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Medical Marijuana Update

California medical marijuana patients get more protections, so do District of Columbia city employees, and more.

California

California Governor Signs Bill Protecting Medical Marijuana Patients from Healthcare Discrimination. Gov. Gavin Newsom (D) has signed into law Assembly Bill 1954, barring doctors from discriminating against patients based on a positive test for THC if the patient is a registered medical marijuana user. The bill adds that healthcare professionals cannot be punished for treating a patient who uses medical marijuana in compliance with state law. He also signed into law Senate Bill 988, which amends an existing law that permits registered patients to use medical marijuana products at hospitals. It would repeal a provision that currently requires that "health care facilities permitting patient use of medical cannabis comply with other drug and medication requirements."

Nebraska

Federal Appeals Court Rejects Attempt by Medical Marijuana Campaign to Block Nebraska Ballot Process. As medical marijuana campaigners ran into problems with signature gathering earlier this summer, they sued, arguing that the state's requirement that initiative campaigns not only reach a certain statew0ide signature threshold but also get signatures from at least 5 percent of voters in at least 38 of the state's 93 counties violated free speech and equal protection rights. Nebraskans for Medical Marijuana and the ACLU prevailed in district court in June, winning a temporary injunction suspending the 5 percent requirement. But state officials appealed, and the US 8th Circuit quickly put a hold on the judge's order pending an appeals court ruling. That ruling came Wednesday, when a split panel of the court ruled for the state. "The district court abused its discretion by granting the plaintiffs’ request for a preliminary injunction,” Judges Raymond Gruender and David Stras ruled. Judge Jane Kelly disagreed, writing that "if the right to vote is fundamental, I see no reason why it should not apply equally to the initiative process at the heart of Nebraska’s electoral and legislative system." The campaign and the ACLU said the effort would continue and that they may seek a ruling from the full 8th Circuit.

Washington, DC

DC Court Reverses Firing of Government Worker Who Tested Positive for Marijuana. An administrative court in the DC Office of Employee Appeals (OEA) has reversed the firing of medical marijuana patient and city government employee who was accused of being high on the job and later tested positive for marijuana. The employee argued that the city's communications office falsely accused her of being impaired because her eyes were red and she was talking quietly. She pointed out that her eyes were red because she had spent the previous night at a hospital sitting beside a relative who had overdosed. She also presented a valid medical marijuana patient card. The court held that the communications office was negligent in how it handled the process for reasonable suspicion of impairment from drugs. The judge noted that supervisors allowed her to continue working after they accused her of being impaired: "Because Employee was allowed to perform her duties and did in fact adequately do so after being observed by her supervisors, I find that [the supervisors] did not reasonably believe that Employee’s ability to perform her job was impaired. As such, I further conclude that a reasonable suspicion referral was unwarranted," the judge wrote in the ruling. 

Poll Finds SAFE Banking Act Has Broad Support, DEA Fentanyl Scaremongering, More... (9/7/22)

Missouri's Republican governor rejects a call to include marijuana legalization in an upcoming special session, a DC court reverses the firing of a medical marijuana-using employee accused of being high on the job, and more.

"Rainbow" fentanyl--not aimed at kids, experts say. (Multnomah County Sheriff)
Marijuana Policy

Survey: Most Voters Support Federal Banking Reforms for Licensed Marijuana Retailers. The overwhelming majority of voters believe that federal law should be amended so that state-licensed marijuana businesses can readily utilize banks and other financial services, according to national survey data compiled by Morning Consult and commissioned by the Independent Community Bankers of America. Consistent with prior survey data, 65 percent of respondents “support allowing cannabis-related businesses to have access to banking services in states where cannabis is legal.” Moreover, 63 percent of voters agree that allowing cannabis-related businesses to access the banking system will help improve public safety, and 58 percent say that it is “important” that members of the U.S. Senate vote to establish a safe harbor for licensed cannabis businesses. The SAFE Banking Act (HR 1996), which would do just that, has repeatedly passed in the House only to be blocked in the Senate by Senate Majority Leader Charles Schumer (D-NY) and his allies, who are holding out for passage of a full-fledged marijuana legalization bill.

Missouri Governor Will Not Include Marijuana Legalization in Special Session. Efforts to do a legislative end run around a pending marijuana legalization constitutional amendment (Amendment 3) have come to naught after Gov. Mike Parson's office said Tuesday that he will not expand the scope of his upcoming legislative special session to consider legalizing marijuana. "The call will not be amended to include marijuana legalization," Kelli Jones, spokeswoman for Parson, said. Lawmakers hoping to blunt momentum for the measure had called on the governor to include marijuana legalization, but even though Parsons has called Amendment 3 "a disaster," he demurred.

Medical Marijuana

DC Court Reverses Firing of Government Worker Who Tested Positive for Marijuana. An administrative court in the DC Office of Employee Appeals (OEA) has reversed the firing of medical marijuana patient and city government employee who was accused of being high on the job and later tested positive for marijuana. The employee argued that the city's communications office falsely accused her of being impaired because her eyes were red and she was talking quietly. She pointed out that her eyes were red because she had spent the previous night at a hospital sitting beside a relative who had overdosed. She also presented a valid medical marijuana patient card. The court held that the communications office was negligent in how it handled the process for reasonable suspicion of impairment from drugs. The judge noted that supervisors allowed her to continue working after they accused her of being impaired: "Because Employee was allowed to perform her duties and did in fact adequately do so after being observed by her supervisors, I find that [the supervisors] did not reasonably believe that Employee’s ability to perform her job was impaired. As such, I further conclude that a reasonable suspicion referral was unwarranted," the judge wrote in the ruling. 

