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Tuesday, 8 February 2011

The Deceitful World of Anti-Drug Zealots

Just how far will anti-drug and anti-harm minimisation pundits go to push their agenda? Read on as Paul Gallagher examines how some groups and individuals are bombarding us with flawed, cherry picked data as they attempt to influence drug policy.

The Deceitful World of Anti-Drug Zealots
A special report for The Australian Heroin Diaries
By Paul Gallagher

On February 2nd, an email appeared on the ADCA Update list from Jo Baxter, Executive Officer of the Australian branch of Drug Freedom, Drug Free Australia Inc. In line with the reality that Drug Free is Evidence Free, Jo had taken issue with Alex Wodak's insightful piece Agony over Ecstasy is helping no-one . It examined the arrest of Matthew Chesher, a suddenly erstwhile official in the NSW government and hubby to state minister Verity Firth, for purchasing an Ecstasy tablet.

Alex, Director of the Alcohol and Drug Service at St. Vincent's hospital Sydney, had returned from Lisbon, Portugal ten days prior and naturally included their now proven decriminalisation policy in his article. Jo wanted readers to get the real facts, and directed us, quite naturally one supposes, to Decriminalisation of Drugs in Portugal - The Real Facts!. Uh-oh, I cringed. An exclamation mark - the conspiracy theorists secret handshake - and "wfad" in the URL. 

What could it be? Decriminalisation causes autism? Portuguese stoners were behind 9/11? Not going to jail makes one more violent than video games? I braced myself and was rewarded with text book crap, ducking and weaving, thundering away at the evidence. The author was a moron, a crackpot even given his opinionated ramblings. He belonged on the World Forum Against Drugs site.

In recent and delightful forays into the twilight world of anti-vaccination conspiracies, I became acquainted with Scopie's Law. The anti-vaccination brigade are gullible in the extreme shirking reality - never mind evidence - in their quest to shift universal facts, including history, physics, geology, medicine, etc. Scopie's Law originated on the Bad Science forum thanks to Rich Scopie and states;

In any discussion involving science or medicine, citing Whale.to as a credible source loses you the argument immediately ...and gets you laughed out of the room.

It also includes "Answers in Genesis" to argue Creationism, or Educate-yourself.org. With respect to The World Forum Against Drugs, a strong case can be made to include it also. At least in our busy world, and given the importance of drug policy, it seems we find ourselves faced with the need for an equally efficient device. This is entirely due to time wasting to stem from balderdash published there solely to convey a negative view, couched in phoney "scientific" terms, of all manner of progressive policy initiatives. Not least, illicit drug decriminalisation in Portugal by Drug Free, prohibition worshipping, anti-drug proponents who also present archaic, brutal notions as rosy. 

The text of Decriminalisation of Drugs in Portugal - The Real Facts!, Manuel Pinto Coelho (Chairman of APLD - Association for a Drug Free Portugal and member of International Task Force on Strategic Drug Policy) - Feb. 2010, was published in a slightly updated form in Replies to Drug Decriminalisation in Portugal, October 2010, BMJ. He really shouldn't have continued the farce. Because three months prior the 2008 figures on Portugal were published, leaving him scant, if any pickings indeed.

As usual without a cursory bibliography it is difficult to confirm or deny the context of such sweeping statements, particularly as they are presented without trend or comparison. Citing the European Observatory for Drugs and Drug Addiction 2007, a number of claims are made. A quick search for the "Observatory" yields only the same articles by Coelho, and indeed The European Monitoring Centre for Drugs and Drug Addiction. The Observatory is mentioned in the Nov. 2003 Congressional Record USA, Vol 149, under "Intervention of the delegation of The Holy See", and a nice little reference to Pope John Paul II. Perhaps he meant the EMCDDA. Either way, it does him no good.

Some of his claims include;

In 2006, the total number of deaths as a consequence of overdose did not diminish radically compared to 2000, nor did the percentage of drug addicts with AIDS decrease significantly (from 57% to 43%). The opposite occurred. 

"The opposite occurred"? Page 48 of EMCDDA 2006 data, gives us some clarity on changing trends over time;

Data from the GMR (Selection B of the DRD Protocol) continue to indicate a decrease which started to take place from 1996 (114 cases) until 2005 (9 cases). The number of cases implies that breakdown data on them ceased to be available for statistics privacy reasons.

Although acute drug-related deaths are not yet possible to identify amongst the cases reported by the SMR, it has been possible to identify the percentage of suspected acute drug-related deaths. In 2006, 216 cases with positive post mortem toxicological tests were reported by the Special Register. A figure close to the one registered in 2005 (219) but an increase in comparison to previous years (156 on 2002, 152 in 2003 and 156 in 2004). 52% of the cases with positive toxicological tests and information on the presumed aetiology of death were suspected to be acute drug-related deaths. This percentage, which decreased between 2000 and 2003, increased in 2004 to 51% and again in 2005 to 58%, in comparison to previous years (44% in 2003, 58% in 2002, 73% in 2001 and 72% in 2000) and decrease again in 2006.

Regarding HIV/AIDS page 52 offers;

Taking only 2006 notified cases, 37% of the AIDS cases, 28% of the AIDS related complex cases and 19% of the asymptomatic carriers cases were drug use associated.
This agains reinforces the decreasing trend, verified since 1998, in the absolute numbers and percentage of drug users in the overall number of diagnosed AIDS cases, as seen in the graph below, despite the fact that, in 2005, the infection by HIV was included in the national list of diseases which implies mandatory notification.

