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Chronicle AM -- March 6, 2014

Oregon's medical marijuana dispensary regulation bill has gone back to the Senate with compromise language allowing only temporary local bans, a GOP US Senate candidate there says legalize it, Chuck Schumer fights heroin, Canada's Tories look to be going soft on pot law enforcement, and more. Let's get to it:

Canadian Justice Minister Peter Mackay hints that something much like marijuana decriminalization is coming. (petermackay.ca)
Marijuana Policy

Alaska Legalization Debate Draws Hundreds. A week after the Alaska marijuana legalization initiative was officially certified for the ballot, hundreds of people streamed into the Wendy Williamson Auditorium at the University of Alaska in Anchorage for a debate on marijuana policy. In an opening speech, Ethan Nadelmann of the Drug Policy Alliance called the war on drugs "a rat hole of waste" and that marijuana prohibition was "grounded in bigotry, prejudice, and ignorance." Then a panel of five people, including Nadelmann, as well as an anti-legalization Project Sam representative, went at it. Click on the title link for more.

Another Missouri Legalization Initiative Approved for Signature-Gathering. Missouri Secretary of State Jason Kander approved a marijuana legalization initiative for signature gathering Wednesday. This is not one of the initiatives filed by Show-Me Cannabis, which had a bakers' dozen of similarly-worded initiatives approved earlier this year, but has decided to wait until 2016 for its effort. The initiative has a May 4 deadline for handing in petitions, and must obtain signatures from registered voters equal to 8% of the total votes cast in the 2012 governor's election from six of the state's eight congressional districts.

Maryland Sheriffs Rally Against Legalization. Local sheriffs attended a rally in Annapolis to voice opposition to proposed legislation to decriminalize marijuana in Maryland Wednesday. Sheriffs from the Eastern Shore and local police chiefs attended a rally sponsored by the Maryland Sheriff's Association and its supporters. The sheriffs are taking a stand against legalizing marijuana in Maryland, as lawmakers ponder a legalization bill.

Oregon GOP US Senate Candidate Endorses Legalization. Portland attorney Tim Crawley, who is seeking the Republican US Senate nomination, favors marijuana legalization. In a press release this week, he said he had "long been concerned with the tremendous waste of money and human potential the criminalization of marijuana has involved." In a subsequent interview, Crawley said he would support a legalization initiative in Oregon and if elected to the Senate, he would support removing marijuana from the controlled substances list.

Medical Marijuana

Oregon House Passes Dispensary Regulation Bill With Only Temporary Local Bans. The statewide dispensary legalization and regulation bill, Senate Bill 1531, passed out of the House on Wednesday with a provision allowing localities to ban dispensaries, but only for a year while they develop regulations for them. The Senate has already passed a version without the temporary ban language, but is expected to accept this compromise language.

Florida CBD Medical Marijuana Bill Advances with House Committee Vote. A bill that would allow the use of high-CBD cannabis oil to treat seizure disorders passed the House Criminal Justice Subcommittee Wednesday. House Bill 843 now heads for the House Judiciary Committee.

South Carolina Medical Marijuana Bill Introduced. A bill to allow patients with specified diseases and conditions to use medical marijuana with a doctor's recommendation to use and grow their own medicine or purchase it at dispensaries has been introduced. House Bill 4879, filed by Minority Leader Rep. J. Todd Rutherford (D-Columbia, has been referred to the House Judiciary Committee.

Heroin

Schumer Wants New York Heroin Database. US Sen. Charles Schumer (D-NY) called Wednesday for a standardized heroin database to fight crime and addiction related to the drug's use. "Data and information sharing drives solutions, and we're seriously lacking in that department," said Schumer. "All we know for sure is heroin is ravaging families across New York state." He called on the Office of National Drug Control Policy (ONDCP) to help set up a statewide "Drugstat" database to track heroin use patterns, hospitalizations, and overdoses, which he said could help police combat the drug.

Law Enforcement

California Informants Sue San Luis Obispo Over Rogue Narc. A civil lawsuit recently filed in federal court against the city and county of San Luis Obispo by two former confidential informants of disgraced narcotics detective Cory Pierce charges that Pierce allegedly forced the female informant to have sex with him. Pierce is currently serving a prison term for corruption. According to prosecutors in his federal trial, both informants aided Pierce in acquiring cash, oxycodone and heroin, and now allege that they were forced into indentured servitude, including being kept addicted to drugs and engaging in dangerous and illegal activities. According to prosecutors, Pierce used the informants to set up drug buys with local dealers, then later robbed them. The federal lawsuit alleges that Pierce used his position as a detective to force the woman into engaging in sex with him, including an act of oral copulation, and on another occasion, forced sexual intercourse. Click on the link for more sleazy details.

International

Canada's Tories Hint at Move Toward Ticketing Marijuana Possession Offenders. Conservative Justice Minister Peter Mackay said Wednesday that the government is seriously considering looser marijuana laws that would allow police to ticket anyone caught with small amounts of pot instead of laying charges, Justice Minister Peter MacKay said Wednesday. "We're not talking about decriminalization or legalization," MacKay said prior to the weekly Conservative caucus meeting on Parliament Hill. "The Criminal Code would still be available to police, but we would look at options that would... allow police to ticket those types of offenses." Liberal Party leader Justin Trudeau has called for legalization.

Vancouver Police Say They Won't Bother with Busting Dispensaries. All but a handful of medical marijuana dispensaries are supposed to be illegal after Canada's new medical marijuana law comes into effect April 1, but Vancouver police said Wednesday they are not going to bother them unless there are signs they are selling to people without a medical marijuana permit. "I don't think for now there is any plan to change the current drug policy that is in place to fit specifically with these changes," said Constable Brian Montague. "We don't have plans for massive raids on April 2nd."

