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Chronicle AM: Thousands of Federal Drug Prisoners to Be Freed, Ohio Early Voting, More (10/6/15)

Major sentencing news today; early voting starts today in Ohio (marijuana legalization is on the ballot), a North Carolina hemp bill has gone to the governor, Colombia will still spray a nasty herbicide on coca crops, and more.

Federal prisons will be a little less crowded a month from now. (nadcp.org)
Marijuana Policy

California Governor Vetoes Law Criminalizing Hash Oil Explosions. Gov. Jerry Brown (D) Monday vetoed Assembly Bill 849, which would have made it a crime to cause an explosion causing bodily harm. The bill was inspired by a series of butane hash oil lab explosions, but in his veto message, Brown said the conduct is already proscribed and another law on the matter "creates increasing complexity without commensurate benefit."

Early Voting Starts Today on Ohio Legalization Initiative. Ohioans can vote for or against Issue 3, the controversial ResponsibleOhio initiative beginning today. Early voters can mail in absentee ballots or visit early-voting locations across the state.

Oregon's Multnomah County (Portland) Issues Report on Legalization. The Multnomah County Health Department has issued a report saying there are drawbacks and benefits from marijuana legalization, but that more research is needed. The report recommends implementing policies to address impaired driving, teen use, and dependence; there should be warnings for pregnant and nursing women, and there should be limits on the potency of pot, as well as on contamination from pesticides and other substances.

Medical Marijuana

Washington State Issues Emergency Medical Marijuana Rules. The state Health Department has just released emergency rules as the state moves to merge medical marijuana into the recreational pot regulatory system. The rules set standards for packaging "High THC compliant products," testing requirements, safe handling, employee training, and labeling. Click on the rules link for all the details.


North Carolina Hemp Bill Heads to Governor's Desk. A measure legalizing industrial hemp production has been approved by the state legislature and now heads to the desk of Gov. Pat McCrory (R). The measure is Senate Bill 313. McCrory must veto it to block it; if he fails to act, it is approved.

Heroin and Prescription Opiates

An Overdose an Hour in Chicago Last Week. In the middle of last week, Chicagoans were overdosing on heroin, prescription opiates, or drug combinations at a rate of more than one an hour. Authorities reported responding to 74 overdose calls in 72 hours between last Tuesday and last Friday. ER doctors are suggesting that heroin cut with the powerful opioid fentanyl is behind the outbreak.


Feds to Free 6,000 Drug Prisoners at Month's End, More to Follow. The Justice Department has announced that some 6,000 federal drug war prisoners will get early release from prison between October 30 and November 2. Most will go to halfway houses and home confinement before being freed on supervised release. This is the result of actions by the US Sentencing Commission, which cut sentences for some drug offenders last year and later made the chance retroactive, affecting currently serving inmates. An estimated 46,000 of nearly 100,000 federal drug prisoners should eventually qualify for the program.


Colombia Will Continue to Use Glyphosate, Just Won't Aerially Spray It Anymore. Colombian police will continue to use the herbicide glyphosate to eradicate coca plants, even though it won't apply it with aerial sprays, the chief of police said. The National Narcotics Council outlawed aerial spraying earlier this year, after glyphosate was found to contain massive amounts of carcinogens, but eradicators will now spray by hand, Police Chief Rodolfo Palomino said. "We will continue with other forms of manual eradication and land fumigation with glyphosate," said Palomino.

Chronicle AM: Late Uncertainty on CA Initiatives, FL Heroin Deaths at Record High, More (10/2/15)

There are signs of dissension around the ReformCA legalization initiative, Oklahoma medical marijuana supporters are searching for signatures, a federal bill to require police to report lethal force incidents is introduced, and more.

Heroin killed a record number of people in Florida last year, but more died of prescription drug overdoses. (NJ State Police)
Marijuana Policy

Last Minute Uncertainties for California's ReformCA Initiative. There are signs the unified front behind the pending ReformCA legalization initiative isn't as unified as was thought. The LA Weekly is reporting that one of its key backers, the Drug Policy Alliance, might go its own way. "We want to have a plan B option that's ready to go in case [another] initiative doesn't represent and uphold the values and principles," said Lynne Lyman, the DPA's California director. "We're most concerned about a case where it doesn't move forward." DPA, NORML, and the Marijuana Policy Project had been listed on the ReformCA website as supporters; now they're not. MPP has confirmed that it asked for its name to be removed. But Dale Gieringer, a spokesman for ReformCA, downplayed the situation. "It's not that chaotic. It will all be clear in a few days. It's about last-minute negotiation."

