A Maryland bill implementing legal marijuana commerce is signed into law, an Oklahoma bill cracking down on illicit medical marijuana grows is signed into law, and more.

A change in DOT drug testing rules could eliminate marijuana false positives. (Creative Commons)

Maryland Governor Signs into Law Bill Implementing Marijuana Legalization. Gov. Wesley Moore (D) on Wednesday signed into law Senate Bill 516, which implements a voter-approved referendum to legalize marijuana. The bill allows currently operating medical marijuana dispensaries to apply for licenses to sell to the adult market beginning in July and mandates that licenses for up to 300 marijuana retailers by July 2024. The bill also sets a 9 percent sales tax on marijuana products, except for registered medical marijuana patients, who are exempt. The bill also allows patients to grow up to four plants at home and increases the amount of marijuana patients can possess.

Medical Marijuana

Oklahoma Governor Signs into Law Bill Cracking Down on Illegal Medical Marijuana Grows. Gov. Kevin Stitt (R) on Wednesday signed into law House Bill 2095, which puts the Oklahoma Attorney General's Office, the Oklahoma Bureau of Narcotics and Dangerous Drugs Control, and the Oklahoma State Bureau of Investigation full enforcement authority over the state's medical marijuana laws. The bill is aimed at cracking down on a plethora of illegal marijuana grow operations and says that authorities can seize and destroy marijuana that was "not properly logged in inventory records or untraceable product not required to be in the system." The bill also makes it a misdemeanor for a licensed medical marijuana commercial grower to hire undocumented immigrants to work anywhere on the property where medical marijuana is grown.

Drug Policy

Washington Governor Announces Special Session to Take Up Drug Possession Law. Gov. Jay Inslee (D) announced Tuesday that will call a special session to begin May 16. The session will focus on passing a new drug possession law. Inslee set the date after conversations with Democratic and Republican legislative leaders. In 2021, the Washington Supreme Court overturned the state's felony drug possession law in the Blake case. Legislators adopted a temporary misdemeanor policy that expires July 1. The so-called "Blake fix" was the only remaining must-do item legislators did not finish during the regular legislative session that ended April 23. In the absence of a statewide policy, several cities and counties have announced their intent to pass their own ordinances which would create a confusing patchwork of policies, treatment options and penalties.

Drug Testing

Department of Transportation Finalizes New Marijuana Testing Policies to Reduce False Positives. The US Department of Transportation (DOT) on Tuesday finished work on a rule that will allow oral saliva drug testing as an alternative to urine-based tests. Urine tests detect THC metabolites for weeks or months after consumption, leading to positive test results for people who are not actually impaired on the job. Oral testing, on the other hand, usually detects THC in saliva for no more than 24 hours after use.

"Allowing employers to use oral fluid testing may improve the effectiveness of drug testing," DOT said. "Oral fluid testing can detect the recent use of some drugs, including marijuana and cocaine, while urine drug testing has a longer window of detection." This will be good news for the trucking industry, which has suffered from driver shortages, including thousands of drivers who have been dismissed because of positive urine-based tests.

International

Luxembourg Releases Two-Phase Plan for Marijuana Legalization. A group of experts appointed by the government has released a report detailing plans for a legal marijuana regime. The report, "An Experimental System of Legal Access to Marijuana for Non-Medical Purposes," lays out the outlines of a legal marijuana market for those over 18. It would allow for possession of up to three grams, the home cultivation of up to four plants, and the development of a legal framework where adults could buy up to five grams a day, but no more than 30 grams in a month. Legalization will come in two phases, with the first requiring that the country's drug law be amended. Once that happens, home cultivation can commence. The second phase will be the development of a state system for the commercial cultivation and sale of marijuana. That will involve the launching of a pilot program to see how commercialization can work.

Two New Jersey women who ate poppy seed bagels before going to the hospital to give birth, and were then reported for possible child abuse or neglect after testing positive for opiates, have filed complaints with state officials charging that the hospital that conducted the tests did so without their knowledge or consent. In doing so the hospital violated the state's law against discrimination on the basis of sex and pregnancy, they argued.

