 I'd like to introduce our opening keynote and for me this is an absolute huge honour because when I heard his opening address last year in Denver I was deeply moved. At the end of the speech when he was calling for freedom and justice it was incredibly emotional, incredibly compelling, incredibly sincere So much so, I actually shared it here. That kind of rhymes to you, doesn't it? That was a bonus. But they weren't tears of pain, they weren't tears of anguish, they were tears of joy. They were tears of joy because I knew that with people like this working so passionately for a better world, for a fairer world, for a world where good science means good policy I knew that with people like this on the pathway to reform with us, I knew we'd get there. I knew that it wasn't just possible. I knew that reform based on compassion and science was inevitable. So ladies and gentlemen, please welcome the Founder and Executive Director of the Drug Policy Alliance all the way from New York City, Dr Ethan Natelman. Thank you very much Graeme and I'll count on somebody to give me a five minute warning over there. Sort of appropriate background sound for a drug conference I guess. What I've been asked to do is to put the New Zealand development with your psychoactive drugs regulation into a global context. And that's what I'm going to try to do here. I'm not the expert on your law, some of you are the expert. I want to learn as much as I can so I can tell more and more people about it because I think it is an important and historical breakthrough. But let me just start off by saying I've been involved in this for a long time. I started off researching and working actually as a consultant in the US government and interviewing drug enforcement agents around the world and writing books about the internationalization of law enforcement and drug enforcement. I then was a professor and I've really been involved and really committed my life to trying to end this war on drugs. And the reason I've done that is because I think that the war on drugs is a horrific nightmare on the face of the earth. Is it the greatest threat facing us with environmental threats and all this? I don't know, right? But I can tell you that a policy that criminalizes hundreds of millions of people around the world that arrests tens of millions, that incarcerates millions, that deprives people of basic civil liberties and human rights, that generates vast black markets, that empowers organized criminals, that creates more corruption than almost any other activity known in modern society, that makes drugs more dangerous, that spreads HIV and encourages the death by people of opiate overdose, that deprives people of access to drug treatment, that lies to our children and creates a massive institutionalized hypocrisy in our society. I don't like that stuff and I don't see why we have a need to continue on that line, right? I don't see that but I also know that changing that stuff is not necessarily about inspiring people to share my or some of ours passion around ending the drug war. I know in fact that the way that we ultimately prevail is by persuading people that what we're advocating for makes more sense than what we've been doing. And that what we're advocating for is actually going to create a safer world for young people, for future generations and really for the vast majority of society. There's no policy that works best for everybody but there are overwhelming arguments deeply grounded in the evidence that the essence of drug policy reform ultimately results in less harm to health and safety, more protection of young people and others. And it's those arguments, as I say to my allies many times in the US and elsewhere, we don't win until a majority of ordinary parents of teenagers have come to believe that what we're advocating for is going to better protect their kids and other kids than what the government has been advocating for. That's the bottom line. Now here's, let me just put it, my basic underlying suppositions and frame and then try to offer a frame in which to think about drug policy and about the alternative to drug policy and then I'll lay out what are the cutting edge developments around the world and put this New Zealand thing into context. So I start off with the assumption that, by the way, can we close that door over there for the, nothing? Anyway, I start off with the assumption first of all that drugs are here to stay, that there is more or less never been a drug-free society in human history, that there are not going to be drug-free societies in the future, whether we like it or not, that people have been uncovering, discovering, devising all sorts of substance plants and chemicals for a long period of time and that process is simply going to accelerate. We are moving into another generation where the pharmaceutical products that are used are ever more sophisticated, where the drugs we give young boys with ADD and the drugs we give for depression and mood altering and the ones we do to help older men get erections and all of these things are just going to become ever more sophisticated and integrated and brain science is going to develop and that's going to be the fact of the matter. You may not like this, I may not like this, some of us may want to be pharmacological luddites, but that's not really an option. The option is how do we, how do we learn how to live with this reality of psychoactive drugs in our midst in such a way that these substances cause the least possible harm and in