Prescription Opiates

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

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

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

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

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

Asset Forfeiture

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

Heroin and Prescription Opioids

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

International

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

Chronicle AM: Key Pot Issues Dividing MA Pols, Bolivia's Morales Says Some Coca Diverted, More... (6/27/17)

Massachusetts lawmakers are slugging it out over what legalization will look like this week, Bolivia's president acknowledges and decries the diversion of coca to the black market, and more.

Evo acknowledges and decries the diversion of Bolivian coca t the black market, and says he enjoys coca flour. (Wikimedia)
Marijuana Policy

Massachusetts Legalization Implementation: What Divides the House and Senate. As legislators work this week to seek compromise between competing legalization implementation bills passed by the House and Senate, six major issues are at play. They are: tax levels (the House wants more), whether localities need to put marijuana bans to a popular vote, expungement of past marijuana convictions (the House doesn't address it; the Senate does), governance structures, safety and packaging regulations, and racial equity provisions.

Virginia Marijuana Driving Law Goes Into Effect on Saturday. A law that ends automatic drivers' license suspensions for marijuana offenders  goes into effect Saturday. Instead, judges will have the option of ordering community service instead of license suspension for marijuana offenders who were not behind the wheel when busted.

Heroin and Prescription Opioids

Kentucky Tighter Opioid Prescribing Rules Go Into Effect Friday. A new law restricting the prescribing of Schedule II opioids goes into effect Friday. Under the new law, patients being treated for acute pain will be prescribed no more than a three-day supply, with a number of specified exceptions.

International

Bolivia's Morales Acknowledges, Decries Coca Being Diverted to Black Market. In his closing remarks at last weekend's Coca Fair in Cochabamba, Bolivian President Evo Morales acknowledged and decried the diversion of coca into the cocaine black market. "Unfortunately, part of the coca crop goes to an illegal coca market in the West," Morales said. He also called for continued coca industrialization, saying it would bring economic benefits to Bolivia, and revealed that he consumes coca flour daily. "I’m not ashamed, since last year I have eaten coca flour twice a day, that’s how I can build up my stamina," he said.

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

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

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

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

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

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

Medical Marijuana

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

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

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

Heroin and Prescription Opioids

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

Chronicle AM: NV Syringe Vending Machines, Good and Bad CO MJ Bills, More... (4/17/17)

Nevada will soon see the first syringe vending machines in the country, the Colorado legislature responds to a threatened federal crackdown -- for better and worse -- Wisconsin Gov. Scott Walker is moving forward with plans to drug test Medicaid recipients, and more.

Syringe vending machines -- coming first to Nevada. (wikimedia.org)
Marijuana Policy

A Majority of American Adults Have Tried Marijuana, Poll Finds. A new Marist/Yahoo poll finds that 52% of American adults have tried marijuana at least once, and that 56% find the drug "socially acceptable. The same poll has support for legalization at 49%, with 47% opposed.

DC Marijuana Activists to Hand Out Free Joints on Capitol Hill for 4/20. The same folks who brought legal marijuana to the nation's capital are planning to hand out more than a thousand free marijuana joints on Capitol Hill Thursday, 4/20, the unofficial marijuana holiday. Anyone over 21 who has a congressional ID is eligible for the free weed, said DCMJ. The activists said the action was meant to life the "special interest smokescreen" blocking marijuana reform in Congress.

Homeland Security Chief Says Marijuana "Not a Factor" in Drug War. DHS Secretary John Kelly said Sunday that marijuana is "not a factor" in the country's drug war and that "arresting a lot of users" will not solve the country's drug problems. Kelly responded to a question about whether legalizing marijuana in the US would help or hinder his work attempting to interdict drug shipments to the US. "Yeah, marijuana is not a factor in the drug war," Kelly responded, adding later: "It's three things. Methamphetamine. Almost all produced in Mexico. Heroin. Virtually all produced in Mexico. And cocaine that comes up from further south." And rather than arresting users: "The solution is a comprehensive drug demand reduction program in the United States that involves every man and woman of goodwill. And then rehabilitation. And then law enforcement. And then getting at the poppy fields and the coca fields in the south."

