Addiction Treatment

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Chronicle AM: Dark Web Drug Sales Site AlphaBay Busted, Owner Kills Self in Jail, More... (7/14/17)

AlphaBay is history, Nevada moves to ease its legal pot shortage, the White House opioid commission misses a deadline -- again -- and more.

Marijuana Policy

Nevada Regulators Approve Emergency Measures to Ease Pot Shortage. The state Tax Commission voted Thursday to let the Department of Taxation to again determine whether limiting marijuana transport licenses to licensed alcohol distributors would result in a shortage of legal marijuana distributors. If the department does make that determination, it could then award transport licenses to previous medical marijuana distributors. "When businesses operate we get the tax revenue and that's what the state wants," testified Deonne Contine, director of the Department of Taxation. "We need to do everything we can to get more distributors licensed so these businesses can continue operating."

Industrial Hemp

Utah Regulators Give Initial Approval for Hemp Research Grows. The state Agricultural Advisory Board on Thursday gave initial approval to a new rule that would allow limited marijuana cultivation for research purposes. The rule would allow anyone with a permit to grow industrial hemp. State universities are already able to cultivate hemp for research purposes under the 2014 federal Farm Bill, but this rule now expands who can grow the plant. The rule is open for public review through the summer and if finalized, would allow the state to begin issuing permits next January.

Heroin and Prescription Opioids

White House Opioid Commission Again Misses Deadline. The president's Commission on Combating Drug Addiction and the Opioid Crisis, led by New Jersey Gov. Chris Christie (R), will miss a second deadline for filing an interim report. Under a Trump executive order establishing the commission, the panel had until June 27 to file its interim report, but failed to do so and said it would on July 17. Now, in a notice printed in the Federal Register Friday, the commission said it would reschedule its July 17 call until July 31, again missing its deadline. The commission has until October 1 to issue a final report.

Law Enforcement

Dark Web Giant AlphaBay Busted, Owner Hangs Himself in Thai Jail. AlphaBay, one of the largest drug sales websites on the Dark Web, has gone dark. It wasn't, as some suspected, a scam and rip-off by the owners, but the result of a joint law enforcement operation by police in Canada, the US, and Thailand. Canadian citizen Alexandre Cazes, identified as AlphaBay's owner, was arrested July 5 in Thailand, where he owned three luxurious homes. He was found hanged in a Thai jail cell Wednesday.

Chronicle AM: Vets MedMJ Vets Advances in Senate, Drug War Bill Advances in House, More... (7/13/15)

Congress is dealing with medical marijuana and drug policy issues, legalization advocates call on New Hampshire's governor to kill a marijuana study commission bill, Rhode Island's governor issues an executive order dealing with the state's opioid crisis, and more.

VA docs could recommend medical marijuana for veterans under legislation moving in the Senate (Sonya Yruel/Drug Policy Alliance)
Marijuana Policy

Alaska's Largest City Wants Social Consumption at Pot Shops. The Anchorage Assembly on Tuesday urged the state Marijuana Control Board to allow tourists and locals to smoke or otherwise consume marijuana at retail stores. The move comes as the board is set to meet in Fairbank later this week. The board is expected to examine several proposals related to consumption in pot shops at that meeting.

Montana Man Challenges State's Standard for Marijuana DUIs. A Billings man facing a vehicular manslaughter charge for an accident while he was allegedly under the influence of marijuana is challenging the state's de jure standard of 5 nanograms of THC per milliliter of blood. Kent Roderick Jensen and his attorney argue that the standard is arbitrary and the charge should be dismissed. "There is no science to back up the 5 ng/mL level as a level that indicates impairment in a sizable enough portion of users to make it a standard for everyone," his attorney wrote in a motion seeking dismissal. The judge in the case has heard oral arguments and received written briefs, but has yet to make a decision.

New Hampshire Governor Should Veto Marijuana Study Commission, Reform Advocates Say. Advocates sent a letter to Gov. Chris Sununu (R) asking him to veto House Bill 215, a bill that would create a study commission to consider marijuana legalization and regulation. The letter, which was signed by leading advocates including the bill's prime sponsor, Rep. Renny Cushing (D-Hampton), notes that, "The commission envisioned by the final bill includes numerous vocal opponents, such as the Association of Chiefs of Police and New Futures, but it does not include any known supporters." The House version of the bill included a representative of the American Civil Liberties Union of New Hampshire and a representative from the Marijuana Policy Project, which would have added some balance to the commission, but the Senate removed those prospective members from the bill.

Wisconsin Lawmaker Files Legalization Bill. Rep. Melissa Sargent (D-Madison) on Thursday announced she would file a marijuana legalization bill. There are no details on it yet. This would be the fourth time she has filed a similar bill.

Medical Marijuana

US Senate Panel Approves Medical Marijuana for Veterans. The Senate Appropriations Committee voted on Thursday to adopt an amendment that would allow military veterans to get medical marijuana recommendations through the Department of Veterans Affairs. The bipartisan measure picked up four more votes than last year in the committee. Then, it was approved by the full House, but killed in conference committee.

Heroin and Prescription Opioids

Rhode Island Governor Signs Executive Order Dealing With Opioid Crisis. Gov. Gina Raimondo (D) was joined by White House acting drug czar Richard Baum on Thursday as she signed an executive order aimed at curbing the "alarming rate of deaths" due to opioid overdoses. The 18-point order includes directives calling for a family task force on impacts of opioid use, expanded access to "sober" homes for people in recovery, and the creation of diversion programs to keep people out of the criminal justice system, among others.

Drug Policy

House Judiciary Committee Approves Bill that Gives Attorney General Sessions Unchecked Power to Ban New Drugs and Set Criminal Penalties. The committee on Wednesday advanced legislation that greatly expands the penalties for new drugs and gives Attorney General Sessions unilateral new powers to schedule drugs. Opponents warned that the legislation is a counterproductive approach to the opioid crisis that will exacerbate mass incarceration and enable Attorney General Sessions to ban hundreds of substances and prosecute people with long federal prison terms in violation of the new drug laws. The measure is House Resolution 2851, the "Stop the Importation and Trafficking of Synthetic Analogues Act of 2017," or "SITSA."

International

Colombia's Coca Crop Substitution Program Faces Same Old Obstacles, Report Finds. A new report from the Colombian Ideas for Peace Foundation casts doubt on the government's ability to eradicate 250,000 acres of coca plantings, saying a vacuum left by the demobilization of leftist FARC guerrillas has not been filled by the state, but is instead being filled by illegal armed drug trafficking groups and paramilitary formations. That means the state is not providing adequate security measures and sustainable alternatives in areas historically hit hardest by decades of armed conflict.

