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Oregon Drug Decrim is Slashing Drug Arrests, Massively Funding Services [FEATURE]

In a groundbreaking move a year ago now, Oregon voters approved decriminalization for personal use amounts of all illicit drugs, with Measure 110 passing with a healthy 59 percent of the vote. That made the state the first in the US to make this dramatic break with decades of the war on drugs. Now, as other states pondering a similar move look for evidence to bolster their case, some of the initial results in Oregon are looking pretty impressive.

Oregon's Mt. Hood. (David Mark/Pixabay)
Measure 110 promised not only thousands fewer drug arrests, but also a turn from the punitive to the compassionate -- providing hundreds of millions of dollars for greatly expanded access to evidence-informed drug treatment, peer support, housing, and harm reduction services, without raising taxes to do so. Services would be funded through excess marijuana tax revenue (over $45 million) and savings from no longer arresting, incarcerating, and prosecuting people for drug possession. State analysts estimated the excess marijuana tax revenue alone should result in over $100 million in funding for services in the first year and up to $129 million by 2027.

The state analysts were off the mark. Last week, the Drug Policy Alliance (DPA), whose legislative action arm, Drug Policy Action spearheaded the successful campaign, and the Oregon Health Justice Recovery Alliance, which is working to implement treatment, harm reduction, and support programs, announced they had secured funding of $302 million over the next two years. That's over $150 million a year, including $30 million lawmakers agreed to release ahead of schedule in May of this year.

That initial round of grants went to 70 organizations in 26 of the state's 36 counties, with these results:

  • 33 harm reduction and addiction recovery service providers expanded access to treatment services for indigent, uninsured individuals.
  • 52 organizations hired peer support specialists -- a role that addiction medicine experts have long heralded as essential to one's recovery journey.
  • 32 service providers added recovery, supportive and transitional housing services.
  • 30 organizations increased harm reduction services, which include life-saving interventions like overdose prevention; access to naloxone, methadone and buprenorphine; as well as drug education and outreach.

"We were about to have to close our doors in Wasco County, which would have been devastating to the people that depend on us for support there, but thanks to Measure 110 passing, we were not only able to get the funding we needed to stay open, but also to expand the services and spectrum of care we were able to provide our clients," said Monta Knudson, Executive Director of Bridges to Change, a nonprofit that offers peer recovery support, housing and treatment services in the state.

"Addiction has touched us all somehow, some more personally and heartbreakingly than others," said Tera Hurst, Executive Director of the Health Justice Recovery Alliance. "Too many of us have lost loved ones to addiction, or struggled with it ourselves. COVID-19 has made things much worse, decreasing access to care during a time when Oregonians need these services more than ever before. That's why we celebrate the great strides made when it comes to addressing Oregon's addiction crisis, while recognizing that there's still much work to be done. Our immediate focus is to ensure every Oregonian knows these critical harm reduction and recovery services are being invested in and expanded so that they will be available to anyone who wants and needs them, and that they can feel comfortable and safe accessing them."

But while the huge expansion of treatment, harm reduction, and related social services is undeniably a good thing, drug decriminalization is ultimately about getting people out of the criminal justice system by not getting them sucked into it in the first place. It's looking like Measure 110 is achieving that goal.

According to the Oregon Criminal Justice Commission, there were roughly 9,000 drug arrests a year prior to passage of Measure 110, and while it is too early to have precise numbers, thousands of Oregonians who would have been arrested for drug possession this year have instead faced only their choice of a $100 fine or a health assessment. It won't be 9,000 fewer drug arrests, though, because some felony drug possession arrests (possession of more than the specified personal use amounts) have been downgraded to still arrestable misdemeanors. Still, it will be thousands fewer people subjected to the tender mercies of the criminal justice system and all the negative consequences that brings.

"A year ago, Oregonians voted yes on Measure 110 to remove criminal penalties for possession of drugs and expand access to health services. Now, because of this measure, there are thousands of people in Oregon that will never have to experience the devastating life-long barriers of having a drug arrest on their record, which disproportionately and unjustly affected Black and Indigenous people due to targeted policing," said DPA Executive Director Kassandra Frederique. "Because of this measure, there is more than $300 million in funding that did not exist before being funneled into community organizations to provide adequate and culturally competent care that people desperately need. And while the devastation of 50 years of cruel and counterproductive policies can’t be erased overnight, by all metrics we hoped to achieve, and what voters asked for, we are going down the right path."