Colorado Social Consumption Bill Dies. A bill that would have set up the country's first statewide law allowing for on-premises marijuana consumption at licensed businesses is dead, with legislators citing fear of a federal crackdown for its demise. The House voted last Thursday to amend Senate Bill 17-184 to remove the provision that would have allowed adults to bring their own weed to businesses and consume it on-premises.

Colorado Senate Approves Bill to Shift Legal Marijuana Inventories Over to Medical Marijuana in Event of Federal Crackdown. The state Senate has approved Senate Bill 17-192, which would allow adult-use marijuana businesses to transfer their inventory to medical marijuana status if a federal crackdown on adult-legal weed happens. The bill now goes to the House.

Nevada Legislature Still Faces Heavy Load of Marijuana Bills. The legislative session marked its first key deadline last Friday when all proposed bills had to have passed out of their committee of introduction or be declared dead. And fourteen marijuana-related bills remain alive, including one, Senate Bill 302, that would allow dispensaries to begin selling marijuana to any adult beginning in July. Click the link for the rest of the bills and their status.

Tennessee Governor Signs Bill Killing Decrim in Memphis and Nashville. Gov. Bill Haslam (R) last Friday signed into law House Bill 173, which bars cities in the state from crafting marijuana penalties lesser than state law. The bill was a response to moves by the state's two largest cities, Memphis and Nashville, which had passed municipal decriminalization ordinances.

Medical Marijuana

Arkansas Regulators Finalize Medical Marijuana Rules. The state Medical Marijuana Commission last Tuesday gave final approval to rules governing dispensaries and cultivation facilities. The rules must still be approved by the legislature, which has passed some legislation that appears to conflict with them. The legislature only has until May 8 to modify the rules or the state will be out of compliance with the Medical Marijuana Act, which is now part of the state constitution.

Heroin and Prescription Opioids

Alabama House Approves Tougher Penalties for Heroin, Fentanyl. The House voted last week to approve harsh new penalties for the possession and sale of heroin and fentanyl. In a unanimous vote, the chamber approved a one-year mandatory minimum sentence for simple possession and increased penalties for trafficking, including a mandatory life sentence without parole for trafficking 10 or more kilos of either drugs. The bill is House Bill 203, which is now before the Senate.

Maryland General Assembly Passes Package of Heroin/Opioid Bills. The Assembly last week approved a package of bills aimed at tackling the state's heroin and prescription opioid crisis. One bill would create 24/7 drug treatment centers for addicts, increase reimbursements for drug treatment, and ease access to the opioid overdose reversal drug naloxone. A second bill would create drug awareness programs in schools and allow school nurses to stock and dispense naloxone. A third bill would require doctors to follow best practices when prescribing opioids, while a fourth bill increases prison sentences for people convicted of fentanyl offenses. The bills now await the governor's signature.

Asset Forfeiture

Arizona Governor Signs Civil Asset Forfeiture Reform Bill. Gov. Doug Ducey (R) last week signed into law House Bill 2477, which requires a higher evidentiary standard before police and prosecutors can seize assets from suspects. Instead of a "preponderance" of the evidence, cops must now provide "clear and convincing evidence" that the assets are linked to a crime.

Drug Policy

New York City Council Passes Bill to Coordinate Drug Policy Among City Departments. The city council recently passed legislation to create a coordinated municipal drug strategy. The bill empowers the Mayor to designate a lead agency or office to convene stakeholders including city agencies, outside experts, and communities impacted by drug use to develop a city-wide, health-focused plan for a coordinated approach in addressing issues related to drug use.

West Virginia Legislature Passes Bill Creating Drug Policy Office. A bill that would create an Office of Drug Control Policy within the Department of Health and Human Services has passed both houses of the legislature and awaits the governor's signature. The measure, House Bill 2620, passed last Friday, the final day of the session. Gov. Jim Justice (D) has fifteen days to sign the bill.

Drug Testing

Wisconsin Governor Moving Forward With Plan to Drug Test Medicaid Recipients. Gov. Scott Walker (R) on Monday posted his proposal for moving people off state Badgercare Medicaid, which includes a provision requiring drug screenings for Medicaid recipients. People suspected of illegal drug use after screening would be ineligible for coverage until they are tested. People who test positive would be offered drug treatment, while people who refuse the test would lose benefits for six months.

