Medical marijuana gets attention in the statehouse, another drug war atrocity in New Mexico, Greece's first safe injection site is open, and a gram of opium or a few pounds of pot can get you the death penalty if you're in the wrong place. And more. Let's get to it:

Medical Marijuana

Key Michigan Politico Says Medical Marijuana Top Priority in December. House Judiciary Committee Chair Kevin Cotter (R-Mount Pleasant) said Monday his top priority next month is to take up three medical marijuana-related bills. The first,House Bill 4271, would revive medical marijuana dispensaries in Michigan after recent court rulings effectively stopped the facilities from operating in the state. Cotter also plans to take up two other medical marijuana-related bills. House Bill 5104 would allow patients to use edible forms of marijuana. And Senate Bill 660 would clear the way for pharmacies to sell medical marijuana in Michigan, but only if the federal government decides to regulate cannabis as a prescription drug.

New Jersey Lawmaker Files Bill Allowing Patients to Buy Out of State. Assemblywoman Linda Stender (D-Union) Monday introduced a bill that would allow Garden State medical marijuana patients to buy their medicine in other states where it is legal and consume it in New Jersey. The bill attempts to address restrictions in the state's medical marijuana law that prevent easy access to some medical marijuana formulations, especially strains with high levels of CBD.

Alabama Lawmaker Ready to Try Again on Medical Marijuana. State Rep. Patricia Todd (D-Birmingham) will reintroduce medical marijuana legislation again next year, she said Monday. The bill would allow for the use of CBD. Todd's previous medical marijuana bills have gotten nowhere in Montgomery.

Hemp

New Jersey Hemp Bill Wins Committee Vote. A bill that would create an industrial hemp license to regulate the "planting, growing, harvesting, possessing, processing, selling, and buying" of the crop passed the Assembly Agriculture and Natural Resources Committee Monday. The bill, Assembly Bill 2415, sponsored by Assemblyman Reed Gusciora (D-Mercer), would require the end of federal hemp prohibition before licenses could be issued.

Law Enforcement

New Mexico Woman Sues over Vaginal Macing During Drug Arrest. What on earth is going on in New Mexico? Just weeks ago, it was forced enemas and colonoscopies for drug suspects; now, another New Mexican, Marlene Tapia, is suing Bernalillo County after she says jail guards strip searched her and sprayed mace in her vagina, where she was hiding drugs. The ACLU of New Mexico is taking the case.

New Jersey Bill Would Increase Drug Penalties. A bill that would reduce the amount of heroin necessary to be charged with a first-degree crime and allow prosecutors to charge drug offenses by the number of units of the drug involved instead of their weight passed the Assembly Judiciary Committee Monday. The bill, Assembly Bill 4151, is sponsored by Assemblyman Scott Rumana (R-Passaic).

International

Greece Sets Up First Supervised Injection Site. Greece has opened its first "drug consumption" room in a bid to slow the spread of blood-borne diseases among injection drug users there. The site has been open since last month and has been used by more than 200 people so far.

European Drug Experts Urge Austerity-Battered Governments Not to Cut Drug Treatment. Drug experts and policy makers from around Europe gathered in Athens Monday to urge governments to exclude drug-abuse treatment from austerity budget cuts, citing an alarming rise in HIV infections among drug users in Greece. Included in the call are harm reduction programs like the Greek supervised injection site, which is funded with Council of Europe funds.

Colombia's FARC Wants to Lead Alternative Crop Pilot Project. The leftist guerrillas of the FARC, now in peace negotiations with the Colombian government, want an active role in a pilot project to get coca farmers to grow alternative crops. The group is proposing that one of its local military units team with the government in a village in southern Colombia in a five-year project intended to get farmers to quit growing coca.

Malaysia Court Gives Thai Woman Death Sentence for Weed. A judge in Malaysia Monday sentenced a 36-year-old Thai woman to death after she was caught with about 30 pounds of marijuana at a bus depot. Barring a successful appeal, Thitapah Charenchuea will be hanged. DPP Nor Shuhada Mohd Yatim prosecuted the case.

Dubai Prosecutors Seeks Death Penalty for Less Than One Gram of Opium. Prosecutors in Dubai are seeking the death penalty for an Iranian worker accused of possessing 0.8 grams of opium. They charged he possessed it for "promotional purposes," the equivalent of "with the intent to distribute."

The US states of Colorado and Washington voted last year to legalize marijuana and are moving forward toward implementing legalization. Activists in several states are lining up to try to do the same next year, and an even bigger push will happen in 2016. With public opinion polls now consistently showing support for pot legalization at or above 50%, it appears that nearly a century of marijuana prohibition in the US is coming to an end.

