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Friday, June 2, 2023

New Approach to Drugs Seeks Footing in C.R.

The drug debate in Latin America hasstarted to shift.

For decades, possession and addiction in the Americas have been treated with a zero tolerance policy. Efforts to slow drug use have largely centered on arresting and penalizing users.

But packed jails, overburdened court systems, and a growing consensus that the war on drugs is failing are transforming the discussion.

In August 2009, Argentina’s Supreme Court ruled that it was unconstitutional to prosecute people for possession of drugs for personal use. One month later, Colombia’s high court issued a similar ruling.

In Peru and Bolivia, there are now small clinics that give coca leaves to crack addicts in order to manage and lessen their addiction. Bolivia’s President, Evo Morales, has asked the United Nations to eliminate the narcotics label on the coca plant.

Now, in Costa Rica, high-ranking officials are joining the tolerance dialogue.


A New Approach


In March, Costa Rica’s Chief Prosecutor, Francisco Dall’Anese, proposed offering free drugs to addicts as a way to compete with dealers. Squeezing in between the addict and the supplier to offer a cheap alternative would “break” the finances of drug pushers and “reduce demand,” he told the Spanish– language daily La Nación.

“Here, what we would do is preempt drug dealing,” he said.

The reasoning behind the proposal is fairly simple. By stopping the flow of income to drug dealers and eradicating the addict’s need to steal in order to buy another fix, crime rates should drop.

This idea is not revolutionary. Countries in North America and Europe have used harm reduction techniques such as methadone clinics for years to treat heroin addiction.

These efforts have been regarded as successful in reducing crime and curbing addiction by medical journals.

Dall’Anese’s proposal would represent a fundamental shift in Costa Rican drug policy, as providing addicts with free, chemical substitutes would take the drug addiction problem out of the hands of law enforcement and place it at the doorstep of public health officials.

Should the suggestion gain ground, treatment centers would be established where addicts could enjoy a legal high with a legitimate pharmaceutical substitute.

“What you are trying to do is get people to switch from the intensive version of the drug to a form that is less destructive to them and monitor (its use) in a controlled environment,” said Ethan Nadelmann, the executive director of the Drug Policy Alliance, a New York based non-profit organization.

By removing addicts from the streets, governments can better manage addiction and help addicts lead more normal lives, Nadelmann said.

But while methadone clinics have proven successful in North America and Europe, Costa Rica’s addiction situation is different.

Here, cocaine is the main problem.

According to a 2006 report by the Alcoholism and Drug Abuse Institute (IAFA), an estimated 0.9 percent of Costa Ricans use crack and 1.8 percent use cocaine every year.

The report did not offer statistics regarding heroin consumption, but noted that while only 0.8 percent of citizens had heard of heroin use in the country, almost 50 percent knew of a cocaine or crack user.

So far, no approved substitute for cocaine exists in the United States, according to the U.S. National Institute on Drug Abuse.

Guiselle Amador, president of IAFA, acknowledged the success of the drug substitute programs, but admitted that in this country, more research about a crack alternative is necessary to make Dall’Anese’s idea viable. She told the daily La Nación, that “the prosecutor’s vision is fit,” but noted that possible substitutes have caused side-effects that include an increased heart rate.

For Mauricio Boraschi, director of the Costa Rican Drug Institute (ICD) and soon to-be Costa Rican drug czar, the simple fact that no effective substitute exists is enough discard the idea.

“That’s why a (substitute) program, in our reality, won’t function,” he told La Nación.


Treat with Cocaine?


In Vancouver, Canada, former mayor Sam Sullivan supported a plan to offer cocaine to cocaine users after a trial program that gave heroin to heroin addicts proved more successful than methadone in improving health and reducing crime rates.

While the Canadian government decided to back the heroin plan, officials failed to agree to support a similar cocaine initiative.

“Our mayor couldn’t understand why it wasn’t feasible to just give them cocaine,” said Donald MacPherson, former Vancouver drug policy coordinator. “They are going to go out and get the crack cocaine anyway. If they have do sex work to get the money for it, they will. Why don’t we just get in the middle so they don’t have to do the sex work?”

Some critics, though, see the argument that giving addicts drugs or drug substitutes reduces crime as oversimplified.

Steven Kogel, former director of IAFA and an addiction therapist, said that drug clinics fail to get to the core of addiction. He claims that offering drugs or a chemical substitute simply turns one addiction into another.

“It’s not at all recommendable,” he said. “In the end it does nothing to treat the addiction. It might reduce crime, but it doesn’t focus on prevention in the proper way.”

Kogel said state money would be better spent on more rehabilitation centers and youth programs, such as D.A.R.E.

Still, MacPherson believes that both treatment and monitored consumption can work symbiotically.

“The drug isn’t the answer,” MacPherson, said. “The drug is like the carrot to get addicts into treatment. When people stop worrying about where their drugs are coming from, they can start to work on other aspects of their life.”

Dall’Anese’s proposal has far to go before programs dispensing legal crack and cocaine or possible substitutes pop up here. But his idea is on par with many officials throughout the Western Hemisphere who are edging away from zero tolerance policies.

“The Chief Prosecutor’s instincts are correct, but the details matter,” Nadelmann said. “This is a contentious area and its contention has stopped a lot of things from happening. The first step forward is to talk about it.”


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