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Video: How to Prevent Prescription Drug Overdoses

The next video from the International Drug Policy Reform Conference, by our friends from the Hungarian Civil Liberties Union (who were also the conference's official videographers). The video highlights interviews with US-based harm reduction experts on ways to prevent prescription drug overdoses.

New Daily Roundups from Drug War Chronicle

If you've been following Drug War Chronicle on our web site the past week, you have probably noticed a new, daily feature, "Chronicle AM." The AM is a roundup of stories that have hit the news wires. As Phil noted in his award speech two weeks ago, there is too much happening now to be able to give it all even medium-level coverage, much less to do so quickly. Chronicle AM is a way to survey a lot of the important stories each day, and we continue to publish our usual features and newsbriefs on a daily basis too. The following are the stories we noted in Chronicle AM installments during the past week.

Marijuana Policy

New Hampshire Marijuana Legalization Bill Dies in Committee. House Bill 492, which would have taxed and regulated marijuana like alcohol was defeated in the House Criminal Justice and Public Safety Committee Wednesday on an 11-7 vote. The action came just a week after a state poll showed 60% supported the bill.

Federal Judge Cuts Marijuana Sentences. Maryland US District Court Judge James Bredar Monday handed down sentences lighter than called for in federal guidelines in a major marijuana smuggling case, saying such offenses are "not regarded with the same seriousness" as they were just a few decades ago. Bredar also noted that the federal government's decision to largely leave marijuana sales in legalization states raised "equal justice" concerns.

Amendments Filed to California Marijuana Legalization Initiative. Americans for Policy Reform, the people behind the 2014 Marijuana Control, Legalization and Revenue Act initiative, Wednesday filed amendments to the proposed law. They include strengthening some penalties and clarifying medical marijuana patient ID card requirements. This is one of two initiatives aiming at 2014 in California, neither of which have big donor support.

Portland, Maine, Marijuana Legalization Initiative Draws Late Opposition. Small signs urging Portlanders to "Vote No on Question 1, NO to POTland" have begun popping up just days before the city votes on legalization next week. Who put them up is a mystery; no group has filed paperwork at city hall opposing the initiative. The initiative would not legalize marijuana per se, but would allow people 21 and over to "engage in activities for the purposes of ascertaining the possession of marijuana and paraphernalia."

Arkansas Attorney General Rejects Marijuana Legalization Initiative. Attorney General Dustin McDaniel Tuesday rejected the ballot title for a proposed legalization initiative, saying the language was ambiguous. This is the second time he has rejected the measure, which can still be rewritten and resubmitted.

Colorado to Vote Tuesday on Marijuana Tax. Colorado voters will decide Tuesday whether to impose a 15% excise tax on marijuana sales to pay for school construction and a 10% sales tax to pay for marijuana regulation. The tax vote wasn't included in Amendment 64 because state law requires any new taxes to be approved by the voters. The measure is expected to pass despite opposition from some marijuana activists.

No Pot in Washington Bars, State Regulators Say. The Washington State Liquor Control Board Wednesday filed a draft rule banning any business with a liquor license from allowing on-site marijuana use. The state's pot law already bars public use, including in bars, clubs, and restaurants, but some businesses have tried to find loopholes allowing customers to use on premise, such as by having "private clubs" within the establishment.

DC Marijuana Reform Moves Could Spur Congress to Ponder Legalization. The DC city council appears set to approve decriminalization, and DC marijuana activists are pondering a 2014 ballot initiative to legalize marijuana. That could set the stage for Congress to finally turn its sights on federal marijuana legalization, Bloomberg News suggested in this think piece.

One-Fourth of Americans Would Buy Legal Weed, Poll Finds. At least one out of four Americans (26%) said they would buy marijuana at least on "rare occasions" if it were legal, according to a Huffington Post/YouGov poll released Thursday. Only 9% said they buy it on rare occasions now. One out of six (16%) of respondents said they never buy it now, but might if it were legal.

Dispensaries like this one could become marijuana retail stores in Colorado.
Let A Hundred Pot Shops Bloom… in Colorado. The Colorado Marijuana Enforcement Division reported late last week that it has received applications from 136 people seeking to open adult use marijuana retail stores. By law, only people currently operating medical marijuana businesses could apply. Those who applied by the end of October will have decisions on their applications before year's end, meaning they could open on January 1, the earliest date adult marijuana sales will be allowed in the state.

NYC Subway Vigilante Bernie Goetz Busted in Penny Ante Marijuana Sting. The New York City man who became a national figure after shooting four teens who asked him for money on the subway back in 1984 was arrested last Friday over a $30 marijuana sale. Bernie Goetz is accused of selling the miniscule amount of marijuana to an undercover officer.

Colorado Voters Approve Marijuana Taxes. Colorado voters approved a taxation scheme that will add 25% in wholesale and retail taxes to the price of legally sold marijuana in the state. Proposition AA was winning with 64% of the vote at last report.

Three Michigan Cities Approve Marijuana Measures. Voters in the Michigan cities of Lansing, Jackson, and Ferndale handily approved local measures to legalize the possession of small amounts of marijuana by adults 21 and over. The measures passed with 69% of the vote in Ferndale, 63% in Lansing, and 61% in Jackson. The trio of towns now join other Michigan cities, including Grand Rapids and Detroit, that have municipally decriminalized pot possession.

Medical Marijuana

Florida Lawmakers Oppose Medical Marijuana Initiative. Florida House and Senate leaders said late last week that they will join Attorney General Pam Bondi (R) in asking the state Supreme Court to block a medical marijuana initiative from going to the ballot. "We certainly don't want a situation like they've got in Colorado," explained state Rep. Doug Holder (R-Venice). Petitioners have gathered only about 200,000 of the more than 600,000 signatures they need to make the ballot. They have until February, unless the state Supreme Court puts the kibosh on the effort.