Opioids and Opiates

DEA Warning that Colored Fentanyl Pills Are Aimed at Kids is Nonsense, Experts Say. On August 30, the DEA warned the public about fentanyl in colorful pills being sold by "drug cartels" to "made to look like candy to children and young  people," calling it "Rainbow fentanyl" and charging that it is "a deliberate effort by drug traffickers to drive addiction amongst kids and young adults." But drug policy experts said such statements were misleading—and used harsh terms in doing so.

The charge is "typical drug war bullshit," said Dr. Nabarun Dasgupta, a pharmaceutical scientist at the University of Carolina at Chapel Hill. DEA's framing "was so divorced from any reality of what drug markets are actually like, it was almost laughable that our country's top drug enforcement folks are so out of touch.We've been talking about colored dope for years. This is like completely nothing new."

Claire Zagorski, a licensed paramedic, program coordinator and harm reduction instructor for the PhARM Program at The University of Texas at Austin College of Pharmacy, described the DEA announcement as "old recycled drug propaganda" that echoes the perennial myth of dope-laced Halloween candy. "Why would someone give away their expensive drugs to some random person they don't know, just so they might have a bad experience? It doesn't make sense," Zagorski told Salon. "At the end of the day, drug sellers are business people, and they're not going to invest in some kind of change to their supply if they don't think there's some good return on it … Kids don't have a lot of money that their parents don't supervise or give to them. So it just doesn't make sense from a business standpoint."

PA Pot Pardon Program Unveiled, New York City Rally for Safe Injection Sites Statewide, More... (9/2/22)

New York City's child welfare agency is still holding marijuana use against parents--especially black ones--San Francisco's new DA is approaching misdemeanor drug prosecutions much like the old one she accused of being "soft on crime," and more. 

San Francisco's Tenderloin is a drug hot spot. (Creative Commons)
Marijuana Policy

New York City Child Welfare Agency Still Citing Marijuana in Family Separations Despite Legalization and Policy Changes. Marijuana legalization went into effect in New York in March 2021, but court records and interviews with people involved show that the city's child welfare agency continues to use marijuana use by parents to take their children from them. Many interviewees were parents who said "it has felt impossible to extricate themselves from deeply rooted biases in the child welfare system surrounding marijuana use, specifically toward people of color." City child welfare authorities cite parental marijuana use to justify initial separations and prolong family separations by demanding drug testing or participation in drug treatment programs. All of the parents interviewed were black and all of them said marijuana was used against them because of their race. Child welfare said official policy is not to remove children solely on the basis of parental marijuana use, but families and attorneys say the agency does not follow the policy, pointing to petitions in which the only evidence of neglect cited was parental marijuana use.

Pennsylvania Announces Month-Long Pardon Project for People with Small-Time Marijuana Convictions. Gov. Tom Wolf and Lt. Gov. John Fetterman, the Democratic nominee for US Senate in the state, who is running on a platform of marijuana legalization, announced a one-time, large-scale project to pardon people with past minor and non-violent marijuana convictions. The state Board of Pardons will accept applications for the PA Marijuana Pardon Project from Thursday, Sept. 1, through Friday, Sept. 30.  People who were convicted of simple marijuana possession or possession of marijuana for personal use are eligible for the pardons if they have no other criminal convictions. Those who do have additional convictions are invited to apply for clemency. The state estimates that "thousands" of people will qualify for the program.

Harm Reduction

New York City Harm Reductionists Take to Streets on International Overdose Awareness Day to Demand Safe Injection Sites Statewide. At least nine people were arrested outside Gov. Kathy Hochul's Manhattan office Wednesday as hundreds of people rallied to advocate for an expansion of safe injection sites statewide as they marked International Overdose Awareness Day. Two safe injection sites operate in New York City, but none in the rest of the state. Protestors changed "no more drug war" and blocked traffic, leading to the nine arrests. "It’s exhausting to keep experiencing loss after loss after loss, and to keep fighting without a proper response to this epidemic from politicians, said Alicia Singham Goodwin, drug policy campaign coordinator at VOCAL-NY, which helped organize the action. There were also actions to mark the day in Boston, New Hampshire, and California, where a coalition of more than 50 harm reduction groups rallied across the state and criticized Gov. Gain Newsom (D), who just a week ago vetoed a safe injection site pilot project bill. "Governor Newsom not only used his pen to cosign our participants to death, he did so while blaming his choice on our harm reduction infrastructure," said Soma Snakeoil, executive director of Sidewalk Project.