A number of states -- including Washington, Massachusetts, Vermont, Maine, New York, Rhode Island, Maryland and Kansas -- the District of Columbia, and even the United States Congress have introduced bills or launched campaigns to similarly remove criminal penalties for drug possession and increase access to health services since the passage of Measure 110. These initial results should provide plenty of ammunition for advancing those campaigns.

Capitol Hill Democrats Divided on Marijuana Reform Progress, Administration Releases Model Naloxone Legislation, More... (11/18/21)

South Dakota lawmakers are ready to take up marijuana legalization in the next session, the drug czar suggests the pandemic-related easing of methadone restictions could be made permanent, and more.

Drug czar Dr. Rahul Gupta is pushing harm reduction and is considering loosening methadone restrictions. (March of Dimes)
Marijuana Policy

Democratic Divisions Threaten Progress on Federal Marijuana Reforms. Democrats on Capitol Hill are finding it difficult to push forward with marijuana law reforms as they split on whether to pass a bipartisan bill to provide state-legal marijuana firms access to banking services or instead push a full-fledged marijuana legalization bill. Backers of the banking bill have tried to move it by attaching it to a must-pass defense spending bill, but Senate Majority Leader Chuck Schumer (D-NY) is proving a roadblock. He is instead siding with Sens. Cory Booker (D-NJ) and Ron Wyden (D-OR) as a cosponsor a marijuana legalization bill, the Cannabis Administration and Opportunity Act.

The Senate trio and their supporters argue that passing the banking bill first would make passing their broader bill more difficult. "To me, it wouldn't be a win," Booker said Tuesday. "It would be a setback for expunging the records of all of the people who are waiting for some kind of justice. And unfortunately, if you do that, the pressure won't be there to get it done." Those prioritizing the banking bill "are doing a big disservice to our ability to get restorative justice principles passed, and it's really unfortunate they can't see the urgency for the millions of Americans who are carrying criminal charges for nonviolent drug offenses involving marijuana and have had their lives destroyed because of a war on marijuana that has disproportionately impacted people of color." But supporters of the banking bill, the SAFE Banking Act, say it has bipartisan support that legalization lacks and the time has come for Congress to chipping away at pot prohibition.

South Dakota Top Lawmakers Officially Recommend Marijuana Legalization Bill for 2022 Session. The legislature's Executive Board, led by the House speaker and the Senate president pro tempore, has unanimously approved a report from the Marijuana Interim Study Committee recommending that the legislature take up a bill to legalize marijuana during the 2022 session. Meanwhile, activists who ushered a marijuana legalization initiative to victory last year only to see it blocked in court (the state Supreme Court has yet to decide the case) are pushing to put another legalization initiative on the ballot next year, too. As drafted, the current version of the legislation approved in committee and by the executive board would allow adults 21 and older to purchase and possess up to an ounce of cannabis. The state Department of Revenue would be responsible for regulating the market and issuing marijuana business licenses. It does not include the right to grow your own.

Harm Reduction

Biden Administration Releases Model Naloxone Legislation. The administration on Wednesday released model legislation to help states improve access to naloxone treatment for opioid overdoses. The move comes as the nation recorded a record-high 100,000 drug overdose deaths in a one-year period ending in May. The model bill encourages people to obtain naloxone, protects them from prosecution when administering it, requires health insurance to cover it, and provides increased access to it in schools and correctional facilities. "This model law can help all states implement consistent, evidence-based policies to make naloxone always accessible to those who need it," said Office of National Drug Control Policy (ONDCP -- the drug czar's office) head Dr. Rahul Gupta. "We certainly hope that state leaders will carefully consider this model law, which can help save lives."

Drug Czar Wants to Expand Use of Addiction Medication. Dr. Rahul Gupta, head of the Office of National Drug Control Policy (ONDCP -- the drug czar's office) said Wednesday that the Biden administration is now considering making permanent the easing of restrictions on methadone that has occurred during the coronavirus pandemic. Patients must go to a clinic to have methadone administered but were allowed to take a supply home with them during the pandemic, and Gupta suggested that change could be here to stay. "Adoption of these services did increase access to opioid and substance use disorder treatment," Gupta said, so making the changes permanent is "under consideration and we remain pretty hopeful about it."