(This article was published by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also shares the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Hoffman, Heroin, and What Is To Be Done [FEATURE]

The news last Sunday that acclaimed actor Phillip Seymour Hoffman had died of an apparent heroin overdose has turned a glaring media spotlight on the phenomenon, but heroin overdose deaths had been on the rise for several years before his premature demise. And while there has been much wailing and gnashing of teeth -- and quick arrests of low-level dealers and users -- too little has been said, either before or after his passing, about what could have been done to save him and what could be done to save others.

cooking heroin (wikimedia.org)
There are proven measures that can be taken to reduce overdose deaths -- and to enable heroin addicts to live safe and normal lives, whether they cease using heroin or not. All of the above face social and political obstacles and have only been implemented unevenly, if at all. If there is any good to come of Hoffmann's death it will be to the degree that it inspires broader discussion of what can be done to prevent the same thing happening to others in a similar position.

Hoffman, devoted family man and great actor that he was, died a criminal. And perhaps he died because his use of heroin was criminalized. Criminalized heroin -- heroin under drug prohibition -- is of uncertain provenance, of unknown strength and purity, adulterated with unknown substances. While we don't know what was in the heroin that Hoffman injected, we do know that he maintained his addiction and went to meet his maker with black market dope. That's what was found beside his lifeless body.

In a commentary published by The Guardian, actor Russell Brand, a recovered heroin addict, laid the blame for Hoffman's demise on the drug laws. "Addiction is a mental illness around which there is a great deal of confusion, which is hugely exacerbated by the laws that criminalise drug addicts," Brand wrote, calling prohibitionists' methods "so gallingly ineffective that it is difficult not to deduce that they are deliberately creating the worst imaginable circumstances to maximise the harm caused by substance misuse." As a result, "drug users, their families and society at large are all exposed to the worst conceivable version of this regrettably unavoidable problem."

We didn't always treat our addicts this way. Even after the passage of the Harrison Act in 1914, doctors continued for years to prescribe maintenance doses of opiates to addicts -- and hundreds of them went to jail for it as the medical profession fought, and ultimately lost, a battle with the nascent drug prohibition bureaucracy over whether giving addicts their medicine was part of the legitimate practice of medicine.

The idea of treating heroin addicts as patients instead of criminals was largely vanquished in the United States, but it never went away -- it lingers with methadone substitution, for example. But other countries have for decades been experimenting with providing maintenance doses of opioids to addicts, and to good result. It goes by various names -- opiate substitution therapy, heroin-assisted theatment, heroin maintenance -- and studies from Britain and other European countries, such as Germany, the Netherlands, and Switzerland, as well as the North American Opiate Medications Initiative (NAOMI) and the follow-up Study to Assess Long-Term Opiate Maintenance in Canada have touted its successes.

Those studies have found that providing pharmaceutical grade heroin to addicts in a clinical setting works. It reduces the likelihood of death or disease among clients, as well as allowing them to bring some stability and predictability to sometimes chaotic lives made even more chaotic by the demands of addiction under prohibition. Such treatment has also been found to have beneficial effects for society, with lowered criminality among participants and increased likelihood of their integration as productive members of society.

The dry, scientific language of the studies obscures the human realities around heroin addiction and opioid maintenance therapy. One NAOMI participant helps put a human face on it.

"I want to tell you what being a participant in this study did for me," one participant told researchers. "Initially it meant 'free heroin.' But over time it became more, much more. NAOMI took much of the stress out of my life and allowed me to think more clearly about my life and future. It exposed me to new ideas, people (staff and clients) that in my street life (read: stressful existence) there was no time for."

"After NAOMI, I was offered oral methadone, which I refused. After going quickly downhill, I ended up hopeless and homeless. I went into detox in April 2007, abstained from using for two months, then relapsed. In July 2008 I again went to detox and I am presently in a treatment center... I am definitely not "out of the woods" yet, but I feel I am on the right path. And this path started for me at the corner of Abbott and Hastings in Vancouver... Thank you and all who were involved in making NAOMI happen. Without NAOMI, I wouldn't be where I am today. I am sure I would be in a much worse place."

Arnold Trebach, one of the fathers of the drug reform in late 20th Century America, has been studying heroin since 1972, and is still at it. He examined the British system in the early 1970s, when doctors still prescribed heroin to thousands of addicts, and authored a book, The Heroin Solution, that compared and contrasted the US and UK approaches. Later this month, the octogenarian law professor will be appearing on a panel at the Vermont Law School to address what Gov. Peter Shumlin (D) has described as the heroin crisis there.

Phillip Seymour Hoffman (wikimedia.org)
"The death of Phillip Seymour Hoffman is a tragedy all the way around," Trebach told the Chronicle. "It's a bad idea to use heroin off the street, and he shouldn't have been doing that."

That said, Trebach continued, it didn't have to be that way.

"If we had had a sensible system of dealing with this, he would have been in treatment under medical care," he said. "If he was going to inject heroin, he should have been using pharmaceutically pure heroin in a medical setting where he could also have been exposed to efforts to straighten out his personal life, and he could have access to vitamins, weight control advice, and the whole spectrum of medical care. And if he had had access to opioid antagonists, he could still be alive," he added.

While Hoffman may have made bad personal choices, Trebach said, we as a society have made policy choices seemingly designed to amplify the prospects for disaster.

"This is a sad thing. He is just another one of the many victims of our barbaric drug policy," he said. "This was a totally unnecessary death at every level. He shouldn't have been using, but we should have been taking care of him."

The stuff ought to be legalized, Trebach said.

"I'm an advocate of full legalization, but if we can't go that far, we need to at least provide social and psychological support for these people," he said. "And even if we were to decriminalize or legalize, I would still want to figure out ways to provide support and love and kindness to people using the stuff. I advise you not to do it, but if you're going to use it, I want to keep you alive. I remember talking to people from Liverpool [a famous heroin maintenance clinic covered in the '90s by Sixty Minutes, linked above] about harm reduction around heroin use back in the 1970s. One of the ladies said it is very hard to rehabilitate a dead addict."

