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Check Those Pills! Harm Reduction and Club Drugs [FEATURE]

[This article was written in partnership with Alternet, and was originally published here.]

With the holiday break coming up soon, millions of young Americans will be looking to party. And tens, perhaps hundreds of thousands of them will be looking to stimulant drugs, especially Ecstasy (MDMA), to help them dance to the throbbing beats far into the night. MDMA is a synthetic stimulant with a chemical structure related to both methamphetamine and mescaline. It's great at providing the energy for partying the night away with a psychedelic tinge. The new scene drug, Molly, is simply Ecstasy in powdered form.

According to the 2013 National Household Survey on Drug Use and Health, some 17 million Americans have taken Ecstasy at least once, more than a half million reported taking it within the past month, and about three-quarters of a million reported taking it for the first time that year. Those monthly-use and first-use figures have been roughly stable for the past few years.

Some of those fun-seekers are going to take too much. And some of them are going to end up ingesting something they thought was Ecstasy, but wasn't. And one or two or three of them might die. Despite breathless media reports, people dying from Ecstasy or from what they thought was Ecstasy or what they thought was a drug like Ecstasy, is not that big a problem, especially compared with the 16,000 or so people who died last year from opiate overdoses. The number of Ecstasy-related deaths each year ranges from the single digits to the low dozens.

Still it is a problem. Any avoidable death is a problem, and those deaths are largely avoidable. They occur because of varying combinations of ignorance, greed and bad public policy. Some people are working to prevent those deaths, and the work extends from the club or rave or festival door to the halls of power in Washington.

The harm reduction group Dance Safe is among those doing that work. The small non-profit offers educational services, encourages people to submit their pills for testing ("drug checking"), and has informational booths at venues that will let them.

Where 20 years ago, the Ecstasy and party drug scene was largely limited to word-of-mouth raves, things have changed, said Dance Safe executive director Missi Wooldridge.

"We've seen a real explosion in the scene that has been transformed from an underground rave culture to a real mainstream electronic dance music culture," she said. "People are likely to experiment with drugs at raves and dances, as well as with friends at parties or night clubs."

They are also likely to be ingesting either adulterated Ecstasy or other new synthetic drugs misleadingly marketed as Ecstasy. That is reflected in reports on drug checking websites such as Pill Reports and Ecstasy Data, as well as drug discussion forums like Bluelight.

Pill Reports warns that Yellow Pacman tablets found earlier this month in Kansas and Texas contain not MDMA but the synthetic methylone, a methcathinone stimulant that is a chemical analog to MDMA, but is not MDMA. And at least two different pills currently being peddled in Canada as Ecstasy are actually methamphetamine.

"A lot of what we're seeing is the new psychoactive substances infiltrating the market and the scene," said Wooldridge. "People can purchase these substances online. I see a lot of positive results for methcathinone, MDPV, methylone, and the like. Similarly, people think they're taking LSD, but it's actual N-Bomb, or maybe ketamine. People operate under misconceptions about what they're taking, and that can be serious because there are lots of differences in things like onset, duration and potency."

Educated, sophisticated drug consumers may take advantage of drug checking services, as well as have advanced understandings of drug potency, duration and the like, but they are a minority. Most people just want to party, and they want to do it with Ecstasy.

"In contrast with some places in Europe, the market for people seeking out new synthetics is very small in the US," said Stefanie Jones, nightlife community engagement manager at the Drug Policy Alliance "But that doesn't mean they're not here. Many of the people buying them are after MDMA, but here in the US, the market is young people, and many are not that well-informed or familiar with notions like drug checking to see what's in that powder. It's largely an uninformed market, so there's a lot of adulteration."

Dance Safe's Wooldridge concurred.

Web sites like Pillreports.com will tell you whether your pills are bunk. Don't eat the Yellow Pacman! It's methylone.
"People are taking these substances unknowingly for the most part, rather than checking them out," the Denver-based activist said. "There is a relatively small segment that is into the experimentation and the understanding, but most users are not that sophisticated and are taking these drugs without really knowing what they are."

When people die, as two people did at New York's massive Electric Zoo festival last year, the pressure is on promoters and club owners to crack down on drugs, to increase security, even to decrease or do away with harm reduction measures out of fear of appearing to encourage drug use. In large part, that's because of the RAVE Act, a 2003 law sponsored by then Sen. Joe Biden (D-DE) that threatens owners and promoters with possible criminal sanctions for encouraging drug use.

"The RAVE Act is the elephant in the room," said Wooldridge. "Its intent wasn't to harm or prosecute legitimate event producers, but to expand the crack house laws and go after people solely having events for drug use or sales. But there has been an unintended consequence. People in the industry fear that if they attempt to address drug use they'll be help legally liable for overdoses or other emergencies. Their legal teams and insurance companies say to stay clear, turn a blind eye, but that increases the risks. We need to educate the lawyers and insurers on this. Show me a case where an event producer has been prosecuted for doing harm reduction."

"If the law is making owners scared, we should change the law so they are explicitly protected," said Jones. "Put the focus on the health and safety of the patrons. Including harm reduction shouldn't be seen as encouraging drug activity, but as prioritizing health and safety. Changing the law at the federal level would send a message to the industry that harm reduction is valuable and you won't get in trouble, and that could change the landscape of festivals."

One woman is working to do just that. Dede Goldsmith didn't mean to become a reformer, but when her daughter, Shelley, a University of Virginia student, died after taking Ecstasy at Washington, DC electronic music show the same weekend at the Electonic Zoo last year, that's what happened.

She told Vox in an October interview that when one of Shelley's friends told her Shelley had taken Molly, her first response was, "Who is Molly?" In her search for answers, she came to the realization that Molly didn't kill her daughter; federal drug prohibition and policies that discourage education about safe drug use did.

On the anniversary of her daughter's death in August, Goldsmith launched the Amend the RAVE Act campaign. Its goal, Goldsmith says, is "to make EDM festivals and concerts safer for our young people. Specifically, I am asking for language to be added to the law to make it clear that event organizers and venue owners can implement safety measures to reduce the risk of medical emergencies, including those associated with drug use, without fear of prosecution by federal authorities. As the law currently stands, many owners believe that they will be accused of 'maintaining a drug involved premises' under the act if they institute such measures, opening themselves to criminal or civil prosecution."

Irony alert: Shelley Goldsmith meets RAVE Act author Joe Biden a year before she died on Ecstasy. (amendtheraveact.org)
"It's not that producers don't care, it’s that they're terrified," said Wooldridge. "Amending the RAVE Act can be a way to organize the community so people don't fear law enforcement if they're addressing drug use. What's more detrimental—a fatal overdose or having harm reduction teams and medical teams on site?"

"The campaign is just getting underway," said Jones. "They're collecting signatures, and Dede is just having first meetings with legislators to try to get them on board, to try to get some bipartisan support."

In the meantime, other steps can be taken.  

"One of the biggest things we can do is to educate with a true public health approach," Wooldridge said. "We need to have honest conversations and we need to implement drug testing; we have to have that opportunity to create an early warning system when these substances begin to appear."

"Education is really, really critical," said Jones. "We need to be able to get real drug education out to young people and meet them where they are. We need to be explicit about what the drugs are, what they look like, what the common dose it. Integrating harm reduction practices into the culture is also really important, and Dance Safe is great at that."

An effective means of tracking new and available drugs, such as a publicly funded, more comprehensive version of the drug checking websites would also be useful. But that requires someone willing to spend the money.

"We don't really have a surveillance system set up to track these new psychoactive substances," Wooldridge complained. "We don't have the public health monitoring. As a non-profit, we do some of that on a small scale, but we don't have the capacity or the resources to really do the job. What are the priorities and where is the funding to collect the data?"

"Changing policy to allow for drug checking is also an important avenue to pursue," said Jones. "If we're going to be in a world where drugs remain illegal, we will continue to have problems with imitations and new synthetics, with people not knowing what they're getting. That would be the least we can do."

There is one other obvious response.

"It's unrealistic to think we can keep drugs out of clubs and bars and festivals. Trying to do that causes more harm than good," Wooldridge said. "We need to be realistic and recognize drug use first and foremost as a health concern, not a criminal justice issue. These drugs are often being sold as something they're not, and that's because of prohibition and the black market," said Wooldridge. "One obvious option is legalization and regulation. Then you'd have quality control and you wouldn't need all this drug-checking."

But we're not there yet. Until we are, people are going to have to watch out for themselves and for each other. Check those drugs, kids!

