12/08/17 Richard Andrews

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James P. Gray retired Superior Court Judge re failure of drug war, Elizabeth Brico journalist re Trump/opioid crisis, Dr. Richard Andrews first hand observations of Portuguese drug policy

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TRANSCRIPT

CULTURAL BAGGAGE

DECEMBER 8, 2017

TRANSCRIPT

DEAN BECKER: I am Dean Becker, your host. Our goal for this program is to expose the fraud, misdirection, and the liars whose support for drug war empowers our terrorist enemies, enriches barbarous cartels, and gives reason for existence to tens of thousands of violent US gangs who profit by selling contaminated drugs to our children. This is Cultural Baggage.

Hi friends, this is Dean Becker. Thank you for being with us on this edition of Cultural Baggage. Our first guest is the man who kicked me in the butt, turned me into a real drug reformer, now retired superior court judge out of California, he's author of Why Our Drug Laws Have Failed And What We Can Do About It: A Judicial Indictment Of The War On Drugs, speaking at a recent TED talk, my friend, Judge James P. Gray.

JUDGE JAMES P. GRAY: I was raised probably the same way that all of you were, to in effect equate heroin with bad, with evil, and with prison. And you kind of don't think about it that much, but we all know that being addicted to any of these substances is certainly not a good thing, and nothing that I will say will imply in any fashion that it's not a serious thing.

After the Peace Corps, I went into law school and was immediately being drafted, it was the height of the Vietnam War, about 1968, and so I joined, enlisted with the Navy, and after law school I became a Navy lawyer, a staff judge advocate in the US Naval Air Station in Guam, and thereafter a criminal defense attorney at the US Naval Air Station in Lemoore, California.

And in Guam, I saw of course that I was filling out charge sheets against my shipmates for numbers of offenses, certainly including drug offenses, and then as additional duty, I was a criminal defense attorney, and defending people, other shipmates fro other commands that were charged with other things, including drug offenses.

Didn't think about it very much, just thought that was the normal thing to do. I was in effect a drug warrior. Looking back, though, at the beginning in Guam, in about 1972, they had big headlines in the paper, saying that they had their first homicide since the end of the Second World War, and they were all concerned about that and wondered how it happened, and as time went along, it turned out that lots of people were starting to bring illegal drugs during the Vietnam War in military aircraft from Vietnam from Thailand, and this homicide turned out to be yet another drug deal that went wrong.

And by the time I left the island, a couple of years later, unfortunately it was a fairly common experience, to have homicides that were drug related. After that, then, I was discharged from the Navy, I became a federal prosecutor in Los Angeles, and for at least a short time held the record for the largest drug prosecution in the central district of California, 75 kilos of heroin, 165 pounds, was and is a whole bunch of heroin.

But does anyone have a concept of what the record prosecution is today, in the central district of California? Seventeen tons of cocaine in one place. Just boggles your mind as to the amount of drugs that we're talking about. And if you really think about it seriously, there's no society in the history of mankind that has not had some form of mind altering, sometimes addicting substance to use, to misuse, to abuse, and even get addicted to, except maybe the Eskimos because they couldn't grow anything, but now chemistry and transportation has changed that as well.

So let's come to the blunt reality here, that these drugs, harmful as they can be, are here to stay. I'm sorry to be so blunt, but that's the reality. So if that's the case, they're going to bring harm to our society, so we should, as a government, as a people, come up with forms of approaches to that that reduce those harms. And that's where we should go, and prison is not in that list.

So, you come to other realizations, that for example you can arrest, convict, incarcerate a big time drug users -- excuse me, a big time drug seller, and that does not reduce the amount of drugs, illegal drugs, in your society. Yes, maybe for six, twelve, fourteen hours, but then other people see it as an employment opportunity, and end up replacing that person and drugs are fully available.

You look at the system otherwise, if you arrest and convict a serial rapist, rape goes down in your community. You arrest and convict a burglar, car theft, those offenses go down as well, but it's not true with drugs.

I was one time giving a talk, in front of a pretty conservative group, and there happened to be three prison wardens in the audience, and I made the comment, look, folks, we can't even keep these drugs, bad as they can be, out of our prisons, for heaven's sake, how do you expect to keep them off the streets of any of our towns and cities, when you can get as many drugs as you want in your prisons, depending basically on price. And one of the wardens smiled and said, well, you can't get all you want, but okeh.

So let's come to that realization. You then look at Governor Gary Johnson's comment, a friend of mine, who said, okeh, it's clear that we have drug problems in our society, but about ten of them are related to the drug itself. Again, not minimizing them, but ninety percent are drug prohibition problems. Drug money problems.

Graphic example: Look at what's going on in Mexico. All of this violence, crime, beheadings, has nothing to do with drugs whatsoever, nothing. It's all drug money that causes those things. And it's our drug money that does it.

So let's come to that reality. Look. We cannot repeal the law of supply and demand. And figuratively, if you have somebody holding a fifty dollar bill out on a street corner, saying give me fifty dollars worth of marijuana, somebody is going to meet that demand. So we're either going to have marijuana, for example, in our society, regardless. Marijuana's the largest cash crop in the state of California today. That implies to me that somebody's using it.

So let's recognize that -- oh by the way, grapes is number two. So if we have -- that is a major product, let's take away a whole lot of money from juvenile street gangs, from Mexican drug cartels, and other thugs, and use it, control it and use that money to pay our firefighters, pay our teachers, and fix our roads. How can difficult can this be?