"There are plenty of things we can be doing," said Hilary McQuie, Western director for the Harm Reduction Network, reeling off a list of harm reduction interventions that are by now well-known but inadequately implemented.

"We can make naloxone (Narcan) more available. We need better access to it. It should be offered to people like Hoffman when they are leaving treatment programs, especially if they've been using opiates, just as a safeguard," she said. "Having treatment programs as well as harm reduction programs distribute it is important. We can cut the overdose rate in half with naloxone, but there will still be people using alone and people using multiple substances."

There are other proven interventions that could be ramped up as well, McQuie said.

"Safe injection sites would be very helpful, so would more Good Samaritan overdose emergency laws, and more education, not to mention more access to methadone and buprenorphine and other opioid substitution therapies (OST)," she said, reeling off possible interventions.

Dr. Martin Schechter, director of the School of Population and Public Health at the University of British Columbia in Vancouver, knows a thing or two about OST. The principal study investigator for the NAOMI and the follow-up SALOME study, Schechter has overseen research into the effectiveness of treating intractable addicts with pharmaceutical heroin, as well as methadone. The results have been promising.

"What we're using is medically prescribed pharmaceutical diacetylmorphine, the active ingredient in heroin," he explained. "It's what you have when you strip away all the street additives. This is a stable, sterile medication from a pharmaceutical manufacturer. We know the precise dose tailored for each person. With street heroin, not only is it adulterated and injected in unsterile situations, but people really don't know how strong it is. That's probably what happened to Mr. Hoffman."

Naloxone (Narcan) can reverse opiate overdoses (wikimedia.org)
In NAOMI, 90,000 injections were administered to study participants, and only 11 people suffered overdoses requiring medical attention.

"Never did we have a fatal overdose," Schechter said. "Because it was in a clinic, nurses and doctors are right there. We administer Narcan (naloxone), and they wake up."

Heroin maintenance had even proven more effective than methadone in numerous studies, Schechter said.

"There have been seven randomized control trials across Europe and in Canada that have shown for people who have already tried treatments like methadone, that medically prescribed heroin is more effective and cost effective treatment than simply trying methadone one more time."

Those studies carry a lesson, he said.

"We have to start looking at heroin from a medicinal point of view and treat it like a medicine," he argued. "The more we drive its use underground, the more overdoses we get. We need to expand treatment programs, not only with methadone, but with medically prescribed heroin for people who don't respond to other treatments."

Safe injection sites are also a worthwhile intervention, Schechter said, although he also noted their limitations.

"Injecting under supervision is much safer; if there is an overdose, there is prompt attention, and they provide sterile equipment, reducing the risk of HIV and Hep C," he said. "But they are still injecting street heroin."

He would favor decriminalizing heroin possession, too, he said.

Harm reduction measures, opioid maintenance treatments, and the like are absolutely necessary interventions, said McQuie, but there is a larger issue at hand, as well.

"We still need to look at the overall issue of the stigmatization of drug users," she said. "People aren't open about their use, and that puts them in a more dangerous situation. It's really hard in a criminalized environment."

Stigmatization means to mark or brand someone or something as disgraceful and subject to strong disapproval. Defining an activity, such as heroin possession, as a crime is stigmatization crystallized into the legal structures of society itself.

"The ultimate harm reduction solution," McQuie argued, "is a regulated, decriminalized environment where it is available by prescription, so people know what they're getting, they know how much to use, and it's not cut with fentanyl or other deadly adulterants. People wouldn't have to deal with all the collateral damage that comes from being defined as criminals as well as dealing with the consequences of their drug use. They could deal with their addictions without having to worry about losing their homes, their families, and their freedoms."

While such approaches have a long way to go before winning wide popular acceptance, policymakers should at least be held to account for the consequences of their decision-making, McQuie said, suggesting that the turn to heroin in recent years was a foreseeable result of the crackdown on prescription opioid pain medication beginning in the middle of the last decade.

"They started shutting down all those 'pill mills' and people should have anticipated what would happen and been ready for it," she said. "What we have seen is more and more people turning to injecting heroin, but nobody stopped to do an impact statement on what would be the likely result of restricting access to pain pills."

The impact can be seen in the numbers on heroin use, addiction, and overdoses. While talk of a "heroin epidemic" is overblown rhetoric, the number of heroin users has increased dramatically in the past decade. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the number of past year users grew by about 50% between 2002 and 2011, from roughly 400,000 to more than 600,000. At the same time, the number of addicted users increased from just under 200,000 to about 370,000, a slightly lesser increase.

If there is any good news, it is that, according to the latest (2012) National Household Survey of Drug Use and Health, the number of new heroin users has remained fairly steady at around 150,000 each year for the past decade. That suggests, however, that more first-time users are graduating to occasional and sometimes, dependent user status.

And some of them are dying of heroin overdoses, although not near the number dying from overdoses from prescription opioids. Between 1999 and 2007, heroin deaths hovered just under 2,000, even as prescription drug deaths skyrocketed, from around 2,500 in 1999 to more than 12,000 just eight years later. But, according to the Centers for Disease Control, by 2010, the latest year for which data are available, heroin overdose deaths had surpassed 3,000, a 50% increase in just three years.

While the number of heroin overdose deaths is still but a fraction of those attributed to prescription opioid overdoses and the numbers since 2010 are spotty, the increase that showed up in 2010 shows no signs of having gone away. Phillip Seymour Hoffman may be the most prominent recent victim, but in the week since his death, another 50 or 60 people have probably followed him to the morgue due to heroin overdoses.

There are ways to reduce the heroin overdose death toll. It's not a making of figuring out what they are. It's a matter of finding the political and social will to implement them, and that requires leaving the drug war paradigm behind.

New York City, NY
United States

Could Different Drug Policies Have Saved Philip Seymour Hoffman?

