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White House 2013 National Drug Strategy Released

The White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) released its 2013 National Drug Control Strategy Wednesday. The strategy is being billed as a "21st Century Approach" to drug use and trafficking, but despite some rhetorical softening maintains the US hard-line approach to the issue.

"The president has outlined his vision of an America built to last -- where an educated, skilled workforce has the knowledge, energy and expertise to compete in the global marketplace. Yet -- for far too many Americans -- that vision is limited by drug use, which not only diminishes the potential of the individual, but jeopardizes families, communities and neighborhoods," ONDCP wrote on a blog post announcing the strategy's release and touting reductions in cocaine and prescription drug abuse as progress made.

"Today we are releasing a science-driven plan for drug policy reform in America to build upon this progress," ONDCP continued. "This 21st century drug policy outlines a series of evidence-based reforms that treat our nation's drug problem as a public health issue, not just a criminal justice issue. This policy underscores what we all know to be true: we cannot arrest or incarcerate our way out of the drug problem."

The strategy emphasizes treatment and prevention, but despite the rhetoric, the Fiscal Year 2014 federal drug budget it accompanies continues to be imbalanced, with 58% of federal anti-drug spending directed at law enforcement and interdiction efforts. That figure does mark a decline from previous years, but only a marginal one.

And even its emphasis on treatment also includes punitive criminal justice elements, such as its embrace of the drug court system, where drug-addicted people are subjected to legal sanctions for such addiction-related behaviors as failing a drug test or missing an appointment. That has some drug reformers calling foul.

"The administration says drug use is a health issue but then advocates for policies that put people in the criminal justice system," said Bill Piper, director of national affairs for the Drug Policy Alliance. "Until the drug czar says it is time to stop arresting people for drug use, he is not treating drug use as a health issue no matter what he says. I know of no other health issue in which people are thrown in jail if they don't get better."

While much of the strategy is little more than the same old same old, the strategy does call for expanded access to naloxone, a low-cost antidote that can reverse the effects of opioid overdoses. That is in response to the rapid growth in prescription drug overdose deaths in recent years.

"Director Kerlikowske should be applauded for taking steps to reduce drug overdose fatalities, but he's not doing much to reduce drug arrests or the many other problems associated with treating drug use through the criminal justice system," said Piper.

But while the drug strategy shows flexibility in its efforts to deal with fatal drug overdoses, it maintains a staunch opposition to marijuana reform and includes attacking outdoor and indoor marijuana cultivation as one of its key goals.

"The administration's continued opposition to marijuana law reform shows they're not serious about reforming US drug policy," said Piper. "At the very least they should stop getting in the way of states that are trying to improve public health and safety by regulating marijuana like alcohol."

Washington, DC
United States

DC 911 Good Samaritan Drug Overdose Bill Takes Effect

As of Tuesday, there will be limited legal protections for people who witness or experience a drug overdose in the District of Columbia and summon medical assistance. That's because the District's Good Samaritan Overdose Prevention Amendment Act goes into effect then.

Passed last fall by the DC city council, the new is aimed at reducing overdose deaths by removing the threat of arrest from overdose victims and those who might assist or seek help for them. Many overdose deaths do not occur immediately, and medical interventions can save lives, but some drug users and their peers are reluctant to seek help because of fear of arrest and prosecution.

"Criminalization should not be a barrier to calling 911," said Grant Smith, policy manager with the Drug Policy Alliance. "This new law will help encourage District residents who witness an overdose to pick up the phone and help save a life." 

Under the new law:

  • Law enforcement officers who observe small amounts of illegal drugs or paraphernalia at the scene of an overdose should not consider these drug law violations to be crimes for the individual experiencing the overdose and the witness who sought emergency medical services.
  • A minor is provided limited protection from criminal charges for underage possession of alcohol if they experience an overdose or seek emergency medical services for a peer.
  • An adult who is 25 years of age or younger is given limited protection from criminal charges for providing alcohol or other drugs to a minor who is 16 years of age or older if they seek emergency medical services for the minor in need.
  • The possession of naloxone – a medication that rapidly reverses opiate overdoses – and its use by lay persons on individuals experiencing an opiate overdose is decriminalized.

