Google has been ordered to shell out a $500 million fine to settle charges that it knowingly ran illegal ads for fraudulent Canadian pharmacies to Internet users in the United States, the Justice Department announced yesterday. The  mammoth penalty, one of the largest in corporate history, spares the Internet giant from criminal prosecution in the matter. A federal investigation, which was made public in May, alleged that Google executives knew that many of the pharmacies it advertised sold drugs like Oxycontin and Ritalin without requiring prescriptions. But instead of declining to run the suspect ads, the government charges that Google kept accepting them—and in some cases even helped the pill mill improve their websites. In a statement issued following the Justice Department's announcement, the company admitted that “It’s obvious with hindsight that we shouldn’t have allowed these ads on Google in the first place.” Indeed, Google policy had expressly banned similar ads in the past. The forfeiture covers revenue that Google earned from the advertisers as well as funds that the crooked Canadian pharmacies received from US customers—slashing Google's profit by 22% for this financial quarter. Illegal online pharmacies often stay under the radar and bounce back under different names if they get busted. In 2004, Sheryl Sandberg, a former vice president for Google's global online sales and now a top exec at Facebook, testified before the Senate that Google was keeping a strict watch on phony pharmacies. But a New York Times source claimed the company “did not turn a blind eye... but rather played a game of Whac-A-Mole with the rogue pharmacies.” The DOJ and others say Google knew about the problem and should have done more to address it. “Google does have a responsibility in this regard,” said Susan E. Foster, director of policy research and analysis at Columbia University’s National Center on Addiction and Substance Abuse. “To the extent that they allow ads for illegal pharmacies, they’re aiding and abetting the problem and profiting from it as well.”

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Billionaire philanthropist George Soros’s Open Society Institute—which runs an international harm reduction effort as part of its health program—has just released a graphic novel to promote the fact that methadone and buprenorphine maintenance programs dramatically cut the rates of HIV infection in countries where the epidemic is skyrocketing. The 24-page comic book, Methadone Man and Buprenorphine Babe, stars a dynamic superhero duo pushing back against the worldwide War on Drugs to advocate drug-maintenance—both as a tool to treat addiction and to stop the spread of AIDS. “Methadone stops HIV in its tracks!” declares Methadone Man, the comic's caped crusader. “Buprenorphine each day keeps injection away!” adds his comely pal, "Bupe Babe." Designed to reach young people in the developed and developing worlds, the glossy comics are a far cry from the ones you grew up with as a kid. They're also bound to raise some hackles among anti-drug groups who feel that Methadone is a poor substitute for outright abstinence.

Methadone, a synthetic long-acting full-agonist opioid drug, has been used in medication-assisted addiction treatment (MAT) for decades to block addicts' cravings for narcotics such as heroin and Oxycontin. Buprenorphine—AKA Suboxone, Subutex or "bupe"—is a newer synthetic long-acting partial-agonist opioid. Developed for pain treatment and to conduct short-term detoxes from full-agonist drugs, it's increasingly being used as a maintenance drug by many doctors. Like methadone, Buprenephorine can block cravings and prevent addicts engaging in criminal or unhealthy activities—like needle-sharing—to support their habits. Outside sub-Saharan Africa, one third of HIV infections are attributed to IV drug users sharing unsanitary works—IV drug use accounts for 10% of new infections around the world. The World Health Organization calls methadone and buprenorphine “essential medicines,” and they're recognized as such by the UN Office on Drugs and Crime, UNAIDS, and other international organizations. Methadone and bupe are available to drug addicts in 65 countries, but because of onerous restrictions they fail to reach many who could benefit, an Open Society report says. The comic book contains startling stats about the link between addiction and HIV: In Vietnam IV drug users account for 65% of HIV infections, but fewer than 0.5% have access to drug maintenance; HIV has reached epidemic levels among IV drug users in Russia—37% of Russian IV drug users reportedly have HIV, and they make up 80% of new cases—yet Russia has outlawed methadone and bupe; Poland has limited its drug maintenance program to just 1,000 people; 88 countries have IV drug-use problems but no MAT programs.

