Source: Honolulu Weekly Contact: Pubdate: 22 October 1997 Website: http://www.honoluluweekly.com/ Editor's note: Our newshawk and author writes: This story appeared in the Honolulu Weekly as the cover story in the October 22, 1997 issue. It can be accessed, in a format w/ graphics displayed [at the above website]. For a hard copy, contact [our newshawk]. Hawai'i's "War on Drugs" is creating many casualties, but it can't be won. War Stories Pam Lichty Oct. 22, 1997 The special police unit, draped in protective white spacesuits, bursts through the door of the apartment complex, following a distinctive acetone smell. In the kitchen, they find the makings of a smalltime methamphetamine lab: saucepans, bags of white powder, cookie sheets. Nearby sits a rickety highchair. That night's TV news leads with the story of the dramatic bust. It highlights the danger to the child in the apartment and to the neighbors, and the courage of the arresting officers. This is the public face of the Drug War in Hawai'i. The scrawny woman shuffles quietly into the emergency room late on a Thursday night. She pulls up her sleeve to reveal an angry, festering sore on her upper arm. Her fever's making her dizzy, and she can barely explain that her arm's been hurting for weeks, but finally got so bad that her boyfriend forced her to come in. Why not before? "Hey, I one junky. I scared; they wen treat me like garbage in heah last time." Across town, the 72yearold man walks shakily to the ringing phone. He's just finished his second course of chemotherapy, his constant retching has exhausted him, and he's already lost 11 pounds. His doctor gave him Marinol, but he can't keep it down long enough to do any good. His daughter in California is telling him he should try smoking some pakalolo. He bristles at her: "I'm a lawabiding citizen; I never broke one law in my life. ... I gotta go." This is the private face of the Drug War in Hawai'i. Progressive social policy has been a hallmark in Hawai'i since the '60s. The list of firsts is impressive: first to decriminalize abortion, first to require employerprovided insurance; first to pass the ERA. When it comes to drug policy, however, all bets are off. In this area, policymakers don't deal with costs and benefits or Legislative Reference Bureau recommendations with rational, factbased analysis. They can't. It's a war out there. Or is it an ideological crusade? In both, it's your commitment to the cause that counts. If you question what motivates policy or the outcomes of those policies, then you're a traitor. In today's parlance, you're a "legalizer" or a "drug user," or perhaps you're "sending the wrong message to our youth." (There is one exception: Hawai'i's sevenyearold, statewide needleexchange program; more on this later.) In a war, of course, anything goes. Civil liberties get in the way, so we amend our laws to provide what are called "drug exceptions to the Bill of Rights": If they suspect drugs are present, police can stop a car, or enter a house unannounced; if drugs are found, public officials can kick a family out of public housing, or seize a person's property. All this ideology makes for a very narrow consideration of drug policy issues. It is true that on the federal level, the war terminology has been downplayed, although we do have a general or is he a czar? in charge of the nation's efforts. But if you follow the money, you'll find that despite the cooling of the rhetoric, spending in the United States on efforts to curtail drug use remains skewed at twothirds for enforcement and onethird for prevention and treatment. Identical proportions hold true for Hawai'i, according to a 1995 report from the Hawai'i State Substance Abuse Task Force. When it comes to policy toward illicit drugs, Hawai'i is pretty much in lockstep with the feds. Our leaders, from the Governor and the mayors to virtually all of the state legislators, and obviously the police, take an unwavering hard line on drugs. They believe drug use is primarily a law enforcement issue, and that the public wants them to be "hard on crime and hard on drugs." In other parts of the United States, there's another battle raging. Successful medical marijuana initiatives in California and Arizona have resulted in an explosion of interest in current drug policies and how they're working. (Hawai'i, of course, lacks an initiative process; the only way to legalize such use here is through legislation.) Increasingly, though, observers are questioning the warondrugs approach with special attention to its economic and social costs: $16 billion per year in federal spending; onethird of all young AfricanAmerican men under the purview of the criminal justice system; the largest per capita and total prison population in the world, housed for $30,000 per prisoner per year. The costs are astronomical, and they divert funding from other areas, such as education, health and welfare. The question is: What are we doing about drug problems in Hawai'i? Are we winning the war on drugs here? Would anyone honestly assert that we are? Our prisons are overfull; 600 prisoners have