EMCDDA 2006 DATA, p. 52


Further reading of that page offers more clarity. The 2007 data report reads very closely. 
Coelho continues; 

Portugal faces a worrying deterioration of the drug situation. The facts prove "With 219 deaths from 'overdose' per year, Portugal has one of the worst results, with one death every two days. Along with Greece, Austria and Finland, Portugal registered an increase of deaths by more than 30% in 2005 " and " Portugal remains the country with the highest increase of AIDS as a result of injecting drugs (85 new cases per million residents in 2005, when the majority of countries do not surpass 5 cases per million).  Portugal is the only country that recorded a recent increase, with 36 new cases estimated per million in 2005 when in 2004 only 30 were registered" (European Observatory for Drugs and Drug Addiction 2007). The European report also confirmed that in 2006, Portugal had registered 703 new cases of SIDA, which corresponds to a rate eight times higher than the European average!

It's a bit like screaming at surgeons in Causality as they begin to operate on a loved one bleeding to death from multiple injuries. "His B.P. is lower than when he arrived, he lost consciousness not long after you touched him! Of the 27 people in here he's one of the worst! This is a hospital and he's not getting better - why isn't he better? There's blood everywhere and I now have proof of bone fractures and swelling on the brain - which I didn't have before I came here!"

What's truly devious about the tactics used by anti-drug campaigners is the cherry picking of data. Despite having read, and quoted in the same article, the World Drug Report 2009 our friend Manuel will ignore it when it suits him. Extraordinary claims require the evidence to back them and that means a link or a citation backed by a bibliography. Another trick used to pass Portugal off as a nation of drug induced tragedy and woe, is Coelho's use of "Western European" figures or "France, Ireland, Spain, The United Kingdom, Italy, Denmark and Portugal". He omits to share with us, for example in the case of opiates, that of nine indices Portugal has lower usage per capita than Switzerland and on UK population figures, Portuguese addicts would equal approximately 260,000 - not the UK's own 440,000. Statistically opiate use is still lower than Italy, whilst higher than Germany, France, Spain and The Netherlands.




WORLD DRUG REPORT 2009 - PAGE 55.


Whilst 219 deaths from overdoses and a 2005 increase of 30%, "along with Greece, Austria and Finland" is eye catching, Coelho's "real facts" are quite welcome if we note annual OD's were ~ 400 before decriminalisation and "HIV cases caused by using dirty needles to inject heroin, cocaine and other illegal substances plummeted from nearly 1,400 in 2000 to about 400 in 2006, according to a report released recently by the Cato Institute, a Washington, D.C, libertarian think tank." 


Coelho dispatches Cato and others smartly in his opening, ominously painting himself into a corner. He writes;

Recent articles in the weekly British magazine, The Economist and The Cato Institute of Washington promote government options as a legitimate right. The problem is the rest; the manipulation of the facts and numbers is unacceptable!

Remember that - "manipulation of the facts and numbers...". More so, the very recent slight increase in negative outcomes is not contested by policy analysts nor a viable proof of legalisation's social malignancy, as seemingly claimed. The Boston Globe reported last month, citing research by Caitlin Elizabeth Hughes and Alex Stevens;

In fact, drug-related deaths in Portugal — after falling between 1999 and 2002 — jumped considerably between 2005 and 2008. 

But the drug-related death data is misleading, most likely due to a “shift in measurement practices,” and an increase in the number of toxicological autopsies performed, according to Hughes’s and Stevens’s research. And Hughes also takes issue with Humphreys’s argument that drug use, in general, is increasing at a dramatic clip.

What’s most relevant, she [Hughes] said, is not the percentage of people reporting using drugs at some point over some course of their lifetime, but the percentage of people reporting using drugs in the past year. “That’s going to be affecting the government and communities now,” she said. And here, the increase of Portuguese reporting illicit drug use is much smaller — up from 3.4 percent in 2001 to 3.7 in 2007."

The percentage of people reporting drug use in the past year... going to be affecting government and communities. 

Wise words from Hughes. When we look at “ever used”, “lifetime use” and recent use, vastly different conclusions can be drawn. If drug use is falling over a short time frame or in response to new initiatives, the drop can be lost if “ever used” figures are quoted. This includes, say, one time experimenters and new/long term sober ex-users responding to treatment, giving a skewed view of ever increasing drug use. 

Audaciously, Coelho scurrilously quotes the same IDC 2008 data as that used by Hughes and Stevens who arrive at almost polar conclusions, to state the mundane. "On the contrary, the consumption of drugs in Portugal increased by 4.2% - the percentage of people who have experimented with drugs at least once in their lifetime increased from 7.8% in 2001 to 12% in 2007". Which, in the context of pre-legalisation uptake and the now much reduced harm, increased treatment, reduced crime and deaths is nothing short of petulant and laughable.

More so, if one searches for these key words hoping to find the IDT making much of the equation, 12% - 7.8% = 4.2% one finds Coelho lurking in almost every corner of the internet that Portugal's success is reported. As noted he repeated his piece in Rapid Responses to Drug Decriminalisation in Portugal, BMJ - Oct. 2010. It's repeated in a comment to a BBC article here September 2010. The same day as he published it at WFAD it appears on Brazilian Humanitarians in Action. Comments at Wired In To Recovery January 12th, 2011 see "PeaPod" copy/paste the same text. In fact, everywhere one sees that 4.2% pop up it is attributed to Manic Manuel. Golf clap, dear reader, golf clap.

In The British Journal of Criminology, What Can We Learn From The Portuguese Decriminalisation Of Illicit Drugs?, Hughes and Stevens consult the IDT data extensively. Strangely, 4.2% is entirely absent in this voluminous text. It is here we can see why Coelho makes liberal use of combining Portugal with Spain and other nations. Consider Fig's 2 & 3 - number of offender arrests.