So you get closer to the situation, and you will understand the truth that the term "controlled substances" is the biggest oxymoron in our world today. That means basically a term that's internally consistent. Controlled substances, no, because as soon as you prohibit a substance, you give up all of your controls to the bad guys. You know, anything dealing with quality control, a huge issue, demand, advertising, price, age restrictions, you all give those up to the Mexican drug cartels and the juvenile street gangs. We couldn't do it worse if we tried.

So these are things that we need to look at. We need to allow ourselves to discuss this, because we have a prohibition on discussion. Just because we discuss drug policy, just because we discuss that we have options, or even engage in those options, does not mean we condone drug use. If we just get that point across to our fellow citizens, I guarantee you we will change away from drug policy -- from drug prohibition.

So I felt so strongly about this, I became a judge at the end of 1983, and would see in my own courtroom, we're churning low level drug offenders through the system for no good purpose whatsoever.

By the way, many of them are mentally ill, that are self-medicating in order to stave off the demons or whatever, and we're doing untold harm to these mentally fragile people by putting them in jail.

The United States of America leads the world in the incarceration of our people, both by sheer numbers as well as per capita. You'll hear the statistic, and it should really bother you as it bothers me. We have five percent of the world's population and 25 percent of its prisoners. We're either the most criminally oriented people in the world or we're doing something wrong. Which do you think it is?

So, I did something very unusual for a sitting trial court judge in Orange County, California, back in April of 1992, and I held a press conference. Very unusual thing to do. And told anyone that would listen, hey, we're not doing it right. We could do it better. Drug prohibition isn't working.

And since that time, I've been speaking publicly as often as I can to people who would hear me, and now when I talk to Rotary Clubs, religious organizations, chambers of commerce, whatever, I tell them the stark truth, which is, drug prohibition is the biggest failed policy in the history of the United States of America, second only to slavery.

And if you'll listen, regardless of what your interests are, I will tell you that regardless of what that is, it can be with education, or healthcare, of criminal, or terrorism, environment, I will show you to your satisfaction how it is made worse because of our nation's policy of drug prohibition. We couldn't do it worse if we tried.

So these are things that we're facing. Most people realize that drug prohibition is not working, and that word is getting out, so why do we perpetuate this failed system, and the answer, there are basically two answers, and the first answer comes in two words: and the answer is, our children.

We want to protect our children. So we will continue with this failed policy for all of its defects, unquote, because we want to keep our children away from a lifestyle of drug usage and drug selling.

But I'm here to tell you, when I was in juvenile court you'd see this time and again, that we're putting our children in harm's way for two extremely important reasons, and the first is, don't take my word for it, ask the next ten teenagers you find, what is easier for you to get if you want to, marijuana or alcohol? And every last one of them, if they care, would know where to go, it would be easier for them to get marijuana or any other illicit substance than it would be alcohol. Why?

Because drug dealers don't ask for ID. You know, the least concern of an illegal drug dealer is age restrictions. They don't care. Somebody might say, oh, no one wants to get my 12 year old daughter hooked on cocaine, and the answer is sure they do, because they'll make money on them. A disgusting situation.

We couldn't do it worse if we tried. And number two, putting our children in harm's way, is, look, most people understand, oh I want to be in the NBA, I want to play professional football in the NFL. Most of our kids understand that there really aren't very many Michael Jordans, Kobe Bryants, or Stephan Currys, so the odds of that are not good.

So we otherwise might as well take out billboards in the inner cities or anywhere else saying if you want to make some money, the most money you can ever make is selling drugs. Juvenile street gangs are using this as a recruiting tool: hey, you want to make some money? Join our gang and be part of the action. Not a good thing.

So let's take the money away from those folks. And on the macro level, let's look at Mexico like we said, with all the beheadings. Hey, let's look at something else. Drug prohibition is the golden goose of terrorism. If our country really cared, our government really cared about fighting terrorism, understand that the largest source of funds for terrorist organizations around the world is drugs, illegal drugs, and if our government cared, it puts tears in my eyes to say this, but I believe it, they would do the thing that would give the most results in fighting terrorism, which is take away their money. Take away their funding. And our government doesn't even discuss that issue, which is really a stupid result.

Portugal, in the year 2000, recognized that they had the largest drug problem of any country in the European Union. So they did something really intelligent. They actually put up a neutral commission, a non-political commission, and tasked them to go out into the country, figure out what our problems are, and give us recommendations for what to do about it.

And the commission took about nine, twelve months, and came back and said, we have two problems in our country. Number one is, if you are a problem drug user, you're afraid of your own government. You're not going to bring your problem to the government, because they'll punish you, so they take it underground.

And number two is, we're spending so much money on the investigation, prosecution, and incarceration of nonviolent drug offenders, we don't have any money left for drug treatment. Decriminalization means almost literally it is still illegal in Portugal or in Holland by the way to buy, use, sell, possess any of these drugs, but as long as you keep within very well known general guidelines, the police are instructed, frequently in writing, to look the other way and not -- and to leave these people alone.

Now look, I'm a judge. I believe in having reasonable laws, and I believe in enforcing those laws, and to instruct your police not to follow the law conceptually causes me some problems. Nevertheless, the Cato Institute, about ten years after that, took the information, digested it, and reported to the country and the world. Not in our newspapers much, but to the world, and they said, you know, drug use in Portugal pretty much remains the same, which gives the lie to pretty much every drug czar we've ever had in our country, who says, oh if we were to have a different option we'd become a nation of drug zombies or something like that.