Chronicle Book Review: The Dope [FEATURE]

The Dope: The Real History of the Mexican Drug Trade by Benjamin T. Smith (2021, W.W. Norton, 462 pp, $30 HB)

This past weekend, top-level American officials were in Mexico City meeting with their Mexican counterparts to discuss rebuilding cooperation in the endless struggle against Mexican drug trafficking organizations. The meeting comes nearly 15 years after then-President George W. Bush and then-Mexican President Felipe Calderon initiated the Merida Initiative to fight drugs, crime, and violence. In 2007, when the Merida Initiative began, there were about 2,300 drug-related deaths in Mexico. Fifteen years and $1.6 billion in US security assistance later, the annual Mexican death toll is north of 30,000, American overdose deaths largely linked to Mexican-supplied fentanyl are at an all-time high, and despite killing or capturing dozens of "kingpins," the so-called "cartels" are more powerful than ever.

In The Dope: The Real History of the Mexican Drug Trade, Mexico historian Benjamin T. Smith relates the story of another meeting between American and Mexican officials more than 80 years ago. It was at the League of Nations in 1939, and Mexican diplomat Manuel Tello was trying to sell the assembled narcotics experts on a novel approach to opioid addiction: Post-revolutionary Mexico had just passed a new drug law that allowed for state-run morphine dispensaries. Doing that could treat addiction and allow users to get their fix without resorting to a black market, he argued.

That proposal, one much in vogue in harm reduction and public health circles these days, was shot down by none other than Harry Anslinger, head of the American Federal Bureau of Narcotics and self-appointed dope cop to the world. He made it clear to the Mexicans, who had also irked him by challenging his Reefer Madness propaganda, that no such nonsense would be tolerated. That encounter, Smith's narrative makes clear, is emblematic of the US-Mexico relationship when it comes to drugs. The US, with its insatiable appetite for mind-altering substances, has for decades leaned on Mexico to repress the trade its citizens demand, and the results have for decades been dire.

As Smith shows, US pressure on Mexico to ramp up its anti-drug efforts, particularly in the 1940s and 1970s, produced temporary results but also long-term pathologies. Where Mexican authorities had been happy to manage the trade rather than repress it, Washington demanded strict enforcement and aggressive action. Harsher enforcement, including the resort to torture and murder (with the knowledge, encouragement, and sometimes the participation of DEA agents), produced a meaner criminal underworld. Smith especially notes the American insistence on a broad strategy of relying on informants as an aggravating factor in escalating trafficker violence, as traffickers turned on each other for revenge or to protect themselves from potential rats.

Smith also clarifies that the drug trade has always been seen not just as a scourge but as a resource by elements of the Mexican state. Early on, a post-revolutionary governor in Sinaloa taxed the opium traffickers and used the proceeds for public works. Governors in border states like Baja California and Chihuahua followed suit, taxing the trade, protecting favored traffickers and making exemplary busts of those without favored status to please the Americans. Although, as he notes, the politicians increasingly tended to forget the public works and just pocket the money themselves.

Smith described the structure of the relationship between the Mexican state and the drug traffickers as more a "protection racket" than an adversarial one Prior to the 1970s, the racket was carried out at the state level, with the governors and the state police forces providing the protection. Levels of violence were generally low, but likely to spike when a change of administration meant a new set of players in the racket and a new set of favored and disfavored traffickers. The favored traffickers could get rich; the unfavored ones could get jailed or killed as sacrificial lambs to appease the Americans.

In the 1970s, though, both the repression and the protection racket went national, with the mandate to fight the drug trade (and the license to manage it) going to the dreaded federales and their masters in the Ministry of Justice and the presidential palace. The levels of violence increasingly dramatically as the federales and the armed forces pleased the Americans by arresting, torturing, and killing marijuana- and opium-growing peasants as well as traffickers. Traffickers who could once accommodate themselves to the occasional exemplary short prison sentence now fought back when faced with death or years behind bars.

But in this century, thanks largely to fabulous profits from the cocaine trade, the drug traffickers have flipped the script. They no longer work for the cops; the cops now work for them. It's a process Smith refers to as "state capture," even if the state function that is being captured is illicit. Now, cops and politicians who don/t understand who is charge end up in unmarked graves or starring in horrid torture/murder videos.

The Dope is a fascinating and sobering tale, full of colorful characters like Dr. Leopoldo Salazar Viniegra, the crusading post-revolutionary physician who argued that marijuana was harmless and whose government office was behind the morphine dispensary plan, and La Nacha, Ignacia Jasso, the dope queen of Ciudad Juarez for decades, along with a veritable rogue's gallery of traffickers, cops, spooks, and politicians, all of whom vie for control of the trade and its incredible profits.