The tragic death of actor Philip Seymour Hoffman yesterday has prompted expressions of grief and of praise for his talent. It also, naturally, has prompted discussions of addiction, the impact of pain pill prescriptions on the addicted, even of pain pill restrictions causing more people to turn to heroin.

Philip Seymour Hoffman at the 81st Academy Awards (courtesy Chrisa Hickey, flickr.com/photos/chrisahickey/, via wikimedia.org)
While the latter raises the question about whether different drug policies could make things safer or less damaging or risky for heroin addicts, I haven't heard that question directly raised in the media. Although we don't know how Hoffman would have fared under a different system -- a system that had more options available, we do have information from places that do offer more options, and they are worth examining.

One of those options is heroin maintenance programs (also known now as heroin assisted treatment, or HAT). The most famous such program operated in Liverpool, England, before the conservative Thatcher government, encouraged by the Reagan administration (so we heard), shut it down. But HAT programs current operate in Switzerland, The Netherlands, Germany, Denmark, and the Canadian cities of Vancouver and Montreal. Patients in such programs receive a supply of pharmaceutically-produced heroin from a clinic (for free, though one can infer similar benefits if the heroin were merely cheap). They regularly access health services as a part of their participation. Those who need to inject the drug to relieve their cravings receive instruction on how to do so without damaging their veins, and heroin is made available in other forms as well.

A 2009 paper by leading drug policy researcher Peter Reuter, written for The Abell Foundation in Baltimore, reviewed research done in three of those countries. According to Reuter, Switzerland found a decrease in criminal involvement from 70% of the patients down to 10% after 18 months; and an increase in employment, from 14% to 32%. The health safety results were particularly impressive, including decreased contact with the street drug scene, and with very few adverse events or safety issues.

Many of those findings relate more to indigent addicts than they would to a famous actor. But the final point seems key, very few "adverse events" (e.g. overdoses and so forth) or safety issues, in any of the programs. Again, we don't know how Hoffman would have fared if he had entered a heroin maintenance program instead of buying it on the street. For that matter, we don't know if under legalization, broad or just for the addicted, whether Hoffman would have accessed such services in time, or chose to access them at all. But we know that many people do access these services in the countries that offer them, and that very few of the patients enrolled suffer overdose.

More generally, by prohibiting heroin, even for people who are already addicted to it, we prevent a whole class of possible approaches from every being taken to try to help people -- a whole set of options that people with substance abuse problems might be able to use to manage their problems -- to literally save their lives.

In the meanwhile, there are things to do that are legal even now, at least in a few states that have moved forward with them, with no federal laws standing in the way. These are Good Samaritan policies, that protect people from criminal liability when they seek help in an overdose situation; and use of the antidote medication for heroin overdoses, Naloxone. Meghan Ralston wrote about these in an oped yesterday.

We can also improve the debate. It's not enough to talk about the challenges of addiction and the risk of relapse people can face their entire lives, important as that is. It's a good start that people are starting to recognize the unintended consequences of the pain pill crackdown. But that isn't enough either. It's also important to take the next logical step in the argument, and rethink prohibition.

Chronicle AM -- January 17, 2014

Washington's attorney general has dealt a body blow to the statewide legalization of marijuana commerce there, medical marijuana continues to keep state legislatures busy, a New Mexico town and county pay out big time for a horrid anal search, heroin legislation is moving in Kentucky, and more. Let's get to it:

Marijuana Policy

Washington Attorney General Rules Localities Can Ban Marijuana Businesses. In a formal opinion released Thursday, the Washington attorney general's office held that "Initiative 502 as drafted and presented to the voters does not prevent local governments from regulating or banning marijuana businesses in their jurisdictions." The ACLU of Washington said the attorney general's opinion is mistaken and it "will go to court if necessary" to see it overturned, while the state Liquor Control Board, which is charged with implementing I-502 said that the "opinion would be a disappointment to the majority of voters who approved the law."

Marijuana Reforms Will Be on the Legislative Agenda in Louisiana Again This Year. State Rep. Austin Badon (D-New Orleans) has already introduced House Bill 14, which would dramatically lessen the state's draconian marijuana penalties, and further-reaching bills could be forthcoming. The Badon bill passed the House last year before dying in the Senate.

Medical Marijuana

Pennsylvania Medical Marijuana Bill to Get Hearing This Month. State Senate Law and Justice Committee Chairman Chuck McIlhinney (R) said Thursday he had scheduled a public hearing for January 28 on a medical marijuana bill introduced this week. The bill, Senate Bill 1182, is cosponsored by Sens. Daylin Leach (D) and Mike Folmer (R).

Hawaii House Speaker Says State Needs Dispensaries. House Speaker Joe Souki said Wednesday that the lack of places for medical marijuana patients to obtain their medicine was "a gap in the law" that needs to be addressed. That patients can use medical marijuana but have no place to obtain it is "an anomaly," he said. Addressing dispensaries is a "humanitarian" issue, he added.

Utah Poll Finds Narrow Majority for Medical Marijuana. A new Salt Lake Tribune poll has 51% of Utahns supporting medical marijuana, but 67% opposing decriminalization or legalization.

Georgia Poll Finds Narrow Majority for Medical Marijuana. A new InsiderAdvantage poll has 51% of Georgians supporting medical marijuana "in very specific instances, such as in a liquid form to reduce seizures from young children." Some 27% were opposed, and 22% undecided. "The key here is that any legislation must be on a limited basis. That said, Republicans and Democrats both support this legislation by well over 50 percent, while independent voters are close to a majority as well," said Matt Towery, president of InsiderAdvantage and a former legislator.

Heroin

Kentucky Senate Approves Bill to Reduce Overdose Deaths, Increase Trafficking Penalties. The state Senate Thursday approved Senate Bill 5, which would create more treatment beds for heroin users and lengthen prison sentences for heroin and methamphetamine traffickers. A similar version of the bill passed the Republican-led Senate last year, but stalled in the Democratic-led House. The bill would require the state Medicaid program to cover several inpatient and outpatient treatment options for people addicted to opiates, including heroin and prescription painkillers. It also would divert some of the state's hoped-for savings from a 2011 prison sentencing reform package to expand treatment programs. But the bill would also stiffen penalties for people convicted of trafficking in larger quantities of heroin, methamphetamines or both, requiring them to serve at least half of their prison sentences before they are eligible for shock probation or parole.

