Opinions of Opium

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OPINIONS OF OPIUM
Washington Post Articles Collection Collected by Me

May 1997

Clinton Decries 'Heroin Chic' Fashion Look
He says, 'You do not need to glamorize addiction to sell clothes'

WASHINGTON (AllPolitics, May 21) -- President Bill Clinton today decried "heroin chic" fashion photography for sending a message that using the once-feared drug is "glamorous" and "sexy." Clinton, speaking about U.S. drug policy to a group of big-city mayors, took note of recent admissions by magazine editors that the "wasted addict" look in some fashion layouts has glamorized heroin use. "In the press in recent days, we've seen reports that many of our fashion leaders are now admitting -- and I honor them for doing this -- they're admitting flat-out that images projected in fashion photos in the last few years have made heroin addiction seem glamorous and sexy and cool," Clinton said. "And as some of those people in those images start to die now, it has become obvious that that is not true," Clinton said. "You do not need to glamorize addiction to sell clothes." The glorification of heroin, Clinton said, "is not creative. It's destructive. It's not beautiful. It is ugly. And this is not about art. It's about life and death. And glorifying death is not good for any society." Clinton said society can't take a tough attitude toward illegal drugs "and on the other hand, send a very different message every time there might be a little money to be made out of it." Clinton said when he was growing up, heroin was feared as the worst drug imaginable. "There were these horrible images associated with it -- strung-out junkies lying on street corners in decidedly unglamorous ways," he said. Now, though, heroin use has gone up while cocaine use has declined, and Clinton said part of the reason are "images that are finding their way to our young people." Clinton's remarks were prompted by a New York Times story on Tuesday about the fatal drug overdose of Davide Sorrenti, 20, a fashion photographer, and the use of models in drugged stupor-like poses in some fashion magazines. -----------ooOOoo-------------

Source: Sunday Times Date: 13 September 1998

How aspirin turned hero
A hundred years ago Heinrich Dreser made a fortune from the discovery of heroin and aspirin - but he may have ended his days as an addict. RICHARD ASKWITH reports on a chemist who prescribed heroin for coughs (A) (M) (H)

CHEMICAL REACTION: Dreser (seated, right) with his staff at Bayer, where he tested aspirin and heroin on himself. As early as 1899, researchers began to report patients developing 'tolerance' to the drug, while a German researcher denounced it as 'an extremely dangerous poison'. By 1902 - when heroin sales were accounting for roughly five percent of Bayer's net profits - French and American researchers were reporting cases of 'heroinism' and addiction. THE MAN in the 100-year-old photograph is not, to the modern eye, prepossessing. Balding, bespectacled and clerkish, he scarcely dominates his own portrait, let alone the picture of him with his staff in his laboratory. Yet Heinrich Dreser, chemist and opportunist, was one of the most influential men of his age. Between 1897 and 1914, Dreser worked for Bayer, the former dye factory that was to become the first of the world's pharmaceutical giants, in Wuppertal, north-west Germany. Friedrich Engels was born there. While Dreser made less of a mark on history, you could argue he had the greater influence on the 20th century. As head of Bayer's pharmacological laboratory, he was responsible for the launch of two drugs that have shaped the way we live: aspirin, the world's most successful legal drug; and heroin, the most successful illegal one. Aspirin, of which the world now consumes 40 billion tablets a year, was launched 100 years ago next February. A fanfare of publicity will mark the centenary. The centenary of heroin is more ambiguous: it was launched in November 1898 but was registered as a trademark in various countries from June that year, most lucratively in the US in August. But whenever the centenary falls, Bayer won't be celebrating. This is understandable; but the stories of aspirin and heroin are intertwined, not least through Dreser.

Born in 1860, in Darmstadt, the son of a physics professor, he showed promise as a chemist from an early age. After receiving his doctorate from Heidelberg University, he worked in various laboratories before becoming a professor at Bonn University in 1893. Four years later he joined the Bayer Company, where he was in charge of testing the efficacy and safety of new drugs. Dreser was admired for his thorough, methodical approach, and for his innovations in testing (he was, for example, the first chemist to use animal experiments on an industrial scale). The credit for originating new products for Bayer belonged, strictly speaking, to the researcher Arthur Eichengruen, but Dreser had the power to decide which new products would be developed. He had also negotiated a special deal which guaranteed him a share of the profits from products he launched. In 1897 the Bayer chemist Felix Hoffmann, acting on Eichengruen's instructions, discovered a new process for modifying salicyclic acid (a remedy for fever and inflammation which unfortunately has excruciating digestive side effects) to produce acetylsalicyclic acid (ASA). This compound, later to be named Aspirin, had been isolated before and the healing powers of salicylates (derived from willow bark) had been known for centuries. But Hoffmann had created a reliable process for making it. Eichengruen enthusiastically recommended ASA to Dreser in 1898. Dreser, after cursory consideration, rejected it. Ostensibly, his objection was that ASA would have an "enfeebling" action on the heart. "The product has no value," he pronounced confidently. But the real problem was almost certainly that he had another product on his mind whose impending success he was anxious not to jeopardise. This was heroin. Like aspirin, the drug that Bayer launched under the trademark Heroin in 1898 was not an original discovery. Diacetylmorphine, a white, odourless, bitter, crystalline powder deriving from morphine, had been invented in 1874 by an English chemist, C R Wright. But Dreser was the first to see its commercial potential. Scientists had been looking for some time for a non-addictive substitute for morphine, then widely used as a painkiller and in the treatment of respiratory diseases. If diacetylmorphine could be shown to be such a product, Bayer - and Dreser - would hit the jackpot. Diacetylmorphine was first synthesised in the Bayer laboratory in 1897 - by Hoffmann, two weeks after he first synthesised ASA. The work seems to have been initiated by Dreser, who was by then aware of Wright's discovery, even though he subsequently implied that heroin was an original Bayer invention. By early 1898 was testing it on sticklebacks, frogs and rabbits. He also tested it on some of Bayer's workers, and on himself. The workers loved it, some saying it made them feel "heroic" (heroisch). This was also the term used by chemists to describe any strong drug (and diacetylmorphine is four times stronger than morphine). Creating a brand name was easy. In November 1898, Dreser presented the drug to the Congress of German Naturalists and Physicians, claiming it was 10 times more effective as a cough medicine than codeine, but had only a tenth of its toxic effects. It was also more effective than morphine as a painkiller. It was safe. It wasn't habit-forming. In short, it was a wonder drug - the Viagra of its day.

"What we don't recognise now," says David Muso, professor of psychiatry and the history of medicine at Yale Medical School, "is that this met what was then a desperate need - not for a painkiller, but for a cough remedy". Tuberculosis and pneumonia were then the leading causes of death, and even routine coughs and colds could be severely incapacitating. Heroin, which both depresses respiration and, as a sedative, gives a restorative night's sleep, seemed a godsend. The initial response to its launch was overwhelmingly positive. Dreser had already written about the drug in medical journals, and studies had endorsed his view that heroin could be effective in treating asthma, bronchitis, phthisis and tuberculosis. Now mailshots and free samples were sent out by the thousand to physicians in Europe and the US. The label on the samples showed a lion and a globe. (There is a notorious brand of Burmese heroin, Double Globe, that uses remarkably similar packaging today.) By 1899, Bayer was producing about a ton of heroin a year, and exporting the drug to 23 countries. The country where it really took off was the US, where there was already a large population of morphine addicts, a craze for patent medicines, and a relatively lax regulatory framework. Manufacturers of cough syrup were soon lacing their products with Bayer heroin. There were heroin pastilles, heroin cough lozenges, heroin tablets, water-soluble heroin salts and a heroin elixir in a glycerine solution. Bayer never advertised heroin to the public but the publicity material it sent to physicians was unambiguous. One flyer described the product thus: "Heroin: the Sedative for Coughs . . . order a supply from your jobber." "It possesses many advantages over morphine," wrote the Boston Medical and Surgical Journal in 1900. "It's not hypnotic, and there's no danger of acquiring a habit." But worrying rumours were surfacing. As early as 1899, researchers began to report patients developing "tolerance" to the drug, while a German researcher denounced it as "an extremely dangerous poison". By 1902 - when heroin sales were accounting for roughly five percent of Bayer's net profits - French and American researchers were reporting cases of "heroinism" and addiction. The bandwagon took time to stop. Between 1899 and 1905, at least 180 clinical works on heroin were published around the world, and most were favourable, if cautious. In 1906, the American Medical Association approved heroin for medical use, though with strong reservations about a "habit" that was "readily formed". But with the accumulation of negative reports and the steady encroachment on the market by other manufacturers, it was clear heroin would never deliver the riches that Dreser had yearned for. Had heroin been his only pet project, this disappointment could have spelt career disaster. Dreser had the kind of personality that needed commercial results to lend it plausibility. With his unfashionably formal clothes and his habit of dragging an overweight dachshund to work with him, he was seen as an eccentric loner, a "difficult" man whose ready sarcasm and autocratic manner meant he did not want for enemies.

Luckily, although his first "baby" was showing signs of turning into a monster, Dreser had belatedly adopted another: aspirin. Eichengruen, refusing to accept Dreser's rejection of ASA, had continued to investigate it and to lobby for its development. Eventually, Dreser recognised which way the wind was blowing, tested ASA on himself (as well as on his laboratory of rabbits), and finally published an enthusiastic scientific paper recommending it, particularly for the treatment of rheumatism - but omitting to mention the contributions of Eichengruen and Hoffmann. In February 1899, the brand name "Aspirin" was registered, and in June, Dreser presided over its launch. Like heroin, aspirin more or less sold itself. As a painkiller without undesirable side effects, it was - and remained for decades - unique. By the end of 1899 it was being used all over Europe and the US, and by the time the heroin bubble burst, aspirin had more than filled the gap. Bayer was on its way to becoming an industrial giant. Hoffman and Eichengruen do not seem to have received any special compensation for their efforts. For Dreser, though, the rewards were spectacular. In 1913, Bayer decided to stop making heroin. There had been an explosion of heroinrelated admissions at New York and Philadelphia hospitals, and in East Coast cities a substantial population of recreational users was reported (some supported their habits by collecting and selling scrap metal, hence the name "junkie"). Prohibition seemed inevitable and, sure enough, the next year the use of heroin without prescription was outlawed in the US. (A court ruling in 1919 also determined it illegal for doctors to prescribe it to addicts.) But Dreser was now earning, on top of his "substantial" salary, more than 100 000 marks a year (about In 1924, health problems forced Dreser to give up his institute and he moved to Zurich, where he remarried. That year, the US banned the use and manufacture of heroin altogether, even for medical purposes. (In Britain, the medical use of heroin continues to this day, accounting for 95 percent of the world's legal heroin consumption.) The same year, four days before Christmas, Dreser died. The cause of death was given as a cerebral apoplexy, or stroke. It is just conceivable - had anyone known it - that he could have averted this fate by the simple expedience of taking an aspirin a day. If the rumours of addiction were true, the irony is doubled: Dreser, incorrigible in his misjudgment, had spent his twilight years taking a daily dose of the wrong wonder drug. Even before its properties as a prophylactic against circulatory disease became known, aspirin changed the lives of millions, reducing the sum of human misery. It also produced untold wealth for, among others, the shareholders of Bayer, which still earns about R4billion a year from the drug. (Those "others" include the generations of lawyers who acted in an 80-year orgy of litigation in which the original Bayer company, having had its American assets confiscated at the end of World War One, fought to reclaim the right to sell "Bayer aspirin" in the US.) The impact of heroin is harder to assess. In 1898, there were an estimated 250 000 morphine addicts in the US - a per capita rate roughly twice as high as today's. In Britain, similarly, opium use was widespread, especially in East Anglia, where it was a more or less necessary antidote to the malaria endemic in the Fens. It was also used as a sedative for babies. (In Britain, however, opium seems to have been superseded not by heroin but by other modern drugs - notably aspirin.)

But the appearance of heroin played a crucial role in cementing the link between drug abuse and crime. Pharmacologically, heroin has the same effect as morphine. But you need only about a quarter as much to get the same effect. It is also cheaper, quicker and easier to use. As national and international legislation against opiates gathered force after 1914, addicts who wished to continue their habit inevitably switched to heroin. By 1924, 98 percent of New York's drug addicts were thought to be heroin addicts. With legal channels of supply closed, criminal gangs - first Jewish, then Italian - began to monopolise the trade. By the end of the 30s, the Mafia was inextricably involved. Today, heroin use in Britain and the US is increasing faster than at any time since the 60s: heroin seizures rose by 135 percent between 1996 and 1997. There are thought to be between 160 000 and 200 000 heroin addicts in the UK, who spend almost R30-billion a year on heroin. And the British government spends R14-billion a year on drug-related policies. The other great change resulting from Dreser's marketing of a faster-acting and more conveniently consumed opiate has been a change in the profile of the average opiate abuser. In 1898, the typical morphine addict in Britain or the US was a middle-class woman in her forties, whereas today's typical addict is an 18-year-old male. Advertisement

Heroin as a cough medicine oo--------------------------*

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Source: Nature Date: 11 May 2000

Dial 'P' for pleasure
A new way to beat morphine addiction could be in prospect thanks to work on genetically engineered mice. HENRY GEE

There is a chemical in the brain with an enigmatic name that seems to be involved in a variety of emotional responses. Modulating the activity of this substance has been suggested as a radical new way of dulling anxiety, relieving depression and beating stress. This mystery molecule is involved in the perception of both pleasure and pain. Now research reported in Nature1 shows that it has a specific part to play in the brain's response to opiates -- substances including drugs of abuse such as morphine and heroin. The name of this chemical -- simply, 'substance P' -- could come straight out of a James Bond movie. Stephen P. Hunt of University College, London, and colleagues have been studying the behaviour of mice specially bred to lack the gene for the receptor for substance P. Without this receptor -- known as the 'Neurokinin-1' or 'NK-1' receptor -- substance P cannot work, and all sorts of interesting things happen. In 1998, the researchers showed that mice without the NK-1 receptor were less responsive than normal mice to pain. This is not to say that the mice felt no pain, but they did not show the usual reflexes or behaviour associated with pain, such as stress. Nor did they show the normal aggressive response to territorial challenge. If these results are translated to humans, it could be that the aura and associations of fear surrounding pain -- rather than pain itself -- involve substance P. So therapeutic intervention in the relationship between substance P and its receptor might be useful in combating emotional problems such as stress or anxiety. One consequence of stress in some people is to fall back on bad but comforting habits, such as eating or drinking -- and taking hard drugs. Substance P is found both in parts of the brain linked to the processing of responses perceived as depression, anxiety and stress, and in a brain region called the nucleus accumbens. This area is associated with the motivational properties of natural rewards (such as food) and drugs of abuse, including opiates. If we need a little help from heroin or just chocolate, we feel it in the nucleus accumbens. In their latest research, Hunt and his collaborators show that mice without the NK-1 receptor are unresponsive to substance P and do not experience the pleasurable effects of morphine. Similarly, they do not experience the physical effects -- 'cold turkey' -- of morphine withdrawal.

Mice without the NK-1 receptor did get a kick from cocaine because cocaine works through a different set of neural pathways from those controlled by substance P. This research looks promising for the treatment of addiction in humans. A drug that dulls the activities of the NK-1 receptor could be used to wean addicts off opiates and keep them off. And if the link between substance P and stress holds up, it could also be used to dampen the craving for drugs when times are hard.

oOOOo

Afghanistan, Opium and the Taliban

JALALABAD, Afghanistan (February 15, 2001 8:19 p.m. EST U.N. drug control officers said the Taliban religious militia has nearly wiped out opium production in Afghanistan -- once the world's largest producer -- since banning poppy cultivation last summer. A 12-member team from the U.N. Drug Control Program spent two weeks searching most of the nation's largest opium-producing areas and found so few poppies that they do not expect any opium to come out of Afghanistan this year. "We are not just guessing. We have seen the proof in the fields," said Bernard Frahi, regional director for the U.N. program in Afghanistan and Pakistan. He laid out photographs of vast tracts of land cultivated with wheat alongside pictures of the same fields taken a year earlier -- a sea of blood-red poppies. A State Department official said Thursday all the information the United States has received so far indicates the poppy crop had decreased, but he did not believe it was eliminated. Last year, Afghanistan produced nearly 4,000 tons of opium, about 75 percent of the world's supply, U.N. officials said. Opium -- the milky substance drained from the poppy plant -- is converted into heroin and sold in Europe and North America. The 1999 output was a world record for opium production, the United Nations said -- more than all other countries combined, including the "Golden Triangle," where the borders of Thailand, Laos and Myanmar meet.