Ten states (California, Connecticut, Colorado, Florida, Illinois, Massachusetts, New Mexico, New York, Rhode Island and Washington State) have already enacted Good Samaritan laws for preventing fatal drug overdoses. Good Samaritan legislation is currently pending in New Hampshire, North Carolina, Missouri and other states. A coalition comprised of the Drug Policy Alliance, Students for Sensible Drug Policy, American Civil Liberties Union of the Nation's Capital, Bread for the City, HIPS, students from the George Washington University School of Public Health and Health Services and GW Law Students for Sensible Drug Policy, parents and advocates supported passage of the Good Samaritan law.

"Implementation of this new law by public health and law enforcement officials is critical to improving public willingness to immediately seek medical assistance for overdoses involving illegal drug and alcohol use," said Smith.

Spurred by the rapid rise in opioid pain medication prescribing and the diversion of pain pills, drug overdose rates nationwide have increased five-fold since 1990 and more than doubled between 2000 and 2010. Heroin and other opiates are the second leading cause of overdose deaths in the District in recent years, following cocaine.

Washington, DC
United States

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

FDA Panel Wants Tighter Control over Pain Pills

A US Food and Drug Administration advisory panel voted last Friday to recommend that popular pain relievers containing the opioid hydrocodone be moved from Schedule III to Schedule II of the Controlled Substances Act. Popular prescription drugs containing hydrocodone include Vicodin and Lortab.

That would put Lortab and Vicodin in the same schedule as morphine and Oyxcontin, which contains oxycodone.

If the FDA agrees with its advisory panel and reschedules hydrocodone, pain patients using the drug will have to go the doctor's office to get prescriptions written twice as frequently as now. Schedule III drugs can be prescribed for up to six months at a time, while Schedule II drugs can only be prescribed for three months without another visit to the doctor.

The FDA has for years resisted efforts to tighten controls over hydrocodone, saying it could limit patients' access to pain medicine, but as overdose deaths and addiction rates from prescription pain relievers have jumped in recent years, pressure has been mounting on the agency. The agency is acting now after receiving a request from the DEA to consider rescheduling.

The advisory panel's 19-10 vote received mixed reviews from experts consulted by the Milwaukee Journal-Sentinel.

Andrew Kolodny, a psychiatrist and addiction specialist who heads Physicians for Responsible Opiate Prescribing lauded the vote, saying it will lead to fewer people getting addicted to opiates.

"Doctors have had a false sense of security (about prescribing the drugs)," said Kolodny. "This is a clear message that hydrocodone is addictive," he told the Wisconsin newspaper.

"It seemed pretty clear to me that the preponderance of the evidence supported rescheduling," said Peter Kaboli, associate professor at the University of Iowa Carver College of Medicine.

But Jan Chambers, president of the National Fibromyalgia and Chronic Pain Association, said she voted against the proposal because she has heard so much from family members of people who have committed suicide because they are in such pain.

"Millions of people don't have access to the pain specialist or the doctors who can prescribe these Schedule III drugs," she said.

And Lynn Webster, president-elect of the American Academy of Pain Medicine, said putting tighter controls on hydrocodone will reduce prescribing and abuse, but worried about the impact on pain patients.

"I hope chronic pain patients and acute pain patients don't suffer as a result," said Webster, who spoke at the panel hearing but was not a panel member.

The FDA has not said when it will make a final decision on the issue. Now, the FDA and the National Institutes of Health must make a recommendation to the assistant secretary for health, who will make a final recommendation to the DEA.

Washington, DC
United States

Naloxone Anti-Overdose Bill Moving in New Jersey

A bill that would expand access to the overdose-blocking drug naloxone is moving in the New Jersey legislature. The bill, Senate Bill 2082, the Opioid Antidote and Overdose Prevention Act passed the Senate Health, Human Services and Senior Citizens Committee Monday on a unanimous vote and now heads for a Senate floor vote.

A companion measure, Assembly Bill 95, awaits a hearing before the Assembly Health and Senior Services Committee.

