Transcript by Diana Hajer

Guests: Donald MacPherson, City of Vancouver Drug Policy Coordinator

(Audio Track) Intro – My name is Dean Becker; I don’t condone or encourage the use of any drugs, legal or illegal. I report the unvarnished truth about the pharmaceutical, banking, prison, and judicial nightmare that feeds on eternal drug war.

Dean: Good evening and welcome to this Cultural Baggage. Our guests for tonight will be Donald MacPherson, the coordinator of the drug policy for the city of Vancouver, British Columbia, Canada; and we’ll have him on here in just a few minutes, but first up I want to go ahead and bring you the reports from three of the Drug Truth Network staff. Poppygate, bizarre news about the U.S. policy on controlling heroin, featuring Glenn Greenway:

Greenway: U.S.-occupied Afghanistan now produces 87% of the world's opium. Afghanistan's opium production was 4200 tons in 2004, an amazing 2,170% increase since the U.S. invasion. This week in Eastern Afghanistan, a special anti-narcotics task force seized 15 tons of opium. However, no arrests were made.

The United Nations has alerted health officials globally that the Afghan opium boom is likely to result in increasing numbers of overdose deaths throughout the world. New Jersey, where heroin seizures have increased 6-fold in recent years, now has the purest heroin in the U.S. with twice the national average purity, the DEA announced Thursday.

Also on Thursday, a young addict in recovery told a reporter for Channel 8 TV in Grand Rapids, Michigan that "Heroin is here. Its easier than getting pot." He was speaking a day after his 18-year-old friend died from heroin overdose.

This is Glenn Greenway reporting for the Drug Truth Network.

Dean: Our reporter, Winston Francis, dons the hat of Harry J. Anslinger to report the official government “truth.”

Francis: Tonight’s official government truth is read almost verbatim from a publication of White House drugpolicy.org. Whether marijuana can provide relief for people with certain medical conditions including cancer is a subject of intense national debate. It is true that THC, the primary active ingredient in marijuana, can be useful for treating some medical problems. Synthetic THC is the main ingredient in Marinol, a safe and effective FDA-approved alternative to marijuana that has been available by prescription since 1985. However, smoking marijuana is a crude THC delivery system. It is more likely to harm one’s health. Medicines are not approved in this country by popular vote. Before any drug can be released for public use, they must first undergo rigorous clinical trials to demonstrate that they are both safe and effective and then be approved by the Food and Drug Administration. Our investment and confidence in medical science will be seriously undermined if we do not defend the proven process by which we allow medicines to be brought to the market. And that, my friend, is the official “government truth.” (Laughter)

Dean: Did you ever get a bee in your bonnet or a thorn in your side? Here with this week’s investigation into the obvious truths about the drug war is Steve Nolin with Steve’s Peeves:

Nolin: We need to provide some extra training for our men in blue: How to tell a medical marijuana user from a non-medical marijuana user. The first sign that this might be a medical situation would be the presence of a wheelchair or other hospital paraphernalia. This can range from medication bottles for the AIDS virus to actual hospital beds at the residence. Is this a valid medical marijuana patient, or is it some underaged teenager partying it up while his parents are in the Hamptons? There is only one way to tell: Check the ID. If the medical marijuana card has been issued from one of the states that have recognized marijuana as medicine, this is a medical marijuana patient. If you see one of these official medical marijuana cards, then you should allow these people to go about their business. There are also some people that are part of the Federal government’s IND Compassionate Care Program. These are also easily IDed by the government-issued tins of pre-rolled marijuana cigarettes and the proper paperwork allowing them to possess their medicine. We cannot stress enough that medical marijuana users are not drug abusers.