Exactly how it comes to an end and what will replace it are increasingly important questions as we move from dreaming of legalization to actually making it happen. The Netherlands, which for decades now has allowed open marijuana consumption and sales at its famous coffee shops, provides some salutary lessons -- if reformers, state officials, and politicians are willing to heed them.

To be clear, the Dutch have not legalized marijuana. The marijuana laws remain on the books, but are essentially overridden by the Dutch policy of "pragmatic tolerance," at least as far as possession and regulated sales are concerned. Cultivation is a different matter, and that has proven the Achilles Heel of Dutch pot policy. Holland's failure to allow for a system of legal supply for the coffee shops leaves shop owners to deal with illegal marijuana suppliers -- the "backdoor problem" -- and leaves the system open to charges it is facilitating criminality by buying product from criminal syndicates.

Still, even though the Dutch system is not legalization de jure and does not create a complete legal system of marijuana commerce, reformers and policymakers here can build on the lessons of the Dutch experience as we move toward making legal marijuana work in the US.

"Governments are looking to reform their drug policies in order to maximize resources, promote health and security while protecting people from damaging and unwarranted arrests," said Kasia Malinowska-Sempruch, Director of the Open Society Global Drug Policy Program. "The Netherlands has been a leader in this respect. As other countries and local jurisdictions consider reforming their laws, it's possible that the Netherlands' past offers a guide for the future."

A new report from the Open Society Global Drug Policy Program lays out what Dutch policymakers have done and how they have fared. Authored by social scientists Jean-Paul Grund and Joost Breeksema of the Addiction Research Center in Utrecht, the report, Coffee Shops and Compromise: Separated Illicit Drug Markets in the Netherlands tells the history of the Dutch approach and describes the ongoing success of the country's drug policy.

This includes the separation of the more prevalent marijuana market from hard drug dealers. In the Netherlands, only 14% of cannabis users say they can get other drugs from their sources for cannabis. By contrast in Sweden, for example, 52% of cannabis users report that other drugs are available from cannabis dealers. That separation of hard and soft drug markets has limited Dutch exposure to drugs like heroin and crack cocaine and led to Holland having the lowest number of problem drug users in the European Union, the report found.

Pragmatic Dutch drug policies have not been limited to marijuana. The Netherlands has been a pioneer in harm reduction measures, such as needle exchanges and safe consumption sites, has made drug treatment easy to access, and has decriminalized the possession of small quantities of all drugs. As a result, in addition to having the lowest number of problem drug users, Holland has virtually wiped out new HIV infections among injection drug users. And, because of decriminalization, Dutch citizens have been spared the burden of criminal records for low-level, nonviolent offenses.

The Dutch have, for example, virtually eliminated marijuana possession arrests. According to figures cited in the report, in a typical recent year, Dutch police arrested people for pot at a rate of 19 per 100,0000, while rates in the US and other European countries were 10 times that or more.

For veteran drug reform activist Joep Oomen of the European NGO Coalition for Just and Effective Drug Policies (ENCOD), the report is welcome but not exactly "stop the presses" news.

"The conclusions of this report have been known for a long time," he told the Chronicle. "Already by the end of the 1990s, when European governments had to acknowledge that Dutch drug policies had proven more effective in reducing risks and harms than many other countries, the criticism that had been expressed earlier by mainly German and French heads of state was silenced. For instance, in the Netherlands the age of first heroin use is the highest of Europe, which is explained by the relative tolerance concerning cannabis use." [Ed: A high age of first use is considered good, because it means that fewer people are experimenting with a drug when they are young -- which in turn means fewer people ever trying it, and those who do being more likely to be capable of avoiding problematic use.]

While the Dutch can point to solid indications of success with their pragmatic drug policies, it is not all rosy skies. The "back door problem" alluded to above continues unresolved, and the relative laxness of Dutch marijuana policy has led to an influx of "drug tourists," especially from neighboring countries, such as France and Germany. Both of those irritants have provided fodder for conservative parties and administrations that have sought to roll back the reforms.

"There seems to be more admiration for Dutch drug policy outside the Netherlands than inside," Oomen observed. "Right-wing governments that have dominated the Dutch political climate since 2002 have slowly dismantled acceptance-oriented drug policy. Lately the establishment of the Weedpass in the southern part of the country [which excludes non-Dutch from access to the coffee shops] and new measures against grow shops and coffee shops are definitely threatening to undermine the coffee shop model," he said.

"Instead of completing the regulation of this model by solving the coffee shops' back door problem, the government seems to apply a policy of slow elimination by making the conditions worse in which the shops have to operate," Oomen continued. "And the Dutch press follows blindly, often referring to coffee shops as a link in a criminal chain, which is unavoidable since the ban on cultivation forces shop owners to deal with criminals, but without questioning the measures that reinforce the criminal aspect."