Naloxone is an opioid antagonist, meaning it blocks and reverses the effects of opioid drugs, such as heroin, morphine, and Oxycontin. A Centers for Disease Control and Prevention report from last February found that some 50 naloxone programs nationwide had reversed more than 10,000 overdoses.

Naloxone is available only by prescription in New Jersey. The bill would expand access to the drug by providing protection from civil and criminal liability to medical professionals who prescribe the drug and laypersons who administer it.

Advocates applauded the bill's clearing the first hurdle and urged the legislature to finish the job.

"We must have a comprehensive strategy to reduce the huge number of tragic and preventable overdose deaths in New Jersey," said Roseanne Scotti, New Jersey state director for the Drug Policy Alliance. "Expanded access to Naloxone is a key component in that strategy. This bill will save lives and should now be acted on by the legislature with all possible speed. Lives hang in the balance."

"Drug overdose continues to be the leading cause of accidental death in New Jersey," said Sen. Joseph Vitale (D-Woodbridge). "Each year it surpasses the number of deaths caused by automobile accidents and guns.  Expanding access to naloxone will allow this medication to reach its full public health potential and will be an important part of New Jersey's comprehensive efforts to address drug abuse."

Patty DiRenzo of Blackwood lost her son, Salvatore, to an overdose when he was 26 years old.

"Sal was a beautiful soul who unfortunately struggled with addiction. If the people he was using with on the night he died had access to naloxone, he might still be alive today. Instead, my son was left alone to die. It's extremely important to have policies like this one in place, so that other families are spared the grief that mine has endured."

Eight states and the District of Columbia have already passed legislation easing access to Naloxone in a bid to reduce drug overdose deaths.

Trenton, NJ
United States

Naloxone Cheap Way to Prevent Drug OD Deaths, Study Finds

Drug overdose deaths are now the leading cause of accidental death in the US, surpassing automobile accidents, but a new study suggests that distributing naloxone to opioid drug users could reduce the death toll in a cost-effective manner. The study was published this week in the Annals of Internal Medicine.

Naloxone package (wikimedia.org)
Opioids, including not just illicit heroin but also widely used prescription pain pills, are responsible for about 80% of drug overdose deaths. Naloxone, an opioid antagonist, works by blocking opioid receptors in the brain, making it possible to reverse the effects of overdoses.

At least 183 public health programs around the country have trained some 53,000 people in how to use naloxone. These programs had documented more than 10,000 cases of successful overdose reversals.

In the study published in the Annals, researchers developed a mathematical model to estimate the impact of more broadly distributing naloxone among opioid drug users and their acquaintances. Led by Dr. Phillip Coffin, director of Substance Use Research at the San Francisco Department of Public Health, and Dr. Sean Sullivan, director of the Pharmaceutical Outcomes Research and Policy Program at the University of Washington, the researchers found that if naloxone were available to 20% of a million heroin users, some 9,000 overdose deaths would be prevented over the users' lifetimes.

In the basic research model, one life would be saved for every 164 naloxone kits handed out. But using more optimistic assumptions, naloxone could prevent as many as 43,000 overdose deaths, saving one life for every 36 kits distributed.

Providing widespread naloxone distribution would cost about $400 for every year of life saved, a figure significantly below the customary $50,000 cut-off for medical interventions. That's also cheaper than most accepted prevention programs in medicine, such as checking blood pressure or smoking cessation.

"Naloxone is a highly cost-effective way to prevent overdose deaths," said Dr. Coffin. "And, as a researcher at the Department of Public Health, my priority is maximizing our resources to help improve the health of the community."

Naloxone has proven very effective in San Francisco, with heroin overdose deaths declining from 155 in 1995 to 10 in 2010. The opioid antagonist has been distributed there since the mid-1990s, and with the support of the public health department since 2004. But overdose deaths for opioid pain medications (oxycodone, hydrocone, methadone) remain high, with 121 reported in the city in 2010. Efforts are underway in the city to expand access to naloxone for patients receiving prescription opioids as well. This study is the latest to suggest that doing so will save lives, and do so cost-effectively.