Dean: A report just came out of Canada today saying that Health Canada has issued a qualifying notice for Sativex, the whole-plant marijuana extract, and it seems we are returning to the science of pre-1937. Earlier today, I got a chance to visit with Bruce Mirken of the Marijuana Policy Project. Here’s a one-minute clip I did with him:

Mirken: “What a lot of people forget now, because it was so long ago, is that there were more than 2 dozen marijuana-based medicines legally sold in the U.S. available in pharmacies up until 1937 when the first Federal ban went into effect. This product, of course, is made with much more advanced technology and more advanced knowledge than was in existence in the 20s and 30s. It is essentially the same principle. It is a liquid extract made from the natural plant. Containing not just THC, but the other cannabinoids – CBD, and there are a number of others that have been studied now as well as the various terpenoids and other naturally occurring things – which seem to have something to do with amplifying the benefits. What this shows is that it’s just crazy to arrest patients for using marijuana in one form after it is now acknowledged to have benefit in another form. It just makes no sense. It’s like saying you can drink a cup of coffee, but we will throw you in jail for possession of coffee beans. So one can only hope that this will help bring some sense to U.S. policies as well.

Dean: Okay, welcome to Cultural Baggage. We do have with us on the line our guest for tonight, Mr. Donald MacPherson, the coordinator for the drug policy for Vancouver. Hello, Donald.

MacPherson: Hello, Dean, how are you?

Dean: I’m well, sir. Thank you for joining us. In our discussion last week, I put forward the thought that there is just such a diversity between your city and mine insofar as drug policy. Tell my listeners, what are the “four pillars”? What is the drug policy of Vancouver?

MacPherson: Well, Dean, I’m not an expert on your city at all, but I have certainly been around our city, Vancouver, British Columbia, for several years trying to work towards a sane and comprehensive approach to drug problems in the city. And we’ve developed, largely influenced by European approaches to these situations, what we call the four-pillar strategy – which really says primarily that addiction and problematic drug use is primarily a health issue and really should be responded to with a range of health programs and that enforcement is part of it or policing is part of it because of our drug laws and the fact that there is organized crime involved in selling and producing some of these substances. So the four pillars are treatment, prevention, harm reduction, and enforcement. And we had a large public discussion in Vancouver, mostly in response to quite a desperate situation that was going on in our inner city where we saw the growth of a drug market, an open drug market, an HIV epidemic among injection drug users, a high rate of overdose deaths throughout the 90s that started around ‘92, ‘93, and just climbed and peaked in ‘98 with about 200 people in Vancouver dying of mostly heroin overdoses. So we felt we had to respond and at the city level we thought we had the problem and that the city itself should develop a plan or a strategy. And that’s what we have done even though we don’t have authority. Our Federal provincial governments and regional Health Authority has more – they have the budget and they have the mandate to provide services. We felt that we needed some action, and that cities were very well positioned to come up with a strategy that would actually work at the ground level.

Dean: I think it was September 23, you guys celebrated one year of having your safe injection sites open?

MacPherson: That’s right, that’s right. Part of the strategy, and the strategy really put forward saying you need all these pieces: you need a good comprehensive approach to prevention, and you need treatment services, and you can’t dismiss harm reduction services. They are absolutely essential in any part of a problematic, comprehensive plan. And of course you need to work in cooperation with the police and you need the police to work in cooperation with you. That’s very important, too. So part of one of the areas that we wanted to move forward on was developing a range of low-threshold services for people who were injection drug users at the street level, who were homeless, or close to homeless, and they really needed a place to go that was safe. We needed to get them out of the back alleys where they were injecting using unsanitary condition, sharing needles sometimes. So we really looked to models in Europe where injection sites have been around since ‘86 in Switzerland, so it’s nothing new over there. It’s a fairly sort of run-of-the-mill approach for that population. And we really felt that this would be an important component of a larger strategy.

Dean: You referenced what has gone on in Switzerland, and I realize the time frame is not – one year is not a whole lot to do evaluations, but in those instances where they have given heroin or allowed patients to more freely have access to medical assistance, they have learned that the amount of crime goes down, age of those who become addicted is actually raising instead of lowering as it does in the U.S. Talk about that aspect – how it might change that person’s attitude, their ability to work and or prosper.