The Open Society’s program is part of a larger effort to lower HIV infection rates among injection drug users. The recent International AIDS Conference in Vienna declared that the War on Drugs is helping to spread AIDS and called for a policy overhaul. The Vienna Declaration was signed by thousands of people worldwide, including the Nobel-laureate co-discoverer of the HIV virus and other prominent health-policy figures. President Obama’s Emergency Plan for AIDS Relief also reportedly endorses MAT and harm-reduction strategies. A raft of methadone treatment programs were recently initiated in countries including Tajikistan, Afghanistan and Morocco, Cambodia and Bangladesh. In countries that already have MAT programs, like Georgia, Kyrgyszstan and Indonesia, IV addicts face prohibitively long waiting lists. The Open Society’s five-point harm reduction approach to reducing HIV infection also includes increasing needle exchanges, legal reform to end the focus on criminalizing addicts, increasing the availability of antiretroviral treatment, and teaching addicts to take care of their sexual health.

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• Mexico Gunmen Set Casino on Fire, Killing 53 [LA Times]
• Why It's No Longer Raining Cocaine in the Dominican Republic [Time]
• Mexico Drug War: Local Mayor Found Murdered [International Business Times]
• Rodney King Charged with DUI for July Arrest [CBS News]
• New York Man Admits Dealing Drugs Out of Ice Cream Truck [Reuters]
• Mobile Meth Lab Found in Pickup Truck [Heartland Connection]

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Fix Editor-in-Chief Maer Roshan appeared on CNN Headline News last night, to discuss Russell Armstrong's suicide. On Monday The Fix published an exclusive interview by Roshan with the much-maligned Real Housewives husband, an alleged wife beater and one-time financial felon who became a passionate advocate for recovery in recent years. Armstrong, the child of an alcoholic father who supported his sister through her meth addiction, and quietly paid for the treatment of several other addicts, approached Roshan about investing in The Fix just six weeks before his his death. On the show, Roshan pointed out that while Armstrong may have been no saint, reality T.V. doesn't always encourage good behavior, noting that many mshows ply their subjects with alcohol and radically edit  segments to achieve maximum drama.

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Most of us learned back in high school that a bottle of beer is the rough equivalent of a shot of hard liquor—which is also broadly the equivalent of a glass of wine. But perhaps Russian President Dmitry Medvedev went to a different school. He stated this week that the development of the country's winemaking industry could “contribute to the eradication of alcoholism”—it's the production and consumption of “other drinks,” according to Medvedev, that leads to alcohol abuse. The seemingly illogical idea of tackling widespread alcoholism by producing more alcohol seems to make perfect sense to Medvedev. Then again, he runs a country where beer has only recently been classified as an alcoholic drink, rather than a food. "Countries where [winemaking] is strong, have no problems with alcohol abuse,” stated the president, sweepingly. Medvedev’s plan to eradicate alcoholism—quite apart from any "minor" flaws—faces some significant obstacles: 40% of Russians—almost 57 million people—drink to excess, per capita alcohol consumption is twice the critical norm set by the World Health Organization, and tens of thousands of Russians die from alcohol poisoning every year. The idea of expanding a small industry, based around vineyards near the Caspian and Black seas, to transform the vodka-swilling masses into wine-sipping connoisseurs would seem excessively ambitious—even if it weren't also insane.

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In a case that raises important questions about culpability, a man who stabbed his neighbor to death during a burglary 24 years ago—while in an alcohol- and marijuana-induced stupor—could be the first person to face lethal injection after a summer pause in executions in Ohio. Billy Slagle, now 42, broke into the Cleveland home of 40-year-old Mari Anne Pope in 1986 and stabbed her 17 times with a set of sewing scissors. He was just 18 at the time of the crime and his motive may have been to obtain money to buy more alcohol. But public defender Joe Wilhelm argues that the court should show mercy to his client, in part because of Slagle's alcoholism. "Billy suffered from the stunting effects of drugs and alcohol when he committed his crime," said Wilhelm, adding that Slagle couldn't even remember the night in question. "He had no clue as to why he killed Mari Anne." Wilhelm listed a difficult upbringing and the speculated genetic predisposition of Native Americans—Slagle is of Chippewa heritage—as contributing factors to his addiction. He also noted Slagle's good behavior for well over two decades—most of his life—in the absence of drugs and alcohol in prison. Wilhelm added that Slagle had an emotional age of 12 in 1986. Executions were suspended in Ohio in early July amid concerns that lethal injection policies were being "haphazardly" enforced, but may soon resume. A final hearing on Billy Slagle's case is scheduled for September 13—just a week before his planned execution on September 20.

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