The Top Ten Drug Policy Stories of 2012 [FEATURE]

In some ways, 2012 has been a year of dramatic, exciting change in drug policy, as the edifice of global drug prohibition appears to crumble before our eyes. In other ways it is still business as usual in the drug war. Marijuana prohibition is now mortally wounded, but there were still three-quarters of a million pot arrests last year. The American incarceration mania appears to be running its course, but drug arrests continue to outnumber any other category of criminal offense. There is a rising international clamor for a new drug paradigm, but up until now, it's just talk.

The drug prohibition paradigm is trembling, but it hasn't collapsed yet -- we are on the cusp of even more interesting times. Below, we look at the biggest drug policy stories of 2012 and peer a bit into the future:

1. Colorado and Washington Legalize Marijuana!

Voters in Colorado and Washington punched an enormous and historic hole in the wall of marijuana prohibition in November. While Alaska has for some years allowed limited legal possession in the privacy of one's home, thanks to the privacy provisions of the state constitution, the November elections marked the first time voters in any state have chosen to legalize marijuana. This is an event that has made headlines around the world, and for good reason -- it marks the repudiation of pot prohibition in the very belly of the beast.

And it isn't going away. The federal government may or may not be able to snarl efforts by the two states to tax and regulate legal marijuana commerce, but few observers think it can force them to recriminalize marijuana possession. It's now legal to possess up to an ounce in both states and to grow up to six plants in Colorado and -- barring a sudden reversal of political will in Washington or another constitutional amendment in Colorado -- it's going to stay that way. The votes in Colorado and Washington mark the beginning of the end for marijuana prohibition.

2. Nationally, Support for Marijuana Legalization Hits the Tipping Point

If Colorado and Washington are the harbingers of change, the country taken as a whole is not far behind, at least when it comes to public opinion. All year, public opinion polls have showed support for marijuana legalization hovering right around 50%, in line with last fall's Gallup poll that showed steadily climbing support for legalization and support at 50% for the first time. A Gallup poll this month showed a 2% drop in support, down to 48%, but that's within the margin of error for the poll, and it's now a downside outlier.

Four other polls released this month
demonstrate a post-election bump for legalization sentiment. Support for legalization came in at 47%, 51%, 54%, and 57%, including solid majority support in the West and Northeast. The polls also consistently find opposition to legalization strongest among older voters, while younger voters are more inclined to free the weed.

As Quinnipiac pollster Peter Brown put it after his survey came up with 51% support for legalization, "This is the first time Quinnipiac University asked this question in its national poll so there is no comparison from earlier years. It seems likely, however, that given the better than 2-1 majority among younger voters, legalization is just a matter of time."

Caravan for Peace vigil, Brownsville, Texas, August 2012
3. Global Rejection of the Drug War

International calls for alternatives to drug prohibition continued to grow ever louder this year. Building on the work of the Latin American Commission on Drugs and Democracy and the Global Commission on Drug Policy, the voices for reform took to the stage at global venues such as the Summit of the Americas in Cartagena, Colombia, in April, the International AIDS Conference in Washington in July, and at the United Nations General Assembly in September.

While calls for a new paradigm came from across the globe, including commissions in Australia and the United Kingdom, this was the year of the Latin American dissidents. With first-hand experience with the high costs of enforcing drug prohibition, regional leaders including Colombian President Santos, Guatemalan President Perez Molina, Costa Rican President Chinchilla, and even then-Mexican President Calderon all called this spring for serious discussion of alternatives to the drug war, if not outright legalization. No longer was the critique limited to former presidents.

That forced US President Obama to address the topic at the Summit of the Americas and at least acknowledge that "it is entirely legitimate to have a conversation about whether the laws in place are doing more harm than good in certain places" before dismissing legalization as a policy option. But the clamor hasn't gone away -- instead, it has only grown louder -- both at the UN in the fall and especially since two US states legalized marijuana in November.

While not involved in the regional calls for an alternative paradigm, Uruguayan President Mujica made waves with his announcement of plans to legalize the marijuana commerce there (possession was never criminalized). That effort appears at this writing to have hit a bump in the road, but the proposal and the reaction to it only added to the clamor for change.