Florida Governor Candidate Supports Medical Marijuana Initiative. Candidate for the Democratic gubernatorial nomination Nan Rich said last Friday she supports a proposed medical marijuana ballot initiative. "I've seen the research, I've studied the issue, and I've met with patients who clearly benefit and desperately need medically prescribed cannabis," Rich said in a statement. "That's why I'm signing the petition to get this important measure on the ballot in 2014 and I'm calling on all of my friends and supporters to do the same. There is simply no reason patients should suffer when an effective, safe, and organic remedy is readily available."

Washington State Regulators to Hold Hearing on Controversial Medical Marijuana Plans. The Washington state Liquor Control Board announced last Friday it will hold a hearing November 13 in Lacey to take public testimony on proposed changes to the state's medical marijuana system. Regulators have issued draft recommendations that would reduce the amount of medical marijuana patients could possess and end their ability to grow their own, among other things.

Search and Seizure

Federal Appeals Court Blocks Judge's Ruling on NYPD Stop-and-Frisk. The 2nd US Court of Appeals in New York City blocked an order by District Court Judge Shira Scheindlin requiring changes in the NYPD's much criticized stop-and-frisk program. In an unusual move, the appeals court also removed Judge Scheindlin from the case, saying she had violated the code of conduct for federal judges by giving media interviews and publicly responding to criticism of her court. Scheindlin had found that NYPD violated the civil rights of tens of thousands of people by subjecting them to stop-and-frisk searches based on their race.

New Mexico Man Sues over Forced Anal Drug Search. A Deming, New Mexico, man detained for running a stop sign allegedly had his buttocks clenched when ordered out of his vehicle by police, leading them to suspect he had drugs secreted in his rectum. Police obtained a search warrant from a compliant judge, then had medical personnel forcibly subject the man to repeated anal probes, enemas, and a colonoscopy in a futile attempt to find any drugs. In addition to the unreasonableness of the invasive searches, they also took place outside of the jurisdiction where the warrant was issued and after the timeline specified in the warrant. The victim, David Eckert, ought to be picking up a nice check one of these years.

Second New Mexico Anal Drug Search Victim Emerges. Yesterday, the Chronicle AM noted the case of Deming, New Mexico, resident David Eckert, who was subjected to anal probes, enemas, x-rays, and colonoscopies without his consent after being pulled over for running a stop sign. The cops suspected he had drugs. He didn't and is now suing the police, the county, and the medical personnel who participated. Now, a second victim has emerged. Timothy Young was stopped for failure to use a turn signal. As was the case with Eckert, a drug dog -- Leo the K-9 -- alerted, but as was the case with Eckert, no drugs were found, despite the extensive invasive searches. Turns out the drug dog has not been certified for more than two years and has a history of false alerts, and the hospital where the searches were conducted was not within the jurisdiction of the search warrant. It looks like another New Mexico resident will get a big check at the taxpayers' expense one of these days.

Drug Testing

Truckers Object to Federal Bill to Allow Hair Drug Tests. A bill pending in Congress, House Resolution 3403, the "Drug Free Commercial Driver Act of 2013," is drawing opposition from an independent trucker group, the association's organ Landline Magazine reports. The bill would allow trucking companies to use hair testing for pre-employment and random drug tests. Currently, federal regulations mandate urine testing and allow hair testing only in conjunction with urine tests, not as a replacement. Hair-based testing can reveal drug use weeks or months prior to the testing date. The independent truckers accuse bill sponsors of carrying water for larger trucking firms that want to undercut their competition.

Michigan Governor Signs Unemployment Drug Testing Law. Gov. Rick Snyder (R) Tuesday signed a bill that denies unemployment benefits to job seekers who fail employer drug tests. The law is in effect for one year as a pilot program.

Drug Testing Provision Stripped from New Hampshire Hep C Bill. A bill written in the wake of an outbreak of Hep C infections linked to an Exeter Hospital employee will not include random drug testing for health care employees. The bill, House Bill 597, originally contained such language, but it was stripped out in the House Health, Human Services, and Elderly Affairs Committee. Federal courts have held that drug tests constitute a search under the meaning of the Fourth Amendment and thus require probable cause, except in limited circumstances.

Psychedelics

New Group Formed to Assure Sustainability of Psychedelic Plants. The Ethnobotanical Stewardship Council was launched at the International Drug Policy Reform Conference in Denver last weekend. It will concentrate on "assuring the sustainability and safe use of traditional plants," and prominently mentioned ayahuasca in its formation announcement.

Sentencing Reform

Bipartisan Mandatory Minimum Reform Bill Introduced in US House. On Wednesday, Reps. Raul Labrador (R-ID) and Bobby Scott (D-VA) introduced the Smarter Sentencing Act, which would significantly reform mandatory minimum drug sentencing policies. Companion legislation in the Senate, Senate Bill 1410, was introduced in July. The bills would halve mandatory minimum sentence lengths and expand safety valve access, as well as extend retroactivity under the Fair Sentencing Act of 2010.

Study Shows Way to Louisiana Sentencing Reform. A study released Tuesday by the Reason Foundation, the Pelican Institute for Public Policy, and the Texas Public Policy Foundation details how Louisiana can reduce its prison population and corrections spending without lessening public safety by eliminating mandatory minimum sentences for nonviolent offenders and reforming its habitual offender law. The study, "Smart on Sentencing, Smart on Crime: Reforming Louisiana's Determinate Sentencing Laws," is available online here.