Mullah Mohammed Omar, the Taliban's supreme leader, banned poppy growing before the November planting season and augmented it with a religious edict making it contrary to the tenets of Islam. The Taliban, which has imposed a strict brand of Islam in the 95 percent of Afghanistan it controls, has set fire to heroin laboratories and jailed farmers until they agreed to destroy their poppy crops. The U.N. surveyors, who completed their search this week, crisscrossed Helmand, Kandahar, Urzgan and Nangarhar provinces and parts of two others -- areas responsible for 86 percent of the opium produced in Afghanistan last year, Frahi said in an interview Wednesday. They covered 80 percent of the land in those provinces that last year had been awash in poppies. This year they found poppies growing on barely an acre here and there, Frahi said. The rest -- about 175,000 acres -- was clean. "We have to look at the situation with careful optimism," said Sandro Tucci of the U.N. Office for Drug Control and Crime Prevention in Vienna, Austria. He said indications are that no poppies were planted this season and that, as a result, there hasn't been any production of opium -- but that officials would keep checking. The State Department counternarcotics official said the department would make its own estimate of the poppy crop. Information received so far suggests there will be a decrease, but how much is not yet clear, he said, speaking on condition of anonymity. "We do not think by any stretch of the imagination that poppy cultivation in Afghanistan has been eliminated. But we, like the rest of the world, welcome positive news." The Drug Enforcement Administration declined to comment. No U.S. government official can enter Afghanistan because of security concerns stemming from the presence of suspected terrorist Osama bin Laden. Poppies are harvested in March and April, which is why the survey was done now. Tucci said it would have been impossible for the poppies to have been harvested already. The areas searched by the U.N. surveyors are the most fertile lands under Taliban control. Other areas, though they are somewhat fertile, have not traditionally been poppy growing areas and farmers are struggling to raise any crops at all because of severe drought. The rest of the land held by the Taliban is mountainous or desert, where poppies could not grow. Karim Rahimi, the U.N. drug control liaison in Jalalabad, capital of Nangarhar province, said farmers were growing wheat or onions in fields where they once grew poppies. "It is amazing, really, when you see the fields that last year were filled with poppies and this year there is wheat," he said. The Taliban enforced the ban by threatening to arrest village elders and mullahs who allowed poppies to be grown. Taliban soldiers patrolled in trucks armed with rocket-

propelled grenade launchers. About 1,000 people in Nangarhar who tried to defy the ban were arrested and jailed until they agreed to destroy their crops. Signs throughout Nangarhar warn against drug production and use, some calling it an "illicit phenomenon." Another reads: "Be drug free, be happy." Last year, poppies grew on 12,600 acres of land in Nangarhar province. According to the U.N. survey, poppies were planted on only 17 acres there this season and all were destroyed by the Taliban. "The Taliban have done their work very seriously," Frahi said. But the ban has badly hurt farmers in one of the world's poorest countries, shattered by two decades of war and devastated by drought. Ahmed Rehman, who shares less than three acres in Nangarhar with his three brothers, said the opium he produced last year on part of the land brought him $1,100. This year, he says, he will be lucky to get $300 for the onions and cattle feed he planted on the entire parcel. "Life is very bad for me this year," he said. "Last year I was able to buy meat and wheat and now this year there is nothing." But Rehman said he never considered defying the ban. "The Taliban were patrolling all the time. Of course I was afraid. I did not want to go to jail and lose my freedom and my dignity," he said, gesturing with dirt-caked hands. Shams-ul-Haq Sayed, an officer of the Taliban drug control office in Jalalabad, said farmers need international aid. "This year was the most important for us because growing poppies was part of their culture, and the first years are always the most difficult," he said. Tucci said discussions are under way on how to help the farmers. Western diplomats in Pakistan have suggested the Taliban is simply trying to drive up the price of opium they have stockpiled. The State Department official also said Afghanistan could do more by destroying drug stockpiles and heroin labs and arresting producers and traffickers. Frahi dismissed that as "nonsense" and said it is drug traffickers and shopkeepers who have stockpiles. Two pounds of opium worth $35 last year are now worth as much as $360, he said. Mullah Amir Mohammed Haqqani, the Taliban's top drug official in Nangarhar, said the ban would remain regardless of whether the Taliban received aid or international recognition.

"It is our decree that there will be no poppy cultivation. It is banned forever in this country," he said. "Whether we get assistance or not, poppy growing will never be allowed again in our country.

Source: Guardian Date: 20 July 2001

Portugal Decriminalizes Drug Use
LISBON TAKES DRUG USE OFF THE CHARGE SHEET Addicts Treated As Health And Social Problem

Portugal has forced back the frontiers of drug liberalisation in Europe with a law which, at a stroke, decriminalises the use of all previously banned narcotics, from cannabis to crack cocaine. The new law, which came into effect on 1 July, takes a socially conservative country with traditional Catholic values far ahead of much of northern Europe, including Britain, in treating drug abuse as a social and health problem rather than a criminal one. Vitalino Canas, the drug tsar appointed by the Socialist prime minister, Antonio Guterres, to steer the law into place, said yesterday that it made more sense to change the law than ignore it, as police forces do in Holland, parts of Swizerland, and now experimentally in the Brixton area of London. "Why not be clear about this, and change the law to recognise that consuming drugs can be an illness or the route to illness?" he said. "America has spent billions on enforcement but it has got nowhere. We view drug users as people who need help and care." He admitted that Mr Guterres was taking a risk, but said Portugal had no real choice. The police had stopped arresting suspects and the courts were throwing out cases against users rather than apply legislation which sent them to prison for up to three years. Margarida Costa, 35, a skeletal addict who has found a home at a drug treatment hostel, said prison had never helped her. "In fact, I started taking drugs in jail," she said. "You could get everything you wanted in there, every day." Still emaciated from 10 years of heroin abuse and living rough, she is on methadone and preparing to return to living with her mother.

Out Of The Ghetto
She is lucky. She has escaped from Casal Ventoso, Europe's worst drugs ghetto, where 800 or so addicts lived rough in tents or shacks of wood and corrugated iron. Up to 5,000 more poured in daily to buy their heroin fix. The government is now bulldozing the ghetto but hundreds of addicts still shoot up there at all hours. Up to 100 at a time gather nearby in Maria Pia Street, blocking traffic as they wait for dealers, and are joined by smart couples in four-wheel-drive vehicles seeking their daily

dose. "I know of doctors, lawyers, teachers, and even a police officer, who are all secretly hooked on heroin," said Luis Patricio, the psychologist who led the campaign to treat Casal Ventoso as a public health problem. Most countries had got the relationship between drugs, crime and jail the wrong way around, he said. "Prison is a university of crime. People learn violence there." The rightwing opposition is predicting a catastrophic boom in drug consumption and the sudden arrival of thousands of hardened addicts and thrill-seekers from around Europe. "We promise sun, beaches and any drug you like," Paulo Portas, leader of the Popular party, said. But Mr Canas insisted that he was not turning Portugal into Europe's drug paradise. "We are still fighting a war against drugs, but wars have their victims and the drug users are victims of the traffickers," he said. The police, armed with new laws prescribing hefty prisons sentences and the confiscation of all money and property, have been ordered to turn their undivided attention to the drug mafias. Decriminalising drugs is not the same as legalising them, Mr Canas pointed out. In fact drug use can still be punished under the new law, but the responsibility has been shifted to independent drug dissuasion commissions, which can impose pounds 900 fines, order community service or detoxification programmes, and take away the jobs of those no longer fit to hold them. "The courts just made things worse. Here we will help them, but also watch over them," said Americo Gegaloto, the lawyer who heads the commission in Setubal, south of Lisbon.

Fines And Treatment
He and the two social workers who sit with him now decide what happens to drug users in a district covering the industrialised south bank of the Tagus. The police still detain users and confiscate their drugs but, instead of locking them up or taking them to court they send their names and addresses to the commission. In the Setubal commission's offices in the basement of a city centre block of flats, in a small room decorated with floral prints, they are questioned across what could be a dining room table and a decision on their future is taken.

It is the recreational drug users who are most likely to be fined. Addicts will be sent to detoxification or other health programmes, if the pounds 175m budget for implementing the law allows. Mr Gegaloto expects heroin users to take up much of his time. But yesterday his only drug user was a boyish 19-year-old national serviceman called Paulo in sailor's uniform, sent by the military police, whose dogs sniffed out a lump of hash. Paulo was all smiles and polite handshakes, thankful that he would have no criminal record but bewildered by the attention of so many people. He was let off without a fine, but had to promise to give up joints and visit weekly. His name will go on a confidential drug users register for five years. At Casal Ventoso, Police Sergeant Henrique Pires was not so sure about the new law. The presence of his squad of 10 men had simply pushed addicts 20 metres down the street. Occasionally his unit's van is stoned or a bottle flies out from the rubble. "It was better before," he grumbled. Paulo Lima, a former Casal Ventoso resident now at a detoxification clinic, disagreed. "There is no point arresting us. But they should still take the drugs off people."

ooOoo

11-Jan-2002

Protein Could Be Used To Raise The Pain Threshhold
Pain management is a major issue for terminal illnesses such as cancer and for many other diseases. Traditional analgesics, such as morphine, are seriously flawed because they often provide insufficient relief and can cause unwanted side effects for those debilitated by persistent pain. Although recent research has advanced the understanding of how the body perceives and reacts to pain, effective management of chronic pain remains elusive. Results from a study published in today's issue of Cell may lead to a dramatic improvement in the effectiveness of treatments for chronic pain. Researchers from the United States and Canada report that a protein called DREAM (downstream regulatory element antagonistic modulator) appears to play a specific role in mediating pain responses. Mice lacking DREAM were much less responsive than normal mice to a variety of painful stimuli. These included tests that caused acute pain, such as heat, pressure on the paw and injection of noxious substances, and also chronic inflammatory pain, which is more similar to the type of pain felt in, for example, arthritis. The DREAM-deficient mice were normal in all other respects, suggesting that DREAM action is specific for pain pathways and may thus be a good target for therapeutic intervention. Pharmacological studies showed that the reduction in pain perception in DREAM-deficient mice involves specific receptor molecules in the brain and spinal cord that are known to be important for regulation of pain perception. DREAM acts to suppress the production of proteins involved in modulating pain perception, although precisely how this leads to control of pain perception is still unclear. These results suggest that modulation of DREAM function could be used to alter the threshold of pain perception. This could be particularly useful for the treatment of chronic pain, where a permanent reduction in the ability to sense pain could produce a dramatic improvement in quality of life. Overall, the results provide important new information about the mechanisms that underlie pain responses and highlight an exciting new target for the development of specific and effective pain therapies.

oOOOo

Source: The New York Times Date: 23 June 2002

Re-engineering the Drug Business
By MATTHEW BRZEZINSKI
The vial of heroin lands in my lap, and for a few uncomfortable seconds, as an undercover police officer and a very jittery drug dealer both grope my midriff, I worry someone will panic and go for his gun. The dealer is shouting -- for his money, for us to hurry -- peppering his exhortations with unprintable expressions. He looks no more than 20, with baggy trousers, high-top sneakers and a Baltimore Orioles baseball cap perched at a rakish angle. His grasping fingers, I can't help noticing, are bejeweled, like those of the rap artists one sees on MTV videos. Lost in the chaotic exchange, and now rolling on the littered floor of the unmarked police pickup truck, is the small vial of heroin. It contains a milligram of opiate in fine powder form and is sealed with a color-coded plastic cap. The top is pink in this instance, but it's also available in an assortment of other hues, each denoting a variation in purity and price, to tap the widest possible customer base. If that sounds incongruously like something out of an M.B.A. textbook, that's because it is: the strategy is called microbranding, and it is the reason so many different varieties of Coca-Cola sit on grocery shelves these days. The pinktop I have just clumsily purchased has its particular niche, or target market: the ''kids from the counties,'' as middle-class teenagers from the suburbs are known in Maryland. They are the same trendy audience that advertisers slaver over, and Baltimore's inner-city dealers have tailored the pink-top to their finicky needs. The product is just strong enough so that it can be snorted -- all the rage nowadays -- yet, at $20, cheap enough that it won't make too much of a dent in its average customer's weekly allowance. Beneath its veneer of violence, narcotics trafficking is a surprisingly sophisticated industry, marketing-driven just like any consumer-products business. Only illegal drugs are a bigger business than most, generating global revenues in excess of $400 billion annually, according to a United Nations study. From source to street, pushing drugs shares many common elements with hawking soda pop or cigarettes. It requires lots of working capital, steady supplies of raw materials, sophisticated manufacturing facilities, reliable shipping contractors and wholesale distributors, the all-important marketing arms and access to retail franchises for maximum market penetration. Just as in most sectors of the economy, innovation and technology are engines of growth. New uses of old products like heroin, or the introduction of synthetic drugs like methamphetamine and Ecstasy, keep pace with the changing demands of the marketplace, redistributing income from traditional profit centers like marijuana and cocaine. As in the automotive industry, different source nations compete in the global arena, with producers popping up in one country as quickly as they are pushed down in another. Occasionally, aggressive upstarts catch complacent giants unawares, as the Japanese did with Detroit carmakers in the 1980's. The principal difference between the narcotics trade and legitimate commerce, of course, is that the drug business must operate in the shadow of the law. This throws the entire organizational chart out of whack. Transportation becomes paramount, consolidation and

vertical integration -- those cherished buzzwords of merger-hungry multinationals -impossible. As a result, the narcotics industry has adapted what might be called the Osama bin Laden approach to management: base your operation in remote safe havens, the more war-torn and chaotic the better; stay small and shifty; use specialized subcontractors or freelancers on a need-to-know basis; vary your routes and routines whenever possible; and most important, always insulate yourself with plenty of expendable intermediaries in case someone gets caught and talks. Sept. 11 and its new world of heightened border controls has made decentralization doubly important for international smuggling networks, be they Chinese, Colombian, Turkish or Nigerian. Ever since the big Cali and Medellin cartels were wiped out nearly a decade ago, virtually the entire narcotics trade has radically slimmed down. With the added pressure of 9/11 security measures, drug kingpins have adopted the mantra of their more enlightened corporate cousins, that size does not necessarily create efficiency, and that to survive you have to stay nimble. Heroin is the perfect drug for the new age of small-batch manufacturing and decentralization, a high-value-added commodity where a little goes a very long way. In fact, it's so well suited to the changing times that many cocaine traffickers are retooling their production lines to include heroin and joining the global trend toward leaner, meaner, terrorist-style operations. The restructuring is helping the business survive what could otherwise be a difficult period. Despite the military and security measures taken to fight international terrorism and shore up America's borders, Heroin Inc. has had a remarkably good fiscal year. The industry has managed to sustain gains made during the boom of the late 1990's, largely shrug off 9/11 and make further inroads in cocaine markets in the United States. Supplies in America are at an all-time high. European operations are thriving as well. The Taliban's 2000 ban on poppy cultivation in Afghanistan has had little effect on the bottom line, with existing stockpiles and rerouted deliveries from Southeast Asia more than making up for the temporary shortfall. And the European sector is looking forward to a strong year in 2002. Now that the Taliban has been routed, bumper harvests are projected for Afghanistan. Elsewhere, analysts predict that Colombian distributors will continue their ambitious expansion plans in the eastern United States. And China's entry into the World Trade Organization is expected to further open a vast new market for both domestic consumption of heroin and its transit to other countries. The only uncertainty clouding the business's outlook is the long-term effect of Sept. 11. In the post-9/11 era of linking drugs with terror, of beefed-up border security and improved communication between international law-enforcement agencies in both intelligencegathering and interdiction, the industry is likely to grow even more diffuse. Power will continue shifting from remote producers to highly specialized smuggling subcontractors, and outsourcing in general will become the crucial factor to survival and success. The signs of the industry's new business model can already be seen at the very earliest stages of heroin production, in the distant and troubled lands where poppies grow. The men with guns and gold watches live down in the valleys below. But it is high in the mist-shrouded mountains along the border between China and Myanmar, as Burma is now known, where the monsoon washes away roads linking lonely villages without electricity or running water, that heroin begins its long journey to America.