Medical Marijuana

Oklahoma Initiative Signature Gathering Goes Forward. The Green the Vote medical marijuana initiative campaign was doing signature gathering in Ardmore Thursday. The group has 90 days to gather 130,000 valid voter signatures to qualify for the November 2016 ballot.

Heroin and Prescription Opiates

Florida Heroin Deaths at All-Time High. Heroin was detected in 447 fatalities last year, according to state medical examiners. That's more than double the 199 people who died with heroin in their bodies in 2013. Fentanyl was also surging; there were 538 deaths of people who had the powerful prescription opioid in their systems, nearly double the 292 from the previous year. While heroin deaths were at record levels, more than twice as many (978) people died with oxycodone in their systems. There were 8,587 fatal drug overdoses reported in Florida last year; many of them included multiple substances.

Drug Policy

New Hampshire GOP Lawmakers Want Online Drug Dealer Registry. Three GOP lawmakers have presented slightly different bills that would create an online drug dealer registry similar to sex offender registries, but advocacy groups said such a move is unfair and unnecessary. "It's a stupid, gratuitous and entirely unnecessary proposal," said Ethan Nadelmann, executive director of the Drug Policy Alliance. ''It reminds me of the sort of foolish rhetoric and foolish laws that flowed from back at the height of the drug war." Click on the title link for more detail.

Law Enforcement

Federal Bill Requiring Police to Report Use of Lethal Force Filed. Sen. Tim Scott (R-SC) Thursday filed S. 2112, "a bill to require law enforcement agencies to report the use of lethal force, and for other purposes."

Chronicle AM: CA on Verge of Regulating MedMJ, Federal No Mandatory Minimums Drug Bill Filed, More (9/11/15)

Nearly 20 years after the passage of Prop 215, California may finally get statewide medical marijuana regulation; the Illinois governor's veto pen has an impact, but also gets blunted; there's a new report on drug policy and human rights in Latin America, and more.

Rep. Maxine Waters (D-CA) has filed a bill to end mandatory minimum sentences for drug offenses. (house.gov)
Marijuana Policy

Illinois Decriminalization Bill Dies… For Now. The bill, House Bill 218, passed out of the legislature, only to be the subject of an amendatory veto by Gov. Bruce Rauner (R), in which he made several changes to the text of the bill. Now, the clock has run out on the legislature approving that language, but a new bill is expected to emerge and the state could still pass decriminalization this year.

Medical Marijuana

California Legislators Set to Pass Historic Medical Marijuana Regulation Package. Before day's end, the legislature is expected to approve bills that would finally bring statewide regulation to the thriving industry. The bills, Assembly Bill 266 and Senate Bill 643, are to be amended and passed today and then signed by Gov. Jerry Brown (D). Passage should create a full-fledged, highly regulated system with licensing for all stages of cultivation, production, distribution, and sales.

Illinois Governor Vetoes Medical Marijuana for PTSD. Gov. Bruce Rauner (R) Thursday vetoed a measure that would have allowed people with Post-Traumatic Stress Disorder to qualify for medical marijuana. His administration also refused to expand access to medical marijuana for 10 other ailments. The Illinois Medical Cannabis Advisory Board had recommended adding the 11 conditions, but Rauner killed PTSD and the Department of Public Health killed the rest. Rauner said expanding the program was premature.

Heroin and Prescription Opiates

Senators Call for Review of FDA Decision on Oxycontin for Kids. A bipartisan group of senators have asked the Senate Health, Education, Labor, and Pensions Committee to investigate the Food and Drug Administration's August decision to approve the use of the powerful pain reliever in pediatric patients. The senators called the FDA move "a step in the wrong direction" in the face of growing levels of opiate dependency and abuse.

Illinois Legislature Overrides Veto of Heroin Treatment Funding. The state Senate Wednesday voted 44-11 to override Gov. Bruce Rauner's (R) veto of portions of an omnibus heroin bill that would have mandated Medicaid paying for drug treatment for heroin users. The state House had already voted to override, so now the whole range of House Bill 1 will go into effect.