It also reveals some broad findings. First, economics is the driving force of the drug trade, and the economic opportunity it has provided (and continues to provide) to millions of Mexicans means it is not going away, Second, as noted above, authorities have sought to harness income from the drug trade, with the result that they are now harnessed to it. Third, aggressive anti-drug policies are driven more by moral panics, the need for bureaucratic fundraising, and scapegoating, and "are rarely implemented for their effectiveness." Nor do they work, even on their own terms, as our current overdose death numbers shout out. Fourth, the causes of violence originate "not from inside the drug trade, but inside the state," particularly with the churning of protection rackets with the arrival of new political leadership. "The other principal cause of violence has been the war on drugs itself."

There is an extensive mythology around the Mexican drug trade. Benjamin T. Smith has gone a long way toward dispelling those myths by providing an accurate, in-depth, well-sourced history of the trade and the domestic and international politics around it. To understand today's fearsome Mexican drug cartels, start here.

Booker & Warren Call on DOJ to Deschedule Marijuana; US & Mexico Meet to Forge New Relations on Crime & Drugs, More... (10/12/21)

California's governor vetoes a "contingency management" drug treatment bill, a pair of progressive senators call on the Justice Department to deschedule marijuana, and more.

Sens. Cory Booker (D-NJ) and Elizabeth Warren (D-MA) send letter to DOJ seeking marijuana descheduling. (Creative Commons)
Marijuana Policy

Booker, Warren Call on DOJ to Decriminalize Cannabis. Senators Cory Booker (D-NJ) and Elizabeth Warren (D-MA) sent a letter last Wednesday to Attorney General Merrick Garland urging the Department of Justice (DOJ) to decriminalize cannabis by removing the drug from the Federal controlled substances list. Under the Controlled Substances Act of 1970 (CSA), the Attorney General can remove a substance from the CSA's list, in consultation with the Secretary of Health and Human Services (HHS), based on the finding that it does not have the potential for abuse. Decriminalizing cannabis at the federal level via this descheduling process would allow states to regulate cannabis as they see fit, begin to remedy the harm caused by decades of racial disparities in enforcement of cannabis laws, and facilitate valuable medical research.

"While Congress works to pass comprehensive cannabis reform, you can act now to decriminalize cannabis," wrote Booker and Warren. "We urge the DOJ to initiate the process to decriminalize cannabis. Doing so would be an important first step in the broader tasks of remedying the harmful racial impact of our nation's enforcement of cannabis laws and ensuring that states can effectively regulate the growing cannabis industry, including by assisting small business owners and those most harmed by our historical enforcement of cannabis laws."

Drug Treatment

California Governor Vetoes Bill That Would Have Paid People to Stay Off Drugs. Governor Gavin Newsom (D) has vetoed a bill that would have made California the first state to embrace "contingency management," the drug treatment program in which users are paid money to stay sober, receiving increasing payments for each drug test passed. Such a program has been underway with military veterans for years, with research showing it is an effective way to get people off stimulants such as cocaine and methamphetamine, for which there are no pharmaceutical treatments available. Newsom had asked the federal government to allow the state to use federal tax dollars to pay for it through Medicaid, but still rejected Senate Bill 110 without explanation.

Foreign Policy

US, Mexico Meet to Restore Cross-Border Cooperation on Drugs, Crime. Leading Biden administration officials including Secretary of State Anthony Blinken, Homeland Security Secretary Alejandro Mayorkas, and Attorney General Merrick Garland met with their Mexican counterparts in Mexico City Saturday to try to create a new framework for cooperation on drugs, crime, and border issues. The high-profile meeting comes after months of quiet talks to rebuild relations that grew especially fraught after DEA agents arrested a retired former senior Mexican military officer for alleged links to drug traffickers. That prompted the Mexicans to demand -- and obtain -- his release and to pass a law limiting the involvement of the DEA inside Mexico. The new framework appears to signal a break with Plan Merida, the more than decade-old security agreement under which billions of dollars in US security assistance went to help Mexico fight drug traffickers, but which also saw drug-related killings rise to record levels.

NY Governor Signs Package of Bills Aimed at Curbing OD Crisis, CA Governor Signs Hemp Regulation Bill, More... (10/8/21)

Another poll has two-thirds support for freeing the weed, Oklahoma activists file initative petitions to legalize marijuana, and more.

