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One Simple Way to Reduce Deadly Heroin and Pain Pill Overdoses

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

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

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

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

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

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

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

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

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

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

Medical Marijuana Update

A new study suggests that medical marijuana can reduce opioid abuse, Arkansas and Florida continue to grapple with addressing voter-approved medical marijuana laws, and more.

National

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

Arkansas

Last Thursday the Senate passed two medical marijuana "fix" bills. The state Senate approved two bills aimed at modifying the state's voter-approved medical marijuana law. The Senate approved House Bill 1400, which would ban the smoking of marijuana anywhere tobacco smoking is banned. That bill now goes to the governor's desk. The Senate also approved Senate Bill 721, which would require dispensaries to appoint a pharmacist director who would be available for consultations with patients during hours the dispensary is open. That bill now heads to the House.

Colorado

Last Wednesday the patient plant limit rose to 24 as a bill limiting home grows advanced. A bill aimed at limiting marijuana home grows has been amended -- again -- in the House Judiciary Committee. In a Wednesday vote, the committee approved raising the plant limit under House Bill 1220 to 24 plants. The bill had originally set the number at 12, but lawmakers then upped the count to 16, and now 24 -- if patients register with the state. The bill now heads for a House floor vote.

Florida

On Tuesday a restrictive medical marijuana bill advanced. While a half-dozen competing measures aim to address the state's voter-approved medical marijuana system, the most restrictive measure advanced in the House on Tuesday. House Bill 1397 would limit growers to the seven currently permitted and bans smoking, vaping, and edibles. It moved out of the Health Quality Subcommittee on a 14-1 vote, but faces two more committee votes before heading for the House floor. None of the five Senate bills addressing medical marijuana have yet had a hearing.

Georgia

On Tuesday a CBD cannabis oil expansion bill passed the House. The House voted 167-4 Tuesday to approve Senate Bill 16, which would add six new qualifying conditions for the use of cannabis oil, including autism, AIDS, Tourette's Syndrome, and Alzheimer's. The state Senate approved the bill last month.

Maine

On Monday Ma bill to make medical marijuana users eligible for organ transplans got a hearing. Legislators heard powerful testimony from patients removed from life-saving organ transplant lists because they used marijuana as they considered Legislative Document 764. The bill would targets the Maine Medical Center, the only transplant center in the state, whose transplant policy states that "use of prescribed or recreational marijuana by any route of administration is absolutely prohibited." No vote was taken, and the bill is scheduled for more hearings next month.

Oklahoma

On Monday the state Supreme Court ruled the former attorney general wrongly changed initiative ballot question wording. Former state Attorney General Scott Pruitt (R), now head of the federal Environmental Protection Agency, changed the ballot title for a medical marijuana initiative in a way that would mislead voters. The original ballot question read: "A yes vote legalizes the licensed use, sale, and growth of marijuana in Oklahoma for medicinal purposes," but Pruitt changed that to: "This measure legalizes the licensed use, sale, and growth of marijuana in Oklahoma. There are no qualifying medical conditions identified." Now, the original language for the 2018 initiative has been restored.

West Virginia

Last Friday a medical marijuana bill advanced. The Senate Health and Human Resources Committee voted to approve Senate Bill 386, the West Virginia Medical Cannabis Act. The bill would create a system of regulated cultivation sites and dispensaries and allow the use of medical marijuana by persons suffering from a list of qualifying conditions. The bill now heads to the Senate Judiciary Committee.

[For extensive information about the medical marijuana debate, presented in a neutral format visit MedicalMarijuana.ProCon.org.]

Chronicle AM: GA CBD Bill Advances, SD MedMJ & Legalization Inits Pass Hurdle, More... (3/29/17)

South Dakota activists hope the third time's the charm when it comes to medical marijuana initiatives, a Georgia CBD expansion bill advances, the Oklahoma Supreme Court slaps down former Attorney General (now EPA head) Scott Pruitt over medical marijuana ballot language, and more.

