don't see. So yeah, I mean, this is the fact of, that's why decriminalization is very interesting so that people can come forward so that the authorities have the information of what is going on in the market. Dr. Khalid Tenasti: (21:55) And for example, some cities can just be in the United States saying like, we have, we have so many fentanyl on the streets, be careful of not buying this, et cetera, et cetera. And those are messages of prevention of course, and keeping people alive. Yeah. But that, that's very hard to do in a repressive environment where people are afraid of law enforcement everywhere in the world, you know, and I will, I think it's more, more powerful. The, the stigma here in the United States that, uh, I mean, you probably heard the phrase, you, if you're getting busted for drugs, you can no longer get a job, credited housing, an education. Uh, there are so many roadblocks put in your way. So many court fees and fines and other obstacles to creating a new life, a new process. And I guess what I'm saying here is that what you guys are doing in Europe and elsewhere, it shows intelligence. Dr. Khalid Tenasti: (22:51) It shows that this is still a human being. It's still a life worthy of respect. And second chances, third chances, more chances. And, and here in the U S as well, once you get that stigma of a druggie, your life is facing a lot of obstacles. Well, I, there's also, I mean, that is, I totally agree with you. And there is no way, no way, no way to minimize the impacts of stigma and discrimination on people's lives. And most certainly on people that are in the most difficult situation to start with. Right. But I mean, and that stigma is more related. It's not only about drugs. I mean, let's be honest. It's about a lot of things. Drugs are cross-cutting issue. They touch upon so many wrong things in our societies. It also falls. I mean, even the implementation of drug laws is so arbitrary people that can afford to do it behind high walls that no one sees they do. Dr. Khalid Tenasti: (23:43) And they don't, they're not impacted to get arrested, et cetera. They get people to deliver to their homes, et cetera, whatever they need. So it is also that nature of arbitrary that makes it very difficult. And it goes also again to all the populations, but I mean, people are starting to get aggressive with death and we are getting out of marijuana because, um, I don't know if this is positive or negative, but I saw the, um, uh, author of the wire, you know, the TV show. And he was speaking about Colorado in their experiment of the marijuana legalization. He was saying that he was worried because in an interview and he was saying, he was worried to some extent, because we are getting out the people that have the political voice, the college white college students, we're getting them out of this, of the prohibition, if we legalize cannabis, because in my want, because that's their substance and what is going to be the issue with other people that use other drugs and do not have that same voice that do not have that same social status and class, and that do not have that same presence in the public debate. Dr. Khalid Tenasti: (24:35) So it is so drugs are used a lot as a bond for a lot of things as well, but those are also issues that are related to the socioeconomic, to the ethnic et cetera issues. And that is not only in the United States, that is the case in the United Kingdom. That is the case in France. That is the case in the Russian Federation, where more people that are arrested do not have Slavic names. They have other names. This is the case everywhere. You know, I mean, you can look at it in every perspective and countries of the South countries of the North, the rich countries, et cetera, when you have something that is, that has been so stigmatized and built being built. That's why I said the convention speak about addiction as evil. So this is the state of spirit that we have since the very beginning into this discussion at the time, also to remember that, of course, as I said, maybe the intentions were good, maybe not, but to some extent at the time Europe was in reconstruction, um, the many countries in the South we're getting there, we're getting there decolonized. Dr. Khalid Tenasti: (25:29) This is where to thinking about the sixties. I mean, most of Africa has been getting its independence in 1960, et cetera. And of course the United States was becoming the cultural hedge amount around the world, et cetera. And so that was what, the kind of spirit that went everywhere that went everywhere, which is really funny because at the same time, alcohol and tobacco were glorified and were sold and pushed through marketing, et cetera. So, and this is the spirit that was still fine today, almost everywhere. It is the case in the United States versus very sad because the United States, of course, I mean, people have more access to education, to information more easily, et cetera. And they should get a little bit more informed on the issues to understand also, I mean, I mean, problematic drug use is not far away from anyone's life. Anyone can fall into different circumstances, you know? Dr. Khalid Tenasti: (26:15) And so people have to look at it into a perspective from a societal societal perspective. What kind of societies do we want is these injustices that are not very far from anyone and the opiod crisis shows it. I mean, people from all social classes die, people suffer from everywhere, et cetera. So it is about getting informed about what kind of societies will want together. This is why the global commission has always called since the very beginning for, um, net for local national stay, you know, consultations people around the table, talking get in parents of children, getting the police, getting school teachers, getting people who use drugs, get in, uh, health workers, social workers, uh, prosecutors, everyone around the table so that everyone can hear the concerns of everyone. I mean, this is a one society. People have to sit together and find the issue. And this is what happened in Switzerland actually to prepare the national policy of the four pillars, which is a prevention treatment harm reduction repression. Dr. Khalid Tenasti: (27:11) So this is how drug policy is handled here is the four pillars. And so that was based on many, many, many federal kind of tonal because it's also here, a federal country, fentanyl and local, uh, consultations and discussions where people would come in and say their issues about Lake, you know, the neighborhoods with, with the syringes in the street, uh, people being afraid because the syringes are near the parks where the children play the perspective of the police, the perspective of the prosecutors. And, you know, so everyone has to come together to find a consensus, to some extent and advance the issues little by little. But I mean, again, just to say, it's been 50 years of, you know, making the same nod and it's so big now that it has to be done a little by little by little by little, because whenever you try to do something so quick, the unintended consequences become very big because drug policy is so cross cut into so many other issues to health, to housing, to employment, you know, it is with a person. So it touches upon everything. Dean Becker (28:11) What you bring forward there. I want to kind of delve into, and that is the cantons I guess, are the sub governmental agencies and whatever, but we haven't United States. We have the 50 States, we've got cities counties. And then, then we have, uh, governors versus state congresses, et cetera, people battling on this issue. But what, what, uh, where the changes are being made are on the local level cities deciding they're not going to enforce a law as vigorously or in the same way as they did before my city of Houston being a prime example, um, you can have up to four ounces of marijuana now and not be arrested. You get a ticket and you got to take a class and that's in essence, contrary to state law, or I dunno, skirts the state law in some fashion. And I guess what I want to bring forward is that at the national level, the federal level, we have just a handful of people. Dean Becker (29:15) The, the U S attorney general, the head of the DEA, the head of the office of national drug control policy, a few others who have this quote authority whose pronouncements ensure that these drug laws continue forever because they, they quote have the moral authority. They know what in the heck they're doing. And I would love the opportunity to have five minutes to show. They don't have a clue what they're doing because they, they, they don't care how many people die. How, how many kids have access, how many gangs and terrorists are funded. They just do not care about that. They have a mandate that's as you say, that started out 50 years ago as being, you know, sanctified and pure, but it has been shown to be nothing but madness from my perspective, you know, your responsibility. Dr. Khalid Tenasti: (30:05) Well, I mean, the impacts are the impacts of the prohibition on the war, on drugs and being very repressive can not be concealed.