Not only is that silly, I think it's insulting. You know, I wouldn't -- you could give away cocaine on the street corner, I'm not going to jam cocaine up my nose, and I don't think most other people are either. Drug usage pretty much remained the same, but, problem drug usage went down by fifty percent. By half. Why? Because now, if a police officer or someone encounters somebody that's under the influence of these various drugs, or is injecting, or whatever, yes they're given a citation, but not to come to judges like me, but to go to medical professionals that can help them.

You know, come in, hey Charlie, what are you using, what's your lifestyle, what can we do to help you? Help you get a job, help you have medical issues et cetera. Problem drug usage has gone down by fifty percent. The minister of health held a press conference in Holland numbers of years ago and said, we only have half the marijuana consumption in our country per capita as you do in the United States, listen to this, both for adults and for teenagers. Why, he went on to say. Ah, we have succeeded in making pot boring.

We glamorize it by making it illegal, by having an obscene profit motive to get you and other people hooked on it. Look, people could sell alcohol in their -- at high school campuses, they could sell Jim Beam for all that matters. They don't. They could. Why not? Because there's no money in it. Let's make the same thing with regard to these other drugs as well.

Switzerland. I don't know how many of you are familiar with what's happened in Switzerland since the late 1990s. They put in clinics, in various heroin using cities and towns in Switzerland, clinics made up of social workers, medical doctors, registered nurses.

They would bring these people into the clinic, and then what would they do? Pretty much the same thing you or I would do, they'd try to help them get drug treatment, get off their heroin, but if they didn't want to, they'd say, look, as long as you satisfy three criteria, we have a program for you. The criteria are you're at least 22 years of age and have failed traditional drug treatment at least twice, that you are addicted to heroin, not that hard to prove, and number three that you'll remain crime free in the future.

If you do that, you're on the program. What did that mean? They are given a prescription for heroin, they can have it filled at pharmaceutical prices, and then they can inject their heroin under medically controlled circumstances at the clinic.

Now, stop for a minute. None of these drugs we're talking about is expensive. The only reason they're expensive is because they're illegal. You know, marijuana's not called a weed for nothing, it will grow anywhere, and heroin's the opium poppy, by the way. For years, the National Park Service was growing it in Monticello, until the DEA found out about it. It's a beautiful flower. DEA made them take it out, but I assure you if it will grow in Virginia, it will grow anywhere.

So the only reason these things are expensive is because they're illegal. So if you're going to get a prescription for a maximum amount of about ten dollars a day, under pharmaceutical controlled prices, you can afford that drug.

Number two, this is not an orgy, so-called, of heroin usage, because remember, there's a medical doctor on this team. Hence by the way the program is called a heroin maintenance program.

Back to the story. Soon, they found out that of course no one there had overdosed, because overdosing is a quality control problem. It's unknown strength, it's unknown purity. On the streets, you can use the same amount of heroin today that you used yesterday, unbeknownst to you it's three times stronger, you use it, and you die. That's a drug prohibition problem. Nobody's overdosed in Switzerland. Nobody's gotten AIDS. Nobody has caused, gotten any of these other blood borne diseases. Employment has gone up by fifty percent. They're basically able to get off the dope, treat their families like they want to.

This is also very consistent with my libertarian philosophy. So it's a medical issue. You want to bring them closer to medical professionals that can help them instead of rendering them automatic criminals and pushing them farther away. But, if Robert Downey Junior, Betty Ford, you or I drive a motor vehicle impaired by, you name it, methamphetamines, alcohol, which is my drug of choice, marijuana, heroin, whatever, that's a crime. What's the difference?

Hear ye, hear ye. I love that statement. The criminal justice system is designed for and quite good at holding people accountable for their actions, protecting us from each other, so if you drive a motor vehicle impaired by any of these you're putting our safety at risk, legitimate criminal justice issue.

But, if all you're doing is harming yourself, the criminal justice system is not designed to protect us from ourselves. And that makes perfect sense philosophically, because as far as I'm concerned, the government has as much right to control me as an adult as to what I put into my body as it does put in -- I put into my mind. It's none of their business.

Any of us, if we're over 21, could go home tonight and drink 10 martinis if we wanted to. Certainly not a smart thing to do, certainly not a medically healthy thing to do, but it's not a violation of law. And you look further into this entire area. The most successful program that we have had with regard to any form of mind altering, sometimes addicting substances, is what we've done in the last 10 or 20 years with regard to cigarettes.

You know, we can look at that, and see that we have reduced consumption of cigarettes, not by making it illegal, that would just bring Al Capone and Mexican drug cartels into the cigarette distribution business, but by putting out honest information in the marketplace, for people, honest medical information, social mores, regulations, you can't smoke cigarettes in this building. Hooray for that.

And I keep thinking to myself, wait a minute, you know, we all know smoking cigarettes is harmful to your health, but at least if you go to your local minimart and buy a pack of Marlboros you're going to know it's not laced with methamphetamines. Those are drug prohibition problems.

So let's all get together. I make you a guarantee. As soon as we come to our senses and repeal drug prohibition, all of us, within a year, maybe two, will join hands, look back, be aghast that we could have perpetuated such a failed system for so long. That is a guarantee.

It's for the sake of our children, it's for the sake of our country, it's really for the sake of the world. So that is my view from my judge's perspective. Use your own insights, and I'm sure you will come to the same conclusion. Thank you.