Law Enforcement

San Francisco's New DA Prosecuting Few Misdemeanor Drug Cases. After city voters ousted former DA Chesa Boudin for being "soft on crime," they expected a crackdown from his successor, Brooke Jenkins. But while police have brought three times as many drug cases to her office than in Boudin's time, about two-thirds of them are not being prosecuted. When it comes to misdemeanor offenses such as simple drug or paraphernalia possession, 99 percent of those cases are being dismissed, sent to another law enforcement agency, or recommended for probation or parole revocation. Jenkins spearheaded the recall effort against Boudin, but she looks to be just as "soft on crime" as Boudin was.

(This article was prepared by StoptheDrugWar.org's 501(c)(4) lobbying nonprofit, the Drug Reform Coordination Network, which also pays the cost of maintaining this website. DRCNet Foundationtakes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

MI Police Admit Pot Driving Drug Tests Are No Good, CA Pot Bills Go to Governor, More... (9/1/22)

Indonesia has more than 200 people on death row for drug offenses, an effort by a Nebraskas medical marijuana campaign to block part of the state's signature-gathering requirements is rejected by an appeals court, and more

Michigan State Police alerted prosecutors that their drug tests for THC instead alerted for CBD. (Creative Commons)
Marijuana Policy

California Governor Has a Pile of Marijuana Bills on His Desk. Lawmakers were busy as the legislative session came to an end Wednesday, sending another batch of marijuana-related bills to the desk of Gov. Gavin Newsom (D). Now, there are more than a dozen bills awaiting his signature. One would bar localities from banning medical marijuana deliveries, another provides employment protection for off duty marijuana-using workers, another streamlines record-sealing procedures for past marijuana offenses, another would allow the state to set up interstate cannabis commerce, another would authorize medical marijuana for pets, another would protect the rights of marijuana-using parents, another would allow for insurance coverage for marijuana businesses, another changes the state's cannabis tax policy, another would bar doctors from discriminating against registered patients for a positive THC test, another amends the state law requiring medical facilities to accommodate medical marijuana use, another would allow cannabis beverages to be packaged in clear containers, another would add advertising and labeling requirements for vape products, another would bar marijuana regulators from denying temporary event license applications solely because the licensee also has a liquor license, and, last but not least, one would require reporting on marijuana tax revenues distributed to a youth education and prevention program.

Medical Marijuana

Federal Appeals Court Rejects Attempt by Medical Marijuana Campaign to Block Nebraska Ballot Process. As medical marijuana campaigners ran into problems with signature gathering earlier this summer, they sued, arguing that the state's requirement that initiative campaigns not only reach a certain statew0ide signature threshold but also get signatures from at least 5 percent of voters in at least 38 of the state's 93 counties violated free speech and equal protection rights. Nebraskans for Medical Marijuana and the ACLU prevailed in district court in June, winning a temporary injunction suspending the 5 percent requirement. But state officials appealed, and the US 8th Circuit quickly put a hold on the judge's order pending an appeals court ruling. That ruling came Wednesday, when a split panel of the court ruled for the state. "The district court abused its discretion by granting the plaintiffs’ request for a preliminary injunction,” Judges Raymond Gruender and David Stras ruled. Judge Jane Kelly disagreed, writing that "if the right to vote is fundamental, I see no reason why it should not apply equally to the initiative process at the heart of Nebraska’s electoral and legislative system." The campaign and the ACLU said the effort would continue and that they may seek a ruling from the full 8th Circuit.

Drug Testing

Michigan State Police Say Tests for THC in Drivers Actually Showed CBD; Thousands of Cases Could Be Impacted. State police notified prosecutors late last month that drug tests designed to detect THC in the blood of drivers instead alerted to the presence of non-psychoactive CBD and that they have now halted the blood toxicology testing program. "After further review, we now believe this discrepancy may impact cases that occurred on or after March 28, 2019, where the alleged violation is based on the finding of THC alone and there is insufficient evidence of impairment, intoxication, or recent use of marijuana to otherwise support the charged offense," state police said Wednesday. "Laboratory data indicates there are approximately 3,250 laboratory reports that may be impacted," state police said. "These are reports in which there was a THC-confirmed result without other drugs present or alcohol detected above the 0.08% blood-alcohol content legal threshold." March 28, 2019, is when CBD became legal in the state.

International

Indonesia Has More Than 200 People on Death Row for Drug Offenses. There are 404 death row inmates in the island archipelago, and more than half of them are there for drug offenses. It has already executed another 80 drug offenders since the beginning of the coronavirus pandemic out of 94 executions overall. Those executed include seven foreign nationals. The resort to the death penalty comes even as the country has since 2009 softened its drug laws, allowing judges to impose rehabilitation instead of prison for drug users and health authorities established guidelines for rehabilitation and treating drug use. 

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United States

CA Bill to Protect Workers' Off-Duty Marijuana Use Passes, OK Supreme Court to Decide If Legal Pot Initative Makes Ballot, More... (8/31/22)

Workers' rights to use marijuana off duty are in the news, a Missouri marijuana legalization campaign draws organized opposition from within the cannabis community, and more.

