"Other countries do look at us and seek our expertise. If we divest too much, then one day we'll have to talk about the Portuguese drugs policy in the past tense." That's what Joao Goulao, the chief of Portugal's national drugs agency, says about the grim prognosis for his country’s pioneering program. The 11-year old policy of decriminalizing all drugs and treating addiction purely as a health issue—which recently won Portugal a spot on The Fix's list of the world's best drug laws—is reportedly under threat, thanks to austerity measures brought in as a result of the global financial crisis. The cuts come just a news of Portugal’s success in curbing HIV rates and bringing the number of injecting drug users under control is belatedly spreading, with countries like Norway and Argentina looking to follow suit.
The rot began when last year, when Goulao's autonomous agency and its 1,700 staff had to merge with the country's National Health Service as a cost-cutting measure; the health service then lost almost 10% of its funding for 2012. “This integration amid the crisis and with healthcare in a shambles can only yield bad results," says Joao Semedo of Portugal's opposition Left Bloc, who is deputy chairman of the parliamentary healthcare committee. "We already see teams being suspended, programs on the ground discontinued, the end of financing for projects with a high social impact.”
For the past 11 years Portugal’s approach to drug addiction has been a well-documented success. The policy of focusing on treatment rather than punishment for drug use has tackled a previously raging heroin problem—with correspondingly high HIV/Aids rates—and reduced the country's number of injecting drug users by half. But the current cuts in services coincide with a more recent spike in addiction rates; when economies worsen, heroin use typically rises. The number of injecting drug users seeking help through the national drugs agency's centers doubled last year—although the figures are still well below those before the current policy was adopted in 2000—and looks set to increase further. Funding for existing programs is guaranteed until December of this year—but after that, it’s anyone’s guess.
Cutting back drug programs at a time of financial crisis isn't necessarily a smart idea. Greece—a country that's suffered terribly since the start of the economic crisis—was forced to reinstate its initially abandoned prevention programs, after HIV infections among drug users increased 12-fold. As Alexander Kentikelenis, a Cambridge University sociologist, says of the Greek example, "There is a lesson there. The government will think twice now before cutting further in this area. Such spending has to be countercyclical. People need it the most in downturns, not when your economy is growing."
Medical marijuana advertising in Denver has a reputation for being shockingly in-your-face, flaunting psychedelic themes and promoting great highs at a low price. But these aggressive ads will soon be out-of-sight. The city council unanimously passed a ban on outdoor advertising on marijuana yesterday, which would apply to things like billboards, bus benches and sidewalk sign spinners. While the ordinance would not affect print, radio or television ads, these would have to include a disclaimer that marijuana is “for registered Colorado medical marijuana patients only.” The ban is not yet official, as it still needs to pass one more vote next week, but the odds certainly seem in its favor. “I don't appreciate folks that are out in front of a creepy old van slinging this dope, and they're making this industry look bad," says Councilman Paul Lopez. "I'm sick and tired of my neighborhood being overrun by folks who don't respect it." Some medical pot groups spoke in support of the ban, including the Medical Marijuana Industry Group. "Because we want to be good community members, we can make reasonable concessions that satisfy community concerns,” says Mike Elliott, the group’s executive director. But not all weed advocates agreed: "We don't necessarily need sign spinners on the side of the road, but we do need to opportunity to educate," says dispensary owner Cheri Hackett. The Cannabis Business Alliance chimed in, saying that the ban isn’t clear about what is allowed and what is not. For example, would dispensaries be able to hand out T-shirts with a logo on it? "It's pretty short on specifics," says spokeswoman Kristen Thomson, "and for us it leaves many unanswered questions."
In upcoming film Sparkle, a remake of the 1976 musical of the same name, actress Carmen Ejogo plays the role of a familiar-sounding character—a drug-addicted singer coping with her sudden rise to fame. And she received some expert coaching. Apparently the late singer Whitney Houston, who plays the role of Ejogo's mother in the film, took the 38-year-old under her wing and shared candid personal stories of her own drug use. "She was very open with me about her battles," says the actress. "I was quite shocked. She shared some very personal stories. She was willing to be totally vulnerable so I could understand what it was like. She wanted my character to be authentic, and she went there in order for me to be able to bring that to the screen." In light of Houston passing away last February due to an accidental drowning and cocaine use, Ejogo says she expects the film to serve as a cautionary tale for anyone hoping to make it in Hollywood. "[Houston] was willing to be the example of what to avoid," she says. "She made this film for her daughter and for all girls to recognize the importance of not letting your light be dimmed by anything. To have gone through what she'd gone through, the public humiliation, and still have the guts to share that story is incredibly brave." Sparkle hits theaters nationwide on Friday.