some cases the greatest possible good? That's the broader challenge. How do we as a society say we can't realistically build a moat between those drugs and our children, between those drugs in our home? How do we accept that? How do we look at the fact that if you go to those parts of the world where people are too poor to even buy a little smoke of a cigarette or a hit off a crack pipe or a joint, what do they do? They sniff gasoline and inhalants and solvents. Probably the most dangerous psychoactive substance is no into man. Is there a criminal justice response to the problem of gas sniffing, gasoline and solvents and all that? No, there can't be. These things are too universally available. And if there's no solution to dealing with a single, most dangerous substance available, what makes us think that prohibitionist approaches should be the first in primary way we deal with a range of other psychoactive substances in our society? So that taking the big, deep collective breath and letting that breath seep up into government's lungs so that we can actually adopt the wise policy rather than the hysterical one that my government has so aggressively promoted for almost a century, that's the challenge. Now how do we think intellectually about drug policy alternatives? The way I think about it is I imagine a spectrum with a whole variety of policies from the most punitive policies at this end that kind of chop off their heads, pull out their fingernails, rip them off the streets, drug test them without cause, put them into treatment programs that are actually prison camps, Saudi Arabia, Singapore, you name it. All the way to reducing the harshness and increasing the public health approach till you get to the very other end where actually you're at the free market approach. Where there's essentially no controls except maybe to limit access to kids. I'm thinking about cigarette policy in my country and probably yours 50 years ago, right? The free markets for some, the libertarian dream of this, right? And I ask the question, where in fact along this spectrum do we find the best drug policy? Well, that begs the question, what do you mean by the best drug policy? I define the best drug policy and I hope you'll agree as the one which accomplishes two things. Is the one that most effectively reduces the harms of drugs and the one that most effectively reduces the harms of drug prohibitionist policies. And the optimal policy is the one that best accomplishes a mix of those objectives. The one that seeks to reduce the death, disease, crime and suffering associated with drugs and also the one that seeks to reduce the death, disease, crime and suffering, incarceration, violation of human rights, undermining of public health, all these other things associated with prohibitionist policies. That's the mix, that's the mix. If I'm asked to define drug policy reform in one sentence, I can do it. It's a long sentence, but I can do it. And I would define the objective of drug policy reform as reducing the role of criminalization and the criminal justice system in drug control to the maximum extent consistent with protecting public safety and health. I'll say it again. Reducing the role of criminalization, the criminal justice system in drug control to the maximum extent consistent with protecting public self, public safety, public health. That's it. It means not the leap to the legalization scenario and in fact there is no leap. There's no 18th amendment. You know in America our alcohol prohibition was called the 18th amendment. There's no 18th amendment of global drug prohibition to be repealed as we did in America by 21st amendment and evidently the reforms will be incremental. It's moving down that spectrum cautiously, proactively trying to think about testing and trying, but stopping short where we push the reforms and the reduction of criminalization and criminal justice so far that it actually presents greater threats to public health and safety. That's the frame. Now here's the good news. The good news is that all of the incremental steps, the ones that take us away from that punitive policy of Saudi Arabia and Singapore and here's the United States, there's Russia, you know, a range of other countries and then we start to get the more reasonable ones like in Western Europe to some extent New Zealand, Australia, et cetera, et cetera, right? And then moving in this way. And if you look over here we're talking about tougher and tougher tobacco policies and alcohol policies. Some of what we're trying to do is to sort of stretch kind of a deprohibitionized, the prohibitionist policies as much as possible without increasing risk. And at the same time increase the regulatory role responsible regulation of legal drugs, alcohol, tobacco, et cetera, et cetera to the maximum extent without generating its own sets of negative consequences and trying to stretch these two models together until we come to something that seems like the right policy for various types of drugs, right? Well, what do we know if you look around the world? What I focus on is who are the models? Who are the role models? Who's doing this right? Who's doing this right? Well, first I look at the Europeans and especially with respect to harm reduction. I mean with the Europeans really began to do the Dutch and then the Swiss and then Germans and the English and a range of others in various ways was basically to embrace the notion of harm reduction of accepting the drugs we're here to stay and seeking to reduce the