Harm Reduction

Nevada Becomes First State to Install Needle Vending Machines. In a bid to combat the spread of HIV/AIDS and Hep C, a needle exchange program in Las Vegas is now providing clean needles in vending machines. The Las Vegas Harm Reduction Center worked together with the Southern Nevada Health District and the Nevada AIDS Research and Education Society to install the new machines. Each client will be limited to two kits per week, with the kits including syringes, alcohol wipes, condoms, and a needle disposal box.

International

Canada Unveils Plan for Legal Marijuana Sales by June 2018. The Liberal government of Prime Minister Justin Trudeau last Thursday filed legislation designed to implement marijuana legalization by June of next year. The bill would allow adults 18 and over to possess up to 30 grams of dried marijuana and would allow the federal government to regulate producers, while the provinces would regulate sales to consumers. Other issues, such as pricing, taxation, and packaging are still to be worked out.

Trump Drug Czar Nominee: Tough on Colombian Peasants and US Marijuana Users

President Trump will name Pennsylvania Congressman Tom Marino (R) to head the Office of National Drug Control Policy (ONDCP -- the drug czar's office), CBS News reported Tuesday. The White House gave no official comment, but sources told CBS that an official announcement would come soon.

Reported drug czar nominee Rep. Tom Marino (R-PA) (marino.house.gov)
Marino's legacy of legislative achievements around drug policy offers little comfort to reformers looking for signs that the "law and order" theme of the Trump administration may not be as bad as it sounds. Marino is a former prosecutor now in his third term in the House. His 2016 Transnational Drug Trafficking Act expands the ability of US prosecutors to use extraterritoriality to go after international drug traffickers, but while the law is touted as aiming at "kingpins," but observers south of the border have argued that the law "targets people on the lowest rungs of the trafficking ladder, i.e. Colombia's coca farmers." Marino has also been a reliable vote in opposition to marijuana reform in Congress.

Marino's rural congressional district has seen rising concern about heroin and opioids, and he serves on the House bipartisan committee combating the opioid epidemic. A bill he was an author and key supporter of in that area may suggest a more complex picture -- the 2016 Ensuring Patient Access and Effective Drug Enforcement Act, which supporters characterized as balancing the needs of patients, the pharmaceutical industry, and law enforcement, but which critics describe as a means of undercutting the DEA's ability to hold pharmaceutical drug distributors accountable for the diversion of large amounts of opioid pain relievers.

The ability of pain patients to have access to the drugs that can help them is a continuing -- and under-covered -- issue in the debate around prescription opioids. So is the ability of physicians to appropriately prescribe them within running afoul of regulatory authorities or even drug enforcement authorities. If Marino's bill reflects a concern with such issues, or a more general willingness to treat DEA pronouncements on such matters with skepticism, that could be useful. Conversely, however, the nation is also in the midst of a much more well-covered increase in the misuse of opioids. ONDCP has a role to play in promoting public health measures that can reduce overdoses and the risk of addiction. If Marino is too deferential to the preferences of big pharma lobbyists, while otherwise hooked on hard-line drug war approaches, opportunities to advance positive approaches for reducing the risks that go with opioids may be squandered.

In the fight over the 2016 Act, Marino, as chairman of the House Judiciary Committee on Regulatory Reform, clashed repeatedly with DEA Office of Diversion Control head Joseph Rannazzisi. In a 2014 conference call with congressional staffers, Rannazzisi warned that the bill, backed by a pharmaceutical industry lobbying campaign, would protect corporations engaged in criminal activity.

"[If t]his bill passes the way it's written we won't be able to get immediate suspension orders, we won't be able to stop the hemorrhaging of these drugs out of these bad pharmacies and these bad corporations," Rannazzisi recalled telling them. "What you're doing is filing a bill that will protect defendants in our cases."

Rannazzisi's opposition infuriated Marino, who ripped into the veteran DEA official's boss, then-DEA Administrator Michele Leonhart at a congressional hearing later that year.

"It is my understanding that Joe Rannazzisi, a senior DEA official, has publicly accused we sponsors of the bill of, quote, 'supporting criminals,' unquote" Marino said. "This offends me immensely."