On Marijuana, Congress Giveth and Congress Taketh Away [FEATURE]

[This article was written in partnership with Alternet, and was originally published here.]

With final approval by the Senate Saturday night, the Congress has successfully approved a massive, $1.1 trillion dollar omnibus spending bill, and the president has signaled he will sign it. The bill includes two provisions that illustrate Congress's currently schizophrenic approach to loosening marijuana laws.

On the one hand, the bill contains an amendment that will effectively end federal interference in states where medical marijuana is legal by barring the Justice Department from using its funds to go after patients and providers there. On the other hand, it also contains a rider that seeks to undo the will of the voters of the nation's capital by blocking the District of Columbia from enacting the recently approved Measure 71 marijuana possession and cultivation legalization initiative.

Sponsored by Reps. Dana Rohrabacher (R-CA), Sam Farr (D-CA), and 10 others, the medical marijuana amendment is blunt. After listing all the medical marijuana states, it says: "None of the funds made available in this Act to the Department of Justice may be used… to prevent such States from implementing their own State laws that authorize the use, distribution, possession, or cultivation of medical marijuana." (The bill also includes similar language barring the use of Justice Department funds to interfere with hemp research authorized under the already approved Agricultural Act of 2014.)

The amendment is also important. In the past three years alone, the Justice Department has threatened elected officials, dispensary operators, and their landlords with legal action over medical marijuana. Those threats have delayed or stopped implementation of medical marijuana laws in at least six states. Similarly, threats of criminal prosecution and/or asset forfeiture aimed at landlords in California and Colorado have resulted in the closure of at least 600 state law-abiding medical marijuana businesses.

And DEA teams have aggressively raided and US Attorneys have prosecuted medical marijuana patients and providers. One stark example is the case of the Kettle Falls Five, a family of patients who were growing medical marijuana for their own personal use in accordance with Washington state law. In a state where marijuana is legal, federal prosecutors are seeking to send a pair of elderly patients and their children to prison. That prosecution is now in doubt.

"This is truly a long-fought victory for medical marijuana patients who have lived in fear of being caught in the crossfire of conflicting state and federal laws for nearly two decades," said Steph Sherer, executive director of Americans for Safe Access (ASA), which has lobbied for years for passage of the measure. "But this is also a victory for taxpayers because of the hundreds of millions of dollars saved on unnecessary and harmful enforcement."

Last year, ASA issued a report showing the Obama administration had spent $80 million a year on medical marijuana enforcement. That may be chump change in a trillion-dollar spending bill, but it's still $80 million that could be better used each year.

"Congress has finally initiated a drawdown in the federal government's war on medical marijuana," said Mason Tvert, director of communications for the Marijuana Policy Project (MPP). "This legislation makes it clear that the DEA has no business interfering in states' medical marijuana laws. Taxpayer money should not be used to punish seriously ill people who use medical marijuana and the caregivers who provide it to them."

"For the first time, Congress is letting states set their own medical marijuana and hemp policies, a huge step forward for sensible drug policy," said Bill Piper, director of national affairs for the Drug Policy Alliance (DPA). "States will continue to reform their marijuana laws and Congress will be forced to accommodate them. It's not a question of if, but when, federal marijuana prohibition will be repealed."

But if federal marijuana prohibition will someday be repealed, no one has told congressional Republicans, and congressional Democrats didn't seem to care much, either. The second part of Congress's schizoid pot policy two-step was a slap in the face to both marijuana legalization and the will of the voters of the District of Columbia.

Maryland Rep. Andy Harris (R) authored a rider to the bill that says that the District cannot "enact or carry out any law, rule, or regulation to legalize or otherwise reduce penalties associated with the possession, use, or distribution of any schedule I substance under the Controlled Substances Act (21 U.S.C. 801 et seq.) or any tetrahydrocannabinols derivative."

Republican House committee heads got it inserted into the House version of the bill, and Senate Democrats didn't consider it important enough to fight to remove.

Marijuana reform proponents (and believers in democratic rule for the residents of DC) were livid, and they are not ready to roll over in the face of congressional attempts to quash legalization in the District.

"In light of recent events in Ferguson and New York, it would be particularly disturbing if Congress has chosen to overturn the will of the voters in a majority black city," said Dr. Malik Burnett, DPA policy manager and vice-chair of the DC Cannabis Coalition, the group that got Measure 71 passed. "DC voters chose to reform their marijuana laws, which have a direct impact on how communities of color interact with police. Congress should not undermine that."

Rep. Andy Harris (R-MD), author of the rider to block DC marijuana legalization. (house.gov)
"By prohibiting the regulation of marijuana in the District, they are ensuring authorities have no control over it," Tvert said. "If drug cartels and gangs had lobbyists on the Hill, preventing marijuana regulation would be their top legislative priority. If the District can regulate and tax alcohol sales, it should be allowed to do the same with a less harmful substance like marijuana."

The District city council has been advancing a bill that would tax and regulate marijuana sales, but the Harris rider effectively kills that. Less certain, however, is whether it can really block Measure 71 from taking effect.

House Minority Leader Nancy Pelosi; Rep. Eleanor Holmes Horton, the Congressional Delegate from DC.; Rep. Jose Serrano (D-NY), the ranking member on the House appropriations subcommittee that funds DC; Rep. Nita Lowey (D-NY), the ranking Democrat on the House Appropriations Committee; and others have said that the DC rider allows Initiative 71 to stand. The DC government is blocked from enacting any new marijuana law reforms but it is free to implement and carry out reforms that have already been enacted.

The congressional Republicans who pushed the measure naturally disagree. They argue that Measure 71 has not been enacted because the DC council has not yet sent it to Congress and that the rider thus blocks it from being implemented.

While the question is likely to end up being settled in the courts, the next move is up to the District city council. It can go ahead and send the measure to Congress despite what the budget bill rider says. Advocates are urging the council to do just that.

And the council seems to be in a mood to stick up for the initiative -- and for democratic rights for the District. DC Council Chair Phil Mendelson told The Washington Post even before the final Senate vote that he plans to ignore the rider. He said he will instead follow normal procedure for voter-approved initiatives in a city that exists under the congressional thumb. He will sent a bill implementing the initiative to Congress next month for a 30-day review in which lawmakers can vote it up or down.

And if that doesn't work, there's still the courts.

"If the question is whether I'd be open to legal action, the answer is yes," Mendelson told Politico after the House vote.

Whether Congress has successfully blocked marijuana legalization in DC clearly remains to be seen. What is not in dispute, though, is that Congress has taken a major step toward clearing the way for medical marijuana, and that's a big deal.

Washington, DC
United States

GOP Effort to Block DC Marijuana Reforms Continues, Advocates Pressure Dems [FEATURE]

[This article was written in partnership with Alternet, and was originally published here.]

Reflecting the will of the voters, the elected representatives of the people of Washington, DC -- the DC city council -- approved marijuana decriminalization earlier this year. District voters went even further than the council in last month's elections, approving an initiative to legalize the possession and cultivation of small amounts of pot with a whopping 70% of the vote.

Now, congressional Republicans are working feverishly to block the District from putting the results of this exercise in democracy into effect. Rep. Andy Harris (R-MD) is leading a House effort to block federal funds being used for DC pot law reforms. Harris has crafted an amendment to the DC appropriations bill that would bar the use of federal or local funds to implement the reforms, and Rep. Harold Rodgers (R-KY), head of the House Appropriations Committee, has agreed to include Harris's amendment in the bill.

And, according to the Drug Policy Alliance (DPA), which has been deeply involved in DC marijuana reform efforts, "Democrats are rumored to be cutting a deal with Republicans" that would sacrifice legalization in order to save decriminalization."

[Update: Late Tuesday afternoon, DPA released the following report: "Currently, sources are reporting that Congress is considering allowing Initiative 71, approved by 70% of District residents, to stand while preventing future action on the District of Columbia's ability to tax and regulate marijuana. These reports stand in sharp contrast to a previously reported deal that would have stopped the ballot measure from taking effect."]

House Minority Leader Rep. Nancy Pelosi (D-CA) hasn't exactly quelled those rumors. At a press conference last Friday, she said she supported the District's autonomy, but stopped short of saying any Republican moves to block the implementation of decriminalization or legalization would be a "deal breaker" on agreement for a broader appropriations package. (Republicans are also seeking to use the appropriations bill to overturn DC firearms safety laws.)