DEAN BECKER: Place twelve monkeys in a room. Place a ladder in the middle of the room. Hang a bunch of bananas from the ceiling over the ladder. Leave the room. And watch through a two-way mirror. When the first monkey starts climbing the ladder, seeking bananas, wack the monkey with a broomstick. Wack additional monkeys as necessary to prevent them from reaching the bananas. Continue this effort until the monkeys begin stopping one another from climbing the ladder.

Remove one of the original 12 monkeys and replace with a monkey who has never been wacked with a broom. Watch as the original monkeys keep the newbie from climbing the ladder. Replace the original monkeys one by one. Watch as a roomful of unwacked monkeys keep one another from the ladder, and the bananas, even though none of them know the original reason to refrain. Observe the perfect example of the mechanisms of drug war in action.

Well, just the other day, I was on my facebook page, I saw this story that linked me to a political magazine article, it was titled Trump Is Continuing The War On Drugs That Kept Me Addicted, subtitled I'm A Former Heroin Addict, I Know All Too Well Where Trump's Opioid Plan Goes Wrong, and it's written by our next guest, Elizabeth Brico. Hello, Elizabeth.

ELIZABETH BRICO: Hi, thank you for having me.

DEAN BECKER: Ah, Elizabeth, look, your story destroys the logic of the drug war, I think we could summarize it with that quite well. But if you would, tell us a little bit about your experience, the type of work you do.

ELIZABETH BRICO: Well, I'm freelance writer, so my training is in writing, pretty much my entire life. But I've been doing a lot of work recently about mental health and addiction issues, because of my own experience with those things. I have PTSD and I'm in recovery from heroin addiction, as you mentioned.

And I talk about that in the article, my experience, essentially becoming addicted in college, and being really afraid of stigma and criminalization, and not going to treatment for several years because of those fears.

DEAN BECKER: Right. And that's typical enough, there's --

ELIZABETH BRICO: Yeah.

DEAN BECKER: -- so many complication, ramifications, if you were to do so, it can further complicate your life, right?

ELIZABETH BRICO: It's actually pretty scary. There are a lot of people who have committed no crime besides taking drugs who have criminal records, maybe can't vote or get certain jobs, and just have parts of their lives kind of cut down by their addiction, and that's it.

DEAN BECKER: Right. Now, the situation is really in flux right now. We've got people pushing and pulling on both sides of this issue, quite strongly. We have, the thing that really just blew my mind, they appointed Kellyanne Conway as the new opioid czar, if you will. Your thought in that regard. How preposterous was that?

ELIZABETH BRICO: Yeah, preposterous is the right word, I think. I mean, honestly, I was just thinking about that before you called, and kind of just the whole political climate here in the United States right now, and I feel like I'm living in a George Saunders story, like, everything is just absurd and weird, and doesn't make any sense, and it seems like it's just going into a terrible place where we're going to need some giant hand from the sky to come fix everything.

DEAN BECKER: No, I agree with you, Elizabeth. It is, it's well beyond the norm, there's no other way to put it. Now, let's come back to the fact that, you know, you were an opiate user, you had --

ELIZABETH BRICO: Yeah.

DEAN BECKER: -- your problems with that, but did you need a -- did you need a prison sentence? How did you end your relationship?

ELIZABETH BRICO: Well, I've never been to prison, so that wasn't a factor. I was lucky enough in that regard, which I think definitely I would say is because I look white. I'm actually Cuban, but I look white, and I had police officers tell me essentially they knew I was using drugs but they weren't going to arrest me. And they didn't say it was, I'm not going to arrest you because you're a white, young white woman, but I think that that's probably why.

I can't prove that, but I think that's -- there's a lot of evidence behind that statement. So I don't have a prison record. But I am on buprenorphine, so I am in long term treatment, which I've been on for a while. And I tried stopping it. I've also tried methadone. And methadone had some side -- excuse me -- methadone had some side effects I didn't really like, but when I tried stopping buprenorphine, it was difficult for me to stay sober, but beyond that, it was just kind of difficult for me to function, because it helps with my PTSD a little bit as well.

So for me, buprenorphine is something that I'm not looking to stop soon. I think PTSD is something that complicates addiction a lot, and some people who don't have it may have a different need, but buprenorphine helps with both disorders for me.

DEAN BECKER: Well, that's good, and, you know, and that's the, oh, I don't know, the stigma of those replacement means, still exists in my state of Texas, and many other states around the country. You are in Washington state?

ELIZABETH BRICO: Yeah.

DEAN BECKER: And, you know, you guys up there are talking about, well, not just needle exchanges, you already have that, but safe consumption rooms, et cetera. It's my understanding that Seattle is leaning in that direction quite strongly. Your response, please.

ELIZABETH BRICO: Yeah, Seattle has been talking about having some safe consumption sites. I'm actually doing a story right now about someone who runs one of the syringe exchange programs that's not government affiliated, but he's, I think a crucial part of that conversation, and according to him, it's slow going. There are a lot of people pushing for it, and it's something that -- that the city, that many people do want to have happen, but that's been really difficult to actually enact, legally.

DEAN BECKER: Right.

ELIZABETH BRICO: So, it's not -- it's not something that I don't, I don't think we're going to have one opening up, you know, by the end of this year or something like that.

DEAN BECKER: Right.

ELIZABETH BRICO: But it is a conversation we're having.

DEAN BECKER: Right. And there are legislators, and officials, that are speaking positively in that regard, which is, you know, I guess the first step along the way.

ELIZABETH BRICO: Yeah.