Asset Forfeiture

California Legislature Kills Asset Forfeiture Reform Bill. Under heavy lobbying pressure from law enforcement, the state Assembly Wednesday killed Senate Bill 443, which would have reformed civil asset forfeiture in the state. The bill had enjoyed bipartisan support and nearly unanimous votes prior to the final Assembly vote. But there is still a chance the bill will be reconsidered and passed today, the last day of the session. Stay tuned.


Senator Kelly Ayotte Introduces Bill to Increase Fentanyl Trafficking Sentences. Sen. Ayotte (R-NH) Thursday filed S. 2027 to increase penalties for the synthetic opioid. There are no particulars on the bill available yet.

Rep. Maxine Waters Introduces Bill to End Mandatory Minimums for Drug Offenses. Rep. Waters (D-CA) Thursday filed H.R. 3489, "to eliminate mandatory minimum sentences for all drug offenses." There are no particulars on the bill available yet.


New Report Examines Drug Policy and Human Rights in Latin America. The Argentine Center for Legal and Social Studies (CELS) has released a new report, The Impact of Drug Policy on Human Rights: The Experience of the Americas, covering a wide range of issues, from long prison sentences for minor drug offenses to the way harsh drug policies run counter to international human rights standards. The report also highlights how such policies have a disproportionate effect on the poor, minorities, and other vulnerable members of society.

Chronicle AM: Utah SWAT Raids Almost All Drugs, Bolivia Reduces Coca Growing (Again), More (8/18/2015)

A Wisconsin tribe may legalize marijuana, Ohio foes line up against the legalization initiative there, more Washington state dispensaries will be forced to close, a Utah SWAT reporting law shows what those squads are up to -- and it isn't hostage situations or "active shooters" -- Bolivia coca growing down, and more.

Bolivian President Evo Morales had a few choice words for US drug policy. (wikimedia.org)
Marijuana Policy

Ohio Legalization Initiative Foes Get Organized. Business, children's advocacy, parents, religious groups, and other groups organizing to defeat the ResponsibleOhio marijuana legalization initiative have formed an opposition organization, No on 3. Some are opposing it because of its limitations on who could grow commercial marijuana; others, like the Ohio Children's Hospital Association, have more traditional plaints: "The legalization of marijuana in Ohio at this time and the way issue three proposes would set too dangerous of a precedent and put at risk the other three million kids in the state," said Nick Lashutka, president of the association.

Wisconsin's Menominee Tribe to Vote on Legalizing Marijuana. The Menominee, one of the poorest tribes in the country, are set to vote this week on whether to legalize and sell marijuana. The move comes after the state rejected the tribe's plan to build a casino in Kenosha. The Menominee say they are interested in marijuana to "Explore all opportunities to diversify the tribe's economy, create jobs, and provide revenue to the tribe necessary to fund health, education, social, law enforcement and and other important services."

Medical Marijuana

Most Tacoma Dispensaries to Be Shut Down. The city council this week decided to shut down most of the city's 60 unregulated medical marijuana dispensaries. The dispensaries have 45 days to close. After passage of Senate Bill 5052, which essentially folds the medical marijuana system into the recreational marijuana system, dispensaries and collective gardens will have to get licenses from the state beginning next July 1 or shut their doors.

Heroin and Opioids

Massachusetts Officials Want to Jack Up Penalties for Fentanyl. State Attorney General Martha Healey joined legislators and law enforcement officials at a press conference Tuesday to press for legislation that would double prison sentences for people caught in possession of more than 10 grams of the synthetic opioid fentanyl. People caught with large amounts of heroin face up to 30 years, but under a lacuna in state law, people caught with large amounts of synthetic opioids can only be charged with possession with intent to distribute, with a maximum sentence of 10 years. "By criminalizing the trafficking of fentanyl, we will give police and law enforcement the tools they need to get this deadly drug off the streets and out of the hands of those struggling with addiction," Healey said. Some 1,200 people died of drug overdoses in the state last year, and another 312 in the first quarter of this year. [Ed: Why 10 years isn't more than enough for almost any law enforcement purpose, especially in a time of mass incarceration when that type of sentencing is coming under increasing criticism from across the political aisle, is not clear. How sad that a Democrat and former civil rights official in a liberal state is campaigning for longer sentences.]

Law Enforcement

Utah SWAT Reporting Law Shows Overwhelming Majority of Deployments Were for Drug Raids. Utah passed a SWAT reporting law last year, and now the first numbers are in. They show that SWAT teams were deployed nearly twice a day (559 reported incidents, with 25% of agencies failing to report) and, most startlingly, 83% of all SWAT deployments were to serve search warrants for drug offenses. Two-thirds (65%) of the drug raid SWAT deployments either "no-knock" or "knock and announce" raids where police force entry into homes without giving residents a chance to just let them in. Much more at the link.