International

At Least Five Dead in Mexico Vigilante vs. Cartel Clashes. Attacks in the Western Mexican state of Michoacan, home of the Knights Templar cartel, between anti-cartel vigilantes and cartel members left at least five dead and thousands without electric power last weekend. The fighting erupted after anti-cartel "self defense forces" marched Friday in the Knights Templar stronghold of Apatzingan and accelerated over the weekend. Vigilantes said they saw the bodies of at least 12 cartel members.

UNODC Head Says Afghan Opium Crop is Thriving, Spreading. In remarks in advance of the release of the UN Office on Drugs and Crime's annual Afghan opium survey early in November, UNODC head Yury Fedotov warned that the poppy crop will increase for the third straight year and that cultivation had spread into formerly poppy-free areas under central government control. Afghanistan accounts for about 90% of the global illicit opium supply.

New Zealand to Host International Conference on Drug Reform Laws. The country has drawn international attention for its innovative approach to new synthetic drugs -- regulating instead of prohibiting them -- and will be the site of a March 20, 2014 "Pathway to Reform" conference explaining how the domestic synthetic drug industry began, how the regulatory approach was chosen and how it works. International attendees will include Drug Policy Alliance head Ethan Nadelmann and Amanda Fielding, of Britain's Beckley Foundation.

Canada SSDP to Hold National Conference in Vancouver. Canadian Students for Sensible Drug Policy (CSSDP) will hold its sixth annual conference on November 22-24 in Vancouver, BC. Featured speakers will include Donald McPherson, head of the Canadian Drug Policy Coalition; Dana Larsen, director of Sensible BC and the Vancouver Dispensary Society; and Missi Woolrdige, director of DanceSafe, among others.

Hong Kong Docs Criticize Government Drug Testing Plan. The Hong Kong Medical Association said Monday that a government plan to allow police to test anyone for drug use based on "reasonable suspicion" is flawed and violates basic human rights. The local government began a four-month consultation on the plan in September, and now the doctors have weighed in. The association said that drug testing was an unproven method of reducing drug use and resources should instead be devoted to prevention and education campaigns and cooperation with mainland police against drug trafficking.

India to Greatly Expand Opiate Maintenence Centers. Responding to an increase in the number of injection drug users, the Indian government is moving to expand the number of its Opiate Substitution Therapy (OST) centers six-fold, from a current 52 to 300 by the end of the year. Drug user groups, including the Indian Drug Users Forum, and harm reduction groups, such as Project Orchid have been involved in planning the expansion. It's not clear what drug the Indians are using in OST.

Ireland Parliament to Debate Marijuana Legalization This Week. A private motion by independent Dail, or Irish parliament, member Luke "Ming" Flanagan will be debated on Tuesday and Wednesday. Flanagan's bill would make it legal to possess, grow, and sell marijuana products.

Cartel Violence Flares in Mexican Border Town. Sunday shootouts between rival drug trafficking organizations and between traffickers and soldiers left at least 13 people dead in the Mexican border town of Matamoros, just across the Rio Grande River from Brownville, Texas. Four men and a woman were killed in clashes between rival gangs, and eight more died in fighting with Mexican Marines. Somewhere north of 75,000 people have been killed in violence since former President Felipe Calderon called out the armed forces to wage war on the cartels six and a half years ago. Meanwhile, the drugs continue to flow north and the guns and cash flow south.

Toronto Mayor Rob Ford (wikipedia.org)
Toronto Mayor Admits He Smoked Crack, But Says He's Not an Addict. Months after rumors of a video showing Toronto Mayor Rob Ford smoking crack cocaine emerged, but only days after Toronto police said they had a copy of that video, Ford told reporters Tuesday that he had indeed smoked crack, but that he did so "in a drunken stupor" and that he wasn't an addict. Time will tell if his political career survives the revelation.

Marijuana Legalization Debate Looms in Morocco. Moroccan activists and politicians are close to firming up a date later this month for the parliament to hear a seminar on the economic implications of legalization hosted by the powerful Party of Authenticity and Modernity. Morocco is one of the world's largest marijuana producers, with output estimated at 40,000 tons a year, most of which is transformed into hashish and destined for European markets.

Czech Police in Mass Raid on Grow Shops. Although the Czech Republic has a reputation as a pot-friendly destination, recreational marijuana use remains illegal. Czech police served up a reminder of that reality Tuesday, raiding dozens of stores that sell growers' supplies. Police seized fertilizer, grow lights, and marijuana growing guidebooks and said they suspected store owners of violating drug laws by providing people with all the equipment they needed to grow their own. There was no mention made of any arrests.

New Zealand Court Says Employer Can't Force Workers to Undergo Drug Tests. New Zealand's Employment Court has ruled that companies cannot impose random drug tests on workers, nor discipline them for refusing such a test. Mighty River Power Company had a collective bargaining agreement with workers, which allowed testing only under specified circumstances, but initiated random drug tests later. If the company wants random drug test, the court said, it would need to negotiate a new provision in the collective bargaining agreement.

Mexican Military Takes over Key Pacific Seaport in Bid to Fight Cartels. The Mexican military has moved into the major port of Lazaro Cardenas and the adjoining town of the same name in the violence-plagued state of Michoacan. Soldiers are now responsible for policing duties, and all 113 police officers in Lazaro Cardenas have been sidelined until they undergo drug testing and police training. The port of Lazaro Cardenas is the main entrepot for precursor chemicals used in the manufacture of methamphetamine, which is produced in the state by the Knights Templar cartel. The Knights are also engaged in ongoing fighting with vigilante "self-defense" forces in the state.

