January 31, 2009 from The New York Times
Editorial
Time Lag in Vienna?
Programs that give drug addicts access to clean needles have been shown the world over to slow the spread of deadly diseases including H.I.V./AIDS and hepatitis. Public health experts were relieved when President Obama announced his support for ending a ban on federal funding for such programs.
Unfortunately, Mr. Obama’s message seems not to have reached the American delegation to a United Nations drug policy summit in Vienna, where progress is stalled on a plan that would guide global drug control and AIDS prevention efforts for years to come. The delegation has angered allies, especially the European Union, by blocking efforts to incorporate references to the concept of “harm reduction” — of which needle exchange is a prime example — into the plan.
State Department officials said that they were resisting the harm-reduction language because it could also be interpreted as endorsing legalized drugs or providing addicts with a place to inject drugs. But the Vienna plan does not require any country to adopt policies it finds inappropriate. And by resisting the harm-reduction language, the American delegation is alienating allies and sending precisely the wrong message to developing nations, which must do a lot more to control AIDS and other addiction-related diseases.
Some members of Congress are rightly angry about the impasse in Vienna. On Wednesday, three members fired off a letter to Susan Rice, the new American ambassador to the United Nations, urging that the United States’ delegation in Vienna be given new marching orders on the harm-reduction language. If that doesn’t happen, the letter warns, “we risk crafting a U.N. declaration that is at odds with our own national policies and interests, even as we needlessly alienate our nation’s allies in Europe.”
Saturday, January 31, 2009
Tuesday, January 27, 2009
Plan Merida Kills from Agence France Presse
22 killed in surging wave of violence in Mexico
Tue Jan 27, 9:06 pm ET
MONTERREY, Mexico (AFP) – Twenty-two people were found shot dead late Monday and Tuesday in northern Mexico, including four found on property belonging to the state-run oil giant Pemex, police said.
The killings are likely the result of the ongoing war between powerful drug cartels for control of lucrative access corridors to the United States, officials said.
Petroleos de Mexico workers found the bodies of the four men, some half-dressed and with tape over their eyes, piled up in a well on company property some 150 kilometers (93 miles) northeast of Monterrey, on the US-Mexican border.
The men had all been shot in the head, police in this prosperous and heavily industrialized city told AFP, speaking on condition of anonymity.
Meanwhile to the west in the state of Chihuahua, a state also bordering the United States, police found 18 bodies.
Among the dead were three men were found Tuesday afternoon in the state capital Chihuahua with their hands and feet tied. Police said that witnesses saw how the victims were forced out of a vehicle and riddled with bullets on the spot.
Other bodies were found in different state cities, including five in Ciudad Juarez, the epicenter of a war between the Juarez and Sinaloa drug cartels. Already 116 people have been killed in drug violence in Juarez in 2009.
In 2008 some 2,400 people were murdered in Chihuahua state, 1,600 of them in Ciudad Juarez, according to government figures.
The Mexican government has deployed some 36,000 soldiers across the country to battle organized crime.
Across the country, 5,300 people were murdered in 2008, the government said.
Copyright © 2009 Agence France Presse. All rights reserved. The information contained in the AFP News report may not be published, broadcast, rewritten or redistributed without the prior written authority of Agence France Presse.
Tue Jan 27, 9:06 pm ET
MONTERREY, Mexico (AFP) – Twenty-two people were found shot dead late Monday and Tuesday in northern Mexico, including four found on property belonging to the state-run oil giant Pemex, police said.
The killings are likely the result of the ongoing war between powerful drug cartels for control of lucrative access corridors to the United States, officials said.
Petroleos de Mexico workers found the bodies of the four men, some half-dressed and with tape over their eyes, piled up in a well on company property some 150 kilometers (93 miles) northeast of Monterrey, on the US-Mexican border.
The men had all been shot in the head, police in this prosperous and heavily industrialized city told AFP, speaking on condition of anonymity.
Meanwhile to the west in the state of Chihuahua, a state also bordering the United States, police found 18 bodies.