The pressure is on House Minority Leader Nancy Pelosi (D-CA) (house.gov)
"I have expressed concerns about treating the District of Columbia in a fair way, respecting home rule," Pelosi said. "I'm not saying any one of them is a deal breaker, but I'm saying this is an array of concerns that we have: clean air, good food standards, workplace safety, fairness to the District of Columbia, how the top line dollar is allocated within the legislation."

That not-so-ringing endorsement of the District's ability to democratically determine its own drug policies, as well as the rumored deals, has prompted DPA and other reform supporters to ramp up the pressure on congressional Democrats. In an open letter to the Democratic leadership today, a number of civil rights and other advocacy groups, including DPA, DC Votes, and the DC branches of the ACLU, NAACP, and NOW, called on the Democrats to grow a backbone.

"As you conclude negotiations over the FY15 Financial Services and General Government appropriations bill, we urge you to reject all efforts to include undemocratic restrictions on DC's rights," said the letter addressed to Pelosi and Senate Majority Leader Harry Reid (D-NV). "As you know, the spending bill passed by the House included new provisions that would interfere in the District of Columbia's local affairs, including language intended to overturn the results of a local voter initiative. The undersigned organizations advocate on diverse issues, but are united in our opposition to the inclusion of social policy riders targeting the District of Columbia in the appropriations bill."

"Democratic leadership made it clear they would stand with voters on this crucial racial justice issue, and push back against Republican opposition to the DC law," said Michael Collins, policy manager at DPA's office of national affairs. "Democrats have always made claims of supporting DC home rule now is their chance to stand with 70% of voters in the District who voted for marijuana reform," Collins said.

Advocates are particularly dismayed given the racial disparities in the enforcement of marijuana laws in the District. According to a 2013 ACLU report, not only did DC have the highest per capita number of pot possession arrests -- more than three times the national average -- but it also saw black people arrested for pot possession at a rate more than eight times that of whites. In that regard, DC was second, trailing only the state of Iowa among the 50 states.

The Republican efforts to interfere -- and block these moves to reduce racial disparities in the District -- takes on added salience in the context of weeks of protests nationwide over racially biased policing.

"In light of recent events in Ferguson and New York, it is particularly disturbing that Congress would choose to overturn the will of the voters in a majority black city," said DPA policy manager and vice-chair of the DC Cannabis Campaign, which was responsible for the passage of Initiative 71, the legalization initiative. "DC voters chose to reform their marijuana laws, which have a direct impact on how communities of color interact with police. Congress is poised to undermine that."

But the Republican Party is no longer a monolith when it comes to marijuana law reform. On at least five votes this year, some Republican legislators voted in favor of such reforms. It is questionable whether the GOP could block DC's reforms on a straight up-and-down vote. By tying the effort to the broader appropriations bill, however, the issue is placed in the hands of the congressional leadership, and that could leave the District hanging out to dry. It's time for Nancy Pelosi and Harry Reid to stand up for the District and for democratic principals, the advocates say, and they are prodding them today.

The March Toward Marijuana Legalization: 2016 and Beyond [FEATURE]

State-level marijuana law reform won big in this month's elections, with legalization initiatives triumphing convincingly in Alaska, Oregon, and Washington, DC. The Florida medical marijuana initiative lost, but only because it had a higher bar of 60% of the popular vote. It ended up with 57%, a clear sign of solid majority support. And don't forget Guam -- the US territory approved medical marijuana with 56% of the vote.

The California Coalition for Cannabis Policy Reform is laying the groundwork for 2016. (CCPR)
Local marijuana reform initiatives also fared well. In Maine, Massachusetts, and Michigan, activists built on earlier successes to win more victories this year, while in New Mexico, voters in Albuquerque and Santa Fe voted in favor of decriminalizing pot possession.

All in all, a good year for marijuana law reform, the second good election year in a row. Since 2012, voters in four states and DC have been asked to legalize marijuana. They've now said yes in all of them.

And now, eyes to turn to 2016 and beyond. There are excellent prospects for more victories in the West, as well as in the Northeast. And there could be some surprises lurking out there in the middle of the country.

California, of course, is the big prize, and efforts are already well underway to ensure that legalization is on the ballot in 2016 -- and that it actually wins this time. Arizona and Nevada are also on the radar, and the Nevada initiative campaign has already turned in twice the number of signatures needed to make the 2016 ballot.

In the Northeast, both Maine and Massachusetts are initiative states, and legalization appears headed for the ballot in both. In Rhode Island and Vermont, the push will come in the state legislatures.

"Things are clearly headed in the right direction," said Marijuana Policy Project (MPP) communications director Mason Tvert, scanning the post-election terrain. "Even in a midterm where we saw large Republican gains, we also saw large gains for marijuana policy reform. A lot of people would say the turnout was smaller and more conservative, yet we still saw strong majorities approving measures making marijuana legal in various states and cities."

MPP will be backing 2016 initiatives in five states, Tvert said, although the Nevada legislature could ease its burden by just approving an initiative rather than punting to the voters.

"In Nevada, the petition drive has just wrapped up. At this point, our goal there is to pass the ballot initiative; if the legislature chooses to take an objective look and give it some real consideration, that would be excellent, too," he said.

"We also have committees filed to support initiatives in Arizona, California, Maine, and Massachusetts," Tvert said. "In California, we want to begin to raise money to support that effort, but it's pretty early in the process. We expect to see very solid support for such a measure in California, especially running in a presidential election year when support for legalizing marijuana has been growing nationwide. Prop 19 got 47% in 2010; that will be six years ago come 2016."

"We have a pretty comprehensive statewide coalition working on this," said Dale Gieringer, executive director of California NORML, which is a key part of that grouping, the California Coalition for Cannabis Policy Reform. "The coalition includes us, the Prop 19 people, Law Enforcement Against Prohibition, MPP, the Emerald Growers Association, and the Drug Policy Alliance (DPA) has been a partner in this, too."

A little less than two years out, it's a work in progress, said Gieringer.

"Pretty much all the leading groups interested in drug reform are interested in collaborating, but exactly how that will work hasn't been settled yet," he said.

Now that four states and the District of Columbia have legalized marijuana, Gieringer sees some political space for pushing the envelope.

"Home cultivation will be in it," he said. "They have that in Oregon and Colorado, and we're going to have it in California. I also want to provide for on-site consumption; we're working to get that instituted here in Oakland. In Colorado, they banned public use, which is one thing if you mean smoking pot on the street, but governments tend to have an expansive view of what constitutes public use, like a public accommodation under the Civil Rights Act. I think we can provide for licensed on-site consumption, at least by local option."

And no reason to make what he called "unnecessary concessions."

"We have a DUID law, and we don't need to change that," he said. "They didn't do that in Colorado and Oregon, and we don't need to do it. We learned a lesson in Washington -- that lack of an express DUID provision didn't make a difference -- and we're not going to repeat that."

Although more than any other group in the coalition, CANORML represents the interests of marijuana consumers, Gieringer said it's not pot smokers or growers who are going to make an initiative victorious.

Maybe Missouri's Show Me Cannabis will show us all.
"Marijuana users are 12% to 15% of the population here; we really have to depend on more than that," he said. "The users and growers will not determine this campaign. And I'm sure there will be people discontented with however the initiative turns out; there always are. But there aren't that many growers in the state, anyhow. Some growers didn't like Prop 19, but it failed for other reasons. It didn't win in Los Angeles County, and that's not because of the growers."

In some states, such as Massachusetts, activists have been piling up marijuana reform victories for years. MassCANN/NORML and the Drug Policy Forum of Massachusetts have an unbroken record of winning non-binding public policy questions on marijuana reform issues going back seven election cycles. Voters in the Bay State have also signaled their approval of marijuana law reform by passing statewide medical marijuana (2008) and decriminalization initiatives (2012).

Now, Bay State Repeal has formed to free the weed in 2016, and it has a pot populist tinge to it. The group wants home cultivation, not just to keep prices down, but "to keep the cops from busting through the door just because there is marijuana growing there" and it wants taxation and regulation, but only "moderate," not "cash-cow taxation or giant licensing fees."

In Maine, where MPP has been active, putting successful municipal legalization initiatives on the ballot in Portland and South Portland (but losing one in Lewiston), there could be not one but two legalization initiatives unless differing actors come together. In addition to the MPP effort, a new group, Legalize Maine, is also moving forward with plans for an initiative.