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

Chronicle AM -- November 4, 2013

Remember Bernie Goetz? He made the news again over the weekend, and so did Florida's medical marijuana initiative. There's also drug policy news from around the world. Let's get to it

Colorado medical marijuana dispensaries like this one could reopen as adult pot stores on January 1. (wikipedia.org)
Marijuana

Let A Hundred Pot Shops Bloom…in Colorado. The Colorado Marijuana Enforcement Division reported late last week that it has received applications from 136 people seeking to open adult use marijuana retail stores. By law, only people currently operating medical marijuana businesses could apply. Those who applied by the end of October will have decisions on their applications before year's end, meaning they could open on January 1, the earliest date adult marijuana sales will be allowed in the state.

NYC Subway Vigilante Bernie Goetz Busted in Penny Ante Marijuana Sting. The New York City man who became a national figure after shooting four teens who asked him for money on the subway back in 1984 was arrested last Friday over a $30 marijuana sale. Bernie Goetz is accused of selling the miniscule amount of marijuana to an undercover officer.

Medical Marijuana

Florida Lawmakers Oppose Medical Marijuana Initiative. Florida House and Senate leaders said late last week that they will join Attorney General Pam Bondi (R) in asking the state Supreme Court to block a medical marijuana initiative from going to the ballot. "We certainly don't want a situation like they've got in Colorado," explained state Rep. Doug Holder (R-Venice). Petitioners have gathered only about 200,000 of the more than 600,000 signatures they need to make the ballot. They have until February, unless the state Supreme Court puts the kibosh on the effort.

Florida Governor Candidate Supports Medical Marijuana Initiative. Candidate for the Democratic gubernatorial nomination Nan Rich said last Friday she supports a proposed medical marijuana ballot initiative. "I’ve seen the research, I’ve studied the issue, and I’ve met with patients who clearly benefit and desperately need medically prescribed cannabis," Rich said in a statement. "That's why I’m signing the petition to get this important measure on the ballot in 2014 and I’m calling on all of my friends and supporters to do the same.  There is simply no reason patients should suffer when an effective, safe, and organic remedy is readily available."

Washington State Regulators to Hold Hearing on Controversial Medical Marijuana Plans. The Washington state Liquor Control Board announced last Friday it will hold a hearing November 13 in Lacey to take public testimony on proposed changes to the state's medical marijuana system. Regulators have issued draft recommendations that would reduce the amount of medical marijuana patients could possess and end their ability to grow their own, among other things.

International

Canada SSDP to Hold National Conference in Vancouver. Canadian Students for Sensible Drug Policy (CSSDP) will hold its sixth annual conference on November 22-24 in Vancouver, BC. Featured speakers will include Donald McPherson, head of the Canadian Drug Policy Coalition; Dana Larsen, director of Sensible BC and the Vancouver Dispensary Society; and Missi Woolrdige, director of DanceSafe, among others.

Hong Kong Docs Criticize Government Drug Testing Plan. The Hong Kong Medical Association said Monday that a government plan to allow police to test anyone for drug use based on "reasonable suspicion" is flawed and violates basic human rights. The local government began a four-month consultation on the plan in September, and now the doctors have weighed in. The association said that drug testing was an unproven method of reducing drug use and resources should instead be devoted to prevention and education campaigns and cooperation with mainland police against drug trafficking.

India to Greatly Expand Opiate Maintenence Centers. Responding to an increase in the number of injection drug users, the Indian government is moving to expand the number of its Opiate Substitution Therapy (OST) centers six-fold, from a current 52 to 300 by the end of the year. Drug user groups, including the Indian Drug Users Forum, and harm reduction groups, such as Project Orchid have been involved in planning the expansion. It's not clear what drug the Indians are using in OST. 

Ireland Parliament to Debate Marijuana Legalization This Week. A private motion by independent Dail, or Irish parliament, member Luke "Ming" Flanagan will be debated on Tuesday and Wednesday. Flanagan's bill would make it legal to possess, grow, and sell marijuana products.

Cartel Violence Flares in Mexican Border Town. Sunday shoot-outs between rival drug trafficking organizations and between traffickers and soldiers left at least 13 people dead in the Mexican border town of Matamoros, just across the Rio Grande River from Brownville, Texas. Four men and a woman were killed in clashes between rival gangs, and eight more died in fighting with Mexican Marines. Somewhere north of 75,000 people have been killed in violence since former President Felipe Calderon called out the armed forces to wage war on the cartels six and a half years ago. Meanwhile, the drugs continue to flow north and the guns and cash flow south.

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

Health Canada Approves Heroin Maintenance [FEATURE]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Vancouver
Canada

Pot Apocalypse Looms, Marijuana Foes Warn

Not everybody is happy with Thursday's Justice Department announcement that it would not interfere with taxed, regulated, and legalized marijuana in Colorado and Washington. While the announcement was greeted with accolades (and some questions) by the drug policy reform community, opponents of marijuana law reform were up in arms and prophesying hellfire and damnation.

It's Reefer Sadness for prohibitonists today.
"Decades from now, the Obama administration will be remembered for undoing years of progress in reducing youth drug use in America," Dr. Paul Chabot of the Coalition for a Drug Free California said in a statement. "This president will be remembered for many failures, but none as large as this one, which will lead to massive youth drug use, destruction of community values, increased addiction and crime rates."

Chabot is also the the coauthor, along with Richard Morgan, of "The Eternal Battle Against Evil: A Comprehensive Strategy to Fight Terrorists, Drug Cartels, Pirates, Gangs, and Organized Crime," and the coalition web site also hawks Morgan's "Soros: The Drug Lord. Pricking the Bubble of American Supremacy."