Eating poppy seed bagels can result in a positive drug test for opiates, and that can have consequences. (Pixabay)

Both women and their families were subjected to traumatic investigations by the DCPP during what should have been joyful first months with their new infants, shattering their trust in medical personnel and causing fear of further unnecessary intrusions by the state, their complaints say.

They are seeking to force both hospitals to end what they call an unlawful practice, as well as compensatory damages for emotional distress. They are being represented by the American Civil Liberties Union (ACLU) of New Jersey. Their case is the latest in which patients in several states -- including in New York, Illinois, and Pennsylvania -- have filed cases to challenge similar hospital practices, resulting in policy changes and monetary damages.

"No one should be subjected to unnecessary and nonconsensual drug tests. Our clients are sending a clear message to hospitals that these testing and reporting policies are unacceptable," said ACLU-NJ Staff Attorney Molly Linhorst. "Discriminatory testing policies like these upend what should be a time of joy for families, and so often subject them to further trauma and unwarranted investigation by the state."

"I felt like they were questioning my character and parenting skills," said Kate L. "I'm terrified of ever going to a hospital again; I'm always going to worry that our family could be torn apart. That's why we are doing all we can to stop this from happening to anyone else."

"I feel violated. This whole ordeal has been extremely stressful and has turned our lives upside down and now, because of what happened, I live in fear of medical tests and how they might be used against me as a mother," said Kaitlin K. "I found out later that the lab used a testing threshold far, far lower than what the federal government uses."

Maternal drug testing is not only discriminatory, but it and the decision on whether to report a positive result are also permeated with racial bias, with healthcare professionals are more likely to administer drug tests on pregnant Black women and their babies.

The practice is also opposed by health care providers who warn that it can deter people from seeking medical care during and after pregnancy. The American College of Obstetricians and Gynecologists specifically rejects drug testing in part of the legal consequences a positive test result can unleash.

Poppy seeds can lead to positive test results for opiates. "Research shows that morphine and codeine can sometimes be detected in the urine up to 48 hours after ingestion of poppy seeds from some pastries, such as bagels, muffins, and cakes," says the href="https://www.usada.org/spirit-of-sport/education/can-poppyseeds-cause-a-positive-drug-test/" target=_blank_>US Anti-Doping Agency, the national organization for US Olympic sports.

But positive drug tests from poppy seed bagels would not be a problem if doctors and hospitals were not doing such testing on patients without their knowledge or consent and with no good medical reason. Perhaps having to pay damages for the harm they inflicted on these two women will cause those hospitals to think twice.

Legal adult marijuana sales have begun in Connecticut, a marijuana legalization bill is filed in Tennessee, and more.

Insurance companies were fraudulently billed more than $125 million. (Creative Commons)

It's Official: Connecticut Legal Adult Use Marijuana Sales are On. Gov. Ned Lamont (D) announced the start of adult-use marijuana sales in a Tuesday news release: "The opening of the adult-use cannabis market in Connecticut marks the start of an expanded cannabis industry that prioritizes the safe and equitable regulation of adult-use cannabis, as well as the preservation of the medical marijuana market, which continues to serve nearly 50,000 patients in the state," the statement said. "Today marks a turning point in the injustices caused by the war on drugs, most notably now that there is a legal alternative to the dangerous, unregulated, underground market for cannabis sales," Gov. Lamont said. "Together with our partners in the legislature and our team of professionals at the Department of Consumer Protection, we've carefully crafted a securely regulated market that prioritizes public health, public safety, social justice, and equity. I look forward to continuing our efforts to ensure that this industry remains inclusive and safe as it develops."