As with Bay State Repeal, there is a pot populist tinge. Legalize Maine couches its argument not only in terms of justice and common sense, but also talks about jobs and economic development. And it wants marijuana regulated in a way that "focuses on people instead of large economic interests that seeks to dominate the marijuana industry."

Legalization could also pop up in some unexpected places, too. While the major movement organizations already have selected targets for 2016 and have plans well afoot, things could break faster than the big players anticipate, and local activists in some states -- Arkansas and Missouri, for example -- may manage to get initiatives on the ballot without significant outside support.

In Missouri, Show Me Cannabis has been undertaking a vigorous and energetic campaign to put an initiative on the ballot in 2016. It submitted its initiative to state officials earlier this month; the first step in getting the measure before the voters. Similar efforts by different groups are also underway next door in Arkansas.

Those Ozark-area efforts don't have the backing of big national organization behind them, but that could change.

The Drug Policy Alliance's Ethan Nadelmann wants to see the polling. (OSI)
"If these initiatives are well-drafted and the polling is strong, we'll help as best we can, but we're not making any financial commitments," said DPA executive director Ethan Nadelmann. "We have a major commitment in California, and we're helping MPP draft initiatives in other states. In Missouri, let's make sure there's a solid draft initiative, and if the polling is there, well, a victory in Missouri would be very compelling."

Seeing marijuana legalization creep along the West Coast, make inroads on the East Coast, and maybe even in the Ozarks would make for a very impressive 2016, but some Midwestern activists are looking further down the road.

Led by indefatigable Tim Beck, Michigan activists have managed to pass municipal personal legalization initiatives in all the state's largest cities in the past few years. This year, they went eight for 13 with similar initiatives in smaller Michigan communities.

Michigan voters also approved marijuana in a statewide initiative in 2008, but, for Beck, getting the state's dispensary situation settled -- not legalization -- is the first order of business.

"Although the state legislature is totally controlled by the GOP, we've been working with them, and they've kind of seen the light on a regulated system with a lot of local control, which is big with Republicans," he said. "We have one of the best medical marijuana laws in the country, and it's going to get better with a regulated dispensary system, as well as ingestibles. We won 95-14 in the House, and it's going through the Senate now," he said.

"We have over 1.5 million people now living in cities that have decriminalized," Beck said. "And we liberated 140,000 this year -- on the cheap. This has an impact. When we have dispensaries and when we have decriminalization, local officials won't be able to say 'Oh, we don't want marijuana here,' because the voters do."

Legalization may not be the first order of business, but it is the ultimate goal, Beck said.

"My philosophy has never been that the solution is medical, but straight-out, unadorned legalization, but we're -having to do it on our own," he explained. "Michigan is fly-over country for the big players. It's a large state with a population of more than 10 million, so it's expensive to win a campaign, and it's a bit more conservative than the East or West coasts."

That means Michigan needs to be patient.

"Our realistic priority for the next couple of years is to work with the legislature," Beck said. "We have a new class of entrepreneurs who have come out of the closet, and we've been able to fund our own lobbyist to the tune of about $150,000. Once we get dispensaries, then we'll turn to decriminalization at the statehouse. We had a decriminalization bill this year, but it was introduced by a Democrat and went nowhere."

Beck is also waiting for the opinion polls to move further in the right direction.

"There's a weird dichotomy in our polling," the veteran activist explained. "We get well over 60% saying yes to reallocating police resources away from small-time marijuana users, but when it comes to legalization, that number drops dramatically. We might be at 50%; we'll do another poll at year's end, but I don't think much will change. It's hard to demand that anyone open their checkbook when you're only running 50%. We have to just keep going on an incremental basis. Maybe by 2018 or 2020, we'll be ready."

While Beck counsels patience, Nadelmann is counseling prudence. And while he is of course happy that all the legalization initiatives passed, he doesn't want people to think it's going to be a walk in the park from here on in.

"The downside is a sense of overconfidence, a feeling that marijuana will legalize itself," he said. "That could make it more difficult to fundraise if there's a sense that you can put anything on the ballot and not anticipate serious opposition. There could be a sense in the industry that you can be free riders while the activists raise the money."

There are other potential pitfalls. Entrepreneurs trying to push the envelope could push too far, Nadelmann said.

"Don't forget the Montana disaster," he warned, referring the wide open medical marijuana expansion there that created a backlash that drove the industry back into the ground. "Don't be short-sighted and greedy, and contribute and support the organizations working on this."

And don't forget federal pot prohibition.

It's one thing for a handful of states -- or even more -- to legalize marijuana, but as long as federal marijuana prohibition remains on the books, even the legal marijuana states could theoretically face a concerted federal effort to roll back the clock. Using federal marijuana prohibition as a hammer, a hostile Congress and president could wreak havoc with state-level regulation and taxation. (Ironically, a move to do that could result in marijuana being legal to smoke and possess in those states, but not to sell or be taxed or regulated.)

But if repealing federal pot prohibition is the Holy Grail, reformers still have a ways to go.

"A lot more states are going to have to approve this before it gets to the point where repeal can pass," said Nadelmann. "When you look at medical marijuana and how slowly that moves on Capitol Hill, you see that it wasn't until this year that we actually got something passed, and that was just to stop federal interference in medical marijuana states. I'm more optimistic about winning votes like that next year, to get the federal government out of the way."

Congress has not been especially responsive to growing support for marijuana legalization, and there's no reason to expect that to change anytime soon, Nadelmann said.

"It's hard to imagine Congress playing any sort of leadership role on this stuff," he explained.

Maybe when we have 24 legal marijuana states, not just four of them. That means there's still plenty of work to be done at the state house and the ballot box.

Marijuana Arrests Drop, But Still 1.5 Million Drug Arrests Last Year [FEATURE]

More than 1.5 million people were arrested for drug offenses in the US last year, and more than 693,000 of those for marijuana offenses. The figures come from the FBI's 2013 Uniform Crime Report, which was released today.

One drug arrest out of 1.5 million last year. (www.justice.gov)
That's about one pot bust and slightly more than one other drug arrest every minute, 365 days a year. The vast majority of them are for simple possession. Over 87% of all marijuana arrests and 82% of all drug arrests were for possession only.

Marijuana arrests have declined from peaks early in this century. In 2008, there were a record 872,000 marijuana arrests, so pot busts have declined by slightly more than 20% since then. But arrests for other drug offenses continue apace, actually increasingly slightly last year. Still, because of the decline in marijuana arrests, the overall number of drug arrests dropped by about 50,000.

In 2008, marijuana arrests accounted for a majority (52%) of all drug arrests. Now, it is down to 40.6%.

Some of the decline in marijuana arrests can be attributed to the passage of decriminalization and legalization laws, particularly in the West, where pot arrests accounted for only 18% of all drug arrests. California decriminalized pot possession in 2011, and Colorado and Washington legalized it in the 2012 elections.

The move to marijuana legalization is helping shrink pot bust numbers. (Sandra Yruel/drugpolicy.org)
In other parts of the country, marijuana arrests continued to roll along, even in the Northeast, where they accounted for 46% of all drug arrests. In the South, the figure was 49.8%, and in the Midwest, pot accounted for 51.7% of all drug arrests.

When it comes to race, blacks continue to be disproportionately represented among drug arrestees. African-Americans accounted for 30.7% of all drug arrests, but they only make up about 13% of the population. That means blacks are being arrested for drugs at 2 ½ times the rate their percentage of the population would predict.

Drug arrests were the single largest category of arrests made in the US and accounted for about 13% of all arrests. The 1.5 million drug arrests well exceeded second place larceny-theft (1.232 million) and third place driving under the influence (1.167 million). More than three times as many people were arrested for drug offenses than for all violent crimes combined (480,000).

The continued law enforcement emphasis on drug enforcement drew criticism from Law Enforcement Against Prohibition (LEAP).

But this attitude still persists among law enforcement. (bartoncounty.org)
"Police made more drug arrests than for any other single category of crime. Meanwhile, only 64% of murders and 48% of violent crimes generally are being solved," said LEAP executive director Major Neill Franklin (Ret.), citing the FBI statistics. "We clearly have our priorities in the wrong place."

The Marijuana Policy Project (MPP), fresh from last week's successful "marijuana midterms," pronounced itself pleased with the decline in pot busts, but called for them to end, not just diminish.

"We're pleased to see the drop, but arresting even one adult for using a substance that is objectively less harmful than alcohol is inexcusable," said MPP communications director Mason Tvert. "Every year we see millions of violent crimes attributed to alcohol, and the evidence is clear that marijuana is not a significant contributing factor in such incidents. Yet our laws continue to steer adults toward drinking by threatening to punish them if they make the safer choice. These arrest numbers demonstrate that the threat is very real," he noted.