Their final conclusion continues the unraveling of Coelho...

In the Portuguese case, the statistical indicators and key informant interviews that we have reviewed suggest that since decriminalization in July 2001, the following changes have occurred:

small increases in reported illicit drug use amongst adults;

reduced illicit drug use among problematic drug users and adolescents, at least since 2003;

reduced burden of drug offenders on the criminal justice system;

increased uptake of drug treatment;

reduction in opiate-related deaths and infectious diseases;

increases in the amounts of drugs seized by the authorities;

reductions in the retail prices of drugs.

Perhaps the most damning abuse of evidence at Coelho's hands is that of the World Drug Report 2009. He quotes it in his article and thus, has clearly read it. From misrepresentation to fabrication, every "reference" made can be qualified differently. For a chap popping lofty titles after his name and leading the charge for a "Drug Free" Portugal it's incomprehensible that he's unaware of the INCB's 2004 mission to Portugal, and their conclusion that possession remained prohibited. 

Initially he refers to decriminalisation as "in prejudice of the guidelines of the UN Conventions of which Portugal is a signatory." According to the WDR 2009, that our friend Manuel has read, the INCB conclude Portugal's legislation is within Convention Parameters.

On page 168 we read;

Those in possession of a small amount of drugs for personal use are issued with a summons rather than arrested. The drugs are confiscated and the suspect must appear before a commission. The suspect’s drug consumption patterns are reviewed, and users may be fined, diverted to treatment, or subjected to probation. Cases of drug trafficking continue to be prosecuted, and the number of drug trafficking offences detected in Portugal is close to the European average.

Page 183;

The International Narcotics Control Board was initially apprehensive when Portugal changed its law in 2001 (see their annual report for that year), but after a mission to Portugal in 2004, it “noted that the acquisition, possession and abuse of drugs had remained prohibited,” and said “the practice of exempting small quantities of drugs from criminal prosecution is consistent with the international drug control treaties...


The intentional deception goes on. Coelho writes in a masterpiece of Special Pleading;

With regard to hashish, it is difficult  to assess the trends and intensive use of hashish in Europe, but among the countries that participated in field trials, between 2004 and 2007 (France, Spain, Ireland, Greece, Italy, Greece, Italy, The Netherlands and Portugal) there was an average increase of approximately 20% " (EMCDDA, 2008).

20%! Really? Remember, his article is called "Decriminalisation Of Drugs In Portugal - The Real Facts". What if we isolate Portugal from page 111 of the 2009 WDR. In 2001 Portugal's annual prevalence of cannabis use was 3.3%. Five years later in 2006 it was 3.6%. Italy had more than double from 6.2 to 14.6% up to 2007. But the juiciest bit on page 110 is that DRUG FREE Sweden increased cannabis use by almost 300% rising from 0.7% in 2000, to 2.2% in 2004 to 2.0% in 2006. So, by 2006, Sweden's Drug Free Zero Tolerance led to a three fold increase vs Portugal's 9.0% increase. 

And how convenient to include Spain in misrepresenting illicit drug trends in Portugal. Spain tops the world for cannabis resin seizures grinning away at 50% or 653,631 kg for 2007. Portugal manages 3% - or 42,772 kg. So, Manuel almost certainly knows it's not "difficult to assess" at all. Coelho is cherry picking his data to convey his outmoded ideology as statistically valid. 

However, Manuel has referenced the European Monitoring Centre for Drugs and Drug Addiction - EMCDDA 2008. It would indeed be most remiss of me to not fan the smoke and remove the mirrors here also. The site itself is a triumph of illicit drug research collation for Europe. A search for "Portugal, 2008" pulls up 300 items. This is where Coelho's lack of citation, a favourite trick of prohibitionists, gives him the inside lane again. The EMCDDA publishes 2007 Portugal data in 2008. 2008 Portugal data in 2009. Hence "EMCDDA, 2008" is a nonsense reference not worthy of a high school essay. Referring to psychoactive substance EMCDDA 2007 data states (page 17); 

Results from the II National Population Survey on Psychoactive Substances in the Portuguese Population (15-64 years) indicate that cannabis, cocaine and ecstasy are the substances preferely used by Portuguese, with lifetime prevalences respectively of 11,7%, 1,9% and 1,3%. Between 2001 and 2007, despite the increase of lifetime prevalence in several illicit substances, a generalised decrease was verified in the continuation rates use.

You can read the breakdown of populations into sex, age, military, etc for yourself. Lifetime prevalence for cannabis for 3rd cycle students in 2001 was 10%, in 2007 6.3%. High school students showed 26% in 2001 and 19% in 2007. For total population use over the last 12 months is the same in 2001 and 2007 - 2.4%. 15 - 34 years indicate 4.4% in 2001 and 4.7% in 2007. These figures really aren't cause for carry on in either direction. They certainly don't support Coelho's claim of a 20% increase as part of policy failure. 

But what perhaps exposes our Chairman of the Association for a Drug Free Portugal for the reckless fool he is, must be his obsession with prohibition. Right up to the point of ignoring the growth in Drug Free communities and referrals laid out on page 46 of the same document he uses in his failure to statistically condemn Portugal. As in Australia the Drug Free mob seem to be lonely fringe dwelling outcasts, unable to reciprocate outside their peculiar conservative beliefs.

Inpatient drug free treatment is mainly available in public and private15 therapeutic communities. In 2007 there were 76 therapeutic communities (3 public and 73 private units) in mainland Portugal. In comparison to 2006 there was 3 more private therapeutic communities. Contrarily to the decreasing figure that has been registered since 2002, in 2007 the number of registered clients in both public (134 clients, 110 in 2006) and private units (4 423 clients, 4 118 in 2006) increased in comparison to previous years.