By the time it reaches the streets of Baltimore, the world's most powerful narcotic will have traveled through half a dozen countries, soared at least 5,000-fold in price and changed hands a hundred times. The first fingers to touch it, though, belong to a slender 36-year-old mother of seven. Xiamin Dwan Swan and her husband, Ju -- like the other 40 families who live in this hilltop hamlet in Myanmar -- have been farming opium for generations, ever since the British introduced poppy cultivation to these parts more than a century ago. It's not a lucrative living, judging by the straw huts, mud floors and barefoot children, but it is the only one that the residents of Chaw Haw have ever known. The ritual begins every September, when the steep fields are burned and the poppy seeds scattered. They thrive in these altitudes, just about the only crop that does, but it is not only a quirk of climate that allows them to do so. A key competitive advantage of this rugged landscape is that it lies beyond the reach of any law-enforcement agency. As is the case in the world's other opium-producing regions -- the guerrilla-controlled jungles of Colombia, the lawless fiefs of Afghanistan -- central authorities have no say here. Power is exercised by renegade insurgent groups with prickly notions of territorial sovereignty, not to mention private armies 15,000 to 20,000 strong. By February, Xiamin Dwan Swan and her husband begin the harvest by scoring each poppy pod with a needle-like knife. A creamy gum oozes from the cuts, and once it turns black it is scraped off with a crescent-shaped tool that has been in her family ever since she can remember. It is painstaking work, and for their labor the Dwan Swans earn $600 annually, barely enough to feed their children, three pigs and two ornery dogs. Brokers come from the valley in early March to purchase the raw opium gum, which sells for about 1,500 yuan per vis -- the equivalent of about $135 a kilogram. (A vis is a unit of measure equal to 1.6 kilos, or about 3 pounds.) ''I don't know who buys our harvest,'' Xiamin says, which is the smart answer, but probably not true, given that she and her husband have most likely been dealing with the same broker for the past 20 years. Nor does she claim to know what happens to her harvest once the brokers collect it from Chaw Haw and other villages. This is probably true, since refineries buy their opium gum from the brokers rather than risking exposure by dealing directly with hundreds of separate suppliers. That is just the first of many layers of insulation that characterize the heroin trade and must be factored into the cost of doing business. For their services, the brokers, usually tribal elders, charge a 20 percent markup, sometimes more if they have lent villagers money in anticipation of their crop. In Helmand Province in Afghanistan, for example, some farmers grew so indebted during Mullah Omar's fatwa banning poppy cultivation that for a time after being liberated by American forces, they were selling raw opium to creditors for as little as $35 per kilogram. (That short-lived ban temporarily toppled Afghanistan from its nearly decade-long dominance among global opium producers, allowing Myanmar to briefly claim the dubious title, with up to 60 percent of the world total. But once the final tallies are in for this year's harvest, Afghanistan is once again expected to regain the top spot, followed by Myanmar, Colombia and Mexico.) Unlike poppy cultivation, refining is a complicated, capital-intensive process, limiting the number of players with the financial wherewithal to participate. This phase of the business is controlled mostly by the Wa, Kokang and Shan warlords, who run rebel states within Myanmar. ''They tax it, or receive money for protection,'' says Kyaw Thein, a Burmese

brigadier general. Indeed, ask a Wa official about opium, and he'll rattle off his town's yields as if he's quoting from the municipal budget. ''Four thousand, six hundred vis,'' says Lu Kyar Shin, a Wa mayor who sports a Rolex and a sidearm. ''Down from 10,000 vis a few years ago.'' Like the cocaine labs of Colombia, Myanmar's heroin refineries are temporary facilities buried deep in the jungle. They are set up to fill specific orders and can be quickly struck down in case the heat is on. But that only happens occasionally, when central authorities stumble on a refinery that falls within their territorial jurisdiction. Burmese officials proudly display the precursor chemicals seized in one such recent raid. The materials stand stacked in neat rows of blue and white industrial drums, filling a courtyard lined with papaya trees and barbed wire: 900 gallons of calcium hydroxide needed to cook raw opium into morphine, the first stage of the refining process; liquid ether smuggled into Myanmar by Indian networks; and Chinese-made ammonium chloride, which transforms the morphine into the lower-grade No. 3 heroin, or ''brown sugar,'' as it is popularly known; and finally, out front in a place of honor, 150 gallons of hard-to-come-by acetic anhydride, the key ingredient to producing the 90-percent-pure No.4 heroin destined for American and European markets, the notorious China White. Though China White is often packaged by refiners in 700-gram bricks, known as units, the universal measure in the global narcotics business is the 1,000-gram kilo. A kilo that will ultimately fetch in excess of $200,000 (wholesale) in New York City costs as little as $2,500 in Myanmar. That, at least, is what Saikyaw Myat, an unemployed stonemason, was expecting to get for it before being busted by an undercover agent. Ma Lwan Gyi and her two young friends, Ma Kaing Hland and Ma Ban Mong, were nabbed in a similar sting. They had each been promised $20 to deliver a kilo of the famed Double Lion brand into town. All four now sit in leg irons in a stifling corrugated-steel prison, a labyrinth of low wooden cages constructed from thick teak bars, forbidden to move from the lotus position, where they are to contemplate the error of their ways for the next 10 years. The modest price of the China White they carried illustrates how in the overall cost structure of the heroin industry, refining is not a particularly large profit center. That's because the risks of interdiction within Myanmar are too low to factor significantly into the final price. The markup on the finished product is about 20 percent, in line with other forms of contract manufacturing in Asia like semiconductors or cellphones, where the real money goes to designers and distributors. Once the sourcing and processing stages are complete, isolated countries like Myanmar or Afghanistan lose their competitive advantage. ''The Wa or the Kokang don't have the sophistication or international networks to get their product to market,'' explains Maj. Win Naing, who heads the narcotics task force in the bustling northern Myanmar border town of Muse. ''They leave that to foreigners.'' Much the same holds true with Afghan growers, who despite being the source of 80 percent of the heroin in the $12 billion European market, earned at most only a modest $56 million from opium sales last year, according to a United Nations survey. The real profits in heroin, to borrow a term from the embattled accounting industry, are all downstream -- in transportation and distribution. To reach global markets, heroin leaves Myanmar through two principal pipelines. With each route, a different set of players, with specific expertise, is involved. The first, and most

used, is north through China's Yunnan Province to Hong Kong or the free-trade zones around Guangdong. Chinese smuggling syndicates ply this route, charging as little as $1,000 per kilo to sneak the contraband across the border from Muse to as much as $10,000 per kilo to get it all the way to Hong Kong. One such group operated until recently in Muse, where the border with China is a four-foot-high fence that runs right through the center of town. The syndicate was headed by a 39-year-old Chinese national by the name of Tan Xiaolin, who set up shop in a large pink-and-green villa a few hundred yards from the frontier. Until his arrest last year through the joint efforts of Chinese and Burmese authorities, he had smuggled more than three tons of pure heroin to Hong Kong, where different trafficking organizations with a more international orientation sent it on to Sydney, Vancouver and the United States. Tan has since been extradited to China and, according to Burmese officials, sentenced to death. The harsh penalties handed out in Asia for trafficking do not seem to be a great deterrent. That, say American officials, is because you can often buy your way out of jams or simply purchase protection from underpaid local Communist authorities. United States drugenforcement officials, however, concede that the inner workings of the balkanized China pipeline are somewhat of an intelligence black hole because of spotty relations with Beijing. Much more is known about the second major route out of Myanmar, which travels south and then east, through Thailand. Much as he tries, Mike Carter finds it hard to blend in with the crowd at his posting in the northern Thai city of Chiang Mai. For one, Carter, a special agent for the Drug Enforcement Administration, is a very large individual; well over six feet tall, a close-cropped former marine who went to college in Texas on a football scholarship and used to maul opponents as a 250-pound linebacker. Then there is the 9-millimeter Glock tucked into the waistband of his jeans. And those dark, wraparound aviator sunglasses. Even though he has picked up Thai and speaks it more or less grammatically, there's not much chance of passing himself off as a native. So he lurks in the shadows, behind the tinted windows of his silver Toyota, playing a supporting role, waiting for the drugs to come across the border. Today he has brought some cash to entice traffickers, to expedite matters. It lies temptingly in a green satchel on top of my bag, five million baht, just over $116,000 at the current exchange rate. It's what's called ''flash money,'' and it will be shown to a Burmese broker by an undercover Thai policeman posing as a customer. The deal is set to go down in Chiang Saen, at the confluence of the Mekong and Ruak Rivers, where Myanmar, Thailand and Laos meet: the heart of the Golden Triangle. ''This all used to be poppy country, and 10 years ago there were refineries everywhere on the Thai side,'' Carter explains as we drive on broad, freshly paved roads. With all the tour buses and golf resorts around, it's difficult to imagine Thailand as a major heroin producer. But it once was a world leader, until the economy picked up and pressure from the international community forced traffickers to relocate across the border in Myanmar. Much the same happened in Pakistan, Turkey, Bolivia and Peru in the 1980's, as successful eradication efforts and increased standards of living forced production to shift to the more lawless and impoverished corners of Afghanistan and Colombia. That fluidity is another key feature of the rapid-reaction narcotics business: push it down in one place, and it simply pops up somewhere else. In that sense, heroin is truly a global commodity.

Carter's cellphone rings. It's Col. Dussadee Arajavuth, the head of the Narcotics Suppression Bureau, or N.S.B., in northern Thailand. The Burmese broker, he informs Carter, has taken the bait. Now it's only a matter of time and patience. While we wait, Colonel Arajavuth arranges for me to meet with one of his prized sources, a foot soldier in one of the warlord armies that smuggle heroin across the Thai border. We meet in a hotel room in Chiang Rai, not too far from where the N.S.B. keeps a safe house. ''The heroin leaves the refineries in caravans,'' the informant begins. ''There are usually 50 to 100 people in each caravan. Half are porters carrying up to 500 units of heroin, the other half are soldiers.'' The soldiers, he continues, are heavily armed with rocket-propelled grenade launchers and are provided -- for a fee -- by either the United Wa State Army or the Shan State Army, insurgent groups that operate close to the Thai frontier. The final destination is either Thailand proper or Tachileik, a rough Burmese border town that apparently inspires such dread that the superstitious residents of Mae Sai, on the Thai side, have erected a black steel scorpion the size of a tank to ward away their neighbors' evil spirits. In Tachileik, brokers like the one Agent Carter is currently trying to set up take delivery of the heroin, which, because of high transportation costs, rises in price to $4,500 per kilo. There are approximately 20 such brokers representing the Wa and the Shan in Tachileik, says the informer. ''Everyone knows who they are.'' Delivering heroin directly into Thailand is a bit trickier, and the added risk is reflected in the slight price hike to $5,500. The drug caravans move over the dense mountain frontier, under cover of night, when Thai border patrols are in their barracks. To see how porous the frontier can be, Carter drives me to the Ban Phai border post atop Mount Doi Tung. We barely make it up the steep road, since Carter's Toyota is loaded down with M-4 assault rifles discreetly tucked into golf bags in the trunk. The firepower is a precaution. Tensions at the Ban Phai outpost -- a collection of bamboo huts reinforced with black sandbags, trenches and M-60 heavy-caliber machine guns -- are running high. Just a few days before, two advance scouts from a Wa caravan were caught by a nearby border-patrol unit. The Wa took exception to the arrest and unleashed a mortar barrage. The Thais responded with 105-millimeter Howitzers. Miraculously, only one person was injured. Once the shipment has arrived in Thailand or Tachileik, a whole new set of players enters the fray. These are Thais from Bangkok, who converge on the border area to pick up heroin. They, too, have their specific niche: moving the product to buyers in Bangkok. One such transportation subcontractor, who had 37 kilos of China White in his black Land Rover, was recently wounded by Burmese border guards in Tachileik. The bust clearly showed just how decentralization keeps the narcotics trade in business. The load was a mix of the Double Lion brand favored by Wa refineries and the 999 brand popular with labs in the Shan region. Under interrogation, the driver could not name his sources and could only provide police with a disconnected contact number to a broker in Tachileik. The chain to the producers was already broken. The transport subcontractors themselves add another layer of protection for both the brokers in the border area and outside buyers, because no one here will do business with a farang, as foreigners are known. They are ''too conspicuous,'' says Colonel Arajavuth. ''We'd pick them up right away.'' In fact, most of the foreign buyers are West Africans -- Nigerians, to be precise -- who tend to stick out in the Thai provinces even more than Agent Carter does. They prefer the more cosmopolitan anonymity of Bangkok and are prepared to pay for the added security. In the

Thai capital, the local middlemen charge between $7,500 and $9,500 to deliver each kilo of heroin, depending on the quantity ordered. West Africans are not the only foreign customers; there are smugglers from Taiwan and Europe. But the Nigerians are by far the most organized and entrenched group. Their job in heroin's ever-lengthening supply chain is also among the riskiest: to get the heroin into the United States. Few C.E.O.'s of major American corporations lie awake nights agonizing over logistics. That's what companies like DHL or U.P.S. are for. The drug trade, too, has its courier services, outfits such as ''Nigeria Express'' or Mexico's notorious A.F.O. The drug runners breach every United States frontier, but one of their main targets is San Ysidro, Calif., America's busiest border crossing, the fragile demarcation line that separates San Diego from the smuggler's paradise of Tijuana. Between a quarter and a third of the heroin, cocaine and marijuana entering the country passes through here and four smaller checkpoints in Southern California, and on a good day the Customs Service can hope to make at least a dozen decent-size seizures. Up to now, it has been relatively easy going for China White traffickers. Nigerians, having taken delivery of the heroin in Bangkok, have either shipped it via couriers to transit countries like Mexico or Canada or, more commonly, have sent it home to Lagos. Given Nigeria's perennial position near the top of the global-corruption rankings, forwarding through Lagos international airport does not pose much of a barrier. In Nigeria, the drugs are repacked into smaller parcels, often into condoms that couriers swallow and transit through nonsource countries like Britain or France to throw Customs officials off the trail. If the heroin is sent directly from Thailand to the United States, Caucasian couriers are usually employed to foil racial profiling. They are often female, in their 20's and 30's. It is also at this stage that another complication arises for Southeast Asian heroin. As it approaches its target market, it brushes up against the competition, including Mexicanproduced Black Tar, known derisively as Mexican Mud because of its poor quality; the more superior Mexican Brown in powder form; and especially high-grade Colombian White, its biggest rival. (Afghan heroin is conspicuously absent at San Ysidro and only occasionally shows up in the United States, in places like Detroit. Its principal market is Europe, where it arrives from Turkey, Russia and the Balkans.) Colombia is a relative upstart in the international heroin trade, with cocaine traffickers there deciding to get into the business only around 1990. It was a decision based purely on demographics. The cocaine craze of the 80's was waning as the drug fell out of fashion with urban professionals. Moreover, dealers were discovering that unlike heroin addicts, many habitual coke users tended to burn out after five years. Faced with a dwindling customer base in America, cocaine traffickers tried to expand into Europe. But they had only limited success, in places like Spain, England and, most recently, the Netherlands. The hard drug of choice in the European Union was heroin, and Pakistani and Turkish groups had the market sewn up there. So Colombian cocaine traffickers decided to diversify and launched a poppycultivation drive, importing seeds, equipment and expertise from Southwest Asia. ''It took them three or four years to get it right,'' recalls Felix J. Jimenez, the D.E.A.'s New York bureau chief, ''to procure the proper refining know-how and precursor chemicals like acetic anhydride.'' But by the mid-90's, he says, the Colombians were producing heroin with purity levels exceeding 90 percent. Suddenly Colombian smugglers had a product that was equal to, if

not better than, China White. All they had to do was get the new product to the market, past points of entry like San Ysidro. One sure sign of the high regard in which traffickers hold San Ysidro's defenses is the risk premium attached to making it across. If getting heroin into China or Thailand bears a markup of $1,000 per kilo, here it's a different story altogether. After it makes the 100-yard journey across the border, a kilo of Black Tar will soar in value to $54,000 once safely on the San Diego side. Colombian heroin will rise by as much as 20 times once it gets to Los Angeles. And China White will command well into the six figures once it reaches American soil. With the stakes so high, smuggling syndicates go to great lengths to keep tabs on what is going on at San Ysidro; when, for instance, shifts are ending, how many rovers are deployed on a given day, which canine units are on patrol. But mostly they just play the numbers game, the law of averages. More than 40 million people enter the United States through San Ysidro annually, and Customs can't check them all. ''We get up to 60,000 cars a day, and you have to keep in mind that 99 percent of the passengers are honest travelers,'' says Robert Hood, a supervisory Customs inspector. ''So the bad guys come straight at us. And if we intercept a few loads, that's just a tax they factor into the cost of doing business.'' Most of the China White passing through San Ysidro is spirited through the pedestrian crossing, a long concrete corridor lined with metal detectors, airport-style X-ray scanners and D.E.A. posters offering $2 million for information leading to the arrest of Benjamin Arellano Felix and his brother, Ramon. The Arellano Felix Organization, A.F.O. for short, is a testament to just how important transportation subcontractors have become in the drug industry. The Tijuana-based outfit started out humbly, smuggling duty-free cigarettes and alcohol in the late 70's. Over time, they moved up to marijuana and were well placed to reap a bonanza from the cocaine craze of the 80's. By the 90's, they were moving tens of billions of dollars in contraband, controlled an estimated three-quarters of everything that passed through San Ysidro and even built complex tunnels into Texas. ''They took over,'' says Jayson Ahern, director of field operations for United States Customs in Southern California. ''They effectively supplanted their old bosses in Colombia and became a cartel of their own.'' The A.F.O.'s competitive edge was location: right on the Mexican-American border. However, the critical error that would lead to their downfall, as with the Colombian cartels before them, was getting too big and flouting the laws of decentralization. Colombia's Medellin and Cali cartels were the first drug-trafficking organizations to vertically integrate. Like the big oil companies with gasoline, the cartels tried to hang on to their product through its entire chain of manufacturing, distribution and sale to consumers. For a while it worked, but the downside of any vertically integrated structure is that one broken link can bring down the whole organization. By using freelance subcontractors who don't know one another or even the identity of their employers, traffickers of China White assiduously avoid this peril. The Nigerian buyers in Bangkok, for instance, don't even move the heroin themselves. Instead they hire American, European or Canadian couriers that they send on circuitous journeys to finally enter the United States in places where they hope Customs will have its guard down.