Tvert also echoed LEAP in criticizing law enforcement priorities.

"Law enforcement officials should be spending their time and resources addressing serious crimes, not arresting and prosecuting adults for using marijuana," he said. "Every year, these statistics show hundreds of thousands of marijuana-related arrests are taking place and countless violent crimes are going unsolved. We have to wonder how many of those crimes could be solved -- or prevented -- if police weren't wasting their time enforcing failed marijuana prohibition laws."

The laws must change, he said.

"A majority of Americans think marijuana should be legal for adults and treated similarly to alcohol. Voters in four states and the District of Columbia have now passed laws that reflect that, and we expect several more will do over the next few years. It's time for our laws to catch up with public opinion."

Federal Sentencing Reforms Go Into Effect Today [FEATURE]

Federal drug sentencing reforms adopted earlier this year by the US Sentencing Commission went into effect today. They should result in tens of thousands of federal prisoners seeing their sentences cut and being released early, as well as ensuring that future offenders are not sentenced so harshly.

The Sentencing Commission, an independent body in the judicial branch which is charged with setting federal sentencing guidelines, voted unanimously in April to reduce the guidelines for most drug sentences. Then, in July, it voted—again unanimously—to make those sentencing reductions retroactive, meaning they will be applied to current federal drug prisoners.

Congress had an opportunity to disapprove of the sentencing reductions, but failed to act, so the changes are now in effect.

As of today, current federal drug prisoners can begin petitioning courts for sentence cuts based on what the new guidelines call for. If the courts determine they are eligible for the sentence cuts and a reduction is appropriate, the sentences will be reduced. That will result in some federal prisoners getting out early, but none will be released until a year from today.

The sentence cuts will not, though, reduce mandatory minimum sentences, which are set by Congress. Prisoners serving sentences longer than the mandatory minimum may win sentencing reductions, but not below the mandatory minimum.

(The federal sentencing reform group Families Against Mandatory Minimums provides an overview page on the move and what it means, as well as FAQ page for prisoners and their families.)

For the past two decades, the Sentencing Commission has attempted to rein in the harshly punitive impulses in Congress that led it to impose lengthy prison sentences for even low-level drug offenses in the 1980s. The federal prison population has increased more than three-fold since 1980, driven largely by the war on drugs. According to the Bureau of Prisons, the 98,482 federal drug prisoners make up 48.8% of all federal prisoners.

The federal prison at Butner, NC. Will there be room at the inn? (bop.gov)
"The reduction in drug guidelines that becomes effective tomorrow represents a significant step toward the goal the Commission has prioritized of reducing federal prison costs and overcrowding without endangering public safety," Judge Patti Saris, chair of the Commission, said in a statement. "Commissioners worked together to develop an approach that advances the causes of fairness, justice, fiscal responsibility, and public safety, and I am very pleased that we were able to agree unanimously on this reasonable solution. I am also gratified that Congress permitted this important reform to go forward."

According to the Commission, more than 46,000 current drug prisoners will be eligible for sentence reductions through retroactive application of the revised sentencing guidelines. The Commission estimates that the sentence cuts will reduce the federal prison population by 6,500 within five years and more significantly as time goes on.

The Drug Policy Alliance (DPA) applauded the sentencing reductions, and especially the Commission's move to apply them to current prisoners.

"It makes little sense, of course, to reform harsh sentencing laws proactively but not retroactively," said Ethan Nadelmann, DPA executive director. "But that’s what politicians do when they’re scared of allowing people out of prison early. The Sentencing Commission really had no choice but to rectify the moral absurdity of keeping people locked up based on sentences that are no longer the law. What they did was right and just."

"This is an important step toward undoing some of the worst harms of the drug war by allowing people to be reunited with their families," added DPA media relations manager Tony Papa, who served 12 years in prison for a nonviolent drug offense.

The US Sentencing Commission considers retroactivity at a meeting in May. (uscourts.gov)
While the Sentencing Commission has been working for years to address prison overcrowding and unduly harsh sentencing, recent years have also seen some advances in Congress. In 2010 Congress unanimously passed legislation reducing the crack-powder cocaine sentencing disparity. Bipartisan legislation reforming mandatory minimum sentencing, the Smarter Sentencing Act (S 1410), has already passed out of committee this year and is awaiting a floor vote in the Senate. Attorney General Eric Holder has made numerous changes this year, including directing U.S. Attorneys to charge certain drug offenders in a way that ensures they won’t be subject to punitive mandatory minimum sentencing.

Sentencing Commission Chair Judge Parris said Congress still needs to get around to passing comprehensive reforms.

"Only Congress can act to fully solve the crisis in federal prison budgets and populations and address the many systemic problems the Commission has found resulting from mandatory minimum penalties," she said. "I hope that Congress will act promptly to pass comprehensive sentencing reform legislation."

Maybe then we can actually reverse the decades-long trend of sustained growth in the federal prison population. Actually, thanks to reforms already passed by Congress, we may see the first decrease in the federal prison population announced next month, when the Bureau of Justice Statistics issues its annual prison population report. The preliminary numbers suggest that the population may have peaked in 2012.

This move by the Sentencing Commission will only accelerate that (presumed) trend, but will only result in sentence reductions for about half of incarcerated federal drug offenders. There is still more work to be done. 

Washington, DC
United States

Marijuana Reform on Local Ballots in Five States Next Week: The Rundown [FEATURE]

Election Day is less than a week away, and it's not just statewide marijuana, medical marijuana, sentencing reform, and drug testing initiatives that we're watching. In five states, voters in some cities or counties will have opportunities to cast ballots for local marijuana reform measures.

In four out of the five states—California being the exception—the local initiatives, some binding, some not, are chances to vote for decriminalizing or legalizing pot. In all of those states, these city- or county-level measures are just the latest steps in sometimes years-long campaigns laying the groundwork for state-level legalization, either through the ballot box or through the legislature.

California is a special case this year. With pot possession already decriminalized, its unique medical marijuana laws providing broad, if uneven, access, and the near certainty that statewide legalization is going to be on the ballot in 2016, nobody is bothering with local legalization measures in 2014 (although they had successful ones in a number of cities in the past).

In California, all the action is about medical marijuana. Let's start there.

California

With the state legislature unable or unwilling to pass statewide medical marijuana regulations, battles on the topic regularly devolve to the local level. This year is no exception. There are three broad areas of contention this year: cultivation, dispensaries, and taxes.

Four counties are dealing with cultivation issues. In Butte County, Measure B is a less restrictive ordinance than Measure A, which was passed by the board of supervisors. Both are on the ballot. In Lake County, Measure O and Measure P, both seek to overturn the restrictive Measure N, which was narrowly approved by voters last year. Measure O would allow more plants to be grown, while Measure P declares that personal—not commercial—grows  are a fundamental right and that people growing for their own use are exempt from county cultivation ordinances.

In Nevada County, Measure S would liberalize the county's restrictive cultivation ordinance by allowing indoor cultivation anywhere, eliminating some minimum distance and other restrictions, and allowing up to 60 plants to be grown on plots over 30 acres. In Shasta County, Measure A is a referendum on an ordinance banning outdoor grows and home cultivation. A "no" vote on Measure A would repeal the ordinance.

Medical marijuana remains contested terrain in California. (wikimedia.org)
Dispensaries are on the ballot in a number of cities and counties. In Orange County's Santa Ana, two competing measures are on the ballot. Measure CC would allow for a minimum of 22 dispensaries, while the more restrictive, city council-sponsored Measure BB has no minimum number of dispensaries, a higher tax rate, and more restrictions than Measure CC.

In San Diego County, two cities have dispensary measures on the ballot. In Encinitas, Measure F would allow dispensaries and tax them at a 2.5% rate, while in La Mesa, Measure J would do the same thing. In Riverside County, Blythe's Measure Z would authorize and regulate dispensaries, with a 15% business tax.

Straight taxation questions are also on the ballot in Santa Cruz County (Measure K), the city of Santa Cruz (Measure L), Shasta Lake City (Measure C), and two Riverside County communities, Cathedral City (Measure N) and Desert Hot Springs, which has both a cultivation tax measure (Measure HH) and a dispensary tax measure (Measure II) on the ballot.

[Thanks to the Drug Policy Forum of California and its November 2014 Election Guide for the information on California local initiatives.]