Marijuana Policy

California Bill to Protect Workers from Firing for Off-Duty Marijuana Use Heads to Governor's Desk. A bill that would provide broad employment protections for workers who use marijuana off the job, Assembly Bill 2811, has been approved by the legislature, easily winning a final concurrence vote in the Assembly late last week. The bill would "make it unlawful for an employer to discriminate against a person in hiring, termination, or any term or condition of employment, or otherwise penalize a person" solely because of off-duty marijuana use. The bill would also bar employees from demanding that workers or potential hires undergo marijuana testing, with exceptions for federal employees and some safety-sensitive positions. The bill now heads to the desk of Gov. Gavin Newsom (D).

Missouri Marijuana Legalization Initiative Draws Organized Opposition—from Within the Cannabis Community. The marijuana legalization initiative from Legal Missouri 2022 has drawn its first organized opposition, and those foes are coming from within the Kansas City cannabis community and allied lawmakers. The critics say the initiative does not offer social equity provisions and that by legalizing marijuana through a constitutional amendment, it removes legislators from the process and prevents legislative oversight. Members of the Impactful Canna Reform Coalition include state Rep. Ashley Bland Manlove (D-Kansas City), a pair of Kansas City medical marijuana businesses, a cooking and catering business, a holistic wellness company, an herbal remedy company, and Kansas City-based community organizers. "The capitalism monster loves to exploit you, and that is what’s happening with this petition," Bland Manlove said in a statement. "Myself and like-minded community partners realized people from politicians to Bob on the street didn’t know the details. We want to make it known."

Nevada Supreme Court Rules That Recreational Use of Marijuana Is Not Protected Off-Duty Conduct. The state's highest court has ruled that a casino employee who was fired after he was injured on the job and then tested positive for marijuana does not any legal recourse. Under state law, workers cannot be punished for the "lawful use" of products while not on duty, but the Supreme Court held that because marijuana remains illegal under federal law, its use is not "lawful," and the employee is therefore not protected. The case is Ceballos v. NP Palace LLC.

Oklahoma Supreme Court Agrees to Consider Whether Marijuana Legalization Initiative Should Be on November Ballot. Organizers behind the State Question 820 marijuana legalization initiative handed in sufficient signatures to meet state requirements, but the initiative still might be kept off the ballot because, for the first time, the state used a private contractor to count signatures and that contractor slow-walked the signature counting process so long that the statutory deadline to put the question on the ballot passed last week. The count, which normally takes two or three weeks, took seven weeks this time, and now, proponents have asked the state Supreme Court to intervene. On Tuesday, the Supreme Court agreed to take up the issue. If it rules against the initiative campaign, the measure would then go before voters either in a later special election called by the governor or on the November 2024 ballot.

Biden DOJ Opposes Gun Rights for MedMJ Patients, MO Legal Pot Initiative Qualifies, More... (8/10/22)

A Florida marijuana legalization initiative campaign aimed at 2024 gets underway, a Colorado natural psychedelic initiative comes up short, and more.

Marijuana testing is contributing to the truck driver shortage. (Creative Commons)
Report: Spike in Marijuana Positives Fueling Truck Driver Shortage, Supply Chain Disruptions. Amid chronic shortages of long-haul truck drivers, federal data from the Department of Transportation (DOT) shows that more than 10,000 truck drivers have been ordered off the road after testing positive for marijuana just between January 1 and April 1 of this year. That is a 33 percent increase over the same period in 2021. DOT's Federal Motor Carrier Safety Administration has also doubled the frequency of drug testing of truck drivers. Under federal law, CDL licensed drivers are not permitted to consume cannabis under any circumstances, regardless of whether marijuana use is legal where they live. Currently, more than 89,000 commercially licensed truck drivers are barred from the road because of positive drug tests; more than half of them are for people testing positive for marijuana.

Florida 2024 Marijuana Legalization Initiative Campaign Launched. A group calling itself Smart & Safe Florida filed a marijuana legalization initiative aimed at the 2024 ballot Monday. The campaign is initially being bankrolled by Trulieve, the state's largest medical marijuana provider. The measure would legalize the possession of up to an ounce by people 21 and over and allow existing medical marijuana retailers to sell to the recreational market, which would benefit Trulieve. It includes a provision that allows for -- but does not require -- the state to issue additional retail licenses. It does not include provisions for expungement, social equity, or home cultivation. The campaign will need to come up with roughly 900,000 valid voter signatures to qualify for the 2024 ballot. Previous initiative campaigns have been rejected by the state Supreme Court, but Smart & Safe Florida says its bare-bones initiative should be able to avoid or overcome legal challenges.

Missouri Marijuana Legalization Initiative Qualifies for November Ballot. A marijuana legalization initiative sponsored by Legal Missouri 2022 has qualified for the November ballot, Secretary of State Jay Ashcroft announced Tuesday. The initiative takes the form of a constitutional amendment that would remove bans on the possession, manufacturing, and sales of marijuana from the state constitution for people 21 and over. Building on an earlier medical marijuana constitutional amendment, the measure would also increase the number of retail sales licenses. It also includes a provision for the expungement of records.

Medical Marijuana

Biden DOJ Says Medical Marijuana Patients Too "Dangerous" to Own Guns. The Justice Department on Monday sought to persuade a federal court to overturn a policy blocking medical marijuana patients from buying or owning guns. The department was responding to a lawsuit filed by Florida Agriculture Commissioner Nikki Fried and several medical marijuana users that argues that the policy deprives patients of their 2nd Amendment rights. The Justice Department told the court that it would be too "dangerous to trust regular marijuana users to exercise sound judgment" around guns. The department also argued that gun rights are reserved for "law-abiding" people, noting that marijuana remains illegal under federal law. "This memorandum uses the phrase 'medical marijuana' for convenience, but Congress has found that marijuana 'has no currently accepted medical use.'"