DEAN BECKER: You talked about, you know, most of your senior year was lost to the haze of heroin, and that what you do remember is fear, and, let's talk about that fear, that just complicates the hell out of everything.

ELIZABETH BRICO: Yes, definitely. I mean, I, about the time that I realized I was addicted, you know, when I realized that I had to take an opiate or else I was not going to be able to get through my day, I no longer wanted to be addicted. I wanted to stop. But I wasn't able to do it on my own, and I was terrified to go to treatment, and part of that was I had a -- or, I have a son, and he wasn't living with me. He was the child of my abuser, the person who caused me to have PTSD, but he was in my legal custody, which was something that me and the family members who were caring for him did partially in order to prevent my abuser from being able to come in and do anything.

He wasn't involved in his life in any way at that time, or now. And, so I was really afraid, though, because he was in my legal custody, that if I told anyone that I was addicted to heroin, that there was going to be some kind of child services intervention, or I was going to have some kind of child neglect charge or something, even though I was not using around him, and I have no idea if that's true.

DEAN BECKER: The, the --

ELIZABETH BRICO: Yeah.

DEAN BECKER: -- with the, with the legal enforcement of these laws, it's haphazard, it's slipshod in many cases.

ELIZABETH BRICO: Yeah.

DEAN BECKER: I want to come back to a number I noticed in your article there in Politico. You talked about when Trump declared his emergency, opioid crisis, that they had a mere $57,000 in funds to cover everything from telemedicine to nalaxone distribution. Your response there, please.

ELIZABETH BRICO: Yeah, I mean, and that's actually to cover just the public health concerns, so that's, like, those are the funds for all of it, I mean, you know, not just opioid addiction, which is a huge problem, because opioid addiction requires so much more than that, and so do a whole other host of health issues, and if there was, you know, if we had, let's say, this flu season was especially lethal or something like that and we needed those funds for that, like, then we'd have to split the funds. Like, it's a huge problem, and there, the Centers for Disease Control thinks that we need billions of dollars to help with the opioid issue? $57,000 doesn't come close to that, that's, I think, less than a cent per person who's addicted.

DEAN BECKER: Yeah.

ELIZABETH BRICO: So, it just doesn't make any -- it's not going to do anything, it's just not going to help.

DEAN BECKER: No, I think, I'm an accountant, auditor, I figure, they talk about perhaps 12 million addicts in the United States. That works out to just under one half cent per person.

ELIZABETH BRICO: Yeah.

DEAN BECKER: To cover everything. It is so preposterous. Well, friends, we've been speaking with Elizabeth Brico. She's an independent writer. She's written for Vox, Vice, Stat, Racked, and Talk Poverty, among others, and you can find this latest one out there on Politico. It's titled up, "Trump Is Continuing The War On Drugs That Kept Me Addicted." Elizabeth, any closing thoughts, a website you might want to share?

ELIZABETH BRICO: Sure, yes, I do have a website, a blog about PTSD and addiction, called Betty's Battleground, BettysBattleground.com. And you can find my portfolio at EB-Writes.com, where I write more about writing and addiction and all of the issues that we've been discussing.

I guess my closing statement would simply be that we need a lot more compassion rather than criminalization when it comes to treating people who are experiencing addiction.

DEAN BECKER: It's time to play Name That Drug By Its Side Effects!

ALEX TREBEK: A 2009 study recommended treating heroin addicts with diacetylmorphine, the active ingredient in this?

DEAN BECKER: The time’s up! The answer, from a recent edition of Jeopardy:

ALEX TREBEK: Karen?

KAREN: What is heroin?

ALEX TREBEK: Yes.

I'm a physician, my original training was in family medicine, and then later I went back and got a second specialty training, a residency, for preventive medicine and public health, and then currently I work in the southwest Asia Town area, portion of Houston, at a clinic for uninsured patients and also insured patients. We see anybody, but we try to make the care affordable. It's a nonprofit clinic.

DEAN BECKER: Doctor Andrews, as I understand, you just returned from Portugal. Please tell us about that visit.

RICHARD ANDREWS, MD: Okeh. Well, it was actually in early September, and on the way over to Portugal, actually, because I treat a lot of patients with hepatitis B and hepatitis C, and so on the way over to Portugal, as it turns out, there was just by coincidence there was a very relevant and interesting symposium, or conference, on hepatitis in substance users, and that was taking place in the Newark, New Jersey area, and so I attended that for about three days immediately before my Portugal trip.

DEAN BECKER: Well, let's hold off then on Portugal, and tell us what you learned there in New Jersey.

RICHARD ANDREWS, MD: Okeh, well, the, at the international symposium, now this is something that is generally held in other countries, this is the first time it's been held in the US, and this is doctors, nurses, social workers, and advocates of substance users, and it was really a fascinating conference, and it, they look at ways of, you know, how can we better screen for viral hepatitis, hepatitis B and C, which as you know is sometimes found, or often found, in patients who, or in people who share needles, for example, or share other equipment, and of course, you, the evidence seems clear that you're more likely to see these infections in systems where you have, you know, punitive approaches to drug use, and whatnot, and people are less likely to, you know, I mean, they're less likely to have access to needle exchange programs, and that sort of thing.

So it was really fascinating to hear about the different, not only the different advances in treatment for viral hepatitis in these populations, but innovative ways of reaching out to communities of substance users and addicts, who are often marginalized populations.

