San Francisco Could Pay Welfare Recipients to Stay Drug-Free, MA Safe Injection Site Hearing, More... (7/29/24)

The ACLU of Missouri is suing over state officials punishing a probationer for using medical marijuana; Glasgow, Scotland, is seeking to open a drug checking site, and more.

Market Street in San Francisco's Tenderloin district, home to many of the city's welfare recipients. (Creative Commons)

Medical Marijuana

Missouri ACLU Sues Over Medical Marijuana for Probationer. The American Civil Liberties Union (ACLU) of Missouri and a private law firm have filed a lawsuit against the state, the director of the Department of Corrections, and the Dallas County Prosecuting Attorney on behalf of a probationer, Sharon Stewart, the terms of whose probation bar her from using her doctor-recommended medical marijuana.

The lawsuit seeks injunctive and declaratory relief to bar the state from punishing her. It argues that denying probationers access to medical marijuana violates their constitutional right to access prescribed medical treatments and the right to be free from probation violations related to any use of marijuana.

"The people of Missouri voted not once, but twice, to add protections that prohibit the state from applying lawful marijuana use as a basis for a violation of parole, probation, or any type of supervised release," said Gillian Wilcox, Director of Litigation at the ACLU of Missouri. "The state is trampling the constitutional rights of the plaintiff and others on probation while interfering with medical treatments that have been prescribed by state-licensed physicians."

The constitutional amendment through which voters legalized the use of medical marijuana in 2018 clearly states "registered qualifying patients on bond for pre-trial release, on probation, or further supervised release shall not be prohibited from legally using a lawful marijuana product as terms of condition or release, probation, or parole."

Further protection for probationers came when voters legalized adult-use marijuana via a 2022 constitutional amendment, which includes language stating that "lawful marijuana-related activities cannot be the basis for a violation of parole, probation, or any type of supervised release."

Despite these protections, the state twice issued Stewart citations for violating probation after testing positive for THC, and the Dallas County prosecutor each time attempted to revoke her probation. The first time, the court did not determine that a violation occurred, but the second time, the court held that she violated probation by testing positive, thus failing to "obey all laws and ordinances," since marijuana remains federally legal. She served two days of "shock incarceration" in May.

"The unconstitutional application of probationary terms has not only violated Stewart's rights but has led to her serving two days of 'shock incarceration' as punishment for merely attempting to exercise those rights as contemplated by the Missouri Constitution," said Jonathan Schmid, Policy Counsel for the ACLU of Missouri.

Drug Policy

San Francisco Supervisor Files Bill to Pay Welfare Recipients for Not Using Drugs. Supervisor Matt Dorsey filed a bill on Monday that would provide cash to welfare recipients who tested negative for drugs. The bill is designed as a complement to Proposition F, the March ballot measure that requires drug screening and treatment for welfare recipients to keep receiving benefits.

The bill's "Cash Not Drugs" program would provide an extra $400 a month to participants who test negative. Single adults without children currently receive $712 a month through the county Adult Assistance Program.

Dorsey's bill would create a three-year pilot program to be assessed by an independent academic researcher. It is backed by Mayor London Breed (D), who sponsored Proposition F in a bid to address public drug use and overdoses.

"This is more carrot than stick," said Dorsey. "It's a pretty promising approach."

Dorsey's program has the backing of Mayor London Breed, who placed Prop. F on the ballot.

Dorsey's plan is an example of "contingency management," a drug treatment strategy that rewards people for positive behavior as a reinforcement mechanism. The San Francisco Department of Public Health oversees several similar programs on a small scale. Dorsey said the costs of the program could be reimbursable through Medi-Cal.

Keith Humphreys, a Stanford professor who worked on drug policy for the Obama administration, said there is evidence that the contingency management approach can make an impact.

"It has been done all over the country," said Keith Humphreys, a Stanford University drug expert. "There are over 150 clinical trials supported by the National Institute of Health that have shown positive effects."

Harm Reduction

Massachusetts Senate to Take Up Safe Injection Site Bill Tomorrow. The Senate Ways and Means Committee is taking up a bill to authorize safe injection sites, Senate Bill 1242, as a means of preventing drug overdoses. More than 2,000 state residents have died of overdoses each year since 2016.

The House earlier passed a bill addressing substance use and addiction, but that measure does not include a provision for safe injection sites.

"I think from a Senate perspective, we need an approach that meets the urgency of the crisis and that includes utilizing and deploying every evidenced-based harm reduction tool available, including overdose prevention centers," said Sen. Julian Cyr (D), co-chair of the Public Health Committee. "I think a majority of senators support these harm reduction tools, which is why the Senate bill is including these provisions. We're going to try our best to come to common ground and reconcile these differences with our House colleagues before the end of formal sessions."

In addition to allowing safe injection sites, the Senate bill also allows municipalities to run other harm reduction programs including needle exchange programs and drug testing services. The proposal offers limited liability protections for program administrators and participants.

After tomorrow's committee session, House and Senate negotiators will have only one day to resolve differences in their respective substance abuse bills before the session formally ends.

"Everyone knows that it's brat summer," Cyr said when asked how the compressed timeline would affect the compromise bill. "Sometimes, that means a little bit of a messy process, but we're going to work hard to ensure that we have final legislation that meets the moment on the substance use epidemic and a myriad of other challenges facing the commonwealth."

International

Glasgow Applies for License to Launch Drug Checking Service. The city of Glasgow is applying for license to open a drug checking service as part of a $1.2 million pilot project. The Scottish capital will join the cities of Aberdeen and Dundee as participants in the plan.

The Glasgow facility, if approved, will be based in the east end of the city, where Britain's first official safe injection site is set to open later this year.

The plan is to allow drug users to submit a drug sample for testing to identify the substances it contains and allow healthcare staff at the site to provide specific harm reduction information.

"Glasgow's licence application is a welcome milestone," said drugs and alcohol policy minister Christina McKelvie. "Drug-checking facilities would enable us to respond faster to emerging drug trends, which is particularly important given the presence of highly dangerous, super strong synthetic opioids like nitazenes in an increasingly toxic and unpredictable drug supply. These increase the risk of overdose, hospitalization and death, and are being found in a range of substances."

The Home Office has created a set of criteria that each site must satisfy before a license is issued, and officials have already inspected the Aberdeen and Dundee sites. Glasgow will be next.