Psychedelics

Colorado Natural Psychedelic Decriminalization Initiative Falls Short on Signatures. Campaigners for Initiative 61, "Legal Possession and Use of Entheogenic Plants and Fungi," announced Monday that the measure would not qualify for the ballot. Monday was the last day to turn in signatures, and organizers said their all-volunteer signature-gathering campaign had come up short. Another psychedelic reform measure, Initiative 58, the "Natural Medicine Health Care Act," has already qualified for the November ballot. It would decriminalize the possession of psilocybin and allow for its use in state-regulated settings.

Chronicle Book Review: American Cartel

American Cartel: Inside the Battle to Bring Down the Opioid Industry, by Scott Higham and Sari Horwitz (2022, Twelve Press, 400 pp., $30.00 HB)

Phillip S. Smith, with contributions from David Borden

https://stopthedrugwar.org/files/americancartel.jpg
Pulitzer Prize-winning Washington Post investigative reporters Scott Higham and Sari Horwitz have been on the opioid beat for years, teaming up (with others) on the Post's "The Opioid Files" series, which was nominated for a Pulitzer in 2020. Now, with American Cartel, the pair provide a deeply-sourced account of how opioid manufacturers, distributors, and pharmacies waged an all-out campaign to fend off DEA efforts to stanch the flow of billions of opioid pain pills, and to evade any culpability, even as the overdose death toll mounted year by year.

The picture Higham and Horwitz paint of corporate and political malfeasance is damning. But the laser sharp focus with which they paint it, omits much of the context in which the opioid crisis has unfolded. And that context is also very important.

An article in yesterday's Guardian shows one of the reasons why. In much of the world, very few pain patients are able to access opioids at all. Much suffering results, sometimes leading to suicide attempts. Dr. MR Rajagopal, chair of Pallium India, told the Guardian, "Pain is not visible. It happens in hospital beds or patients' rooms and is not visible to the world. Addiction, on the other hand, is very visible in headlines which quote the US epidemic and overdose deaths. No one talks about the western European success over decades; all the news is about the opioid crisis in the USA. This means that when we try to have discussions, our work becomes harder because many minds are primed against opioids."

In other words, by speaking too solely to one side of an issue, one risks adversely impacting the other sides. Whether "opiophobia" is real or significant in the US is another question. Higham and Horwitz don't venture a view on this, at least not in American Cartel.

One entity that has warned about opiophobia (without using the term) is the US Centers for Disease Control. In a 2019 memo, CDC writes that a 2016 guidance the agency issued on prescribing opioids for chronic pain had seen "misapplication[s]" by some physicians that put patients at risk. The memo cites a New England Journal of Medicine commentary by the authors of the 2016 guidance. It warns against "hard limits" on opioid dosages or cutting patients off; abrupt tapering of prescriptions; applying the guidance to acute pain situations patients face in situations like active treatment for cancer or sickle cell anemia or post-operative care; and applying it to medication-assisted treatment prescriptions for addiction.

Technically the CDC memo addressed a period of a few years beginning in 2016. But the dynamics it describes are inherent risks in a situation where providers are charged with supplying a substance that's useful but also addictive and potentially deadly if misused, and for which they can be sanctioned professionally or even prosecuted and imprisoned if things go wrong or someone disagrees. Pharma-driven promotion of their new opioid products was a factor in driving up prescribing rates to where they reached. But a part of the increase was also the medical community reacting to a real problem of under-treatment or non-treatment of pain for some patients, a problem that coexists with over-prescribing to some other patients. That increase in turn came with a learning curve.

The authors also give short shrift to the impact of today's woes and inequalities in driving the so-called deaths of despair -- a concept coined by Princeton professors Anne Case and Angus Deaton -- alienation and anomie, helplessness and hopelessness afflicting many Americans who have been left behind in the modern economy, especially in the opioid use heartlands of the Midwest and Appalachia. The Midwest deindustrialized beginning in the 1970s, and both regions largely missed out on the tech boom of the '90s and '00s. Then came even more pain with the Great Recession, followed by COVID and more economic and social disruption. People there (and elsewhere) are dying not just of opioids, but of smoking, drinking, and suicide. Big Pharma is easily (and oh so deservingly) demonized, but the laser focus on the companies allows us not to have to look in the mirror about the pain our society produces.

That factors like these should play a role in the opioid crisis, though, doesn't exonerate Big Pharma. Rather, the misleading promotions of their products carried out by pharma, took an even greater toll due to the vulnerabilities those other factors had brought to the fore.