While Chabot, with his Anslingerian fulminations and Manichean thinking, represents old school Reefer Madness-style prohibitionism, the new school prohibitionists aren't too pleased either.

"We can look forward to more drugged driving accidents, more school drop-outs, and poorer health outcomes as a new Big Marijuana industry targeting kids and minorities emerges to fuel the flames," warned former US Rep. Patrick Kennedy in a statement issued by Project SAM (Smart About Marijuana), a neo-prohibitionist organization that couches its policy aims amid public health concerns.

"This is disappointing, but it is only the first chapter in the long story about marijuana legalization in the US. In many ways, this will quicken the realization among people that more marijuana is never good for any community," said Project SAM cofounder and director Kevin Sabet.

Project SAM warned that after the Obama administration instructed prosecutors to go easy on medical marijuana in 2009, "public health consequences soared" and called on the federal government to fund "robust data monitoring systems" to track those alleged consequences.

"In Colorado, we've seen an explosion of consequences among kids as a result of the new industry that emerged around so-called medical marijuana after 2009," remarked Christian Thurstone, SAM Board Member and Denver Health treatment provider. "We now have to prepare the floodgates."

Just what will come through those floodgates, though, is unclear. Reform advocates point to 2011 data showing that youth marijuana use declined in Colorado since the state adopted its system of regulated dispensaries in 2009.

CADCA conference (nationalservice.gov)
The taxpayer-funded Community Anti-Drug Coalitions of America (CADCA) also weighed in with disappointment, doom, and gloom.

"The Department of Justice announced that it will not sue to block the implementation of laws in Colorado and Washington that legalize marijuana, despite the fact that these laws are in conflict with federal law," said CADCA head Gen. Arthur Dean in a statement. "CADCA and its more than 5,000 community coalitions across the country have been anticipating a response from the administration that would reaffirm the federal law and slow down this freight train. Instead, this decision sends a message to our citizens, youth, communities, states, and the international community at large that the enforcement of federal law related to marijuana is not a priority."

"The fact remains that smoked marijuana is not medicine, it has damaging effects on the developing adolescent brain, and can be addictive, as evidenced by the fact that 1 in 6 youth who use it will become addicted," Dean claimed, adding that the country is in "a growing crisis" as marijuana law reforms take hold. "The nation looks to our Justice Department to uphold and enforce federal laws. CADCA is disappointed in the Justice Department's decision to abdicate its legal right in this instance. We remain gravely concerned that we as a nation are turning a blind eye to the serious public health and public safety threats associated with widespread marijuana use."

Despite the bitter disappointment of the prohibitionists, marijuana law reform is moving forward, and the momentum is only likely to accelerate in the years to come. We may see in a few years if their dire warnings are correct -- if the country is still standing, that is.

With Legalization Looming, Lessons from the Netherlands [FEATURE]

The US states of Colorado and Washington voted last year to legalize marijuana and are moving forward toward implementing legalization. Activists in several states are lining up to try to do the same next year, and an even bigger push will happen in 2016. With public opinion polls now consistently showing support for pot legalization at or above 50%, it appears that nearly a century of marijuana prohibition in the US is coming to an end.

A coffee shop in Amsterdam, where clients can sit and smoke. Why no on-premises consumption here? (wikimedia.org)
Exactly how it comes to an end and what will replace it are increasingly important questions as we move from dreaming of legalization to actually making it happen. The Netherlands, which for decades now has allowed open marijuana consumption and sales at its famous coffee shops, provides some salutary lessons -- if reformers, state officials, and politicians are willing to heed them.

To be clear, the Dutch have not legalized marijuana. The marijuana laws remain on the books, but are essentially overridden by the Dutch policy of "pragmatic tolerance," at least as far as possession and regulated sales are concerned. Cultivation is a different matter, and that has proven the Achilles Heel of Dutch pot policy. Holland's failure to allow for a system of legal supply for the coffee shops leaves shop owners to deal with illegal marijuana suppliers -- the "backdoor problem" -- and leaves the system open to charges it is facilitating criminality by buying product from criminal syndicates.

Still, even though the Dutch system is not legalization de jure and does not create a complete legal system of marijuana commerce, reformers and policymakers here can build on the lessons of the Dutch experience as we move toward making legal marijuana work in the US.

"Governments are looking to reform their drug policies in order to maximize resources, promote health and security while protecting people from damaging and unwarranted arrests," said Kasia Malinowska-Sempruch, Director of the Open Society Global Drug Policy Program. "The Netherlands has been a leader in this respect. As other countries and local jurisdictions consider reforming their laws, it's possible that the Netherlands' past offers a guide for the future."

A new report from the Open Society Global Drug Policy Program lays out what Dutch policymakers have done and how they have fared. Authored by social scientists Jean-Paul Grund and Joost Breeksema of the Addiction Research Center in Utrecht, the report, Coffee Shops and Compromise: Separated Illicit Drug Markets in the Netherlands tells the history of the Dutch approach and describes the ongoing success of the country's drug policy.

This includes the separation of the more prevalent marijuana market from hard drug dealers. In the Netherlands, only 14% of cannabis users say they can get other drugs from their sources for cannabis. By contrast in Sweden, for example, 52% of cannabis users report that other drugs are available from cannabis dealers. That separation of hard and soft drug markets has limited Dutch exposure to drugs like heroin and crack cocaine and led to Holland having the lowest number of problem drug users in the European Union, the report found.

Pragmatic Dutch drug policies have not been limited to marijuana. The Netherlands has been a pioneer in harm reduction measures, such as needle exchanges and safe consumption sites, has made drug treatment easy to access, and has decriminalized the possession of small quantities of all drugs. As a result, in addition to having the lowest number of problem drug users, Holland has virtually wiped out new HIV infections among injection drug users. And, because of decriminalization, Dutch citizens have been spared the burden of criminal records for low-level, nonviolent offenses.