Hemp products like these will be regulated under a new California law just signed by Gov.Gavin Newsom (D). (Creative Commons)
Marijuana Policy

Yet Another Poll Finds Supermajority Support for Marijuana Legalization. A new Harris Research poll has 66 percent of respondents supporting marijuana legalization, with millennials (79 percent) and Generation X (76 percent) being the most supportive. For Baby Boomers, slightly less than half supported legalization. The findings are in line with other recent polls showing a supermajority for legalization.

Oklahoma Activists File Marijuana Legalization, Medical Marijuana Regulation Initiative Petitions. Activists organized as Oklahomans for Responsible Cannabis Action have filed a pair of petitions related to marijuana policy. Question 817 would legalize marijuana for people 21 and over, while Question 818 would replace the Oklahoma Medical Marijuana Authority with a stand-alone agency. The group now has 90 days to come up with 178,000 valid voter signatures in order to qualify for the November 2022 ballot.

Hemp

California Governor Signs Hemp Regulatory Bill. Governor Gavin Newsom (D) on Thursday signed into law Assembly Bill 45, which creates a comprehensive regulatory framework for the manufacture and distribution of hemp-derived products in the nation's most populous state. The bill allows for the sale of smokeable hemp products, as well as hemp-infused foods and drinks. The bill should also provide clarity to consumers, reassuring them that products are independently tested and properly labeled. Because the law was passed as an emergency measure, it goes into effect immediately.

Opioids

New York Governor Signs Package of Bills Aimed at Blunting Overdose Crisis. Governor Kathy Hochul (D) on Thursday signed into law a package of bills designed to ease the overdose epidemic in the state. One bill eases access to the opioid overdose drug naloxone, another allows for the use of medication-assisted treatment in state prisons, a third decriminalizes the sale and possession of needles and syringes, a fourth creates an online directory of naloxone distributors, and the fifth creates a judicial diversion program for some felony offenders. "Addiction can impact any family, suddenly and harshly - those who find themselves trapped in a vicious cycle are there through no fault of their own," Governor Hochul said. "This is a personal battle for me and I am proud to be able to combat the opioid crisis by signing these bills into law. There is no shame in seeking help for substance use and I want to let all New Yorkers know that we are here for you. Treatment should always be accessible for those who need it."

Pennsylvania Marijuana Legalization Bill, MI Opioid Treatment Bills, More... (10/6/21)

A crack appears in Pennsylvania Republicans' opposition to legalizing marijuana, that DEA agent killed in Tucson on Monday died enforcing marijuana prohibition, and more.

A proposed Michigan bill would let community-based organization dispense the opioid overdose reversal drug naloxone. (CC)
Marijuana Policy

Pennsylvania Sees Bipartisan Effort to Legalize Marijuana. A Republican state senator has joined forces with a Democrat in a bid to garner bipartisan support for marijuana legalization. Senator Mike Regan (R) and Rep. Amen Brown (D) are teaming up on Regan's proposed bill, which would legalize marijuana, includes social equity provisions, and seeks to create a tax and regulatory structure for legal weed. Democratic politicians in the state, including Gov. Tom Wolf, have been calling for legalization, but the Republican-controlled legislature has so far resisted such entreaties. It's time for us to move forward in Pennsylvania," said Regan, a former US marshal who played a role in crafting the state's medical marijuana program. "If we can take the violence out of it and we can regulate it and tax it and let police focus on the really serious crimes, I think it's a huge step forward."

Opioids

Michigan House Committee Takes Up Opioid Treatment Expansion. The House Health Policy Committee has met to discuss several pieces of health-related legislation, including a pair of bills that would expand access to treatment for opioid use disorder, HB 5163 and HB 5166. "HB 5163 will expand capacity to treat opioid overdoses in emergency departments, a key interception point for people who use drugs where we see a high risk of overdose upon discharge," said bill sponsor Rep. Angela Witwer. The bill would allow emergency departments to provide medication-assisted treatment, create specific hospital overdose care protocols, and provide referrals to community-based care organizations. HB 5166 would increase access to the opioid overdose reversal drug naloxone by allowing community-based organizations to distribute the drug. Currently, under a 2016 standing order law, pharmacists can give the drug without a prescription, similar to an over-the-counter drug. No votes were taken on the bills.