Inspector Hood is familiar with this type of ruse. ''I had this one lady pull up to the pedestrian crossing in a cab,'' he recalls. ''I took a look at her passport and it had an exit stamp from Thailand dated three days before. She said her vacation had been cut short because her goddaughter got sick and she had to get back to Baltimore quickly. I didn't buy it. There are definitely more direct routes to Maryland than driving through Mexico.'' It turns out that the woman had nearly three kilos of heroin in her luggage and was a courier for Nigerian traffickers. They had hoped that a white waitress would not fit the profile of the Latin American smugglers usually seen at San Ysidro. ''They probe for weaknesses,'' adds Hood, ''figuring we are not looking for Southeast Asian heroin here, the way they do on flights arriving from Bangkok to J.F.K.'' Many couriers -- mules, or body-packers, as they are known in the trade -- are swallowers who ingest honey-coated condoms filled with heroin. This makes them perilously hard to detect. Usually, it's only when something goes badly wrong that they get caught. One of Hood's colleagues, for instance, recently stumbled on a jittery gentleman claiming to be a pharmacist from Colombia. ''The guy was too jumpy,'' recalls the colleague, Chief Inspector Mark Wilkerson. ''And he didn't look like a professional type.'' In other words, he fit the mule profile. Wilkerson asked him to remove his tie and put it back on. ''He couldn't do it, couldn't tie a knot,'' Wilkerson laughs. The faux pharmacist was a mule who had been promised several thousand dollars to make the delivery. To the uninitiated, all this may seem like a great deal of trouble to go through to move a mere kilo. China White is unusual that way. Of all the branches of the narcotics trafficking trade, it is by far the least efficient on a cost-per-kilo basis. According to a study by an economist, Peter Reuter, Latin American-produced cocaine is as much as 10 times cheaper to transport because it is usually shipped in bigger batches, 250 kilos and up. This allows traffickers economies of scale to spread out the, say, $500,000 fee pilots of small aircraft or go-fast boats often charge. The discrepancy has its roots in the heritage of Colombian cocaine traffickers, many of whom came to the trade from the marijuana rackets, where bigger payloads were always the norm. But it also reflects the nature of heroin and demonstrates why it is increasingly the drug of choice for the savviest smugglers. With its high market value, heroin is ideally suited to traveling tens of thousands of miles, crossing countless borders. It requires far smaller networks to smuggle than the big organizations needed for cocaine or marijuana. And spreading loads over dozens of individual couriers minimizes risk. ''If I had to make any analogies,'' says Mike Chapman, a senior special agent with the D.E.A. in Washington, ''it would be to Al Qaeda.'' Heroin traffickers tend to operate more like highly compartmentalized terrorist cells than multinational corporations or the sprawling Colombian cartels of the Pablo Escobar era. But that's also the case, increasingly, across the entire narcotics industry. ''This type of activity does not allow concentration of power like legitimate commerce,'' says Ethan Nadelmann, an economist and drug-policy expert. ''If smugglers get too big, they develop security and personnel problems and get targeted by law enforcement.'' Indeed, Pablo Escobar -- El Patron, as he was known in his heyday -- would be living proof of this, had he not been killed in 1993 after one of the most intense international manhunts

in history. It's the same story with the high-flying Tan Xiaolin from Muse, who is currently on death row in China along with 18 of his associates. Even those D.E.A. posters of the Arellano Felix Organization, the closest thing to a cartel since the leaders of the Cali and Medellin gangs were locked up almost a decade ago, are already dated. Ramon is dead, shot in February by Mexican authorities, and his brother Benjamin was arrested in March. Drug traffickers are also vulnerable to shifting international winds. Smugglers have had a rough time since Sept. 11 changed the way most nations view border security. In late 2001, heroin seizures rose sixteenfold along the California-Mexico border, largely at San Ysidro, which, like every port of entry in America, has been on Level 1 alert since the attacks on the twin towers. ''For the first few weeks,'' recalls Hood, ''we didn't see any drugs whatsoever. It was eerily quiet, as if the traffickers were hanging back, waiting to see what we would do.'' But smugglers, like anyone else, have bills to pay and can't afford to sit on inventory for too long. ''Eventually they have to move,'' says Vincent E. Bond, a public affairs officer with United States Customs in San Diego. ''And this isn't a very good time to be trying to fly in a Cessna under radar,'' he adds. ''You're liable to have an F-16 up your tail.'' So syndicates are shifting away from air routes and big ports of entry, trying to hide their tracks better, bury their loads deeper and use more marine cargo and speedboat deliveries. (The Coast Guard reports making seizures at a pace more than twice last year's.) And for once, the law of averages is now tilting toward interdiction efforts. ''Regular passenger traffic has been way down since 9/11,'' says Bond. ''That gives us more time to scrutinize each entrant.'' Once in the territorial United States, heroin typically makes its way to three major collection centers. On the West Coast it travels up Interstate 5 to Los Angeles. There, the wholesale price of a kilo of high-quality heroin jumps to between $86,000 and $100,000, from the $40,000-to-$54,000 range in San Diego. Along the way, importers jack up the bottom line by cutting the product -- ''stepping on'' it, in street parlance. This is usually the first of many adulterations to follow, all intended to increase profits by decreasing purity, and a variety of agents are used for this purpose: quinine, talcum, even lactose. In America, as in Europe, immigrants are the major importers and distributors of heroin. This is simply because the smuggling networks prefer to deal with their own and don't trust outsiders. Nigerians will sell to fellow West Africans, Chinese to immigrants from back home and so on. The American market for heroin, worth about $10 billion annually, is thus roughly divided into ethnic spheres of influence. Los Angeles-based Mexican groups control wholesale markets west of the Mississippi. Nigerians operating out of Chicago have the northern parts of the Midwest. And New York-based Dominican syndicates fronting for Colombians dominate the East Coast. Smaller Chinese gangs operate on the fringes, moving mostly in areas like San Francisco or New York that have large Asian communities. The divisions, notes Jimenez, the D.E.A.'s top man in New York City and a leading expert on heroin in America, are fluid. Mexican groups, for instance, regularly impinge on the West

Africans in Chicago, who in turn intrude on Dominican turf in places like Baltimore. The competition can be fierce and at times violent, but more often than not it tends to be fought along straight marketing lines. One such battle changed the face of the heroin trade on the Eastern Seaboard. It occurred in New York in the mid-1990's. Up to then, Jimenez explains, the wholesale heroin business on the East Coast belonged to Chinese triads. (They themselves had supplanted Italian crime families the decade before.) But with the entry of the Colombians, the established Chinese rings found themselves with a serious fight on their hands. Astonishingly, what broke out was almost entirely a price war. China White, which was often smuggled a kilo at a time in people's stomachs, sold for between $160,000 and $180,000 per 700-gram unit, explains Jimenez. But the Colombians would include heroin in their large cocaine shipments, benefiting from drastically lower transportation costs. ''They could charge $80,000 a kilo and undercut the Chinese by half.'' The Colombians, of course, enjoyed the geographic advantage of closer proximity to the United States. But they had another, equally important, competitive advantage: established distribution centers. ''They would force their Dominican cells to take, say, two kilos of heroin for every hundred kilos of coke they ordered and give out free samples to their customers.'' The move turned out to be a marketing coup, creating an entirely new clientele for heroin, much the same way that the introduction of crack cocaine in the previous decade had exposed a yuppie drug to the mass market. Because the Colombians insisted that their distributors keep the heroin at high purities, upscale coke users could now snort or smoke it, ridding the product of the stigma of dirty needles and H.I.V. ''I put a hidden camera on a street corner where I knew they sold heroin,'' Jimenez says. ''You wouldn't believe the customers we got on film: lawyers, doctors, teachers.'' The net result of the innovative strategies, says Jimenez, is that by the new millennium, Colombian heroin dominated markets in New York and throughout the Eastern Seaboard. From collection centers like New York City, heroin travels down the I-95 corridor to secondary markets like Philadelphia, Baltimore and Washington. Dealers from those satellite towns will usually make the trip to New York once every few weeks, picking up anywhere from one to five kilos at a time, explains Detective Lieutenant Michael Tabor of the Baltimore police department. While New York can boast of hundreds of ''cells,'' as Jimenez labels major distribution rings, a city the size of Baltimore will have no more than two dozen dealers capable of buying in kilo quantities. ''We know who they are,'' Tabor says, rattling off names. ''We've got phone taps on all of them,'' he adds. ''But they're damn slick.'' As you go progressively down the food chain, though, things get a little easier from a lawenforcement perspective. I find myself setting out once again to cruise the streets of Baltimore with narcotics officers. Special Operations Unit One meets daily at 11 a.m. in a newly renovated conference room that appears industriously messy, like the marketing department in a successful midsize company. But no one in Sgt. Mark Janicki's eight-man unit looks remotely corporate:

beards, braids, ponytails and skull-and-bones ear studs form part of the dress code, which leans heavily toward leather and jeans. Sergeant Janicki goes over the game plan. I am to accompany one undercover officer on a heroin buy, while the rest of the unit is divided into surveillance and enforcement squads. The officer I'm accompanying, a 34-year-old Long Island native who uses the street name Mike, goes off to change into his disguise. We're posing as construction workers -- strungout construction workers by the look of it when Mike returns wearing filthy, tar-splattered jeans, heroin-chic dark eyeliner and a backward baseball cap that pins down his stringy, shoulder-length hair. I'm suddenly glad that I didn't shave this morning. Janicki gives us a lift to a nearby parking garage, where the department keeps a white Dodge pickup with scaffolding sections scattered in its flatbed for added effect. Kentucky Fried Chicken wrappers and crumpled 7-Eleven coffee cups litter the floor of the cab, more props. As we head southeast to one of Baltimore's rougher neighborhoods, Mike explains how the lower rungs of the distribution chain are organized. Baltimore's dozen or so big dealers reparcel the newly purchased kilos into more affordable ounce-size lots. Shops or midsize dealers then break down ounces into grams that are resold to crews in ''packages'' of 100 vials or gelcaps, each containing one milligram. Gelcaps, as opposed to the pink-, blue- or green-tops, cater to the low end of the market, the addicts who inject heroin. ''That's when they're really stepping on the product,'' says Mike. ''The rule is generally six to one,'' Jimenez elaborates, meaning that from the one kilo purchased from wholesalers, up to seven kilos will be produced by adding sundry adulterants by the time it hits the street. ''This is where the biggest markups occur,'' he adds. ''From wholesale to retail, because that's where you face the biggest risks. You have to protect yourself not only from the police but from rivals and people in your own organization who know you are carrying large amounts of cash.'' As we drive deeper into the drug zone, the violence and poverty that accompany the lowest echelons of the heroin trade become more visible. Mike spots a street corner that is not too busy. He doesn't want to risk leaving me alone with a crowd. He radios Sergeant Janicki to coordinate surveillance. ''Corner of East Monument and Belnord,'' he says, stowing the walkie-talkie. ''All right, put away your notebook,'' he says. ''And whatever happens, don't get out of the truck.'' We slow down and pull up to the curb. ''Yo, man, dope's out?'' he calls. Dope is street slang for heroin, which is also sometimes called boy. ''I got shirleys,'' responds the dealer, a tough-looking youth in shiny white sneakers with a stick of red licorice clenched between a solid row of gold teeth. Shirley means crack cocaine, which is also called girl. ''He waitin' on a fresh pack,'' says the youth, nodding across the street to a man with no teeth. A pack is 100 heroin gelcaps, each filled with heavily adulterated heroin -- scramble'' in the local dialect -- which means he is expecting a delivery from his crew boss. Mike doesn't like it. To make the buy, he has to get out of the truck and leave me alone. He hesitates for a moment. ''Be cool,'' he finally tells me, and much as I try, I find it hard to follow his instruction, what with the licorice guy eyeballing me menacingly. Mike returns a few nerve-racking minutes later and hands me a clear capsule that looks like cold medicine. It is filled with a chunky white substance. ''Scramble,'' he says, putting the pickup in gear.

Mike paid $10 for the milligram, the purity of which usually ranges from 4 to 7 percent, but recently has been testing as high as 12 percent -- a sure sign that heroin is in plentiful supply in Baltimore. ''What's that come out to per kilo?'' I ask. ''Math was never my strong suit,'' Mike says. ''But a lot.'' I crunch a few numbers while we drive away, giving Sergeant Janicki and his enforcement unit time to swoop in on the unsuspecting mark. Moments later Janicki radios in to inform us that he has picked up the dealer, a 31-year-old black male with 21 prior arrests for heroin and cocaine distribution. ''Guy's a junkie,'' Mike says sadly, shaking his head. ''Probably gets 50 bucks and a free fix to sit out there all day.'' There are thousands of others like him in Baltimore -- and throughout inner cities across the United States -- working, much like the stranded peasants of Myanmar, for next to nothing, for a lack perhaps of economic alternatives. And as for the heroin that unites them in their poverty, a lone kilo, which began its economic life cycle so humbly at the hands of a Burmese mother of seven, will have generated sales just shy of a million dollars by the time it ends its deadly journey and enters the American bloodstream.

Source: BBC News Date: 3 Dec, 2002

Heroin to be offered on the NHS

Heroin is to be available on the NHS to all those with a clinical need for it, as part of the government's new drugs strategy. About 400 heroin users already get the drug legally on NHS prescription but access nationwide is patchy. The new drugs plan centres on a "treatment strategy" aimed at those using hard drugs like heroin and crack cocaine. It was published amid criticism from the government's former drugs policy co-ordinator that ministers' stance on cannabis was now a "dog's breakfast". Heroin users would be given prescribed supplies of the drug in safe, medically supervised areas, using clean needles. A government official said the drug would be prescribed only where other treatments, such as methadone, had not worked or where doctors believed they would not work. The plan does not extend to Scotland, where the Scottish Executive says it will monitor the move. Cutting the rapid rise of crack cocaine use is another target of the government plan, which updates the 1998 strategy.

Cannabis trials
New plans include reducing the supply of the drug to the UK and introducing more specialist treatment programmes. The focus on Class A drugs follows research suggesting that 99% of the costs run up by drug users comes from Class A addicts. Clinical trials have been taking place into the use of cannabis for medical treatment. The drugs company steering those trials is now set to apply for a licence and ministers say they are encouraged by the results of the tests so far.

Other plans in the strategy include: ï‚· ï‚· ï‚· Increasing spending on tackling drug use by 44%, taking spending to almost £1.5bn for 2005/6 Expansion of residential treatment programmes Launching an education campaign in the new year, aimed at young people.

Mr Blunkett said: "We know cannabis is dangerous but it does not lead to the kind of total disintegration of people's lives that heroin, crack and ecstasy do, and we know they kill. "We are concentrating on a massive increase in treatment - we have the first National Treatment Centre - and we are going to link that with rehabilitation." Specific targets for reducing the numbers of people taking drugs are being dropped. In a move that has provoked criticism, Mr Blunkett said the target of halving hard drug use by 2008 was "not credible". Those who prefer a more liberal strategy say the government is sending out mixed messages. Under the new Criminal Justice Bill, to be debated by MPs this week, any individuals caught with any Class C drugs could be arrested. Mr Blunkett downgraded cannabis from Class B to C in order to allow greater focus on Class A drugs such as heroin and cocaine. That meant it remained illegal, but possession of small amounts would no longer be considered an arrestable offence.