been sent to Texas in the past year. But it's not easy to determine how many are locked up for drug offenses. University of Hawai'i sociologist Gene Kassebaum figures that 26 percent are in for "drug law violations" drugspecific offenses such as selling, cultivating or manufacturing drugs. Many others are in prison for parole or probation violations and these offenses are usually drugrelated (for "dirty" urine tests). When these violators are figured in, the estimated percentage of drugrelated offenses rises to at least 35 percent. This does not include the many property crimes, assaults and robberies committed to obtain money to buy drugs, or because of a turf battle or a drug deal gone sour. Then there's domestic violence. According to Billy Mills, substance abuse officer for the Department of Public Safety, an estimated "80 percent of the general felon population needs treatment for underlying substance abuse problems" (including alcohol). So we lock up several hundred prisoners per year, almost all of them with a substance problem, and give them treatment while incarcerated. Right? Not exactly. The KASHBOX Program at Waiawa, a nine to 15month Twelve Step program like Alcoholics Anonymous, has recently been expanded to 84 beds, and will soon increase to 200. Ho'omana, a similar program at the women's facility, has just 15 beds for its six to ninemonth month program. These are the only programs currently available to the hundreds of inmates who could use them. Nor can every person with a history of substance abuse be helped by a Twelve Step approach. Most treatment professionals agree that a variety of approaches should be available. Despite a growing body of research showing that treatment is at least seven times more costeffective in treating drug problems than criminalization, funding for treatment in Hawai'i has been static for many years. At the same time, says Larry Williams, executive director of Salvation Army Addiction Treatment Services, demand is soaring, as Hawai'i's sour economy and its stresses drive more people toward substance abuse. Drug treatment programs here are deluged with applicants. Women's Way, the only inpatient program in the state that treats women with their children, has a waiting list of 20 to 40 at any time; the wait ranges from one to three months. The situation is even worse on the Neighbor Islands, where there are few treatment options. Methadone programs, with a 30year successful track record of stabilizing users' lives and reducing criminal activity, are currently available only on O'ahu and in Hilo. Efforts are under way to open a facility on Maui. DOH's Alcohol and Drug Abuse Division estimates that there are 12,000 heroin injectors in the state, yet at any one time there are less than 500 people enrolled in methadone programs statewide. Police, of course, are the ones who see much of the fallout from our drug problems. Major Ken Tano, head of HPD's Narcotics and Vice Division, believes that "the users are the victims of the whole cycle." It's those distributing drugs that he sees as the real villains. They are the ones he'd like to "put away." Crystal methamphetamine or "ice" remains the most problematic drug in Hawai'i, with an apparently constant demand. Major Tano estimates that of the 15 to 18 narcotics search warrants HPD serves each month, 90 percent of them are for ice. Despite clear evidence of its harmfulness, the message is not coming across. Major Tano believes that one reason for ice's popularity here is that it is smoked like marijuana, a more familiar form of drugtaking and not nearly as stigmatized as injection. National drugreform organizations contend that without marijuana, there could be no War on Drugs. According to the FBI, marijuana arrests have increased every year of the Clinton administration, to a record high of 642,000 in 1996. The National Organization for the Reform of Marijuana Laws notes that there has been an 80 percent increase in such arrests since 1990; 85 percent of these arrests were for simple possession. Arrests for all illicit drugs in 1996 totaled 1.5 million. In Hawai'i, as in the rest of the United States, marijuana is by far the most widely used illicit drug. The Department of Health and Human Services estimates that nearly 70 million Americans have tried it; of these, 18 million smoked it within the last year. In Hawai'i the comparable figures are 33.6 percent (high school students in 1993) and 28.9 percent (adults in 1991) for lifetime use. As for the virtually discredited "gateway" theory, the National Institute on Drug Abuse found that 77 percent of all current illicit drug users report that marijuana and hashish are the only illegal drugs they use. Despite Hawai'i police officials' assertions that they rarely bust people for simple possession, the 652 individuals who were arrested on this charge statewide during the first six months of 1996 might disagree. A January 1997 report from the Attorney General's office ("Crime Trend Series") shows that arrests for marijuana possession rose 8.5 percent in the City and County of Honolulu from 1995 to 