negative consequences, right? It wasn't just Australia and the Netherlands but even Margaret Thatcher's England that in 1985 said this devastating virus of HIV is spreading and of course we don't want people doing drugs and of course we're going to try to make them stop but we have to stop the spread of this deadly disease for which we have no cure and if that means providing clean needles to active illegal drug injectors so be it that's what we will do and they did it even before the evidence was conclusive that you could do those policies, reduce HIV and Hep C without increasing drug use but it saved large numbers of lives in my country where we did not embrace the evidence where we did not embrace common sense roughly 200,000 people died who would not and did not need to have died if we had embraced the sensible pragmatic policies of other countries and the people who died were not just the injecting drug users but also their lovers and spouses and children and others to whom the disease was transmitted, right? We know that when the Swiss 20-odd years ago were plagued by the problems of drug dealers selling drugs on the streets of areas of Zurich and elsewhere were deeply offended by this unsightly mess and they said let's expand, let's arrest them and the cops arrested, arrested didn't seem to work very well, just more kept coming Switzerland richest currency in the world if you're a drug dealer you want to sell drugs somewhere you go to Switzerland, biggest return because of the price of the currency they couldn't solve that problem, right? Then they said let's make more treatment available they did that, methanol maintenance, drug free treatment all sorts of things like that but there was still thousands of people wanting to do this stuff and they said well let's put them all in a park behind the train station you may remember something called Needle Park were great for the first six months or a year all the junkies went there all the law enforcement, everybody was there but then it got out of control became like a zoo and they had to shut it down they didn't give up at that point and say let's go back to the law enforcement approach at that point they said let's try something new let's allow people, older heroin addicts who are really burnt down in the life of the streets and living without to come to a clinic and get heroin pharmaceutical heroin up to three times a day up to as much as they want either they pay a few dollars a day or the government covers it within a good treatment context for their services the Swiss did this on an experimental basis it was remarkable crime dropped, drug addiction dropped overdoses dropped, arrest dropped turned out to be a net fiscal savings for the taxpayer people signed up in the program some of them ultimately decided to stop using heroin for the first time in their life what? free heroin? and for the first time you're going to stop? well I think that was the moment when for the first time they could look at that white powder and ask themselves the question is that what I'm spending my life doing chasing that white powder I'm going to go back and make methadone work maybe I'm just going to get off this stuff totally that was remarkable a little like the finding of the first needle exchange program which turned out to be the number one point recommending people to drug free treatment ha? a needle exchange program where people go to get clean needles so they can keep shooting illegal drugs becomes the number one point of reference into conventional drug treatment well because what we realize is that model that my government has promoted so heavily the drug court model put this in people's face and if you use the drug will give you a couple of chances to get clean but if you don't we're going to lock you up for a few days the first time a week you can't ever stop and you won't ever stop we're just going to lock you up for good and you know nobody gets beyond a drug addiction without being forced to by the government that's an underlying almost ideological belief in my own country but the experience in those Tacoma needle exchange programs and the experience in the Swiss heroin maintenance showed in fact that people would choose to put a drug addiction behind them or be unable to put an addiction behind them if they were treated as human beings it's the point at which harm reduction in the 12 steps movement overlap and intersect it's the reign of cognition that if you want to avoid losing control of your drug use or if you want to regain control of your drug use after you've lost control or if you want to put your drug use behind you for good the single most essential thing is uncovering discovering refinding your fundamental dignity dignity core sense of dignity is the best single protection against losing control with drugs so the Swiss did that heroin maintenance and then the Dutch and the Germans and then the Danes and the Canadians and the English and that thing has worked and I sure hope that one of these I know you have almost no heroin here I guess it's very good but you know the Australians almost did it but it's an approach where now the top journals say this stuff works it works it works and it's the champions of heroin maintenance because it reduces drug markets it reduces a quiz of crime by drug addicts and it gives a nod to the public health people that was the Swiss innovation and breakthrough the Portuguese well the Portuguese you know I mean they who knew when they changed their law in 2001 fewer people knew