As the Chairman of a national organisation Coelho has had ample time to retract and/or correct his piece/s. He hasn't and ignores further data to the contrary. The 2009 National Report on Portugal (2008 data) to the EMCDDA gives a swift rebuttal to Coelho's trick of submerging Portugal in a string of nations. It is heavy on IDT data - the source of Coelho's primary claim of increasing drug use - which we shall consult and clarify. However the IDT website offers the following measured view; 

Drugs in Portugal - situation and responses
In the context of Drugs and Drug Addiction, the year 2006 was distinguished by the effort developed by all Bodies and Entities with intervention in this area, in order to find effective coordination forms, with a clear definition of the priorities and responsibilities of each intervenient.

Following the assessment of the Portuguese Drug Strategy 1999, the year in which the strategic goals were redefined and included in the National Action Plan Horizon 2012 and was outlined the Action Plan mid-term (Horizon 2008), with the actions’ schedule, clear assumption of the responsibilities in the carrying out and definition of measurable indicators in order to be monitored

Drug use
Cannabis continues to be the most used drug and its visibility in several indicators continues to increase, alone or in combination with other substances.

Nevertheless, heroin remains as the main drug involved in health drug use related consequences and in some of the legal drug use related consequences.

The presence of cocaine is increasingly being mentioned in several indicators, namely concerning the recreational, treatment and market settings.
          
Lifetime prevalence of illicit drug use (Balsa 2001)
2006 school survey data seems to indicate a decrease in drug use prevalence amongst the pupils of the 6th, 8th and 10th grades (aged 12 to 19). However this is based on preliminary data only and more in-depth analyses will be needed to confirm this apparent decrease.

Responses to drug use were re-organised at national level, following the 2004 evaluation and the 2005 drafting of new National Plan.

Emphasis will be placed in local needs assessment and the provision of integrated responses, in accordance with the identified needs. Integrated responses will have the possibility of including the areas of prevention, harm reduction, treatment and rehabilitation.

The news ticker on the site happens to only offer The Success of Drug Decriminalisation in Portugal.

But on to the EMCDDA 2008 Report. Page 5 offers;

Results from national estimations on problematic drug use in Portugal indicate that there are between 6.2 and 7.4 problematic drug users for each 1 000 inhabitants aged 15-64 years, and between 1.5 and 3.0 for the definition of problematic drug users (injecting drug users). Between 2000 and 2005, the estimate number of problematic drug users in Portugal has shown a clear decline, with special relevance for injecting drug users… 

...Indicators available continue to suggest effective responses at treatment level (increase in the number of clients involved in both drug free and substitution programmes) and at harm reduction level. The number of active clients in the outpatient public treatment network increased as well as first treatment demands (for the second time since 2000 changed the decrease trend). Heroin continues to be the main substance associated to health consequences and specifically in the sub-population of drug users that seek access to different treatment structures, but references to cocaine, cannabis and alcohol in this setting are increasing.

The availability of substitution programmes continues to increase and the number of clients continues to increase steadily (increases were registered in the number of clients in methadone and buprenorphine programmes).

Page 6 does indeed show a negative trend in General Mortality in 2008 - up 6 from 14 to 20 which Coelho misses. However, Coelho's claims of increasing use and HIV are seen to be false along with a welcome drop in HCV rates.

The decreasing trend in the percentage of drug users in the total number of notifications of HIV/AIDS cases continues to be registered. Concerning HIV infection in the treatment setting, the percentages of HIV positive cases (prelavences) varied between 9% and 25%, showing a tendency for decrease in last years.

Hepatitis B positive cases (prevalences) remained stable in comparison to previous years and Hepatitis C registered the smaller values of the last four years.

This decrease may be related, amongst other factors, to the implementation of harm reduction measures, which may be leading to a decrease in intravenous drug use (also visible in data concerning administration route in first treatment demands), or to intravenous drug use in better sanitary conditions, as indicated by the number of exchanged syringes in the National Programme “Say no to a second hand syringe”.

...In 2008, a increase was registered on drug-related mortality in the General Mortality Register in comparison to 2007 (20 in 2008 and 14 in 2007)...

...In Portugal, treatment for HIV, AIDS and Hepatitis B and C is included in the National Health Service and therefore available and free for those who need it.

In 2008, it is worth noting the enlargement of the socio sanitary structures and responses to drug users, the definition and implementation of technical guidelines in order to improve the quality of intervention and procedures that are more efficient, as well as the participation in working groups to define responses to populations with specific needs.

In the prison setting, inmates and staff are routinely vaccinated against Hepatitis B.

Remember the ubiquitous Coelho paragraph, polluting our search results?

The decriminalization of drugs in Portugal did not in any way decrease levels of consumption. On the contrary, "the consumption of drugs in Portugal increased by 4.2% - the percentage of people who have experimented with drugs at least once in their lifetime increased from 7.8% in 2001 to 12% in 2007 (IDT-Institute for Drugs and Drug Addiction Portuguese, 2008).

On the contrary? On the contrary, Manuel, that's remarkably ignorant. Did you correct for that ubiquitous inflator of "drug use" figures - the one off or infrequent cannabis user? Perhaps not. What does the IDT data show within EMCDDA 2008, seeing as you're booming about it?  From Page 19;

There are no significant differences between 2001 and 2007 results; there was a slight increase of cocaine and heroin use at least once in lifetime by females and a decrease in all the other substances.