Among the dead were three men were found Tuesday afternoon in the state capital Chihuahua with their hands and feet tied. Police said that witnesses saw how the victims were forced out of a vehicle and riddled with bullets on the spot.
Other bodies were found in different state cities, including five in Ciudad Juarez, the epicenter of a war between the Juarez and Sinaloa drug cartels. Already 116 people have been killed in drug violence in Juarez in 2009.
In 2008 some 2,400 people were murdered in Chihuahua state, 1,600 of them in Ciudad Juarez, according to government figures.
The Mexican government has deployed some 36,000 soldiers across the country to battle organized crime.
Across the country, 5,300 people were murdered in 2008, the government said.
Copyright © 2009 Agence France Presse. All rights reserved. The information contained in the AFP News report may not be published, broadcast, rewritten or redistributed without the prior written authority of Agence France Presse.
The Epidemic That Wasn’t from the New York Times
January 27, 2009
The Epidemic That Wasn’t
By SUSAN OKIE
BALTIMORE — One sister is 14; the other is 9. They are a vibrant pair: the older girl is high-spirited but responsible, a solid student and a devoted helper at home; her sister loves to read and watch cooking shows, and she recently scored well above average on citywide standardized tests.
There would be nothing remarkable about these two happy, normal girls if it were not for their mother’s history. Yvette H., now 38, admits that she used cocaine (along with heroin and alcohol) while she was pregnant with each girl. “A drug addict,” she now says ruefully, “isn’t really concerned about the baby she’s carrying.”
When the use of crack cocaine became a nationwide epidemic in the 1980s and ’90s, there were widespread fears that prenatal exposure to the drug would produce a generation of severely damaged children. Newspapers carried headlines like “Cocaine: A Vicious Assault on a Child,” “Crack’s Toll Among Babies: A Joyless View” and “Studies: Future Bleak for Crack Babies.”
But now researchers are systematically following children who were exposed to cocaine before birth, and their findings suggest that the encouraging stories of Ms. H.’s daughters are anything but unusual. So far, these scientists say, the long-term effects of such exposure on children’s brain development and behavior appear relatively small.
“Are there differences? Yes,” said Barry M. Lester, a professor of psychiatry at Brown University who directs the Maternal Lifestyle Study, a large federally financed study of children exposed to cocaine in the womb. “Are they reliable and persistent? Yes. Are they big? No.”
Cocaine is undoubtedly bad for the fetus. But experts say its effects are less severe than those of alcohol and are comparable to those of tobacco — two legal substances that are used much more often by pregnant women, despite health warnings.
Surveys by the Department of Health and Human Services in 2006 and 2007 found that 5.2 percent of pregnant women reported using any illicit drug, compared with 11.6 percent for alcohol and 16.4 percent for tobacco.
“The argument is not that it’s O.K. to use cocaine in pregnancy, any more than it’s O.K. to smoke cigarettes in pregnancy,” said Dr. Deborah A. Frank, a pediatrician at Boston University. “Neither drug is good for anybody.”
But cocaine use in pregnancy has been treated as a moral issue rather than a health problem, Dr. Frank said. Pregnant women who use illegal drugs commonly lose custody of their children, and during the 1990s many were prosecuted and jailed.
Cocaine slows fetal growth, and exposed infants tend to be born smaller than unexposed ones, with smaller heads. But as these children grow, brain and body size catch up.
At a scientific conference in November, Dr. Lester presented an analysis of a pool of studies of 14 groups of cocaine-exposed children — 4,419 in all, ranging in age from 4 to 13. The analysis failed to show a statistically significant effect on I.Q. or language development. In the largest of the studies, I.Q. scores of exposed children averaged about 4 points lower at age 7 than those of unexposed children.
In tests that measure specific brain functions, there is evidence that cocaine-exposed children are more likely than others to have difficulty with tasks that require visual attention and “executive function” — the brain’s ability to set priorities and pay selective attention, enabling the child to focus on the task at hand.