A week later, Marino and Rep. Marsha Blackburn (R-TN) demanded that the Justice Department Office of the Inspector General investigate Rannazzis for "intimidating" members of Congress. Rannazzissi was replaced and retired in October 2015.

Marino's record is good enough for anti-marijuana crusader and former ONDCP advisor Kevin Sabet of Smart Approaches to Marijuana (Project SAM). "My understanding is that Tom has a deep understanding of the issue and is excited to get started," he enthused to CBS News.

But it's not good enough for anyone interested in a truly progressive approach to drug policy.

Chronicle AM: Uruguay Legal Pot Sales to Start in July, ID Gov Vetoes Forfeiture Reform, More... (4/7/17)

The Uruguayan government sets the date for legal marijuana sales in pharmacies to begin, West Virginia is just a governor's signature away from becoming the 29th medical marijuana state, Idaho's Republican governor vetoes a broadly-supported asset forfeiture reform bill, and more.

Marijuana Policy

Montana Bill to Study Marijuana Legalization Filed. State Rep. Mary Dunwell (D-Helena) filed House Joint Resolution 35 on Thursday. The bill calls for "a study of the legalization and control of marijuana," with results to be reported to the next session of the legislature. The study would include input from the Departments of Public Health and Human Services, Justice, Revenue, and Agriculture, as well as local law enforcement, courts, schools, and lobbying groups.

Medical Marijuana

Arizona Appeals Court Strikes Down Criminal Ban on Possession of Medical Marijuana on College Campuses. The state Court of Appeals ruled on Thursday that even though colleges and universities can bar the possession of medical marijuana through administrative means, the state cannot make on-campus possession a criminal offense. The state's medical marijuana law barred its possession in prisons, schools, and on school buses, but the legislature in 2012 added college campuses to the list. Now, the appellate court has ruled the state couldn't do that. The case is Arizona v. Maestes.

Ohio Medical Marijuana Grower Applications Will Be Accepted Starting in June. The state Department of Commerce will begin accepting applications for 24 medical marijuana grow licenses beginning in June, the department announced on Friday. Once licenses are awarded, holders will have nine months to meet all requirements. Application forms and instructions should be released in the next two to three weeks, the department said.

West Virginia Medical Marijuana Bill Heads to Governor's Desk. The Mountaineer State is poised to become the 29th medical marijuana state after the legislature gave final approval to Senate Bill 386 Thursday, sending the measure to the desk of Gov. Jim Justice (D). The bill would set up a dispensary system, but does not authorize patients to smoke marijuana or grow their own.

Heroin and Prescription Opioids

Kentucky Bill to Raise Heroin, Fentanyl Penalties Awaits Governor's Signature. The General Assembly last week approved House Bill 333, which would increase penalties for the sale of heroin, fentanyl, or carfentanil. Under current laws, adopted as sentencing reform measures in 2011, traffickers face one to five years in prison. Under this bill, they would face five to 10 years in prison. The bill is currently on the desk of Gov. Matt Bevin (R).

Asset Forfeiture

Idaho Governor Vetoes Asset Forfeiture Reform. Gov. Butch Otter (R) on Thursday vetoed House Bill 202, a civil asset forfeiture reform bill that passed the legislature with broad bipartisan support. The bill would have ended asset forfeiture absent a criminal conviction, as well as imposing reporting and other requirements on law enforcement. The governor insisted there is no problem to fix, although lawmakers clearly disagreed.

Drug Policy

Beto O'Rourke Leads Bipartisan Bill that Repeals Federal Transportation Law Requiring States to Suspend Driver's Licenses for Drug Offenses. US Rep. Beto O'Rourke (D-TX) and five bipartisan cosponsors have filed House Resolution 1952, which would repeal a 26-year-old federal law that mandates states to automatically suspend driver's licenses for anyone convicted of a drug offense or risk losing federal highway aid money. Some 38 states have already opted out of that program, but 12 states -- including Texas, New York, Michigan, and Florida -- still comply with the requirement.

