01/21/18 Ronnie Cowan

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The UK House of Parliament held a debate recently on safe injection sites, otherwise known as drug consumption rooms. On today's show, we hear from Ronnie Cowan, MP from Inverclyde; Thangam Debbonaire, MP for Bristol West; and Alison Thewliss, MP for Glasgow Central.

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JANUARY 21, 2017


DEAN BECKER: The failure of drug war is glaringly obvious to judges, cops, wardens, prosecutors, and millions more now calling for decriminalization, legalization, the end of prohibition. Let us investigate the Century Of Lies.

DOUG MCVAY: Hello, and welcome to Century Of Lies. I'm your host Doug McVay, editor of DrugWarFacts.org.

On Wednesday, January 17, there was a debate in the UK Parliament’s House of Commons on the question of supervised injection facilities, also known as drug consumption rooms or safe consumption spaces.

First up, the Member of Parliament who arranged for this debate to take place, Ronnie Cowan, a member of the Scottish National Party representing the constituency of Inverclyde.

RONNIE COWAN: Let me start with a few undisputed facts. Drug deaths due to overdose are increasing year on year in the United Kingdom. People have been taking drugs of various types for thousands of years. In the last hundred years or so, we've run a campaign to criminalize, persecute people that take certain categories of drugs. We decide what drug does or does not belong in a certain category.

Some criminals have become staggeringly rich through their involvement in the production and supply of drugs. Users are stigmatized as junkies, crackheads, and stoners. Society adopts this language to dehumanize and ostracize sections of a community. This facilitates their abuse and allows them to be used as scapegoats.

So where are we now? The drive to arrest and incarcerate the producers, distributors, dealers, and users, often referred to as a war on drugs, has seen a massive increase in violent crime and corruption, along with hundreds of thousands of deaths and the criminalization of some people for the most minor offenses.

The perceived problem that the war on drugs set out to solve has in fact been compounded by the war. As a result, time, money, and lives have been wasted.

JOAN RYAN: Division has been called. The sitting is suspended until this series of votes is concluded. When that series of votes is concluded, the sitting will be resumed, five minutes after the announcement of the result of the last vote in this series.

DOUG MCVAY: At that point, a recess was called so that MPs could vote in the House of Commons on the main legislation for the UK’s exit from the European Union, the so-called “Brexit” bill. The recess lasted for two hours, after which members returned to the debate. Ronnie Cowan picked up where he left off.

RONNIE COWAN: Thank you very much, Ms. Ryan. As I was saying before we were so rudely interrupted, we created this situation and we can fix it, but it will take a change in attitude at governmental level to do so.

Rather than paying lip service to people with an addiction, we need to start listening to what they're asking for. We need to treat addiction as a health issue, not a criminal justice one, not just in part, but in its entirety.

One part of the solution is drug consumption rooms. Supervised drug consumption facilities where illicit drugs can be used under the supervision of trained staff have been operating in Europe for the last three decades. These facilities primarily aim to reduce the acute risk of disease transmission through unhygienic injecting, prevent drug related overdose deaths, and connect high risk drug users with addiction treatment and other health and social services.

CAROLINE LUCAS: Will the gentleman give way?

RONNIE COWAN: Certainly.

CAROLINE LUCAS: I thank the gentleman for giving way. Would he agree with me that indeed, one of the big strengths of DCRs is precisely in reaching those people with drug addiction problems who aren't otherwise known to the services? In other words, if we can begin to build relationships with them over time, then when that trust is there, it's much more likely to be able to get them into the kind of services to begin to really address the reasons for the addiction.

RONNIE COWAN: I completely agree. It's one of the steps in the beginning of a healing process, if you can build a working relationship with people and earn their trust, they'll come back to you without suspicions which were built around drug users in general.

They also seek to contribute to reduction in drug use in public places, and the presence of discarded needles and other related public order problems linked with open drug scenes. Typically, drug consumption rooms provide drug users with: sterile injecting equipment; counselling services before, during and after drug consumption; emergency care in the event of overdose; primary medical care; and referral to appropriate social healthcare and addiction treatment services.

Currently, people are sharing needles, using a product that may kill them instantly, and living a chaotic lifestyle that harms them, their friends and their families. DCRs provide needles, instantly we reduce the spread of HIV and hepatitis C, instantly we improve the health of the user and instantly we engage users back into society, where they can be signposted to relevant services.