The Dutch have, for example, virtually eliminated marijuana possession arrests. According to figures cited in the report, in a typical recent year, Dutch police arrested people for pot at a rate of 19 per 100,0000, while rates in the US and other European countries were 10 times that or more.

For veteran drug reform activist Joep Oomen of the European NGO Coalition for Just and Effective Drug Policies (ENCOD), the report is welcome but not exactly "stop the presses" news.

"The conclusions of this report have been known for a long time," he told the Chronicle. "Already by the end of the 1990s, when European governments had to acknowledge that Dutch drug policies had proven more effective in reducing risks and harms than many other countries, the criticism that had been expressed earlier by mainly German and French heads of state was silenced. For instance, in the Netherlands the age of first heroin use is the highest of Europe, which is explained by the relative tolerance concerning cannabis use." [Ed: A high age of first use is considered good, because it means that fewer people are experimenting with a drug when they are young -- which in turn means fewer people ever trying it, and those who do being more likely to be capable of avoiding problematic use.]

While the Dutch can point to solid indications of success with their pragmatic drug policies, it is not all rosy skies. The "back door problem" alluded to above continues unresolved, and the relative laxness of Dutch marijuana policy has led to an influx of "drug tourists," especially from neighboring countries, such as France and Germany. Both of those irritants have provided fodder for conservative parties and administrations that have sought to roll back the reforms.

"There seems to be more admiration for Dutch drug policy outside the Netherlands than inside," Oomen observed. "Right-wing governments that have dominated the Dutch political climate since 2002 have slowly dismantled acceptance-oriented drug policy. Lately the establishment of the Weedpass in the southern part of the country [which excludes non-Dutch from access to the coffee shops] and new measures against grow shops and coffee shops are definitely threatening to undermine the coffee shop model," he said.

"Instead of completing the regulation of this model by solving the coffee shops' back door problem, the government seems to apply a policy of slow elimination by making the conditions worse in which the shops have to operate," Oomen continued. "And the Dutch press follows blindly, often referring to coffee shops as a link in a criminal chain, which is unavoidable since the ban on cultivation forces shop owners to deal with criminals, but without questioning the measures that reinforce the criminal aspect."

While the national government may now be hostile to pragmatic marijuana policies, it is facing considerable resistance from elected officials. The Weedpass program now appears to be largely a dead letter, thanks to opposition from the likes of Amsterdam Mayor Eberhard van der Laan, and other local elected officials are moving to address the back door problem.

"Several Dutch mayors have plans for municipal cannabis farms to supply the coffee shops and take crime out of the industry," said Grund, research director at the Addiction Research Center. "But if Dutch drug policy offers one lesson to foreign policymakers, it is that change should be comprehensive, regulating sale to consumers, wholesale supply and cultivation."

Grund is watching the American experience with legalization in Colorado and Washington and had some observations he shared with the Chronicle.

"As far as I can judge," he said, "these are both pretty solid proposals, although quite different in detail and approach -- e.g., a vertically integrated chain of supply in Colorado and separate licensing for producers, processors, and retailer in Washington. Clearly in both states legislators have done their best. Interesting then, that they end up with rather different plans, which is actually fine, as it provides us with the opportunity to evaluate different models. For more than 25 years, there was just about only the Dutch experience with cannabis decriminalization and coffee shops; now we see different models of cannabis reform and distribution being implemented across continents. Comparing these experiences as they evolve should allow us to develop more effective drug policies."

Policymakers and regulators should try to avoid rigidity and be ready to deal with unintended responses and consequences, the Dutch social scientist said.

"The point is to approach these flexibly and pragmatically; adjust when necessary, while keeping your eyes on the ball: cutting the link between cannabis on the one hand, and criminal records, mafia and more, on the other," Grund advised, noting that the 1976 Dutch law separating hard and soft drugs did not anticipate the arrival of the coffee shop phenomenon. "As Dr. Eddy Engelsman, former chief drug policy maker at the ministry of health -- and known as the architect of Dutch drug policy -- said when we interviewed him, 'coffee shops just emerged.' The policymakers deemed that these fit their overall policy objectives and allowed for them to ply their trade openly," he recalled.

Grund also weighed in on personal cultivation -- Colorado allows it; Washington does not -- and public use, which it appears will remain forbidden in both states.

"I think Washington presents more of a business and revenue raising strategy, while Colorado feels more like grassroots meets civil libertarian meets amenable regulator," he opined. "The more social, homegrown orientation of the Colorado proposal – allowing for home growing, bartering between friends -- could perhaps engender a less market driven distribution structure, where friends compete in growing the most pleasant marijuana, not the most profitable. Something like the Spanish cannabis clubs," he suggested.

Public, convivial pot smoking in designated areas should be allowed, Grund said, because it has benefits.

"Dedicated places of consumption -- such as the coffee shops in the Netherlands or shisha parlors -- offer an opportunity to promote responsible behavior around cannabis consumption," he argued. "Smoking cannabis in a safe, hospitable and stress free environment engenders different use patterns from quickly getting high in a service ally behind a bar or in a car parked in a quiet place. Coffee shops offer a moderating environment where self regulation is supported by social learning and control."

While Grund was looking forward to the future in the US, Oomen was thinking of the unfinished business in the Netherlands, but his musing also provide food for thought for American reformers, especially those contemplating decriminalization measures.