Rand Paul, Elijah Cummings File Bills to Seal Criminal Records for Federal Nonviolent Offenses. US Sen. Rand Paul (R-KY) and US Rep. Elijah Cummings (D-MD) have filed identical bills in the Senate and House to seal the federal criminal records of non-violent offenders, which includes tens of thousands of federal drug offenders. The measures are Senate Bill 827 and House Resolution 190, respectively.

International

Uruguay to Allow Marijuana Sales at Pharmacies Beginning in July. The office of President Tabare Vasquez said Thursday that legal marijuana sales through pharmacies will begin in July. That's the last step in implementing a 2013 law that made Uruguay the first country to legalize marijuana. While other parts of the law have been in place, pharmacy sales had been on hold under Vasquez, who isn't nearly as enthusiastic about legalization as was his predecessor, Jose "Pepe" Mujica, who shepherded the law to passage during his term. A gram of weed will go for $1.30.

Four Out of Five French Presidential Candidates Support Marijuana Reform. The leading candidate, centrist Emmanuel Macron, and the rightist candidate, Francois Fillon, both support decriminalizing marijuana possession, leftist candidates Jean-Luc Melenchon and Benoit Hamon have both called for marijuana legalization, while only far-right candidate Marine LePen favors the status quo, which calls for up to a year in jail for the possession of any drug.

One Simple Way to Reduce Deadly Heroin and Pain Pill Overdoses

The United States is in the grips of the worst drug overdose crisis ever, with prescription opioids and illicit opiates like heroin killing tens of thousands of people each year, but many of those people aren't dying from opioids alone. Another class of prescription drugs is too often involved.

Those drugs are the benzodiazepines -- with brand names like Valium and Xanax -- and are prescribed by the millions to treat anxiety, They can be deadly on their own, with federal data showing nearly 9,000 fatal benzo ODs in 2015. But here's the kicker: Nearly half of all fatal benzo ODs involve both them and opioids.

And a new study published in the British Medical Journal provides further evidence of the risks of doing benzos and opioids together. That study drew on a sample of more than 300,000 patients continuously enrolled in private health insurance plans between 2001 and 2013, and researchers looked at emergency room visits for drug overdoses among those prescribed only opioids versus those prescribed both opioids and benzos.

The results were dramatic: People prescribed both types of drugs had nearly double the risk of an ER or inpatient visit for a drug overdose. Based on the results, researchers estimated that cutting benzo prescriptions for opioid users reduced the risk of ER visits by 15%. If that figure holds true for overdose deaths, some 2,630 opioid-related overdose deaths could have been prevented in 2015 alone.

The policy implications are clear, said study coauthor and Stanford University drug policy expert Keith Humphreys: Don't prescribe benzos to people being prescribed opioids.

"Even if we didn't change opioid prescribing at all, the data here suggest that we could cut overdoses dramatically just by getting prescribers to not put people on a benzodiazepine at the same time," Humphreys said.

That would require a real shift in prescribing practices. The number of patients in the study being prescribed both benzos and opioids nearly doubled between 2001 and 2013, from 9% to 17%.

Reducing co-prescriptions could be problematic for some patients. If they are suffering both pain and anxiety, they and their doctors will have to work together to decide which issue is most serious and which could be treated with alternatives. But making such tough choices could lead to a reduced risk of fatal overdose.

The BMJ study has its limits. It looked only at legally prescribed benzos and opioids, missing the effects of concurrent use of illicit drugs, and it looked only at ER and inpatient visits, not fatal overdoses. And it only demonstrated correlation, not causation. It's possible some factor other than co-prescribing was driving up overdose rates among study patients, but given that the overdose risks of mixing benzos and opioids are well established, suggesting that co-prescribing them results in increased overdoses is not exactly controversial.

Doctors can do their part to reduce the number of overdose deaths by reducing benzo and opioid co-prescribing, but since much benzo and opioid use occurs outside legal medical channels, users in non-medically supervised settings are also going to have to be keenly aware of the dangers of mixing those drugs. If they are, the evidence suggests they can save some lives.

Chronicle AM: American College of Physicians Says Addiction Not a Moral Failing, More... (3/28/17)

A leading doctors' group comes out for a progressive approach to opioid addiction, new research suggests medical marijuana can reduce opioid-related emergencies and overdoses, the Tennessee legislature slaps down pot decriminalization in Memphis and Nashville, and more.

