United Nations Office for Drug Control and Crime Prevention, World Drug Report 2000 Oxford: Oxford University Press, 2000. 172 pages. A review by Arnold S. Trebach Professor emeritus, American University Founder and past president, Drug Policy Foundation Washington, D.C. This annual report on drug control from the United Nations contains, in my opinion, much information that appears to be rational and helpful. It provides a good reflection of the thinking of many of the established leaders in drug control and treatment. There is a comprehensive review of official country reports on trafficking, consumption, prevention, and treatment. The report also provides a summary of the present and future drug policies and strategies of the United Nations. The inquiring reader can thus be brought up to date on how perhaps the highest drug agency in the world looks at that world in terms of the global drug picture. However, sad to say, this report is also riddled with bias, irrationality, and outrageous errors. It does not deal fairly with the massive number of new innovations and experiments that are clearly visible on the cutting edge of the drug field. Indeed, harm reduction -- including such methods as drug maintenance, needle exchange, general health care for using addicts, among others -- receives inadequate attention. This is true despite the endorsement of various phases of the harm reduction message by such Establishment figures as UN Secretary-General Kofi Anan, WHO Director-General Gro Brundtland, and UNAIDS Executive Director Peter Piot. Based upon those experiments and new insights, there is no doubt that in the foreseeable future, we must create an entirely new international drug control system governed by new treaties. This is not what I am now dealing with in this review. Instead, I am saying that within existing treaties and international institutions it is possible to fashion responsible reports laying out practical strategies that will improve the terrible problems now afflicting much of the world in the drug arena. Such future United Nations reports ought to be blueprints for change based upon those cutting-edge experiments in the member states. While this report describes some encouraging innovations around the world, it hews mainly to established, traditional methods closely in line with a conventional mind-set. Moreover, at the very beginning of the Introduction by the ODCCP Executive Director, Pino Arlacchi, the worldwide drug policy reform movement is characterized, although not explicitly by name, in harsh terms as reflecting "the psychology of despair that has gripped the minds of a generation and would have us believe that nothing can be done to roll back, let alone stop, the consumption of drugs." He goes on to seemingly equate modern reformers with those "who believe that states and institutions are weak and will capitulate in the face of the organized criminal networks." To those negative thinkers, he goes on to lay out "a raft of recent and decidedly positive developments on the drugs front." Indeed, the entire report is in many respects a defense of the existing order of control in the world - and of the jobs of the staff and of the continued existence of their institution. It is a professional effort, though a failed one. The major examples of success floating on Mr. Arlacchi's raft involve huge recent reductions in opium or coca production in such countries as Pakistan, Bolivia, Peru, Laos, and Vietnam. He then goes on to state that such successes have a sound basis in history. The example of an important past success is, believe it or not, Red China, which "succeeded in eradicating opium between 1949 and 1954, together with the organized crime, gambling and prostitution that was so much a feature of its recent past." Not only Mainland China, but also Iran is described as "having a proven track record of combating drug trafficking. No country has a more exemplary record…. The authorities in Tehran stamped out the domestic production of illicit opium after 1979." One must approach all of these claims of forced sharp reductions in drug production and consumption with a great deal of caution, which seems to be lacking in these reports. While such reductions have occurred throughout history, they often appear to have been only cyclical or temporary. I do accept the claim by some experts that it is possible that certain authoritarian regimes may have practically eliminated drug traffic and use for a period of time in many regions of their countries - so long as those regimes showed no mercy, no restraint. However, I do not believe that the pattern of trafficking can be kept down for long periods of time, in part because it is difficult to keep up the required level of fierce repression for extended periods, even by totalitarian leaders. Reductions in drug activity by the masses do not often occur because of planned government actions but rather due to unpredictable changes in broad cultural behavior patters. Moreover, whenever I have looked closely at such claims of forced mass reductions, I came up with serious reservations about their effectiveness. Those claims of reductions forced by tough government action must deal with what I have termed The Lesson of Ayatollah Khalkhali, a precept that seems to answer in advance the claims of Iranian success in this report. After the Iranian revolution of the late 70s, there was chaos in the society along with a flood of opium and heroin, much of it imported. Many leaders were appalled at this development, especially the Muslim fundamentalists newly running the country. These leaders responded with what may be termed as one of the harshest responses to drugs in the annals of modern history. The roving executioner of the revolution, Ayatollah Sadegh Khalkhali, shouted at alleged drug traffickers, "I shall exterminate you vermin!" He then held brief trials and ordered summary executions, which were