Maine

In Maine, the Marijuana Policy Project (MPP) and local allies are sponsoring possession legalization initiatives in two towns, Lewiston and South Portland. A similar effort in York was blocked by recalcitrant town leaders. This year's effort builds on last year's success in Portland, Maine's largest city, where a similar initiative was approved with 67% of the vote.

In Lewiston, the personal legalization initiative is Question 2; it South Portland, it is Citizen-Initiated Ordinance #5.

Lewiston is the state's second largest city, while South Portland is its fourth largest. Victories in those two cities next week, along with last year's victory in Portland, will lay the groundwork for a statewide legalization push in 2016, which MPP says is coming.

Massachusetts

For the last six election cycles, activists with the Drug Policy Forum of Massachusetts and MassCann/NORML have been laying the groundwork for marijuana law reform through the use of non-binding Public Policy Questions (PPQs), by which voters signal their reform desires to their elected representatives. The questions have been on medical marijuana, decriminalization, and legalization—and they have never lost.

MassCann/NORML practices some street activism. (masscann.org)
Public opinion in the form of successful public policy questions helped decriminalize marijuana in 2008 and legalize marijuana in 2012. This year, the questions are all about legalization, and the aim is clear: making Massachusetts a legal marijuana state within the next couple of years.

This year, the question asks: "Shall the State Representative from this district be instructed to vote in favor of legislation that would allow the state to regulate and tax marijuana in the same manner as alcohol?"

Voters will be answering that question in the following districts: 4th Barnstable, 4th Berkshire, 1st Essex, 2nd Franklin, 14th Middlesex, 15th Middlesex, 24th Middlesex, and 8th Norfolk.

But wait--there's more. Meanwhile, Bay State Repeal has an even less restrictive question on the ballot in five districts. That question asks whether voters would like to tell their representatives to "replace the state's restrictions on marijuana with a law that regulates the cultivation and commerce in marijuana by persons over the age of 21, in the same manner as laws that apply to the cultivation and sale of fruits, vegetables, and herbs."

That question will be asked the following districts: 4th Essex, 7th Essex, 8th Essex, 3rd Middlesex, and 6th Middlesex. A slightly different form of the question will be asked in the 2nd Hampshire district. 

Michigan

In an fight led by the Safer Michigan Coalition, marijuana decriminalization is on the ballot in 11 Michigan towns and cities this year. Like the efforts in Maine and Massachusetts, the effort in Michigan this year is part of an ongoing process whose ultimate end is legalization. Eleven other Michigan cities, including Detroit, Flint, Grand Rapids, Kalamazoo, and Lansing—the state's largest cities—have already passed similar measures. No city has ever defeated one.

This year, voters will have the chance to do the same in Berkley, Clare, Frankfort, Harrison, Huntington Woods, Lapeer, Mt. Pleasant, Onaway, Port Huron, Pleasant Ridge and Saginaw.

All will be voting on questions similar to this one, from Port Huron: "Shall the Charter of the City of Port Huron, Michigan be amended such that nothing in the Code of Ordinances shall apply to the use, possession or transfer of less than 1 ounce of marijuana, on private property, or transportation of 1 ounce or less of marijuana, by a person who has attained the age of 21 years?"

New Mexico

The state's most populous county, Bernalillo County, and its third most populous, Santa Fe County, will vote on advisory, non-binding questions designed to measure popular support for marijuana decriminalization.

In both counties, the question asks: "Are you in favor of the [...] County Commission supporting County, City, and Statewide efforts to decriminalize possession of one ounce or less of marijuana?"

There should also have been a pair of municipal decriminalization initiatives in Albuquerque and Santa Fe, but it didn't work out that way. The Drug Policy Alliance and Progress New Mexico worked through the summer and into the fall to put the initiatives before the voters in Albuquerque and Santa Fe, but neither actually happened.

In Santa Fe, the city council, when presented with the qualified initiative, just voted to accept it instead of putting it to a popular vote. In Albuquerque, the reason no vote is occurring is not so happy. Although the city council voted to put the initiative on the November ballot, Mayor Richard Berry (R) vetoed it.

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If the past is any indication, these building-block local initiatives should all fare very well at the polls and continue to build the number of American political jurisdictions that have gone on record for ending pot prohibition. Come back next week to see if we can confirm that. 

Putting the Statewide Marijuana Initiatives Over the Top [FEATURE]

It's now less than two weeks until Election Day, and statewide marijuana initiatives are on the ballot in four states. All have a shot at winning, and as the clock ticks down, all of them are seeking last minute help to get them over the top.

The Chronicle talked this week to people in the various campaigns, and all of them have concrete ideas on what people can do to help -- whether in-state or not -- in the final days. But before we get to what can be done, let's first review the initiatives, three that would legalize marijuana and one that would legalize medical marijuana:

Alaska Measure 2

The Measure 2 initiative allows adults 21 and over to possess up to an ounce and up to six plants (three flowering). It also allows individual growers to possess the fruits of their harvest even in excess of one ounce, provided the marijuana stays on the premises where it was grown. The initiative also legalizes paraphernalia.

The initiative grants regulatory oversight to the state Alcoholic Beverage Control Board, but gives the legislature the authority to create a new entity, the Marijuana Control Board. In either case, the regulatory authority will have nine months to create regulations, with applications for marijuana businesses to open one year after the initiative becomes effective.

A $50 an ounce excise tax on sales or transfers from growers to retailers or processors would be imposed.

The initiative does not alter either existing DUI laws or the ability of employers to penalize employees for testing positive for marijuana.

The initiative would not interfere with existing medical marijuana laws.

DC Measure 71

The Measure 71 initiative would allow adults 21 and over to possess up to two ounces of marijuana and six plants, three of which can be mature. Households could grow up to 12 plants, six of which can be mature. Growers can possess the fruits of their harvests. Plants could only be grown indoors.

Adults could transfer up to an ounce to other adults without remuneration. There are no provisions for taxing and regulating marijuana sales because District law forbids initiatives from taking up tax and revenue matters. A bill is pending before the DC city council that would do precisely that.

The initiative also legalizes the sale and possession of paraphernalia used for marijuana consumption. It does not change existing DUI law, nor does it "make unlawful" any conduct covered by the District's medical marijuana law.

Oregon Measure 91

The Measure 91 initiative allows adults 21 and over to possess up to eight ounces and four plants per household. Individuals can also possess up to 16 ounces of marijuana products or 72 ounces of liquid marijuana products. And individuals can also transfer up to an ounce of marijuana, 16 ounces of marijuana products, or 72 ounces of liquid marijuana products to other adults for "non-commercial" purposes.

The initiative would designate the Oregon Liquor Control Commission to regulate marijuana commerce. The commission would license, audit, and inspect growers, suppliers, and retailers. The commission could set purchase amount limits, which are not specified in the initiative. The commission would have until January 4, 2016 to begin licensing growers, producers, and retailers.

Marijuana sales from producers to processors or retailers would be taxed at a rate of $35 per ounce, $10 per ounce of leaves, and $5 per immature plant. The commission can recommend to the legislature any changes in the tax structure, which would then have to act to enact them.

The initiative does not alter either existing DUI laws or the ability of employers to penalize employees for testing positive for marijuana.

The initiative would not interfere with existing medical marijuana laws.

Florida Amendment 2

The Amendment 2 medical marijuana initiative makes legal the use of marijuana by a qualifying patient or caregiver. It would also make it legal for doctors to recommend medical marijuana and for "marijuana treatment centers" to distribute it.

Patients qualify by having a "debilitating medical condition" including, but not limited to, cancer, multiple sclerosis, hepatitis C, HIV, and Crohn's Disease. Doctors could also recommend marijuana for "other conditions for which a physician believes that the medical use of marijuana would likely outweigh the potential health risks for a patient."

The Florida Department of Health would regulate medical marijuana and would issue patient and caregiver ID cards, develop rules and regulations for dispensaries, and define reasonable amounts of marijuana for medical use.

The initiative specifically does not allow use of medical marijuana by non-qualifying patients or the use of motor vehicle by patients under the influence. Nor does it require any accommodation for medical marijuana in schools or on the job or that health insurance companies cover medical marijuana expenses.

Because the initiative is a constitutional amendment, it needs 60% of the votes to pass.

What Can You Do?

Even with less than two weeks left in the campaigns, people can still help. There are slightly different tasks and needs in the different states, but all the campaigns are eager for help.