Cocaine exposure may also increase the frequency of defiant behavior and poor conduct, according to Dr. Lester’s analysis. There is also some evidence that boys may be more vulnerable than girls to behavior problems.
But experts say these findings are quite subtle and hard to generalize. “Just because it is statistically significant doesn’t mean that it is a huge public health impact,” said Dr. Harolyn M. Belcher, a neurodevelopmental pediatrician who is director of research at the Kennedy Krieger Institute’s Family Center in Baltimore.
And Michael Lewis, a professor of pediatrics and psychiatry at the Robert Wood Johnson Medical School in New Brunswick, N.J., said that in a doctor’s office or a classroom, “you cannot tell” which children were exposed to cocaine before birth.
He added that factors like poor parenting, poverty and stresses like exposure to violence were far more likely to damage a child’s intellectual and emotional development — and by the same token, growing up in a stable household, with parents who do not abuse alcohol or drugs, can do much to ease any harmful effects of prenatal drug exposure.
Possession of crack cocaine, the form of the drug that was widely sold in inner-city, predominantly black neighborhoods, has long been punished with tougher sentences than possession of powdered cocaine, although both forms are identically metabolized by the body and have the same pharmacological effects.
Dr. Frank, the pediatrician in Boston, says cocaine-exposed children are often teased or stigmatized if others are aware of their exposure. If they develop physical symptoms or behavioral problems, doctors or teachers are sometimes too quick to blame the drug exposure and miss the real cause, like illness or abuse.
“Society’s expectations of the children,” she said, “and reaction to the mothers are completely guided not by the toxicity, but by the social meaning” of the drug.
Research on the health effects of illegal drugs, especially on unborn children, is politically loaded. Researchers studying children exposed to cocaine say they struggle to interpret their findings for the public without exaggerating their significance — or minimizing it, either.
Dr. Lester, the leader of the Maternal Lifestyle Study, noted that the evidence for behavioral problems strengthened as the children in his study and others approached adolescence. Researchers in the study are collecting data on 14-year-olds, he said, adding: “Absolutely, we need to continue to follow these kids. For the M.L.S., the main thing we’re interested in is whether or not prenatal cocaine exposure predisposes you to early-onset drug use in adolescence” or other mental health problems.
Researchers have long theorized that prenatal exposure to a drug may make it more likely that the child will go on to use it. But so far, such a link has been scientifically reported only in the case of tobacco exposure.
Teasing out the effects of cocaine exposure is complicated by the fact that like Yvette H., almost all of the women in the studies who used cocaine while pregnant were also using other substances.
Moreover, most of the children in the studies are poor, and many have other risk factors known to affect cognitive development and behavior — inadequate health care, substandard schools, unstable family situations and exposure to high levels of lead. Dr. Lester said his group’s study was large enough to take such factors into account.
Ms. H., who agreed to be interviewed only on the condition that her last name and her children’s first names not be used, said she entered a drug and alcohol treatment program about six years ago, after losing custody of her children.
Another daughter, born after Ms. H. recovered from drug and alcohol abuse, is thriving now at 3. Her oldest, a 17-year-old boy, is the only one with developmental problems: he is autistic. But Ms. H. said she did not use cocaine, alcohol or other substances while pregnant with him.
After 15 months without using drugs or alcohol, Ms. H. regained custody and moved into Dayspring House, a residential program in Baltimore for women recovering from drug abuse, and their children.
There she received psychological counseling, parenting classes, job training and coaching on how to manage her finances. Her youngest attended Head Start, the older children went to local schools and were assigned household chores, and the family learned how to talk about their problems.
Now Ms. H. works at a local grocery, has paid off her debts, has her own house and is actively involved in her children’s schooling and health care. She said regaining her children’s trust took a long time. “It’s something you have to constantly keep working on,” she said.
Dr. Belcher, who is president of Dayspring’s board of directors, said such programs offered evidence-based interventions for the children of drug abusers that can help minimize the chances of harm from past exposure to cocaine or other drugs.
“I think we can say this is an at-risk group,” Dr. Belcher said. “But they have great potential to do well if we can mobilize resources around the family.”
The Epidemic That Wasn’t
By SUSAN OKIE
BALTIMORE — One sister is 14; the other is 9. They are a vibrant pair: the older girl is high-spirited but responsible, a solid student and a devoted helper at home; her sister loves to read and watch cooking shows, and she recently scored well above average on citywide standardized tests.
There would be nothing remarkable about these two happy, normal girls if it were not for their mother’s history. Yvette H., now 38, admits that she used cocaine (along with heroin and alcohol) while she was pregnant with each girl. “A drug addict,” she now says ruefully, “isn’t really concerned about the baby she’s carrying.”
When the use of crack cocaine became a nationwide epidemic in the 1980s and ’90s, there were widespread fears that prenatal exposure to the drug would produce a generation of severely damaged children. Newspapers carried headlines like “Cocaine: A Vicious Assault on a Child,” “Crack’s Toll Among Babies: A Joyless View” and “Studies: Future Bleak for Crack Babies.”
But now researchers are systematically following children who were exposed to cocaine before birth, and their findings suggest that the encouraging stories of Ms. H.’s daughters are anything but unusual. So far, these scientists say, the long-term effects of such exposure on children’s brain development and behavior appear relatively small.
“Are there differences? Yes,” said Barry M. Lester, a professor of psychiatry at Brown University who directs the Maternal Lifestyle Study, a large federally financed study of children exposed to cocaine in the womb. “Are they reliable and persistent? Yes. Are they big? No.”
Cocaine is undoubtedly bad for the fetus. But experts say its effects are less severe than those of alcohol and are comparable to those of tobacco — two legal substances that are used much more often by pregnant women, despite health warnings.
Surveys by the Department of Health and Human Services in 2006 and 2007 found that 5.2 percent of pregnant women reported using any illicit drug, compared with 11.6 percent for alcohol and 16.4 percent for tobacco.
“The argument is not that it’s O.K. to use cocaine in pregnancy, any more than it’s O.K. to smoke cigarettes in pregnancy,” said Dr. Deborah A. Frank, a pediatrician at Boston University. “Neither drug is good for anybody.”
But cocaine use in pregnancy has been treated as a moral issue rather than a health problem, Dr. Frank said. Pregnant women who use illegal drugs commonly lose custody of their children, and during the 1990s many were prosecuted and jailed.
Cocaine slows fetal growth, and exposed infants tend to be born smaller than unexposed ones, with smaller heads. But as these children grow, brain and body size catch up.
At a scientific conference in November, Dr. Lester presented an analysis of a pool of studies of 14 groups of cocaine-exposed children — 4,419 in all, ranging in age from 4 to 13. The analysis failed to show a statistically significant effect on I.Q. or language development. In the largest of the studies, I.Q. scores of exposed children averaged about 4 points lower at age 7 than those of unexposed children.
In tests that measure specific brain functions, there is evidence that cocaine-exposed children are more likely than others to have difficulty with tasks that require visual attention and “executive function” — the brain’s ability to set priorities and pay selective attention, enabling the child to focus on the task at hand.
Cocaine exposure may also increase the frequency of defiant behavior and poor conduct, according to Dr. Lester’s analysis. There is also some evidence that boys may be more vulnerable than girls to behavior problems.
But experts say these findings are quite subtle and hard to generalize. “Just because it is statistically significant doesn’t mean that it is a huge public health impact,” said Dr. Harolyn M. Belcher, a neurodevelopmental pediatrician who is director of research at the Kennedy Krieger Institute’s Family Center in Baltimore.
And Michael Lewis, a professor of pediatrics and psychiatry at the Robert Wood Johnson Medical School in New Brunswick, N.J., said that in a doctor’s office or a classroom, “you cannot tell” which children were exposed to cocaine before birth.
He added that factors like poor parenting, poverty and stresses like exposure to violence were far more likely to damage a child’s intellectual and emotional development — and by the same token, growing up in a stable household, with parents who do not abuse alcohol or drugs, can do much to ease any harmful effects of prenatal drug exposure.
Possession of crack cocaine, the form of the drug that was widely sold in inner-city, predominantly black neighborhoods, has long been punished with tougher sentences than possession of powdered cocaine, although both forms are identically metabolized by the body and have the same pharmacological effects.
Dr. Frank, the pediatrician in Boston, says cocaine-exposed children are often teased or stigmatized if others are aware of their exposure. If they develop physical symptoms or behavioral problems, doctors or teachers are sometimes too quick to blame the drug exposure and miss the real cause, like illness or abuse.
“Society’s expectations of the children,” she said, “and reaction to the mothers are completely guided not by the toxicity, but by the social meaning” of the drug.
Research on the health effects of illegal drugs, especially on unborn children, is politically loaded. Researchers studying children exposed to cocaine say they struggle to interpret their findings for the public without exaggerating their significance — or minimizing it, either.
Dr. Lester, the leader of the Maternal Lifestyle Study, noted that the evidence for behavioral problems strengthened as the children in his study and others approached adolescence. Researchers in the study are collecting data on 14-year-olds, he said, adding: “Absolutely, we need to continue to follow these kids. For the M.L.S., the main thing we’re interested in is whether or not prenatal cocaine exposure predisposes you to early-onset drug use in adolescence” or other mental health problems.
Researchers have long theorized that prenatal exposure to a drug may make it more likely that the child will go on to use it. But so far, such a link has been scientifically reported only in the case of tobacco exposure.
Teasing out the effects of cocaine exposure is complicated by the fact that like Yvette H., almost all of the women in the studies who used cocaine while pregnant were also using other substances.
Moreover, most of the children in the studies are poor, and many have other risk factors known to affect cognitive development and behavior — inadequate health care, substandard schools, unstable family situations and exposure to high levels of lead. Dr. Lester said his group’s study was large enough to take such factors into account.
Ms. H., who agreed to be interviewed only on the condition that her last name and her children’s first names not be used, said she entered a drug and alcohol treatment program about six years ago, after losing custody of her children.
Another daughter, born after Ms. H. recovered from drug and alcohol abuse, is thriving now at 3. Her oldest, a 17-year-old boy, is the only one with developmental problems: he is autistic. But Ms. H. said she did not use cocaine, alcohol or other substances while pregnant with him.
After 15 months without using drugs or alcohol, Ms. H. regained custody and moved into Dayspring House, a residential program in Baltimore for women recovering from drug abuse, and their children.
There she received psychological counseling, parenting classes, job training and coaching on how to manage her finances. Her youngest attended Head Start, the older children went to local schools and were assigned household chores, and the family learned how to talk about their problems.
Now Ms. H. works at a local grocery, has paid off her debts, has her own house and is actively involved in her children’s schooling and health care. She said regaining her children’s trust took a long time. “It’s something you have to constantly keep working on,” she said.
Dr. Belcher, who is president of Dayspring’s board of directors, said such programs offered evidence-based interventions for the children of drug abusers that can help minimize the chances of harm from past exposure to cocaine or other drugs.
“I think we can say this is an at-risk group,” Dr. Belcher said. “But they have great potential to do well if we can mobilize resources around the family.”
Thursday, January 22, 2009
Saturday, January 10, 2009
Cocaine Use Up Among White Youth - NY Times
January 10, 2009
Op-Ed Columnist
Cocaine and White Teens
By CHARLES M. BLOW
Last month, President Bush touted the results of a government-sponsored study by the University of Michigan called Monitoring the Future. It reported a broad decline in drug use among young people since 2001. This included a 24 percent drop in the overall use of illicit drugs. There was one exception he said: abuse of painkillers. But, one important metric that wasn’t mentioned, and that stubbornly resisted the downturn, was the use of cocaine.
According to data from the group that produced the report, the percentage of both black and white 12th graders who confessed to using cocaine in the past 30 days has essentially stayed flat since 2001. The major difference is that white usage outweighs black usage 4 to 1. (If you take a longer view back to 1991, when cocaine usage bottomed out following the outrageous ’80s, usage among white 12th graders since then has nearly doubled, while usage among black 12th graders has fallen a bit.)