about it than when New Zealand changed your law last year Portugal people didn't even know where it is in my country right but they said we're tired of chasing the same thing the junkies around town excuse my use of the phrase junkies I'm using it as a provocative way I mean illegal people who inject drugs illegally and if I lapse into the colloquial it's meant only in the most endearing and infectionate way so let me just clarify that but what they basically said is they made a commitment that we are not going to put people in jail for simple drug use or possession any drug cocaine, methamphetamine, marijuana whatever it is we are not putting them in jail we're going to send them to something called a dissuasion committee you love the term I don't know what it sounds like in Portuguese but a dissuasion committee so people can have their mental illness their addiction whatever it might be addressed ten years later two years ago the Portuguese evaluate this policy and what they find is is that the number of drug users in the country has not changed that much but you know what's happened each of your behaviors is down hepsy behaviors is down arrest is down, crime is down more resources are being made to help people in a drug problem rather than locking people up the drug trafficking is illegal but the market lost the vitality it had before the view of the Portuguese is we are not going to put you in jail or take away your freedom simply for using drugs we're not going to drug test you and threaten you i dwezio nolait. We're going to offer you help and services and be innovative with it. And if you're really a bad guy, we'll get you for something else. That's the view. In my country unfortunately it's been, you know, if you use illegal drugs, you're probably a bad guy. Therefore let's catch you before you make the turn and lock you up first. Whether you actually do harm to anybody else or not, that's a very very very expensive approach and ineffective. It works for a small number and not for most others. The Portuguese won British Journal of Criminology, Stevens and Hughes a piece a couple of years ago shows the evidence that this stuff works. Well then we come to the issue of cannabis. The Dutch led the way, that coffee shop system where in the late 70s they effectively legalized the retail sale of cannabis while keeping the wholesale side illegal, and what happened? Well at some point marijuana use went up in the Netherlands, but you know what? It also went up in other countries that did not decriminalize cannabis. Basically the trends in cannabis use among Dutch went up and down at roughly the same rates as other European countries that did not liberalize. What else? The rates of cannabis use in the Netherlands remain much lower than they did in your country or my country, notwithstanding the fact that our policies were quite punitive and yours were more punitive than the Dutch. What else? It turned out that the percent of young people who used cannabis and then went on to try the so-called harder drugs was less than in other countries. Why? Because the Dutch had effectively separated the cannabis market from the other markets and what we know about the so-called gateway theory, it's not that there's some magic of cannabis that you use this and you want to go try all the other drugs, right? What it was was people were going to drug dealers and the Netherlands drug dealers either it was that coffee shops here or the other dealers there, it was not all merged together as it is in my country and perhaps yours as well, right? But then the Europeans sort of sat in their hands and I got to tell you, I've been traveling the world speaking about drug policy for a long time. Typically when I go abroad and especially when I go to parts of Latin America, I start off by apologizing. Not so much apologizing for being an American, but apologizing for the atrocious actions and behavior of my government around the world and for the global drug war that we promoted bilaterally and multilaterally in our enforcement efforts through global conventions and all this sort of stuff. You know something? In at least one area, I don't need to apologize anymore. Because even as my country has led the world in incarcerating our fellow citizens, you know the United States, we have less than 5% of the world's population, but almost 25% of the world's incarcerated population, right? We rank first in the world in the per capita incarceration of our fellow citizens. We lock up people at five, six, seven, eight times the rates of other countries including I think New Zealand and European countries, right? We have the highest rate of incarceration of any democratic society in history and our incarceration of young men of color, especially young black men, makes apartheid South Africa look like a walk in the park. In fact, the rates of incarceration of young black men in America grossly exceed the rates of incarceration of the Soviet gulogs of the 30s, 40s and 50s, which was the greatest system of mass incarceration in recent history, right? So we do things terribly. And our notion of promoting our policies, the notion that any other government would want to look at us and say, look at America, they lead the world in incarcerating people, they spend vastly more money locking people up and trying to help them. We want to be just like them. It's always struck me as peculiar. But then again, we're an influential government. We've been the superpower for a long time and so we can sort of wave it around