MacPherson: Well, it’s a basic, fundamental, compassionate response to someone who has a serious problem. If you are injecting in the back alley, behind a dumpster, you have a serious problem; and so the least we can do is to try and maximum your contact with the health services. And when we looked at European evidence, we found no problems with injection sites. We saw no problems with their heroin prescription programs. All of them showed positive results. So for us it really was, because we had a phenomenon of a fairly concentrated, open drug scene where people were injecting in public – we felt it very important that we try to implement something like this to encourage people to move into a health care setting, to deal with what we are calling a health care issue. And we took a fair bit of time discussing this with the public and with the police, and the police have come – they weren’t the first to jump onboard, but they certainly have worked with us; and I think they feel it is a fairly powerful response at the street level.

Dean: Insofar as the story I was addressing there earlier with Bruce Mirken, the fact that Canada is poised to back the cannabis painkiller Sativex – I realize it is early on here – what might you tell us? What’s the word there?

MacPherson: Well, I checked the Health Canada website today, and I don’t see anything on the Health Canada website; but I did get the notice off the JW Pharmaceutical’s website and it looks like there are some more hoops to go through, but there is – whatever it means to have this sort of note that they have been given, it is certainly a notice of compliance with conditions, it sounds like they are moving forward towards doing this. And again, there is a fair bit of pressure from quarters in Canada to view these – to not get in the way of best practice in the public health realm. So if that’s practiced in the public health realm – to allow these types of medications to be developed for certain conditions, that should be supported. Just as if best practice in preventing HIV/AIDS is comprehensive needle exchange programs, we shouldn’t be getting in the way of that. We should be encouraging those things to happen because they are basically helping improve the health of our citizens.

Dean: That brings up a very important point, and one I would like to dwell on a little further, and that is here in the U.S. in many municipalities and various locales, it is illegal to do these needle exchange programs. What has been the result of that for the city of Vancouver?

MacPherson: The needle exchange programs in Vancouver?

Dean: Yes, sir.

MacPherson: Well, we are sort of moving to try to normalize needle exchange as just one of many health services that people with addictions can get. So that when they go to a community health center, they will be able to get some counseling, some Methadone prescriptions, some home detox support if they do have a home, or some referrals to other kinds of detoxes; they will be able to access needle exchange in their local community health centers. So we are saying if it is a public health issue, if we really believe that addiction is a public health issue, then addiction services should be just part of an array of health services available to people who have those addictions. And people with addictions don’t just have addiction problems, they have a whole range of medical problems, just like all sorts of other people in society. So we are trying to sort of bring addiction services into the new millennium and integrate them into other health services.

Dean: Now, insofar as just marijuana use in general, I understand that Vancouver has a somewhat lax attitude towards the use. How does that play into the Vancouver policy at all? Do you guys have a direct adjunct aspect of the four pillars that applies to the use of recreational marijuana?

MacPherson: That’s actually an area that we are just working on now. Our initial response at the city level was to focus on people who were dying at the street level and there were a significant number of them, so we put a lot of our focus on injection drug use and overdose prevention, HIV prevention, development of low-threshold services for that population. We are very aware that there is a significant issue with cannabis in British Columbia, and in Vancouver, and that any discussion we have around prevention strategies or trying to have open discussions about this are hampered by the fact that it is illegal and there is not much official policy to guide those discussions.

Dean: We are going to take our little midpoint break here.

It’s time to play “Name That Drug By Its Side Effects”: abscesses, amnesia, constipation, diarrhea, dizziness, drowsiness, gall stones, vaginal inflammation, abdominal bleeding, black stools, blood in the urine, congestive heart failure, depression, hair loss, inability to concentrate, inability to sleep, kidney failure, vomiting blood, rapid fluttering heartbeat, and a 50% greater chance of a heart attack. Time’s up. The answer: according to today’s Washington Post, Aleve for headaches. Another FDA-approved product.

It’s amazing, these drugs that are approved – and there is an ongoing series – Celebrex, and Vioxx, and now Aleve; all approved and yet they all cause great harm. And yet marijuana has yet to kill anybody.

MacPherson: Right. Well you could argue other drugs, too. I would think, personally, I would move much more towards a regulated market in all substances. The only way to go. Not that that would solve all our problems, but I think it would assist and help us to get a handle on some of the negative effects of some of these drugs, because there are some serious drugs out there with negative effects and we need to know how to handle them.