Mixed messages?
Keith Hellawell, former UK drugs coordinator for the government, said he felt the cannabis issue had become a "dog's dinner". He added: "David Blunkett is making the signal to young people that it is alright. "He will deny it but that is the signal." Roger Howard, chief executive of charity DrugScope, praised the focus on hard drugs and the shift towards more treatment. But Mr Howard added: "We regret that the government did not seize this opportunity to be more bold. "Important opportunities to save lives have been missed by refusing to back harm minimisation schemes, such as safe injecting rooms."

Stirring moral panic

Mr Howard argued that putting ecstasy in the same bracket as cocaine and heroin would seriously undermine the strategy's credibility among young people. The Conservatives have been pushing for many more rehabilitation centres for users of heroin and cocaine. The Liberal Democrats meanwhile welcomed the focus on hard drugs but said making possession of Class C drugs an arrestable offence made a mockery of reclassifying cannabis. Home affairs spokesman Simon Hughes said: "The government should stop whipping up moral panic about cannabis and ecstasy and focus the efforts of the criminal justice system on heroin and crack cocaine."

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Source: Washington Post Date: 21 May 2003

N. Korea's Growing Drug Trade Seen in Botched Heroin Delivery
By Richard C. Paddock and Barbara Demick, Times Staff Writers

WYE RIVER, Australia -- For a day and a half last month, the people of this small tourist town watched in puzzlement as the rusty freighter Pong Su maneuvered off the coast. At times, they say, the 350-foot cargo ship came within a few hundred yards of the rugged shoreline that is famous for shipwrecks. Just after midnight April 16, the ship approached a rocky, deserted beach and launched a rubber speedboat. In it were two men and the only cargo the ship had been carrying: at least 110 pounds of high-quality heroin. The Pong Su was an unlikely drug-running vessel from an unexpected place: North Korea. The sea was especially rough that night, and 8-foot waves swamped the little boat. The heroin and one North Korean made it to safety, but the other crewman did not. His kelpentangled body washed up on shore. Later that day, police in a nearby town seized three men and the heroin, estimated to have a street value of $50 million. The 4,480-ton Pong Su led Australian police vessels on a four-day chase in 30-foot swells until commandos boarded the freighter by helicopter and boat. The 29 remaining crew members, also North Koreans, were arrested and charged with aiding and abetting narcotics smuggling. North Korea has been quietly involved in the drug trade since at least 1976, when a North Korean diplomat in Egypt was arrested with 880 pounds of hashish. Since then, there have been at least 50 arrests or drug seizures involving North Koreans in more than 20 countries, William Bach of the State Department's Bureau for International Narcotics and Law Enforcement Affairs told a Senate Governmental Affairs subcommittee Tuesday. In the past several years, most North Korean trafficking has involved methamphetamine and heroin destined for Japan, Taiwan, China and Russia, Andre D. Hollis, a Pentagon counter-narcotics official, testified at Tuesday's hearings. The Pong Su's covert mission in southern Australia appears to have been a daring expansion into the Australian heroin market by a bankrupt regime increasingly desperate to stay afloat. The ship is owned by a company headquartered in Pyongyang, the North Korean capital, and several of the arrested crew members were members of the ruling Korean Workers' Party.

'Smear Campaign'

The North Korean government has denied allegations that it was involved in the heroin delivery and says the charges are part of a U.S. "smear campaign" to increase international pressure on the regime to shut down its nuclear program. The Australian government says it is investigating whether the communist regime was behind the smuggling enterprise. Officials and defectors said any other explanation would be hard to accept. "North Korea is a socialist state. There is no private enterprise in North Korea," Australian Foreign Minister Alexander Downer said after issuing a protest to the regime's ambassador. "I am confident that the drugs seized [from the Pong Su] were North Korean products," a North Korean defector, whose name was withheld to protect his identity, told the Senate panel. The man, who wore a hood and was a former high-level government official who defected to South Korea in 1998, said he had direct knowledge of 30 other officials involved in narco-trafficking. North Korea's narcotics business has long been overshadowed by the regime's program to build nuclear weapons. The Bush administration recently expressed concern that the regime may try to manufacture weapons-grade plutonium and smuggle it abroad. If so, the Pong Su's journey to Australia raises the possibility that the same method could be used to smuggle plutonium. The North Korean government says that the Pong Su is a "civilian trading ship" and that its owner had no knowledge of the heroin. According to shipping industry insiders, the Pong Su is the flagship of a commercial shipping company known as Pong Su Ship Management, which owns six vessels and has been expanding in recent years. "The company is owned by North Korea," said Neil Tsang, a ship broker based in Taiwan who sold several vessels to the company and helps the firm lease them out for transporting products such as lumber, coal, steel and feldspar around Southeast Asia. He said he doubts that company managers knew the ship was carrying drugs. The company's manager, Kim Chu Nam, could not be reached by telephone at his office in Pyongyang. It is unlikely that a North Korean company would be dealing drugs without government involvement, said Cho Sung Kwon, a South Korean criminologist who has advised his country's intelligence service on North Korea. "North Korea is a socialist country, so everything is closely monitored and controlled," he said. "It is not just the kind of state-sanctioned drug trafficking you might see in Latin America. It is state-sponsored." The defector who testified to the Senate on Tuesday said North Korea started secret drug production in the mountains in the late 1970s but that it only began to produce and sell drugs in earnest in the late 1980s, when North Korean founder Kim Il

Sung, father of the current leader Kim Jong Il, designated an area around the town of Yonsa in North Hamgyong province as an opium poppy farm. "Kim Il Sung told his people to grow opium because he needed cash," the defector said. In late 1997, the government decreed that all North Korean collective farms must allocate about 25 acres of land to poppy farming, the defector said. The opium is sent to pharmaceutical plants in the Nanam area of the east coast city of Chongjin, where it is processed into heroin under the supervision of seven or eight drug experts from Thailand - all under direct government control, he said. North Korea produces a ton of heroin and a ton of methamphetamine a month, which can be sold for about $5,000 a pound in China or about $7,500 a pound elsewhere, he said. Yoon Yong Sol, a former North Korean police official who lives in Seoul, said in an interview last month that he was personally involved in ordering farmers to switch their fields to poppy cultivation during the height of the famine that killed an estimated 2 million people. "There were some complaints that during the famine we should be growing grain, not poppies, but the instruction from the central government was that if we grow poppies we can sell the product for 10 times as much to buy grain," Yoon recalled.

Asian Drug Market
He said drugs were sold by security agency officials at the Chinese border or shipped to Taiwan, Hong Kong, Macao and Japan. Yoon said he once made a delivery of illegal narcotics to the Chinese border. "This country is so desperate to go on that they will do anything to survive," Yoon said. "Ninety-nine percent of their factories are not operating, there are no raw materials and no energy. Even fishing boats can't fish because there is no oil for fuel. The only way to earn hard currency is by drugs." While high school students elsewhere might get lectures on the evils of narcotics, another defector, who lives in Seoul and who declined to be named, said that he and his classmates were assigned at harvest time to work in the fields, slashing open the poppies for their resin. "The boys used to work for 40 minutes, the girls for only 30 minutes. You would get dizzy if you stayed too long," the defector recalled. "We didn't really know what it was, and we didn't ask. When I think back on it, I realize that North Korea is an ideal place to grow and export drugs because nobody will question the authorities or even question whether it is legal."

Key Producer of Opium

U.S. military intelligence officials in Seoul say that North Korea is the third-largest producer of opium despite its inhospitable climate and soil. Estimates of drug revenue range from $100 million to $500 million a year. The botched Australian deal appears to mark the beginning of a more ambitious approach by a regime badly hurt by a crackdown on weapons exports after the Sept. 11 attacks and by cuts in international donations of fuel, food and fertilizer. According to drug experts, North Korea had not attempted to sell its own heroin in Australia because the quality was so poor. This time, Australian police say, the heroin was of the high-quality Double UOGlobe brand most likely produced in Myanmar, another dictatorship largely closed off to the outside world. The Pong Su was registered in Tuvalu and flew the small Pacific nation's flag. Its owners equipped the vessel with extra fuel tanks so it could travel long distances - even circumnavigate Australia - without having to stop. The ship most likely picked up its cargo of heroin in Myanmar or Thailand and headed south around Australia's west coast, using established shipping lanes. By mid-April, the Pong Su had reached the southern end of the continent and headed toward Wye River, a popular tourist town about 80 miles southwest of Melbourne. If the smugglers had done their homework, they might have come up with a different plan. The place they chose to make their delivery is one of the country's most treacherous stretches of coastline. Similar to California's rugged Big Sur, it is known as the Shipwreck Coast because so many vessels ran aground here during the 19th century. The smugglers also picked the worst time for their rendezvous. Heavy surf is so predictable this time of year that an annual surfing contest is held up the coast at Bell's Beach. The week the Pong Su arrived, Wye River was packed with visitors enjoying a school holiday. "Everyone along the whole coast was wondering, 'What's that ship doing?' " said Richard Buckingham, a longtime Wye River resident. "It got so close people thought it was going to run aground. They did it right in front of everybody." About that time, Australian police were conducting electronic surveillance on two Malaysians and a Singaporean who were visiting Australia and were suspected of involvement in drug smuggling. But police were not on hand to see the Pong Su approach Boggeley Creek, two miles from Wye River, and launch its speedboat to hand over the drugs to the three foreigners. It's not clear where the small boat overturned; police suspect some of the shipment may have been lost in the surf, though 110 pounds made it to shore. For days afterward, divers searched the water and police scoured the beach. "No officers saw the boat capsize," said Frank Prendergast, the Australian Federal Police's southern operations director.

Hours after the bungled delivery, police found the body on the beach and arrested the three foreigners with the heroin in the nearby town of Lorne. It wasn't until the next day that an officer stumbled on the surviving North Korean smuggler hiding in the bushes at Boggeley Creek. Soon after the arrests, the chase of the Pong Su began. The cargo ship, traveling 10 knots, headed along the coast toward Sydney with surveillance planes and police, customs and navy vessels hot on its tail. The captain refused orders to pull into an Australian port, saying he had come from Indonesia and was headed to Papua New Guinea. For four days, the waves were so huge that police and customs agents could not board. "There was no chance that the vessel was going to get away," said customs spokesman Leon Beddington. "It was just a matter of deciding when it was safe to board it." When the seas calmed April 20, special forces commandos were lowered from helicopters, landed on the deck and seized the ship. More commandos boarded by boat. The Pong Su's crew offered no resistance. The ship was seized and taken into Sydney Harbor, where authorities discovered the custom-made fuel tanks. Authorities meticulously searched the vessel, using a particle analyzer so sensitive that it can find a grain of sand in an Olympicsize swimming pool.

'On Illegal Mission'
"In circumstances where the vessel had no cargo, no reason to be in Australia, was so far away from where it normally travels, and appears to have been modified for the purpose of making the journey, we say the ship was on an illegal mission to deliver that heroin to Australia," prosecutor Scott Bruckard told a Melbourne court in April at a hearing for the members of the crew. All 30 are being held for trial this year. Like the rest of Wye River, Max Rathbone, 77, was captivated by the vessel offshore, which he could see from his house on the hill above town. Smuggling heroin, the retired builder said, is more effective in destroying the West than making nuclear weapons. "It's a good way to kill a country," he said. "You don't have to fire bullets. They'll make a lot of profit, and they'll bring the young of the country down to their knees." Paddock reported from Wye River and Demick from Seoul. Times staff writer Sonni Efron in Washington and researcher Rie Sasaki in The Times' Tokyo Bureau contributed to this report.

Source: Los Angeles Times Date: 19 October 2003

Hidden Pain in Pain Pill

Vicodin's euphoria can extract a price, and Limbaugh may be paying for it. By Greg Critser,

Greg Critser is the author of "Fat Land: How Americans Became the Fattest People in the World" and the forthcoming "One Nation, Under Pills." Just when really serious things like war, disease and a bummer economy threaten to make the media business a rather dreary realm, enter the downfall by drugs of Rush Limbaugh. The drama has spawned comparisons (he's the "new Elmer Gantry"), compassion (he's an addict and we should show mercy even if he didn't show it to others) and vengeful rebuke (talk about hypocrisy!). Yet the truth about Limbaugh's fall may be more mundane than anyone wants to admit, Limbaugh included. Beyond the cultural politics swirling outside his detox room door, one truth is clear: What you don't know can hurt you, especially when it comes to a little pill called Vicodin, one of the painkillers Limbaugh is said to have used. Anyone who's had a tennis injury, root canal or — at least on the Westside — a bad hangnail knows Vicodin is good stuff. Not only does it kill pain but it also, as "Permanent Midnight" author Jerry Stahl said about heroin, "makes you feel so good, you feel like calling the phone company and telling them what a good job they're doing." Between 1988 and 1998, the number of prescriptions written per year for first-time users — most of them

middle- and upper-middle-class — of Vicodin and similar powerful painkillers grew from 500,000 to 1.6 million. Some of the people who got those prescriptions have undoubtedly become addicted to the euphoria they produce. And yet this aspect of Vicodin is little appreciated by the prescription-writing medical community. That is because critical, objective information about the drug — the kind we are accustomed to in these days of long FDA reviews and dramatic advisory committee meetings — is thin at best. Hydrocodone (the chemical name of Vicodin's primary ingredient along with acetaminophen) is one of hundreds of older drugs that were introduced before 1962, when Congress passed a landmark amendment to the Food and Drug Act that gave the FDA much more power to oversee safety and efficacy testing. But buried in a series of tests done in the 1930s are a number of troubling facts. First, a primer: Hydrocodone was first manufactured in the early 1920s by the German pharmaceutical company Knoll. As its name denotes, hydrocodone is the codeine molecule with a hydrogen atom attached. At the time, Knoll believed hydrogenizing codeine might make it less toxic and easier on the stomach. At about the same time, the U.S. government was searching for an answer to the growing "opium problem," the thousands of middle-class Americans who became hooked on opium derivatives then used as cough suppressants. In 1929, the U.S. Bureau of Social Hygiene gave the National Research Council several million dollars to study various new compounds like hydrocodone, seeking to find a less addictive painkiller. To do so, the National Research Council appointed Dr. Nathan Eddy, a pharmacologist and professor at the University of Michigan. Eddy's charge was to assess the safety, efficacy and side effects of 350 drugs, from morphine and codeine to Dilaudid and hydrocodone. Efficacy testing was rigorously carried out on hundreds of laboratory animals. To find out how well a substance killed pain, Eddy devised a test in which a cat would be immobilized by a series of metal clamps; pressure would then be applied to its tail. A researcher would record how hard and long the pressure was applied before the animal "displayed a response." The animal would then be dosed with any one of a number of compounds. The researcher would then apply the same pressure, say, 25 minutes later. If the animal did not yelp, more pressure would be applied until the it finally "displayed a response." The difference between the first number and the last came to represent the compound's "analgesic effect." Fortunately for science, but unfortunately for the animals, Eddy was a thorough and dogged researcher, performing these experiments thousands of times. The results showed, among other things, that hydrocodone was an effective painkiller with predictable side effects. But hydrocodone also stood out from the pack in one remarkable way: It provoked such euphoria in the animals that Eddy felt compelled to warn of its abuse potential. Hydrocodone was a good cough suppressant, he wrote in 1934, but it also "induced euphoria, and therefore there was danger of addiction." It produced "excitation indistinguishable from that produced by morphine in morphine- tolerant rats." There was something else that made hydrocodone different from the other addictive compounds. As Eddy noted: "Its repeated administration to dogs and monkeys leads to the development of tolerance but more slowly than that of morphine or Dilaudid and to the occurrence of abstinence syndromes that are less severe than with the other drugs." Translation: One can become dependent on it without knowing one is dependent on it — until one is really hooked.