and force people to sign on and all that. Thank God that more and more other governments are resisting and fortunately in America, the people and civil society and state governments, when it comes to marijuana, are saying, there's another way to do this, another way to do this. It's remarkable. We have gone from roughly 36% of Americans in favor of legalizing marijuana, taxing and regulating it just 10 years ago and 60% opposed. To now having between 55% and 60% of Americans saying, yes, it's time to do it, to legally tax and regulate this stuff, take the money away from the criminals, have the cops focus on real crime and that shift has happened because the majority of parents of adolescents have said that's the way to go. Let's stop pretending that somehow keeping marijuana illegal and arresting 750,000 people a year is the way to protect our young people. When the young people are looking at the adults and saying, you think mass incarceration and keeping marijuana illegal is protecting us, what exactly have you been smoking, mom and dad? Because that's now what I would call rational thinking, right? So we've seen it happen. First with medical marijuana, 20 states legalizing marijuana from medicinal purposes, a few million Americans now with a legal recommendation from their doctor or a medical marijuana ID card from the state or local government. And by the way, would you hear on the news about California and people selling it to anybody and everybody who's got a hang nail? That's California. Other parts of the country in New England and New Mexico and elsewhere are tight regulatory systems with medical review boards, approved conditions, doctors having to register, all this sort of stuff. So it's a responsible way to do it and to the extent New Zealand wants to look in that direction, what I would say first is don't even look at America. Look at Israel. Israel under the conservative government of Benjamin Netanyahu actually were the most sophisticated and developed medical marijuana program in the world. That's the model I think that New Zealand should be looking at and I think it's sad, sad actually, that New Zealand will not acknowledge legitimate medical rights of people from marijuana truly is a medicinal benefit. So we did that and I think doing that actually helped change the public discussion because people began to look at, you know, wait a second. We're allowing marijuana to be sold above ground, we're taxing it, regulating it, people go to dispensaries and the sky hasn't fallen and we're not seeing any major increases in marijuana use among adolescents or others. Well, Colorado and Washington, November 2012, a vote through the ballot initiative process to legalize marijuana tax and regulate it. These were not squeaker votes. They weren't quite like your parliamentary vote on the psychoactive drugs bill last year, but the vote to legalize marijuana in Colorado got more votes in November 2012 than Barack Obama did and he beat Romney badly in Colorado. It got almost as many votes as him in Washington and more than the governor and the guys who won the gubernatorial and attorney general races. Colorado set it up, they started to roll it out. So the only surprise in the 12 or 13 weeks since Colorado set up that allowed people to buy and sell marijuana through licensed shops is that the state government says they got twice as much tax revenue in the first month as they expected. Something to consider, right? Washington state's going to roll out soon and then Uruguay in December becomes the first government to do this, right? Who's going to be next? Well, the Europeans have been sitting on their hands and I think now they're going, I thought we were leading the world on sensible drug policy. Colorado, Washington and Uruguay have just leapfrogged us and so now in the Netherlands and the Czech Republic and in Denmark and Switzerland and Spain there are all sorts of conversations about looking for responsible ways to remove marijuana from the black market and to legally regulate it. You know what we're fighting for in this effort in the United States? It's so that a generation from now people will look back on the marijuana arrests and marijuana prohibition and marijuana rhetoric of the late 20th and early 21st century, the same way that today Americans look back on our experience with alcohol prohibition and go, what the hell was that all about, right? Will marijuana use to increase if we make it legally available? I think it will, I think it will. Will it be increased among adolescents? I don't think so. Why? Because adolescents already have incredibly great access to marijuana today. It's not going to change that much if we make it legal and tax-irregulated for adults, right? I mean, there are three surveys in my country where young people say it's easier to buy marijuana than it is to buy alcohol. I mean, if ever there was an indictment of a failed prohibitionist policy, that has got to be it. You know, I think legalizing it for adults, taxing and regulating it is not going to lead to an increase in adolescent use. The price may drop, that may affect it a bit, but I don't think we're going to see that change. Who's going to use more marijuana once it's legal? My bet, it's going to be people in their 40s and 50s and 60s and 70s and 80s and 90s. And it's going to be people saying, you know, I think I prefer that puff or that nibble at the end of the evening instead of that sleeping pill. I don't wake up with the same kind of funny hangover. I think I prefer