1996. They were up a startling 26.1 percent in Kaua'i County (although the numbers there were small), but fell in Hawai'i and Maui Counties. Concerns about marijuana use largely drive the concerns about teenage use. While headlines scream that cocaine use among high school seniors has tripled, a closer look shows that we're talking single digit figures, where one or two points can make a dramatic difference. Kids do distinguish between the risks of marijuana and those of harder drugs, and their usage figures show this. The University of Michigan "Surveying the Future" report of 1996 showed 4.9 percent of seniors admitting use of cocaine, and 1 percent using heroin, while 35.8 percent said they'd used pot. Many local observers especially on the Big Island believe it's no coincidence that the upsurge in the use of ice and crack cocaine occurred in the late '80s, at the same time marijuana eradication campaigns intensified and street prices for pot soared to $7,000 to $9,000 per pound. There is a wellrecognized substitution effect among drug users: When their drug of choice becomes unavailable or too expensive, they switch to another substance. And if both of them happen to be smokeable ... that makes the transition easier. The Big Island now has the worst social problems of any county, and the crackdown on marijuana growing has undoubtedly been a factor, according to Rep. Robert Herkes and other public officials. Not to worry, though; the Hawai'i County prosecutors are on the case: On Sept. 9 of this year, a sixyearold prosecution ended in a hung jury. The defendant was 60yearold hemp activist Aaron Anderson, whose crime was ordering sterile hemp seeds from a legitimate mailorder firm. During the trial, Deputy Prosecutor Kay Iopa stated that she was only prosecuting the defendant because of his vocal support for marijuana law reform. The case has been beamed all over the Internet; Mainlanders must be wondering if this is truly the most urgent drug problem facing our state. Needless to say, antimarijuana hysteria in Hawai'i has pretty much doomed any rational consideration of growing hemp, marijuana's nonpsychoactive relative, as a replacement crop for sugar and pineapple. Police Major Tano sees great promise in Hawai'i's 16monthold Drug Court Program, which has just "graduated" its third class. This program, under the leadership of Judge James "Duke" Aiona Jr., has compiled a good record for keeping its participants out of jail. Essentially, the program targets nonviolent drug offenders who undergo careful assessment. Those selected are offered the choice of drug court in lieu of prison. If they enter the program, they are subject to intensive monitoring, including routine drug testing and regular appearances before the court, and receive comprehensive counseling. If they are successful at staying clean and adhering to the program requirements, they graduate, and their arrest is expunged from their record. To date, of 205 admissions into the program, 41 have graduated, 41 have been terminated (read: sent to prison) and the remaining 123 are still in the program, which averages 14 months. Critics of drug courts contend that they are yet another punitive, abstinencebased, lawenforcement approach to drug use and this is true. Yet, even critics admit that the individuals involved with Hawai'i's program, from the judge on down, really care about the clients and bend over backwards to help them succeed. Opponents of current lock 'em up approaches believe we've spent enough time and money on law enforcement approaches to our drug problems. Other countries and at least one U.S. city (Baltimore) are trying an alternative approach known as "harm reduction," or "medicalizing" the drug problem. These strategies employ a public health, researchbased model using incremental goals. Harm reductionists assume that mindaltering substances are here to stay, and that a realistic goal is control, not eradication. Examples of harm reduction include drugmaintenance programs (a limited form of legalization, providing controlled doses for drugdependent clients); permitting methadone to be dispensed by family physicians without burdensome overregulation; expansion of clean needle availability (vending machines are used in some nations); and "low threshold" treatment programs that are easy to join. Harm reduction is sometimes called "the third way," lying between prohibition and legalization. It attempts to reduce the harms to individuals and society both from drug use AND from the fallout of our current harsh policies. In Hawai'i, the rhetoric of harm reduction has made some minor inroads, thanks to two successful harm reduction conferences in Honolulu. It remains controversial, however, because it doesn't view abstinence as the only desirable goal for a user; instead, harm reduction applauds any degree of positive change. Proponents, such as those in the fledgling Harm Reduction Hawai'i Project, are sometimes accused of supporting legalization of drugs. Most supporters, however, are nonideological, practical people working in HIV prevention or treatment. Many of them