4. Mexico's Drug War: The Poster Child for Drug Legalization

Mexico's orgy of prohibition-related violence continues unabated with its monstrous death toll somewhere north of 50,000 and perhaps as high as 100,000 during the Calderon sexenio, which ended this month. Despite all the killings, despite Calderon's strategy of targeting cartel capos, despite the massive deployment of the military, and despite the hundreds of millions of dollars in US aid for the military campaign, the flow of drugs north and guns and money south continues largely unimpeded and Mexico -- and now parts of Central America, as well -- remain in the grip of armed criminals who vie for power with the state itself.

With casualty figures now in the range of the Iraq or Afghanistan wars and public safety and security in tatters, Calderon's misbegotten drug war has become a lightning rod for critics of drug prohibition, both at home and around the world. In the international discussion of alternatives to the status quo -- and why we need them -- Mexico is exhibit #1.

And there's no sign things are going to get better any time soon. While Calderon's drug war may well have cost him and his party the presidency (and stunningly returned it to the old ruling party, the PRI, only two elections after it was driven out of office in disgrace), neither incoming Mexican President Enrique Pena Nieto nor the Obama administration are showing many signs they are willing to take the bold, decisive actions -- like ending drug prohibition -- that many serious observers on all sides of the spectrum say will be necessary to tame the cartels.

The Mexican drug wars have also sparked a vibrant and dynamic civil society movement, the Caravan for Peace and Justice, led by poet and grieving father Javier Sicilia. After crisscrossing Mexico last year, Sicilia and his fellow Mexican activists crossed the border this summer for a three-week trek across the US, where their presence drew even more attention to the terrible goings on south of the border.

5. Medical Marijuana Continues to Spread, Though the Feds Fight Back

Eighteen states and the District of Columbia have now legalized the use of marijuana for medical purposes, and while there was only one new one this year, this has been a year of back-filling. Medical marijuana dispensaries have either opened or are about to open in a number of states where it has been legal for years but delayed by slow or obstinate elected officials (Arizona, New Jersey, Washington, DC) or in states that more recently legalized it (Massachusetts).

None of the newer medical marijuana states are as wide open as California, Colorado, or Montana (until virtual repeal last year), as with each new state, the restrictions seem to grow tighter and the regulation and oversight more onerous and constricting. Perhaps that will protect them from the tender mercies of the Justice Department, which, after two years of benign neglect, changed course last year, undertaking concerted attacks on dispensaries and growers in all three states. That offensive was ongoing throughout 2012, marked by federal prosecutions and medical marijuana providers heading to federal prison in Montana. While federal prosecutions have been less resorted to in California and Colorado, federal raids and asset forfeiture threat campaigns have continued, resulting in the shuttering of dozens of dispensaries in Colorado and hundreds in California. There is no sign of a change of heart at the Justice Department, either.

6. The Number of Drug War Prisoners is Decreasing

The Bureau of Justice Statistics announced recently that the number of people in America's state and federal prisons had declined for the second year in a row at year's end 2011. The number and percentage of drug war prisoners is declining, too. A decade ago, the US had nearly half a million people behind bars on drug charges; now that number has declined to a still horrific 330,000 (not including people doing local jail time). And while a decade ago, the percentage of people imprisoned for drug charges was somewhere between 20% and 25% of all prisoners, that percentage has now dropped to 17%.

That decline is mostly attributable to sentencing reforms in the states, which, unlike the federal government, actually have to balance their budgets. Especially as economic hard times kicked in in 2008, spending scarce taxpayer resources on imprisoning nonviolent drug offenders became fiscally and politically less tenable. The passage of the Proposition 36 "three strikes" sentencing reform in California in November, which will keep people from being sentenced to up to life in prison for trivial third offenses, including drug possession, is but the latest example of the trend away from mass incarceration for drug offenses.

The federal government is the exception. While state prison populations declined last year (again), the federal prison population actually increased by 3.1%. With nearly 95,000 drug offenders doing federal time, the feds alone account for almost one-third of all drug war prisoners.

President Obama could exercise his pardon power by granting clemency to drug war prisoners, but it is so far a power he has been loathe to exercise. An excellent first candidate for presidential clemency would be Clarence Aaron, the now middle-aged black man who has spent the past two decades behind bars for his peripheral role in a cocaine deal, but activists in California and elsewhere are also calling for Obama to free some of the medical marijuana providers now languishing in federal prisons. The next few days would be the time for him to act, if he is going to act this year.