Bolivia Coca Production Falls for Fourth Straight Year. The UN Office on Drugs and Crime announced Monday that the amount of land devoted to coca production dropped by 11% last year, continuing a trend that has seen land devoted to coca drop by more than a third since 2010. President Evo Morales touted his government's approach as more effective than the US-led war on drugs. "Eradication and fighting a war on drugs with military bases is not the solution, as we've seen in some Andean countries, where there are US officials waging the war on drugs," he said. He was referring to the world's two largest coca and cocaine producers, Colombia and Peru, where eradication efforts have provoked sometimes bloody strife.

Chronicle AM: Good New Pot Polls, State Dept. Drug Report Released, UN Iran Drug Aid Criticized, More (3/19/15)

A new national pot poll has good numbers and so does a Vermont poll, a Washington state home grow bill is filed, a Missouri hemp bill moves, the DEA warns on fentanyl, critics pounce on the UNODC over aid to Iran, and more.

UNODC is preparing a new drug aid package for Iran despite the country's resort to the death penalty. (handsoffcain.info)

Benenson Strategy Group Poll Has Support for Legalization at 61% Nationwide. The poll, which has a 3.5 +/- margin of error, also has 72% for decriminalization. A General Social Survey poll, the "gold standard" of polls, last week had support at 52%. Other recent polls have also found support above the 50% mark. In this week's BSG poll, Republicans were practically split, but 59% of GOP voters under age 50 supported legalization.

Massachusetts Initiative Group Warns Legislators on Excessive Taxation. The group Bay State Repeal, which intends to run a legalization initiative campaign next year, has released a statement saying it welcomed legislative efforts to legalize it, but cautioned against excessive taxation and fees. "A major aim of legalization is to limit access to minors by driving out the black market," the group said in its statement. "But inevitably, unlicensed producers will continue to supply consumers at the black market if legal marijuana is more expensive."

Vermont Poll Has Support for Legalization at 54%. A new Castleton Polling Institute survey has a majority for legalization, with 70% of respondents under 45 in favor and 61% of respondents over 65 opposed. The poll comes as the legislature considers a legalization bill, but signs are the bill will not move this year.

Washington State Bill Would Allow Home Grows. Washington is the only legalization state that does not allow home cultivation (except for medical), but a pair of bills introduced today would change that. Senate Bill 6083, sponsored by Sen. Jeanne Kohl-Welles, and House Bill 2196, sponsored by Rep. Brian Blake, would let adults 21 and over grow up to six plants and possess up to eight ounces of their harvest.

Medical Marijuana

North Carolinians Rally for New Medical Marijuana Bill in Raleigh. More than a hundred people rallied at the state capitol today in support of House Bill 317, which would allow for medical marijuana use by terminally ill patients. Rep. Kelly Alexander formally introduced it today.

Tennessee GOP Senator Says He Will File Medical Marijuana Bill. State Sen. Steve Dickerson (R-Nashville) said today he is working on a bill that would allow for medical marijuana. He said he expected to have final details by Monday. A Democratic bill in the House has yet to make it out of committee.


Missouri Hemp Bill Heads for House Floor Vote -- Maybe. An industrial hemp bill, H.B. 830 has passed its final House committee hurdle and awaits a House floor vote. But it is unclear whether House Majority Leader Todd Richardson (R-Poplar Bluff) will give it time for a debate and a vote.


DEA Warns on Fentanyl. Fentanyl is increasingly showing up in heroin, the DEA warned yesterday. The opioid is up to 50 times stronger than heroin, and dealers are using it to increase the potency of their products, but the result can be accidental overdoses. "Drug incidents and overdoses related to fentanyl are occurring at an alarming rate throughout the United States and represent a significant threat to public health and safety," said DEA administrator Michele Leonhart.


State Department Releases Annual International Narcotics Control Strategy Report. "The two-volume report offers a comprehensive assessment of the efforts of foreign governments to reduce illicit narcotics production, trafficking and use, in keeping with their international obligations under UN treaties, while also presenting information on governments' efforts to counter money laundering and terrorist financing," State says. Click on the link to read the report.