Will South Dakota ever approve medical marijuana? Voters could have another chance in 2018. (Flickr)
Marijuana Policy

South Dakota Marijuana Legalization, Medical Marijuana Initiatives Get Attorney General Approval. State Attorney General Marty Jackley (R) has provided required attorney general explanations for two proposed initiatives. A marijuana legalization initiative would allow the possession of up to an ounce and the cultivation of up to five plants, as well as taxed and regulated marijuana commerce, while a medical marijuana initiative would allow patients to possess up to three ounces and grow a minimum of six plants. The initiatives are now ready for signature gathering and both need 13,871 valid voter signatures to qualify for the November 2018 ballot.

Medical Marijuana

Restrictive Florida Medical Marijuana Bill Advances. While a half-dozen competing measures aim to address the state's voter-approved medical marijuana system, the most restrictive measure advanced in the House on Tuesday. House Bill 1397 would limit growers to the seven currently permitted and bans smoking, vaping, and edibles. It moved out of the Health Quality Subcommittee on a 14-1 vote, but faces two more committee votes before heading for the House floor. None of the five Senate bills addressing medical marijuana have yet had a hearing.

Georgia CBD Cannabis Oil Bill Clears House. The House voted 167-4 Tuesday to approve Senate Bill 16, which would add six new qualifying conditions for the use of cannabis oil, including autism, AIDS, Tourette's Syndrome, and Alzheimer's. The state Senate approved the bill last month.

Oklahoma Supreme Court Says Former Attorney General Wrongly Changed Initiative Ballot Question Wording. Former state Attorney General Scott Pruitt (R), now head of the federal Environmental Protection Agency, changed the ballot title for a medical marijuana initiative in a way that would mislead voters. The original ballot question read: "A yes vote legalizes the licensed use, sale, and growth of marijuana in Oklahoma for medicinal purposes," but Pruitt changed that to: "This measure legalizes the licensed use, sale, and growth of marijuana in Oklahoma. There are no qualifying medical conditions identified." Now, the original language for the 2018 initiative has been restored.

Asset Forfeiture

Iowa Senate Approves Civil Asset Forfeiture Reform. The state Senate on Tuesday approved Senate File 446, which would bar the seizure of property valued at less than $5,000 unless there was a prior criminal conviction. The measure also increases the standard of proof required for asset forfeiture from "a preponderance of the evidence" to "clear and convincing evidence." The bill is now in the House, where it must advance by a committee this week to survive.

Law Enforcement

Arizona Senator, Congresswoman File Federal Bill to Increase Penalties for Border "Spotters." US Sen. John McCain (R-AZ) and Rep. Martha McSally (R-AZ) have introduced the "Transnational Criminal Organization Illicit Spotter Prevention and Elimination Act," which would toughen penalties on "spotters" who warn drug and human smugglers about the position of Border Patrol surveillance or officers. The bill would subject such people to up to 10 years in federal prison. The bill is not yet available on the congressional web site.

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

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

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

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

Medical Marijuana

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

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

Heroin and Prescription Opioids

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

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

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

Marijuana Policy

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

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

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

Heroin and Prescription Opioids

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

Asset Forfeiture

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

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

Drug Policy

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

Law Enforcement

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

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

International

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

Legal Marijuana: The Sky is (Probably) Not Falling [FEATURE]

This article was produced in collaboration with AlterNet and first appeared here.

Barrels of ink have been spilled over the prospect that the Trump administration could attempt to turn back the clock when it comes to legal marijuana, but for all the wailing and gnashing of teeth out there, marijuana industry insiders, advocates, and activists don't seem all that worried.

Jeff Sessions loathes marijuana, but is going after it the best use of DOJ resources? (senate.gov)
"I don't think there's any more reason to be scared than to be hopeful at this point," said Mason Tvert, Denver-based communications director for the Marijuana Policy Project. "The administration has not changed its marijuana policy, and there is reason to believe it may maintain the existing policy or adopt a similar one that respects states' laws regulating marijuana."