Meanwhile, the death toll continues to mount -- over 100,000 per year, and with a new record high every year. Prescription opioids still figure prominently in overdoses. But the greatest part of the problem by far is black-market fentanyl, used deliberately by some high tolerance heavy users of opioids, but primariy causing overdose as an adulterant in heroin, counterfeit prescription pills, and other street drugs, essentially a poisoning crisis. But as Higham and Horwitz note, that is part of a wave of opioid use that began with pharmaceutical companies such as Purdue Pharma taking Oxycontin onto the market in the late 1990s. The first decade of this century also saw other prescription opioids -- oxycodone, hydrocodone, Vicodin, Percocet, Opana, et al. -- hit the market.

Higham and Horwitz are fond of tossing around astounding numbers of pills produced by manufacturers or sold by certain pharmacies, such as Mallinckrodt producing 3.5 billion 30 milligram hydrocodone pills in one year, and critics could protest that those numbers need context, too. A prescription for a medication doesn't just have a number of pills to take. It specifies how large a dosage there is inside each pill. A smaller number of pills that each contain a higher dose might mean more than a larger number that each contain a smaller dose. And a higher dose prescription sometimes reflects a patient's tolerance to opioids built up through past medical (or non-medical) use. Maybe West Virginia didn't really need 81 million pain pills during a five-year span. But maybe it did. Without more information, it's just not clear what these numbers mean.

They do provide some context, though, for example by comparing pain pill sales across all drug stores in a region and pointing out anomalies not easily explainable by, say, differing rates of cancer or other serious illness. And they demonstrate that plenty of businesses -- from Big Pharma to the drug store chains and individual pharmacies -- were either in it for the money or at best screwed up, both through detailed analysis and telling anecdote. For example, there was the guileless Florida pharmacist who explains to investigators that she fills pain pill prescriptions all day long, but always keeps a certain number of pills on reserve "for my real pain patients."

When the DEA cracked down first on Wild West internet sales of opioids and then on the "pill mills," medical practices with perfunctory examinations and huge numbers of opioid prescriptions whose entire business model seemed to be writing opioid prescriptions, it succeeded in reducing access to those drugs. But the people using opioids didn't stop; they went to black market drugs, fueling first a resurgence in heroin use and now an opioid crisis driven by fentanyl.

A key figure in the tale is Joe Rannazzisi, who as head of DEA's Office of Diversion Control from 2006 to 2015 oversaw the agency's endless effort to ensure that prescribed opioids are only prescribed for legitimate medical purposes and not leaking into the black market. We are inclined to think of the DEA as a prohibitionist agency, but in this case, it is acting as a regulatory agency. And what Higham and Horwitz uncover is a case of regulatory capture -- when the industry being regulated manages to set the terms under which it is regulated, for its own benefit, not that of the public.

Rannazzisi and his team of DEA lawyers spent years going after opioid manufacturers, distributors, and pharmacy chains who were repeatedly (administratively) busted for failing to do due diligence about just who was buying their products. The companies would pay huge fines, promise not to do it again, and then continue to pump massive amounts of opioids through the supply chain.

The companies mobilized against Rannazzissi and his campaign, forming industry front groups, undertaking lobbying efforts, hiring legions of high-priced law firms, and crafting legislation that would rein in what they saw as an out-of-control agency. As Higham and Horwitz document in great detail, it worked.

Sponsored by Rep. Tom Marino (R-PA) and Sen. Marsha Blackburn (R-TN), both of whom received substantial contributions from the industry, but written by industry lobbyists, the nicely named Ensuring Patient Access and Effective Drug Enforcement Act removed from the DEA tools that Ranizzisi had been using to try to force drug distributors to monitor and report suspicious orders, such as the 1.2 million oxycodone tablets one distributor bought from Mallinckrodt in one day, only to order another 1.2 million the next day.

The bill passed, only to be drastically revised amidst scandal after an earlier Post report on the opioid bill derailed then-President Trump's effort to name Marino drug czar. But Higham and Horwitz also detail rot inside the DEA, where the industry managed to get to high-ranking officials who sidelined Rannazzisi, forcing him into retirement and forcing many of his team members into bureaucratic Siberia. It's an ugly little story of money and power, the sort that is all too common in Washington.

If the first part of American Cartel reads like a detective novel, the second part is more like a legal thriller, It covers the massive wave of civil lawsuits filed against the drug companies, and it is not particularly edifying reading. You see hundreds of high-powered attorneys from the country's top litigating firms -- including dozens of former DEA attorneys working now working for the industry they regulated -- facing off against armies of lawyers for the thousands of states, cities, and counties. You see massive settlements from the companies and massive damages wrested from companies that went to court and lost. While it is unclear just how the moneys won or negotiated by the various plaintiffs is actually being used to help people who suffered from the opioid crisis, what is clear is that it has been a bonanza for the legal profession, with winnings -- excuse me, earnings -- by attorneys reaching well over a billion dollars.

They weren't all in it for the money, though. Some, like West Virginia attorney Paul Farrell, whose state was one of the epicenters of the pain pill epidemic, were sickened by the toll of addiction they saw all around them. Not willing to settle for the pittance the town and county he represented would receive under a massive settlement agreed to by most of the suing entities, he gambled on going it alone against the drug distributors. As this book went to print in April, he was still waiting for a decision. Earlier this month, he lost, with a federal judge ruling that drug distributors were not responsible for the area's opioid crisis.

The litigation goes on, and the dying goes on. Sometimes the drug companies settle, sometimes they lose and have to pay even more. But sometimes they win.