The ACP sees an opioid crisis and has some progressive approaches. (Creative Commons/Wikimedia)
Marijuana Policy

Tennessee Bill to Block Municipal Decriminalization Passes Legislature. After the state's two largest cities, Memphis and Nashville, passed municipal marijuana decriminalization ordinances, the legislature has struck back. The Senate on Monday approved House Bill 173, which bars cities in the state from crafting marijuana penalties lesser than state law. The measure passed the House last week and now head's for the governor's desk.

Medical Marijuana

Legalized Marijuana Could Help Curb the Opioid Epidemic, Study Finds. A new study reported in the journal Drug and Alcohol Dependence finds that in states with medical marijuana, hospitalization rates for opioid pain pill dependence and abuse dropped by nearly a quarter (23%), while opioid overdose rates dropped by 13%. Researchers had expected to see an increase in marijuana-related visits. "Instead, medical marijuana laws may have reduced hospitalizations related to opioid pain relievers," said study author Yuyan Shi, a public health professor at the University of California, San Diego.

Maine Bill Would Make Medical Marijuana Users Eligible for Organ Transplants. Legislators heard powerful testimony from patients removed from life-saving organ transplant lists because they used marijuana as they considered Legislative Document 764 Monday. The bill would targets the Maine Medical Center, the only transplant center in the state, whose transplant policy states that "use of prescribed or recreational marijuana by any route of administration is absolutely prohibited." No vote was taken, and the bill is scheduled for more hearings next month.

Heroin and Prescription Opioids

American College of Physicians Calls for Opioid Addiction to Be Treated as Chronic Condition, Not Moral Failing. In a position paper in the Annals of Internal Medicine, the American College of Physicians released a comprehensive set of public policy recommendations for the prevention and treatment of substance use disorders that calls for treating addiction as a treatable chronic condition, not a moral failing or criminal activity. The guidelines call for expanded access to the overdose reversal drug naloxone and opioid maintenance therapies, as well as urging physicians to avoid opioids as first-line treatments for most chronic pain and to limit opioids for acute pain to the lowest possible dose for the shortest possible time. And they suggest that it is time to consider drug decriminalization or legalization: "Stakeholders should assess the risks and benefits of removing or reducing criminal penalties for nonviolent offenses involving illicit drugs."

Chronicle AM: Canada Legalization mid-2018?, Christie Named "Drug Commissioner," More... (3/27/17)

Canada says it will legalize marijuana by July 1, 2018; Chris Christie will be named White House "drug commissioner," Illinoisans are ready to legalize weed, and more.

Marijuana Policy

Illinois Poll Has Strong Support for Marijuana Legalization. A new Paul Simon Public Policy Institute poll has support for marijuana legalization at 66% if it is taxed and regulated like alcohol. The poll comes days after legislators filed a marijuana legalization bill, House Bill 2353.

Michigan Legalizers Release 2018 Initiative Draft. Backed by the Marijuana Policy Project, the Michigan Coalition to Regulate Marijuana Like Alcohol has released the latest draft of the cannabis legalization initiative the group hopes to put to voters in November 2018. Under the draft, adults would be able to possess up to 2.5 ounces of pot and grow up to 12 plants, and marijuana commerce would be taxed and regulated. An initiative campaign last year came up just short in signature gathering.

Nevada Bill Would Allow Medical Marijuana Dispensaries to Sell Recreational Weed. State Sen. Tick Segerblom (D-Las Vegas) and Assemblyman Steve Yeager (D-Las Vegas) rolled out Senate Bill 302 last Friday. The bill would allow for an early start to recreational marijuana sales by allowing existing dispensaries to sell to non-patients before the January 1, 2018 deadline set in last fall's voter-approved ballot initiative. The move is aimed at stamping out the black market and allowing the state to get tax revenues. A similar move is afoot at the state Department of Taxation.

Heroin and Prescription Opioids

Maryland Democrats File Pair of Heroin Bills. Some three dozen Democratic General Assembly members gathered last Friday to announce a pair of bills aimed at fighting rising heroin overdoses in the state. Senate Bill 1060, the Start Talking Maryland Act, would require drug education programs to address the high lethality of fentanyl and colleges that teach medical providers to include addiction treatment education. Senate Bill 967, the Heroin and Opiate Prevention Effort (HOPE) and Treatment Act, would require the Department of Health and Mental Hygiene to establish 10 heroin crisis centers around the state, as well as easing access to buprenorphine and naloxone.