"Marijuana is one of the least of my concerns with the Trump administration," said Dale Gieringer, coauthor of the pioneering 1996 Prop 215 medical marijuana initiative and long-time head of California NORML. "That's the first time I've been able to say that, but I just don’t see where there's any percentage in them going after marijuana. The polls are on our side, and they can't enforce the law."

The industry, too, seems to think that there's not really that much to fear from the Trump administration.

"We are in a posture of cautious optimism," said Taylor West, communications director for the National Cannabis Industry Association (NCIA). "We're definitely not taking anything for granted -- it's quite clear that Sessions has really strong personal opposition to the industry -- but we are encouraged by the intense pushback, not just from the industry, but from elected officials, regulators, and lawmakers from both sides of the aisle. That is probably the most powerful signal to the Justice Department that dramatic changes to current policy would cause them a lot of problems."

West pointed to the strong reaction from state officials in marijuana-legal and medical marijuana states, as well as support from federal lawmakers and not just Democrats. She cited Nevada US Sen. Dean Heller as an example of a Republican lawmaker siding with the industry over the administration.

"They are speaking up because the industry and individual businesses and consumers have spoken up as their constituents and taught them about the industry and what we stand far and why we deserve respect from the federal government," she said.

And the marijuana money people appear largely unperturbed, too. In a report released Thursday, Arcview Market Research projected that the industry is going to continue to boom regardless of what happens in Washington, with revenues of nearly $7 billion this year and an astounding projected annual growth rate of 27% through 2021.

"While the uncertainty created by the mixed signals coming out of the administration may cause a temporary dip in some valuations of cannabis companies and some more risk-averse institutional investors and multinational companies may continue to stay on the sidelines, it won't impact the growth of the market much at all," said Troy Dayton, CEO of Arcview Market Research. "No matter what the administration does, states will continue to issue cannabis licenses to a long line of applicants and licensed cannabis outlets will continue to have long lines of consumers ready to purchase this product from regulated establishments."

Maintaining the Status Quo

Legal marijuana could be a $7 billion industry by 2021. (Creative Commons/Wikimedia)
Medical marijuana is now legal in more than half the states and adult recreational use is legal in eight, including the entire West Coast. Some early enforcement actions notwithstanding, the Obama administration largely turned a blind eye to state-legal but federally-illegal marijuana. The Obama Justice Department adhered to the Cole memorandum, a 2013 "guidance" to federal prosecutors that essentially limited them to going only after legal marijuana operations that crossed specified lines: selling to minors, diverting product to non-legal states, being involved in violence or other trafficking, and the like.

Medical marijuana states at least are also protected by the Rohrabacher-Farr amendment, which bars the Justice Department from using federal funds to go after state-compliant medical marijuana operations. A similar measure, the McClintock-Hollis amendment, would have extended that same shield to the adult-legal states, but came up just short in the last Congress. Both amendments will be offered again this year.

"Jeff Sessions doesn't like marijuana -- that much is clear -- but that's not the question," MPP's Tvert argued. "The question is whether he believes limited federal resources should be used to interfere in state marijuana laws. As of right now, there's no reason to believe that's the case."

Tvert pointed to Sessions' seeming acceptance of the Cole memo, as well as a memo Sessions sent to federal prosecutors last month telling them to go after "the worst of the worst" and violent crime.

"State licensed and regulate marijuana businesses are by no means violent or the 'worst of the worst,'" Tvert noted. "They want to go after cartels and violent criminals and focus on serious crime, so why force marijuana back into the underground market?"

"President Trump said states should be able to determine own marijuana policies, and he also had strong support for legal access to medical marijuana, and we haven't heard anything new from him on it," said Tvert. "But again, it's not a question of the president's personal views, but of what the federal laws are and the realities of enforcement. Sessions has said on multiple occasions that the federal government cannot effectively enforce federal prohibition in states where it is legal."