Chronicle AM: IL Passes Forfeiture Reform, House Heroin Task Force Proposals, More... (6/28/17)

Utah's new medical marijuana initiative is exposing fissures between the LDS leadership and membership, an asset forfeiture reform bill sits on the desk of Illinois' governor, a bipartisan House heroin task force releases its proposals, and more.

Utahns are ready for medical marijuana. (Harborside)
Medical Marijuana

Utah Poll Has Strong Support for Medical Marijuana. Just days after the Utah Patient Coalition took initial steps to put an initiative on the November 2018 ballot, a poll it sponsored showed that 73% of Utah voters support the initiative, with only 20% opposed. Support came from all demographic groups, including active Mormons, 63% of whom said they were in favor.

Mormon Church Opposes Utah Medical Marijuana Initiative. The powerful Salt Lake City-based Church of Jesus Christ of Latter Day Saints (Mormons) has come out in opposition to a medical marijuana initiative filed this week by the Utah Patients Coalition. The church acknowledged ongoing interest in medical marijuana and said it supported further research but argued that approval of medical marijuana should come after "the FDA approval process that all other drugs must go through before they are prescribed to patients."

Asset Forfeiture

Illinois Legislature Passes Asset Forfeiture Reform. The legislature last Friday gave final approval to an asset forfeiture reform measure, House Bill 303, that raises the standard of evidence for seizures from probable cause to a preponderance of the evidence and bars seizures of under $500 in most drug cases. The bill does not, however, require a criminal conviction before a seizure can occur -- a sop to prosecutors and law enforcement groups who lobbied for that provision to be dropped. The bill now awaits action from Gov. Bruce Rauner (R).

Heroin and Prescription Opioids

House Bipartisan Heroin Task Force Releases Proposals. A bipartisan group of House members released a raft of proposals Tuesday aimed at fighting the nation's drug problems as "an American issue," not a partisan one. The package of bills from the Bipartisan Heroin Task Force includes increased funding for drug-screening gear at the border, studies on the effects of synthetic drug use, greater flexibility for use of health savings accounts, and creation of treatment centers for infants exposed to opioids during their mothers pregnancy.

International

Georgia Parliament Takes Up Drug Decriminalization. The Parliamentary Health Committee has introduced a bill to decriminalize the possession of all drugs that was developed by the National Drug Policy Platform, a grouping of more than 40 NGOs. The bill would annul the country's much-criticized strict 2007 drug law, as well as making changes to at least 10 criminal and administrative laws. The core principle behind the bill is to shift the country's drug policy away from a criminal justice approach, treating drug use instead as a public health issue. Earlier this month, parliament gave initial approval to marijuana decriminalization. Both pot decrim and broader drug decrim should be addressed during parliament's looming autumn session.

Chronicle AM: Koch Bros Critical of Trump Drug Policies, FL Drug Treatment Fraud, More... (6/26/17)

Florida's medical marijuana regulatory system is now set, the conservative Koch network has some issues with Trump drug war policies, Support Don't Punish marches are going on worldwide, there's something rotten in the Florida drug treatment complex, and more.

Demonstrators took to the streets in more than 200 cities around the globe Monday to call for drug reforms.
Marijuana Policy

Alaska Regulators to Revisit On-Site Consumption Next Month. The state Marijuana Control Board will look at three different options for on-site marijuana use at its meeting next month. One proposal would allow people to try marijuana at retail shops before leaving. Another proposal would allow consumption of edibles, but wouldn't allow smoking. A third proposal would limit on-site use to pot purchased at the site. But none of it is likely to happen before 2018, since the matter won't come up for a vote until August, and there's a 30-day public comment period after that.

Medical Marijuana

Arkansas to Begin Accepting Medical Marijuana Applications. The state Medical Marijuana Commission will begin accepting applications from potential medical marijuana growers and distributors as of this Friday, while the state Health Department will begin accepting applications from patients the same day.

Florida Governor Signs Medical Marijuana Implementation Bills. Gov. Rick Scott last Friday signed into law Senate Bill 6A and Senate Bill 8A, which formalize the voter-approved constitutional amendment legalizing medical marijuana in the state and set up regulations for the new industry.

Utah Advocates Begin Medical Marijuana Initiative Campaign. Medical marijuana supporters organized as the Utah Patients Coalition delivered a proposed initiative to the lieutenant governor's office Monday. Frustrated by the state legislature's refusal to enact a medical marijuana law, the coalition wants to take the issue directly to voters. To qualify for the November 2018 ballot, supporters must hold at least seven public hearings around the state and collect 113,000 valid voter signatures. The measure would not allow smoking medical marijuana and the number of medical marijuana facilities would be limited. It creates a list of specified qualifying conditions.

Drug Policy

Koch Network Critical of Trump Administration on Drug Policy. The conservative Koch brothers political network isn't happy with Trump administration drug policy. At a meeting in Colorado over the weekend, one of the network's top leaders, Mark Holden, decried the administration's return to "the harsh sentencing era of the war on drugs" and added that "You are never going to win the war on drugs. Drugs won." Holden went on to criticize Attorney General Sessions' directive to reevaluate marijuana policies, saying "it's legal in a number of states, so we have to come to grips with that somehow" and that medical marijuana should be "off limits" in any federal crackdown.

Drug Treatment

Florida's Billion Dollar Drug Treatment Industry is Plagued With Fraud and Overdoses. An NBC News investigative report has found crooked treatment centers have created an "insurance fraud mill" by partnering with "body brokers" and operators of "sober homes" to find patients with good health insurance and then billing insurance companies tens of thousands of dollars "for often questionable counseling, costly and potentially unnecessary drug screens, and exotic laboratory tests." And some treatment centers actually encourage drug use because for them, relapse doesn't mean failure, it means more profits.

International

Thousands Take to Streets in Global Drug Reform Day of Action. Thousands of people took to the streets in more than 200 cities in more than 90 countries as part of the Support Don't Punish campaign's "Global Day of Action." Events range from concerts and debates in Belgium, to a float parade and dialogue with parliamentarians in Ghana, a capacity building workshop for religious leaders in Mauritius, drug user and NGO gatherings in Malaysia, Lithuania, Canada and Australia, street art in Portugal, Bolivia, Ecuador and Montenegro, a 250km bike tour to sensitize the general public in India, a football tournament between people who use drugs and service providers in Morocco, the launch of a global call in support for harm reduction in Brazil, and much, much more.