In Alaska, the Measure 2 campaign is asking for people to go to its Talk It Up Alaska web page, where people can choose from a number of ways to help.

"On that page, there are tabs that let people send messages to friends and family -- basically a pre-written email -- as well as phone banking tool," said Chris Rempert, Alaska political director for the Marijuana Policy Project, which is backing the campaign. "We have a limited phone bank list targeted toward people likely to support us, but less likely to get out and vote. People can go there, sign up, and start calling."

The campaign could also use some cash. Donations can be made online here.

"We've spent so much money on advertising, we're running low on funds for the final push," said Rempert. "We need money for yard signs, campaign literature, and the like."

And volunteers on the ground could help, too.

"Especially in Anchorage, we need help with getting signs up and phone banking," Rempert said. "We'll be doing door-to-door canvassing and volunteers would be welcome."

Don't forget engaging with local media.

"People who are in Alaska should be writing letters to the editor," he said. "The opposition has formed a grass-roots Facebook and letter-writing effort, so anyone who can write a letter will be appreciated."

In the nation's capital, the DC Cannabis Campaign is already in the early voting phase of the election. It is using social media, including a #YesOn71 Twitter hashtag, to get the word out.

It could, though, still use volunteers to go to the precincts and hand out information, as well as for phone banking. And it could use more money. To volunteer, go here; to donate, go here. You can even pay in bit coins, if you have them.

In Oregon, the Vote Yes on 91 campaign is urging people to contact their in-state friends and family members, do phone banking, and more.

"If you know any Oregonians, write them a short personal email about why passing Measure 91 is so important," said campaign spokesman Peter Zuckerman. "Reach out to your friends and family members and tell them to vote yes."

Volunteers can still help, too.

"Whether you're an Oregonian or not, you can volunteer," Zuckerman said. "We're working very hard to get out the vote, and we need help. Go to our web site, where we have mobile GOTV groups. If you can get at least six people to phone together at a house, we will send you materials to do it."

There's still more to come, too, Zuckerman said.

"We will be rolling out other ways to help soon, so stay tuned," he advised. "Voter turnout is going to be really important in this election. This is a tough campaign, and we have to fight for every vote. We know your readers are really committed to this issue. Please do everything you can to encourage your readers to help us out."

In Florida, the United For Care campaign is engaged in an uphill battle to hit that difficult 60% mark. As the election season enters its final days, the campaign is still looking for volunteers and still accepting donations. Florida would be the first state in the South to pass a full-blown medical marijuana initiative, and it could still use your help.

It's not too late to make a difference. Act now.

Fighting Stigmatization of Drug Users in Denver [FEATURE]

In many ways, ours is harsh, moralistic, and punitive society. One need only look at our world-leading incarceration rate to see the evidence. We like to punish wrongdoers, and our conception of wrongdoers often includes those who are doing no direct wrong to others, but who are doing things of which we don't approve.

We label those people of whom we don't approve. When it comes to drugs and drug use, the labels are all too familiar: Heroin users are "fucking junkies;" alcohol abusers are "worthless drunks;" cocaine smokers are "crack heads;" stimulant users are "tweakers;" people with prescription drug habits are "pill poppers." The disdain and the labeling even extends to the use of drugs on the cusp of mainstream acceptance. Marijuana users are "stoners" or "pot heads" or "couch potatoes."

Such labeling -- or stigmatizing -- defines those people as different, not like us, capital-O Other. It dehumanizes the targeted population. And that makes it more socially and politically feasible to define them as threats to the rest of us and take harsh actions against them. It's a pattern that we've seen repeatedly in the drug panics that sweep the nation on a regular basis. Drug users are likened to disease vectors or dangerous vermin that must be repressed, eradicated, wiped out to protect the rest of us.

(It is interesting in this regard to ponder the response to the most recent wave of opiate addiction, where, for the first time, users are being seen as "our sons and daughters," not debauched decadents or scary people of color who live in inner cities. Yes, the impulse to punish still exists, but it is now attenuated, if not superseded, by calls for access to treatment.)

Never mind that such attitudes can be counterproductive. Criminalizing and punishing injection drug use has not, for example, slowed the spread of blood-borne infectious diseases such as HIV and hepatitis C. To the contrary, it has only contributed to the spread of those diseases. Likewise, criminalizing drug possession does not prevent drug overdoses, but it may well prevent an overdose victim's friends or acquaintances from seeking life-saving medical attention for him.

A recent survey from the National Council on Alcoholism and Drug Dependence reinforces the view that we tend to stigmatize drug users as morally decrepit. That survey found that Americans are significantly more likely to have negative attitudes about drug addiction and addicts than about mental illness.

Only one out of five said they would be willing to work closely on the job with a person addicted to drugs (as compared to 62% for mental illness), and nearly two-thirds said employers should be able to deny a job to someone with an addiction issue (as compared to 25% for mental illness). And 43% said drug addicts should be denied health insurance benefits available to the public at large.

"While drug addiction and mental illness are both chronic, treatable health conditions, the American public is more likely to think of addiction as a moral failing than a medical condition," said study leader Colleen L. Barry, Ph.D. of the Johns Hopkins Bloomberg School of Public Health. "In recent years, it has become more socially acceptable to talk publicly about one's struggles with mental illness. But with addiction, the feeling is that the addict is a bad or weak person, especially because much drug use is illegal."

"The more shame associated with drug addiction, the less likely we as a community will be in a position to change attitudes and get people the help they need," study coauthor Beth McGinty, Ph.D. said in a news release. "If you can educate the public that these are treatable conditions, we will see higher levels of support for policy changes that benefit people with mental illness and drug addiction."

As the survey suggests, the process of stigmatization is an impediment to smart, evidence-based approaches to dealing with problematic drug use. Now, the Denver-based Harm Reduction Action Center is trying to do something about it.

In the last few days, it has rolled out a new anti-stigmatization campaign featuring the faces of injection drug users, the locations where they overdosed or suffered other bad consequences, and their individual stories in brief.

"My name is Alan," says a middle-aged man with a brushy mustache. "I overdosed on heroin. Right there in that parking lot in that picture. I know the risks of doing heroin, but drug dependency is strong."

The second part of Alan's message is repeated with each drug user pictured: "There are 11,500 injection drug users like me in Metro Denver. 73% of us carry Hepatitis C. 14% of us have HIV. The transmission of bloodborne diseases and drug overdoses are nearly 100% preventable. Support the Harm Reduction Action Center. Learn more about how our public health strategies keep you, and the people you know, safe."

"My name is Andrew," says a dreadlocked and pierced young man whose image is coupled with a photo of an empty apartment. "After a decade living as a homeless youth, the most traumatic thing that happened to me didn't happen to me at all. It happened to my best friend Val. She died of a heroin overdose. Right here in this picture. She was my friend. She was someone's daughter. Sobriety has taught me a lot about the thin line that separates us all. Val was someone you knew. She probably served you coffee. She probably even greeted you with a friendly smile."

"My name is Joanna," says a woman whose image is paired with a photo of a car parked beneath a highway overpass. "When I was diagnosed with lymphoma, I was prescribed a heavy dose of pain killers. Cancer hurts, but with treatment, it went away. My dependency on opioids did not. Two years later, this is where I live; in a car, under the interstate. I did not choose to get cancer. I did not choose to get dependent on opioids."

The images and the messages are strong and direct. That's the idea, explained HRAC executive director Lisa Raville.

"This campaign is about bringing awareness of our work in the community, focusing on the common sense approach championed by harm reduction," she said. "Stigma, of course, is one of the biggest stumbling blocks, preventing otherwise reasonable conversation on the matter of communicable diseases and accidental overdoses. This campaign sets the scene that harm reduction is a valid and evidence-based approach to public health. Access to clean syringes, proper syringe disposal, and naloxone are key components to a comprehensive public health strategy that curbs the spread of HIV, HVC, and reduces the rate of otherwise fatal overdoses."

It's a message directed at the general public even more than drug users themselves, Raville said.

"One of the fundamental problems faced by health care advocates working with injection drug users is a generalized, public perception that the issue is isolated to people and places outside of the normal social sphere. Generally speaking, our tendency is to dissociate our ordinary experiences -- the people we know and the places we go -- from things that we consider dangerous, dark, or forbidden," she said.