The view was not quite as sanguine from Washington, DC, where national NORML has its offices.

"As far as the industry goes, even the threat of a crackdown by the Justice Department has a chilling effect," said Justin Strekal, NORML political director and lobbyist. "While medical marijuana is protected under Farr-Rohrabacher, the adult use economy has no such protections -- at least for now."

"The Cole memo is just a piece of paper," Strekal said, "and there is nothing stopping Sessions from just throwing it away, as the Heritage Foundation has called for him to do. But the Justice Department has no way to force states to recriminalize marijuana in decrim or legal states. The worst case would be that the adult use states are rolled back to a situation where there is no way to have a legal distribution system, but local law enforcement is not going to be enforcing federal marijuana prohibition."

Where apprehension about the direction of Trump administration pot policy is having a real impact right now is in causing politicians to think twice about legalization in states that are considering it, Strekal said.

"We're hearing feedback from legislators in Connecticut and Maryland saying that the attorney general's comments are acting as a road block, while in Georgia, we just saw a defelonization bill defeated. The mere presence of a Reefer Madness-era Jeff Sessions is frightening off potential supporters of ending prohibition."

Still, Bad Things Could Happen

If Congress blocks funding, DEA can't go after legal marijuana (sort of). (justice.gov/dea)
While an oppositional Trump administration may retard the expansion of legal marijuana in the states, the status quo of a fifth of the country living under legalization and more than half with access to medical marijuana appears unlikely to be rolled-back. But that doesn't necessarily mean a free ride for legal weed.

"There could be some sort of federal action against some adult use facility or grower or cultivation company whose product is found to have gone across state lines in quantity, or something like that," CANORML's Gieringer offered. "Like if you have a situation where Nebraska complains, maybe that could stir up pressure in the Justice Department. But that's the most I expect. I could be wrong, though."

"Since Colorado started its licensing program, there's always been a fear that the Justice Department would just bring a lawsuit saying the state is participating in an ongoing conspiracy to distribute a Schedule I drug," Gieringer observed. "They had their chance and they didn't do it. If they tried it now, they will have taken away hundreds of millions of dollars from Colorado and potentially billions from other states and leave anarchy. They can't enforce the marijuana laws anyway; it's a drain on federal resources to even try."

"A federal injection is a potential threat, but it was a potential threat six months ago, too," said MPP's Tvert. "It's still a question of resources. If that were to happen, marijuana would continue to be legal, but the federal government would be preventing states from controlling its production and sale. That would be a real serious problem."

But Tvert warned that the heavy hand of the federal government could still reach out and slap someone down.

"Sean Spicer said they would have greater enforcement, and that could mean anything," he said. "They could be planning to more rigorously enforce the laws against people not in compliance with state laws, there could be more enforcement against illegal actors, they could push states to strengthen their regulations to prevent interstate trafficking. They perhaps could encourage states to increase funding to law enforcement to investigate illegal activity. There is plenty they could do without interfering with the legal market."

The Fightback Against Rollback Will Only Grow Stronger

The advent of a potential hostile Trump administration isn't changing the way NORML does business, Strekal said.

"We're continuing to do what we've always done and act as a grassroots consumer advocacy group," he explained. "We have 150 chapters and we're engaging as an advocacy group at every level of government from city councils to state legislatures to the federal government. At the federal level, we're very encouraged by the formation of the congressional cannabis caucus. We've been working with them to host a few events."

"This moment in time, where there is a lot of uncertainty at the federal level, is the kind of moment the NCIA was created for," said West. "We've been building relationships and allies in DC around industry issues, so when we need those allies, we have them."

Like MPP, the NCIA has a full-time staff lobbyist in Washington. It also works with another DC-based lobbying firm to work the Hill, and with legislators and elected officials.

