Arnold TREBACH, President of the Drug Policy Foundation

and Professor at the American University, Washington, D.C.

Origins

We are making history. Baltimore Conference is the first international conference of officials during recent years in which the major purpose is to explore new methods of dealing with drugs - as distinguished from conferences that sought desperately to shore up the existing system of rigid prohibition. Of course, not every official here is convinced of the need for dramatic changes in drug policy, but have attended simply because they want to gather information. They are welcome; in a sense we are all seeking information. Yet, it is fair to say that virtually every person in attendance is convinced that some type of far-reaching action must be taken in order to save modern societies, particularly the cities, from being torn apart by seemingly senseless crime and violence, by racial hate, by vicious drug-traffickers, and by rampant disease, especially AIDS.

A few days ago, The Washington Post reported that over the previous nine days there had been 17 killings in the nation's capital city, and no arrests so far in part because homicide detectives are so overwhelmed with the workload. There is nothing terribly unusual about this story, except in this case the lead story on the front page is that the president made a major emotional speech against crime.

Based upon past data, it is likely that approximately half of those killings were related to the virulent illegal drug trade in Washington. The relationship between the drug trade, the war on drugs, and American deaths is a strong one. Indeed, I would estimate that since 1980 between 60,000 and 80,000 of my brother and sister Americans may have died preventable deaths due to the failures of our drug strategies - perhaps 30-40,000 in drug trade violence and another 30-40,000 from AIDS that was originally transmitted by intravenous drug use. Such grisly realities are seen most strongly in urban areas and are making many of our cities virtually uninhabitable.

Certainly, our president would agree with the concerned city officials gathered here from 19 countries that the current path leads only to more disaster. But what new paths should we explore? I am saddened to have to report that while Mr. Clinton and his Administration deserve high marks for the improvement they have made in the overall tone of drug policy, they are largely paralyzed in terms of concrete positive action in the drug field. They are now in a state of internal conflict. Their collective heart seems to say "we must do something effective quickly to stop the drug-trade killings and the deaths from AIDS or we will be untrue to our own better angels" while their collective head seems to say "we have enough political trouble with gays in the military, with the new health plan, and with the North American Free Trade Agreement - and thus we cannot risk being seen as soft on drugs and soft on crime." Within the past few weeks, Drug Czar Lee Brown has gone so far as to heatedly declare that this Admin

istration will not consider any dramatic changes in drug policy, certainly not medicalization which he lumped with full legalization.

Yet, of all the possible new paths for any city or nation the most practical, sensible, and effective is medicalization or, as it is now frequently called, harm reduction, according to a growing consensus of experts across the political spectrum. The essence of harm reduction is the acceptance of the enduring reality of drug use, the absurdity of even attempting to create a drug-free society, and the need to treat drug users and drug abusers as basically decent human beings. In return, we must demand that they behave responsibly and refrain from crime. While this approach may seen to some as soft or permissive, in fact it has proven to be much more effective in terms of controlling drug abuse, crime, and AIDS than the current harsh war on drugs.

The best examples of harm reduction I have seen in the past were in the United Kingdom and The Netherlands. The latter country was particularly praiseworthy in my eyes because it persisted in the most enlightened and effective national drug policy in the world despite intense criticism from its continental neighbors. Such pressure came especially from Germany, the dominant nation in Europe and the one seemingly most committed to imitating the failed drug policy of the most powerful nation in the world where we meet today.

It is both ironic and wonderful that Germans, especially German city officials, are now in the forefront of effective drug policy change. The principles of the pioneering Frankfurt Resolution, signed in the German city that bears its name in 1990, offer the greatest hope of starting to solve the crisis affecting so many cities. In the drug file, that resolution ranks in importance with the British Rolleston Report of 1926 in terms of its compelling clarity and the practical guidance it provides for those who seek to solve the riddle of drug abuse.

The work of the European Cities on Drug Policy, the organization created in the wake of the signing of the Frankfurt Resolution, demonstrates that cities must move forward to carry out enlightened drug control and treatment programs in the face of indifference or even hostility from their respective national governments. This is difficult, to be sure, without political and economic support from higher levels of governement, but the cities are in terrible condition and courage is a necessary commodity in modern urban governement. The ECDP has also demonstrated that courageous and effective action in the cities can sometimes convince regional, provincial, and national governments to change. Thus, every city official here should contemplate just how far he or she can move the local government forward even though the national government is now unhelpful.

American officials have a special burden. Those officials must admit, openly if they can find the heart to do so, that the future of drug policy is to be found in Europe and other countries, in the Frankfurt Resolution and in the ECDP and not in any official American law, position, or document. We are first in computers, first in space, first in military power, first in wealth, first in the vitality of our sports - and dead last in drug policy. It hurts to admit this but it will hurt us all more if we do not.

American officials should ask their friends and colleagues in the national government to stop the practice of criticizing the attempts of European or other government officials to experiment with new approaches to save their peoples from the ravages of rigid prohibition. Sometimes this criticism has reached the level of intimidation. More than that, leading officials in Washington should be asked by officials in attendance here to lend active support, even the granting of foreign aid when appropriate, to those countries whose cities display the courage to explore the new frontiers of drug treatment and control.

Now a few words of praise to those who helped make all of this happen. During last year's Drug Policy Foundation conference in Washington, Luigi Del Gatto and Antonio Contardo of the International Antiprohibitionist League and the Radical Party - two related organizations remarkable for their growing effectiveness - told me how much they respected the work of the Frankfurt Resolution group of cities and suggested that DPF should work with the group more closely. Even though we must turn down most suggestions for additional work because of limited resources, I was struck by the compelling logic of their proposals. Therefore, I responded positively because I saw that progress might only be possible through action at the local level. I knew about the work of the ECDP but had never thought about extending its ideas to the United States. The suggestions of Messrs. Del Gatto and Contardo almost instantly kindled the thought in my mind that the ECDP concept could help my country and perhaps others outside of Euro

pe. Accordingly, I suggested that perhaps we in the Foundation could spread the European network of cities to this country. Moreover, I threw out the thought that perhaps the first meeting of the American network could be in Baltimore just before the 1993 Foundation annual meeting. I suggested Baltimore because I view Mayor Kurt Schmoke as the most important American drug policy pioneer now in office, but I had no idea how he would react to the concept.

The rest is a happy chapter in history. My colleague Kevin Zeeze took a major role in developing the idea. So did Kendra Wright, the DPF Director of Conferences and Development. Mayor Schmoke reacted quite positively to a letter we sent raising the idea of a meeting and a related network of cities. This historic meeting could never have happened without the enthusiastic support of Kurt Schmoke and of his devoted staff, especially Lee Tawney and Horward Lavine. Nor could it have occurred without the generous support of the funders listed in the program - The Arca Foundation, Willard Hackerman, The John D. and Catherine T. MacArthur Foundation, and the Open Society Fund - who provided grants to the Drug Policy Foundation allowing us to cover most of the costs of this conference, including travel for some delegates and accomodations for almost all of them.

Positive reactions to the idea of the Conference and the expanded network also came from Paul Vasseur, the Drug Policy Coordinator of Amsterdam, and from Werner Schneider, who holds a similar position in Frankfurt - and later from Ueli Locher and Horst Bossong who hold the same positions in Zurich and Hamburg.

A meeting with these officials and with representatives of many of the ECDP cities at the Rotterdam town hall in March of this year solidified the new working relationship for reforms. It was agreed to move forward with the new alliance, the International Network of Cities on Drug Policy, which would be built largely on the principles and following the example of the ECDP. It was also understood that the Drug Policy Foundation would serve as the secretariat of the new group. We in the Foundation appointed Kendra Wright to direct our work regarding the INCDP. Ms. Wright took the lead in setting up a pioneering series of visits to American cities for Werner Schneider, herself, and other experts during the summer and fall of 1993. The purpose of these trips was to ascertain the willingness of America city officials to move forward with new approaches to drug control and to attend this conference in Baltimore. The results of the trip were most positive.

One of the most encouraging signs of change has been interest in the Frankfurt Resolution itself, which as is well known, calls upon the cities to take the lead in drug policy reform. During our meeting in Rotterdam, Mayor Kurt Schmoke announced through his representative that he intended to sign the Frankfurt Resolution at this event in Baltimore.

My hope is that every city official here will consider how his or her city can benefit from adhering to the principles of harm reduction as embodied in the Frankfurt Resolution. Attempt to implement as many of its features as possible in your city. For example, appoint a drug policy coordinator as one first step forward. If you feel it is appropriate and if you can secure the proper approvals, sign the Resolution for your city. If not, do not consider that a defeat. While 15 European cities have signed, another 35 have affiliated themselves with the ECDP network even though they have not yet signed the Resolution.

(The numbers increased during the interventing months). Whatever you do, continue to work with us, to attend future meetings, to share information, and to help create a movement that will truly make a difference.

Mayor Schmoke has announced his intention to implement many of the principles of that resolution in this city, partly due to the recommendations of his own Mayor's Working Group on Drug Policy Reform which he created this year. Thus, we meet in the city that could become the model of urban peace and security for this nation. It is our job at this conference and in our future work together to help make that dream come true for Baltimore, for our nation, and for all of the people of the world.

The Meeting and its Aftermath

In most respects, the conference was a great success. A total of 88 delegates from 41 cities and 19 countries participated in the meeting. There never has been an event like it; a major international meeting dominated by officials in which the fundamental theme was the need to change the existing world order in drug control. As we had hoped, European city officials especially those involved in the ECDP, provided excellent guidance on models of harm reduction in practice. Mayor Schmoke once again demonstrated the courage and the understanding that has placed him in a preeminent position among American reformers. The mayor signed the Frankfurt Resolution during the Baltimore Conference. Also, he declared: "The United States war on drugs and similar campaigns in other countries have failed. Only a harm reduction policy, led by public health experts and emphasizing treatment, can be expected to reduce addiction, stop drug-related crime, and slow the transmission of AIDS."

Mayor Schmoke's unique status in America politics - he is a Friend of Bill's - was reflected in the fact that the Clinton Administration felt compelled to send a high ranking State Department official to speak at the conference. R. Grant Smith, the Assistant Secretary of State for International Narcotic Matters, proceeded to explain: "I am not here because this Administration agrees with decriminalization or medicalization. We emphatically do not. I am here because unlike previous Administrations, the Clinton Administration believes in open discussion and debate on social issues". The remainder of his calm, polite talk was actually an attack on the most moderate positions of the reformers in the room. Morevover, a few weeks later when Surgeon General Joycelyn Elders suggested simply studying legalization, the White House reacted in horror. Through his press secretary Mr. Clinton stated forcefully that he would not even study the question of legalization. Moreover, when the new Clinton drug strategy plan came

out in February 1994, legalization was dismissed with a regal wave of the hand using language similar to that used by Mr. Smith in his Baltimore presentation: prohibition keeps drugs under control. When drug Czar Lee Brown was asked why the plan did not contemplate legalization, he replied that it would be a destructive policy and that the Clinton Administration did not intend "to spend one nickel" studying the matter. So much for open debate on drug policy in the Clinton White House.

Another important American official who appeared on the Baltimore program was Ms. Silvie Bryant, who came in her capacity as Chief of the New York Office, United Nations Drug Control Program. Ms. Bryant was as polite as Mr. Smith and just as unyielding in her support of current policies, which of course are based on the continuing support of rigid prohibition and a worldwide war on drugs. She described the existing United Nations Program with barely a nod to the existence of the massive amount of criticism that has been leveled at it by the experts from around the world sitting in the audience before her.

This is the political universe in which Kurt Schmoke functions. It is risky world for any honest politician, but he perseveres and survives. For him, it is a simple matter of principle and humanity. His principled stand is helped by the support of many experts from around the world. As journalist Cynthia Cotts explained in a subsequent article in The Village Voice, at these conferences sometimes "a contact high sets in, the thrill of being with fellow subversives..." Even straight arrow Kurt Schmoke is feeling the buzz. Later, he will describe "this wonderful euphoria we had, talking to one another about reform".

In the face of resistance to talking seriously about fundamental change at the top of the American political structure, such conferences as that at Baltimore are vital for discussing ideas and also for bolstering the resolve of reformers. The demand, even hunger, for fundamental change in drug policy by official delegates was remarkable. This was particularly true of officials from Latin America. They told of how centuries of tradition in nondestructive patterns of coca cultivation and use were being destroyed by the war on drugs. They also told how the democratic structures and the economies of their countries were being destroyed by drug traffickers made rich and powerful by the profits spawned by rigid prohibition. So were the personal lives of these Latin American officials. Because they sought to combat the cartels created in response to the gringo war on drugs, the officials were themselves targets. One delegate from Colombia told the Conference of the bullet holes in his legs. Thus, the Latin American

delegates had personal as well as patriotic reasons for supporting a dramatic change in drug policy.

A particularly dramatic moment took place when another Colombian delegate, Attorney General Gustavo de Greiff, took the floor and made a startling pronouncement, all the more so since he was the highest ranking official present. Attorney General de Greiff seemed to be struggling within himself as he contemplated the political forces affecting his office; yet he stated his honest conclusions: "The war on drugs is a lost battle...(It) has been fought on the interdiction level and it has failed... The profits are so large that it is a delusion to think jailing or killing major traffickers will result in fewer drugs on the market... In the end, the only solution is legalization, with regulations to control the market." He said that the drugs should be regulated in a fashion similar to alcohol. While de Greiff had made somewhat similar comments in Colombia, this was the first time he had made them openly in the United States.

It is worth noting at this point that there were reports that in a closed meeting shortly after this pronouncement, U.S. Attorney General Janet Reno and another top Justice Department official severely criticized Mr. de Greiff for his stand on legalization. It is also worth noting that these same American officials were full of praise a few weeks later when on December 2 Colombian forces under de Greiff's leadership cornered and killed Pablo Escobar, one of the most notorious of the cartel criminals. During the Baltimore conference Attorney General de Greiff made it clear that while he favored legalization, he was duty bound to enforce current laws: "in the meantime our obligation is to go after the narcotraffickers, and we are doing that".

The courageous Colombian is also sticking to the most important position he announced in Baltimore. He was the highest ranking official to agree to be a signatory to the full-page advertisement we in the Drug Policy Foundation ran in major newspapers in early 1994. The ad declared the drug war a costly failure and called for full consideration or alternative policies, including study of legalization, as Surgeon General Elders had requested.

Other Baltimore delegates supported the call of Gustavo de Greiff for full legalization and for regulating now illegal drugs like alcohol. Emma Bonino, chair of the Radical Party, at one point looked out at the delegates and observed almost impatiently, "they say we need Prohibition, but I say, why not try legalization? If it turns out to be a disaster, we'll go back!". In a similar vein, Senator Enrique Gomez of Colombia argued forcefully for a fundamental and radical change of the drug laws that were the source of so much agony for his country. One of his remarks later got headlines: "Everybody knows we are right. They're just afraid to face it. The same thing happened to Galileo!".

Most delegates, however, did not advocate full legalization but rather they supported the middle ground of harm reduction, which in the past has been labeled medicalization or the public health approach. This was reflected in the major presentation made by Dr. John Marks of Liverpool, England, the area from which many of the modern concepts of harm reduction originate. Dr. Marks made it clear that the core of the enlightened British system is alive and well. He provides medical care, including heroin, cocaine, amphetamines, or other drugs and clean needles to many addicts. "The results are zero drug-related deaths, zero HIV infection among injecting drug takers, a ... reduction of ... 96 percent acquisitive crime. And perhaps most puzzling of all, a fall in the incidence of addiction among the public at large of ... 92 percent", The British psychiatrist explained to the Baltimore delegates.

The support of such harm reduction policies was reflected in the consensus statement issued at the end of the conference. The statement pointed to the "track record of success (that) has been developed by progressive drug policies in key cities in the Netherlands, Germany, Switzerland, England and Australia. In addition, cities across the United States have adopted elements of harm reduction programs, with New Haven leading the way in terms of comprehensive programs. Consistently, the new policies have reduced crime by drug users, curbed the spread of disease, increased the numbers of drug users seeking treatment and improved the quality of life for many residents"? Key points of agreement for the future were that, "Cities must be the laboratories of changes in drug policy, because national governments are still dominated by advocates of continuing and expanding drug prohibition ... A new network of cities to be called the International Network of Cities on Drug Policy, shall bolster the efforts of city offi

cials worldwide to craft new, more effective approaches to the problems presented by drugs in our societies."

The success of the Baltimore conference and the advent of INCDP are indicators that while the task of reform is huge, some progress in reform is taking place - and more is possible. While the Clinton Administration sometimes seems hopelessly mired in the past, it no longer talks in harsh tones, as I indicated earlier, about a war on drugs aimed at the American people. The latest Clinton drug strategy plan downplays interdiction and provides greatly increased funding for prevention and treatment. Kevin Zeeze and I have been called in by Administration officials for serious, cordial talks about their interest in cooperating with us on exploring new initiatives to settle the medical marijuana issue. We also see indications that some Administration officials would support an expansion in needle exchange programs.

Immodestly, we believe that some, even most, of this progress has taken place because the American reform movement has become so much more respected and powerful since this Foundation came into being in 1986. Many others have taken major initiatives as well. One shining example of such allied progress is the Resolution for a National Commission on Drug Policy developed at a meeting during February 1993 at the prestigious Hoover Institution in Paolo Alto. The Resolution was drafted primarily by California Judge James P. Gray and by Hoover Institution Fellow Joseph D.McNamara, who is also a member of the DPF board of Directors. In light of the fact that the resolution declares the war on drugs a failure, it is highly significant that a wide array of distinguished Americans have signed it, including former segretary of State George Shultz, San Francisco Major Frank Jordan, and Nobel Laureate Milton Friedman. We fund further evidence of a hunger for change among distinguished officials and private citizens when

we at the Foundation were seeking financial support and signatories for our advertisements in early 1994. Within several weeks we raised funds sufficient to cover the first full-page advertisement and could have filled the page with impressive signatures.

In this mixed universe, with ample grounds for both hope and despair, we in the Drug Policy Foundation intend to emphasize the former to overcome the latter. One of the major engines to express our hope is the new network of cities. We are now working on the practical details of building the International Network of Cities on Drug Policy. Among the issues to be resolved are the relationship between the INCDP and the ECDP and other developing regional networks; how the new network is to be funded; and the selection of members and officers. Our fervent wish is that the INCDP can be as successful as the ECDP.

Certainly, the help of the ECDP will be vital to the success of the network. There is an element of poetic justice in seeing the saga of the "old" world helping the "new" chart a course through the perilous waters of addiction policy.