Clearly, cannabis is the dominating drug. And we can see the relevance of Caitlan Hughes stating that, "... percentage of people reporting drug use in the past year", is of significance. With no change over the past 30 days in six years and an insignificant change over 12 months, this reflects more experimentation and infrequent use - not lumbering stoners. 

Some of Manuel's best distortions however, are in carving up his cocaine lines. Pun intended.

Coelho correctly informs us that drug related murders increased 40%. The report notes elsewhere Portugal's position as a transit nation. "It was the only European country with a significant increase in (drug-related) murders between 2001 and 2006", he warns citing the WDR 2009. So, let's check that very report on page 168 to note;

While cocaine seizures in a number of European countries increased sharply during that period, in 2006, Portugal suddenly had the sixth-highest cocaine seizure total in the world. The number of murders increased 40% during this same period of time, a fact that might be related to the trafficking activity. Although the rate remains low and Lisbon is one of Europe’s safest cities, Portugal was the only European country to show a significant increase in murder during this period.

This rapid increase in trafficking was probably related to the use of Guinea-Bissau and Cape Verde, former colonies, as transit countries. Most of the traffickers arrested in Portugal in 2007 were of West African origin. As international awareness of the problem increased, cocaine seizures fell in a number of European countries, but France and Portugal, two countries with former colonies in the region, showed the most pronounced decreases.

So this is down to non-nationals taking advantage of Portugal's geographic location - and at times getting murdered as a result. Certainly not what Coelho would have us believe. Scare stories about "drug tourism" are without foundation also. 

But let's examine that last sentence - "pronounced decreases";


WORLD DRUG REPORT 2009 - PAGE 72

Again, I can only think of the moron in the man who thought he could quote this report and expect to get away with misrepresenting it. 

On page 168 of the WDR 2009 we read;

...the number of drug trafficking offences detected in Portugal is close to the European average.

These conditions keep drugs out of the hands of those who would avoid them under a system of full prohibition, while encouraging treatment, rather than incarceration, for users. Among those who would not welcome a summons from a police officer are tourists, and, as a result, Portugal’s policy has reportedly not led to an increase in drug tourism. It also appears that a number of drug-related problems have decreased.

Cocaine use for Portugal was 0.3% in 2001 and 0.6% in 2006 - a doubling in 5 years. Seizures over a similar time frame are 5,574 kg in 2001, 3,021 kg in 2003, 18,083 kg in 2005, 34,477 kg in 2006 and 7,363 kg in 2007. If seizures reflected usage they would be around 11,000 kg in 2006 to accommodate the doubling of use. As they reflect transit we see over 34,000 kg.

And on it goes. Page after page in publication after publication supporting Portugal's decriminalisation, refuting critics and most importantly damning the misleading and damaging pseudoscientific twaddle of one Manuel Pinto Coelho. Published in February 2010 Coelho's piece purposely shirks more recent data conveying an entirely different trend. His deception is confirmed by republishing again and again after the World Drug Report 2009 became available in July 2010, refuting his intellectual rampage most thoroughly. Seizing on poor data sets and extreme examples out of context, he’d do climate change denialists proud. Cocaine, cannabis, heroin, stimulants, hashish, murder, HIV and even one of those spooky opinion polls recording “attitudes” of the Portuguese that as we well know, are not science. 

At the last, he tries to pass off an esoteric analysis in which Portugal allows criminal activity to be conducted by “the sick” such that “Pretend you are sick and the government pretends to treat you”. Addicts are now seen as patients, not “delinquents” he bemoans pathetically, who are “assumed” free and responsible. The state is feeding the “disease”.

What is worse however, is that this nonsense is swallowed in it's entirety by Drug Free Australia who then spread it into the community as, no doubt, "the real facts". 

And in doing so, they continue to contribute to ignorance, crime, drug related harm, reduction in treatment income, discrimination, family breakdown, incarceration and the building of more prisons, blood borne viruses - which affect us all - wasted funding dollars and the sequestering of same away from worthwhile community projects.

Some topics are too serious for stupidity and contrariness. There comes a time when despite the media's desire for "balance" and the government's view to allow airing of all views, we must decide if any "debate" still exists. The simple fact is, Jo Baxter and cohorts within Drug Free Australia - despite analogues around the world - cause far too much damage to allow them the quaint belief they might be correct.

I wish they weren't here.


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14 comments:

  1. Here here!

    ReplyDelete
  2. There is much to set right in this article, but time permits only a relatively brief commentary at this stage.
    First and foremost, apart from any careless statements about the integrity of Drug Free Australia, this is an unwarranted and spiteful attack on a person whose first language is not English.
    In the context of the above, Dr Coelho's meaning is quite clear; he considers that current legislation complies with the letter but not the spirit of the UN Conventions. I believe that most reasonably informed commentators from both sides of the debate would agree on that (if little else) Gallagher's comments in this context are small-minded and petty and have unpleasantly xenophobic overtones.
    Of dubious accuracy too, is the 'evidence' base presented by the author. At times erroneous, and at others, conveniently omitted.
    Gallagher's reading of the EMCDDA data is different from Coelho's but he does not cite his precise sources. Perhaps it would be easier all round if he gave us the weblinks so we could assess the accuracy of his claims? (Standard practice in academic circles).
    Gallagher goes on to say that Coehlo "lumps Portugal in with a number of Western European nations frequently, not separating Portugal from total results to deliberately mislead readers." I believe that by the intemperate language used, once again he betrays a degree of prejudice against those who do not appear to share Gallagher's Anglo-saxon heritage. Gallagher may feel himself to have been 'misled' but in my opinion, it is going too far to impute that motive to the author in the circumstances.
    At other times, Gallagher appears to be guilty of precisely the errors that he purports to describe in others.
    For example: "With opiates, Portugal is unremarkable. If Portugal had the level of per capita use the UK does we'd see approx' 260,000 users. We see under 50,000." This is untrue. The United Kingdom has a population of circa 70 million and around 300,000 problem opiate users.
    Portugal has a population of 11 million. Where does he get the "approx' 260,000 users" from? That number appears to be a figment of his own imagination.
    Later: Cannabis use in "Drug free Sweden" may have "increased about 300%...between 200 [sic] and 2006" but it also peaked at around 30% below the lowest figure from Portugal - which Gallagher 'fails' to notice.
    Those seeking transparent and objective data can go to the ESPAD study to get the facts. (http://www.espad.org/documents/Espad/ESPAD_reports/2007/The_2007_ESPAD_Report-FULL_091006.pdf
    For example, on page 85 and 86 there are some interesting figures, especially figure 16b, the last 30 days use. Sweden is at 2% compared with others nations at around 20%. Ten times higher!
    Gallagher then comments: "Murders have increased 40% but are related to increased cocaine transit and are not significantly of Portuguese nationals." I can find no reference to support this explanation in the 2009 WDR.
    Perhaps Gallagher could also explain how "increased cocaine transit" and a 40% increase in murders can be seen as a good thing? The Netherlands also has a serious problem with international drug trafficking and in consequence has seen substantial drug related deaths. Perhaps that is not a coincidence given the 'liberal' drug policies pursued in these two countries.
    Gallagher repeatedly refers to statistics from the UNODC (erroneously citing the 2009 WDR rather 2010) whilst playing down those cited by Coelho from the Instituto da Droga e da Toxicodependencia, which are generally accepted by all parties as the most comprehensive.
    These clearly support Coelho's case for an increase in the prevalence of drugs in all categories and most age groups since 2001. Perhaps that may be in consequence of Gallagher's own lack of language skills - the website is in Portuguese!

    ReplyDelete
  3. Actually most of Jo Baxter's points have been comprehensively addressed in an article published in the British Journal of Criminology in mid 2010.

    <<< The information we have presented adds to the current literature on the impacts of decriminalization.

    It disconfirms the hypothesis that decriminalization necessarily leads to increases in the most harmful forms of drug use. While small increases in drug use were reported by Portuguese adults, the regional context of this trend suggests that they were not produced solely by the 2001 decriminalization. We would argue that they are less important than the major reductions seen in opiate-related deaths and infections, as well as reductions in young people's drug use.

    The Portuguese evidence suggests that combining the removal of criminal penalties with the use of alternative therapeutic responses to dependent drug users offers several advantages. It can reduce the burden of drug law enforcement on the criminal justice system, while also reducing problematic drug use.

    A key implication of this article is the need for more nuanced discussions of decriminalization, with acknowledgement of the different models and approaches that can be adopted and of their various costs and benefits. A further implication is the need for ongoing study of reforms over time. But, ultimately, the choice to decriminalize is not simply a question of the research. It is also an ethical and political choice of how the state should respond to drug use.

    Internationally, Portugal has gone furthest in emphasizing treatment as an alternative to prosecution. Portuguese political leaders and professionals have by and large determined that they have made the right policy choice and that this is an experiment worth continuing. Portuguese policy makers suggest that adoption of such a reform requires time to develop the infrastructure and the necessary collaboration between the criminal justice and health systems. They contend that such reform, while not a swift or total solution, holds numerous benefits, principally of increased opportunity to integrate drug users and to address the causes and damages of drug use.

    As this paper has shown, decriminalization of illicit drug use and possession does not appear to lead automatically to an increase in drug-related harms. Nor does it eliminate all drug-related problems. But it may offer a model for other nations that wish to provide less punitive, more integrated and effective responses to drug use. >>>

    This is a peer-reviewed article in a respected international scientific journal, not an opinion piece posted to an anti-drug website. You can read the full text yourself, for free, here;
    http://bjc.oxfordjournals.org/content/50/6/999.full#sec-5

    The data needed to separate (say) Portuguese cannabis consumtpion from the neighbouring countries Coelho lumps into his analysis is available in the very documents he quotes. If this is not misrepresentation it is lazy junk science.

    Jo Baxter takes offence at Paul G's tone and his lapses into invective, but she does not address the instances of misrepresentation and apparent fabrication of data in Coelho's opinion piece. Calling Paul G a xenophobe (he's actually a rather nice fellow) is an irrelevant distraction to the serious questions he has raised.

    Paul Dessauer.

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  4. So.... Baxter is a liar?

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  5. Well- there is a difference between "lying" and "selection bias". And there's a difference between people who are deluding themselves and those who know better but deliberately try to delude others...

    <<< Perhaps Gallagher could also explain how "increased cocaine transit" and a 40% increase in murders can be seen as a good thing? >>>

    Reading Gallagher's article, I don't see at any point Paul suggesting these were "good things." He was simply pointing out that it is silly to attribute these figures to local drug-law reforms.

    Paul Gallagher quotes accurately from the 2009 World Drug Report;
    ( http://www.unodc.org/documents/wdr/WDR_2009/WDR2009_eng_web.pdf (go to page 168))
    <<< This rapid increase in trafficking was probably related to the use of Guinea-Bissau and Cape Verde, former colonies, as transit countries. Most of the traffickers arrested in Portugal in 2007 were of West African origin. As international awareness of the problem increased, cocaine seizures fell in a number of European countries, but France and Portugal, two countries with former
    colonies in the region, showed the most pronounced decreases. >>>

    Now look at the graph Paul G provided and fig 8 (page 168 WDR link above) to see how dramatic but also how isolated this spike in trafficking is. How can it be causally related to the 2000 decriminalsiation of personal use of cocaine? Short answer- it can't.