"The lesson here is that decriminalization or depenalization are useful concepts for a transition period, but real progress can only be obtained and assured with legal regulation of the entire chain from producer to consumer," the ENCOD leader noted. "The Dutch case shows that politicians will always use the smallest margin they have to maintain to a repressive model, provoking criminal activities which they can use to justify their policies publically. This is the drug policy perpetual motion machine."

Colorado and Washington are already well down their particular paths to marijuana legalization. But there is still time for the next wave of legalization states to learn and apply those lessons, not just from Denver and Olympia, but from the Dutch pioneers as well.

Netherlands

Chronicle Book Review: High Price

High Price: A Neuroscientist's Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society, by Dr. Carl Hart (2013, Harper/Harper Collins Publishers, 340 pp., $26.99 HB)

Dr. Carl Hart grew up black and poor in Miami in the 1970s and 1980s, learned discipline from his desire to be a professional athlete, joined the armed forces, and wandered almost by happenstance into a career in the neurosciences. Now, Hart is at the pinnacle of his field -- a respected researcher in drug effects, the first African-American to become a tenured professor in the sciences at Columbia University, and a member of the National Advisory Council on Drug Abuse and Dependency. And he has some things to say.

Some of those things contradict the conventional wisdom, but Hart has the cred -- both street and academic -- to state them. Although it is the addict or problematic drug user who is too often the media's face of drug use or the subject of scientific research, he notes, the vast majority of drug users are not addicts or problematic. And yes, that even extends to the most demonized drugs, like crack. While we were told one hit could get you strung out, it turns out only a small fraction of crack consumers are addicts, he points out.

Hart also has good, practical advice -- naive drug users shouldn't take drugs the same way experienced users do, for example, or get enough sleep! -- based not only on scientific research, but also personal observation and experience. Now at the pinnacle of his profession, he also wants to restore some sanity to our drug policies.

Dr. Hart has come a long way from the mean, if sun-splashed, streets of Miami, and with High Price, he takes you along for the ride. The journey is well worth it. Part memoir, part social history, part drug science, part plea for sanity on the issues of drugs, race, and class, High Price is revelatory as well as readable, illuminating as well as incisive, as impassioned as it is important.

While Hart grew up the wrong color and in a family scrabbling to hang on to its lower middle class status, his is, above all, an American story -- a story of coming of age, overcoming adversity, and striving for success and understanding in a world seemingly stacked against him. It's also the story of the American working class, buffeted by the de-industrialization that began in the 1970s, targeted by Reagan Republicans with cuts in social programs in the 1980s, and mostly dealt with by "tough on crime" and "tough on drugs" policies that have been in place ever since. That the malignant swelling of the nation's prison population is tied to Reagan era policies ( though many of them enacted by Democratic legislators) too often goes unnoted.

But of course, Hart isn't an unhyphenated American, he's African-American, and that means he carries an additional burden, the assumption too many make of criminality based on little more than his skin color. He wasn't expected to succeed, but to become a number, like so many of his peers. And, as he notes, but for the grace of god he could have gone down that path. He recounts the teenage criminality of he and his peers, making the stark point that a single arrest could make the difference between a career as a scientist and a career as an ex-con car washer. Some of his friends, no better or worse than he, had that unfortunate first encounter with law enforcement and the criminal justice system and never recovered: Educational opportunities blocked, job opportunities lost, they were essentially assigned to the scrap heap.

For some of them, it was a drug bust. Slinging dope was and is a way of life for the marginalized poor, an income, although not a great one, and a way to achieve status and respect. But of course, it's also a ticket to the slammer, particularly if you're poor and of color, without the resources available to middle class white folks. One thing Hart makes crystal clear is just how stacked the deck is against the urban poor, and that alone makes his book worth noting.

Hart grew into young adulthood imbibing the conventional wisdom about how drugs had had such a devastating impact on his community, but he also began to start thinking critically about the mismatch between rhetoric and reality. At some point along the way, he had a Chris Rock moment.

"You know what they say, crack is destroying the ghetto," Rock once famously observed. "Yeah, like the ghetto was so nice before crack. They say that shit like everyone in the 'hood had a yacht, a mansion, and a swimming pool, and crack came by and dried it all up."

As Hart began studying psychology and eventually neuroscience, he began noticing that the effects of crack cocaine widely touted in media and political discourses didn't match the science. In fact, he observed, most of the devastating effects attributed to crack could more fairly and accurately be attributed to poverty. Crack didn't bring guns to the ghetto; they were already there. Crack didn't bring broken families to the ghetto; they were already there. It may not have helped, but it was not the root cause of the problem.

"The effect of crack, when it had one, was mainly to exacerbate the problems that I'd seen in my home and in the hood since the 1970s," he wrote. "The drug's pharmacology didn't produce excess violence."

The studies on which he embarked, moving on from observing the effects of drugs on rats to observing their effects on people, led him to a startling -- and eye-opening -- conclusion: "Much of what we are doing in terms of drug education, treatment and public policy is inconsistent with scientific data."

Hart's critique extends to the science itself. He describes famous experiments where rats or monkeys alone in a cage will repeatedly press a lever to get more drugs, up to the point of death itself. But he then explains how those doses are many times higher than those any human would use, and he makes the crucial point that obsessive drug-taking behavior is reduced when the lab animals are part of a community and when they have other options.

Based on his scientific research, as well as his own observations and historical research (and musical and lyrical inspiration from the likes of Bob Marley and Public Enemy), Hart decided he needed to speak out against the injustices of the war on drugs. He became a board member of the Drug Policy Alliance, he began speaking to groups large and small, and High Price is part of that same education project.