One Year Later, Philippines Drug War Has Killed Thousands, Yet Meth is Cheaper. Philippines President Rodrigo Duterte took power last June 30 and immediately embarked on a brutal campaign to end drug abuse that has left an estimated 9,000 people dead, but the street price of meth has fallen and Filipinos are still as anxious as ever about crime. "If prices have fallen, it's an indication that enforcement actions have not been effective," said Gloria Lai of the International Drug Policy Consortium, a global network of non-governmental groups focused on narcotics.

Chronicle AM: Federal CARERS Act Refiled, RI Legalization Commission Bill Advances, More... (6/15/17)

A bipartisan group of senators reintroduce the CARERS Act to protect medical marijuana in the states, marijuana legalization is keeping legislators busy in the Northeast, New York GOP senators want more drug war to fight opioids, and more.

Kirsten Gillibrand (D-NY) is among a bipartisan group of senators who reintroduced the CARERS Act today. (senate.gov)
Marijuana Policy

Massachusetts Legal MJ Rewrite Bill Delayed By Errors, Concern at High Tax Rates. House Speaker Robert DeLeo (D-Winthrop) has postponed a vote on the legislature's rewrite of the marijuana legalization law approved by voters last fall after errors in the drafting of the bill and the high tax rate proposed -- 28% -- drew protests from Democratic lawmakers. "I think there are certain things that we have to clear up, so because of that, I think it's important that with a bill of this mag that we try to get it right or close to right this first time, so I'd rather do that than try to rush it through," DeLeo said, adding that there was a consensus among Democrats on the basics of the bill.

New Jersey Legalization Bill Gets Hearing Monday. The Senate Judiciary Committee will hold a hearing Monday morning on Senate Bill 3195, which legalizes the possession of small amounts of marijuana and sets up a system of taxed and regulated marijuana commerce. The Drug Policy Alliance has expressed "concern" that the bill "does not include essential components to create a fair and equitable marijuana market in New Jersey." Such legislation must include polices to repair past harms to minority communities, DPA said.

Rhode Island Legalization Study Commission Bill Passes House. A bill that creates a legislative commission to study marijuana legalization -- instead of just legalizing it -- passed the House Wednesday night. House Bill 551A now heads to the Senate. Regulate Rhode Island, the main advocacy group for legalization, has said it will not participate in the commission, which it describes as a delaying tactic.

Medical Marijuana

Bipartisan Bill to End Federal Prohibition of Medical Marijuana Reintroduced in US Senate. US Sens. Rand Paul (R-KY), Corey Booker (D-NJ), and Kirsten Gillibrand (D-NY) reintroduced a bill Thursday that would end the federal prohibition of medical marijuana. Sens. Mike Lee (R-UT) and Lisa Murkowski (R-AK) also signed on to the legislation as original cosponsors. The Compassionate Access, Research Expansion, and Respect States (or CARERS) Act of 2017 would allow individuals and entities to possess, produce, and distribute medical marijuana if they are in compliance with state medical marijuana laws. It would also open up avenues to medical marijuana research and allow physicians employed by the Department of Veterans Affairs to recommend medical marijuana to veterans in states where it is legal. The bill also proposes excluding cannabidiol, a non-psychoactive cannabinoid found in marijuana, from the federal government's definition of "marijuana."

Kentucky Lawsuit Challenges State's Medical Marijuana Ban. Three Kentuckians who say they have used marijuana to ease health problems have filed a lawsuit in state court charging that banning medical marijuana violates their constitutional privacy rights. The suit names as defendants Gov. Matt Bevin (R) and Attorney General Steve Beshear (D).

Rhode Island Governor Proposes Medical Marijuana Expansion. Gov. Gina Raimondo (D) has proposed a budget amendment that calls for "no less than six licensed compassion centers" and increased licensing fees that would generate $1.5 in revenues for the state's general fund. There are three existing dispensaries, which would each be allowed to open one more store front, plus the three additional ones proposed.

Heroin and Prescription Opioids

New York Republicans Want More Drug War to Fight Opioids. A Republican Senate task force says that adding funding for addiction treatment is good, but that it's time to increase heroin penalties "to get dealers off the street." The senators are proposing charging dealers with murder if one of their customers dies and increasing penalties based on the weight of the drugs sold. Assembly Democrats rejected the idea, calling the approach one that's been "tried and failed." The Assembly killed a similar approach last year.

America, We Can Fix This: 24 Ways to Reduce Opioid Overdoses and Addiction [FEATURE]

Drugs, mainly opioids, are killing Americans at a record rate. The number of drug overdose deaths in the country quadrupled between 1999 and 2010 -- and compared to the numbers we're seeing now, those were the good old days.

Some 30,000 people died of drug overdoses in 2010. According to a new estimate from the New York Times, double that number died last year. And the rate of increase in overdose deaths was growing, up a stunning 19% over 2015.

The Times' estimate of between 59,000 and 65,000 drug overdose deaths last year is greater than the number of American soldiers killed during the entire Vietnam War, greater than that number of people killed in the peak year for car crash deaths, greater than the number of people who died in the year the AIDS epidemic peaked, and higher than the peak year for gun deaths.

In the first decade of the century, overdoses and addiction rose in conjunction with a dramatic increase in prescription opioid prescribing; since then, as government agents and medical professionals alike sought to tamp down prescribing of opioids, the overdose wave has continued, now with most opioid OD fatalities linked to illicit heroin and powerful black market synthetic opioids, such as fentanyl and carfentanil.

The Centers for Disease Control and Prevention says we are in the midst of "the worst drug overdose epidemic in history," and it's hard to argue with that.

So, what do we do about it? Despite decades of failure and unintended consequences, the prohibitionist reflex is still strong. Calls for more punitive laws, tougher prosecutorial stances, and harsher sentences ring out from state houses across the land to the White House. But tough drug war policies haven't worked. The fact that the overdose and addiction epidemic is taking place under a prohibition regime should make that self-evident.

More enlightened -- and effective -- approaches are now being tried, in part, no doubt, because today's opioid epidemic is disproportionately affecting white, middle class people and not the inner city black people identified with heroin epidemics of the past. But they are also being tried because for the past quarter-century an ever-growing drug reform movement has articulated the failures of prohibition and illuminated more effective alternatives.