that to the drink I have each night. You know what? That little marijuana, it actually helps with my arthritis. And the doctor says it may be helping with my diabetes or my restless leg syndrome or whatever else it's bothering me, right? You know, some people find that when you've been married 20, 30, 40 years, it spices things up there too. I mean, that's where we're going to see the increase in marijuana use. And people aren't going to be smoking joints anymore. They're going to be vaping, you know, e-cigarette type things and vaping, which is not a major issue in terms of the safety of marijuana because most people who smoke marijuana don't smoke that much. It doesn't have that big effect on lungs, but it is going to be that shift. Will that be a net harm to public health or a net plus? It could in fact potentially be a net plus or at best a minor negative. But to end the hypocrisy and the lying and the arrests and all this other sort of stuff and the racial disproportionality and the way these laws are enforced both in your country and mine, all of those would be very promising things. So I think that has to go. And what I hope now is I turn to New Zealand, is that part of what's happening here is that that debate gets reignited. I came to New Zealand in late 2001 and I spent three days in Wellington and going non-stop, meaning with every one of your ministries and with maybe 15 or 20 of your members of parliament, all sorts of other people, and there was a lively discussion about trying to move towards decriminalisation and regulation of cannabis. A pragmatic, sensible discussion recognizing the reality that people here are using marijuana. The last thing you need is to crack down on marijuana and have people start turning to meth, right? I mean, ba-ba-ba-ba-ba. And the thing died down. But what you did last year, I have to tell you. As we say in my country, mazletuff. That was impressive. I mean, congratulations. To pass a law to say we have an issue here. High numbers of people, especially young people, are using substances that are being produced illegally, quasi-legally, grey market, black market, whatever. Where almost nobody really knows what's in them, where there's little evidence that a prohibitionist approach will really stop young people from using it, and to then begin for the government to be working with people in this grey market industry to say, let's come up with a process, a regulatory process whereby producers of these substances can submit them from review and if they can demonstrate, just like pharmaceutical companies do, that these things have a significant margin of safety and that they pose minimal risk to consumers and that, therefore, they can be legally approved, that's a breakthrough. I think what you somehow did here in New Zealand was to duffstaff the old drug laws and say, you know what? These are not fundamentally moralistic documents. These are ultimately documents about protecting health and safety, public and private. And that if, in fact, a policy like your new psychoactive drugs law can result in less harm to both young people and adults and potentially less harm in terms of public safety, then that will be the wiser policy. And the fact that the government is somehow putting its imprimatur on a drug that people use for fun, to which people go, how can government do that? Oh, forget about alcohol. How can people do that? Well, the fact of the matter is if the bottom line is about health and safety, that's what it's called for. When the Obama administration said in late August that they were going to give Washington and Colorado a chance to implement their new legalization laws, I think it's because they too dusted off the old drug laws and saw that they too were about public health and public safety and our deputy attorney general effectively said that if what Washington and Colorado are trying to do with legal regulation can better advance public health and public safety than can persisting with the old failed prohibitionist policies, then so be it, that's what we will do. So a lot of people around the world, and I'll tell you this because I talked to people around the world, are counting on you guys to do it right. Hopefully your politicians and your councils in Hamilton Ella will wake up and realize that this is the right way to go. Hopefully the government will stick to its guns on this. Hopefully you will find a way to legally approve some of these substances. Hopefully the results will be positive in terms of the reduction of harm to the health of young people and then hopefully that will ignite a broader debate so that the cannabis discussion can be reignited here whether it's being influenced by what's happening in my country or Uruguay or because of what you've done over here on this. And then hopefully, as some of your elected officials have suggested, this model may take off around the world and that frame of thinking that ultimately this is not about a moralistic approach to demonizing and punishing people who put psychoactive drugs in their body, that ultimately government's obligation is to reduce the harms to health and safety and where possible to maximize the positive values of these drugs, that that will become the model for 21st century global drug control and New Zealand will go down in history as having played a pivotal role in that process of advancing drug policies grounded in science, compassion, health and human rights. Thanks a lot. Ladies and gentlemen, Ethan Maderman. Wow. Thank you very much.