Needle exchanges also go some way to doing that, but as the paraphernalia leaves the premises, is often discarded in public places or shared with other users. And users may choose to inject themselves in streets, doorways, or gardens near to the exchange. This is unsuitable for the users and the local residents.

The great thing is that we have evidence from ten other countries that DCRs work. The first supervised drug consumption room was opened in Berne, Switzerland, in June 1986. Further facilities of this type were established in subsequent years in Germany, the Netherlands, Spain, Norway, Luxembourg, Denmark, Greece and France. Outside Europe, there are facilities in Australia and Canada. A total of 78 drug consumption facilities currently operate in seven EMCDDA, European Monitoring Centre for Drugs Addiction, reporting countries. I'll give way.

GRAHAME MORRIS: I thank the honorable gentleman for giving way, and I congratulate the him on securing this debate on a potentially controversial subject, but perhaps one where we need to look at the evidence. And would he agree that there are not only health benefits but there are benefits in terms of crime prevention and reducing crime? The Home Office’s own figures say that 45 percent of crimes are caused by drug users stealing in order to feed their habits, and there would be considerable benefit in terms of tackling that through the introduction of consumption rooms?

RONNIE COWAN: Absolutely. The closest thing we've had to this in the UK was opened by John Marks in the Wirral back in the 1980s. And at that time, local crime dropped by over 90 percent. We have the information at our fingertips.

But most interestingly, no country that has adopted a DCR has ever regretted it and subsequently closed them. Switzerland and Spain have closed DCRs, but only because the need for them reduced significantly. They were so successful that they put themselves out of business.

Before the festive recess, I asked the Prime Minister at PMQs to change the law to facilitate DCRs in the UK, and if she wouldn't do that, then devolve the relevant powers to the Scottish Parliament so the Scottish Government could do so. The law needs changed to protect the people who supervise the rooms and enable the relevant police forces to take a consistent stance which does not set them apart from the rest of the judicial system.

IAN LUCAS: Would the honorable gentleman give way?

RONNIE COWAN: Certainly.

IAN LUCAS: I'm very glad that, like my honorable friend the Member for Easington, I think the evidence is really important on these issues. I'm confused about the ?position in Scotland, where criminal justice is devolved. And the honorable gentleman's just referred to the devolution issue. Can he clarify for me, I'm genuinely interested in this, why this step has to be taken by the UK Parliament?

RONNIE COWAN: There's -- there are certain aspects of the law which are not devolved to Scotland. The laws we require so as people can work in these facilities with impunity still rest here at Westminster. So I want those laws devolved to Scotland, because we have the appetite there to do this job.

DOUGLAS ROSS: Will the gentleman give way?

RONNIE COWAN: One minute. The Prime Minister’s response was that she knows some people are more liberal about drugs than she is, but she's not minded to do anything, which completely misses the point. This isn't about a liberal attitude, it's about compassion and treatment for vulnerable people.

DOUGLAS ROSS: Good evening and I thank the gentleman for giving way. Before we move too far away from law enforcement in Scotland, can he explain, if he were to get these powers devolved, what would be the police’s response? Would they be asked to, you know, ignore people in possession on their way to these venues, regardless how far away from the center they were?

RONNIE COWAN: What we're do -- what this would do would give the police the authority to stay within the law. We're not asking them to turn their eye from people who are breaking the law, but the laws would allow people to carry in their own drugs.

DOUGLAS ROSS: From how far?

RONNIE COWAN: Nobody has -- the limit from which you can carry a drug has not at this point been defined. The point is that Scottish Government and the Lord Advocate have asked for this facility to happen.

DOUGLAS ROSS: The Lord Advocate?

RONNIE COWAN: The alternative would be that we've got people shooting up in alleys and contracting HIV and hepatitis C. And if that's the alternative you want to see in Scotland, it's not what I want to see anywhere in the United Kingdom.

So nobody is saying that drugs are for everybody and that drugs are great. What I and many others are saying is, if we want to stop damaging society and help the many individuals that have a drug addiction problem, then we need to change our approach. DCRs are not a magic wand or a silver bullet, they will not resolve every issue, but they're humane, productive, and cost-effective.

