“They could have killed me very easily,” my conversation with the Mayor of Cali, Colombia

If Zeke and Rahm Emanuel could combine in a single man, it would be Rodrigo Guerrero Velasco, mayor of Cali, Colombia. He is an elected member of the Institute of Medicine, and a PhD in epidemiology from Harvard. He’s played an important role in reducing homicides in Cali, despite that city’s incredible challenges from the cocaine cartel and other sources. (Progress is relative. Cali’s homicide rate remains four times Chicago’s rate.)

We had a wide-ranging conversation about youth homicide prevention, gun and alcohol curfews, and other matters. More here, at the Washington Post‘s Wonkblog section.

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Unravelling the Roots of the Upsurge of Criminal Violence in Mexico

Illegal drug trafficking is not inherently violent. The horrific surge of violence that began in Mexico in 2006 thus requires some specific explanation.

The most common account is that when President Calderon turned the force of the state on to organized crime groups, the old arrangements were overturned and a cycle of violence began. The drug kingpins used violence against government officials and citizens in an attempt to intimidate the state into giving up on enforcement. Further, as gangs were de-capitated, they broke into smaller groups warring for supremacy with each other.

But this account may be entirely wrong or only partly correct. Evidence presented this week in Bogota at the conference of the International Society for the Study of Drug Policy shows that there was another enormous shock to the criminal system concurrent with Calderon’s campaign.

Colombia shifted its cocaine suppression strategy from crop eradication to further down the production chain (e.g., laboratories and exporters), resulting in a more than doubling of cocaine seizures beginning in 2006. At this same time, the Mexican gangs became the dominant partner in their relationship with the Colombian gangs. Rather than simply receiving cocaine at the southern border of Mexico and carting it north, they moved into Central America and the edges of Colombia, giving them a larger role in transshipment and processing.

Cocaine is the biggest source of revenue of the Mexican gangs, meaning that these changes were highly disruptive to the old stasis. The cocaine flow shrank, but what was left became more valuable. This intensified competition among the Mexican gangs which may be the root of the burst of violence.

Whether this explanation is fully or partly correct is being investigated by Dr. Daniel Mejia Londoño and his colleagues at the Universidad de los Andes. He is one of a number of young Latin American scholars who are bringing new perspectives to drug policy research. Collectively, they will help policy analysts escape the trap of seeing drug policy only from the point of view of consumer countries (e.g., Europe and the USA). And in the long term, the “Calderon explanation” for Mexican violence may be only one of the received truths that this new generation of researchers overturns.

A Potentially Life-Saving New Medication for Cocaine Users

Brad Girtz responds cautiously to my article on emerging vaccine therapies for cocaine addiction:

The harmful effect of cocaine is about more than its addictive properties…even recreational and occasional users of the drug put themselves at a higher risk of a heart attack or stroke due to its effect on blood pressure, the artery walls and the nervous system.

He is quite correct that the development of a widely-effective cocaine vaccine, like any other new treatment for addiction, would do nothing to reduce the health damage experienced by non-addicted users. And as Sally Satel and I have pointed out, this damage can be enormous both at the individual and population level. There is however a fascinating new medication being developed for the acute toxic effects of cocaine that could benefit non-addicted users as well as those who are addicted.

Around the roots of the coca plant is a bacteria which contains a remarkable esterase that breaks down cocaine with astonishing speed. Professor James Woods of the University of Michigan has sequenced the bacteria and can produce it in the lab. Rats injected with the esterase are unaffected by even lethal doses of cocaine.

The esterase doesn’t survive long in the body, so it isn’t intended as an addiction treatment. Rather, like naloxone (aka Narcan) for heroin overdose it has the potential to be life saving in crisis situations (e.g., the ambulance arrives to find some in acute cocaine overdose). The beneficiaries could include casual users who overdose as well as addicted people who for example are on an anti-stimulant vaccine and tried to override it with a massive dose of cocaine.

Unfortunately, as with cocaine and methamphetamine vaccines, private industry has shown only tepid interest in the esterase, leading the development process, in Dr. Woods’ word, to be “as slow as the dickens”. The life-saving possibilities of this esterase are another reason why we should use public policy to increase private investment in medication development for stimulant drug users.

(Im)plausible deniability

I’m glad to see that Hillary Clinton has dumped Bill Shaheen as co-chair of her New Hampshire campaign, and apologized to Barack Obama for Shaheen’s references to Obama’s drug use from college days.

Now all she needs to do is fire Mark Penn, who in discussing the issue on TV after HRC’s apology made sure to use the word “cocaine.”

Apologies From the Heart (of Darkness?)

By KATHARINE Q. SEELYE

Senator Hillary Rodham Clinton apologized personally to Senator Barack Obama on Thursday for a top adviser’s public suggestion that Republicans would go after Mr. Obama for his youthful drug use.

This came a day after Mike Huckabee apologized to Mitt Romney, a Mormon, for remarks that suggested Mormons believe that Jesus and Satan are brothers.

But in the aftermath of the apologies, both the Clinton and Huckabee campaigns kept the original slurs alive through a series of interviews, raising questions about the sincerity of their apologies, especially in the heat of a wide-open campaign with the first voting less than three weeks away.

[snip]

On Thursday afternoon, Mrs. Clinton’s top adviser, Mark Penn, appeared on MSNBC with Mr. Obama’s top adviser, David Axelrod, and John Edwards’s top adviser, Joe Trippi. They argued with one another, and it was there that Mr. Penn dropped the word “cocaine,” saying that the Clinton campaign had not raised the issue of “cocaine use.”

That seemed to infuriate the others. “This guy just said ‘cocaine’ again,” Mr. Trippi said.

Anyone who is fooled by HRC’s assertion that there was no central decision to spread slime about Obama must want to be fooled. A fish rots from the head.

Update Wait! It gets worse.

Obama’s ‘surprises’?

Clinton didn’t mention specifics in the taping of an interview on “Iowa Press” this morning, but drew a contrast with unnamed rivals that echoes Bill Shaheen’s now-notorious claim that unexplored elements of Obama’s candidacy will make him an easy Republican target.

“I’ve been tested, I’ve been vetted,” she said. “There are no surprises. There’s not going to be anybody saying, ‘I didn’t think of that, my goodness, what’s that going to mean?’”

This appears to be the emerging core of the electability case against Obama: that elements of his public record and — unspoken — his private past, could scuttle what should be a Democratic sure thing, and that he is untested by real partisan combat.

“Whoever we nominate will be subjected to the full force of the Republican attack machine, and I know that they know I know that and I have no illusions about what this race will entail,” she said.

UPDATE: Asked to elaborate on what she’s suggesting about Obama, Clinton has an answer ready: “I’m only talking about myself.”

I repeat: from the head.

Second update Speaking of going negative … err, “comparative” … Paul Loeb has some comparisons between the conduct of Obama’s “Leadership PaC,” for which HRC has criticized him, and her own conduct. Bottom line: if Hillary hadn’t been such a money hog, spending $40 million to run virtually unopposed and transferring $12 million to her Presidential campaign — if, that is, she’d acted like Edwards and Obama, who raised money for and gave money to other campaigns nationwide — Democrats could have picked up a bunch of extra seats in the House and at least one in the Senate.