The profit-driven wave of opioids that engulfed the country in the last couple of decades is not an anomaly. The pharmaceutical companies have a historical pattern of creating and marketing drugs that later wreak havoc. That's what they did with amphetamines, that's what they did with barbiturates, that's what they did with benzodiazepines. It's almost enough to make one wonder if profit-driven capitalist enterprises should be in charge of the nation's drug supply.

Read Higham and Horwitz's book. But read Case and Deaton's too. And when you see the next "pill mill" story, don't assume that it is, or isn't, what it seems.

Russian Court Sentences American Basketball Star Brittney Griner to Nine Years in Prison

A Russian judge sentenced American basketball star Brittney Griner Thursday to nine years in a Russian penal colony after earlier being found of bringing cannabis oil into the country in her luggage. The guilty verdict was virtually a foregone conclusion in a criminal justice system that wins convictions in 99 percent of cases.

This is what got Brittney Griner a nine year sentence.
Russian authorities detained Griner, a two-time Olympic gold medalist and Women's National Basketball Association (WNBA) star, just a week before Russia invaded Ukraine, and she is widely viewed as having become a pawn in the conflict between Washington and Moscow over the war. Griner's attorneys say they will appeal the verdict.

President Biden, who has been under pressure to win her release from her wife and the athletic community and whose administration is attempting to negotiate a prisoner swap for Griner, called her sentence "unacceptable," and vowed to continue to make every effort to free her.

The US has offered a prisoner swap of Griner and another imprisoned American, Paul Whelan, in return for Russian arms dealer Victor Bout, who is currently serving a 25-year sentence in the US for conspiring to sell arms to Colombia's leftist rebels, the FARC. But the Russians have so far demurred, first saying that Griner's trial had to finish and, more recently, showing littler interest in the matter.

While Griner's sentence seems stiff to Western sensibilities, it is in line with Russia's draconian, zero-tolerance drug laws. Drug offenders make up a quarter of the country's prison population. As Penn State University law professor William Butler noted: "To many in the US, nine years' imprisonment may seem like a harsh penalty for cannabis possession. But in Russia, it is par for the course for this crime."

Another American citizen, 61-year old Marc Fogel, is currently serving a 14-year sentence in Russia for marijuana possession. Fogel and his wife were returning to Russia for the last year of a ten year teaching stint, when he was caught. According to family, Fogel uses marijuana to treat chronic back pain.

AR Legalization Init Has Enough Signatures, UN Experts Criticize Singapore Drug Executions, More... (7/29/22)

Marijuana seizures at the US-Mexican border are down again, Colombia's Gulf Clan is escalating its attacks on police as it jockeys for position in upcoming negotations, and more.

San Francisco could become the largest US city to decriminalize psychedelics. (Creative Commons)
Marijuana Policy

Feds Report Significant Year-Over-Year Decline in Marijuana Seizures at the US Border. The amount of marijuana seized at the US-Mexico border has dropped dramatically this fiscal year, with seizures averaging 408 pounds a day, down from an average of 874 pounds a day during FY 2021, according to the Department of Homeland Security. Other drug seizures at the border are up, but the decline in marijuana seizures is part of a consistent downward trend in recent year. As the DEA has noted, "In US markets, Mexican marijuana has largely been supplanted by domestic-produced marijuana."

Arkansas Marijuana Legalization Initiative Set to Qualify for Ballot. State officials have confirmed that a marijuana legalization initiative from Responsible Growth Arkansas has submitted enough valid voter signatures to qualify for the November ballot. But the state Board of Election Commissioners must first approve the popular name and ballot title of the measure. It would legalize the possession of up to an ounce by people 21 and over, but not home cultivation. It would also set up a system of taxed and regulated marijuana commerce.

Psychedelics

San Francisco Psychedelic Decriminalization Resolution Filed. Supervisors Dean Preston (D) and Hillary Ronen (D) have filed a resolution to decriminalize psychedelics such as psilocybin and ayahuasca. The resolution also calls for broader statewide reform. If the resolution is passed, San Francisco would be the most populous city in the country to decriminalize psychedelics.

International

Colombia's Gulf Clan Trafficking Group Stepping Up Attacks on Police. The Gulf Clan, the country's most powerful drug trafficking organization, is stepping up a campaign of violence against police that began in May, when its leader, Dario Antonio Usuga, known as "Otoniel," was extradited to the United States to face trafficking charges. But now, as the country approaches the transfer of power from conservative President Ivan Duque to leftist former guerrilla Gustavo Petro, is ratcheting up the violence, apparently in a bid to bolster its prospects in potential negotiations with the new government. At least 25 police officers have been killed by the Gulf Clan, 12 of them in the last month, and three in just the past week.

UN Experts Call for Immediate Moratorium on Singapore Executions for Drug Offenses. UN experts have condemned the execution of Nazeri Bin Lajim, a 64-year-old Malay Singaporean national convicted of drug offenses and urged the Government of Singapore to halt plans to execute individuals on death row for drug-related charges. There has been a sharp rise in execution notices issued in Singapore this year.