Compulsive hoarding should be treated as a disorder in its own category, suggests new research. The potentially devastating condition has been seen as a symptom of Obsessive Compulsive Disorder (OCD), but a study published in the Archives of General Psychiatry suggests that hoarding is a condition all of its own. Researchers led by Dr. David Tolin of the Institute of Living in Hartford, Connecticut used functional magnetic resonance imaging (fMRI) to measure participants' brain activity as they made decisions about keeping or discarding their possessions. The scans of 43 compulsive hoarders were then compared to the scans of 31 OCD patients and 33 healthy individuals: the hoarders showed abnormal activity in the brain's anterior cingulate cortex and other regions associated with categorization and making decisions. “These differences in neural function correlated significantly with hoarding severity and self-ratings of indecisiveness among patients with hoarding disorder and were unattributable to OCD or depressive symptoms,” says Tolin. He says the study also spotlights “problems in decision-making processes that contribute to patients’ difficulty in discarding items.”
The research is the first of its kind to examine what happens is the brain when people with hoarding disorder are faced with decisions about whether to keep their belongings. “The results are very timely given the current deliberations to include a new diagnostic category in DSM-5 and further delineate the differences between HD and OCD,” says David Mataix-Cols, a professor at the Institute of Psychiatry, King’s College London, and an Advisor to the DSM-5 Obsessive-Compulsive and Related Disorders workgroup. “This is important because until recently hoarding was thought to be a symptom of OCD. Now we know that most hoarders don’t have OCD.”
- Kremlin Drug Czar Viktor Ivanov Seeks Global War on Traffickers [Newsweek]
- Mexico Catches Drug Cartel Suspect Linked to Killings of Journalists [Washington Post]
- Indictment: Denver Marijuana Dispensary Part of Illegal Pot Ring [Denver Post]
- Scientology Drug Program's Licensing "Extremely Vulnerable" After Deaths [Village Voice]
- "Drunkorexia" Leads to Greater Alcohol-Related Risky Behaviors [Medical Daily]
- Sex Addiction Deniers: What Makes Them so Mad? [PsychCentral]
- The Blurry Line Between Treating Pain and Feeding Addiction [Boston]
- ‘Breaking Bad’ Actor Hosts Heroin Awareness Fundraiser [Albuquerque Journal]
A report released today by the Substance Abuse and Mental Health Services Administration (SAMHSA) confirms a troubling trend in addiction treatment, identified in The Fix’s data-driven “State of the Rehab Union” story from last week: namely, the rise of poly-substance abuse, which sees people checking into rehab hooked on some combo of alcohol and other drugs. According to SAMHSA’s report, more than 37% of people who enroll in treatment do so because of a problem with more than one chemical. Twenty-three percent of admissions are for drinking plus one other drug, while 14% report being addicted to alcohol and two or more other substances. That’s bad news, says SAMHSA Administrator Pamela Hyde, because, “Even by themselves, alcohol and drug abuse can be devastating to one’s health and well-being, but a combination of drug and alcohol abuse increases one’s risk of serious, life-threatening consequences even more.”
Here's a slide from SAMHSA's report:
The Fix’s original research revealed that 17% of those who go to treatment struggle with more than one substance. Susan Foster, MSW, VP and director of policy research and analysis for CASAColumbia, The National Center on Addiction and Substance Abuse at Columbia University, told us that her outfit’s data pointed to an even higher incidence of poly-substance abuse: nearly 56%. Some of the differences in data are likely due to differences in methodology, but the overall takeaway remains the same, which is that the problem of being cross-addicted to a number of different substances (being a “garbagehead,” in the parlance of some 12-step meetings) is growing. Austin Recovery's president and CEO Jonathan Ross says of this trend, “I want to say it’s been evolving for 20 years, but especially in the last five to 10. I think even 10 years ago there was maybe more a single drug of choice.”
Check out this chart from The Fix about what substances and issues led people to seek treatment: