Friday, March 27, 1991

To the Editor:

I might agree with Gerald W. Lynch and Roberta Blotner in "Case for Decriminalizing Drugs Dies in Zurich" (letter, March 13) that drug decriminalization and legalization are bad ideas, if only Zurich's so called "Needle Park" had been an example of either. But the drug free for all that flourished at Platzspitz was the result of an unplanned local compromise not representative of any drug policy reform proposals.

What developed at Needle Park was the worst of both worlds. The park was an island of limited decriminalization in the midst of one of the most harshly prohibitionist societies in Europe. Platzspitz became Needle Park only gradually, as addicts congregated at the park in recent years.

Local authorities tolerated drug activities there largely to ghettoize the drug problem.

This was not an ideal arrangement, but the Swiss at least attempted to respond to the serious problems they faced as a result of strict across the board prohibition. Unfortunately, Needle Park was a half measure from the start, and many predictable problems were not dealt with:

- Until about two years ago, the strategy was simply for the police to be hands off within the park. There was no public health planning; no controls over drugs sold; no age re strictions; indeed no controls of any sort.Thus to call Needle Park an experiment is dubious. It was not a social policy chosen as best from a range of proposals.

- The limited decriminalization allowed by the Swiss within Needle Park was not aimed at reducing the profit motive. Such a policy would have been truly legalization, setting up a system in which drugs could be purchased relatively cheaply through legal means - at special stores, through physicians. Addicts in Platzspitz bought their drugs from dealers, who set up shop in the park, and they paid very high prices: reports ran as high as $200 to $325 a gram of heroin, compared with $40 a gram in Amsterdam, where possession is tolerated.

- Though Needle Park was a drug haven for about five years, health services and a clean needle exchange became part of the scene only two years ago. Evidence on the effectiveness of these services has yet to be fully assessed, so it is premature to claim that these efforts failed. Some

studies show that the limited objective of preventing the use of infected needles was accomplished.

·Because Needle Park was such an appalling scene, it has been the favorite red herring of opponents of drug policy reform. It was an awful sight because public drug use was allowed; but no serious reform advocates want public drug use. Most comprehensive options include harsh sanctions for those who use drugs in public or work or drive intoxicated.

We can learn much more by looking at reform policies that have been planned and have worked. Three crucial examples are Liverpool, Amsterdam and methadone programs within the United States. All of these have reduced crime, reduced drug abuse and controlled the spread of AIDS among the individuals involved.

I agree with Mr. Lynch and Ms. Blotner in hoping we can move toward proper drug policy priorities, making education and treatment real commitments. I also believe that we must focus on what works, instead of continuing to follow the Bush Administration's wrongheaded lead on drug policy. Enforcement eats up 70 percent of the drug budget pie. As we

move to reverse this disparity, the possibility of decriminalizing some nonviolent drug offenses and looking at options for legal drug distribution must be part of the debate.

Far from closing the drug debate, the Needle Park experience should open it. The Swiss are looking for new solutions beyond total prohibition. We should too.

ARNOLD S. TREBACH

President, Drug Policy Foundation

Washington, March 15,1992

Medical Marijuana

To the Editor:

We were saddened but not surprised by the Government's March 10 announcement that it would bar any extension of medica] marijuana use (news article, March 21). The Public health Service justifies this action by pointing to supposed damage to the lungs or immune system and the availability of better treatments.

But these are obviously pretexts. Thirteen patients are receiving marijuana legally for glaucoma, muscle spasms, severe pain or the nausea and vomiting caused by AIDS and cancer chemotherapy. To get official approval, all of them had to go through a process so rigorous it could be better termed an obstacle course. There is no evidence that any of them has been made sicker by marijuana in any way or that marijuana has ever impaired anyone's health by compromising the immune system, as the Government suggests.

In any event, only a few of the thousands of patients who might benefit from medical marijuana could ever have been supplied under the program, because each case has to be considered at length by a Government making decisions that doctors and patients should make.

Meeting every legitimate claim to medical marijuana under this system would require a huge administrative staff, an army of physicians prepared for a heavy burden of paperwork, and patients willing to tolerate endless delays, instead of going into the street to find the medicine they need.

The Government's real concern is not that marijuana is ineffective as a medicine, but that it is too effective. We discuss its many potential uses in our forthcoming book, "Marijuana: The Forbidden Medicine." The Government cannot acknowledge any of this because it has vastly exaggerated the dangers of marijuana for more than 50 years and is still committed to its war against the drug.

The attitudes and social forces that make criminals out of the millions who use marijuana harmlessly for pleasure have also led to the criminalization of thowsands who need it as a medicine.

LESTER GRINSPOON, M.D.

JAMES B. BAKALAR

Boston, March 12, 1992

the writers are faculty members of Harvard Medical School's Department of Psychiatry.

The Drug Policy Foundation

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