Law Enforcement

DEA Agent Killed in Tucson Was Enforcing Marijuana Prohibition. DEA Agent Michael Garbo, who was killed Monday in a shootout on an Amtrak passenger train in Tucson, died attempting to enforce federal laws against marijuana. The accused shooter, known only as D.T., opened fire on drug task force agents after they found 2.4 kilograms of marijuana, 50 packages of edibles, and "other marijuana and cannabis products," according to the court documents. D.T. and his partner, Devonte Okeith Mathis, were targeted by the DEA, whose agents were given a list "that contained names of several individuals on an Amtrak train that was arriving in Tucson" as part of their routine investigative activities. Task force officers saw Mathis move several bags a few rows away from where he and his partner were sitting, then took the bags off the train to inspect them and found marijuana. When agents then attempted to approach D.T., he opened fire, killing Garbo and wounding another DEA agent and a Tucson police officer. D.T. was then fatally shot.

Congress to Temporarily Extend Fentanyl Analogue Ban, House to Vote on Marijuana Banking, More... (9/22/21)

Protections for banks dealing with state-legal marijuana businesses will get a House floor vote as part of a defense spending bill, the Congress is poised to temporarily extend the ban on fentanyl analogues, and more.

Overdose deaths rose while opioid prescriptions declined. Go figure. (Pixabay)
Marijuana Policy

Amendment to Protect Banks That Service Marijuana Industry Will Get House Vote. The House Rules Committee on Tuesday approved an amendment to the National Defense Authorization Act (NDAA) to provide protections to financial institutions that service the state-legal marijuana industry. The amendment is identical to the SAFE Banking Act, which has already passed the House four times. A House floor vote could come as soon as this week. But advocates were disappointed that other reform measures, including an amendment to promote research into the therapeutic uses of certain psychedelics, were rejected by the committee. Adding non-related amendments to spending bills that are difficult to vote against is often used to get legislation passed that is otherwise stalled.

Medical Marijuana

Pennsylvania Bipartisan Bill to Remove DUI Penalties for Medical Marijuana Users Filed. State Reps. Chris Rabb (D-Philadelphia} and Todd Polinchock (R-Bucks) have introduced legislation that would ensure the rights of the more than 500,000 medical cannabis patients in Pennsylvania, protecting them from DUI penalties. Under current state law, the presence of marijuana metabolites, which remain present for days or weeks after ingestion, is considered evidence of impairment. "A medical cannabis user can take a miniscule amount of medicine for their ailment and weeks later, with traces of cannabis still in their system, be subject to arrest on a DUI charge if pulled over -- not because they've driven impaired, but because our state laws haven't caught up with the science," Rabb said. "And, if you think you don't know someone who falls into this category -- a person who has been prescribed medical cannabis and who drives and is fearful of the potential DUI charge they could face -- you're wrong. I am a card-carrying medical cannabis patient, and I drive regularly, including in and around Philadelphia and to Harrisburg conducting the people's business."

Opioids

Congress to Temporarily Extend Fentanyl Analogue Ban. Rather than make a final decision on whether to make permanent a ban on fentanyl analogues, the House is preparing to vote to extend a temporary ban set to expire October 22, pushing the expiration date to January 28 as part of a stopgap spending bill. The White House has asked Congress to permanently schedule all fentanyl-related substances as Schedule I, but advocates and some lawmakers say such a move is wrongheaded and will lead to over-policing. Sen. Cory Booker (D-NJ) has made such arguments and says he is "not a fan" of extending the deadline. "We have consistently said that this anti-science policy must expire," Maritza Perez, director of the Drug Policy Alliance's Office of National Affairs, said. "This extension will hopefully give Congress ample time to come up with a public health solution that is desperately needed to save lives."

Overdoses Climbed as Opioid Prescriptions Declined, AMA Report Finds. Both fatal and non-fatal drug overdoses have increased over the past decade, even as physicians have prescribed 44 percent fewer opioids during the same period, the American Medical Association said in a new report. The report cited the rise of prescription drug monitoring programs as a key factor in reducing prescribing. The AMA said lawmakers need to "act now" to address the overdose crisis. "The nation's drug overdose and death epidemic has never just been about prescription opioids," said AMA President Gerald E. Harmon, MD. "Physicians have become more cautious about prescribing opioids, are trained to treat opioid use disorder and support evidence-based harm reduction strategies. We use PDMPs as a tool, but they are not a panacea. Patients need policymakers, health insurance plans, national pharmacy chains and other stakeholders to change their focus and help us remove barriers to evidence-based care." The AMA is calling for an end to requiring prior authorization for medications to treat opioid use disorder, evidence-based care including opioid therapy for patients with pain, and support for harm reduction services, such as needle exchanges and the wide distribution of the opioid overdose reversal drug naloxone.