The drug reform movement's most powerful organization, the Drug Policy Alliance, this spring published A Public Health and Safety Approach to Problematic Opioid Use and Overdose, which lays out more than two dozen specific policy prescriptions in the realms of addiction treatment, harm reduction, prevention, and criminal justice that have been proven to save lives and reduce dependency on opioids. These policy prescriptions are doable now -- and some are being implemented in some fashion in some places -- but require that political decisions be made, or that forces be mobilized to get those decisions made. Some would require a radical divergence from the orthodoxies of drug prohibition, but that's a small price to pay given the mounting death toll.

Here are 24 concrete policy proposals that can save lives and reduce addiction right now. All the facts and figures are fully documented in the heavily-annotated original. Consult it if you want to get down to the nitty-gritty. In the meantime:

Addiction Treatment

1. Create Expert Panel on Treatment Needs: States should establish an expert panel to address effective treatment needs and opportunities. The expert panel should evaluate barriers to existing treatment options and make recommendations to the state legislature on removing unnecessary impediments to accessing effective treatment on demand. Moreover, the panel should determine where gaps in treatment exist and make recommendations to provide additional types of effective treatment and increased access points to treatment (such as hospital-based on demand addiction treatment). The expert panel must also set evidence-based standards of care and identify the essential components of effective treatment and recovery services to be included in licensed facilities, especially with regards to medication-assisted treatment, admission requirements, discharge, continuity of care and/or after-care, pain management, treatment programming, integration of medical and mental health services, and provision of or referrals to harm reduction services. The expert panel should identify how to improve or create referral mechanisms and treatment linkages across various healthcare and other providers. The panel should establish clear outcome measures and a system for evaluating how well providers meet the scientific requirements the panel sets. And, finally, the expert panel should evaluate opportunities under the ACA to expand coverage for treatment.

2. Increase Insurance Coverage for Medication-Assited Treatment (MAT): Seventeen state medical plans under the Patient Protection and Affordable Care Act (ACA) do not provide coverage for methadone or buprenorphine for opioid dependence. Moreover, the Veterans Administration's (VA's) insurance system has explicitly prohibited coverage of methadone and buprenorphine treatment for active duty personnel or for veterans in the process of transitioning from Department of Defense care. As a result, veterans obtaining care through the VA are denied effective treatment for opioid dependence. Insurance coverage for these critical medications should be standard practice.

3. Establish and Implement Office-Based Opioid Treatment for Methadone: Currently, with a few exceptions, methadone for the treatment of opioid dependence is only available through a highly regulated and widely stigmatized system of Opioid Treatment Programs (OTPs). Moreover, several states have imposed moratoriums on establishing new OTPs that facilitate methadone treatment despite large, unmet treatment needs for a growing opioid-dependent population. Patients enrolled in methadone treatment in many communities are often limited to visiting a single OTP and face other inconveniences that make adherence to treatment more difficult. Initial trials have suggested that methadone can be effectively delivered in office-based settings and that, with training, physicians would be willing to prescribe methadone to their patients to treat their opioid dependence. Office-based methadone may help reduce the stigma associated with methadone delivered in OTPs as well as provide a critical window of intervention to address medical and psychiatric conditions. Office-based opioid treatment programs offering methadone have been implemented in California, Connecticut, and Vermont.

4. Provide MAT in Criminal Justice Settings, Including Jails/Prisons and Drug Courts: Individuals recently released from correctional settings are up to 130 times more likely to die of an overdose than the general population, particularly in the immediate two weeks after release. Given that approximately one quarter of people incarcerated in jails and prisons are opioid-dependent, initiating MAT behind bars should be a widespread, standard practice as a part of a comprehensive plan to reduce risk of opioid fatality. Jails should be mandated to continue MAT for those who received it in the community and to assess and initiate new patients in treatment. Prisons should initiate methadone or buprenorphine prior to release, with a referral to a community-based clinic or provider upon release. In addition, drug courts should be mandated to offer participants the option to participate in MAT if they are not already enrolled, make arrangements for their treatment, and should not be permitted to make discontinuation of MAT a criterion for successful completion of drug court programs. The Substance Abuse and Mental Health Services Administration will no longer provide federal funding to drug courts that deny the use of MAT when made available to the client under the care of a physician and pursuant to a valid prescription. The National Association of Drug Court Professionals agrees: "No drug court should prohibit the use of MAT for participants deemed appropriate and in need of an addiction medication."

Medication-Assisted Treatment (MAT) can help.
5. Offer Hospital-Based MAT: Emergency departments should be mandated to inform patients about MAT and offer buprenorphine to those patients that visit emergency rooms and have an underlying opioid use disorder, with an appointment for continued treatment with physicians in the community. Hospitals should also offer MAT within the inpatient setting, and start MAT prior to discharge with community referrals for ongoing MAT.

6. Assess Barriers to Accessing MAT to Increase Access to Methadone and Buprenorphine: A number of known barriers prevent MAT from being as widely accessible as it should be. The federal government needs to reevaluate the need for and effectiveness of the OTP model and make necessary modifications to ensure improved and increased access to methadone. And, while federal law allows physicians to become eligible to prescribe buprenorphine for the treatment of opioid dependence, it arbitrarily caps the number of opioid patients a physician can treat with buprenorphine at any one time to 30 through the first year following certification, expandable to up to potentially 200 patients thereafter. Moreover, states need to evaluate additional barriers created by state law, including, among others, training and continuing education requirements, restrictions on nurse practitioners, insurance enrollment and reimbursement, and lack of provider incentives.

7. Establish and Implement a Heroin-Assisted Treatment Pilot Program: Heroin-assisted treatment (HAT) refers to the administering or dispensing of pharmaceutical-grade heroin to a small and previously unresponsive group of chronic heroin users under the supervision of a doctor in a specialized clinic. The heroin is required to be consumed on-site, under the watchful eye of trained professionals. This enables providers to ensure that the drug is not diverted, and allows staff to intervene in the event of overdose or other adverse reaction. Permanent HAT programs have been established in the United Kingdom, Switzerland, the Netherlands, Germany and Denmark, with additional trial programs having been completed or currently taking place in Spain, Belgium and Canada. Findings from randomized controlled studies in these countries have yielded unanimously positive results, including: 1) HAT reduces drug use; 2) retention rates in HAT surpass those of conventional treatment; 3) HAT can be a stepping stone to other treatments and even abstinence; 4) HAT improves health, social functioning, and quality of life; 5) HAT does not pose nuisance or other neighborhood concerns; 6) HAT reduces crime; 7) HAT can reduce the black market for heroin; and, 8) HAT is cost-effective (cost-savings from the benefits attributable to the program far outweigh the cost of program operation over the long-run). States should consider permitting the establishment and implementation of a HAT pilot program. Nevada and Maryland have introduced legislation of this nature and the New Mexico Legislature recently convened a joint committee hearing to query experts about this strategy.

