Altering States is a secondary newsletter that I run within We, The Citizens, focused on drugs and drug policy. It's irregular and always free. When you subscribe, you can choose either We, The Citizens or Altering States, or, better still, both!
The first Altering States wrap was sent out in March and then the GE took up all our attention and energy so I gave up on the April wrap. I won’t lie; it was a little tempting to skip the May wrap because I'm a little tired tonight. But I decided that I need to make an effort, so here we go!
(1)
Since the last Altering States wrap in March, there have been three executions for drug offences (plus one for murder). I think everyone left on death row now has been convicted of drug offences. The last person executed was Mohammad Salleh bin Hamid, who I wrote briefly about in the We, The Citizens newsletter last week.
(2)
Ketamine could be a game-changer for some people with severe depression. This was something that was reported at the beginning of this year but didn’t make it into the March wrap, so I’d like to circle back to it here.
Spravato, a ketamine nasal spray, is being used to treat some cases of depression—particularly those in which the patient hasn’t responded to two or more other types of medication. The Health Sciences Authority allowed the sale in October 2020 and psychiatrists say the results have been good so far.
This isn’t a call for us to now make ketamine widely available. The Straits Times’s interviews with psychiatrists show how careful they’re being with Spravato, monitoring their patients and having safety measures in mind. Here’s an example from the article:
At his clinic, Private Space Medical, patients are supervised by a doctor while they self-administer the stout canisters of nasal spray in one of several dove-grey rooms.
Then, the lights are dimmed and patients put on music of their choice on headphones. They rest alone for about 1½ hours, though doctors pop in periodically until the effects wear off. Only then can they leave the clinic.
The first few sessions, called the induction phase, can be “rocky” and so are more closely watched, said Dr Kwok, who once had a patient with post-traumatic stress disorder slip into a state of childhood fear.
That out-of-body sensation known as dissociation is the most common side effect, along with dizziness, nausea and raised blood pressure, which physicians measure before and after administration, he added.
By the fourth or fifth session, these troubles ease as patients approach the maintenance phase. Said Dr Kwok: “By then, they know what to do; some can read books, answer e-mails and shop for groceries.”
As always, it’s not a binary of a drug being completely harmless and risk-free or it being the devil’s poison. There’s always a weighing of benefits and risks, and the need for careful policy design and thoughtful regulation.
(3)
Singapore’s war on drugs continues apace. Singapore, represented by the Singapore Anti-Narcotics Associations, is going to be part of a new regional coalition of NGOs fighting drug trafficking and “abuse”. This coalition is called the Asia-Pacific Confederation against Drugs (APCD). Announcing this coalition on 15 May, K Shanmugam, the minister for home affairs (and also law, at that time), pointed to issues like the rising threat of potent drugs like fentanyl and noted that nearby countries like Myanmar are already big producers of synthetic drugs.
These are all real issues—fentanyl is scary and Myanmar does play a role in the global drug trade (which is why it’s also important for Singapore to do whatever it can to push for de-escalation and an end to state violence in Myanmar). One serious misrepresentation of abolitionists and advocates for drug policy reform is that we wilfully refuse to recognise the harms and don’t care about people who are harmed by drugs. That’s absolutely untrue. Every activist/advocate I’ve met has been incredibly concerned about people’s welfare and the risks of various substances, and that’s precisely why they’re so fixated on harm reduction.
I’m not going to assume that every NGO in that coalition has bad intentions or is setting out to oppress others. I assume that there will be many participants in that coalition who genuinely want to do what they think is best. But there’s a growing body of research and evidence around the world that’s demonstrating that prohibition and abstinence-only approaches don’t work, and that we urgently need to shift gears.
Learning and reflecting
I learnt a lot from this two-part podcast with Cathy Alvarez and Karen Gomez-Dumpit about the Philippines, the Duterte regime and his terrible war on drugs:
Calum Stuart
Calum Stuart
I’d seen a lot of reporting about the staggering scale of the extrajudicial killings when Duterte was in power, but hadn’t really heard too much of the long-lasting damage that had been done to the country’s judicial system and to communities.
I was still mulling over what Cathy and Karen had said in the podcast while I was editing and reading Leong Kar Yen’s writing on the families of victims of extrajudicial killings. This has been the horrific cost of Duterte’s drug war:
Mekong Review 2
Thank you for reading! As mentioned above, Altering States will always be free to access, so please share this with anyone who you think might be interested. If you’d like to support my work, please consider subscribing to We, The Citizens or leaving a tip!