Vancouver Clinic Offers Take-Home Prescription Heroin, Nepal Marijuana Protest, More... (9/20/21)

Violence linked to cartel infighting continues to rock Mexico's state of Michoacan, a Vancouver clinic is now offering take-home prescription heroin to a small number of patients, and more.

Pharmaceutical heroin. Now available as a take-home prescription drug in Vancouver. (Creative Commons)
nternational

Vancouver Clinic Doing Take-Home Prescription Heroin. In a North American first, the Providence Crosstown Clinic in Vancouver has begun providing take-home medical grade heroin to a small number of addicted patients. The program began as an emergency response to the COVID epidemic, when the provincial health authority allowed clinic staff to deliver syringes filled with heroin to patients so they could stay isolated for 10 to 14 days. "Having done that and done that successfully without any problems, we were able to show and demonstrate the strict requirement of the medication to only be [administered] at the clinic was not necessary," said Dr. Scott MacDonald, head physician at the clinic. The program is currently serving only 11 patients, but MacDonald said expanding the program is a crucial step toward addressing the province's opioid crisis, which has seen more than a thousand overdose deaths so far this year. "Their lives can change dramatically. People can go from accessing street opioids, perhaps having unstable housing and unable to work to stabilized and being able to work, and some people working full-time," he said.

Mexico's Michoacan Sees More Cartel Violence. The Jalisco New Generation Cartel (CJNG) besieged the Michoacan municipality of Tepalcatepec last week, killing and beheading five local men who were manning a checkpoint aimed at keeping cartel gunmen out of town. The cartel had tried to seize control of the city but was met with resistance from local residents and the National Guard. Cartel gunmen then switched their focus to the community of La Estanzuela, located near the border between Tepalcatepec and the Jalisco municipality of Jilotlán. The CJNG has been trying to take control of the region for the past two years and is locked in battle with the Carteles Unidos over control of the region and the state.

Nepal Protest for Marijuana Legalization. Sparked by the September 6 arrest of prominent marijuana legalization advocate Rajiv Kafle for consumption, possession, and distribution of marijuana, a youth group from Kathmandu Valley staged a protest calling for legalization at Maitighar on Monday. Protesters chanted slogans and held up signs citing the medicinal and economic benefits of legalization. Nepal has a history of cannabis use dating back centuries and its charas was enjoyed by Western travelers on the Hippie Trail in the 1060s, but under US pressure canceled the licenses for all cannabis businesses in 1973, and then criminalized cannabis in 1976.

DEA to Increase Research Production Quotas for Marijuana & Psilocybin, SD MedMJ Home Grows Endangered, More... (9/1/21)

Panama legalizes medical marijuana, the DEA boosts quotas for production of marijuana and psilocbyin for research purposes, and more.

South Dakota lawmakers want to ban medical marijuana home grows even though the voters approved them. (Creative Commons)
Marijuana Policy

The DEA Seeks to Increase Federal Production Limits for Psilocybin and Marijuana Research. The DEA has published a new document in the Federal Register proposing a significant increase in federal quotas for the production of psilocybin, psilocin (the metabolized version of psilocybin), and marijuana for research purposes. Both psilocybin and psilocin had a ceiling of 50 grams, which has been increased to 1500 grams and 1000 grams, respectively. The DEA also wants to raise the production quota for marijuana from 1.5 million grams this year to 2 million grams next year, as well as doubling upscale marijuana extract production to 500,000 grams. "DEA firmly believes in supporting regulated research of schedule I controlled substances," wrote the agency. "Therefore, the [Aggregate Production Quota] increases reflect the need to fulfill research and development requirements in the production of new drug products, and the study of marijuana effects in particular, as necessary steps toward potential Food and Drug Administration (FDA) approval of new drug products."

Medical Marijuana

South Dakota Legislative Panel Recommends Overruling Voters and Banning Medical Marijuana Home Grows.The legislature's Medical Marijuana Subcommittee voted 6-4 Monday to recommend banning home grown medical marijuana cultivation, even though it is expressly allowed under the language of IM 26, the medical marijuana initiative overwhelmingly approved by voters last November. The issue now goes to the legislature's full Marijuana Study Committee, which consists of eight senators and 16 representatives. Lawmakers on the adult use committee also discussed banning home grown marijuana on Wednesday as the state awaits a Supreme Court ruling on whether the voter-approved marijuana legalization initiative is unconstitutional.