8. Evaluate the Use of Cannabis to Decrease Reliance on Prescription Opioids and Reduce Opioid Overdose Deaths: Medical use of marijuana can be an effective adjunct to or substitute for opioids in the treatment of chronic pain. Research published last year found 80 percent of medical cannabis users reported substituting cannabis for prescribed medications, particularly among patients with pain-related conditions. Another important recent study reported that cannabis treatment "may allow for opioid treatment at lower doses with fewer [patient] side effects." The result of substituting marijuana, a drug with less side effects and potential for abuse, has had profound harm reduction impacts. The Journal of the American Medical Association, for instance, documents a relationship between medical marijuana laws and a significant reduction in opioid overdose fatalities: "[s]tates with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws."Another working paper from the RAND BING Center for Health Economics notes that "states permitting medical cannabis dispensaries experienced a 15 to 35 percent decrease in substance abuse admissions and opiate overdose deaths." There is also some emerging evidence that marijuana has the potential to treat opioid addiction, but additional research is needed.

Harm Reduction

9. Establish and Implement Safe Drug Consumption Services: States and/or municipalities should permit the establishment and implementation of safe drug consumption services through local health departments and/or community-based organizations. California and Maryland have introduced legislation to establish safe drug consumption services, and the City of Ithaca, New York has included a proposal for a supervised injection site in their widely-publicized municipal drug strategy. In Washington State, the King County Heroin an Prescription Opiate Addiction Task Force has recommended the establishment of at least two pilot supervised consumption sites as part of a community health engagement program designed to reduce stigma and "decrease risks associated with substance use disorder and promote improved health outcomes" in the region that includes the cities of Seattle, Renton and Auburn.

10. Maximize Naloxone Access Points, Including Lay Distribution and Pharmacy Access, As Well As Immunities for Prescription, Distribution and Administration:Naloxone should be available directly from a physician to either a patient or to a family member, friend, or other person in a position to assist in an overdose, from community-based organizations through lay distribution or standing order laws, and from pharmacies behind-the-counter without a prescription through standing order, collaborative agreement, or standardized protocol laws or regulations. Though some states, including California, New York, Colorado and Vermont, among others, have access to naloxone at each of these critical intervention points, many others only provide naloxone through a standard prescription. Civil and criminal immunities should be provided to prescribers, dispensers and lay administrators at every access point. In addition, all first responders, firefighters and law enforcement should be trained on how to recognize an overdose and be permitted to carry and use naloxone. Naloxone should also be reclassified as an over-the-counter (OTC) medication. Having naloxone available over-the-counter would greatly increase the ability of parents, caregivers, and other bystanders to intervene and provide first aid to a person experiencing an opioid overdose. FDA approval of OTC naloxone is predicated on research that satisfies efficacy and safety data requirements. Pharmaceutical companies, however, have not sought to develop an over-the-counter product.88 Federal funding may be needed to meet FDA approval requirements.

11. Provide Dedicated Funding for Community-Based Naloxone Distribution and Overdose Prevention and Response Education: Few states provide dedicated budget lines to support the cost of naloxone or staffing for community-based opioid overdose prevention programs. The CDC, however, reports that, between 1996 and 2014, these programs trained and equipped more than 152,280 laypeople with naloxone, who have successfully reversed 26,463 opioid overdoses.89 Without additional and dedicated funding, community-based opioid overdose prevention programs will not be able to continue to provide naloxone to all those who need it, and the likelihood of new programs being implemented is slim. A major barrier to naloxone access is its affordability and chronic shortages in market supply, 90 which overdose prevention programs, operating on shoestring budgets, can have a difficult time navigating.

12. Improve Insurance Coverage for Naloxone: Individuals who use heroin and other opioids are often both uninsured and marginalized by the healthcare system.91 States should insure optimal reimbursement rates for naloxone to increase access to those who need it most – users themselves.

Overdose reversal drugs need to be made much more widely available -- and affordable. (health.pa.gov)
13. Provide Naloxone to Additional At-Risk Communities: People exiting detox and other treatment programs as well as periods of incarceration are at particularly high risk for overdose because their tolerance has been substantially decreased. After their period of abstinence, if they relapse and use the same amount, the result is often a deadly overdose. States should require overdose education and offer naloxone to people upon discharge from detox and other drug treatment programs and jails/prisons. The Substance Abuse and Mental Health Services Administration has declared that prescribing or dispensing naloxone is an essential complement to both detoxification services as well as medically supervised withdrawal. Vermont passed legislation making naloxone available to eligible pilot project participants who are transitioning from incarceration back to the community. In addition, there are other programs/studies that provide naloxone to recently released individuals on a limited basis, including in San Francisco, California, King County, Washington and Rhode Island.

14. Encourage Distribution of Naloxone to Patients Receiving Opioids: Physicians should be encouraged to prescribe naloxone to their patients and opioid treatment programs should inform their clients about naloxone, if prescribing or dispensing an opioid to them. Pharmacists should similarly be encouraged to offer naloxone along with all Schedule II opioid prescriptions being filled, for syringe purchases (without concurrent injectable medication), and for all co-prescriptions (within 30 days) of a benzodiazepine (such as Valium™, Xanax™ or Klonopin™) and any opioid medication. The Rhode Island Governor's Overdose Prevention and Intervention Task Force found that offering naloxone to those prescribed a Schedule II opioid or when co-prescribed a benzodiazepine and any opioid would have reached 86% of overdose victims who received a prescription from a pharmacy prior to their death, and could have prevented 58% of all overdose deaths from 2014 to 2015.

15. Expand Good Samaritan Protections: "Good Samaritan" laws provide limited immunity from prosecution for specified drug law violations for people who summon help at the scene of an overdose. But, protection from prosecution is not enough to ensure that people are not too frightened to seek medical help. Other consequences, like arrest, parole or probation violations, and immigration consequences, can be equal barriers to calling 911. States with Good Samaritan laws already on the books should evaluate the protections provided and determine whether expansion of those protections would increase the likelihood that people seek medical assistance.