UNODC Preparing New Iran Aid Deal Despite Drug Executions. The UN Office on Drugs and Crime (UNODC) is planning a new five-year financial assistance deal with Iran, one of the world's leading executioners for drug crimes. Iran executed at least 350 drug offenders last year and about two a day so far this year. That has critics very unhappy. "Iran has hanged more than a hundred so-called drug offenders this year, and the UN has responded by praising the efficiency of the Iranian drug police and lining them up a generous five-year funding deal," said Maya Foa, strategic director of the death penalty team for Reprieve, a British advocacy group.

Israeli Marijuana Party Fails to Reach Threshold to Enter Knesset. Aleh Yarok, the Israeli political party pushing for marijuana legalization, failed to gain the 3.25% of the popular vote needed to give it representation in the Knesset. Aleh Yarok garnered only 38,000 votes, or 0.97% of the vote. The party may have lost some votes to Meretz, which appealed to youth voters by also embracing marijuana reforms.

Chronicle AM -- May 13, 2014

The DC marijuana legalization initiative picks up some welcomed support, there's a legal challenge to Washington state's ability to collect marijuana taxes, a Republican US senator talks drug reform and takes some jabs at Obama, fentanyl-laced heroin is killing people in Philadelphia, and more. Let's get to it:

Marijuana Policy

Two Drug Reform Groups Get Behind DC Legalization Initiative. The Drug Policy Alliance has hired Dr. Malik Burnett as a full-time organizer in Washington, DC, to build support for Initiative 71, the DC marijuana legalization initiative. But his work in DC will also go beyond marijuana policy to include broader drug and social justice reform issues. Meanwhile, StoptheDrugWar.org (that's us) has endorsed the initiative and is seeking to deliver 5,000 of the 25,000 signatures needed. You can sign up to donate to our initiative effort here or sign up to volunteer here. Or click on the endorsement link for more information. Click the title link for more info about the DPA move.

Washington State Lawsuit Challenges State's Ability to Collect Marijuana Taxes. A Washington dispensary operator has filed a lawsuit attempting to stop the state from collecting taxes on marijuana sales. The operator, Martin Nickerson, is being prosecuted for the sale of medical marijuana he produced and argues that forcing him to pay taxes on his marijuana sales would violate his 5th Amendment right against self incrimination. He is represented by Douglas Hiatt, a Seattle marijuana and medical marijuana defense attorney and ardent foe of the I-502 legalization scheme. I-502's main proponent, Alison Holcomb, said she thinks the lawsuit has little chance of succeeding.

Ohio Supreme Court Forum to Discuss "Unintended Consequences" of Legalization Today. A discussion on "Marijuana Legalization and the Law of Unintended Consequences" moderated by state Supreme Court Justice Maureen O'Connor will take place today at 5:30pm at the Ohio Supreme Court in Columbus. Panelists are Colorado Deputy Atttorney General David Blake, Ohio State law professor and Sentencing Law and Policy blog author Douglas Berman, and Marijuana Policy Project director of federal policies Dan Riffle. Questions can be submitted via Twitter using hashtag #OhioFOTL.

Illinois Drug Policy Consortium to Discuss New Marijuana Policy Report Monday. The IDPC will have a panel discussing its new report on marijuana policy, Patchwork Policy: An evaluation of arrests and tickets in Illinois, next Monday, the day it is released. Click on the link for more info, including time and location details.

Medical Marijuana

Iowa Governor Likely to Sign Limited CBD Medical Marijuana Bill. Gov. Terry Brandstad (R) told a news conference Monday he has consulted with the governors of other states that have passed limited CBD medical marijuana bills and he thinks Iowa can move forward without "unintended consequences." He gave the legislature credit for crafting a very tight bill. "I think it's important that we respond to legitimate concerns from the public but we also have to protect against unforeseen consequences. I think the legislature in this case has tried to do that. My inclination at this point is to say that I'm inclined to think that it's likely that I will sign it," he said. The bill is Senate File 2360.

Drug Policy

Republican Senator Rob Portman Talks Drug Reform. Sen. Rob Portman (R-OH) is set to give a speech today at the American Enterprise Institute in Washington, DC, in which he will reportedly call for a reassessment of the decades long war on drugs. He will also reportedly criticize President Obama's plan to grant clemency to hundreds or thousands of convicted drug offenders, calling it a "band aid solution" that doesn't address deeper problems driving recidivism. He will also advocate for reauthorization of the Second Chance Act, which is aimed at reducing recidivism. Portman could have national ambitions in 2016.