Psychedelics

Denver Activists Push to Expand Psilocybin Decriminalization to Allow Gifting and Communal Use. The activists who successful managed a campaign to make Denver the first city in the US to decriminalize the possession of psilocybin-containing magic mushrooms are now aimed to legalize the noncommercial gifting and communal use of the substance. Kevin Matthews, founder of Vote Nature and head of the city's Psilocybin Mushroom Review Panel, said the proposal would ensure that people "have the liberty to gather in private group settings to celebrate and commune with psilocybin mushrooms without worrying about law enforcement intervention." The proposal is included in the Denver Psilocybin Mushroom Policy Review Panel's 2021 Comprehensive Report, which has already been approved by the district attorney and is pending further sign-off by other officials.

International

Panama Legalizes Medical Marijuana. After five years of consideration, the national assembly on Monday unanimously approved Bill 153, which legalizes medical marijuana in the Central American nation. The bill allows for home grown medical marijuana but bars its sale. It also requires the government to import marijuana in pill and liquid drop form. That medicine will be distributed through pharmacies that have applied for a permit and pass a site inspection.

DEA to Review Foreign Operations, Vancouver Activists Plan Another "Safe Supply" Drug Giveaway, More... (8/26/21)

California wants to try a form of drug treatment where users are paid not to use, Vancouver activists plan to mark International Overdose Awareness Day with a "safe supply" drug giveaway, and more.

The DEA will review its international operations, although there is no sign it is looking at a paradigm shift.
Drug Policy

DEA Announces Review of International Operations. The Drug Enforcement Administration on Thursday announced a comprehensive review of DEA’s international operations and foreign footprint, including administrative and financial support for those operations from DEA headquarters. Administrator Anne Milgram has recommended a top to bottom review of foreign operations that will be overseen by an independent team.  As part of the review, the team will talk to DEA personnel posted in DEA’s foreign offices and headquarters. DEA listed "international cartels, narco-terrorist violence, and precursor chemicals flowing from other countries" as global threats it faces. "This review will provide recommendations for my consideration upon completion.  Specifically, I expect the team to provide an assessment of DEA’s current international operational capacity, and to identify areas for improvement to ensure DEA’s international operations are impactful and effective, with the appropriate structures, procedures, and controls to ensure integrity and accountability," said Administrator Milgram. There is in indication the agency is undergoing a paradigm shift, though.

Drug Treatment

California Seeks Federal Permission to Do "Contingency Management" Drug Treatment. The state is seeking permission from the federal government to do "contingency management" drug treatment, in which users are paid money to stay sober, receiving increasing payments for each drug test passed. Such a program has been underway with military veterans for years, with research showing it is an effective way to get people off stimulants such as cocaine and methamphetamine, for which there are no pharmaceutical treatments available. Now, Gov. Gavin Newsom (D) is asking the federal government to allow the state to use federal tax dollars to pay for it through Medicaid. Meanwhile, state Sen. Scott Weiner (D-San Francisco) has filed a bill, Senate Bill 110, to do something similar. That bill has already passed the Senate with no  opposition and has a Republican co-sponsor in the Assembly, where it has already been approved by the Health Committee and is now before the Appropriations Committee. Wiener’s bill would require California’s Medicaid program to pay for the treatment while Newsom’s plan would let counties choose whether to participate.

International

Vancouver Activists to Mark August 31 International Overdose Awareness Day by Handing Out Free "Safe Supply" of Drugs. A Vancouver-based safe supply advocacy group, the Drug Users Liberation Front (DULF), handed out free cocaine, heroin, and methamphetamine during a July event to dramatize the need for a "safe supply" of drugs" as the city faces a drug overdose crisis, and now, they are getting ready to do it again. DULF says the July event showed the "life-saving potential of a community-led response to the crisis of prohibition in Canada" as an alternative to Vancouver's proposed model of decriminalization. DULF will be joined at the Overdose Awareness Day Event by the Vancouver Area Network of Drug Users (VANDU), which has raised $13,000 to buy and test drugs to be distributed for free among registered VANDU members. "We recognize this a day to honor those we lost to the War on Drugs," said VANDU. "A senseless war fueled by colonial dispossession, racist violence, capitalist exploitation and police criminalization that has taken far too many lives.

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