"You've been able to see, through our work and the work of others, a very strong pushback from people who previously wouldn't have been in favor of the marijuana industry," West said. "The federal government can try to enforce marijuana prohibition in states where it is legal, but it doesn't really have the personnel to do that without the full cooperation of state and local law enforcement. If states are resisting that crackdown, which elected officials have said they would do, it becomes very difficult, if not impossible."

Legal marijuana is on guard, but it's not running away from a fight. The question for the Trump administration becomes whether this is a fight worth fighting.

Chronicle AM: AZ Init Would Legalize All Drugs, DE Legal MJ Bill Coming, More... (3/24/17)

An Arizona initiative would legalize all drugs, Delaware will see a marijuana legalization bill this year, a West Virginia medical marijuana bill advances, and more.

A Spanish court has refused to convict a man of drug trafficking for importing coca leaf. (YouTube)
Marijuana Policy

Arkansas Attorney General Rejects Marijuana Legalization Initiative Proposal. Attorney General Leslie Rutledge has rejected a proposed marijuana legalization initiative, saying the ballot title is ambiguous and that "a number of changes or additions" are needed "to more fully and correctly summarize" the proposal. The initiative came from Larry Morris of West Fork and would allow for the possession, cultivation, production, distribution, and sale of marijuana in the state.

Delaware Legalization Bill Coming. State Sen. Margaret Rose-Henry (D-Wilmington) is preparing a marijuana legalization bill that she says has support from law enforcement. "Law enforcement wants this bill. I'm pleased to tell you that there are police officers who think this is a good thing that we are going to reduce their having to arrest people who don't need to be arrested," said Rose-Henry. She is currently putting the finishing touches on the bill, she said.

Tennessee House Approves Bill to Undo Nashville's Decriminalization. The House on Thursday approved a bill that would take away Nashville's ability to issue civil citations for small amounts of marijuana instead of arresting people for it. House Bill 173 passed the House 65-28 and now goes to the Senate.

Medical Marijuana

Arkansas Senate Passes Two Medical Marijuana "Fix" Bills. The state Senate on Thursday approved two bills aimed at modifying the state's voter-approved medical marijuana law. The Senate approved House Bill 1400, which would ban the smoking of marijuana anywhere tobacco smoking is banned. That bill now goes to the governor's desk. The Senate also approved Senate Bill 721, which would require dispensaries to appoint a pharmacist director who would be available for consultations with patients during hours the dispensary is open. That bill now heads to the House.

Colorado Patient Plant Limit Rises to 24 as Bill Advances. A bill aimed at limiting marijuana home grows has been amended -- again -- in the House Judiciary Committee. In a Wednesday vote, the committee approved raising the plant limit under House Bill 1220 to 24 plants. The bill had originally set the number at 12, but lawmakers then upped the count to 16, and now 24 -- if patients register with the state. The bill now heads for a House floor vote.

West Virginia Medical Marijuana Bill Advances. The Senate Health and Human Resources Committee voted Friday to approve Senate Bill 386, the West Virginia Medical Cannabis Act. The bill would create a system of regulated cultivation sites and dispensaries and allow the use of medical marijuana by persons suffering from a list of qualifying conditions. The bill now heads to the Senate Judiciary Committee.

Industrial Hemp

West Virginia Hemp Bills Head for Floor Votes. Both the House and the Senate sent hemp-related measures to floor votes in their respective chambers Wednesday. The Senate Agriculture Committee advanced Senate Resolution 35, which calls on Congress to distinguish between hemp and marijuana by THC threshold. Meanwhile, the House Judiciary Committee advanced House Bill 2453, which would allow the state agriculture commissioner discretion to issue commercial hemp production licenses.

Drug Policy

Arizona Groups Files Initiatives to Legalize Marijuana, All Drugs. An organization called RAD Final has filed a pair of initiatives relating to drug policy. Initiative I-13-2018 would legalize all drugs and forbid government from taxing or regulating them, while I-14-2018 would legalize marijuana alone. Initiative organizers would have to gather 150,642 valid voter signatures for each initiative by July 2018 to qualify for the 2018 ballot.