The total operating costs of the Glasgow safer drug consumption facility and heroin-assisted treatment facility are estimated at £2.3 million per annum. A 2009 Scottish Government research paper suggests that in 2006, the cost attributed to illegal drug use in Scotland was around £3.5 billion.

The Vancouver Insite DCR costs the Canadian taxpayers 3 million Canadian dollars per year. The facility claims that for every dollar spent, four are saved, as they are preventing expensive medical treatments for addicts further down the line. This is a figure recognized in many other countries.

A 2011 ruling by the Supreme Court of Canada concluded that Vancouver’s Insite safe injecting room saves lives with no negative impact on public safety in the neighborhood, and that between eight and 51 overdose deaths were averted during a four-year period.

A study in Sydney showed there were fewer emergency call-outs related to overdoses at the time safe injecting rooms were operating. A study of Danish drug consumption found that Danish DCR clients were empowered to feel more “like citizens rather than scummy junkies” -- their words, not mine.

These findings corroborate other investigations as being an essential step towards preventing the marginalization and the stigmatization. NHSGGC [National Health Service - Greater Glasgow and Clyde region] estimate that the annual cost to the taxpayer of each problem drug user is £31,438. They further estimate that the introduction of a new heroin-assisted treatment service could save over £940,000 of public money by providing care for just thirty people who successfully engage with the treatment.

Even if we did not give a damn about people with addictions, it makes good financial sense to provide those facilities. It is more cost-effective to provide DCRs than it is to pick up the bill after the damage has been done.

DCRs are more than just a practical solution; they are humane, compassionate, and financially effective. I can think of only two reasons why the UK Government is so resistant to the proposal: either they are stuck in an ideological mindset that people with addictions are not ill, they're the product of poor lifestyle choices; or the UK Government simply doesn't care.

The UK Government has stated: “It is for local areas in the UK to consider, with those responsible for law enforcement, how best to deliver services to meet their local population needs. We are committed to taking action to prevent the harms caused by drugs use and our approach remains clear: we must prevent drug use in our communities, help dependent individuals recover, while ensuring our drug laws are enforced.”

This cowardly stance simply underlines the UK Government’s disengagement from the reality of the situation. It pushes responsibility on to the shoulders of local administrations and the police force, while refusing to furnish them with the legal powers to act responsibly within the law.

Home Office-led international comparators study in 2014 concluded that there was “some evidence for the effectiveness of drug consumption rooms in addressing the problems of public nuisance associated with open drug scenes, and in reducing health risks for drug users.”

It also said that the ECMDDA, European Monitoring Centre for Drugs and Drug Addiction, considers "that on the basis of available evidence, DCRs can be an effective local harm reduction measure in places where there is demonstrable need”.

But despite that evidence that financially DCRs are viable, the United Kingdom's government has chosen to ignore the evidence. Can the Minister please tell me why?

And in conclusion, I shall once again ask: will the UK Government look at the growing body of evidence and change the law to allow DCRs to be opened in the UK without fear of prosecution? Or will the UK Government devolve the relevant powers to Scotland to allow the SNP Government to pursue ambitious and innovative new methods to tackle the public health issues of unsafe drug consumption?

DOUG MCVAY: That was Ronnie Cowan, a member of the UK Parliament from the Scottish National Party who represents the constituency of Inverclyde, opening a parliamentary debate on supervised injection facilities and drug consumption rooms. That debate took place on January 17. We’ll be back with more in a moment.

You are listening to Century of Lies. We're a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.Net. I'm your host Doug McVay, editor of DrugWarFacts.org.

Now let’s get back to it. This is Thangam Debbonaire, a Labour Party Member of Parliament representing the constituency of Bristol West.

THANGAM DEBBOINAIRE: I'm not going to repeat what other honorable colleagues have said, but I want to make some Bristol-related specific remarks, because I understand why people have an instinctive reaction that drug consumption rooms must be harmful, because they appear to facilitate the use of drugs.

I have to say to honorable friends who have doubts, we already have a drug consumption room in Bristol: it's called Bristol. It's called the square outside my office. It's called the doorstep into my office. It's called the blocks of council flats just on the side of my office. It's called virtually every part of the city center.