While we turned our attention to pills being swiped from parents’ medicine cabinets, the number of youngsters snorting white lines continued virtually unabated, producing a striking consequence.
According to the most recent data from the Substance Abuse and Mental Health Services Administration, admissions of white teenagers to drug treatment centers for crack and cocaine abuse soared 76 percent from 2001 to 2006. Crack and cocaine was the only illicit drug category in which the number of admissions for white teens grew over this period, and in 2006 the number was at its highest level since these data have been kept. By contrast, admissions among black teens for crack and cocaine over the same period held steady. By 2006, white admissions outnumbered those for blacks by more than 10 to 1. (It should be noted that admissions for white youths abusing painkillers in 2006, while growing, was still less than half the number of admissions for those abusing cocaine that year.)
And there are ominous signs. According to the Monitoring the Future study, the risk of using crack and cocaine, as perceived by teenagers, is going down. The newly released 2009 National Drug Threat Assessment puts it this way: “The decrease in perceived risk suggests that adolescents are becoming less wary of trying cocaine, which may sustain demand for the drug in the near future.”
But, in a phone interview, David Murray, chief scientist in the White House’s Office of National Drug Control Policy, insisted that there was good news: a sharp rise in the price of cocaine and a drop in its purity since 2006, among other things, have cut into overall usage.
So, I thought, until policy makers put more of a focus on this issue and figure out how to reach these students, should we just hope that teens are too broke for this weak coke? I don’t think so. We need a real strategy, right now.
E-mail chblow@nytimes.com
Op-Ed Columnist
Cocaine and White Teens
By CHARLES M. BLOW
Last month, President Bush touted the results of a government-sponsored study by the University of Michigan called Monitoring the Future. It reported a broad decline in drug use among young people since 2001. This included a 24 percent drop in the overall use of illicit drugs. There was one exception he said: abuse of painkillers. But, one important metric that wasn’t mentioned, and that stubbornly resisted the downturn, was the use of cocaine.
According to data from the group that produced the report, the percentage of both black and white 12th graders who confessed to using cocaine in the past 30 days has essentially stayed flat since 2001. The major difference is that white usage outweighs black usage 4 to 1. (If you take a longer view back to 1991, when cocaine usage bottomed out following the outrageous ’80s, usage among white 12th graders since then has nearly doubled, while usage among black 12th graders has fallen a bit.)
While we turned our attention to pills being swiped from parents’ medicine cabinets, the number of youngsters snorting white lines continued virtually unabated, producing a striking consequence.
According to the most recent data from the Substance Abuse and Mental Health Services Administration, admissions of white teenagers to drug treatment centers for crack and cocaine abuse soared 76 percent from 2001 to 2006. Crack and cocaine was the only illicit drug category in which the number of admissions for white teens grew over this period, and in 2006 the number was at its highest level since these data have been kept. By contrast, admissions among black teens for crack and cocaine over the same period held steady. By 2006, white admissions outnumbered those for blacks by more than 10 to 1. (It should be noted that admissions for white youths abusing painkillers in 2006, while growing, was still less than half the number of admissions for those abusing cocaine that year.)
And there are ominous signs. According to the Monitoring the Future study, the risk of using crack and cocaine, as perceived by teenagers, is going down. The newly released 2009 National Drug Threat Assessment puts it this way: “The decrease in perceived risk suggests that adolescents are becoming less wary of trying cocaine, which may sustain demand for the drug in the near future.”
But, in a phone interview, David Murray, chief scientist in the White House’s Office of National Drug Control Policy, insisted that there was good news: a sharp rise in the price of cocaine and a drop in its purity since 2006, among other things, have cut into overall usage.
So, I thought, until policy makers put more of a focus on this issue and figure out how to reach these students, should we just hope that teens are too broke for this weak coke? I don’t think so. We need a real strategy, right now.
E-mail chblow@nytimes.com
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