16. End the Criminalization of Syringe Possession: Syringes should be exempt from state paraphernalia laws in order to provide optimal access to people who inject drugs. Twenty-two states criminalize syringe possession. Thus, even if there is a legal access point, such as pharmacy sales, paraphernalia laws still permit law enforcement to arrest and prosecute individuals in possession of a syringe. Public health and law enforcement authorities should not be working at cross-purposes.

17. Reduce Barriers to Over-The-Counter Syringe Sales and Permit Direct Prescriptions of Syringes: While the non-prescription, over-the-counter sale of syringes is now permitted in all but one U.S. state, access is still unduly restricted.States should evaluate the potential barriers to accessing syringes over-thecounter and implement measures to improve access. Moreover, doctors should be permitted to prescribe syringes directly to their patients, a practice few states currently permit.

18. Authorize and Fund Sterile Syringe Access and Exchange Programs; Increase Programs: States should explicitly authorize and fund sterile syringe access and exchange programs, and states that have already authorized them should evaluate how to increase the number or capacity of programs to ensure all state residents – whether in urban centers or rural communities -- have access to clean syringes, as well as evaluate any possible barriers to access such as unnecessary age restrictions.

19. Provide Free Public, Community-Level Access to Drug Checking Services: Technology exists to test heroin and opioid products for adulterants via GC/MS analysis, but it has so far been unavailable at a public level in the US (aside from a mail-in service run by Ecstasydata.org). Making these services available in the context of a community outreach service or academic study would lower the number of deaths and hospitalizations and also allow for real-time tracking of local drug trends.

Prevention

20. Establish Expert Panel on Opioid Prescribing: Though the CDC has issued guidelines for prescribing opioids for chronic pain, the guidelines are voluntary and are likely to exacerbate disparities in treatment that already exist. Research has shown, for example, that African Americans are less likely than whites to receive opioids for pain even when being treated for the same conditions. Moreover, the CDC guidelines only address prescribing practices for chronic pain, not prescribing practices more broadly. States should accordingly establish an expert panel to undertake an assessment as to whether prescribing practices, such as co-prescriptions for benzodiazepines and opioids or overprescribing of opioids, have contributed to increased rates of opioid dependence, and, if so, the expert panel should develop a plan to address any such linkages as well as any treatment disparities. The plan must account for the potential negative effects of curtailing prescribing practices or swiftly reducing prescription opioid prescribing volume. A task force in Rhode Island found that while changes in opioid supply can have the intended effect of reducing availability of abuse-able medications, they have also been linked to an increase in transition to illicit drug use and in more risky drug use behaviors (e.g., snorting and injecting pain medications). The plan must also account for chronic pain patients, particularly those already underserviced, and not unduly limit their access to necessary medications. Finally, to the extent prescribing guidelines are issued as part of the plan, they should be mandatory and applied across the board.

21. Mandate Medical Provider Education: States should mandate that all health professional degree-granting institutions include curricula on opioid dependence, overdose prevention, medication-assisted treatment, and harm reduction interventions, and that continuing education on these topics be readily available.

22. Develop Comprehensive, Evidence-Based Health, Wellness, and Harm Reduction Curriculum for Youth: State education departments, in conjunction with an expert panel consisting of various stakeholders that ascribe to scientific principles of treatment for youth, should develop a comprehensive, evidence-based health, wellness, and harm reduction curriculum for use in schools that incorporates scientific education on drugs, continuum of use, and contributors to problematic drug use (e.g., coping and resiliency, mental health issues, adverse childhood experiences, traumatic events and crisis), as well as how reduce harm (e.g., not mixing opioids with benzodiazepines). Education departments should also establish protocols and resources for early intervention, counseling, linkage to care, harm reduction resources, and other supports for students.

CRIMINAL JUSTICE

23. Establish Diversion Programs, Including Law Enforcement Assisted Diversion (LEAD): LEAD is a pre-booking diversion program that establishes protocols by which police divert people away from the typical criminal justice route of arrest, charge and conviction into a health-based, harm-reduction focused intensive case management process wherein the individual receives support services ranging from housing and healthcare to drug treatment and mental health services. Municipalities should create and implement LEAD programs and states and the federal government should provide dedicated funding for such programs. Various other forms of diversion programs exist and can be implemented should LEAD prove unsuitable to a particular population or municipality.

24. Decriminalize Drug Possession: Decriminalization is commonly defined as the elimination of criminal penalties for drug possession for personal use. In other words, it means that people who merely use or possess small amounts of drugs are no longer arrested, jailed, prosecuted, imprisoned, put on probation or parole, or saddled with a criminal record. Nearly two dozen countries have taken steps toward decriminalization. Empirical evidence from the international experiences demonstrate that decriminalization does not result in increased use or crime, reduces incidences of HIV/AIDs and overdose, increases the number of people in treatment, and reduces social costs of drug misuse. All criminal penalties for possession of small amounts of controlled substances for personal use should be removed.

Chronicle AM: Senators' Sessions Forfeiture Letter, Canada Legalization Debate, More... (5/31/17)

A bipartisan group of US senators has sent Attorney General Sessions a letter asking him to rein in federal civil asset forfeiture, the Rhode Island House is voting on a pot legalization study commission, the Canadian parliament begins debating the government's legalization bill, and more.

Marijuana Policy

California Senate Votes to Make Marijuana Use in Cars an Infraction. The state Senate on Tuesday approved Senate Bill 65, which would prohibit the use of marijuana in automobiles because of concerns over drugged driving. The bill would make the offense a violation, punishable by no more than a fine. The bill now goes to the Assembly.

Rhode Island House to Vote Today on Legalization Study Commission. The House is set to vote today on a bill creating a 17-member panel to "conduct a comprehensive review and make recommendations regarding marijuana and the effects of its use." The commission would have until March 1, 2018 to report its findings to the General Assembly. Adopting the bill effectively blocks legalization in the state until next year at the earliest. This measure is supported by anti-reform state Attorney General Peter Kilmartin and Smart Approaches to Marijuana. If the measure passes the House, it then goes to the Senate.

Wisconsin Decriminalization Bill Gets Lone Republican Supporter. Legislative proponents of marijuana decriminalization held a press conference on Tuesday to rally support for a bill that would remove criminal penalties for possession of 10 grams or less. Three Democratic cosponsors were joined by Republican Rep. Adam Jarchow (District 28) at the presser, where they conceded their bill was unlikely to pass this year, but was intended to get the ball rolling.