Fentanyl-Laced Heroin Killing People in Philly. At least 28 people in Philadelphia died from overdosing on fentany-laced heroin between March 3 and April 20, the Department of Behavioral Health and Intellectual Disability said Monday. The department is awaiting test results on seven more people. Fentanyl is a powerful narcotic many times more potent than heroin and is used to treat severe pain. An earlier wave of fentanyl-laced heroin killed 269 people in the city in 2006 and more than 2,000 people nationwide. The city health department has issued an alert.


Zetas Co-Founder Among Six Killed in Mexican Border Town Shootout. Gallando Mellado Cruz, one of the military deserters who helped found the gang of drug enforcers for the Gulf Cartel that morphed into the Zetas, was among six people killed in a gun battle between Mexican soldiers and cartel gunmen in the border town of Reynosa, Tamaulipas, just across the Rio Grande River from McAllen, Texas. Four other cartel gunmen and one soldier also died. Tamaulipas was the scene of bloody infighting between the Zetas and the Gulf cartel before calming down somewhat in 2012, but fighting has broken out again in recent weeks.

Canada's Sensible BC Announces Future Plans. The Canadian marijuana law reform group Sensible BC, which managed to gather more than 200,000 signatures for a provincial referendum to stop arrests for pot possession in BC, but still failed to make the ballot, has announced it will hold off on another referendum campaign until after the federal election in October 2015. Then, if Conservative Prime Minister Steven Harper wins reelection or if his replacement refuses to move forward on legalization, the group says it will launch a new referendum campaign in 2016. Until then, Sensible BC says it will focus on building its network and organization, keeping the issue alive in the media, and working on municipal elections coming in November.

Chronicle Book Review: The Power of the Poppy

The Power of the Poppy: Harnessing Nature's Most Dangerous Plant Ally, by Kenaz Filan (2011, Park Street Press, 312 pp, $18.95 PB)

Kenaz Filan thinks that Poppy (always capitalized in the book) is a sentient being. Before you roll your eyes as you recall the fervent mushroom cultists who say the same sort of thing, recall also that more mainstream authors, such as foodie Michael Pollan, have been known to talk like that, too, posing similar questions about what plants want. I'm not personally convinced about the sentience of plants, but I find that adherents of such a position definitely bring something of value to the table: respect for their subjects.

The opium poppy certainly deserves our respect. It can bring miraculous surcease from suffering through the pain-relieving alkaloids within, but those same alkaloids can also bring addiction, oblivion, and death. Our "most dangerous plant ally" can be both kindness and curse, boon and bane. Only by respecting Poppy, writes Filan, can we learn how best to manage our relationship with her.

The Power of the Poppy is part historical treatment, part cultural essay, part pharmacopeia, part practical guide. As such, positions on plant consciousness notwithstanding, it's a fascinating and illuminating treatment of the poppy and its derivatives. Filan traces the history of man's relationship with poppy from 6,000-year-old archeological digs in Europe, through early uses in the Roman empire and the Islamic world, and on to the current era of the war on drugs.

While Filan addresses the war on drugs and finds it stupid, this is not mainly a book about drug policy, and he dismisses the issue in short order. "Our war on drugs has been a one-sided rout," he writes in the introduction. "We keep saying 'no' to drugs, but they refuse to listen."

In his few pages devoted to the past century of opium prohibition, he reiterates the futility of trying to stamp out poppy even as its cultivation spreads. "Poppy is happy to fulfill our needs as long as we propagate her species," he writes. "To her, our 'war' is like locust invasions and droughts -- an annoyance, but hardly something that will endanger the continued existence of her children."

From there, Filan turns to the chemistry and pharmacology of opium and its derivatives and synthetics. He traces the isolation of morphine, codeine, heroin, thebaine (from which is derived hydromorphone [Dilaudid], oxymorphone [Opana], hydrocodone [Vicodin], and oxycodone [Oxycontin]), kompot (East European homebrew heroin), methadone, and fentanyl. Along the way, Filan touches on such topics as the lack of pain-relieving poppy products in the developing world, the development of Oxycontin and the rapid spread of "hillbilly heroin," and controversies over needle exchanges, safe injection sites, and methadone maintenance therapies.