This is not your typical drug policy tome. It's not a paean to pot, nor is it a dry academic treatise. But it is important, not only because it provides a voice for the voiceless peers he left behind, but also because it is a science- and evidence-based clarion call for a smarter and more human approach to drugs, one that situates drugs and problematic drug use within the broader social context. And it's a damned good read, too.

Malaysia Minister Talks Drug Decriminalization

A Malaysian government minister said Sunday the Southeast Asian nation is moving toward decriminalizing drug possession, but her remarks also suggested that drug users would be exchanging jail cells for treatment beds. Minister in the Prime Minister's Department Nancy Shukri said the government's policy was moving from prosecuting drug users to treating them.

Nancy Shukri (frim.gov.my)
Her remarks came at the end of a High Level Meeting on Drug Policy and Public Health sponsored by the Global Commission on Drug Policy. The meeting was held in conjunction with the 2013 International Aids Conference held over the weekend in Kuala Lumpur, the Malaysian capital.

Shukri also said that the Association of Southeast Asian Nations' (ASEAN) goal of a drug-free region by 2015 was not realistic, but that smarter approaches by authorities could reduce drug dependence.

"There is no such thing as drug-free but we can control it by changing or shifting our policy," Shukri said. "Instead of looking at drug dependents as criminals, we should actually look at them as patients. Instead of bringing them to jail, we bring them to the clinic," she told a press gaggle after the AIDS conference ended.

Shukri said that Malaysia had been taking steps toward a more effective and humane drug policy, but that those initiatives were not widely known. She cited ongoing needle exchange programs for injection drug users. The sharing of needles is a known vector for the transmission of the AIDS virus, and the program had resulted in a reduction in new HIV/AIDS infections, she said.

"Others include the harm reduction program and upgrading of the rehabilitation centers into Cure & Care Clinics," Shukri said. "We are already there (decriminalizing drugs) but we are not making it loud enough for the people to understand that we have this policy. Our policy has not been established in a formal way."

That could be coming, though. Shukri said the government is currently reviewing the country's drug laws, including the Drug Dependents (Treatment and Rehabilitation) Act of 1983.

"The Law Reform Committee is now in the process of discussing to amend that particular provision [Section 4(1)(b) of the Act which allows the detention of a suspected drug dependent for up to 14 days for a test to be conducted]," she said.

Kuala Lumpur
Malaysia

Nevada Governor Signs Medical Marijuana Dispensary, Needle Bills

Nevada's Republican governor, Brian Sandoval, Wednesday signed into law two drug reform measures, one allowing for medical marijuana dispensaries and one removing syringes from the state's drug paraphernalia law.

On the medical marijuana front, Sandoval signed into law Senate Bill 374, which will establish a state-regulated system of dispensaries. The law envisions up to 66 dispensaries across the state, with up to 40 in Las Vegas, 10 in Reno, and at least one in each county.

"We applaud Gov. Sandoval and the legislature for their leadership and commend those law enforcement organizations that expressed support for this much-needed legislation," said Karen O'Keefe, director of state policies for the Marijuana Policy Project, who testified in support of the bill. "It will make Nevada a safer and healthier place not only for medical marijuana patients, but for the entire community. This new law will provide patients with the safe and reliable access to medical marijuana that they deserve," O'Keefe said. "Regulating medical marijuana sales will also generate revenue and take a bite out of the state's underground marijuana market."

Introduced by Sens.Tick Segerblom (D-Las Vegas) and Mark Hutchison (R-Las Vegas), the bill creates rules and regulations not only for dispensaries, but also infused product manufacturers and cultivation and testing facilities. It also imposes 2% excise taxes on both wholesale and retail sales, with 75% of those revenues going to the education fund and 25% going to cover the cost of regulating the medical marijuana industry.

The state's voter-approved medical marijuana law, passed twice in 1998 and 2000, required the legislature to create a medical marijuana program that included appropriate methods of supplying medical marijuana to patients. Now, the legislature has finally done so. Nevada will now join Arizona, Colorado, Maine, New Jersey, New Mexico, and Rhode Island on the list of states that have state-regulated dispensaries. Two more jurisdictions, Washington, DC, and Vermont should come on board this summer, and the rule-making process for dispensaries is underway in Connecticut and Massachusetts.

On the harm reduction front, Sandoval signed into law Senate Bill 410, which decriminalizes the possession of syringes by removing them from the state's drug paraphernalia list. That opens the way for the over-the-counter sale of syringes and needle exchange programs.

"Back in 1996 when first elected, I was asked what bills I'd be pursuing for my first legislative session," said Sen. David Parks (D-Las Vegas).  "My response was employment non-discrimination, HIV/AIDS state funding and decriminalization of hypodermic devices. Little did I know it would be my 9th session before decriminalization of hypodermic devices would come to fruition."

Nevada becomes the 37th state to decriminalize syringe possession and allow for the over-the-counter sale of needles, as well as needle exchange programs, both proven means of reducing the transmission of HIV, viral hepatitis, and other blood-borne infections.

Nevada harm reduction workers said they were ready to get a needle exchange up and running as soon as the law takes effect.

"In addition to getting sterile syringe out to those who need them, our program will increase safe syringe disposal by individuals in the community," said Sharon Chamberlain, director of Northern Nevada HOPES in Reno. "We will educate these users about the new and needed community disposal options, and strongly encourage them to take advantage of this resource. Previously, no community initiatives provided safe disposal options. "

Carson City, NV
United States

Harm Reduction 2013

Our friends at the Hungarian Civil Liberties Union attended the international harm reduction conference in Vilnius, Lithuania, this week, and have brought some of it to the rest of us through a new video:

 
Among the highlights are the former presidents of Switzerland and Poland.
Location: 
Vilnius
Lithuania

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