Drug Testing

West Virginia Employee Drug Testing Bill Advances. A bill that would let employers require employees to undergo suspicionless drug tests passed the House of Delegates on Thursday. House Bill 2857. The bill now goes to the Senate.

International

Spanish Court Acquits Man of Importing Coca Leaf. The provincial court of Girona has acquitted a Colombian man of drug trafficking charges for importing coca leaf. The decision came after the defense presented evidence and testimony about the historical, cultural, social and medicinal value of the coca leaf.

Chronicle AM: IL Legal MJ Bill Filed, CA Bill Bars Helping Feds Attack Legal MJ, More... (3/23/17)

Illinois lawmakers want to see marijuana legalization; California lawmakers want to protect marijuana legalization, and more.

Marijuana Policy

California Bill Would Block Cops From Aiding Federal Pot Crackdown. Six Democratic legislators have filed Assembly Bill 1578, which would bar state and local law enforcement from cooperating in any federal enforcement activities aimed at state-legal marijuana operations. "Prohibiting our state and local law enforcement agencies from expending resources to assist federal intrusion of California-compliant cannabis activity reinforces… the will of our state's voters who overwhelmingly supported Proposition 64," said Assemblyman Reggie Jones-Sawyer (D-Los Angeles), the lead author of the new bill.

Illinois Lawmakers File Legalization Bill. A group of Chicago Democratic legislators have filed a marijuana legalization bill by amending an existing bill, House Bill 2353. The measure would legalize the possession of up to an ounce by adults (a half-ounce for non-residents), set up a system of legal marijuana manufacture and distribution $50 per 28 grams on all cannabis flowers, and give state regulators 180 days to get a system up and running.

Law Enforcement

Supreme Court Rules Lawsuit From Man Jailed Over Bottle of Vitamins Can Advance. An Illinois man jailed for two months after police claimed the pills in his vitamin bottle were ecstasy despite lab tests that showed they weren't can continue to pursue his federal civil rights claim, the US Supreme Court ruled Tuesday. Elijah Manuel, who is black, said officers pulled over the vehicle in which he was riding, falsely claimed they smelled marijuana, screamed racial slurs, then claimed their field drug test indicated his vitamins were ecstasy. Police continued to hold him in jail even after other tests verified the pills were not ecstasy until prosecutors eventually dropped the case. "No evidence of Manuel's criminality had come to light in between the roadside arrest and the county court proceeding initiating legal process; to the contrary, yet another test of Manuel's pills had come back negative in that period," according to the opinion. "All that the judge had before him were police fabrications about the pills' content. The judge's order holding Manuel for trial therefore lacked any proper basis. And that means Manuel's ensuing pretrial detention, no less than his original arrest, violated his Fourth Amendment rights."

International

Vietnam Sentenced Nine to Death for Drug Trafficking. A court in Hoa Binh province sentenced nine men to death for trafficking more than a thousand pounds of heroin in a trial that ended Tuesday. Vietnam sentences dozens of people to death each year; about a third of them for drug offenses.

Medical Marijuana Update

Busy, busy. Lawmakers in Arkansas and North Dakota try to "fix" medical marijuana initiatives, New York chronic pain patients can now use medical marijuana, a CBD compromise is reached in Georgia, and more.

Arizona

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

Arkansas

Last Wednesday, a bill to ban edibles and public smoking won a committee vote. A bill that would bar medical marijuana patients from consuming edibles or from smoking their medicine in public was approved by the House Rules Committee. But the measure, House Bill 1400, faces an uphill battle to win final approval because any changes to the voter-approved medical marijuana law require a two-thirds vote to pass.

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

On Monday, the House killed a bill banning edibles. The House voted 52-40 to kill House Bill 1991, which would have banned the commercial production of medical marijuana edibles in the state. Bill sponsor Rep. Robin Lundstrum (R-Springdale) argued that patients could make their own and that medical marijuana is medicine, not candy, but her arguments failed to sway her peers.