Medical Marijuana

Arkansas Regulators Delay Voting on Final Rules for Another Week. The state Medical Marijuana Commission needs another week to finalize some rules, commission Chairwoman Dr. Ronda Henry-Tillman said Tuesday. If it indeed finalizes rules next week, applications for medical marijuana businesses will open up on June 30.

Asset Forfeiture

Bipartisan Group of Senators Ask Session to Rein In Asset Forfeiture. Six US senators have sent a letter to Attorney General Jeff Sessions asking him to change Justice Department policy on civil asset forfeiture. "We encourage the Department of Justice to revise its civil asset forfeiture practices to reflect our nation's commitment to the rule of law and due process," Sens. Mike Lee (R-UT), Rand Paul (R-KY), Mike Crapo (R-ID), Martin Heinrich (D-NM), Tom Udall (D-NM) and Angus King (I-ME) wrote to Sessions. "We encourage the Department of Justice to revise its civil asset forfeiture practices to reflect our nation's commitment to the rule of law and due process." Noting that Supreme Court Justice Clarence Thomas had recently expressed skepticism about the practice, they added: "You need not wait for Supreme Court censure before reforming these practices, and, in any event, the Department of Justice should err on the side of protecting constitutional rights."

International

Canada Begins Debating Government's Marijuana Legalization Bill. Parliamentary debate on the C-45 legalization bill got underway Tuesday. Supported by Prime Minister Justin Trudeau, the bill is expected to pass, making Canada the second country after Uruguay to legalize marijuana.

South African Opioid Substitution Program Underway. The city of Tshwane and the University of Pretoria are collaborating on a pilot opioid substitution therapy (OST) program in seven clinics in central Pretoria and Tshwane townships. Doctors are prescribing drugs such as methadone and buprenorphine to be consumed under direct supervision of health workers. The program also links patients to counseling and job skills, as well as testing for HIV and Hep C.

Chronicle AM: DE Legalization Bill Advances, NH Decrim Bill Passes, More... (5/11/17)

A legalization bill in Vermont awaits the governor's signature, and so does a decrim bill in New Hampshire, Trump names an anti-reform drug commission, Senate Democrats signal their concerns over Trump drug policies, and more.

New England is happening! A Vermont legalization bill is on the governor's desk, so is a New Hampshire decrim bill. (Wikimedia)
Marijuana Policy

Delaware Legalization Bill Wins Committee Vote. The House Revenue and Finance Committee on Wednesday approved House Bill 110, which would allow people 21 and over to possess marijuana and buy it from marijuana shops, which would be limited to 75. There is no provision for people to grow their own. The bill now goes to the House floor.

New Hampshire Legislature Approves Decriminalization Bill. With approval by the Senate on Thursday, a decriminalization bill is now headed to the desk of Gov. Chris Sununu (R). House Bill 640 would make possession of an ounce or less of marijuana a civil infraction. It is currently a misdemeanor.

Pennsylvania Poll for First Time Has Majority for Legalization. For the first time, the Franklin and Marshall College Poll is reporting a majority of Keystone Staters favoring marijuana legalization. The poll had support at 56%, a whopping 16-point increase over the last time Franklin and Marshall asked the question in June 2015. But only 44% of Republicans supported it, and the GOP has huge majorities in the state legislature.

Vermont Legalization Bill Awaits Governor's Action. In a historic move, the legislature has approved Senate Bill 22, which would legalize the possession of up to an ounce of marijuana possession and allow for limited cultivation by people 21 and over, as well las creating a commission to study the best ways to tax and regulate marijuana commerce in the future. Now the question is whether Gov. Phil Scott (R) will sign the bill into law. He has expressed concerns about drugged driving, but also said he thinks legalization is "inevitable." He says he will "review" the bill and did not commit to vetoing it.

Medical Marijuana

Calls Grow for Florida Special Session to Deal With Medical Marijuana. House Speaker Richard Corcoran has joined a growing number of people calling for a special legislative session to come up with rules for the state's voter-approved medical marijuana amendment. Senate President Joe Negron has also said the legislature should be responsible for crafting the rules. The session ended earlier this week without the legislature reaching agreement on how to regulate medical marijuana. If the legislature doesn't come back into session to deal with the issue, it will be left up to the state Health Department.

Drug Policy

Trump Names Members of Commission to Combat Drug Addiction. President Trump has named the members of his new commission to combat drug addiction, and the list of names is heavy with opponents of marijuana legalization. The members are New Jersey Gov. Chris Christie (R), North Carolina Gov. Roy Cooper (D), Massachusetts Gov. Charlie Baker (R), Project SAM co-founder and former US Rep. Patrick Kennedy, and former Deputy Director for Demand Reduction at the Office of National Drug Control Policy Dr. Bertha Madras.

Senate Dems Send Letter Raising Concerns on Trump's Opioids, Marijuana Policy. Six Senate Democrats this week sent a letter to the acting director of the Office of National Drug Control Policy (ONDCP -- the drug czar's office) saying they were concerned with the administration's "open hostility" to legal marijuana states and possible budget cuts they said could aggravate the opioid crisis. "We appreciate any sincere efforts to combat substance use disorders. We are concerned that this administration may revert to a policy that focuses on the criminal justice system over public health efforts," the letter reads. The senators referenced Trump's threat to radically defund ONDCP, as well as the repeal of other Obama-era policies responding to the opioid epidemic. "A meaningful effort to combat substance use disorders must focus on the full implementation of the Comprehensive Addiction and Recovery Act, adequate funding for the Substance Abuse and Mental Health Services Administration, and improving the Affordable Care Act by expanding access to mental health and substance use disorder services and health insurance," the letter says. Repealing the Affordable Care Act (Obamacare) would be "a major step backwards in the prevention and treatment of drug addiction," they wrote. "We are very concerned that this administration will exacerbate the opioid epidemic rather than alleviate it," the letter said. And then, there's pot: "We are also concerned by the administration's open hostility to state policies legalizing or decriminalizing the possession and use of medical or recreational marijuana," the senators wrote. "Particularly given the severity of the ongoing opioid use epidemic, federal resources should be targeted at providing comprehensive substance use disorder programs and cutting off the flow of deadly drugs rather than interfering with state regulatory regimes for marijuana," the letter said.

International

Medical Marijuana Now Available in Chilean Pharmacies. Pharmacies in Santiago will begin selling medical marijuana this week, a first for Latin America. Chile legalized the use of medical marijuana in 2015, but until now, patients could only obtain it by importing it or from a small number of dedicated farms set up by a charity. The Congress is currently debating a bill that would allow people to grow their own.