Search and Seizure

New Mexico Town, County Pay Out Big Time for Forced Anal Searches of Drug Suspect. A Deming, New Mexico, man who was subjected to a hospital anal exam involving three enemas, a colonoscopy, and being forced to defecate in front of police and medical personnel in a fruitless search for drugs will get $1.6 million in damages in a settlement from Deming and Hidalgo County. David Eckert will most likely win additional damages from a local hospital where doctors agreed to perform the exam.

Sentencing

Charles Colson Task Force on Federal Corrections Funded in Federal Spending Bill. The omnibus federal spending bill filed this week and expected to pass quickly includes $1 million to establish the Charles Colson Task Force on Federal Corrections, an independent, bipartisan grouping that will examine a number of challenges facing the federal correctional system, including overcrowding and ways to minimize growth, violence behind bars, rehabilitation, and reentry. Colson was a Nixon administration official jailed in the Watergate scandal who became a prison reformer in the wake of that experience.

International

Spurred by Attorney, Bermuda's Medical Marijuana Debate Heats Up. Attorney Alan Gordon's online petition to have the Bermudan government allow emergency access to medical marijuana for cancer patients has spurred considerable notice on the island, with National Security Minister Michael Dunkley and Gordon publicly clashing over the law and whether Dunkley can act. Click on the link to see Dunkley's comments and Gordon's well-publicized written response.

Vietnam Sentences Three Drug Offenders to Death; Iran Executes Six. And the resort to the death penalty against drug offenders continues. According to the anti-death penalty group Hands Off Cain, three Vietnamese men charged with heroin trafficking got death sentences, while Iran, the world's leading drug offender execution, hung another six.

Chronicle AM -- January 16, 2014

Florida's medical marijuana initiative appears poised to qualify for the ballot (if it survives a challenge in the state Supreme Court), a new poll finds the country evenly split on marijuana legalization, Afghanistan was on the agenda in the Senate yesterday, and more. Let's get to it:

harvesting opium poppies in Afghanistan (unodc.org)
Marijuana Policy

ABC News/Washington Post Poll Has Americans Split on Marijuana. A new ABC News/Washington Post poll has support for marijuana legalization nationwide at 49%, with 48% opposed. The poll is in the same ballpark as other polls since the November 2012 elections, where support for legalization has ranged between 45% and 58%. Click on the link to see full poll results.

DEA Operations Chief Bemoans Marijuana Legalization Trend. DEA operations chief James Capra told a Senate committee Wednesday that marijuana legalization at the state level was "reckless and irresponsible" and could lead to dire consequences. "It scares us," Capra said, responding to a question. "Every part of the world where this has been tried, it has failed time and time again." [Editor's Note: No country had legalized marijuana until Uruguay did late last year, and that hasn't gone into effect yet. If Capra is referring to Amsterdam, where sales are tolerated, if not technically legal, cannabis coffee shops are now in their fourth decade of existence, and the problems associated with them are relatively trivial.] "There are more dispensaries in Denver than there are Starbucks," he continued. "The idea somehow people in our country have that this is somehow good for us as a nation is wrong. It's a bad thing. This is a bad experiment. It's going to cost us in terms of social costs."

Missouri Marijuana Legalization Petitions Approved for Circulation. Secretary of State Jason Kander announced Wednesday that 13 marijuana legalization initiatives had been approved for signature-gathering. The bakers' dozen initiatives are all variations on a theme: legalize and regulate marijuana in Missouri. They were submitted by Columbia defense attorney Dan Viets, the chairman of the activist group Show-Me Cannabis. To make the November 2014 ballot, organizers must gather 157,778 valid voter signatures for at least one of them by May 4.

Maryland Coalition to Legalize Marijuana Launched. Maryland legislators Thursday launched an effort to get a marijuana legalization bill, the Marijuana Control Act of 2014, passed this year. They were joined at a press conference by members of the newly formed Marijuana Policy Coalition of Maryland, which includes the ACLU of Maryland, Law Enforcement Against Prohibition, the Maryland League of Women Voters, the Marijuana Policy Project, and the Maryland NAACP.

Medical Marijuana

Florida Initiative Campaign Has Gathered 1.1 Million Signatures. The folks behind the Florida medical marijuana initiative, United For Care/Patients United for Freedom, announced Wednesday night that they had gathered 1.1 million signatures, nearly half a million more than needed to qualify for the ballot. While all the signatures haven't been validated yet, organizers are now confident they will pass that hurdle. Now, they have to wait and see if the state Supreme Court is going to allow the effort to move ahead.

Washington Patients, Advocates Speak Out Against Bill That Would Gut Medical Marijuana System. The House Health Committee got an earful from medical marijuana advocates at a hearing Wednesday on House Bill 2149, which would eliminate cultivation cooperatives (and thus, dispensaries) by 2020 and reduce the amount of marijuana patients could possess and the number of plants they could grow. The bill mirrors many of the recommendations of the state Liquor Control Board, which is charged with implementing I-502 marijuana legalization.

Hemp

Indiana Hemp Bill Introduced. State Sen. Richard Young (D-Milltown) has introduced Senate Bill 357, which would allow the Department of Agriculture to license industrial hemp growing and production. The bill requires the department to get necessary approvals from the federal government, which has yet to approve any such production anywhere in the US.

Illinois Hemp Bill Seeks New Life in 2014. State Rep. Kenneth Dunkin (D-Chicago) introduced a hemp bill, House Bill 2668, last year, but it has languished in committee despite picking up some bipartisan support. He said Wednesday that he was cautiously optimistic that opposition may be softening, and the bill could move this year.