"In the arena of injection drug use, the consequence of this mode of thinking has been historically devastating," she continued. "Instead of crafting public policy that works to minimize the harm caused by addiction, our trajectory tends towards amplifying consequences for anyone that wanders outside of the wire and into these foreign spaces. Rather than treating addiction as a disease, we treat it as something that is volitional and deserving of its consequences. Accordingly, our policies view the contraction of blood-borne pathogens and the risk of overdose as deterrents to the act of injecting drugs."

That cold-blooded attitude may make some people feel better about themselves and their policy prescriptions, but it hasn't proven useful in reducing deaths, disease, or other harms resulting from injection drug use. Instead, it tends to increase them.

"These 'consequences,' of course, have little impact on rates of addiction," Raville argued. "They do, however, all but ensure the continued spread of HIV and hepatitis C. Moreover, possession and distribution of naloxone, a drug that counters the effects of otherwise fatal opiate overdoses, remains criminal in many areas throughout the world."

At bottom, the campaign is not just about drug users but about better public health.

"As our campaign points out, when we drive things underground, we make them truly dangerous," Raville said. "Harm reduction is predicated on the fact that people use drugs. Those who inject drugs are among the most insular and at-risk for contracting HIV, HCV or dying of an overdose. Like a stone that falls in the water, these acute health-related events have ripples which touch all of us, regardless of whether or not we use drugs. HIV infects those who inject the same as those who do not; the best way to prevent its spread is to prevent its spread across all populations of people, not just those deemed more socially 'worthy.' By facing stigma head-on and by humanizing the people in our community who we serve, the Harm Reduction Action Center hopes to normalize the issue and bring the conversation about drug use and healthcare to a more practical level. As a public health agency that serves people who inject, we could get so much more done in our community without stigma."

Denver, CO
United States

California Malpractice Initiative Would Drug Test Doctors [FEATURE]

In California, an initiative designed to increase the caps on medical malpractice awards is catching the attention not only of powerful legal and medical interests, but also drug reformers. That's because, in what opponents call a cynical ploy, the malpractice initiative leads with a provision to impose drug testing on doctors.

Prop 46 would require the suspicionless drug testing of doctors. (wikimedia.org)
Proposition 46, whose controversial ballot title is "Drug and Alcohol Testing of Doctors, Medical Negligence Lawsuits. Initiative Statute," would, if passed, make California the first state in the nation to impose drug testing on doctors. According to a Ballotpedia summary, it would:

  • Increase the state's cap on non-economic damages that can be assessed in medical negligence lawsuits to over $1 million, from the current cap of $250,000.
  • Require drug and alcohol testing of doctors and reporting of positive tests to the California Medical Board.
  • Require the California Medical Board to suspend doctors pending investigation of positive tests and take disciplinary action if the doctor was found impaired while on duty.
  • Require health care practitioners to report any doctor suspected of drug or alcohol impairment or medical negligence.
  • Require health care practitioners to consult the state prescription drug history database before prescribing certain controlled substances.

The fight over Prop 46 is shaping up to be the most expensive initiative campaign ever, with rival groups having already raised nearly $70 million. The vast majority of that funding is coming from opponents of the initiative, primarily the very well-heeled state medical community. The No on 46 campaign committee alone has raised nearly $57 million to kill it.

The stakes are huge. Portrayed by supporters -- mainly trial lawyers -- as a boon to patients harmed by medical misconduct and hamstrung by state laws limiting malpractice awards, state analysts estimate that it could cost state health care programs "tens of millions to several hundred million dollars annually," while a legion of hospitals, health clinics, medical practices, and other health care professionals warn that Prop 46 would drive up health care costs across the board while primarily benefiting the bottom line of malpractice lawyers.

Law firms and attorneys' groups are the biggest backers of Prop 46, but they aren't the only ones. The advocacy group Consumer Watchdog is also backing it to the tune of more than $2 million, and has laid out some arguments in favor of it.

"According to a study published in the Journal of Patient Safety, medical negligence is the third leading cause of death in the country behind only heart disease and cancer. As many as 440,000 people die each year from preventable medical negligence. That's like a 747 crashing every 10 hours," the group said in a March flyer. "The California Medical Board estimates that almost one-in-five doctors (18%) suffer from drug and/or alcohol abuse at some point during their careers -- and leading medical safety experts have called for random drug testing to curb substance abuse and ensure patient safety."

In that same flyer, Consumer Watchdog also warned that "doctors are the biggest suppliers for chronic prescription drug abusers" and that "drug prescribed by doctors caused or contributed to nearly half of recent prescription drug overdose deaths in California." But such scary claims beg the question of who else would be expected to supply prescription drugs.

While lawyers and some consumer advocates are lining up to support Prop 46, it is also generating a huge and powerful group of opponents, including hundreds of medical groups, health care providers, hospitals, insurance companies, and clinics and private practices worried about rising malpractice insurance costs. It is also opposed by dozens of county medical associations, the state Chamber of Commerce and many local affiliates, along with more than a dozen labor unions.

The strange bedfellow opposition extends even further, with the state Republican Party, the state American Civil Liberties Union (and its local affiliates), and the California NAACP all among groups coming out against Prop 46. Also among its foes are most of the major newspapers in the state, which have thoroughly condemned it.

"If doctors are drug-addled, other doctors and nurses have a duty to report them," the Sacramento Bee editorialized. "If doctors make horrible mistakes during surgery, there might be cause for testing. But Proposition 46 would impose the insulting requirement of random testing on all doctors who have hospital privileges, and require that the Medical Board of California discipline any doctors whose tests are dirty. In its propaganda, Consumer Watchdog jokes about privacy concerns in a lowest-common-denominator video showing that other professionals must provide urine samples. Simply because laws allow for testing of some workers doesn't mean physicians' privacy should be trampled."

The conservative San Diego Tribune was similarly irked by the use of doctor drug testing as a come-on designed to induce voters to favor the initiative, calling it "a pathetic scam" in the title of its editorial.

"Plainly, the doctor drug-testing provision is 'the ultimate sweetener' designed to make this foul brew go down better. It wasn't a critic who used that term," the newspaper noted. "It was Jamie Court, president of Consumer Watchdog, in an interview with The Los Angeles Times. Such an openly cynical attempt to manipulate voters shouldn't be rewarded. Vote no on Proposition 46."

The drug testing provision has also provoked opposition from the state's largest marijuana consumer organization, CA NORML, and the Drug Policy Forum of California, which urged supporters to vote no on Prop 46 in its 2014 Election Guide.

Anti-Prop 46 campaign poster (caphq.org)
"Drug testing is about marijuana," explained CA NORML head Dale Gieringer. "More than half the drug test positives out there are marijuana. This initiative deceitfully claims to be about alcohol and prescription drug abuse by doctors, but drug testing is almost useless with alcohol -- unless you're actually drunk at the time, I suppose -- and if you closely read the text of the initiative, you see that prescription drugs are perfectly excusable as long as the doctor has a prescription. So, there's a medical excuse for the prescription drugs mentioned in the ads, but not for medical marijuana, since the initiative only allows exemptions for prescribed controlled substances."

The drug testing regime proposed by the initiative is antiquated, too, Gieringer said.

"This thing is using urinalysis drug testing standards promulgated by the feds a generation ago," he pointed out. "The list of illegal drugs includes PCP -- yeah, that's a major problem, all those docs on PCP -- but doesn't include the new synthetics. And the list specifically includes marijuana metabolites, but not THC. That's because they're relying on urinalysis, which can't detect active THC, so only the inactive metabolite is being considered under this insidious proposition."

In other words, the drug tests wouldn't catch doctors with alcohol problems unless they were literally drinking on the job, would excuse the presence of prescription drugs if the doctor had a prescription, and wouldn't find doctors who were actually high on pot, but would find those who had used the substance days or weeks earlier. But it sounded good in focus groups.

"As we know, the drug testing provision was an afterthought," Gieringer said. "This is being done by trial lawyers, and the basic purpose is to heighten the limits on malpractice liability. But those focus groups showed everybody liked the idea of drug testing doctors."

The drug testing provision may indeed have been a sweetener designed to improve Prop 46's chances at the polls next month. But the well-funded and broad-based opposition campaign is taking its toll.

Although it polled well in a June Field poll, coming in with 58% support, support has declined since then. An August Field poll saw support plummet, with only 34% in favor, 37% opposed, and 29% undecided. But it isn't over until it's over. The number of undecideds less than a month out is big enough to swing the results either way.

The airwaves across California are already filled with Prop 46 campaign ads. We can only expect them to increase in the next few weeks as the deep-pocketed contenders throw everything they've got at the voters in the final days of campaigning.

CA
United States

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