Georgia

Last Thursday, lawmakers reached a compromise on a CBD cannabis oil bill. Lawmakers appear to have reached an agreement that would add six illnesses and conditions to the state's list of qualifying medical conditions, allow the use of CBD cannabis oil in hospice care, and keep the allowable level of THC in cannabis oil at 5% or less. That means Senate Bill 16 should now be able to pass out of the House Human Services Committee and head for a House floor vote.

Massachusetts

Last Thursday, bills to protect patients' employment rights filed. Even as the state Supreme Court heard a case on employment rights for medical marijuana patients, two bills alive in the state legislature would do just that. Rep. Frank Smizik (D-Brookline) has introduced House Bill 2385, which would explicitlyprotect the rights of a medical marijuana patient to use the drug without facing discrimination in hiring, firing or terms of employment. The bill would also protect medical marijuana patients from discrimination in education, housing and child welfare and custody cases. That bill is currently before the Committee on Marijuana Policy. A similar bill was filed last sessions, but didn't pass. A second bill, House Bill 113, is aimed mostly at updating state law to bring it in line with the Americans With Disabilities Act, but one provision clarifies that employers cannot take adverse employment action against someone for using medical marijuana. That bill is before the Joint Committee on Children, Families, and Persons with Disabilities.

Nebraska

Last Wednesday, a medical marijuana bill got a charged hearing. At a hearing in the Judiciary Committee, law enforcement, the state attorney general's office, and the state's top doctor all came out in opposition to a medical marijuana bill, Legislative Bill 622, but legislators also heard emotional testimony in favor of the bill from Army veterans and others who said they would benefit from access to medical marijuana. Five of the bill's sponsors sit on the eight-member Judiciary Committee, so the bill is likely to make it to a House floor vote, where opposition has killed similar measures in past years.

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

Nevada

On Monday, a bill was filed to let medical marijuana patients carry guns. State Sen. Kevin Atkinson (D-Las Vegas) filed Senate Bill 351. That measure would allow medical marijuana users to possess a firearm and a concealed carry permit. Current state law requires sheriffs to deny such permits for medical marijuana users.

New Hampshire

On Monday, Na Senate committee approved the use of medical marijuana for Ehrlers-Danlos syndrome. The Senate Health, Human Services, and Elderly Committee has approved a bill that would add Ehlers-Danlos syndrome to the state's list of qualifying conditions for medical marijuana. The measure now heads for a Senate floor vote. If it passes there, the House will take it up.

New York

Last Thursday, the Health Department said New Yorkers suffering chronic pain will be able to use medical marijuana starting this week. After announcing in December that it planned to add chronic paid to its list of qualifying conditions for medical marijuana, the Health Department said patients could start getting recommendations for chronic pain beginning Wednesday. The department also announced that physicians' assistants can now recommend medical marijuana. "Improving patient access to medical marijuana continues to be one of our top priorities, as it has been since the launch of the program," Health Commissioner Howard Zucker said in a statement. "These key enhancements further that goal."

North Dakota

On Tuesday, advocates threatened a lawsuit or new initiative in the face of legislative meddling. The head of the committee that ran the state's successful medical marijuana initiative campaign warned legislators that they could face a legal challenge or even another initiative campaign if they don't back away from changes contemplated in Senate Bill 2344, which has already passed the Senate. That measure bars patients and caregivers from growing their own plants and restricts the use of smoked medical marijuana to cases where a physician attests that no other form of marijuana would be effective. The comments came from Rilie Ray Morgan as he testified before the House Human Services Committee.

Tennessee

On Tuesday, a medical marijuana bill was prounounced dead. Rep. Jeremy Faison (R-Crosby) said that his medical marijuana bill, House Bill 495, is dead because senators were afraid to vote for it. "The Senate, bless their heart, are just scared to death of their voters," Faison said Tuesday after the House Health Committee shelved the bill and instead approved a non-binding marijuana-related resolution to study the issue over the summer.