Heroin

Maine Heroin Deaths Up Fourfold from 2011 to 2012. The number of heroin overdose deaths in Maine quadrupled between 2011 and 2012, according to numbers released by state officials Wednesday. Officials said the increase was due to tightening restrictions on the use of prescription opiates, a cheap heroin supply, and, possibly, cuts in MaineCare. But while the increase was dramatic, the 28 heroin overdose deaths reported in 2012 is well below the 2005 peak of 43. In the years between 2005 and 2011, heroin deaths declined steadily.

Heroin Prevention Bill Package Passes Wisconsin Assembly. The State Assembly Wednesday passed the HOPE (Heroin Opiate Prevention and Education) package of four bills designed to reduce the number of overdose deaths in the state. Sponsored by Rep. John Nygren (R-Marinette), one bill would allow anyone to use naloxone to reverse overdoses, another would grant legal immunity to drug users who call for help in an overdose emergency, a third would allow communities to establish prescription drug drop-off points, and the fourth would require people to show ID when picking up prescription drugs. The naloxone and legal immunity bills are Assembly Bill 446 and Assembly Bill 447. The package now moves to the Senate.

Kratom

Oklahoma Wants to Ban Kratom, But Meets Resistance. The Oklahoma Bureau of Narcotics wants to ban the Southeast Asian herb kratom, which it calls "the legal form of heroin," but kratom fans are responding with dismay and disputing the narcs' assessment. Kratom is not a controlled substance under federal law, but narc Mark Woodward said he planned to ban it until it is federally proven to have medical benefits. Kratom users have started a petition to challenge efforts to ban Kratom.

Drug Courts

Study Finds Drug Courts Ignore Science When it Comes to Opiate Substitution Therapies. A small study of drug courts in New York state finds that their skeptical approach to opiate substitution therapies (OST), such as methadone and buprenorphine, can be a barrier to successful treatment. "Many courts do not respect medical consensus on scientifically sound treatment standards. Some courts included OST as part of court-mandated treatment options, while others allowed OST for a court-defined period of time as a bridge to abstinence. Still others showed intolerance and even disdain for anything having to do with methadone and buprenorphine, or -- as with the drug court in Albany County -- refused outright to admit people on methadone or buprenorphine treatment," the authors wrote. "Ordering people who are dependent on opioids to get off their prescribed methadone or buprenorphine medicines can force patients to seek out and become dependent on other opioids like prescription analgesics. Addiction to prescription opioids has been recognized as a priority problem by U.S. policy-makers, but drug courts may be exacerbating it."

Search and Seizure

ACLU Sues Border Patrol Over Interior Border Check Point Searches. The American Civil Liberties Union (ACLU) has filed suit against the Border Patrol, claiming its agent routinely violate the constitutional rights of local residents by stopping and searching them at interior checkpoints on highways near the border. In a 1976 ruling, the US Supreme Court ruled that immigration checkpoints were permissible if the stops were brief, involved "a limited enquiry into residence status," and a visual inspection of the exterior of the vehicle. "But that's not what's happening here," said ACLU attorney James Duff Lyall in Tucson. He said the cases mentioned in the lawsuit provide strong indications that the Border Patrol is using the checkpoints for general crime control, "which the courts have said is not acceptable for a checkpoint. The same thing is happening over and over again to many border residents," Lyall said. "They're going on fishing expeditions where there's no reasonable suspicion."

International

Afghan Drug Situation "Dire," Federal Auditor Tells Senators."The situation in Afghanistan is dire with little prospect for improvement in 2014 or beyond," Special Inspector General for Afghanistan Reconstruction John Sopko told the Senate Caucus on International Narcotics Control Wednesday. Poppy cultivation is at record levels and the drug trade now accounts for 15% of Afghan GDP, Sopko said.

US to Help Afghanistan With Drug Problem, State Department Official Tells Senators. At the same hearing mentioned in the story above, Assistant Secretary of State for the Bureau of International Narcotics and Law Enforcement Affairs ("drugs and thugs") William Brownfield vowed the US would remain committed to helping Afghanistan fight drug production and trafficking even after US and NATO troops pull out at the end of this year. "We will continue to ensure our counternarcotics programs are well integrated with broader US efforts, including assistance programs aimed at supporting a vibrant legal economy," he testified Wednesday. "The expanding cultivation and trafficking of drugs is one of the most significant factors putting the entire US and international donor investment in the reconstruction of Afghanistan at risk," he said.

"Obamacare" Heroin Hits the Market

Like any other businessmen seeking to differentiate their product from similar competitors, heroin dealers come up with brand names, too. Among the latest is this entry from Massachusetts: "Obamacare"

This photo comes courtesy of the Massachusetts State Patrol, whose troopers seized 1,250 packets of heroin stamped "Obamacare" or "Kurt Cobain" during a Friday morning traffic stop.

Branding heroin is nothing new; legendary New York City heroin dealer Frank Lucas had his "Blue Magic" back in the 1970s. In recent years, the trend has continued, with names such as "Bugs Bunny," "Buddha," "Bin Laden," and "LeBron James" all making appearances, some for more obvious reasons than others.

"Kurt Cobain" I can understand, from a heroin marketer's viewpoint. This shit will blow your brains out.

But I'm not sure what message dealers are trying to convey with the "Obamacare" brand. Is this stuff gonna kill you as dead as socialized medicine? Or is it gonna bliss you out like knowing you have access to reasonably priced health insurance despite preexisting conditions?

Location: 
MA
United States

Chronicle AM -- November 19, 2013

Hmmm, on the same day the DEA warns that "marijuana availability seems to be on the increase," hundreds of people apply for licenses to sell pot in Washington state. Times are changing, and somebody needs to let the DEA know. And there's more news, too. Let's get to it:

Crackdowns on pain pills are leading the way to comeback for heroin. (wikipedia.org)
Marijuana Policy

Hundreds Apply for Pot Business Licenses in Washington State. Monday was the first day budding ganjapreneurs could apply for licenses to open marijuana cultivation, processing, and retail facilities, and interest was intense. By 2:00pm Monday, 299 applications had been submitted. The state envisions up to 334 marijuana retail shops opening next year; it is unclear how many production and processing facilities will be licensed, although regulators have said they want to limit cultivation to two million square feet statewide. Applications are being accepted through December 17.