Dean: Indeed. Yes, sir, I wanted to ask you – I’m looking at something, a quote I picked up here. An average of almost 600 injection drug users, nearly 3 times the expected number use the site at Hastings and Main each day. Tell us the number of people who make use of your services.

MacPherson: Well, when the Health Authority and community organization, the Downtown East Side, opened the injection site, we were all sort of wondering whether people would use it. After all, it is quite a shift from moving from back-alley injecting into a bright, shiny health facility that is brand new and purpose-built and has people watching and supervising. And the local drug user’s organization, VANDU, Vancouver Area Network of Drug Users, did a lot of work up front with people in the back alleys, sort of telling them and educating people as to what this was and letting them know they weren’t going to be monitored by the police when they went in and that it was a good thing and it was trying to save lives. And with VANDU behind it, that really helped draw people in. At the center, the people trusted the staff and they trusted the sort of authorities that were there – nurses, etc. So we had very quick uptake and the numbers are even higher now. The first annual report in September said about 600 people a day. That’s probably an average. We’ve seen up to 800 injections a day in there. So, it’s unfortunately wildly successful in terms of people using it. And a certain number of those people every day we refer to other services.

Dean: I also read on here, it says you provide them with clean needles, health services – there are medical personnel on staff as well?

MacPherson: That’s right. There are people – when they come in, they have the opportunity to talk to a range of people if they so choose. And there are other services very close by in the neighborhood, if they want to talk to a housing applicant or get on the Methadone program, or try to get into the detox center. So there is a lot of opportunity for contact, and that’s one of the main purposes of the injection site is to maximize and contact and build relationships with people who are in other ways quite marginalized from the helping systems available.

Dean: Okay, now I see another note here that says that y’all have intervened in 107 overdoses and there have been no deaths.

MacPherson: That’s right. As far as I know, there have been no deaths in any injection site on the planet. There are about – oh, I can’t remember how many – 55 of them around Europe, and there is one in Sidney, Australia. It’s fairly hard to die of an overdose if you have people there to help you. Certainly, heroin overdoses do not have to be fatal overdoses. There are many overdose incidents that occur in this city, and they don’t have to be fatal at all if people know what to do and do the right thing; and at an injection site, you have all the conditions to save people’s lives should they have an overdose on some drug.

Dean: You indicated that this was more a scenario developed by the city of Vancouver, not necessarily under your Federal guidelines or whatever. What has been the response of the national authorities?

MacPherson: The Federal government, Health Canada, has been very supportive. They received the application from our local Health Authority to support this type of intervention and actually give our Health Authority an exemption from our Controlled Drugs and Substances Act for the purposes of this research project, which is a 3-year project. So Health Canada is very involved, and they are monitoring it. They have been very helpful. They are funding a big piece of the evaluation that we are doing of it. We hope that we will see these injection sites just become part of the normal array of services for injection drug users across the country.

Dean: Well, the positive results would tend to indicate that will come to pass. If you stop the ODs you are enabling communications between the medical staff and the users. Has it had any impact on crime within the vicinity?

MacPherson: Well, it has indirectly. There’s been a couple of impacts. Certainly, the police working in conjunction with the injection site have found it – instead of just simply harassing injection drug users who are using in public, they now actually have a place to take them or encourage them to go to. So, it’s led to much less injecting going in the public realm. The police cooperated with the injection site by implementing an enforcement program where they put some officers on the street around the injection site, which we thought might discourage people from coming, but it doesn’t seem to have. So it is a fine balancing act. In terms of crime, that’s a more difficult one because the drugs are still illegal. People still have to get their drugs. I think the heroin – clinical heroin trials that are coming up in January – might show that amongst the participants there is less activity in the criminal market, both the drug market and any other related market. Those have been the results from Europe – that have clearly shown that as people are prescribed heroin, their involvement with the criminal market is less.

Dean: Is there a website where folks might be able to learn more about the four pillars and about what’s going on in Vancouver; something you might recommend?

MacPherson: Yeah, you can check the City of Vancouver website, which is at www.city.vancouver.bc.ca.

Dean: Let’s read that again.

MacPherson: www.city.vancouver.bc.ca/4pillars - or Vancouver Coastal Health has a website that has some information about the injection site on it. I don’t have that; but if you Google “Vancouver Coastal Health Authority,” that will take you to their site.