Nazeri Bin Lajim was arrested in April 2012 and convicted for trafficking 33.39 grams of diamorphine under the 1973 Misuse of Drugs Act in September 2019. The mandatory death penalty was subsequently imposed in his case and enforced on 22 July 2022. "Under international law, States that have not yet abolished the death penalty may only impose it for the 'most serious crimes', involving intentional killing," the experts said. "Drug offences clearly do not meet this threshold."

The experts reiterated that, as per the Working Group on Arbitrary Detention's report on arbitrary detention relating to drug policies andits subsequent jurisprudence, imposing the death penalty for drug-related offenses is incompatible with international standards on the use of the death penalty.

Senate Democrats File Marijuana Legalization Bill, Bipartisan Psychedelics for Terminally Ill Bill Filed, More... (7/21/22)

Singapore is set to hang a drug offender today, Sensators Cory Booker (D-NJ) and Rand Paul (R-KY) filed a bill to allow the terminally ill to use certain psychedelics, and more.

Marijuana Policy

Senate Leadership Introduces Legislation to End Federal Marijuana Prohibition. Senate Majority Leader Chuck Schumer (D-NY), along with Sen. Cory Booker (D-NJ) and Sen. Ron Wyden (D-OR), today introduced the Cannabis Administration and Opportunity Act (CAOA). The legislation repeals the federal criminal prohibition of marijuana, provides deference to states' cannabis policies, and establishes mechanisms to help repair the harms associated with the racially and economically disparate enforcement of prohibition. The CAOA removes marijuana from the Controlled Substances Act schedule entirely, ending the threat of federal prosecution for possession and licensed commercial activity, and allows states to implement their own cannabis policies free of federal interference. It also eliminates many problems facing regulated state cannabis markets, including lack of access to financial services, the inability to deduct standard business expenses when filing federal taxes, and the lack of uniform national regulatory standards and guidelines. The legislation also directs funding to reinvest in communities that have been disproportionately impacted by prohibition and helps improve diversity and inclusion in regulated cannabis markets. The bill's prospects in the evenly-divided Senate are unclear, at best.

Psychedelics

Senators Cory Booker, Rand Paul Introduce Bipartisan Legislation to Amend the Right to Try Act to Assist Terminally Ill Patients. US Senators Cory Booker (D-NJ) and Rand Paul (R-KY) introduced legislation Thursday to clarify that the Right to Try Act should allow terminally ill patients to have access to Schedule I drugs for which a Phase 1 clinical trial has been completed. Specifically, the Right to Try Clarification Act would remove any obstacle presented by the Controlled Substances Act with respect to Schedule I substances when they are used by doctors and patients in accordance with the federal Right to Try law. Companion legislation will be introduced in the House by Representatives Earl Blumenauer (D-OR) and Nancy Mace (R-SC).

The federal Right to Try law permits patients who have been diagnosed with life-threatening diseases or conditions, and who have exhausted all approved treatment options, access to certain treatments that have not yet received final FDA approval. In general, a drug is eligible for Right to Try use after a Phase 1 clinical trial has been completed for that drug but prior to the drug being approved or licensed by the FDA for any use. In other words, in limited conditions involving life threatening illness and for drugs that have been proven to be safe, the federal Right to Try law removes the FDA out of doctor-patient decisions and reverts regulation back to the states. Under the terms of the federal Right to Try law, states remain free to permit or prohibit Right to Try use under their own laws.

International

Singapore Set to Hang Drug Offender Today. The city-state is set to hang 64-year-old Singaporean citizen Nazeri Lajim for drug trafficking today. This would be the fifth execution since March after a long pause in hangings during the coronavirus pandemic. He was handed the death sentence in 2017, some five years after being arrested during an anti-narcotics operation. Nazeri was found with two bundles of what was analyzed to be 35.41 grams of heroin, exceeding the 15 gram legal threshold for the imposition of the death penalty.

The country is increasingly out of step with its neighbors on drug policy. Thailand legalized most forms of marijuana last month, and Indonesia and Malaysia are discussing medical marijuana. The government defended its hardline approach: "It really is incumbent upon us to present the choices in very vivid terms and persuade our people, including young people, that we have to make the right choices for them and for society," said Law and Home Affairs Minister K. Shanmugam.

Sudan Defense Lawyers Charge Political Detainees Forced to Undergo Drug Tests. The legal group Sudan's Emergency Lawyers, which defends people seeking to protest against rule by the military-dominated government, is charging that people being arrested at protests are now being subjected to unlawful drug tests. Detainees including at least 15 minors and six women were released after being beaten, assaulted and subjected to drug tests, the group said.

The lawyers said "what is really disturbing is that these people are now subjected to a drugs test," which they stressed "is completely contrary to the law". The lawyers say that those detained were not in possession of drugs and were not found in any suspicious situation that necessitates this procedure or would give authorities common cause. They pointed to the fact that any referral for examination must be made by the prosecution. "This procedure is purely criminal, it violates the rights of the detained, and it is against the principle of assumption of the accused's innocence, and completely contrary to the law. It degrades dignity and has a profound psychological impact," the lawyers added.

Rumors have been circulating that young protesters are using drugs, meth in particular, because they don't seem to show hunger or fatigue, but there has been no evidence to back up the rumors.

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