Our addiction radio podcast this week looks at news of increased coca growing in Bolivia and its complications, the War on Drugs and reports of more opium being grown in Afghanistan on less acres, and differences in efforts at supply reduction vs. new ideas on demand reduction.
Transcript of podcast (click to listen):
CNS: Hello and once again welcome to the internet radio addiction pod cast from CNS. I’m Howard LaMere here with Dr Darryl Inaba and Darryl … a variety of interesting things in the news starting off, I was watching John Stewart show last night and there was a comment about cocaine – nine out of ten dollar bills or, US currency apparently have cocaine residue on them, which is really amazing.
Darryl: That, that’s actually, that’s actually a very old story and one of my favorite stories that dates back to the peak of the cocaine epidemic and the starting of freebase and all that back in the mid to late 1980’s and it does lead to the questions about cocaine. Behind all this meth and ecstasy, and heroin increasing, prescription drugs, you know in a way people have forgotten a little bit about cocaine. But cocaine is also on the rise I believe in, in the United States and in the rest of the world. The DEA and the office of National Drug Control Policy made the war on drugs (into a) war on cocaine and that was under General Barry McCaffrey and may have put in a lot of money and put all their efforts not at all drugs, but they said lets really concentrate on cocaine and they went to Columbia, got the government to basically outlaw any cocaine. Cocaine became outlawed in Columbia the largest growing region and, and people forget that the South Americans from the Incas on down have a real cultural tradition of chewing coca leaves.
CNS: Hundreds of thousands of years.
Darryl: Yeah, and they, they pick the leaves and they don’t extract the cocaine from it they just chew the leaves with some sort of alkaloid. I really like it because in the old days with the Incas they used to mix it with a bird crap and strangely enough I think there’s a lot of evidence that show that, that was a lot healthier than, than what they evolve into and that’s mixing it with lime or soda-lime or mixing it with ashes, now they mix burnt palm leaves that they burn down to ashes and they mix with it, and that the guano, the bat crap was actually organic. It was actually balanced, it was an actual alkaline substrate that in, in your mucus membranes it didn’t have that much damage to your gums and to your teeth and things like that where as now days using much more hygienic, they say and sterile things they’re getting all kinds of denture problems and gum problems from chewing the coca leaves. But this is as you say, for thousands of years it’s been part of the culture. And to think that we can just eradicate it overnight just by making it illegal in Columbia and that people won’t want to do it anymore and not that I’m saying it’s addicting it’s just like coffee or um, it’s, it’s a cultural…
CNS: Norm.
Darryl: People chew coca leaves and they don’t go crazy, they don’t rob other people for it, they don’t have paranoid dilutions, they don’t crave it when they’re taken into the armed services for six or eight years to serve as, as a citizen and they don’t go through withdrawal or anything. So it, it has been a culturally accepted norm thing but eradicating it for Columbia, stimulated Bolivia and the Bolivian President Evo Morales came in, he avowed that this, this is such an important thing to my people we are going to be, I am going to be more liberal and allow coca growing especially targeted for commercial purposes for the chewing of the leaves. I think he chewed the leaves with Oliver Stone on TV just to show, you know, how he’s behind that and it’s not a major addiction issue. For shampoos some of the ingredients, are good in shampoo, and for even tooth paste and things like that he is going to promote more cocaine growing because cocaine is a fairly resistant, it’s a good cash crop, so he’s encouraged that with the belief that the cocaine growing cash crop to Bolivia replaced what Columbia has now, the actual cocaine, the war on drugs the DEA and the Office of National Drug Control Policy were, were actually proud of the fact that there’s major decrease of cocaine production coming out of Columbia and that’s pretty much eradicated. But they didn’t look next door which is Bolivia and Bolivia now is growing a lot of coca, a lot more coca leaves actually they say it’s increased to about 65% than previous years more cocaine growing, cocaine processing. But unfortunately for President Morales there’s been a huge increase in cocaine production. He didn’t want, he wanted coca leaf production, while discouraging cocaine production.
CNS: Probably hard to keep them separate though.