Indiana Marijuana Bills Filed. The state's legislative season is just getting underway and at least four marijuana reform bills have already been filed. Senate Bill 70, introduced by Sen. Mike Bohacek (R-District 8), would decriminalize the possession of one ounce or less of marijuana. Bohacek also introduced Senate Bill 82, which "establishes a defense to operating a vehicle or motorboat with a controlled substance in the person's blood if: (1) the controlled substance is marijuana or a metabolite of marijuana; and (2) the person was not intoxicated." Meanwhile, State Rep. Jake Teshka (R-South Bend) filed House Bill 1039, which would allow for medical marijuana after the drug is removed as a federal Schedule I controlled substance. And House Bill 1065, authored by Rep. Sue Errington (D-District 34), would establish the cannabis compliance advisory committee to review and evaluate certain rules, laws and programs. Last year, 13 marijuana-related bills were filed. None of them went anywhere.

Tennessee Marijuana Legalization Bill Filed. Rep. Bob Freeman (D-Nashville) has filed House Bill 0085, also known as the "Free All Cannabis for Tennesseans Act." The bill would legalize the possession and transfer without remuneration of up to 60 grams (slightly more than two ounces) of marijuana by adults and allow the home cultivation of up to 12 plants, as well as creating a system of licensed and regulated commercial marijuana production and sales.

Drug Testing

Florida Doctor Sentenced to 20 Years for Urine Testing Fraud Scheme. Delray Beach osteopathic physician Michael Ligotti has been sentenced to 20 years in federal prison for approving medically unnecessary urine tests and treatment for alcohol and drug-addicted patients that cost private insurance companies more than $125 million over a decade. Ligotti, who owned a medical clinic in Delray Beach that profited from the scheme, had pleaded guilty in October to conspiring to commit healthcare and wire fraud and was ordered to surrender his Florida medical license.

The 48-year old physician admitted authorizing "fraudulent" urine drug tests for patients at about 50 drug treatment centers, sober homes, and labs in South Florida. In exchange, many of those same patients were recycled through his Delray Beach medical facility, allowing his practice to bill for and profit from redundant drug treatment and testing services. Ligotti also admitted to signing "standing orders" for expensive and unnecessary urine drug tests for patients at the various treatment facilities, including his own clinic.

In turn, the patients' urine specimens were sent to testing laboratories, which then billed private healthcare insurers for the unnecessary urine drug tests. A single test cost thousands of dollars. As a result, between 2011 and 2020, the healthcare insurers were billed more than $746 million for unneeded addiction treatment and urine testing, according to Justice Department prosecutors. In total, the insurers paid about $127 million for fraudulent drug tests and addiction treatment.

A federal appeals court shoots down yet another effort to move marijuana off Schedule I, new research finds prentant Black women are more likely to be tested for marijuana, and more.

The annual list of naughty and nice drug producing and trafficking nations is released. (Creative Commons)

Federal Appeals Court Rejects Challenge to Marijuana's Schedule I Classification. A group of defendants who had been convicted on federal marijuana charges had their bid to have the substance removed from Schedule I of the Controlled Substances Act shot down by the US 2nd Circuit Court of Appeals at the end of August. They had argued that the scheduling of marijuana had no rational basis because it does not meet the criteria for a Schedule I drug and the court should "strike the offending statutory classification as unconstitutional"and leave reclassification to Congress. But the appeals disagreed, ruling that there is a "conceivable basis" for the classification.

Blacks Disproportionately Drug Tested for Marijuana During Labor, Analysis Finds. A study published in the journal Obstetrics & Gynecology found that patients ordered to undergo marijuana-specific drug screening during the labor and delivery process are disproportionately Black and are also likely to be on subsidized health insurance plans. The research assessed drug screening practices at one St. Louis hospital and found doctors ordered marijuana-related drug tests in 753 patients out of just under 4,000 deliveries. Seventy percent of those subjected to testing were Black. Marijuana tests were also more likely for those patients who were younger or on public insurance. Most subjected to testing came up negative, but of those who did positive, 90 percent were referred to child welfare authorities, even though there were no statistically significant differences between them and other mothers in terms of preterm birth rates or other indicators of natal health.