And so that was -- and it was very interesting to see the people who represented the drug users at the conference itself, it was kind of unusual at medical conferences to see, you know, the marginalized population there, you know, very eloquent people who were, you know, as you probably know, of course, since you run this radio show, increasingly you're getting people from the drug using community who are, instead of being isolated, are starting to organize and stand up for themselves, and let the medical community and other communities know what their needs are and how they could -- how their health could be improved, for example, very confident, very poised, very eloquent, and asking hard questions.

DEAN BECKER: Yes, sir. I -- just last week, I interviewed a gentleman, worked up in New York as a supporter, you know, helping addicts coming off the street to, you know, determine how to change their dose, to change medicines, et cetera, you know, a working man.

RICHARD ANDREWS, MD: Sure.

DEAN BECKER: And, and, you know, no medical degree to speak of, but, you know, a guy who knows a lot about the subject, very eloquent, as you say, sir. I was going to bring up this thought, you know, you're talking about the, the ramifications, the failures, actually, that the current system, you know, insists upon, people using drugs in bathrooms, alleyways, et cetera, and therefore sharing needles, and more often likely to encounter or develop these hep C, hep B, and other diseases. Right, sir?

RICHARD ANDREWS, MD: Yes, exactly right. I'll talk about the symposium, now, I did meet one physician who was from Denmark who works in a clinic where they treat addicts, and I knew about Switzerland. Now, many people have heard about Switzerland's kind of innovative approach to heroin addiction, in which they, you know, for maybe five to ten percent of their heroin addicts who for one reason or another are not good candidates for methadone therapy, they will often use, well, about five to ten percent of the time, in these patients they will use heroin itself.

So instead of, you know, using a substitute for heroin, they have medically supervised clean heroin injection so that you are assured exactly what the dose is, you're assured that it's clean heroin, you're assured that your equipment is clean, and they've had, you know, in these settings, they've had zero heroin overdoses in the I don't know how many years it's been now, ten years or so that they've been doing this in Switzerland.

And I learned at this conference that now six other European countries are doing the same thing, again, it's with a relatively small portion of their heroin addict population, but it turns out that the evidence is rather clear, that long term heroin use in those medically supervised settings has not been shown to cause significant harm, especially when compared with the harms of injecting in other settings where they're sharing needles and that sort of thing, that is to say, sort of a prohibition regimen.

DEAN BECKER: Yes, sir. I often, well, I close this show with the thought that because of prohibition you don't know what's in that bag, and unless it's being provided through a government agency, you truthfully don't, do you?

RICHARD ANDREWS, MD: That's exactly right, yeah. Yes. So, it's similar to the idea, when you go to Colorado or Washington state, and you, if somebody were to buy, you know, marijuana brownies or something, it tells you how many milligrams is in each cookie, you know?

DEAN BECKER: Yeah. Yeah.

RICHARD ANDREWS, MD: So, yeah, it's, information is powerful.

DEAN BECKER: Once again, we're speaking with Doctor Richard Andrews, a Houston physician. Doctor Andrews, let me go a little further here then, and let's talk about Portugal. I have plans to go there next year, and tell me what I might be able to ascertain while I visit.

RICHARD ANDREWS, MD: I was there for basically about eight days. So, I arrived on the weekend, and kind of just got the lay of the land, and got situated, and then on each day of the week, I was able to set up meetings with different interesting people that have something to say about Portugal's drug policy.

And, so on Monday morning, I was able to meet with the staff at an agency, a European agency, that's called the European Monitoring Centre on Drugs and Drug Addiction. Now this is again, it's a European agency, you have staff there from virtually all the European countries, and even a few non-European countries that are taking advantage of this resource.

And so they keep a very careful eye on the, you know, drug facts and drug statistics, and drug policy, that come in from all over Europe, so they really have a remarkable website. Anybody can look them up, European Monitoring Centre on Drugs and Drug Addiction, and they have excellent graphs and what not, if you want to get a handle on all European countries and their drug use and drug policies, as well as -- including Portugal, of course.

When we had lunch together, they spoke about the general trend in Europe toward, and really a number of the countries, toward harm reduction policies and, which is I think a beneficial way to look at this whole thing, rather than in a punitive way. Now Monday afternoon, I had also asked if I could meet with somebody on the police side of things. I figured, if I go over there and I am only listening to people that are enthusiastic about the policy, and I never meet with anybody that has anything different to say, then I'm not really getting the full story perhaps, and so I expressly wanted to meet with somebody on the police side of things.

And of course you've got that police background yourself, and so, they set me up with a man named Artur Vaz, and he's, his title is the criminal investigation coordinator of the national unit for fighting drug trafficking, so it's kind of a mouthful, but suffice it to say that he is, you know, high up in the national police organization regarding, you know, criminal interdictions related to drugs.

And so, I had a very nice 45 minute chat with him, and he like virtually everybody else I met in Portugal is extremely down to earth, even though I met a lot of people who are kind of at the top of their, top of their game, and high up in the hierarchy, and yet they're all as down to earth as they can be, which was quite refreshing.

And so we talked about things, and of course, one of the changes that was brought about by the drug policy in 2001 is that they no longer imprison people for using drugs. Now, the penalties, the criminal penalties for trafficking drugs did not change at all, so if they conclude that you are not a drug trafficker, then they simply turn you over to a neighborhood drug dissuasion committee, as they call it, which doesn't even have police involvement, and then they -- and then they're done with you, basically, they're no longer interested once they conclude you're not a trafficker.