Asset Forfeiture

Idaho Legislature Gives Final Approval to Asset Forfeiture Reform Bill. The House last Friday gave final approval to House Bill 172, which would limit civil asset forfeiture to cases involving drug trafficking -- not simple possession -- and would clarify that simply being in possession of large amounts of cash is not evidence drug trafficking. The House had approved the bill earlier, but had to have a final concurrence vote after amendments were added in the Senate. The bill now goes to the governor's desk.

New Mexico Bill That Would Have Directed Seized Funds to Cops Dies. A bill that would have diverted seized assets from the state general fund and given them to law enforcement agencies handling the cases has died in the House, and the cops are unhappy. Senate Bill 202 had passed the Senate unanimously, but couldn't get out of the House Judiciary Committee. "I'm utterly disgusted," said Pecos Valley Drug Task Force Commander James McCormick. "That's just takes away another avenue we have to thwart drug dealing. The money we used to get, we don't have any more."

Drug Policy

Jared Kushner's White House "SWAT Team" Will Include Chris Christie as Drug Commission Chair. The White House "SWAT team" to be led by presidential son-in-law Jared Kushner and aimed at streamlining policy-making will include an official drug commission to be chaired by New Jersey Gov. Chris Christie (R). The commission will emphasis combating opioid abuse, a favorite theme for Trump.

Law Enforcement

New Hampshire Senate Approves Funding More Troopers to Fight Cross-Border Drugs. The state Senate voted overwhelmingly last Thursday to spend nearly $4.5 million over the next two years to hire five new state troopers to wage war on the state's opioid epidemic by targeting traffic from Massachusetts, expand the "Granite Hammer" program counts to local law enforcement, and pay for overtime for specialized enforcement units such as the State Police and Narcotics Investigation Unit. The measure, Senate Bill 131, is now headed for the House, where it is expected to pass.

NYPD Cop Who Killed Ramarley Graham Quits. Graham, 18, was shot and killed in 2012 by Officer Richard Haste after he fled into his own apartment bathroom and was trying to flush a small amount of marijuana down a toilet. Haste avoided criminal charges for the killing, but a departmental trial found him guilty of violating department policies and he was facing firing when he decided to turn in his badge and gun.

International

Canada Will Legalize Marijuana By July 1, 2018. The governing Liberals will announce legislation next month to legalize marijuana, with the new law set to go into effect on Canada Day -- July1 -- next year. The legislation will set 18 as the age limit for legal use and set up a legal, regulated, and taxed system of marijuana commerce. People who want to grow their own will be limited to four plants. [Update: The government's point man on legalization has called this date "highly speculative." Hat tip: Marijuana Moment.]

Chronicle AM: StoptheDrugWar.org in Philippines Controversy, MA Legalization, More... (3/20/17)

StoptheDrugWar.org draws the ire of the Duterte regime in Manila, Vermont's pot legalization bill gets a needed extension, a federal bill to create a National Commission on Criminal Justice is filed, and more.

David Borden's coordination of a video criticizing Philippines Pres. Duterte is making waves in Manila. (YouTube)
Marijuana Policy

Massachusetts Legislature Begins Grappling With Legal Marijuana. The legislature's effort to diddle with voter-approved marijuana legalization began in earnest Monday as the Joint Committee on Marijuana Policy held hearings featuring the state treasurer, gaming commission chairman, representatives of the attorney general's office, and legalization advocates. Some 44 bills have been filed to restrict, delay, or otherwise modify the initiative that passed last November. Further hearings on the general topic are already scheduled, but hearings for the individual bills have not.

Vermont Legalization Bill Misses Deadline, But Gets One-Week Extension. The legalization bill, House Bill 170, missed a Friday deadline for bills to emerge from committee, but House and Senate leaders agreed to give the bill a one-week extension to try to get out of the House Judiciary Committee. The committee had been scheduled to vote on the bill last Wednesday, but abruptly removed the vote from its schedule, suggesting that House leaders weren't confident it would pass out of committee. The bill would legalize the possession of up to an ounce of marijuana by adults, but would not allow for legal marijuana commerce.