Eddy never found a nonaddictive analgesic, but hydrocodone and a number of other drugs he tested did work their way into the U.S. drug system. No one disputed that the drug was effective, and when prescribed in the less-is-more fashion with which painkillers used to be prescribed, it was quite safe. Approaches to pain medication changed dramatically in the late 1980s, when advocates for pain patients finally convinced medical authorities to loosen their grip on the pills. Their contention — a righteous one — was that bona fide pain patients were routinely undermedicated despite the existence of drugs that could alleviate their suffering. The American Medical Assn. and other medical groups issued guidelines to physicians encouraging more aggressive prescribing. Pain was dubbed the "fifth vital sign." Pharmaceutical manufacturers seized the opportunity; samples of hydrocodone, sold as Vicodin, were handed out to pain specialists — and also to dentists, family practitioners and any other physician who might have patients with pain. Generic manufacturers — five in the last eight years — jumped on the bandwagon, making the drug affordable. As prescribing culture changed, so did patient culture. Increasingly, patients were encouraged to "take a more proactive role" in their care. That's not a bad attitude in general, but misapplied to pain it can be disastrous, says Dr. Clifford Bernstein, a pain and addiction specialist at the Waismann Institute in Beverly Hills. "They [patients] find out that Vicodin rounds out the corners of life. Some of them actually think they deserve it, and are ingenious at finding ways to get it." His colleague agrees. "All of the attributes of the winner in today's economy — problemsolving, learning a system and knowing how it works — that's exactly what an addict needs to do," says Dr. David Crausman, a Beverly Hills psychologist who treats many middle-class dopers. "They've read the Physicians' Desk Reference. They read the medical journals so they can tell you, for example, that they are on certain other drugs that preclude you from prescribing a non-opioid." Yet these habits are now coming with bigger costs — costs like broken careers, broken marriages and broken bodies. Chronic abuse can cause liver problems if the hydrocodone is mixed with acetaminophen, as it is in Vicodin. Two studies of abusers strongly implicate the drug in sudden and profound hearing loss. We may be finding out that a drug for a stoic pharmaceutical culture may not be such a good drug for a more permissive culture. As UCLA's Dr. Robert Baloh, a co-author of a study published in Neurology in 2000, puts it, "The question for me is this: Who ever thought that plain old Vicodin would ever become the recreational drug of choice?" Certainly not Rush Limbaugh.

Source: Washington Post Date: October 21, 2003

Doctors Medicate Strangers on Web
Some Physicians Face Own Troubles
By Gilbert M. Gaul and Mary Pat Flaherty SAN ANTONIO -- At his worst, Ernesto A. Cantu was injecting himself 10 times a day with Demerol, swallowing tablet after tablet of hydrocodone, taking Ambien to sleep and using Valium for anxiety. "I became addicted," the stocky 60-year-old doctor said. "It's an illness." Even as Cantu wrestled with his own addiction, he was writing thousands of prescriptions for painkillers for customers of the Internet pharmacy thepillbox.com. Those orders were based on brief telephone conversations with patients Cantu never examined or even met. All together, he approved more than 1 million doses of hydrocodone and other dangerous drugs, court records show. At least five of Cantu's customers were addicts or later became addicted, according to state and federal records. An Alabama patient suffering from chronic alcohol abuse and depression overdosed on hydrocodone and was hospitalized for nine months. A San Francisco patient addicted to narcotics developed liver damage after receiving multiple orders of the painkiller Darvocet. A New Jersey mother previously treated for substance abuse received more than 800 doses of hydrocodone from Cantu and other thepillbox.com doctors. Cantu earned as much as $1,500 a day for writing Internet prescriptions. In nearly eight months, he said, he made $147,000. Other online doctors have made as much as $500,000 a year. "This is not Albert Schweitzer on the other end of the computer box," said Lee S. Anderson, a physician and president of the Texas State Board of Medical Examiners. "The people who are doing this know exactly what they are doing -- and they are doing it for the money." Across America, doctors beset by troubled histories work for rogue Internet pharmacies, grinding out tens of thousands of prescriptions each year for narcotics and other controlled substances. What passes for medicine in these online transactions is mostly a fiction. There are no medical records, examinations, lab tests or follow-ups. The doctors are recruited by middlemen who link them to Internet customers seeking access to the coveted drugs. The result is a virtual pain-management industry that feeds millions of doses of highly addictive drugs into the shadow market for pharmaceuticals, bypassing the normal checks and balances in the physician-patient relationship. "It's an easy way to make big bucks," said Jerry Ellis of the Drug Enforcement Administration's Houston office. "It's not like any of the doctors are truly practicing medicine or caring for the patients."

Internet pharmacies have attracted doctors with substance abuse problems, legal setbacks and financial woes. Among them: David L. Bryson: After losing his job as a staff physician for a state facility in Texas, the 65year-old joined thepillbox.com in 1999 after reading a newspaper article about its owner. Bryson had undergone alcohol dependency treatment in 1995 and filed for bankruptcy protection in 1999, according to Texas medical board records. In fewer than three years for thepillbox.com, he wrote 20,000 prescriptions for more than 4.7 million doses and collected nearly $1 million in fees, records show. About three-quarters of the prescriptions were for hydrocodone and Xanax. In 2002, the Texas board revoked his license for prescribing dangerous drugs to people he had not examined. A consultant to the board called Bryson's actions "a travesty." Bryson pleaded guilty last month in a related federal case and is awaiting sentencing. He declined to comment through his attorney. Allen L. Browne: In 1999, the 46-year-old obstetrician pleaded guilty to sexual exploitation of a minor and was sentenced to 10 months in prison. Browne was caught secretly videotaping his girlfriend's 13-year-old daughter showering and using the bathroom in his home in Mesa, Ariz. He kept his license but closed his practice in March 2001. Soon after, he began writing prescriptions for hydrocodone, codeine and Alprazolam for a Web site based in a Mesa auto parts store. In seven months, Browne wrote 2,568 prescriptions, earning $36,520. He surrendered his medical license earlier this year. He admitted to the board that customers might have misled him to get pills. Browne could not be reached to comment for this story. Marvin Gibbs: The 55-year-old gynecologist had recently lost privileges at an Arizona hospital, where he saw 90 percent of his patients, when he was approached in 2000 to write prescriptions for an online pharmacy. In 10 months, he wrote more than 9,000 prescriptions for more than 700,000 doses of controlled substances, according to records of the Arizona Board of Medical Examiners. "What in God's name were you thinking," a board member asked during a 2002 hearing, "prescribing to folks you have no idea who they are, where they're coming from, what they're doing with the medications?" In February, the board placed Gibbs on 10 years' probation. He did not respond to an interview request. Ricky Joe Nelson: Unemployed and reeling financially after the collapse of a business venture, the 47-year-old physician signed on in 2001 to write prescriptions for an Internet pharmacy in Oklahoma. In a few months, he wrote more than 5,000 prescriptions for controlled substances. In 2002, a federal jury convicted him of conspiring to distribute controlled drugs and launder $175,000 through an offshore bank account. He was sentenced to 51 months. He declined to be interviewed. Many other cases bear out that there are few checks on doctors who hand out drugs over the Internet: A Colorado doctor had a history of alcohol abuse. An Arkansas doctor was being treated for bipolar disorder and drug dependency. A Florida doctor had twice been cited for providing inadequate care to elderly patients, one of whom died. A Texas doctor was under investigation by the FBI for suspected Medicare fraud and later committed suicide. A California doctor was disciplined for operating under a fictitious name. A North Carolina doctor had held 22 jobs in five years.

Prescriptions Without Exams
Doctors who write prescriptions for Internet pharmacies maintain that the practice is safe and serves people who might otherwise not have access to painkillers and other medicines. Cantu, for example, told The Washington Post in an interview that his earlier experience working in a hospital emergency room helped him identify online patients who might abuse drugs. "Yes, it would certainly be better if I saw them, but this is a new form of communication," he said. Others stressed that many of their patients were between jobs, uninsured or had no regular doctor. The Internet sites allow them to refill prescriptions quickly without having to find another physician. State and federal regulators say all of these arguments lead to a larger question: What should physicians reasonably be expected to do before they write a prescription for a dangerous drug? In the past, the answer was relatively simple. Patients went to the doctor's office and were examined. The doctor saw the patient face-to-face "and could form an opinion whether there was drug-seeking behavior," said Anderson of the Texas State Board of Medical Examiners. The rise of the Internet complicated matters. The doctor did not see or know the patient and the patient had little, if any, information about the doctor. Initially, all the patient had to do was fill out a short online form. Later, as regulators started to raise questions, many Web sites added a brief telephone consultation. But those were often little more than a few stock questions. And there usually were no medical records, tests or histories. In 1999, the Texas medical board adopted rules for the Internet that require a face-to-face examination. "We were concerned that the Internet would foment drug-seeking behavior," Anderson said. "We also felt that the traditional physician-patient relationship was being sidetracked, especially for controlled substances. We just felt it was dishonorable." Since then, other state medical boards have adopted similar rules. But not every state. There is a lingering debate over whether Congress should step in with a federal requirement. "If each state would adopt and implement guidelines . . . there probably wouldn't be a need for federal legislation," said James N. Thompson, president of the Federation of State Medical Boards. "There is wide variation. Some states are very strict and some states have no enforcement whatsoever." The borderless nature of the Internet works against state regulation. In one case, a customer in New Jersey visited a site in Arizona that used a doctor in Alaska, while a pharmacy in California filled the order. "Until this happened, medicine was not really an interstate commerce problem," Anderson said. A uniform rule would allow regulators to track dangerous doctors across state lines.

"Right now if a California doctor did something to a kid in Texas, Texas has no authority over that," said Jon E. Porter, a lawyer who formerly directed compliance at the Texas medical board. "We have no idea how many people are being hurt. I think there are hundreds, if not thousands, of cases we don't know about. I think it is a huge crisis that the federal government has ignored." In the late 1990s, Congress considered requiring Internet pharmacies to disclose basic information about themselves and the doctors they used. But the debate was bogged down in arguments over jurisdiction and fears of harming e-commerce. Currently, customers logging on to most online pharmacies and doctor referral Web sites receive little information. Some Internet doctors have been hired by e-mail; others after they walked into pharmacies. Cantu was offered a job when he visited thepillbox.com to buy supplies for his diet center. Sandra G. LaFon, a board-certified internist from Texas, was hired in 2000 by thepillbox.com while she was home recuperating from a broken back. LaFon said she originally thought the site was "a real business." But after a few months she became alarmed when customers began to call her asking for controlled substances. "I had lots of people tell me they fell off the roof," she said. "I heard all kinds of lies. Alarms went off. I thought, this is getting out of control. When I found out a patient absolutely fabricated a whole story, I quit." William A. Stallknecht, the owner of thepillbox.com, pleaded guilty to illegally dispensing controlled substances. He declined to comment through his attorney. For her role in thepillbox.com, LaFon, 39, was fined $1,000 by the Texas medical board and ordered to take 10 hours of continuing medical education in risk management. She considers herself lucky. "I could have lost my license over this. I'm not like those other guys. I didn't write 400 scripts a day. The moment I found out things stunk, I got out."

A Doctor's Downfall
Sitting in a glass-enclosed visitors cubicle in a federal prison in San Antonio, Ernesto Cantu's voice falls to a whisper as he wonders whether there is any chance he will get his medical license back. His drab blue prison garb bears a vague resemblance to a surgeon's gown, but otherwise there are few hints of his medical past. Ever so slowly, Cantu's mouth tightens into a sad smile. "I guess that's wishful thinking," he says, answering his own question. "But I can still hope." At the moment, all Cantu faces is the prospect of more time in prison. In October 2002, he pleaded guilty in two state cases for attempting to buy Demerol with a fictitious prescription and for sexually molesting a 13-year-old girl. That same month, he also pleaded guilty to a federal charge of conspiracy to dispense controlled substances for thepillbox.com. He was sentenced to six years on the state charges. He is now being held in the federal facility while awaiting sentencing for the federal charge. He faces as many as five years in prison and a $250,000 fine.

Cantu has fallen far. He grew up in Brownsville, Tex., on the Mexican border, the eldest of six children. His parents owned a fencing company and encouraged their children to study. Cantu was a good student and worked as a pharmacist in south Texas for several years before completing medical school in Guadalajara, Mexico. After finishing an internship in Camden, N.J., and working in emergency rooms in south Texas, Cantu relocated to San Antonio in 1987. He eventually set up a diet center in a strip mall, where he worked in the mornings. In the afternoons, he ran a small general practice on the other side of town. Cantu described his practices as busy, adding that he was clearing $8,000 to $10,000 a month. Still, he had a significant financial problem. He owed the Internal Revenue Service about $80,000. He eventually filed for bankruptcy protection "to keep the IRS from putting liens on me." That was not his only legal headache. In May 1992, he was charged with assault and making terroristic threats toward his live-in girlfriend. "We had some domestic disputes," Cantu said. The case was dismissed. A 1995 arrest on suspicion of possession of a controlled substance also was dropped. Cantu started writing prescriptions for thepillbox.com in late 2000 and continued through the summer of 2001. He said he purchased supplies from the Pillbox Pharmacy but did not know that its owner, Stallknecht, had started an Internet business. "I didn't know him that well," he said. "One day he asked me, 'How would you like to join up as a consultant?' " Cantu said he made informal inquiries into whether prescribing for Internet customers was legal and was assured that it was. Initially, he said, he wrote about 10 prescriptions a day, gradually increasing to 30 or more. He was paid $45 per prescription. Thepillbox.com used a middleman to arrange the telephone consultations. Cantu said he received some medical records. But as time went on, "the medical records and the diagnoses started to decrease," he said. "I'm not going to sit here and say I had a medical record for every patient." In hindsight, Cantu said, "I am thinking it is not a good way to practice medicine because there is no way to evaluate the progress of the patient and also make sure the patient is not abusing the medication." One patient who took advantage of the system was Connie Cuccaro, 44, a New Jersey mother with a 10-year history of substance abuse. Between Dec. 8, 2000, and Jan. 17, 2001, she received 300 tablets of Vicodin, a brand-name version of hydrocodone, from thepillbox.com. That was at least 100 tablets more than the manufacturer's recommended dose for that time period, according to an investigative report prepared for the New Jersey attorney general. Cuccaro declined to be interviewed. However, in a February 2001 deposition she testified that Cantu never asked her if she had a drug problem.

Q: He never inquired? A: No. The conversation was less than 10 minutes. Very simple, very quick. I was very surprised when I hung up. I couldn't believe it was that easy. Cuccaro admitted taking more of the Vicodin than needed. "I am a prescription-drug addict," she told investigators. In November 2000, Cuccaro was scheduled for another consultation with Cantu but missed the call when she left on a three-day anniversary trip with her husband, Joe. A few days after returning, Cuccaro contacted the doctor referral service to reschedule. The manager said it was not necessary, records show. Her medical chart showed she had already had the consultation. A few days later, Cuccaro received her next shipment of Vicodin, with the number of pills increased from 90 to 100. At that point, Joe Cuccaro was begging thepillbox.com to stop the shipments, he told The Post. "They basically laughed at me," he said. Cantu said he would never have sent Cuccaro more pills without a consultation. "It's not something I would do." It is easy for patients with drug problems to fool doctors, he said. "They were the ones trying to get these meds. They were the ones who asked for certain meds, who gave symptoms that led you to prescribing certain meds."

Road to Addiction
Cantu's own road to addiction started with the pills he said he took 20 years ago for back pain. "I initially started with Darvocet in the '80s and around 1995 I started using hydrocodone." In October 2000, Cantu added Demerol to the mix. "I briefly became addicted to it." At the time, Cantu was living with Anne Malley and her teenage daughter in a gated community known as the Enclave. Although Cantu's signature appeared on the prescriptions he wrote for thepillbox.com, he allowed Malley "to represent herself as Dr. Anne Cantu and provide the telephone consultations with patients," according to the Texas medical board. Cantu said Malley "did answer the phone at times and speak with patients. But she would not prescribe any medications." Malley's name appeared on a summary sheet of physicians prescribing drugs for thepillbox.com, according to a 2001 affidavit prepared by a Food and Drug Administration investigator. The affidavit states that she was paid $42,340 by the Internet pharmacy, and used several of the checks as a down payment for a 2001 Mercedes-Benz E350 costing $54,575.