Dean: Well I find it interesting that after a year, the sky didn’t fall. There are no overdoses going on. There is change afoot, and it seems to be a very positive thing.

MacPherson: I think the key phrase is “there is change afoot.” We are by no means out of the woods. It is still a difficult area. We’ll probably have 40-50 overdoses this year, which is down from 200 in previous years. That’s still way too many. We probably need several injection sites and more treatment capacity, etc., etc. But the key thing is we started a program, and we have to keep soldiering on to implement the full range of it.

Dean: As you indicated a moment ago, the police have not protested once this has begun to unfold. They are not seeing additional problems. They are not protesting. Is that right?

MacPherson: No they are not protesting at all. As a matter of fact, the police on the ground will say that it’s working the way it’s supposed to work. It is targeting the people that it is meant to target. There’s a lot of local people using it. It has made the police’s job much easier because they now have a place to tell people to go if they are injecting in someone’s storefront. Before, it was “you can’t inject there.” “Well, where can I inject?” “Well, you can’t inject anywhere, basically.” So now, there is an actual pragmatic sort of solution to their problem. So at the policing level, I think it’s been a profound intervention that has made a lot of sense to them. Ideologically, some of them still have a problem with it, but that’s always going to be the case.

Dean: I do want to thank you for joining us, Mr. Macpherson. I want to first off just thank you for being willing to talk about this. I tried to talk to the local Harris County Public Health Services to see if they would join us and, like all government agents and politicians, they were unwilling to visit us. But it is important to talk about this, is it not?

MacPherson: The only way we got to where we are today is because of public discussion. And we had a couple of mayors, our current mayor and our previous mayor – Philip Owen, and our current mayor Larry Campbell, who are willing to have that public discussion and get out there and talk to people and say let’s not fool around anymore with wishful thinking. These people aren’t going away. Besides, these people are part of our community. So we need to take care of them, and we need to implement these services. And so you have to get out and muck around in the public realm to move the discussion forward, and it sounds like that’s what you are trying to do.

Dean: And I thank you for joining us. Mr. Donald MacPherson.

MacPherson: Thank you, Dean.

Dean: All right. Next week, some program notes – our guests from NORML, the National Organization for the Reform of Marijuana Laws. We’ll have the outgoing director, Mr. Keith Stroup, the incoming director, Mr. Allen St. Pierre. We’ll also have David Robics in the studio to play us a couple of songs on his fine guitar. It’s nearly Christmas, and I know you, my dear listeners, have been wondering just what to send me this year. Well, I say, “forget it.” All I want from you is a couple of hours of your time, time to draft a quick letter to your congressman, your local paper, and maybe your mayor or police chief. Send the letter, then call them and relay what you perceive of this overall drug war; or maybe focus on the truly insane policy of arresting medical marijuana patients. 75% of those people behind bars are there because of drugs, and 75% of us here on the outside, including the police chiefs of this nation, are for changing our drug policy. So please give yourself the courage to become part of the solution.

I want to thank the staff that helps the Drug Truth Network drive: Steve Nolin, Glenn Greenway, Winston Francis, Philip Guffy, Pam, Dwayne, Cheryl, John, Tammy, and Tammy, and our transcribers, Diana and Lance, and a warm embrace and a mistletoe kiss to all of our affiliates. I wish you a safe and happy holiday. We have to take care of one another. These politicians in power refuse to look at the truth. They are going with 75- and 100-year-old data, superstition, and ignorance. But really, it’s covering up the greed which makes this drug war move forward. You guys own this subject. You are in control. There is no one in government willing to stand and defend this policy of drug war. They absolutely refuse to come on this program. And during this season, friends visit from far- away lands and bring strange and wonderful goodies; and now, even more so, I must remind you, because of drug prohibition, you don’t know what is in that bag. Please, be careful.

For the Drug Truth Network, and our affiliates in the U.S. and Canada, this is Dean Becker for Cultural Baggage, the unvarnished truth. This show is produced at the Pacifica Studios of KPFT, Houston. Tap dancing on the edge of an abyss.

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