And so, he mentioned to me, when I asked him what he thought about the whole policy, what he thought about it then and what he thought about it now, and he said that at the time, he and many of his police colleagues were opposed to the drug policy, that is to say the decriminalization of all drug use, and he, but he said now he admits that that was wrong, and now he's in favor of it, and he said, he said, look, as a member of the police, I'm obliged by law to carry out whatever the laws are. And so, but he said, but I'm also, I'm not just police, I'm also a citizen, he said, and so as a citizen, I think it was the right thing to do.

And so I thought that was remarkable, coming from somebody who's pretty high up in the police organization for the country of Portugal.

On Wednesday, I had asked that -- they had mentioned to me that if I wanted to, I could sort of have a field trip, going to one of their methadone vans. They have these methadone vans that go out in the community. And when I say the community, I mean to, you know, to places where they think, you know, addicts will show up, heroin addicts in particular.

And so then they distribute free methadone to people who are registered with the program. And so that was particularly interesting, and it was literally under a bridge, where the van was, and, but, you know, people were walking by and driving by, at one point a cop walked by, and couldn't have been less interested in the sizable number of addicts that were lined up to get methadone at this methadone van.

The nonprofit organization that gets, you know, funding from the government to do this refers to themselves as an agency or an organization interested in social inclusion, which I thought was interesting language. You know, they view, you know, one of the changes that occurred in 2001 is a move toward viewing people with addiction issues as members of the community. They have a very community focus for the whole thing, and so these were what they regarded as members of their community, you know, being given assistance, and they labeled the methadone van, the sort of approach they have to it, as a low threshold process.

And by low threshold they mean that they want to make sure there are as few barriers as possible to somebody walking up there and getting assistance. And it isn't simply methadone, I mean, that's part of it. But, you know, if you have social care needs, if you need counseling, you know, if you need treatment for certain things, they have a doctor that goes there every now and then. There's a nurse there every day, and then a doctor comes periodically.

They do screening for tuberculosis, they do screening for hepatitis and HIV, they hand out clean syringes, they hand out condoms, I mean, all that kind of stuff, so it's really, I don't want to say full service, but it's, anyway, it's quite a few services.

And they're all free. And these, the addicts that were lined up, you know, they, they feel very comfortable, you know, talking with the people that are staffing the van, the social worker, the nurse, and so now, you have access to a community that, if they were, you know, trying to escape the eye of the law, would not be making themselves known.

On Thursday, now Thursday was my original big day, because I, the person I was most interested in meeting, although as it turns out they were all interesting, but the person I was most interested in meeting, his name is Doctor João Goulão, and he is regarded as the so-called architect of Portugal's drug policy. You know, he's basically a family doctor from southern Portugal who ended up having a lot of patients who were addicts, and then he worked with another family doctor on setting up this -- this clinic to treat the addicts.

And so he, you know, became, even though he hadn't set out to do this, he became an expert on various aspects of addiction, and so he was asked to, you know, be one of the original eleven experts that came up with the drug policy. And then after they came up with the policy and implemented it, he was asked to head up the agency that runs it, and is still the head of that agency, basically.

And, so up until 2001, Portugal had what was regarded widely as the worst heroin problem in Europe and getting worse. And they got to the point where statistics indicated that roughly one percent of Portugal's population was either using or addicted to heroin. And every time they would apply what they call the American solution, it would get worse, you know, they'd have an increase in heroin use, and whatnot.

And so they -- and so what was remarkable about that, I mean, one percent doesn't sound like a big number, but of course it's a huge number when you're talking about how many people are using or addicted to heroin. And, so what was amazing about having so many people addicted like that, is that virtually every family was affected. Virtually every family was, had somebody, a loved one, who was addicted to or using heroin.

So when this committee of eleven experts came up with the idea of decriminalizing all drugs, the population was ready for something innovative, you see? And, now in the US, and some other countries, marijuana is considered a, you know, a lesser drug, and if there's going to be movement toward reform it's typically with marijuana. And then you have the so-called hard drugs, that are less likely to have reforms attached to them, but in Portugal they never saw it that way.

They always lumped marijuana together with all the other drugs, and so instead of having, you know, five different controlled drug schedules, you know, they had, everything was just illegal, and so when they were going to -- so it was easier in a sense, then, for them to go from nothing's legal -- I shouldn't say legal. Nothing's decriminalized, to everything is decriminalized, it was less of a jump than it would be for a society like the US, which regards, you know, has different sort of levels, you might say, or what they consider the seriousness of the different drugs.

On Friday then, I met with -- I went -- I wanted to meet with some addiction people, and so I ended up meeting with two other people who were both fascinating, and the other people that I met, one was a PhD level psychologist, and the other one was a psychiatrist, and they had worked exclusively with addicts for about the last 25 years.

And so their perspective, again, on the whole thing, and their -- and you could see once again that these were, these were people that, they were, you know, that they considered members of the community, that they were interested in helping and the resources were there for them to provide services to this otherwise marginalized community.

One of the fascinating things I heard one of them say was that the addicts had mentioned to them, because we were talking about the nature of addiction itself, which is kind of a complicated thing, as you know, and nobody really understands it all that well, but, they mentioned that their addicts would often say to them that once they had purchased the heroin and the heroin was in their hand, that their withdrawal symptoms would start to subside significantly, even though they hadn't injected yet and wouldn't be injecting for another half hour because they had to travel to get to where they were going to inject or something like that.

So I thought that was particularly fascinating, and --

DEAN BECKER: It does -- it does sound as if there is some psychological intertwinement there, some sort of --

RICHARD ANDREWS, MD: Yeah, absolutely.