And the drug consumption that goes on there, and the drug litter that results, the harm, the visible harm, not just to drug addicts but to bystanders, people who have no interest in taking drugs but want their children to be able to play in the local playground, the harms caused by these existing drug consumption room are many and varied, and they hurt the most vulnerable and the very people that those of us on this side of the House are here to represent in particular. So I particularly want to encourage all colleagues to consider the use of drug consumption rooms.

In Bristol, we have very high rates of injecting and of poly-drug use, particularly crack cocaine mixed with heroin and then injected. But we're recognized by Public Health England in fact of having very high levels of complexity for people who use those drugs and for the high levels of admission to hospital for drug-related harms, and that brings me onto another harm, which is more widely shared amongst us all, that is the cost to the health economy of the existing drug consumption room regime.

The total length of stay in the Bristol Royal Infirmary in 2015-16 for drug-related admissions was 2,758 days, with an estimated cost of drug admissions ?£1,103,200 in 2015-16, and that's from the “Bristol Substance Misuse Needs Assessment”, Bristol City Council, and I thank my colleague Jody Clark for providing me with these figures.

But, hospital admissions specifically for injuries caused by injections accounted for 1,005 bed days, 36 percent of all drug-related stays. That's just 71 individuals, but they had an average stay of 14 days each. So that's over twice the average stay in hospital of 6.6 days for all drug-related admissions, and an estimated cost of in excess of £400,000.

Now, I urge all colleagues to think, if we want to give our health service more money, we need to invest in drug consumption rooms. If we want to make our streets safer, we need to invest in drug consumption rooms. If we want to save the lives of those who have drug addictions, and I do, however unpleasant it is to have to step over a very aggressive, slightly frightening, or sometimes very frightening, drug addict on my office steps, I don't want them to die. I want their lives to be saved and I want the people who live in the blocks of flats near my office to be able to send their children out to play.

And for all of those reasons, I argue that because nobody has ever died in a drug consumption room that was officially sanctioned and clinically run, I urge everyone to consider the drug consumption rooms we have at the moment and to support this.

DOUG MCVAY: That was Labour Party MP Thangam Debbonaire.

Finally, let’s hear from Alison Thewliss, Member of Parliament from the Scottish National Party representing the constituency of Glasgow Central.

ALISON THEWLISS: In Glasgow city center, Ms. Ryan, there are around 500 people, there or thereabouts, injecting drugs on a regular basis. When you come to Glasgow you probably won't see it, but for many of my constituents this is a huge issue.

Before I was selected in 2007, the issue of discarded needles was pointed out by a resident pointing me to a bin in a children’s play park. I have an enduring horror, Ms. Ryan, that eventually, sooner or later, a child will get pricked by a contaminated needle. It's a daily hazard for our council cleansing staff, and no one should have to live with that risk.

The issue has never gone away in that time, it's simply moved around. And indeed, a constituent earlier on tonight, Andy Rae, told me he came back home to find two contaminated needles on his doorstep. As the Member for Bristol West said, the problem is already there. It is on my office doorstep, too.

A constituent wrote to me over the weekend to say that in the 18 months that she's lived in her property, "there have been countless times that I’ve seen people injecting drugs in the bin area, doorways, and carpark. They leave behind their needles, bloody wipes, spoons, and bottles all over the area, strewn all over the ground, grass, and hedges, as well as urine, vomit and blood on the ground. This is a nice, quiet, residential area, home to people both young and old, families with children, students, people taking their dogs out, and is also in very close proximity to the children’s play park directly across the road.”

Another constituent I spoke to on Monday told me of witnessing prostitution in bin shelters and groups of people taking drugs under the stairs.

I regularly walk around this part of my constituency, Ms. Ryan, reporting needles as I find them. And after my surgery on Friday, amongst the usual places, I saw a young woman injecting herself behind a derelict building. There is no dignity for that woman, there's only desperation.

This is the reality of life for intravenous drug users in Glasgow, ?and the impact of their behavior on residents. It is deeply damaging for everyone involved. Each of those people injecting drugs is someone’s child, is loved by somebody, and we owe it to them to find a better way.

There has been no means of dealing with the situation, and it is imperative that we do something different. Glasgow health and social care partnership concluded that the only way to deal with public injecting is to provide a safe, managed space for people to inject. In this way, we can also respond to the concerns of residents and businesses and meet the needs of a very vulnerable and marginalized population who do not engage in services.