Cantu frequently wrote prescriptions for Demerol in the names of patients and employees who had not sought the drugs, state investigators said. The fictitious prescriptions were for the purpose of obtaining Demerol for Respondent's girl friend, Anne Malley, and/or the Respondent himself," the Texas medical board later stated. "There is probable cause to believe that Respondent abused Demerol and/or that he has knowingly aided his girl friend, Anne Malley, in abusing Demerol." When federal agents searched Cantu and Malley's home in October 2001, they found 96 empty vials of Demerol and syringes in the trash. "At that time," Cantu said, "I did not feel either of us was abusing. But at that time both of us were addicted." Malley did not respond to repeated interview requests. Cantu said he was taking as many as 10 tablets of hydrocodone during the day and injecting himself with as many as 10 ampules of Demerol at night. "I didn't use the Demerol during office hours," he said. He insisted that his addiction did not interfere with his practice of medicine. "Just because a person takes hydrocodone and is addicted to it doesn't mean he can't function in a normal way," he said. Anderson, head of the Texas medical board, wondered why the board did not catch Cantu sooner. "What he did is shocking," Anderson said. "It is absolutely shocking behavior, and it's totally out of control." The board did have Cantu on its radar. In October 2000, it alleged that he prescribed "frequent high doses of narcotics" to a patient, including numerous painkillers. Cantu was ordered to complete at least 50 hours of continuing medical education. Porter, the board's former head of compliance, described the settlement as "garbage." He said Cantu "was handing out drugs left and sideways." Porter said he was worried that Cantu was going to repeat his mistake "and probably hurt somebody."

License Suspended
Cantu said that on Thanksgiving 2001 he prepared a turkey and watched as Malley's daughter and two neighborhood girlfriends roasted marshmallows in the fireplace. He had taken Demerol, Soma (a muscle relaxant), Valium and Ambien. He said he went to bed and blacked out. According to court records, Cantu returned to the living room, where the girls were sleeping, and fondled a 13-year-old neighbor. The girl raced from the house. Cantu said he cannot recall the incident. "As to what happened, I have no idea," he said. "I don't remember anything else." He was charged with indecent sexual contact with a child. The next month, on Dec. 7, 2001, Cantu's Texas medical license was suspended. But a week later he appeared at a local pharmacy with a prescription he had written for himself for Demerol. An alert pharmacist contacted the DEA and Cantu was arrested. When police

searched his car, they found a .22-caliber rifle that Cantu said he purchased at a gun show. Police said it was stolen from the Nashville Police Department. "It was broken," Cantu said. "Here in Texas everybody has a rifle." Cantu hopes that he will be released soon and that he will get his license back. Anderson said, "That is very unlikely."

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Source: Expatica Date: 22 October 2003

Orgasm 'akin to a shot of heroin'

AMSTERDAM — According to Groningen professor Gert Holstege, an orgasm is akin to a shot of heroin and his findings could assist in the production of a so-called orgasm pill. Holstege said the interim results of his study — which showed that an orgasm and heroin have a similar effect on the brain and could be thus similar experiences — could have positive consequences for those who have difficulty having sex, such as the elderly, newspaper De Telegraaf reported on Wednesday. The Rijksuniversiteit Groningen professor said researchers used a so-called PET scan to conduct the investigation and sought willing volunteers to have sex inside the scan. The person who experienced an orgasm was requested to hold his or her head still while experiencing the physical sensation. The volunteers had practised before engaging in the research. Male participants were also requested to ejaculate within seven minutes — something that most participants did not have any problems with, Holstege said. The implications of the study means that a pill could in future be developed to assist people to not only have sex, but to also experience an orgasm. Erection pills such as Viagra, only assist people to have sex. But the researcher denied the new pill would be a simple "fun pill", claiming that the medicine could totally influence a person's emotions, allowing them not only to have sex, but to bring it to a satisfying end as well. "And that does not always succeed anymore with many men and women," Holstege said. The professor also said that most people want to continue having sex right up until they die and do not relish the prospect of being unable to give each other an orgasm. No time frame for the development of an orgasm pill was given, but Holstege said it would not occur in the short-term. ***

Source: US Newswire Date: 16 January 2004

Florida's War on Drugs Now a War on Doctors Says Association of American Physicians and Surgeons

WASHINGTON, Jan. 16 /U.S. Newswire/ -- The more than 48 million people who suffer chronic pain in the United States are having difficulty finding doctors to treat them as a result of misguided drug policy, law enforcement, and overzealous prosecutions -- and pending prescription reporting bills will only make things worse in Florida. "The 'war on drugs' has turned into a war on doctors and the legal drugs they prescribe and the suffering patients who need the drugs to attempt anything approaching a normal life," said Kathryn Serkes, public affairs counsel for the Association of American Physicians and Surgeons (AAPS) at a news conference held Friday in Orlando. The AAPS, along with the American Pain Institute, Pain Relief Network, and the National Pain Patients Coalition, joined to denounce the slate of state and Congressional legislative hearings, as stacked and one-sided to paint opioid drug patients as addicts and doctors who prescribe them as drug dealers. The intimidating tactics have resulted in an atmosphere of fear --doctors are afraid to prescribe opioids, and patients can't get the drugs they so desperately need. "Physicians are being threatened, impoverished, delicensed, and imprisoned for prescribing in good faith with the intention of relieving pain," said Ms. Serkes. "And their patients have become the collateral damage in this trumped-up war." Florida law actually requires doctors to treat pain patients, but legislators who want to look tough on "drug dealers" are making that almost impossible. "If they thought they could balance the Medicaid budget on the backs of pain patients, they are seriously mistaken," said Ms. Serkes. Some patients require very large doses, sometimes literally hundreds of pills in each prescription -- a number that may seem alarming to people unfamiliar with current

treatment standards in pain management. Other patients report that they have lied about being heroin addicts in order to get pain medication at methadone clinics. The situation has become so critical that AAPS has issued a serious warning to doctors: "If you're thinking about getting into pain management using opioids as appropriate -DON'T. Forget what you learned in medical school -- drug agents now set medical standards. Or if you do, first discuss the risks with your family." (See http://www.aapsonline.org) "If this continues, pain patients will be back in the Dark Ages of 'pain clinics' that basically told the patients they had to learn to 'live with the pain' -- except possibly if they had cancer and then they wouldn't have to live with it for very long," said Ms. Serkes. "Prosecutors hell-bent on targeting career-making, high- publicity cases on the backs of patients and doctors," said Ms. Serkes. "Recent actions show prosecutors have little concern about the trail of destruction left by their actions as patients face crippling pain and gutwrenching withdrawal." For example, 1. Assistant U.S. Attorney Gene Rossi declared to a reporter that "our office will try our best to root out (certain doctors) like the Taliban. Stay tuned." In September, the President pointed to physician prosecutions as the example of how he wants to pursue terrorists. 2. Florida's "drug czar compared opioid prescribing to "mass murder" and vowed "We want to make an example out of those doctors who are violating the Hippocratic Oath and the law." 3. The prosecutor in the case of Dr. Cecil Knox of Roanoke Virginia told all of Dr. Knox's abandoned patients on the brink of withdrawal to go to federal clinics -- none of which are allowed to prescribe pain treatment, according to a court officer. 4. Doctors such as Jeri Hassman of Tucson, AZ, are effectively prevented from treating patients, sometimes for years, while their cases make their way through the courts. 5. In Florida, Dr. James Graves is serving more than 60 years for manslaughter after several of his patients overdosed on pain medications in combination with other drugs, including illegal street drugs. "If this continues, there won't be one doctor left willing to prescribe the drugs that patients so desperately need," said Ms. Serkes. Ron Myers of Mississippi, both a physician and minister, outlined devastating impact on his patients, and the inordinate impact on the African-American community, and representatives of the Pain Relief Network and National Pain Patients' Coalition told their stories.
(NOTE: The Association of American Physicians & Surgeons is a non-partisan professional association of physicians in all specialties, dedicated since 1943 to protection of the patient- physician relationship. AAPS is dues supported, and accepts no government funding, or pharmaceutical or other corporate underwriting.)

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Source: Daily Telegraph Date: 6 February 2004

Legalise heroin and sell it on street, says police chief
By Nigel Bunyan

North Wales police chief Richard Brunstrom A chief constable provoked outrage yesterday by suggesting that heroin should be sold on street corners or in pharmacies. Richard Brunstrom, who is in charge of North Wales police, said he believed that the drug laws were doing "more harm than good." They left vulnerable people in danger, while enabling criminals to make massive profits. "Heroin is very addictive, but it is not very, very dangerous," he told the Dragon's Eye programme on BBC Wales. "It is perfectly possible to lead a normal life for a full life span and hold down a job while being addicted to the drug. "I don't advocate anybody abusing their bodies with drugs, but clearly some want to. What would be wrong with making heroin available on the state for people who want to abuse their bodies?" He went on: "The question is actually not, 'Am I prepared to see the Government selling heroin on the street corner or through the pharmacy?' but 'Why would we not want to do that? What is wrong with that? "It is a very challenging question. I don't know what society's answer is, but my answer is that is what we should be doing because our current policy is causing more harm than good." He claimed that "an enormous" number of people of all ages and all sections of society were "ready to see a root and branch change to our drug laws". Such a move, he said, could cripple the multi-million-pound trade in illegal drugs.

Mr Brunstrom has recently been heavily criticised over his campaign against speeding motorists. He first outlined his views on drugs three years ago, when he told his police authority that the battle against the suppliers could be won only if drugs were legalised. Despite the outlay of billions of pounds and thousands of hours in police time, the number of addicts had multiplied at an alarming rate. He likened the laws on drugs to those on alcohol prohibition in the United States during the 1920s. The latter, he pointed out, had been "an unmitigated disaster". Mr Brunstrom declined to elaborate on his views last night. His spokesman said: "The chief constable's views on the subject are widely known and there is nothing further to say." The Association of Chief Police Officers was unimpressed by Mr Brunstrom's outburst. Andy Hayman, the Chief Constable of Norfolk and the association's spokesman on drugs, said: "Acpo does not support either the legalisation or open sale of any controlled drug. It is not the role of the police service to advocate measures which require expert medical or scientific opinion." However, a Welsh Labour MP supported the call. Martyn Jones, MP for Clwyd South and chairman of the Welsh affairs select committee in the Commons, said: "I believe he is right to open the debate. "His solution is certainly controversial, but that is no reason to preclude an intelligent and informed debate on this subject. We cannot close our eyes to the problems generated by drugs any longer." ooOOOoo

Source: The Connection Newspapers Date: 21 December 2004

McLean Pain Doctor Sent to Prison
Hurwitz convicted on 50 counts. By Ken Moore

Dr. William E. Hurwitz waited five days for the U.S. District Court jury to reach its verdict after his six-week trial. At 4:35 p.m. on Wednesday, Dec. 15, senior judge Leonard D. Wexler told the McLean pain doctor to rise and face the jury. Hurwitz was convicted of 50 of 62 counts against him, including conspiracy to traffic in controlled substances, drug trafficking resulting in serious bodily injury and death, and drug trafficking distributions. Wexler revoked Hurwitz’s $2 million bond, and he was taken into custody. Sixteen hours later, Hurwitz returned from his first night in Alexandria jail while the jury resumed deliberations on three final counts against him. This time, Hurwitz's 24-year-old daughter, his ex-wife and mother sat in the first row behind the defendant's table. U.S. marshals wouldn't permit Hurwitz to greet his McLean family, and he could only watch as his daughter bowed her head and silently wept. Hurwitz, 59, who was once featured on "60 Minutes" and has received numerous awards for his treatment of patients with chronic pain, shook his head. "I don't give up hope that we can resolve the ideas regarding the issues in this case, short of my spending the rest of my life in jail," Hurwitz said Monday, Dec. 13, during the jury's third day of deliberation. "I am performing a public service even being here. It's brought to a head numerous issues that need to be resolved." The jury, which found Hurwitz not guilty of engaging in continuing criminal enterprise and health-care fraud, couldn't reach consensus on the final three counts. But Hurwitz, who will be sentenced in February or March for the 50 counts on which the jury returned a guilty verdict, faces the possibility of spending the rest of his life in jail. ASSISTANT U.S. ATTORNEYS Eugene Rossi and Mark Lytle introduced 63 witnesses to testify against Hurwitz. They convinced the jury that Hurwitz continued to prescribe high

doses of addictive and highly sought opioid narcotics to patients he knew were addicted, were selling the pills he prescribed, or both. Approximately 15 former patients, convicted of felony offenses, testified; many said they made hundreds of thousands of dollars selling portions of Hurwitz's prescriptions, including those for OxyContin. Although Rossi and Lytle didn't dispute the care Hurwitz provided to some of his patients with chronic pain, they said Hurwitz ignored obvious warning signs that demonstrated that some patients were abusing and diverting his prescriptions. "The huge amount of pills [prescribed] were just obscene. … They sent shock waves across our community," Rossi said, during closing arguments. "Those prescriptions caused havoc and harm." HURWITZ'S ATTORNEYS will appeal the decision by the Feb. 1 deadline set by Wexler. They tried to show the jury that opioid therapy is an evolving science — "still struggling with its own protocols," according to Patrick Hallinan, — and that Hurwitz was one of the few doctors in the country prepared to prescribe enough medication to relieve the unrelenting and debilitating pain suffered by his patients. They called their client a courageous, compassionate doctor who was duped by a small percentage of his patients who exaggerated their pain and sold parts of their prescriptions. When Hurwitz testified, he called abrupt stoppage of prescriptions tantamount to torture, even when patients were addicted. "There's no place a doctor can go to find out what is or what is not permitted," said Hurwitz's attorney, Marvin Miller, after the jury's verdict. THE TRIAL was closely watched by advocates for patients with chronic pain, who say that the prosecution of doctors will force millions of people to suffer, as other doctors around the country refuse to take the risk of prescribing opioid therapy. "The easy answer is to just not get involved," Hurwitz said, while the jury deliberated. "People don't go into medicine to avoid risk.They go into medicine to help people and confront risk. "My instinct was to treat and to take the risk and try to help people," he said. Hurwitz's attorneys requested that he be allowed to stay in the Alexandria Detention Center so they can work with him on their appeal. Wexler recommended this, but said, location is ultimately for marshals to decide. At 10:55 a.m. last Thursday, marshals led Hurwitz back to jail. His family could only watch as he blew them a kiss.

***

Source: New York Times Date: 27 May 2007

Web Sites Listing Informants Concern Justice Dept.
By ADAM LIPTAK There are three “rats of the week” on the home page of whosarat.com, a Web site devoted to exposing the identities of witnesses cooperating with the government. The site posts their names and mug shots, along with court documents detailing what they have agreed to do in exchange for lenient sentences. Last week, for instance, the site featured a Florida man who agreed in September to plead guilty to cocaine possession but not gun charges in exchange for his commitment to work “in an undercover role to contact and negotiate with sources of controlled substances.” The site says it has identified 4,300 informers and 400 undercover agents, many of them from documents obtained from court files available on the Internet. “The reality is this,” said a spokesman for the site, who identified himself as Anthony Capone. “Everybody has a choice in life about what they want to do for a living. Nobody likes a tattletale.” Federal prosecutors are furious, and the Justice Department has begun urging the federal courts to make fundamental changes in public access to electronic court files by removing all plea agreements from them — whether involving cooperating witnesses or not. “We are witnessing the rise of a new cottage industry engaged in republishing court filings about cooperators on Web sites such as www.whosarat.com for the clear purpose of witness intimidation, retaliation and harassment,” a Justice Department official wrote in a December letter to the Judicial Conference of the United States, the administrative and policy-making body of the federal court system. “The posting of sensitive witness information,” the letter continued, “poses a grave risk of harm to cooperating witnesses and defendants.” In one case described in the letter, a witness in Philadelphia was moved and the F.B.I. was asked to investigate after material from whosarat.com was mailed to his neighbors and posted on utility poles and cars in the area. The federal court in Miami has provisionally adopted the department’s recommendation to remove plea agreements from electronic files, and other courts are considering it and experimenting with alternative approaches. Judge John R. Tunheim, a federal judge in Minneapolis and the chairman of a Judicial Conference committee studying the issue, acknowledged the gravity of the safety threat posed by the Web sites but said it would be better addressed through case-by-case actions.