would agree with a recent declaration published by the Federation of American Scientists of "Practical Principles for Drug Policy." This report recommends a third way between prohibition and outright legalization, based on scientific knowledge, not on symbolic language or moral beliefs. Hawai'i's needle exchange program, in place since 1990 and regarded nationally as a model program, is a classic harm reduction program. It draws injection drug users in with the promise of sterile needles in exchange for used ones. Its clients receive health, social service and treatment referrals offered in a nonjudgmental, humane and friendly manner. And its yearly evaluations indicate that is seems to be reducing the spread of HIV in Hawai'i among injection drug users the chief aim of the program. Hawai'i's struggling economy, though, cripples innovation, just as it hampers expansion or even maintenance of existing treatment or prevention programs. DOH's Alcohol and Drug Abuse Division is the single state source for all federal money spent on treatment and prevention services in Hawai'i. Following the lead of the Feds, the Drug Abuse Division has been reluctant to consider treatment or prevention approaches that are not abstinencebased. Public officials also remain hard to convince. In the current climate, they are scared of appearing "soft on drugs," and the media is complicit in this. Mayor Harris' solution to pockets of drug dealing in Chinatown is to tear down or seize the buildings involved. Gov. Ben Cayetano, after running on a platform of "no new prisons," has caved to the pressure. Our hardline corrections chief Keith Kaneshiro, through his unbending application of the law, has forced the exportation of hundreds of our prisoners and thousands of our tax dollars to Texas. Other cities, most notably Baltimore, led by innovative Mayor (and former prosecutor) Kurt Schmoke, are trying the "medicalization" approach. One upshot: Billionaire and drug reform advocate George Soros just gave Baltimore $25 million to implement job training, education reforms and drug treatment on demand. This approach addresses underlying problems leading to drug abuse. Will this help the miserable addict waiting in the emergency room? Will it help the old man with cancer get some relief? We can only hope that Hawai'i's politicians are paying attention. Many have noted the parallels between the Vietnam War and the War on Drugs. Respected New York Times reporter James Reston hit it on the head in 1965, when he wrote, "In any war, the first casualty is common sense, and the second is free and open discussion." With Hawai'i's past leadership in social programs in mind, open examination of the issue should not be too much to ask. Let us shine some light on our state's drug problems and see if some commonsense solutions can be revealed. Pamela Lichty is the vice president of the Drug Policy Forum of Hawai'i, chair of Hawai'i's Sterile Needle Exchange Oversight Committee and the coordinator of the Harm Reduction Hawai'i Project. She is the Hawai'i representative on the national board of the American Civil Liberties Union. sidebar DRUG REFORM IN CYBERSPACE Drug reform activity in the United States has risen dramatically in recent years. Below is contact information for a few of the most active organizations. The Drug Policy Foundation, 4455 Connecticut Ave., NW, Suite B500, Washington, D.C. 20008. The granddaddy of reform organizations, DPF is a "big tent" group, open to all. http://www.dpf.org/ The Drug Reform Coordination Network (DRCNet) is a national organization dedicated to raising public awareness of the consequences of drug prohibition and working for any positive change in drug policy. They publish news briefs and bulletins both online and by mail. http://www.drcnet.org/ More good sites: The Marijuana Policy Project. http://www.mpp.org/ The Lindesmith Center (a drug policy research organization). http://www.soros.org/lindesmith/ (sidebar) THE DRUG POLICY FORUM OF HAWAI'I The Drug Policy Forum of Hawai'i was founded in 1993 (as the Hawai'i Drug Policy Options Group) by citizens concerned about current drug policies in our state and nation. Its mission is to foster informed discussion and analysis of these policies and to explore alternative solutions. DPFH activities include quarterly public forums, bringing together national and international experts with local opinion makers; conferences and workshops; screenings of films and videos; maintenance of a reference library and speaker's bureau; and publication of a quarterly newsletter. Its next public forum, "Women, Drug Laws, and Prison: The Hidden Costs," takes place on Nov. 18, 7:30 p.m. at the UH Law School, Classroom 3. Featured speaker will be San Franciscobased attorney, Ellen Barry, cochair of the National Network for Women in Prison. DPFH has been supported to date largely through small foundation grants. This year it was granted taxexempt status from the IRS, and it is now actively seeking members. For more information about DPFH, contact Don Topping, president, at 9886287, or Pam Lichty, vice president, at 7358001.