Wednesday, July 13, 2005

Screw the "jihad on drugs" - let 'em grow their opium

The NYTimes has an op-ed today about Afghanistan and allowing the trade of opium for two reasons: allow the Afghans to boost their economy and provide other countries with much-needed pain relievers. It's a good article. I've put the whole thing below.


Let a Thousand Licensed Poppies Bloom

By MAIA SZALAVITZ

EVEN as Afghanistan's immense opium harvest feeds lawlessness and instability, finances terrorism and fuels heroin addiction, the developing world is experiencing a severe shortage of opium-derived pain medications, according to the World Health Organization. Developing countries are home to 80 percent of the world's population, but they consume just 6 percent of the medical opioids. In those countries, most people with cancer, AIDS and other painful conditions live and die in agony.

The United States wants Afghanistan to destroy its potentially merciful crop, which has increased sevenfold since 2002 and now constitutes 60 percent of the country's gross domestic product. But why not bolster the country's stability and end both the pain and the trafficking problems by licensing Afghanistan with the International Narcotics Control Board to sell its opium legally?


The Senlis Council, a European drug-policy research institution, has proposed this truly winning solution. Adopting it would improve the Afghan economy, deprive terrorists of income and keep heroin away from dealers and addicts, all while offering pain relief to the third world.

The United Nations estimated that Afghanistan produced more than 4,200 tons of opium last year; cultivation jumped to 323,701 acres from 197,680 acres in 2003. Ten percent of the Afghan population is believed to be involved in the trade, which supplies nearly 90 percent of the world's illegal heroin. Clearly, this drug war is not being won.


The global pain crisis is just as daunting. The World Health Organization has said that opioids are "absolutely necessary" for treating severe pain. But half the world's countries use them only rarely if at all even for the dying, and even though research shows that addiction is exceedingly uncommon among pain patients without a history of it.

Here in the United States, only half of all dying patients receive adequate relief, and those suffering from chronic non-cancer pain are even more likely to be undermedicated. Senlis estimates that meeting the global need for pain medications would require 10,000 tons of opium a year - more than twice Afghanistan's current production.

This shortfall is in part attributable to misguided regulation. Restrictions aimed at preventing diversion to the illegal market are so severe that in some countries, medical use of opioids is practically prohibited. Often, the rich retain access to expensive synthetic opioids like OxyContin, while those who cannot afford brand-name drugs receive no treatment at all. Generic morphine and codeine, made from Afghan opium, could help.

Because farmers aren't the ones who make the big bucks in the illegal drug trade, purchasing their poppies at competitive rates should be possible. But even if we paid exactly what the drug lords do, the entire crop would cost only about $600 million - less than the $780 million the United States planned to spend on eradication in Afghanistan this year.


Besides, eradication efforts have never eliminated a drug crop. Cocaine continues to be widely available, despite the roughly $3 billion that the United States has spent on coca eradication in Colombia over the last five years. And that is only the most recent example.

India's thriving generic drug industry suggests that there is plenty of money to be made in the marketing of generic pain relievers. But even if returns are modest, generating any profit at all is better than stamping out the major driver of an unstable country's economy. Legal products are also safer and easier to regulate than illegal drugs.

Of course, the Senlis plan does present serious logistical problems. Warlords would not relinquish profits without a fight, and their attempts to undermine the proposal could be formidable.

But think of it this way: what's an easier sell with farmers, hard cash now or pesticide spraying and potentially empty promises of economic assistance? Few Afghans begrudge farmers' efforts to feed their families - but many would turn against greedy planters who continued supplying drug lords despite adequate alternatives.

The real barriers here are political, not practical. The Afghan government initially appeared open to the proposal: its counternarcotics minister spoke at a Senlis meeting in Vienna in March. But another minister later dismissed the idea in front of foreign reporters and Hamid Karzai ducked the question in a March meeting with Secretary of State Condoleezza Rice.

The Bush administration has criticized Mr. Karzai's "leadership" on opium (despite his call for "jihad on drugs") but refuses to support measures beyond eradication. Responding to the Senlis proposal, one former State Department official who had been working on narcotics and law enforcement told The Christian Science Monitor: "Anything that went about legalizing an opiate in that market would send exactly the wrong message. It would suggest that there is something legitimate to growing."


But there is: countries like India are licensed by the International Narcotics Control Board to grow opium because modern medicine cannot find anything better than opioids to relieve pain. And think of the goodwill such a gesture could produce, a message that we literally want to assuage the world's suffering - not to mention that of the 30 million to 50 million Americans who endure chronic pain.

The Senlis Council is holding a conference in Kabul this September to secure support from drug policy expertsfor a feasibility study of its proposal. As Afghanistan seems to grow increasingly unstable by the day, let's hope that proposal receives the backing it deserves.

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