Arkansas Attorney General Rejects Another Marijuana Initiative. The Arkansas attorney general's office Monday rejected the proposed language of an initiative that would repeal the state's marijuana laws. The initiative isn't clear about what it seeks to achieve, the office said. The attorney general's office has been busy with initiatives this year; it has already approved two separate medical marijuana initiatives, and the author of this one can come back with new language if she wishes.

Drug Policy

DEA Releases 2013 National Drug Threat Assessment. The DEA Monday released the annual drug threat assessment, which includes looks at drug use and trafficking trends. The report identifies the illicit use of controlled prescription drugs as "the nation's fastest growing drug problem," warns that heroin use and supply is up, as is methamphetamine, but that cocaine use and supply is down. Also, "marijuana availability seems to be increasing," and synthetic drugs "have emerged as a serious problem in the United States."

New Yorkers to Map Out City Drug Policies on Saturday. New York City residents just elected a self-described progressive -- Bill de Blasio -- as mayor. Now, they will have a chance to let him know what direction they want the city to take on drug policy. As part of Talking Transition, "an open conversation about the future of New York City," hundreds of people are expected to attend a Saturday forum on "Ending the New Jim Crow: Mapping the Future of Drug Policy in New York City," then break into small groups to make recommendations on issues ranging from racially-biased marijuana arrests, lack of effective drug treatment, and overdose prevention strategies. Click on the main link for more details.

Heroin

Ohio Attorney General Declares War on Heroin. Ohio Attorney General Mike DeWine Monday announced he had created a new heroin unit within his office to fight back against what he called "an epidemic" of heroin use. The move comes as heroin overdose deaths have doubled in recent years, from 292 in 2010 to 606 last year. DeWine said his office will spend an additional $1 million a year on increased assistance to law enforcement, community outreach workers, and lab technicians. The rise in heroin use in Ohio comes after Gov. John Kasich cracked down on pain clinics in 2011, leaving illicit heroin as the last resort for people strung out on opioids.

International

China to Turn "Re-Education" Labor Camps into Drug Treatment Centers. At its recent Third Plenary meeting, the Chinese Communist Party announced it was abolishing its controversial "re-education" labor camps. Now, it turns out that the camps won't be closing, but will instead be converted into drug treatment and rehabilitation centers. "The new rehab centers will provide compulsory drug rehabilitation treatment for addicts, and help them find self-confidence again," one official explained. There are 1.8 million "officially registered" addicts in China, but the number of actual addicts could run as high as 12 million.

Canadian Students for Sensible Drug Policy Meets in Vancouver This Weekend. Canadian SSDP is holding its annual national conference this weekend in Vancouver. In addition to panels and speeches, there will be tours of Insite, Vancouver's supervised injection facility, a Downtown Eastside Walking Tour, and rides on the Sensible BC bus. For more details, click the link.

UN Drug Chief Warns of Afghanistan "Narco-State"

Afghanistan could collapse into a "full-fledged narco-state" as the looming withdrawal of US and NATO combat forces creates a gaping hole in the center of the country's economy, Yuri Fedotov, the head of the UN Office on Drugs and Crime (UNODC) warned Wednesday.

In an interview with Reuters, Fedotov noted that the Western forces generate about a third of all jobs and investment in Afghanistan. They are due to leave the country by the end of next year, and even the presence of a residual force of up to 10,000 fighters is increasingly in doubt as the US and Afghan haggle over a status of forces agreement that would allow them to stay.

The other major economic activity in the country is opium production, processing, and distribution, including the manufacture of heroin from raw opium, which accounts for roughly another third of the national economy. Since the US invaded Afghanistan in October 2001, it has consistently been the world's leading source of illicit opium production, accounting for nearly 90% of all poppies produced worldwide.

Multi-hundred million dollar annual cash flows associated with the opium economy have benefited the Taliban insurgency, which taxes farmers in areas it controls as well as engaging in or protecting drug trafficking. They have also benefited corrupt Afghan government officials and associated warlords.

Fedotov, whose native Russia has been flooded with Afghan heroin, said Wednesday that an upcoming UNODC survey due later this month will show increases in both opium cultivation and production.

"The situation is worsening, that is clear and very disappointing," he said. "It is a very serious setback, but we need to take that as a warning shot," he added, calling for increased international assistance.

"That is also fertile ground for corruption and other forms of transnational organized crime. It is a multi-faceted challenge and we need to take that as a serious problem," Fedotov warned. "Otherwise we have a serious risk that without international support, without more meaningful assistance, this country may continue to evolve into a full-fledged narco-state," he said. "We have not been able to develop an alternative economy in Afghanistan," Fedotov said. "With all our efforts, it was very hard to move from illicit to licit."

Oh, and those Afghan farmers? When they're not producing opium, they're producing cannabis. Afghanistan is also one of the world's preeminent producers of it, according to UNODC, and production was up again last year, the group reported last month.

Afghanistan

Health Canada Approves Heroin Maintenance [FEATURE]

Last Friday, Health Canada used some creative rule-reading to approve a program that would provide prescription heroin to a small number of hard-core users, and the Conservative health minister isn't happy. But doctors, advocates, and the users themselves are quite pleased -- and once again, Canada stays on the cutting edge when it comes to dealing smartly with heroin use.

Health Canada approved access to prescription heroin for at least 15 people who are completing their participation in Vancouver's Study to Assess Long-term Opioid Dependence (SALOME), which is testing whether prescribing heroin was more effective than prescribing methadone for users who have proven resistant to conventional treatments. The move came after participants and advocates have been calling for an "exit strategy" for the 322 people in the study.