Darryl: Well that’s what he’s finding out. They’re finding out that it’s hard to separate it and now that the former Columbian cartel is a Mexican cartels have all moved into Bolivia where it’s more liberalized to grow it and they’re producing the cocaine now out of, out of Bolivia. I have concern of, of different species, there are several different species of cocaine. One the Erythroxylum-ipadu plant produces different kinds of alkaloids, different types of cocaine alkaloids, that seem to be producing a much greater dependency on South Americans who are using cocaine and not the coca leaf of course and there was a concern that going into other regions, growing different species and doing the process is, it’s just going to accelerate it, it, it sort of also talks about or reminds us that the war on drugs is pretty much a failure. As far back as you look in the history of the war on drugs we continue to invest on the supply side of the equation, the two equations are demand side and the supply side and eight out of ten dollars that are spent in the war of drugs, are spent predominantly on reducing the supply. You know trying to eradicate countries from growing it, the growers, the traffickers, and all of that and it seems like every, the more we spend the more drugs there are coming into this country. Interesting thing about that was they, because they thought that had won the war on cocaine with Columbia, the Office of National Drug Control Policy really went into working on eradication of opium poppy and therefore heroin production out of Afghanistan and they bought up the crops and stopped this, put in this intervention, that intervention and they announced earlier in 2008 that they had decreased the number of acreage that was going to produce opium poppy that’s on it’s way to heroin in Afghanistan and then earlier this year they announced unfortunately that there’s more opium and more heroin being produced because somehow even though there was less acreage being planted there was much greater productivity out of the acreage that was there. But that’s all fluff because what the reality is, is I don’t think we’re ever going to accomplish anything by putting all our efforts I’m saying you can’t totally remove your efforts on supply reduction. But as shown efficacy and I keep harping on this is when you look at the demand side of the equation. You know, treatment, prevention, you look at intervention and, and different ways in which we’re approaching addicts and alcoholics and different medical developments to treat addicts now, its continued to result in improved out comes of people are getting recovered. People understand recovery. There’s less abuse now in the United States of illicit drugs among young people then there ever has been and you know for the last twenty years or so. There’s been a decrease. Unfortunately they didn’t monitor the increase in prescription drug abuse in the interim.
CNS: Right which we talked about that not too long ago.
Darryl: Right it’s, it’s a busy prescription drug abuse. But it does show overall that if we target our prevention, focus our prevention efforts and then especially in treatment, if we can provide treatment on demand. People for what ever reason, what ever time of day, what ever day of the week, they decide you now this, I’ve got to do something about my marijuana use, I’ve got to do something about my cocaine use, my meth use, my ecstasy what ever the drug is, that if they make a call they make a call they can get immediate interaction. Interaction with somebody who can give them some advise, they can come into treatment right away or very quickly there’s no waiting list and, and, and when that occurs I think we will finally be able to see some viable evidence that we, we could win this war on drugs.
CNS: This is a, the Europeans seem to be in many respects ahead of us. Do they have shorter lists or more treatment options then we do here?
Darryl: No they really don’t. There, there is you know the Portugal experiment that we wrote about recently that, that was interesting. The last I, I looked at that it was having some, some really good results in terms of treatment. But unfortunately in terms of, of primary prevention, stopping people from even initiating drug use it had, seemed to have the opposite effect. There was definitely a decrease in real hard drugs, heroin decreased, cocaine decreased, even ecstasy decreased, but there was a, a major increase in marijuana. I think it doubled and so then they were faced with having to deal with why was there, this is a great increase from these drugs and what can they do to stem that. But definitely they then put a lot of, or they, they began to change where their emphases was they weren’t emphasizing supply reduction they put their emphasis on demand reduction and I think that we need to look at that sort of approach. Europe also recently just two a, this week, two a publications in the New England Journal of Medicine which is a very prestigious medical journal, surprisingly published a case of promoting heroin use for treatment of heroin addiction in the United States and they, they sited studies I think one of the researchers was actually here at Oregon Health, Health and Science University in Portland, who analyzed the, the provision of heroin in some European countries to patients who were not able to engage in the methanon treatment approach. The whole converted to the US methanon approach pretty much. But some countries are going back to providing heroin legally as a treatment for heroin addicts in harm reduction approach and they’ve had some solid statistics or enough to satisfy New England Journal medicine head writers.
CNS: Looking at that study in my reading of it, that, it’s gone on for a number of years. It’s not a cursory study.
Darryl: But it’s showing a longitudinal data as you, as you mentioned it’s showing is that these people were put on the heroin maintenance and heroin replacement therapy or how ever you want to refer to it actually, they decreased their use of illicit drugs, cause they got heroin free. But you know the problem here with methadone although they might decrease heroin use with methadone, they greatly increase cocaine use or other ecstasy or other drugs that are out there, sedative use. But the heroin treated people in Europe seemed to decrease their abuse of all other drugs. They seem to be able to get jobs and hold jobs and they seem to be doing a lot better in comparison to their methanon contemporaries who are treated with methanon. So New England Journal of Medicine published that report and then they think it looks convincing enough and the data’s convincing enough to look at that. Unfortunately the whole history of why methanon developed was just this gut reaction fear by society about heroin, what heroin does. So I don’t know if it’s going to go any place because that reaction is still there and the prejudges is still there but it, it’s another thing to look at in terms of how we approach substance abuse treatment.
CNS: That wraps our pod for today. Thanks for visiting the CNS pod cast. Please check back soon for the next in the series and visit our website www.cnsproductions.com.
Tags: coca, cocaine, Demand reduction, heroin, opium, supply reduction, War of Drugs
Get the required QUICKTIME Plugin