7. But the Drug War Juggernaut Keeps On Rolling, Even if Slightly Out of Breath

NYC "stop and frisk" protest of mass marijuana arrests
According to annual arrest data released this summer by the FBI, more than 1.53 million people were arrested on drug charges last year, nearly nine out of ten of them for simple possession, and nearly half of them on marijuana charges. The good news is that is a decline in drug arrests from 2010. That year, 1.64 million people were arrested on drug charges, meaning the number of overall drug arrests declined by about 110,000 last year. The number of marijuana arrests is also down, from about 850,000 in 2010 to about 750,000 last year.

But that still comes out to a drug arrest every 21 seconds and a marijuana arrest every 42 seconds, and no other single crime category generated as many arrests as drug law violations. The closest challengers were larceny (1.24 million arrests), non-aggravated assaults (1.21 million), and DWIs (1.21 million). All violent crime arrests combined totaled 535,000, or slightly more than one-third the number of drug arrests.

The war on drugs remains big business for law enforcement and prosecutors.

8. And So Does the Call to Drug Test Public Benefits Recipients

Oblivious to constitutional considerations or cost-benefit analyses, legislators (almost always Republican) in as many as 30 states introduced bills that would have mandated drug testing for welfare recipients, people receiving unemployment benefits, or, in a few cases, anyone receiving any public benefit, including Medicaid recipients. Most would have called for suspicionless drug testing, which runs into problems with that pesky Fourth Amendment requirement for a search warrant or probable cause to undertake a search, while some attempted to get around that obstacle by only requiring drug testing upon suspicion. But that suspicion could be as little as a prior drug record or admitting to drug use during intake screening.

Still, when all the dust had settled, only three states -- Georgia, Oklahoma, and Tennessee -- actually passed drug testing bills, and only Georgia's called for mandatory suspicionless drug testing of welfare recipients. Bill sponsors may have been oblivious, but other legislators and stakeholders were not. And the Georgia bill is on hold, while the state waits to see whether the federal courts will strike down the Florida welfare drug testing bill on which it is modeled. That law is currently blocked by a federal judge's temporary injunction.

It wasn't just Republicans. In West Virginia, Democratic Gov. Roy Tomblin used an executive order to impose drug testing on applicants to the state's worker training program. (This week came reports that only five of more than 500 worker tests came back positive.) And the Democratic leadership in the Congress bowed before Republican pressures and okayed giving states the right to impose drug testing requirements on some unemployment recipients in return for getting an extension of unemployment benefits.

This issue isn't going away. Legislators in several states, including Indiana, Ohio, Texas, and West Virginia have already signaled they will introduce similar bills next year, and that number is likely to increase as solons around the country return to work.

9. The US Bans New Synthetic Drugs

In July, President Obama signed a bill banning the synthetic drugs known popularly as "bath salts" and "fake weed." The bill targeted 31 specific synthetic stimulant, cannabinoid, and hallucinogenic compounds. Marketed under brand names like K2 and Spice for synthetic cannabinoids and under names like Ivory Wave, among others, for synthetic stimulants, the drugs have become increasingly popular in recent years. The drugs had previously been banned under emergency action by the DEA.

The federal ban came after more than half the states moved against the new synthetics, which have been linked to a number of side effects ranging from the inconvenient (panic attacks) to the life-threatening. States and localities continue to move against the new drugs, too.

While the federal ban demonstrates that the prohibitionist reflex is still strong, what is significant is the difficulty sponsors had in getting the bill passed. Sen. Rand Paul (R-KY) put a personal hold on the bill until mandatory minimum sentencing requirements were removed and also argued that such efforts were the proper purview of the states, not Washington. And for the first time, there were a substantial number of Congress members voting "no" on a bill to create a new drug ban.

