n=8

A young female guinea pig
A young female guinea pig (Photo credit: Wikipedia)

Published in a prestigious journal with an ‘n’ of 8. Unbelievable.

Participants  Eight cocaine-using adults.

Measurements  Subjects completed nine experimental sessions in which they were pre-treated with 0, 100 or 200 mg oral immediate release bupropion. Ninety minutes later they sampled an intranasal cocaine dose [4 (placebo), 15 or 45 mg] and made six choices between that dose and an alternative reinforcer (US$0.25), available on independent, concurrent progressive ratio schedules. Subjects also completed a battery of subject-rated, performance and physiological measures following the sample doses of cocaine.

Findings  After 0 mg bupropion, the high dose of cocaine (45 mg) was chosen five of six times on average compared to 2.25 of six choices for placebo cocaine (4 mg) (P < 0.05). Active bupropion reduced choice of 45 mg cocaine to 3.13 (100 mg) or 4.00 (200 mg) out of six drug choices on average. Bupropion also consistently enhanced positive subject-rated effects of cocaine (e.g. good effects; willing to take again) while having no effects of its own.

Conclusions  The atypical antidepressant, bupropion, acutely appears to reduce preference for intranasal cocaine versus a small amount of money but to increase reported positive experiences of the drug.

Harsh enforcement has failed

drug policy by mmcrae01

This Foreign Policy article provides a concise snapshot of the failure of the “harsh enforcement” approach to drug policy:

As a domestic policy, a harsh enforcement approach has done little to control drug use, but has done a lot to lock up a growing portion of the U.S. population. Cocaine and opiate prices are about half their 1990 levels in in America today. And 16 percent of American adults have tried cocaine — that’s about four times higher than any other surveyed country in a list that includes Mexico, Colombia, Nigeria, France, and Germany. And while criminalization has a limited impact on price and use, it has a significant impact on crime rates. Forty percent of drug arrests in the United States are for the simple possession of marijuana. Nearly half a million people are behind bars in the United States for a drug offense — that’s more than ten times the figure in 1980.

It’s easy to write with certainty when you are vague. It’s also easier when you are only addressing a narrow set of values:

Conversely, the Global Commission on Drug Policy report compiled evidence suggesting that approaches based on treatment rather than punishment were far more effective in reducing consumption, HIV prevalence, and crime rates among users. For example, Britain and Germany, both of which long ago adopted harm reduction strategies for people injecting drugs — programs that include needle exchange programs and medication — see HIV prevalence among people who inject drugs below 5 percent. The United States and Portugal, by contrast, where such strategies were introduced later or only partially, see HIV prevalence among a similar community at above 15 percent.

“Reduced consumption” is a good thing, I suppose. But, is that a good indicator of the welfare of addicts? I’m not so sure.

Based on my knowledge of the UK system, would I rather be a heroin addict in the US or the UK? Easy call—the US recovery model or UK harm reduction model—recovery.

The US’s incarceration rates for drug offenses are terrible, indecent and stupid. However, I’m not certain that a system that believes addicts can’t recover, offers only methadone even though patients express a preference for abstinent recovery is better even if it does reduce crime and disease. Does this show more restraint in the exercise of social control? Not clear to me.

The sands are shifting in both the UK and the US. It’d be nice if we could stop having these either/or discussions and consider entertaining a both/and conversation.

Only 2.6% of welfare applicants test positive

Master Sgt. Urbano Sosa demonstrates the job o...

Not surprisingly, drug testing of welfare recipients does not confirm the assumptions of supporters:

Of the 4,086 applicants who scheduled drug tests while the law was enforced, 108 people, or 2.6 percent, failed, most often testing positive for marijuana. About 40 people scheduled tests but canceled them, according to the Department of Children and Families, which oversees Temporary Assistance for Needy Families, known as the TANF program.

I can’t sleep no more…

Ta-Nehisi Coates reminds us that human error will exist, whatever the drug policy, and uses a recent police killing of an unarmed 18 year old to point out that the stakes are very high when anything is criminalized.

When people talk about ending the War on Drugs, or decriminalizing marijuana, or reining in stop and frisk, they are not simply talking about the right of private citizens to get high, they are talking about the right of private citizens to not be subject to lethal violence at the hands of the state. … For all practical purposes, if an officer, pursuing an arrest, believes you have endangered his life, and can demonstrate that belief, he or she can kill you.

Now, this doesn’t suggest that our choices are criminalize or legalize and it doesn’t suggest that the costs of not enforcing drug laws are acceptably low.

There is no such thing as a problem-free drug policy, the questions we need to answer are:

  • Which problems are we not willing to tolerate?
  • Which problems are we willing to tolerate and how can we minimize them?
I don’t know all the details of this case and these things are usually more complicated than headlines suggest. It sounds like police may have been on edge because of recent shots fired at officers in the area. This interview includes leading questions that advance a narrative of police abuses of a minority community. I have no way of knowing the ways in which this narrative may be true or false, but the parents grief is heartbreaking.