    Now look at figure 9 at the bottom of 168 to see the nationality of those arrested for trafficking in Portugal during the 2007 spike.

    68% of them are African. 18% are South American. 13% are European, but the fraction that are Portugese is so small they don't show up on the chart. If this spike in trafficking is related to relaxed domestic laws, why aren't huge numbers of Portugese taking advantage of it?

    The short answer is because decriminalising possession of quantities small enough to be deemed "for personal use" doesn't make trafficking any easier or safer, and in Portugal it didn't increase the local market in cocaine significantly enough to attract lots more importation.
    The vast majority of that trafficked cocaine was being trans-shipped to other countries.
    It came via Portugal for reasons of simple geography, not local domestic drug policy.

    continued...

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  6. ...continued
    There was a reported 40% increase in murders in Portugal. Jo says she can find no reference to these possibly being connected to the aforementioned spike in trafficking. Yet, (still on page 168 of the WDR 2009 (link above)) we find;
    <<>> So the authors of the WDR do think this is a possibilty. <<< Although the rate remains low and Lisbon is one of Europe’s safest cities, Portugal was the only European country to show a significant increase in murder during this period. >>>

    Are the increased murders related to changes to domestic drug policy? Or to the short but dramatic spike in international traffickers using Portugal as a trans-shipment point? Or are they not related to either factor?

    We can turn to the source for the 40% increase figure, which you will find here;
    http://epp.eurostat.ec.europa.eu/cache/ITY_OFFPUB/KS-SF-08-019/EN/KS-SF-08-019-EN.PDF
    Go to page 3 for homicide stats by country.

    You can see that Portugal has an increasing trend, but, (with a population of 11mil) a rate of 1.35 homicides per 100,000- (compare with England and Wales, 1.49, Northern Ireland 1.52, or Lithuania with a whopping 10.33 homicides per 100,000).

    Portugal has seen an increase in homicides since 1995. There may be other socio-economic factors at work completely unrelated to drug policy- such as increased population density, economic downturn, etc.
    Based on this data alone no responsible scientist would be confident attributing the increased homicide rate to any single factor that is loosely coincidental with the increase. Perhaps a search of coronial records would reveal whether a significant increase in drug-related homicides has occurred, either since decrim in 2000 or coincident with the spike in trafficking (as suggested by the authors of the WDR).

    Lisbon (where there is a concentrated population of drug users) has one of the 3 lowest Homicide rates in all the cities of Europe- 0.68/100,000 population.

    If the increase in homicides is causally related to decriminalisation of street-level drug use (as Jo Baxter and Manuel Coelho suggest), then why is it at half the national rate in the country's most urbanised and largest population centre? Why does Lisbon have less homicides per-capita than any other Eurpoean city apart from Vaduz (capital of Lichtenstein) and Valleta (capital of Malta)?

    I do not pretend to know the answer to these questions.

    However my advice to you, dear reader, is to be VERY wary of anyone who does pretend to know the answers.

    They are either deluding themselves, or trying to delude you, (or possibly both).

    Yours truly,
    Paul Dessauer.

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  7. The first quote in my last comment went AWOL. It should read
    "Jo says she can find no reference to these possibly being connected to the aforementioned spike in trafficking. Yet, (still on page 168 of the WDR 2009 (link above)) we find;
    <<< The number of murders increased 40% during this same period of time,27 a fact that might be related to the trafficking activity >>>.
    So the authors of the WDR do think this is a possibilty."

    Paul D.

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  8. Still Drugs Ruins life of every person who used his excessively. To think that they committed crime upon using illegal drugs is punishable.

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  9. Thanks Paul.

    Fantastic response as usual.

    What does everyone else think?

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  10. Jo Baxter.

    Two points deserve reply.

    The first is the quite reasonable angst expressed at the tone of my "attack". I do think you've gone a tad overboard, however and my Chinese partner of Malaysian birth who supports death penalties for any and all drug use - no trial, no questions - would be bemused at your conclusions as to my supposed intolerance. But, I'll address that later as it is a "live" topic. Suffice it to say, like most pseudoscience the drug free scam is an abuse of the scientific method, and in fact based upon a lie that costs lives.

    As we have zero tolerance for those who prey on society to pursue an ideology why do we accept giving "balance" to contrarians as if there is actually a debate? Climate change, vaccine schedules, gay marriage, the war on drugs. There is no debate. If there is, I expect to see peer reviewed data.

    Nonetheless, you're quite correct to criticise my figures of opiate use per capita. On the 2009 population numbers, that I used the UK has approx' 0.72% opiate users, Portugal 0.37%. Thus, if Portugal did have almost double the per capita opiate use that the UK has then around 79,200 users - not about 40,000 users would be graphed.

    Well spotted - my bad. Still, this is half the level of the UK, which has a more punitive approach.

    On cannabis. Manuel is at pains to push home the point of Portugal's decline into drug abuse as a function of decriminalisation, particularly from 2001 - 2006. You've "missed" the qualifying impact of my point. Here it is in full. Manuel writes:

    >> "With regard to hashish, it is difficult  to assess the trends and intensive use of hashish in Europe, but among the countries that participated in field trials, between 2004 and 2007 (France, Spain, Ireland, Greece, Italy, Greece, Italy (sic), The Netherlands and Portugal) there was an average increase of approximately 20% " (EMCDDA, 2008)." 