10. Harm Reduction Advances by Fits and Starts, At Home and Abroad

Harm reduction practices -- needle exchanges, safer injection sites, and the like -- continued to expand, albeit fitfully, in both the US and around the globe. Faced with a rising number of prescription pain pill overdoses in the US -- they now outnumber auto accident fatalities -- lawmakers in a number of states have embraced "911 Good Samaritan" laws granting immunity from prosecution. Since New Mexico passed the first such law in 2007, nine others have followed. Sadly, Republican Gov. Chris Christie vetoed the New Jersey bill this year.

Similarly, the use of the opioid antagonist naloxone, which can reverse overdoses and restore normal breathing in minutes, also expanded this year. A CDC report this year that estimated it had saved 10,000 lives will only help spread the word.

There has been movement internationally as well this year, including in some unlikely places. Kenya announced in June that it was handing out 50,000 syringes to injection drug users in a bid to reduce the spread of AIDS, and Colombia announced in the fall plans to open safe consumption rooms for cocaine users in Bogota. That's still a work in progress.

Meanwhile, the UN Commission on Narcotic Drugs unanimously supported a resolution calling on the World Health Organization and other international bodies to promote measures to reduce overdose deaths, including the expanded use of naloxone; Greece announced it was embracing harm reduction measures, including handing out needles and condoms, to fight AIDS; long-awaited Canadian research called for an expansion of safe injection sites to Toronto and Ottawa; and Denmark first okayed safe injection sites in June, then announced it is proposing that heroin in pill form be made available to addicts. Denmark is one of a handful of European countries that provide maintenance doses of heroin to addicts, but to this point, the drug was only available for injection. France, too, announced it was going ahead with safe injection sites, which could be open by the time you read this.  

This has been another year of slogging through the mire, with some inspiring victories and some oh-so-hard-fought battles, not all of which we won. But after a century of global drug prohibition, the tide appears to be turning, not least here in the US, prohibition's most powerful proponent. There is a long way to go, but activists and advocates can be forgiven if they feel like they've turned a corner. Now, we can put 2012 to bed and turn our eyes to the year ahead.

Christie Vetoes New Jersey Good Samaritan Overdose Bill

New Jersey Gov. Chris Christie (R) Friday conditionally vetoed the 911 Good Samaritan Emergency Response Act, which would have exempted from criminal prosecution people who participated in or witnessed illegal drug use after the call for help for an overdose victim. The governor vetoed the bill because it would have let drug dealers "off the hook," he said.

Chris Christie is more worried about Bad Samaritans than overdosing drug users. (state.nj.us)
"It's one of these things that sound good in the abstract," Christie told a town hall-style meeting a day earlier in Mount Laurel. "How about if they're not a Good Samaritan? How about if they're the (person) who supplied the drugs? That was my problem with the bill."

Christie said he supported harm reduction strategies, including drug treatment for low-level offenders, but that the Good Samaritan bill as passed was not the right answer.

"What I'm not willing to do is to give is to give people who commit harm to other people a free pass just because they picked up the telephone," he said. "The legislature has got to make the bill better. If they make the bill better, I'll be happy to consider signing it."

His conditional veto means the bill goes back to the legislature, which he has instructed to "study the issue of drug-overdose reporting" for 18 months and recommend "a comprehensive approach."

In the meantime, more and more New Jersey residents are dying of drug overdoses every year. Some 700 died in 2009, 884 in 2010, and about 1,000 last year, according to the state medical examiner.

The bill passed the legislature with bipartisan support earlier this year and is similar to Good Samaritan laws passed in 11 other states.

Trenton, NJ
United States

California Good Samaritan Drug Overdose Bill Signed Into Law

California Gov. Jerry Brown Monday signed into law Assembly Bill 472, the "911 Good Samaritan Bill," aimed at reducing fatal drug overdoses by removing the threat of criminal prosecution for people who seek assistance for people suffering from them. California becomes the 10th state to enact such a law since New Mexico led the way back in 2007.

fatal drug overdose (wikimedia.org)
Sponsored by Rep. Tom Ammiano (D-San Francisco), the bill received bipartisan support in the legislature and was cosponsored by the Drug Policy Alliance, the ACLU of California, and the Health Officers Association of California.

"This is a great victory for parents. None of us want our kids overdosing on drugs, but as I told the legislature, I'd rather have my kid around to yell at than attend a funeral," said Ammiano. "The young friends of those who overdose shouldn’t hesitate to seek help because they fear arrest. With the Governor's signature, they won't have to."