In nearly every case of the development of a new opiate or opioid drug, researchers were hoping to find a substance that maintains poppy's analgesic qualities while eliminating or at least reducing its addictive ones. No such luck. "Despite the best efforts of our chemical minds," Filan writes, "Poppy still demands her bargain…Even as we go to war with Poppy, we are forced to do business with her."

In his next section, demonstrates the bargain poppy extracts as he profiles 11 famous users, including Confessions of an Opium Eater author Thomas de Quincy, Samuel Taylor Coleridge, William Burroughs, Lou Reed (whose Velvet Underground-era Heroin and Waiting for My Man put the 1960s New York junkie experience to music), and DJ Screw, whom I must confess I never heard of until reading The Power of the Poppy. Mr. Screw, whose real name, it turns out, was Robert Earl Davis, was a Houston DJ who rose to hip-hop fame after smoking Mexican weed and accidentally hitting the pitch button as he mixed tapes. The ensuing distorted vocals and slowed down beats became known as "screwed down" and Davis picked up the moniker DJ Screw.

Among the favorite topics of Screw and his crew was "purple drank," a concoction of soda pop, codeine cough syrup, and Jolly Ranchers candy, that created a warm, relaxed high. Screwed down music was the perfect accompaniment for a drank-fueled evening. While DJ Screw died young, in part because of his fondness for drank, he was also an overweight, fried-food loving smoker. While drank may have helped make DJ Screw, as always, poppy exacted her part of the bargain.

In the final segment of the book, Filan gets practical. He describes how to grow your own (from papaver somniferum seeds widely available at gardening stores) and how to extract the raw opium. He describes poppy tea brewing recipes, as well as how to use poppy in pill, tablet, or capsule form; as well as eating smoking, snorting, and shooting it. And he doesn't stint on explaining the dangerous path one is on when one embraces the poppy. Although I don't recall Filan ever using the words harm reduction, he is all about it as he cautions about overdose, dependency, and addiction.

The Power of the Poppy elucidates the many ways the histories of man and poppy are intertwined, and it's full of interesting tidbits along the way. Who knew that the use of "dope" to mean drugs came from Dutch sailors mixing opium and tobacco off China in the 17th Century? They called the mixture "doep," like a greasy stew they ate. Or that calling seedy establishments "dives" derived from scandalized descriptions of California opium dens, with the patrons reclining on divans? Or that the scientific name for snorting is "insufflation"?

If you have an interest in opium and its role in human affairs, The Power of the Poppy will be both entertaining and enlightening. And -- who knows? -- maybe you'll start treating that plant and its derivatives with the respect they deserve.

Pain Management: FDA to Tighten Regulation of Extended-Release and Patch Opioid Meds

The Food & Drug Administration (FDA) is beginning a "massive new program" to reduce overdoses, diversion, and inappropriate use of powerful opioid pain relievers, especially targeting extended-release and patch formulations of fentanyl, methadone, morphine, oxycodone, and oxymorphone. On Monday, the FDA announced it had sent letters to 16 drug companies who produce the 24 listed products informing them they would now have to create a Risk Evaluation and Management Strategy (REMS) "to ensure that the benefits of the drugs continue to outweigh the risks."

That means physicians are likely to face new procedures in prescribing the drugs, and patients are likely to face more hurdles in obtaining them, an FDA official said at a Monday press conference. But pain patients already face serious obstacles in obtaining relief. The FDA action comes in the context of a campaign by the DEA to crack down on doctors it deems to have improperly prescribed large amounts of opioid pain medication -- even though prescribing what at first glance appear to be extremely large amounts is well with standard pain relief practice. Physician's fears of being prosecuted have contributed to what pain patient advocates describe as a crisis in chronic pain relief.

"Pain patients aren't drug abusers looking for a prescription fix," said Gregory Conko, senior fellow at the Competitive Enterprise Institute, which teamed up with the Pain Relief Network last May to create the Politics of Pain campaign to fight for patients' access to sufficient pain medications. "It's a genuine tragedy that the DEA often treats them and their doctors as if they were. It's as though the agency just doesn't care whether its single-minded waging of the war on drugs imposes collateral damage."

The Politics of Pain campaign has collected personal stories from physicians and patients who have explained firsthand how difficult it can be to either offer or find sufficient treatment for pain conditions. In one video interview, Gulf War veteran James Fernandez and his wife tell their story of how he, once a robustly healthy US Marine, is now virtually confined to his home because of severe, ongoing pain that has been under-treated for years.