“We are getting a pretty significant push from the Justice Department to take plea agreements off the electronic file entirely,” Judge Tunheim said. “But it is important to have our files accessible. I really do not want to see a situation in which plea agreements are routinely sealed or kept out of the electronic record.” Judge Tunheim said his committee was working on recommendations for a nationwide approach to the issue. He said he favored putting the details of a witness’s cooperation into a separate document and sealing only that document, or withholding it from the court file entirely. For those who want to read the details on cooperating witnesses, whosarat.com charges between $7.99 for a week and $89.99 for life. The latter option comes with a free “Stop Snitching” T-shirt. The site was started by Sean Bucci in 2004, after he was indicted in federal court in Boston on marijuana charges based on information from an informant. The site was initially modest and free, the seeming product of a drug defendant’s fit of pique. Over time, it attracted thousands of postings, many backed by court documents. Mr. Bucci was convicted in February and will be sentenced next month. Stylianus Sinnis, a lawyer for Mr. Bucci, who is incarcerated, would not say whether Mr. Bucci was still affiliated with the site. Contacted by e-mail, Mr. Capone called a reporter at an arranged time. He would not provide his phone number but insisted that his name was authentic. He said Mr. Bucci was no longer associated with the site. The site itself says it is “designed to assist attorneys and criminal defendants with few resources.” Defense lawyers are, in fact, hungry for any information about the nature of the case against their clients. “The more information out there, the easier it is for the truth to come out at trial,” said David O. Markus, a criminal defense lawyer in Miami. Lawyers and their investigators can, of course, check court files and gather other material featured on the site themselves. But the site makes it easier, cheaper and quicker to find information about informants who may be involved in several cases in several jurisdictions, the site’s spokesman said. Eliminating electronic access to plea agreements and related documents would represent a real hardship, Mr. Markus said. “It doesn’t advance any of the stated safety goals, and it just serves as a roadblock to the public’s constitutional right to access to their court,” Mr. Markus said. “If there is an issue in a particular case, then let’s address it, but to sweep everything under the rug isn’t right.” The site says that it “does not promote or condone violence or illegal activity against informants or law enforcement officers.”

Frank O. Bowman, a former federal prosecutor who teaches law at the University of Missouri, disputed that. “It’s reprehensible and very dangerous,” Professor Bowman said of the site. “People are going to die as a result of this.” Defendants who choose to go to trial will, of course, eventually learn the identities of the witnesses who testify against them. But the site also discloses the identities of people engaged in undercover operations and those whose information is merely used to build a case. The widespread dissemination of informants’ identities, moreover, may subject them to retribution from friends and associates of the defendant. Still, Professor Bowman, an authority on federal sentencing law, said he would hate to see the routine sealing of plea agreements. “It certainly is terribly important for the public ultimately to know who’s flipped,” he said. Professor Bowman added that he was studying the deals prosecutors made in the aftermath of the collapse of Enron, the energy company. “To do that effectively,” he said, “I really need to know who flipped and the nature of their plea agreements.” Judge William J. Zloch, the chief judge of the Federal District Court in Miami, said the move to bar electronic access to plea agreements there was supported by prosecutors and some defense lawyers. “It’s available to the public,” he said of the documents. “It’s just that you have to go the courthouse.” Judge Zloch added that his court would discuss whether to make the change permanent in the coming months. The existence of the site raises a First Amendment issue for its founder, Mr. Bucci. After his conviction, he filed a motion last month seeking a new trial, saying the government’s true purpose in prosecuting him was to shut down the site because “he dared to assert his First Amendment right” to post the information. In a response filed Thursday, prosecutors conceded that “various levels of government have long expressed concern that the Web site endangers the lives of informants and undercover agents, and compromises investigations.” But they denied that the government’s dismay about the site influenced their decision to prosecute Mr. Bucci. Most legal experts agreed that whosarat.com is protected by the First Amendment. In 2004, a federal judge in Alabama refused to block a similar site created by a criminal defendant, Leon Carmichael Sr., who has since been convicted of drug trafficking and money laundering. “While the Web site certainly imposes discomfort on some individuals,” Judge Myron H. Thompson wrote, “it is not a serious threat sufficient to warrant a prior restraint on Carmichael’s speech or an imposition on his constitutional right to investigate his case.” But Judge Thompson’s ruling was not categorical. “A few differences in Carmichael’s site could have changed the court’s calculus,” he wrote. And some law professors said that sites like whosarat.com might be subject to prosecution for obstruction of justice or aiding and abetting crimes.

In its December letter, from Michael A. Battle, then the director of the Executive Office for United States Attorneys, the Justice Department urged courts to put a statement on their Internet sites “warning against the republishing or the other use of official court records for illicit purposes such as witness intimidation.” Judge Tunheim said his Judicial Conference committee was awaiting legal advice on that possibility. For now at least, the Justice Department and the federal judiciary appear to be focused on keeping information from the sites rather than trying to stop the sites from publishing what they learn. Government secrecy, said Eugene Volokh, a law professor at the University of California, Los Angeles, “ends up being part of the price you pay for having broad speech protection.”

***

Drugs & the Christian
By Rev. Dale A. Robbins, D.Min. Today in America, the widespread abuse of drugs and narcotics is a cancer that has devastated our nation. Drugs are linked to virtually every evil and criminal activity within our society. While it should be obvious that the use of mind-bending drugs is inappropriate for serious followers of Christ, yet there are Christians who occasionally attempt to justify their continued use of drugs. Let us be reminded that if any person has genuinely become a “new creature in Christ” the Bible says that old things are supposed to pass away... that all things should become new (2 Cor. 5:17). Therefore, every believer should seek to put on the new creation of Christ, and to put off the old life, including the continued use of mind altering drugs and narcotics. Christians should not do drugs for the following seven reasons:

1. Drugs have a Proven Connection with Sorcery and Witchcraft
Revelation 21:8 “But the cowardly, unbelieving, abominable, murderers, sexually immoral, sorcerers, idolaters, and all liars shall have their part in the lake which burns with fire and brimstone, which is the second death.” According to W.E. Vine’s expository dictionary of New Testament Words (page 1074), the word SORCERY comes from a Greek word, PHARMAKIA - used as a noun, it “signifies a sorcerer,” one who uses drugs, potions, spells, enchantments, as in Rev. 21:8. The english word for drugs, pharmacy, comes from this same root. Drugs and potions have traditionally been used in witchcraft and satanic rituals to induce deeper subconscious states which enable persons to have fellowship and communication with demons. Realizing the satanic relationship with drug use helps us to understand why abusers of drugs experience such bondage and depravation. No where in the Bible or in history have drugs been used to bring people closer to God - they have always been used in relation to bringing people closer to evil powers and demonic influences.

2. Drugs have an Obvious Affiliation with the Desires of Satan
In the daily newspaper reports, the ravages of drugs are continually linked with the headlines of Death, Robbery and Destruction. If this sounds familiar, it should. According to the Bible, these happen to be the identical characteristics of Satan. John 10:10 “The thief [Satan] does not come except to steal, and to kill, and to destroy. I have come that they may have life, and that they may have it more abundantly.” Satan is the evil inspiration behind the destructive nature of drugs. They are his own tools which, when persons are under their influence, accomplish his goals and fulfill his wicked desires. Understanding the satanic relationship with drugs, Christians should find it easy to understand why drug use doesn’t mix with a Christian life-style.

1 Corinthians 10:21 “You cannot drink the cup of the Lord and the cup of demons; you cannot partake of the Lord’s table and of the table of demons.”

3. Drug use will Cause Others to Stumble
According to the Bible, believers are accountable to avoid anything which would lead our brethren astray or cause them to stumble in their relationship with God. Romans 14:21 “It is good neither to eat meat nor drink wine nor do anything by which your brother stumbles or is offended or is made weak.” For the sake of our brethren in Christ, and for our own protection from temptation, the Bible tells us to refrain from anything that may even “appear” sinful. “Abstain from every form of evil” (1 Thes. 5:22). Those who are mature in the Lord are supposed to use their life-styles as an example for others to follow. They deny selfish desires and personal preferences in order to minister to those who are less mature. Romans 15:1-3 “We then who are strong ought to bear with the scruples of the weak, and not to please ourselves. {2} Let each of us please his neighbor for his good, leading to edification. {3} For even Christ did not please Himself; but as it is written, The reproaches of those who reproached You fell on Me.”

4. Christians are no Longer Their Own
The Bible says that we belong to the Lord and we are to glorify Him with our body and with the way we live. 1 Corinthians 6:20 For you were bought at a price; therefore glorify God in your body and in your spirit, which are God’s. 1 Corinthians 10:31 Therefore, whether you eat or drink, or whatever you do, do all to the glory of God.

5. We’re not to be Infected by Mind Bending Stimulants
The Bible warns believers to not be intoxicated by alcohol, and (by implication) others stimulants such as drugs1 which distorts our thinking or alters our ability to control our behavior. Instead, the scriptures teach that we should be under the influence of God’s power -- that is, we should be filled with His Spirit which gives us the “buzz” of His power, His peace and strength. Ephesians 5:17-18 “Therefore do not be unwise, but understand what the will of the Lord is. {18} And do not be drunk with wine, in which is dissipation; but be filled with the Spirit...”

6. We are Warned not to Defile God’s Temple
1 Corinthians 3:16-17 “Do you not know that you are the temple of God and that the Spirit of God dwells in you? {17} If anyone defiles the temple of God, God will destroy him. For the temple of God is holy, which temple you are.” Once again, we are reminded that Christians are God’s possession, and in fact, they are the dwelling place of His Spirit. For this reason, we must consider our bodies something sacred - not something to be trashed or abused. The word defile means to “pollute, foul or corrupt.”

7. Addictions Are Not Pleasing To God
An addiction is anything we cannot free ourselves from, which overrules our freedom to choose, whether physically or psychological. As Christians, we are given power over habits and behavior - they should not have power over us. 1 Corinthians 6:12 “All things are lawful for me, but all things are not helpful. All things are lawful for me, but I will not be brought under the power of any.”

Jesus Can Set You Free!
If you are addicted to drugs, ask Christ to give you power to overcome them, and He will. Don’t seek to justify your addiction, but keep reaching toward full and complete freedom. “But as many as received Him, to them He gave the right to become children of God, even to those who believe in His name:” (John 1:12). Seek the anointed prayers of church leaders and other Christians -- God promises to honor their prayer of faith to help you (James 5:15). Be encouraged. God will never condemn the person who keeps reaching out to Him -- who keeps trying to grow and make progress in Him. If you sin, ask Him to forgive you (1 John 1:9), then get up and keep moving on and growing closer to Him. And be assured, the closer you draw to Him, the further He will withdraw you from the old life of sin and bondage to drugs!

Drugs & the Christian
A response to the article by Rev. Dale A. Robbins from Derek Potter.
Introduction
Robbins has provided seven reasons why Christians should not take drugs:

1. 2. 3. 4. 5. 6. 7.

Drugs have a Proven Connection with Sorcery and Witchcraft Drugs have an Obvious Affiliation with the Desires of Satan Drug use will Cause Others to Stumble Christians are no Longer Their Own We're not to be Infected by Mind Bending Stimulants We are Warned not to Defile God's Temple Addictions Are Not Pleasing To God

Of these, 2, 3, 4, 6 and 7 all amount to the same thing: "Drugs are harmful and Christians have a special responsibility, so don't do them." 1, 4, 5, 6 and 7 touch on the spiritual aspects of drugs.

Hard Drugs
It is, of course, debatable whether even hard drugs are particularly harmful in themselves. Much harm is caused by the fact they are illegal, which immediately puts supply into the hands of criminals and forces the addict into a deplorable lifestyle. This might not happen if smack were freely available without stigma! However, the scenario of a nation of happy healthy hop-heads is probably as repugnant to most people as one where "drugs are linked to virtually every evil and criminal activity". This reaction should not be dismissed lightly and is Christianised - quite legitimately - in reason #7.

Soft Drugs
If the "drugs=crime" equation needs qualification in the case of hard drugs, it comes completely unstuck with non-addictive ones. Many are legal, many are physically harmless and many do not pose any more personal risk than competitive sports. Robbins is clearly mostly concerned with addictive drugs but the majority of readers are probably more interested in recreational and psychedelic/entheogenic use. Robbins does not help his arguments by lumping all such materials together under the perjorative term "drugs" which he then equates to criminalised addictive narcotics.

Recreational Drugs
As far as recreational use of drugs is concerned, although Christians are often shy about mentioning it, the fact is that our experience of God can and does lead to continuous deepfelt joy and occasional hilarity. Indeed, the first account of the Holy Spirit coming upon the Disciples specifically states that onlookers thought they were drunk. Peter, however, quickly showed his clear-headedness with an impromtu sermon. Reason #5 is fully applicable to recreational drug use: Christians have a better high than any artificially induced one. Furthermore, it comes directly from the Most High and therefore always has a point to it even if we don't know what it is immediately. Seeking euphoria for its own sake indicates there is something amiss. For the Christian, a desire to get stoned should be a warning bell: get back to your roots in Christ, draw close to Him and then see whether you still want anything else.

Entheogens
"every believer should seek to put on the new creation of Christ, and to put off the old life, including the continued use of mind altering drugs and narcotics."

The new life is undoubtedly the core reason why Christians should not take drugs. However I do not think that Robbins adequately explains why drug use is to be regarded as part of the old life. Indeed, many people regard drugs as a gateway to another world - and therefore as a way of casting off something which could easily be termed "old life". Clearly Christians need to explain why drug-assisted spirituality is a sham. For our purposes, a herbal DMT/MAOI mix (ayahuasca) typifies the witch's brew, despite the fact that in temperate Europe witches probably used atropine-laden plants for a very different psychological effect. Nevertheless, the principle objection in the Bible to witchcraft is the invocation of spirit beings. It's probably fair to say that whether you trip in order to get help from animal spirits for a specific situation or whether you fool around on the first bardo bartering memes with machine elves (!), either way you are effectively calling on spirit beings outside yourself. "I can call spirits from the vasty deep" "Why so can I, or so can any man; But will they come when you do call for them?" (Glendower and Mortimer in Henry IV Act III Scene 1). Well, they'd better not come and you had better not go to them either! Christianity raises the distinct possibility that they are purely out to deceive you. Unfortunately, psychedelic experiences are pretty convincing and it's not possible to be dogmatic whether all such experiences are pure fantasy out of the mind alone, a meeting with real demons pretending to be something else or a total fantasy obligingly provided by a malevolent intelligence - in order to persuade you that the cosmos is radically different from the created world believed in by Christians. (There are other possibilities, but these are the ones that would be plausible to a Christian.) It seems more than likely that if you call upon spirit beings you will get them but they will hide themselves from you. If you experience such beings it is probably an illusion. In short, the problem with this kind of drug use is not so much the drug but the fact you actively seek to meet with spirit entities despite being warned that they are malicious.

God
For many people the prize jewel of entheogenic use is a profoundly spiritual experience of God Himself (as against any lesser entity). It seems far-fetched to attribute such a thing to malicious spirits - especially if the experience is unsolicited. However, it's not ruled out and, in any case, the possibility of our wrongly interpreting a state of mind when highly suggestible is as strong as ever. We need an independent measure of the experience's validity - it may be unquestionably valid subjectively, but is it true in an absolute sense? Have you really experienced God or was it just a vivid hint with quite mundane causes? (On a trip the distinction may become meaningless: this should tell us something...) St John provides an acid (!) test: "Every spirit which acknowledges that Jesus the Christ has come in the flesh is from God; but any spirit which will not say this of Christ is not from God." Unless an experience points directly to belief that Jesus was God made flesh - and by implication that he came as man to die for our sins - then it is not God. LSD has been described as making a "run around Jesus Christ" bypassing the need for Calvary and faith in Christ. For the Christian this is simultaneously absurd and blasphemous.

Psychedelics
Where does this leave the experimenter who regards extreme states of mind as interesting or enlightening but who doesn't actively seek contact with external non-corporeal

intelligences - other than as a fantasy sequence that can be dissed at any time? Well, probably in a much safer place! But the fact remains that most drugs produce overwhelming impressions of being in another world or state and these are bound to excite spiritual ideas. Simultaneous feelings of oneness and otherness, of empathy and alienation - even at quite low levels of intoxication - are breeding grounds for a pantheistic mysticism which is diametrically opposite to the Biblical concept of a creator God. Of course, some people think their philosophy can transcend and encompass the Biblical view, but the Biblical theology claims to be a monopoly so they can't both be right. The Christian should have made up his or her mind. It may even be with some regret that we have to say we won't experiment with mind-expansion. After all, it's a fascinating subject, yet at its heart is a world-view that is incompatible with Christianity - as I can vouch for out of my own experience.

Redemption
Christianity is quite clear about this. We are redeemed as a free gift through the death and resurrection of Jesus. Robbins is absolutely correct to say that addicts can be set free through Christ - there are many well-documented examples. It is also true that Christ will set you free from the illusory spirituality provided by entheogens. However, redemption is not merely a matter of changing your mind-set, it is a rescue operation in which God replaces your very heart.

Summary
The Christian does have specific reasons to avoid all drugs that have a significant effect on perception - which would include most "highs". These reasons are to do with the nature of the experiences and their effect on our relationship with the creator God who submitted to death by torture - in our world - in order to undo the evil within us.

ooOOOoo

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