The health and social care partnership have a clear, well thought through proposal for a drug consumption room, and I recommend to the Minister, if she has not already read it, to take note of the report, “Taking away the chaos”. Look at the evidence that they've gathered.

I'd like to pay particular tribute to Saket Priyadarshi for his work on this, and to the commitment of Susanne Miller from the Glasgow City Council, and to people like Kirsten Horsburgh of the Scottish Drugs Forum for their advocacy of this important project.

The health and social care partnership have done significant work on establishing needs and protocols on how it would work, to listen to a range of health professionals as well as to those who use drugs, and to find the means of funding it.

It would be more than just a room, but a service, a bespoke service staffed by health professionals, with a wrap-around service to help people to reduce their drug use and stabilize their lives. There would be an opportunity for those not currently accessing health services to do so, and for people to get assistance to rebuild their lives. The proposed Glasgow model is all about engaging with drug users to promote treatment, rehabilitation, and social integration, as well as providing harm reduction services.

The Minister must recognize, she must, that there is a cost in not taking action, and doing what we've already done, and this cost manifests itself in treating the latest HIV and hep C outbreak in Glasgow. It comes at the cost of emergency admissions to hospital. And the report mentions, that over the last five years, there's been an average of 232 ambulance attendances in the city at suspected overdoses, just in Glasgow. There is a cost, as the Member for Brighton, Kemptown mentioned, in doing this, and there's really an example will show how that costs can be saved.

There is a risk to council staff, to housing association staff, in clearing up needles, sometimes in their hundreds, on sites. And as soon as they're cleared, those needles come back again and again and again.

There's also the human cost, Ms. Ryan, the cost of lives written off and wasted. And the Member for Glasgow North East mentioned some of the figures. 867 drug deaths in Scotland in 2016 alone. We can't put a price on that, Ms. Ryan, but for every person lost to addiction a family is bereft.

Anyone’s Child: Families for Safer Drug Control supports drug consumption rooms. And I've listened carefully myself to people who have lost family members, and they were clear that drug consumption rooms would be a positive intervention. That at the very least, their loved one would not risk dying alone in a filthy lane. Instead, they would be in a place of safety, supervised by medical professionals. And as mentioned, there has been not one single death ever in a drug consumption room anywhere.?

The difficulty we have in Glasgow is that this project cannot go ahead without the permission of the UK Government, unlike in Ireland, where the Ana Liffey project and then Minister, now Senator Aodhán Ó Ríordáin made a change to the law to allow it.

The Lord Advocate can't pursue this, and an exemption from the Home Office has been refused. I have a letter signed cross-party from the majority of MPs in Scotland, cross-party, Ms. Ryan, requesting leave for this pilot to go ahead. If it doesn't work, fine, but at least try. The status quo is not acceptable.

I invite the Minister to come to Glasgow, to come to my constituency, and see how people are living. She if she would like to put up with what my constituents put up with every single day. See if she would find it acceptable for somebody she cared about to drop their trousers and inject heroin in their groin in a manky back court surrounded by excrement and contaminated needles.

I'd like to leave with a quote from report from someone in recovery. The person says, “You need to think about it differently. That’s where I think safe injecting routes and injecting heroin is. You take away the chaos. Then you have a chance to work on the attitude.”

DOUG MCVAY: That was Alison Thewliss, a member of the UK Parliament, discussing the need for harm reduction interventions known as drug consumption rooms or supervised injection facilities during a debate in Parliament earlier today.

In the US, we are having that debate on effective harm reduction at the city level, in counties, and now even in state legislatures. The discussion hasn’t reached Congress, our national legislature, quite yet, but give it time.

The choice is clear: implement harm reduction strategies that have been proven to work over the past couple of decades, or keep doing nothing as our friends and our family members get infections and abscesses because of dirty needles; keep doing nothing as they contract hepatitis or HIV; and keep on doing nothing as they die of an overdose.

Municipalities that currently have syringe exchange programs have had some success. Rates of transmission of HIV/AIDS and of hepatitis C are reduced in those jurisdictions compared to those that don’t have syringe service programs. People who inject drugs do get some contact with the healthcare system through these programs.