carried out within minutes. During one seven-week period in 1980, 179 people were reportedly executed for heroin and opium offenses. Even though he was a dedicated man in his field, the Ayatollah was severely criticized for not being more effective in controlling rising trafficking and addiction. His reply was a classic and therein lies the Lesson: "If we wanted to kill everybody who had five grams of heroin, we would have to kill 5,000 people, and this would be difficult." I have encountered anecdotal evidence from westerners who lived in Tehran during this period that many citizens of Tehran refused to bend in their drug habits at the same time as the anti-drug terror was stalking the streets. My informants also told me that their Iranian friends encountered no real difficulty in obtaining supplies of various drugs, not just opiates. It was considered polite to pass the hashish pipe to guests after dinner. When we turn to the alleged Chinese successes, it appears that many people truly believe that after the Communist Revolution the new rulers did stamp out widespread addiction at the point of a gun. Indeed, they might have done so for a period of years in many parts of that vast country. When I look at all the evidence, however, I remain unconvinced of the long-term effectiveness of that approach - in part based upon the Ayatollah's Lesson. Moreover, there have been many reports in recent years of armed conflicts between large gangs of drug traffickers and the army. In addition, the press often reports on executions of drugs offenders. Approximately ten years ago, I asked a group of Chinese police officials visiting American University how they could square claims of revolutionary success in drug control with consistent reports of punishments, including public executions, of drug offenders. They couldn't and didn't. The expert translator became suddenly silent. In my own country, I have wandered the marijuana country of northern California, spoken with growers and local police, and accompanied police into the mountains on a military-style raid on a marijuana field, which was led by the DEA. I saw the dedication and courage of these fine officers - and I also personally observed the futility of their efforts. Marijuana was to be found everywhere in those northern California counties directly in the midst of one of the largest enforcement efforts against the drug, including U-2 spy planes. If I were interested, my feet would have not touched the ground during my stay in that area amidst the troops. The local folks were unfazed by the massive armed enforcement presence and they were quite polite to visiting scholars. Another major defect in this curious official report is that there seemed to be no recognition of recreational illicit drug use. As hard as I searched, I could not find even a glimmer of acceptance of the scientific reality that the great majority of the people who use most illegal drugs do so occasionally and not in an addictive fashion. This is not to say that the drugs are harmless. That is both another issue and a matter of possible debate. It is to say rather that most users manage to use and not abuse even the most powerful drugs. This notion of generally non-harmful use applies particularly to cannabis. Yet, this official expert report tells us that the largest estimated population of "drug abusers "in the world during the 1990s were abusers of cannabis - 144.1 million abusers out of a total world estimate of 180 million abusers of all drugs. The section on treatment and rehabilitation contained a fairly good survey of the range of treatment modalities around the world. I was particularly pleased to see that some positive coverage was given to alternative therapies such as traditional healing, which may help as many people as modern approaches. However, I do not believe, as I have already indicated, that harm reduction methods, such as needle exchange and narcotic maintenance, received their due. The prescribing of injectable medicines, especially heroin, is discussed with palpable distaste, as if this were a subject not fit for polite discourse over dinner. The incredible Swiss successes with heroin maintenance are dismissed as supported by a "still controversial evaluation." Distrust is also exhibited toward needle exchange and other aspects of the encouraging and courageous Swiss advances. At the end of the day, I must report that, on balance, this is a hurtful official document. Since it comes from such a prestigious source, its precepts may be followed by many well intentioned but naïve government officials. The result may be that enforcing the currently dominant drug laws and strategies throughout the world will create more agony and chaos. Accordingly, I strongly suggest that the United Nations make a critical review of how it formulates its own priorities in drug control. If necessary, the UN may wish to consider the painful step of dismissal of most of the senior staff at ODCCP as the first meaningful move in this important direction. There is no personal animus in this suggestion. I know none of them, including Pino Arlacchi, the Executive Director. It is simply that a report so full of distortions must have come from minds that cannot be affected by new information, more closely in tune with reality and modern ways of thinking. At the very least, the UN should consider adding to the senior staff a whole new cadre of drug experts whose heads are not securely buried in the sands of drug control mythology. We would not recruit disciples of the French generals who designed the Maginot Line to formulate modern military policy. Accordingly, we should not look to disciples of Harry Anslinger to formulate drug policy for the new millennium. If all else fails, the International Harm Reduction Association should consider issuing periodic reports to counter these annual volumes from the UN, perhaps starting with World Drug Reform Report 2002.