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HIV/AIDS May be Fueled by War on Drugs

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Joe DeCapua

The fight against HIV/AIDS may have a better chance of success if the war against drugs were waged differently.  That’s according to an official document released Monday, prior to next month’s 18th International AIDS Conference in Vienna.

The Vienna Declaration calls for a scientific approach to illicit drug use and questions the effectiveness of the criminalization of injection drug users.  The document, written by medical and academic professionals, does not criticize law enforcement personnel, but rather the policies they carry out.  It says those policies are helping to spread HIV/AIDS.

Failed strategy?

Dr. Evan Wood is chair of the Vienna Declaration Writing Committee and director of the Urban Health Research Initiative at the British Columbia Center for Excellence in HIV/AIDS in Vancouver, Canada.

“The Vienna Declaration is basically a scientific statement from the scientific community about the harms of illegal drugs in our society, and drawing important attention to the fact that many of the policies, which are in place around the world – this notion of sort of a war on drugs and this over emphasis on law enforcement does more harm than good,” he says.

Locking up drug users is a failed strategy, says the declaration.

“The war on drugs has failed to achieve its stated objectives in terms of reducing drug supply or use.  And on the contrary, if you look at all the international surveillance systems, the prices of drugs continue to go down; and the purity of drugs continues to go up. And that’s despite ever increasing numbers of individuals that we’re locking up.” says Wood.

What’s more, he says, incarcerating all those arrested on drug use charges is “hemorrhaging taxpayers’ dollars.”

Supply and demand

He says the economic of principle of supply and demand keeps the drug trade alive.

“Even conservative economists like Milton Friedman, who won the Nobel Prize, have long known that this sort of war on drugs approach would not be successful,” he says, adding, “Economists will tell you that no market has ever been controlled by the supply side.  And any time that law enforcement has any success at taking out a drug dealer…that has the perverse effect of making it that much more profitable for someone else to get into the market.”

HIV/AIDS May be Fueled by War on Drugs
HIV/AIDS May be Fueled by War on Drugs

Wood says the Vienna Declaration does not criticize law enforcement officers who “risk their lives” to protect communities.  But, he says, “The reality of the situation is that trying to control the drug problem through law enforcement does not work and of course it has a number of unintended consequences.”

The Vienna Declaration begins by stating:

The criminalization of illicit drug users is fueling the HIV epidemic and has resulted in overwhelmingly negative health and social consequences.  A full policy reorientation is needed.

“We know that illegal drugs are more available to young people today than even alcohol or tobacco.  So the starting point for the whole discussion, in terms of an evidence-based, sort of science based discussion about the drug problem and drug policies, needs to be really that things could not get any worse in terms of trying to limit drug supply to young people,” says Dr. Wood.

Eastern Europe and Central Asia

The declaration says that outside of sub-Saharan Africa,

Injection drug use accounts for approximately one in three new cases of HIV.  In some areas where HIV is spreading rapidly, such as Eastern Europe and central Asia, HIV prevalence can be as high as 70 percent among people who inject drugs, and in some areas more than 80 percent of all HIV cases are among this group.

“We know that around the world the HIV rates among drug users are highest in countries that place the greatest emphasis on law enforcement,” he says, “First of all, those countries tend to not to employ public health approaches to try and prevent the spread of HIV….and there’s also the problem with the fact that when you’re chasing drug users around they tend to up in abandoned buildings or under viaducts or other hidden environments.”

As a result, it’s difficult for them to have access to treatment and prevention programs.  What’s more, risky behavior is more common in such environments.  Wood also says drugs are the source of much violence, whether in communities or in Mexico, where the government is battling drug cartels just across the U.S. border.

Scientific approach

Dr. Wood says in using “evidence based policy making” you use what works and discard what doesn’t.  “But when it comes to illegal drug use, we’re in a situation where policymakers continue with a war on drugs approach, even though we certainly know that it doesn’t work.”

He says, for example, that methadone maintenance therapy is the “most effective medication” that we have to treat heroin addiction.  In many areas of the world, where HIV is spreading most rapidly among heroin users, the drug is severely limited or in some place like Russia it’s illegal.”

About five years ago, Portugal weighed the costs of drug user incarceration and decided to take a very different approach.  It decriminalized drugs.

“People like myself, I’m a physician, I’m a public health researcher, we all kind of held our breath,” he says.

He adds, “What’s quite remarkable is that not only has Portugal reduced its drug problem in terms of health issues, like the spread of HIV and the number of overdose fatalities among drug users, but it actually has the lowest rate of marijuana use in the European Union now.”

A website has been set up to gather public support for the declaration: www.viennadeclaration.com

Some estimates say in the United States alone so far this year, over $25 billion has been spent by the federal and state governments on illegal drugs.

The term “war on drugs” is believed first used by President Nixon.  Its goal is to halt the production, distribution and use of illegal narcotics.

Earlier this year, the Obama administration announced it would boost resources for prevention and treatment of drug abuse in its 2011 National Drug Control Budget.

It’s estimated that as many as 1.5 million people in the U.S. are arrested each year on drug charges, with up to a half million sentenced to prison.

Authorities have raised concern that drug traffickers could help fund terrorists.  Drug routes usually start in South America and the Caribbean, extend through Africa, and then on to Europe, the U.S. and elsewhere.

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