Utah

On Tuesday, advocates announced plans for a 2018 initiative. Medical marijuana advocates are gearing up to try to put an initiative on the state's 2018 ballot. They said they would begin the process of signature gathering next month, and they cite promising polling. The state legislature has so far thwarted efforts to create a robust medical marijuana program.

Virginia

Last Thursday, the governor signed a bill legalizing pharmacy distribution of CBD and THC-A oil. Gov. Terry McAuliffe (D) signed Senate Bill 1027 into law. The bill allows for companies to manufacture and provide CBD cannabis oil and THC-A oil for the treatment of epilepsy and provides for its distribution through pharmacies.

[For extensive information about the medical marijuana debate, presented in a neutral format, visit MedicalMarijuana.ProCon.org.]

Chronicle AM: VT Legalization Bill Advances, ID Senate Approves Forfeiture Reform, More... (3/22/17)

Legalization bills are still alive in Rhode Island and Vermont, Idaho (!) is on the verge of passing civil asset forfeiture reform, North Dakota activists are threatening to strike back if the legislature messes too much with the state's new voter-approved medical marijuana law, and more.

Marijuana legislation is on the move in Montpelier. (Creative Commons/Wikimedia)
Marijuana Policy

Rhode Island Legislators Say They Have Votes to Legalize Marijuana. Two state legislators who have spearheaded the effort to legalize marijuana said on Tuesday they have majority support in both chambers to pass marijuana legalization -- if the legislative leadership allows the bills to get to a vote. Rep. Scott Slater (D-Providence), sponsor of House Bill 5555, and Sen. Joshua Miller (D-Cranston), sponsor of companion measure Senate Bill 420, said at a press conference said the House bill is sponsored by one-third of House members and the Senate bill by 15 of 38 senators, and that others don't want to support the bill publicly, but have pledged their private support. Both bills are currently before their respective judiciary committees.

Vermont Legalization Bill Wins Committee Vote. The House Judiciary Committee approved a marijuana legalization bill on an 8-3 vote Wednesday. House Bill 170 would allow adults to possess and grow small amounts of marijuana, but does not contemplate legal marijuana commerce. The bill now heads for a House floor vote.

Medical Marijuana

North Dakota Advocates Threaten Lawsuit or New Initiative in Face of Legislative Meddling. The head of the committee that ran the state's successful medical marijuana initiative campaign warned legislators Tuesday that they could face a legal challenge or even another initiative campaign if they don't back away from changes contemplated in Senate Bill 2344, which has already passed the Senate. That measure bars patients and caregivers from growing their own plants and restricts the use of smoked medical marijuana to cases where a physician attests that no other form of marijuana would be effective. The comments came from Rilie Ray Morgan as he testified before the House Human Services Committee.

Tennessee Medical Marijuana Bill Dies. Rep. Jeremy Faison (R-Crosby) said Tuesday that his medical marijuana bill, House Bill 495, is dead because senators were afraid to vote for it. "The Senate, bless their heart, are just scared to death of their voters," Faison said Tuesday after the House Health Committee shelved the bill and instead approved a non-binding marijuana-related resolution to study the issue over the summer.

Hemp

Texas Hemp Bill Filed. Rep. Bill Zedler (R-Arlington) has filed House Bill 3587, which would legalize the production and processing of industrial hemp for commercial purposes. The bill would direct the state Agriculture Department to set up a licensing and regulation program for hemp.

Asset Forfeiture

Idaho Senate Approves Civil Asset Forfeiture Reform. The state Senate on Tuesday unanimously approved House Bill 172, which would limit civil asset forfeiture to cases involving drug trafficking -- not simple possession -- and would clarify that simply being in possession of large amounts of cash is not evidence drug trafficking. The bill has already passed the House, but must now go back for a concurrence vote after the Senate amended by heightening reporting requirements, among other things.

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