"This is an incredibly special day for the thousands of California family members who worked so hard and for so long to pass this life-saving bill," said Meghan Ralston, harm reduction manager of the Drug Policy Alliance. "This is just a small first step in reducing the number of fatal overdoses in California, but it's a deeply important one."

Drug overdose deaths are the number one cause of accidental death in California, as in many other states. The new law encourages people to seek emergency health services when they witness an overdose by providing limited protections from charge and prosecution for low-level drug law violations, including possession of small amounts of drugs. Those who sell drugs are not protected under the new law.

"I never go a day without thinking of my son Jeff and I never will," said Denise Cullen, cofounder of GRASP (Grief Recovery After a Substance Passing). "Losing a child to a drug overdose is a tragedy in ways I can't explain, but fighting so hard for him and for all the parents just like me, to get this law passed is really the best possible way I can honor him."

"After forty years of the war on drugs, California is finally righting its priorities by putting saving lives ahead of making petty arrests. The message is loud and clear: call for help in case of an overdose. This is an important step toward better drug and public health policies and it will save lives," said Margaret Dooley-Sammuli, senior policy advocate for the ACLU of California.

"The physician Health Officers who provide leadership for public health programs in every county are grateful to Governor Brown for partnering with us on this common sense, no-cost approach to saving lives," said Bruce Pomer, executive director of Health Officers Association of California. "It's urgently needed."

Now the task is to get the word out to those populations where it will do the most good. Advocates from dozens of state and local organizations will be working to do just that, both before the new law goes into effect on January 1, and throughout the following year.

Sacramento, CA
United States

California Drug Overdose Prevention Bill Passes

A bill aimed at saving the lives of drug overdose victims by protecting those who would come to their assistance from prosecution on drug charges passed the California legislature Monday on a bipartisan vote of 54-22 in the Assembly. It had already passed the Senate. The vote came days before International Overdose Awareness Day.

fatal drug overdose (wikimedia.org)
In recent years, Californians have been dying of drug or alcohol overdoses at a rate of ten a day, with the number of fatal overdoses increasing by 24% between 2000 and 2006, according to supporting documentation within the bill.

Introduced by Assemblyman Tom Ammiano (D-San Francisco), the bill, Assembly Bill 472, provides that neither the overdose victim nor a person who seeks emergency treatment for him shall be charged with the crime of drug possession or being under the influence of drugs, provided the drugs are for personal use.

Such bills are known as "Good Samaritan" bills and have already been passed nine other states.

In asking his colleagues to vote for the measure, Ammiano noted that more people die from drug overdoses than in car crashes. Fewer would die, he said, if witnesses sought prompt emergency help, but some hesitate for fear of being arrested for their drug use or possession. That argument got through to members of both parties.

"This is not going soft on crime," said Assemblyman Donald Wagner (R-Irvine). While he added that he does not condone drug use, he said it was necessary to "overlook some indiscretions for the greater good."

"It's critically important to save lives," said Assemblywoman Kristen Olsen (R-Modesto). "This bill doesn't condone drug behavior."

"It's not going to encourage underage use," noted Assemblyman Mike Feuer (D-Los Angeles). On the contrary, he said, the knowledge that overdose is so life-threatening should encourage users to reevaluate their behaviors.

"It's time we started saving lives in California," said Ammiano.

The bill was lobbied for by the Drug Policy Alliance, and supported by a range of organizations including California Society of Addiction Medicine, California Attorneys for Criminal Justice; California Professional Firefighters, California Association of Alcohol and Drug Program Executives County Alcohol and Drug Program Administrators Association of California, National Council of Alcohol and Drug Dependence of the San Fernando Valley, National Association of Social Workers, Asian Pacific AIDS Intervention Team, Bay Area Addiction Research and Treatment, Families ACT!, Grief Recovery After a Substance Passing and Parents for Addiction Treatment and Healing.

The only group to officially oppose it was the California Sheriff's Association.

The bill now goes to the desk of Gov. Jerry Brown (D).

Sacramento, CA
United States

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