"Isolated marijuana use was a poor predictor of other substance exposure in our cohort, but a urine drug screening test result positive for marijuana exposed a historically underserved population that is already subject to pervasive systemic racism in the medical field to further stigmatization without changing outcomes. The utility of using isolated marijuana use as a criterion for urine drug screening appears limited in benefit but rife with inequitable potential to harm and should be carefully reconsidered in labor and delivery units for necessity," the authors concluded.

Drug Treatment

California Governor Signs Forced Drug Treatment Bill. To the dismay of drug reform and mental health advocates, Gov. Gavin Newsom (D) has signed into law Senate Bill 1338, the Community Assistance, Recovery, and Empowerment (CARE) Court Act, which create a civil court system in all counties that would force people who are experiencing substance use disorder and other mental health issues to undergo an involuntary court process and treatment plan. Although the CARE Act sailed through the legislature, the proposal was opposed by a wide range of advocates who feel it is a huge step in the wrong direction. It will take away people’s basic right to make their own decisions and force them into court-mandated treatment programs, which have been shown to often exacerbate harms while worsening existing health disparities and the overrepresentation of people of color in the criminal legal system. The CARE Act will fail to meet the urgent needs of our communities or offer a path to effective evidence-based treatment, recovery and other health services for Californians who are unhoused, struggling with substance use disorder, or experiencing other mental health issues, they argued.

Foreign Policy

White House Issues Annual List of Major Drug Trafficking and Producing Countries; Contains the Usual Suspects. The White House has released its annual Presidential Determination on Major Drug Transit or Major Illicit Drug Producing Countries for Fiscal Year 2023 and has identified the following countries as major transit or drug producing countries: Afghanistan, The Bahamas, Belize, Bolivia, Burma, Colombia, Costa Rica, the Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, India, Jamaica, Laos, Mexico, Nicaragua, Pakistan, Panama, Peru, and Venezuela. The annual exercise also designated four countries—Afghanistan, Bolivia, Burma, and Venezuela—as "having failed demonstrably to make substantial efforts during the previous 12 months to both adhere to their obligations under international counternarcotics agreements." Notably, all four of these countries are political foes of the US, unlike major drug producing and trafficking countries such as Colombia and Mexico, which are US allies.

Grassley, Whitehouse Lead Senate Caucus in Issuing Report onStrategies to Combat Money Laundering By Drug Cartels. Sen. Chuck Grassley (R-IA), Co-Chairman of the Senate Caucus on International Narcotics Control, and Sen. Sheldon Whitehouse (D-RR), Chairman of the caucus, havereleased a bipartisan report entitled: Strengthening U.S. Efforts to Attack the Financial Networks of Cartels. The report offers recommendations for Congress and the Biden administration to reduce the supply of illicit drugs by closing loopholes in the U.S. anti-money laundering (AML) framework that enable narcotics traffickers to obscure and access their illicit proceeds.Senate Caucus on International Narcotics Control members Richard Blumenthal (D-CT), Maggie Hassan (D-NH), Ben Ray Luján (D-NM), and James Risch (R-ID) have also endorsed the report.

Its recommendations include: Help partner nations strengthen their institutions to better defend against corruption and implement justice sector reforms; better track whole-of-government efforts to combat narcotics-related illicit finance;  deploy experts in narcotics-related illicit finance to assist partner nations; authorize innovative and effective programs to combat international money laundering, such as Trade Transparency Units; use regulatory authorities to close loopholes in the U.S. AML framework, including by: ensuring greater transparency in the cross-border transportation of stored value or prepaid access devices, and fully implementing the beneficial ownership requirements of the Corporate Transparency Act; aggressively investigate, prosecute, and pursue the maximum allowable criminal penalties for culpable banks, employees, and executives who fail to timely report suspicious transactions; and address vulnerabilities in the AML framework by swiftly enacting the Combating Money Laundering, Terrorist Finance, and Counterfeiting Act. The report does not explain how these proposals to deepen the drug war would lead to any different result than decades of previous prohibitionist measures.