Chronicle AM: Trump Budget Slashes ONDCP, ACHA Leaves Millions Without Treatment, More... (5/5/17)

The Trump administration wants to slash funding for the drug czar's office by 95%, the American Health Care Act approved in the House Thursday would leave millions without access to drug treatment, and more.

ONDCP faces massive cuts under the Trump budget. But it's early.
Marijuana Policy

Michigan 2018 Legalization Campaign Gets Underway. Backers of a proposed initiative to legalize pot next year launched their campaign on Friday. The initiative is backed by in-state activists and the Marijuana Policy Project, and needs 252, 000 valid voter signatures to qualify for the November 2018 ballot. A similar effort in 2016 came up short after state officials moved to tighten timelines for signature-gathering.

Medical Marijuana

Florida Senate Approves Amended House Medical Marijuana Bill. The Senate on Thursday gave its okay to a heavily-amended House Bill 1397, sending the measure back to the House for final approval. Senate bill sponsor Sen. Rob Bradley (R-Fleming) offered and the Senate approved a "delete all" amendment basically replacing the House text. Among the changes: limiting growers to five retail facilities, allowing the Health Department to grant 10 new licenses this year, and a provision to add five more licenses for every 75,000 patients. The legislative session ends on Monday, so the House must act quickly.

Drug Policy

White House Proposes Massive Cut in Drug Czar's Office Funding. The Trump administration's Office of Management and Budget has released a document that calls for a 95% cut in funding for the Office of National Drug Control Policy (ONDCP -- the drug czar's office). Under the proposal, funding would be slashed from $388 million to $24 million, with up to 33 employees laid off. The budget would also eliminate grants for programs including the High Intensity Drug Trafficking Areas program and the Drug-Free Communities Support program. The OMB says the budget document is preliminary, not final.

Drug Treatment

House Passes Health Care Reform Bill That Would End Access to Treatment for Millions. The House passed the American Health Care Act (ACHA) on Thursday, placing addiction treatment opportunities for millions at risk. As the Drug Policy Alliance noted, "millions of people would lose treatment coverage under this bill and efforts to end the opioid crisis will be put in grave jeopardy." As a result, the advocacy group warned, "people struggling with problematic substance use could relapse to riskier opioid and other drug use behaviors that increase risk for developing costly medical conditions, contracting and transmitting blood-borne disease, and experiencing life-threating overdose." The bill now goes to the Senate.

International

UN Investigator on Executions Rebukes Philippines Over Drug War Killings. United Nations special rapporteur on extrajudicial, summary, and arbitrary executions rebuked the government of President Rodrigo Duterte on Friday, saying world leaders have recognized that a bloody-handed approach doesn't work, can compound social problems, and "can foster a regime of impunity infecting the whole justice sector and reaching into whole societies, invigorating the rule of violence rather than law." Some 7,000 to 9,000 people have been killed in Duterte's drug war since he took office last year.

Chronicle AM: Dr. Bronner's $5 Million for MDMA Research, HRW Says More Naloxone, More... (4/27/17)

FDA-approved research on MDMA and PTSD gets a big monetary bump courtesy of Dr. Bronner's, Human Right Watch condemns the failure to make the opioid overdose reversal drug naloxone more available, a safe injection site bill is moving in California, and more.

Dr. Bronner's CEO (Cosmic Engagement Officer) David Bronner (maps.org)
Industrial Hemp

Nevada Senate Unanimously Approves Hemp Bill. The Senate has approved Senate Bill 396 by a unanimous vote. The bill would expand on existing state law, which allows colleges or the state Agriculture Department to grow hemp for research purposes. This bill would create "a separate program for the growth and cultivation of industrial hemp and produce agricultural hemp seed in this State," allowing the crop to be grown for commercial purposes. The bill now heads to the House.

Ecstasy

Dr. Bronner's Kicks In $5 Million for MDMA PTSD Research. Dr. Bronner's -- the family-owned maker of the popular soap brand -- is donating $5 million over five years to the Multidisciplinary Association for Psychedelic Studies (MAPS) to pursue its FDA-approved Stage 3 studies of the efficacy of MDMA for treating Post Traumatic Stress Disorder (PTSD). The announcement came ahead of last week's MAPS-sponsored psychedelic science conference in Oakland. "There is tremendous suffering and pain that the responsible integration of MDMA for treatment-resistant PTSD will alleviate and heal," said Dr. Bronner's CEO David Bronner. "To help inspire our allies to close the funding gap, my family has pledged $1 million a year for five years -- $5 million total-- by far our largest gift to an NGO partner to date. In part, we were inspired by the incredible example of Ashawna Hailey, former MAPS Board member, who gave MAPS $5 million when she died in 2011."

Drug Policy

Human Rights Watch Report Says US Drug Policy Failures Drive Preventable Drug Overdose Deaths. The US federal and state governments are taking insufficient action to ensure access to the life-saving medication naloxone to reverse opioid overdose, resulting in thousands of preventable deaths, Human Rights Watch said in a report released Thursday. The 48-page report, "A Second Chance: Overdose Prevention, Naloxone, and Human Rights in the United States," identifies federal and state laws and policies that are keeping naloxone out of the hands of people most likely to witness accidental overdoses, denying them the ability to save lives. "The easiest, most effective step that the federal and state governments can take to stem the tide of deaths from opioid overdoses is to make naloxone easier to get," said Megan McLemore, senior health researcher at Human Rights Watch. "Naloxone should be as easy to get as Tylenol. Criminal laws block access to harm reduction programs such as syringe exchanges; the price of the medication is too high; it is not available over the counter -- these and other obstacles are keeping naloxone out of the hands of those who need it the most."

Harm Reduction

California Committee Votes for Supervised Consumption Sites Bill. A bill supported by the Drug Policy Alliance, Assembly Bill 186, passed Assembly Public Safety Committee on Tuesday. It had already been approved by the Assembly Health Committee last month, which marked the first time a US legislative body has ever approved a safe drug consumption site measure. "This is a huge step toward establishing a more effective, treatment-focused approach to drug addiction and abuse in California," said bill sponsor Assemblymember Susan Talamantes Eggman (D-San Joaquin County). "The committee's input has done a great deal to refine the bill since I first introduced it last year, and its support clearly demonstrates the legislature's willingness to consider bold ideas to get people to treatment and counseling, to protect public health and safety and, most importantly, to save lives." The bill now heads for an Assembly floor vote.

Drug War Issues

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