DEAN BECKER: -- lessening of fear helps with the withdrawal.

RICHARD ANDREWS, MD: Sure, sure, absolutely. So, now next year, I'm going to be going back myself, I imagine that will be around the same timeframe, because they're going to have -- the conference I told you about, the fascinating conference on hepatitis and drug users, as it turns out, next year it's going to be in Lisbon, and so that will be a nice opportunity to go to that conference again as well as to be back in Portugal, and kind of follow up on things and with the people that I met there.

But, I think you're going to have a fascinating trip, and it's remarkable. Now in some ways, it's kind of interesting what I did not see, and for example, even though they have this remarkable decriminalization approach to all drug users, and they've done very well with it by most accounts, I mean, some people who are dead set against it are, you know, it all depends on which statistics you're looking at, but, one of the things that I thought was interesting is that now that they did this remarkable policy 16 years ago, they really haven't changed anything since then, and to them, things like, you know, legalizing even marijuana seems radical. You know?

So it was kind of interesting to be over there and hear they regard, and I was telling them some of what was going on in Washington state, and Colorado, and some of the other states, and to them, that sounded radical. So I think -- I think that's something they're starting to look at, now, is are there things we could do to take the next step, you know, whatever that is, you know? I thought that was fascinating.

DEAN BECKER: Oh, I do too. I'm really looking forward to the trip over there. I'm hoping to go to Switzerland as well, if I, you know, get the chance.

RICHARD ANDREWS, MD: Yeah. I have some contacts for you, you know, I know you have your own contacts, but I've got some contacts in Switzerland and stuff like that.

DEAN BECKER: Well, off air, you know, maybe you can shoot me an email, and give me some, you know, names, numbers, or whatever, to help me coordinate my trip.

RICHARD ANDREWS, MD: Yeah, yeah.

DEAN BECKER: Still very much in the early stages. Okeh, once again we've been speaking with Doctor Richard Andrews, a Houston physician, telling us about his trip to Portugal, and some of the great information he learned while over there.

You know, Doctor Andrews, over the past couple of weeks, I've been talking to, you know, folks in Washington state, up in Canada, about the Insite safe consumption space, if you will, safe injection room, however you might want to call it, that's serving so well up in Canada. Cities like San Francisco, Seattle, Portland, and Houston, are now considering, well, hoping to motivate the local politicians, hoping to have that become available in our fair city, because, just like every city in America, we're losing mostly kids, every day, to these opioids, and, there's a way to stop that, or at least diminish that number, were we to open a safe consumption site. Your thought in that regard, sir.

RICHARD ANDREWS, MD: No, no, I totally agree with that, and as you point out at the end of every show, you know, in a prohibition environment, you don't know what's in the bag, and so, and of course, I learned at this hepatitis conference that I went to in New Jersey before going over to Lisbon, they talked about how we all hear about the importance of clean needles, but it turns out there's also a huge amount of contamination that results from all the other accouterments that accompany, whether it's the cotton, or some, you know, some of the equipment --

DEAN BECKER: The spoon?

RICHARD ANDREWS, MD: -- for cooking, the spoon, I mean, any one of those can transmit infection, you see, so if you have a clean needle program, but you don't have other aspects of the policy in place, that make it safer, then you're still going to be getting these unintended infections, and of course these infections can be extremely expensive to treat, they lead to, you know, I mean, untreated hepatitis leads to liver cancer frequently, and, or cirrhosis, with hepatitis B, 25 percent of untreated hepatitis cases will die of their hepatitis, of liver disease, you see.

So it's a huge issue, not to mention the fact, when people are infected then they're getting other people infected. No, that's absolutely correct, we absolutely have to have, you know, safe injection rooms, at a minimum, in order to reduce, you know, people getting infected and then infecting others.

DEAN BECKER: Well, very good. Friends, once again, we've been speaking with Doctor Richard Andrews, a man who fights the good fight, a man who tries to educate himself, a man who wants to learn more about the problems that his patients may be facing. And a man who's discovered that there is a better way. I think we should all take that to heart. Doctor Andrews, I want to thank you for being our guest. Any closing thoughts you might want to share, a website? It's up to you.

RICHARD ANDREWS, MD: Well, like I say, you can take a look at that European Monitoring Centre for Drugs and Drug Addiction, they have great stuff, and I would also encourage, as you probably have before, that people look at the Arthur -- is it Arthur C. Bennett, I think the Arthur C. Bennett drug charts through the Rice University drug monitoring office. You can look that up, William Martin, Professor William Martin is the one that runs those, and so those are great graphs for -- so I think that's what I would look at, is the graphs on actual drug use in the US as opposed to what people run around saying.

DEAN BECKER: You can locate that through the BakerInstitute.org.

I want to thank Doctor Andrews, and he's indicated he's willing to support our safe injection site. I want to thank Elizabeth Brico, you can check out here story on politico. I want to thank Judge James P. Gray, the former vice presidential candidate, and my good friend. And I want to remind you, once again, because of prohibition, you don’t know what’s in that bag. Please be careful.

JIMMY FALLON: [music] You better watch out, you better not cry,
You better not lie to the FBI.
Robert Mueller's coming to town!
Oh yeah, Robert Mueller's coming to town!
Robert Mueller's coming to town!

DEAN BECKER: I urge you to please check out our website, DrugTruth.net.

Dean Becker Wants YOU to Call the Drug Czar