In another interview, Dr. Alexander DeLuca, a board-certified specialist in addiction medicine, describes the obstacles faced by a physician trying to deliver the "standard of care" called for by his own medical training. According to DeLuca, virtually no patients in the country today receive proper treatment for chronic pain.

Still, there are a lot of pain pills out there. Last year, US pharmacies dispensed 21 million prescriptions for the 24 medications listed to 3.7 million patients. "This is a very extensively used group of medications," said Dr. John Jenkins, director of the FDA's Office of New Drugs at its Center for Drug Evaluation and Research. "This will be a massive new program."

Jenkins said that abuse, misuse, and accidental overdoses involving those products had been on the rise over the last decade, and the agency is concerned about doctors inappropriately prescribing them for patients who are not suffering moderate or severe chronic pain.

"We continue to see case reports where someone with a sprained ankle receives a fetanyl patch or extended-release opioid," Jenkins said.

Dr. Bob Rappaport, director of FDA's division of anesthesia, analgesia, and rheumatology products, told the press conference the agency was also deeply concerned with the rising non-medical use of the opioids. He cited a Substance Abuse and Mental Health Services Administration (SAMHSA) report released Monday that showed some 5.2 million people said they had used prescription opioids for non-medical purposes in the past month, and that the figure among 18-to-24-year-olds had increased from 4.1% in 2002 to 4.6% in 2007.

"This is an ongoing problem, and it's getting worse," Rappaport said.

Forcing the drug manufacturers to submit REMS plans is "our attempt to ensure the benefits outweigh the risks," Jenkins said. The agency will seek to find an "appropriate balance between legitimate patient need for such drugs and the threats caused by the abuse and misuse," he added.

But tighter regulation isn't going to happen right away; a series of meetings with various stakeholders over the coming months are being set up to arrive at final regulations, said Jenkins. They will include patient advocates, health care professionals, the pharmaceutical companies, and law enforcement. The first meeting with manufacturers is set for March 3. Hopefully the concerns of patient advocates get heeded and successfully addressed, but it's not clear whether that is even possible with a venture of this nature given the current enforcement climate.

Fentanyl timeline: 1950 through today

United States
Detroit Free Press (MI)

Public Health: DEA Puts Fentanyl OD Death Toll at More Than a Thousand

Last year's wave of overdose deaths from heroin cut with fentanyl, a powerful synthetic opioid pain reliever, killed more than a thousand people, according to the US Drug Enforcement Administration (DEA). The deaths began early in the year in the Mid-Atlantic states before spreading to the Midwest, with significant clusters in Chicago and Detroit.

fentanyl packet
Early official responses to the wave of deaths was slow and spotty, but concern spread as the death toll mounted. By December, more than 120 public health experts signed an open letter to Health and Human Services Secretary Mike Leavitt calling for a more aggressive response. The deaths have continued, but not at the torrid pace of last fall and summer.

The DEA estimate of the death toll came in an interim rule regulating a fentanyl precursor chemical, N-phenethyl-4-piperidone (NPP), published in
Monday's federal register. "The recent distribution of illicitly manufactured fentanyl has caused an unprecedented outbreak of hundreds of suspected fentanyl-related overdoses, at least 972 confirmed fentanyl-related deaths, and 162 suspected fentanyl-related deaths occurring mostly in Delaware, Illinois, Maryland, Michigan, Missouri, New Jersey, and Pennsylvania," the agency reported.

Noting that fentanyl is 30 to 50 times more powerful than heroin, the DEA went on to warn of its dangers. "The legitimate medical use of fentanyl is for anesthesia and analgesia, but fentanyl's euphoric effects are highly sought after by narcotic addicts," the agency explained. "Fentanyl can serve as a direct pharmacological substitute for heroin in opioid dependent individuals. However, fentanyl is a very dangerous substitute for heroin because the amount that produces a euphoric effect also induces respiratory depression. Furthermore, due to fentanyl's increased potency over heroin, illicit drug dealers have trouble adjusting ("cutting") pure fentanyl into proper dosage concentrations. As a result, unsuspecting heroin users or heroin users who know the substance contains fentanyl have difficulty determining how much to take to get their "high" and mistakenly take a lethal quantity of the fentanyl. Unfortunately, only a slight excess in the amount of fentanyl taken can be, and is often, lethal because the resulting level of respiratory depression is sufficient to cause the user to stop breathing."

The death toll suggests the DEA is not exaggerating in this instance. Let's be careful out there, kids.

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