    (Okay - Manuel has used a group of nations to paint a negative picture of Portugal. So... let's look closer:)

    "20%! Remember, his article is called "Decriminalisation of drugs in Portugal - the real facts". What if we isolate Portugal from page 111 of the 2009 WDR. In 2001 Portugal's annual prevalence of cannabis use was 3.3%. Five years later in 2006 it was 3.6%. Italy had more than doubled from 6.2 to 14.6% up to 2007. But the juiciest bit on page 110 is that DRUG FREE Sweden increased cannabis use by almost 300% rising from 0.7% in 2000, to 2.2% in 2004 to 2.0% in 2006. So, by 2006, Sweden's Drug Free Zero Tolerance led to a three fold increase vs Portugal's 9.0% increase. <<

    Portugal increased from 3.3 to 3.6% under a policy of decriminalisation. A fraction of the almost Three Fold increase in Sweden under a Drug Free policy of zero tolerance. Absolute levels may well be 30% less in Sweden, but this doesn't assuage the near tripling of cannabis use. Where is the "drug free" guarantee that is so often promised?

    Above we see Manuel's trick to lump in Portugal with nations that have entirely different records. Objecting to this obfuscation appears of concern to you and you've raised it. Above the scale of error is straining at credulity.

    Seriously Jo. "There was an average increase...". Across 8 nations! The article is claiming Portugal's "real facts" are not published. So what on Earth is Manuel obfuscating isolated Portuguese facts for?

    This - as I expressly state - is compounded by the fact this lone opinion piece is published across the internet again and again, totally "ignorant" of incoming figures that challenge it's claims.

    The 20% levelled falsely at Portugal is really 9% and in Drug Free Sweden he omitted to tell us increases equal 300%. Sure - 30% below in overall terms, but Manuel is talking about percentage increase.

    Clear?

    And, the language is ambiguous as well as deceptive.

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  11. continued...

    Eg; "Along with Greece, Austria and Finland, Portugal registered an increase of deaths by more than 30% in 2005", writes Manuel.

    Does this mean all four alone registered an increase of above 30% or it was a team effort? And what of the changes in measurement practice?

    Spain had half of the the total of cannabis resin seizures globally, Portugal 3% of the total. With cocaine, Coelho writes, "While rates of use of cocaine and amphetamine doubled in Portugal, seizures of cocaine have increased sevenfold between 2001 and 2006, the sixth highest in the world (WDR-World Drug Report, 2009)."

    But page 76 of WDR-2009 shows that in 2007 Portugal was 15th highest in the world by measure of percentage of world total and kg equivalents, notching up 1%. Manuel ignores Portugal specific data.

    Your job is to examine the coloured text and rationalise all the discrepancies that exist. I realise hindsight is a bonus but this was not intended to be an academic masterpiece, and I don't doubt Portugal has shortfalls. In fact I noted Page 6 [EMCDDA 2008 Report] does indeed show a negative trend in General Mortality in 2008 - up 6 from 14 to 20 which Coelho misses. However, Coelho's claims of increasing use and HIV are seen to be false along with a welcome drop in HCV rates.

    Check the above graph from a publication he references for HIV rates across the 2005 period he mentions. Also check the graph on drug use in specifically targeted groups;

    There are no significant differences between 2001 and 2007 results; there was a slight increase of cocaine and heroin use at least once in lifetime by females and a decrease in all the other substances

    Asking me if I think murders and increased transit is "a good thing" is irrelevant. I say it's worse to hide the reality in an attempt to refute decriminalisation. If it fails dramatically, there will be no conspiracy to hide this. Why must the Drug Free movement so frequently misinform, mislead, lie, quote unrelated data sets, use outmoded methods/out dated data, etc?

    As for disrespect, it is very timely. Google "Don't be a dick", and you'll see those of us dealing with enemies of science seek to be cautious. I gave the matter ample thought and this article is less aggressive. But when do we stop? At what point do we refuse to engage Creationists, New Age therapy, Drug War zealots, Anti-vaccinationists, Charlatans, Liars and Frauds?

    Said differently, why should any engage in a fruitless endeavour for academic discourse with an author already shown to be bigoted, intolerant, biased and worse - seemingly content to deceive any who may pass?

    This is not to say I'd approach those genuinely misled, in a similar manner.

    He opens claiming, ".... Socialist Government, neglecting all other European countries and in prejudice of the guidelines of the UN Conventions of which Portugal is a signatory."

    Yet in the WDA 2009 that he has read Jo - he has read it - we see he omitted from p. 168 the INCB found: "... drug possession is still prohibited, but the sanctions fall under the administrative law, not the criminal law."

    Yet, it's Manuel's final words that stand out. "Pretend you are sick and the government pretends to treat you!"

    The World Federation Against Drugs is a dumping ground for intellectual absurdities that catalyse the retributive altruism so typical of early civilisations.

    Dismissing evidence and inventing ones own often leads to crimes against humanity. If you want respect, show respect for evidence you don't like.

    You're all lucky Penn & Teller are yet to find you.

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  12. A lot of words-on both sides, but the key issues are:

    Does does the Portuguese experience stand as solid evidence that should be used for immediate wholesale decriminalisation in other countries?

    Was the data over represented and selective from the begginning, in the CATO study?

    Was that too enthusiastically taken up by the pro legalisation lobby?

    Has it rebounded?


    If you are writing the Australian Heroin diaries you will almost certainly take one view on all these questions. If you are "drug Warrior, you may have another.

    If you are a politician only intermittently tangling with drug policy and having to review drug policy for the future, you might be very suspicious of all claims and ultra cautious.

    That would be the correct way to think of the whole affair.

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  13. bottom line is - who owns your body , you or the state ?

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  14. bottom line is - who owns your body , you or the state ?

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