The problems are, first and foremost, there just aren’t enough of them. Syringe service programs do a lot, yet still, they don’t cover the entire United States. The larger problem, one of the biggest reasons that syringe service programs are limited, is that they’re only kind of legal, depending on what state, county, or city they’re located in. Congress most years won’t even allow the use of federal funds to pay for clean needles.

And now, in this overdose crisis we’re in, it’s apparent that syringe service programs aren’t enough. Sure, people can get clean syringes, then they leave the exchange, then they go back to an alley, or a doorway, and they inject, and because the heroin was contaminated with fentanyl they overdose and they die alone.

That’s where we really need the feds to step up. There are cities, counties, and even states talking about supervised injection facilities and sanitary drug consumption rooms. At the federal level however, the only thing we’ve heard has been from the US Attorney for Vermont, who actually issued a statement threatening legal action, including arrest and forfeiture, if community activists and local leaders try to save lives by moving forward with a supervised injection facility.

Real change comes from the bottom up. Our elected leaders aren’t going to take us where we need to go unless we tell them to, loudly and clearly. The research is clear, the evidence is overwhelming. It just takes two things: courage, the courage to admit that what we’ve been doing has failed, and compassion, the compassion to decide that we will do something that’s different, smart, and humane. The choice is ours.

And finally: the National Institute on Drug Abuse is holding its National Drug and Alcohol Facts Week from January 22 through 28 this year. National Drug and Alcohol Facts Week is NIDA’s annual effort to propagandize young people at high schools and also some colleges.

Actually at the time of this recording, the federal government’s budget authority has expired, non-essential employees are on furlough, and government offices and agencies, other than military and essential personnel of course, are off work, so the National Drug and Alcohol Facts Week is going to have to happen without NIDA.

That's sad, really. I mean, there are so many questions that need asking, and it’s not like the Office of National Drug Control Policy, or the Drug Enforcement Administration is making themselves available. I mean, just start with the name: drug and alcohol facts. What, like alcohol isn’t a drug too? Decades ago, the correct terminology was changed to alcohol and other drugs. AOD for short, or ATOD, Alcohol, Tobacco, and Other Drugs, if you want to be fully inclusive.

So why does NIDA insist on that artificial distinction, “drugs and alcohol”? Heck, their very mission, and ONDCP’s mission too. They should be talking about alcohol and tobacco as drugs. I raised this question recently and someone pointed out that actually there’s a different agency for alcohol, the NIAAA, the National Institute on Alcoholism and Alcohol Abuse. That’s true, actually it was restating my point, but the thing is, NIDA has decided to include alcohol in its drug facts week, yet they’re still maintaining that false distinction.

NIDA is holding its annual National Drugs and Alcohol Facts Week from January 22 through 28 this year. The hashtags for that week are #DrugFacts and #NDAFW. NIDA employees may not have much time for young people this year. I think that drug policy reformers should take this opportunity to step up to the plate.

Young people need to learn the facts about drugs, and about drug policies, and the impact that these policies have on their lives and the lives of others. There are many great resources out there. Share them with your kids, and your grandkids. Share them on social media, especially sites like DrugWarFacts.org, DrugPolicy.org, HarmReduction.org, and SSDP.org. Use the hashtags #DrugFacts and #NDAFW.

The facts are that our current policy of prohibition of some drugs is a failure, and that harm reduction, decriminalization, and legalization are the best approaches to drugs and drug use. Help us spread the word.

And that’s all the time we have. Thank you for joining us. You have been listening to Century of Lies. We're a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I’m your host Doug McVay, editor of DrugWarFacts.org.

The executive producer of the Drug Truth Network is Dean Becker. Drug Truth Network programs are available via podcast, the URLs to subscribe are on the network home page at DrugTruth.net.

The Drug Truth Network is on Facebook, please give its page a like. Drug War Facts is on Facebook too, give its page a like and share it with friends. Remember: Knowledge is power. Follow me on Twitter, I'm @DougMcVay and of course also @DrugPolicyFacts.

We'll be back next week with thirty more minutes of news and information about the drug war and this century of lies. For now, for the Drug Truth Network, this is Doug McVay saying so long. So long!

For the Drug Truth Network, this is Doug McVay asking you to examine our policy of drug prohibition: the century of lies. Drug Truth Network programs archived at the James A. Baker III Institute for Public Policy.

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