Medical Marijuana

Arizona Appeals Court Upholds Limit on PTSD Recommendations. The state court of appeals ruled last Thursday that the Department of Health Services was acting legally when it decided that doctors could only recommend medical marijuana for "palliative care" for PTSD. The department argued there was no evidence showing marijuana could actually cure people of PTSD. The department also limited recommendations to people who were already being treated for PTSD. An Arizona medical marijuana nurses group filed suit against the restrictions, but now the court has ruled against them.

Arkansas Bill to Ban Smoking Medical Marijuana Where Cigarettes Are Banned Passes House. The House voted last Friday to approve House Bill 1400, which would prohibit the smoking of medical marijuana anywhere tobacco smoking is prohibited. The bill passed 88-0. Under the bill, knowingly smoking medical marijuana in the presence of a pregnant woman would be prohibited. The measure also prohibits those under 21 from smoking medical marijuana. A bill that would have banned smoking medical marijuana at all has already died in the Senate.

Nebraska Medical Marijuana Bill Heads for Floor Vote. The legislature's Judiciary Committee voted 6-1 last Friday to advance Legislative Bill 622, which would bring medical marijuana to the Cornhusker state. The bill would authorize cultivation, manufacture, and distribution of medical marijuana products, but would ban smoking the herb or allowing patients to grow their own. The bill is opposed by Gov. Pete Ricketts (R), as well as the state's law enforcement establishment.

Virginia Governor Signs Bill Legalizing Pharmacy Distribution of CBD and THC-A Oil. Gov. Terry McAuliffe (D) signed Senate Bill 1027 into law last Thursday. The bill allows for companies to manufacture and provide CBD cannabis oil and THC-A oil for the treatment of epilepsy and provides for its distribution through pharmacies.

Hemp

Arkansas Industrial Hemp Bill Wins Committee Vote. The House Agriculture, Forestry, and Economic Development unanimously approved a bill to allow the production of hemp. House Bill 1778 now goes to the House floor.

Drug Policy

Federal Bill Would Make All Controlled Substance Analogs Schedule I Controlled Substances. US Sen. John Hoeven (R-ND) last week filed Senate Bill 683, which would "treat all controlled substance analogues, other than chemical substances subject to the Toxic Substances Control Act, as controlled substances in schedule I regardless of whether they are intended for human consumption." The actual bill text is not yet available on the congressional web site.

Drug Testing

Nevada Welfare Drug Testing Bill Filed. State Sen. Michael Roberson (R-Las Vegas) has filed a bill that would require applicants for welfare, food stamps, and other public assistance to undergo a suspicionless saliva drug test. If the saliva test is positive, a follow-up urine test could be used to verify the result. Senate Bill 298 has been referred to the Committee on Health and Human Services.

Law Enforcement

Federal Bill Filed to Create National Criminal Justice Commission. Rep. Ted Deutch (D-FL) has filed House Resolution 1607, which would create a national criminal justice commission. The text of the bill is not yet available on the congressional website.

International

StoptheDrugWar.org Makes Filipino News With Veep's Video Criticizing Duterte's Drug War. StoptheDrugWar.org executive director David Borden is at the center of a controversy in the Philippines over a video message to the UN from Vice President Leni Robredo criticizing President Rodrigo Duterte's bloody drug war, which has led to some 8,000 deaths since Duterte took office last year. Duterte supporters accused Stopthedrugwar.org of timing the video release to bolster an impeachment complaint filed against Duterte last week, but Borden said that was not the case. "The vice president's office did not make any requests of us as to timing or any other matters. We released it a few days before the session as a media strategy to draw attention to Pres. Duterte's atrocities," said Borden.

UN Commission on Narcotic Drugs Adds Fentanyl Precursors to Controlled Substances List. The CND voted last Thursday to add two chemicals used to make fentanyl to the list of internationally controlled substances under UN anti-drug treaties. Putting the chemicals on the list will ensure closer monitoring of fentanyl orders and transactions and would make it more difficult for illicit fentanyl producers to access those chemicals.

Drug War Issues

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