SALOME began at the end of 2011 and has been enrolling participants on a rolling basis for a year at a time. The final group of participants will finish up at the end of next year. It built on the success of the North American Opioid Maintenance Initiative (NAOMI), a study in Vancouver and Montreal from 2005 to 2008. That study found that using heroin is cheaper and more effective than using methadone to treat recalcitrant heroin users.

While the Conservative federal government has been a staunch opponent of heroin maintenance, not to mention also fighting a bitter losing battle to close down the Vancouver safe injection site, Health Canada bureaucrats were able to find a loophole that will allow doctors to prescribe heroin to graduating study participants under the ministry's Special Access Program (SAP).

That program is designed to provide drugs to Canadians with life-threatening illnesses on a "compassionate or emergency" basis. The SAP includes "pharmaceutical, biologic and radiopharmaceutical products that are not approved for sale in Canada." The program covers diseases including intractable depression, epilepsy, transplant rejection and hemophilia, but heroin addiction isn't mentioned.

"Health Canada made a wonderful decision," said Scott Bernstein, Health and Drug Policy Lawyer for the Vancouver-based Pivot Legal Aid Society, which represents 22 SALOME participants and the BC Association of People on Methadone in order to advocate for their continued access to health care and the protection of their human rights. "The decision was one based on the evidence and not ideology. It means that those SALOME participants allowed access can live safer, more stable lives, lives free of crime and remaining under the care of doctors, not drug dealers."

But Health Minister Rona Ambrose appeared to have been caught flat-footed by the Health Canada decision. She issued a statement the same day decrying the move, saying that it contradicted the government's anti-drug stance.

Pharmaceutical diacetylmorphine AKA heroin (wikimedia.org)
"Our government takes seriously the harm caused by dangerous and addictive drugs," Ambrose said. "Earlier today, officials at Health Canada made the decision to approve an application under the Special Access Program's current regulations to give heroin to heroin users -- not to treat an underlying medical condition, but simply to allow them to continue to have access to heroin for their addiction even though other safe treatments for heroin addiction, such as methadone, are available."

The move is "in direct opposition to the government's anti-drug policy and violates the spirit and intent of the Special Access Program," Ambrose said, adding that she would take action to "protect the integrity of the (SAP) and ensure this does not happen again."

Ambrose's remarks prompted a Monday response from SNAP (the SALOME/NAOMI Patients Association), comprised of "the only patients in North America to be part of two heroin-assisted treatment (HAT) clinical trials" -- NAOMI and SALOME. SNAP noted that European heroin-assisted treatment trials had allowed participants to continue to be prescribed heroin on compassionate grounds after the trials ended and that "heroin-assisted therapy is an effective and safe treatment that improves physical and psychological health when the participants are receiving treatment."

"The Canadian NAOMI trial is the only heroin-assisted treatment study that failed to continue offering HAT to its participants when the trial ended in Vancouver," SNAP said. "We do not want to see the same outcome for the SALOME trial. Currently, SALOME patients are being offered oral hydromorphone when they exit the trial. However, there is currently no scientific evidence to support this treatment option for opiate addiction in the doses required; thus we urge you to reconsider your comments and to support Health Canada's decision to grant special access to heroin for patients exiting the SALOME trial. We also urge Canadians to support the immediate establishment of a permanent HAT program in Vancouver, BC."

Patients and their supporters weren't the only ones supporting the Health Canada move and criticizing Minister Ambrose for her opposition. New Democratic Party health critic Libby Davies also had some choice words for her.

Davies was "outraged" that Ambrose would "overrule her own experts," she said. "Medicalized heroin maintenance has been used very successfully in places like Europe. It's another example of the Conservative government ignoring sound public policy, instead making decisions based on political dogma."

Indeed, while Canada has been on the cutting edge of opiate maintenance in North America, being the scene of the hemisphere's only safe injection site and heroin-maintenance studies, similar moves have been afoot in Europe for some time. Prescription heroin programs have been established in several European countries, such as Switzerland, Germany, Denmark, The Netherlands, and the United Kingdom.

Now, it seems that Canada will join them, despite the health minister's dismay.

Vancouver
Canada

Norway Government Wants to Decriminalize Heroin Smoking

The Norwegian government said Friday it wants to decriminalize the smoking of heroin as a harm reduction measure, Agence-France Presse reported. Smoking heroin is less dangerous than injecting it, and the move could reduce the number of overdoses, officials said.

heroin smoking image from 1965 UNODC newsletter
"The number of fatal overdoses is too high and I would say it's shameful for Norway," said Health Minister Jonas Gahr Stoere. "The way addicts consume their drugs is central to the question of overdoses. My view is that we should allow people to smoke heroin since injecting it is more dangerous," he said.

According to the Norwegian Institute for Alcohol and Drug Research (SIRUS), heroin overdoses accounted for 30% of 262 fatal overdoses in 2011. By comparison, only 168 people died in traffic accidents that year.

The city of Oslo has opened a supervised injection site in a bid to reduce overdoses, but decriminalizing heroin smoking would also help, said Stoere. Users currently can't smoke at the supervised injection site.

"This isn't about some kind of legalization of heroin but about being realistic," he said. "Those who are in the unfortunate situation of injecting themselves in a drug room should be able to inhale. It is less dangerous, you consume less and the risk of contracting a disease is lower," he added.

"It's a paradox that you can't smoke heroin when you can inject it, since the first method is less dangerous than the second," SIRUS researcher Astrid Skretting told AFP. "But the culture of injecting which provides a more immediate effect than smoking seems deeply rooted in Norway and it's not certain that a decriminalization will lead to a radical change in behavior," she suggested.

The Norwegian government is set to unveil its latest plan for fighting drug addiction next week. Stoere said the heroin smoking decrim plan has the backing of the center-left government.

Oslo
Norway

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