While the national government may now be hostile to pragmatic marijuana policies, it is facing considerable resistance from elected officials. The Weedpass program now appears to be largely a dead letter, thanks to opposition from the likes of Amsterdam Mayor Eberhard van der Laan, and other local elected officials are moving to address the back door problem.

"Several Dutch mayors have plans for municipal cannabis farms to supply the coffee shops and take crime out of the industry," said Grund, research director at the Addiction Research Center. "But if Dutch drug policy offers one lesson to foreign policymakers, it is that change should be comprehensive, regulating sale to consumers, wholesale supply and cultivation."

Grund is watching the American experience with legalization in Colorado and Washington and had some observations he shared with the Chronicle.

"As far as I can judge," he said, "these are both pretty solid proposals, although quite different in detail and approach -- e.g., a vertically integrated chain of supply in Colorado and separate licensing for producers, processors, and retailer in Washington. Clearly in both states legislators have done their best. Interesting then, that they end up with rather different plans, which is actually fine, as it provides us with the opportunity to evaluate different models. For more than 25 years, there was just about only the Dutch experience with cannabis decriminalization and coffee shops; now we see different models of cannabis reform and distribution being implemented across continents. Comparing these experiences as they evolve should allow us to develop more effective drug policies."

Policymakers and regulators should try to avoid rigidity and be ready to deal with unintended responses and consequences, the Dutch social scientist said.

"The point is to approach these flexibly and pragmatically; adjust when necessary, while keeping your eyes on the ball: cutting the link between cannabis on the one hand, and criminal records, mafia and more, on the other," Grund advised, noting that the 1976 Dutch law separating hard and soft drugs did not anticipate the arrival of the coffee shop phenomenon. "As Dr. Eddy Engelsman, former chief drug policy maker at the ministry of health -- and known as the architect of Dutch drug policy -- said when we interviewed him, 'coffee shops just emerged.' The policymakers deemed that these fit their overall policy objectives and allowed for them to ply their trade openly," he recalled.

Grund also weighed in on personal cultivation -- Colorado allows it; Washington does not -- and public use, which it appears will remain forbidden in both states.

"I think Washington presents more of a business and revenue raising strategy, while Colorado feels more like grassroots meets civil libertarian meets amenable regulator," he opined. "The more social, homegrown orientation of the Colorado proposal – allowing for home growing, bartering between friends -- could perhaps engender a less market driven distribution structure, where friends compete in growing the most pleasant marijuana, not the most profitable. Something like the Spanish cannabis clubs," he suggested.

Public, convivial pot smoking in designated areas should be allowed, Grund said, because it has benefits.

"Dedicated places of consumption -- such as the coffee shops in the Netherlands or shisha parlors -- offer an opportunity to promote responsible behavior around cannabis consumption," he argued. "Smoking cannabis in a safe, hospitable and stress free environment engenders different use patterns from quickly getting high in a service ally behind a bar or in a car parked in a quiet place. Coffee shops offer a moderating environment where self regulation is supported by social learning and control."

While Grund was looking forward to the future in the US, Oomen was thinking of the unfinished business in the Netherlands, but his musing also provide food for thought for American reformers, especially those contemplating decriminalization measures.

"The lesson here is that decriminalization or depenalization are useful concepts for a transition period, but real progress can only be obtained and assured with legal regulation of the entire chain from producer to consumer," the ENCOD leader noted. "The Dutch case shows that politicians will always use the smallest margin they have to maintain to a repressive model, provoking criminal activities which they can use to justify their policies publically. This is the drug policy perpetual motion machine."

Colorado and Washington are already well down their particular paths to marijuana legalization. But there is still time for the next wave of legalization states to learn and apply those lessons, not just from Denver and Olympia, but from the Dutch pioneers as well.

Just a day after the Office of National Drug Control Policy (ONDCP -- the drug czar's office) released its latest annual national drug control strategy, the Government Accountability Office (GAO) has issued a report finding that ONDCP has fallen well short of goals enunciated in its 2010 national drug strategy.

In the report, Office of National Drug Control Policy: Office Could Better Identify Opportunities to Increase Program Coordination, GAO noted that ONDCP and the federal government "have not made progress toward achieving most of the goals articulated in the 2010 National Drug Control Strategy." In some areas, including reducing teen drug use, reducing drug overdose deaths, and reducing HIV infections from injection drug use, GAO found, ONDCP was not only not making progress, but sometimes the numbers were moving in the opposite direction.

For instance, under the broader goal of "curtailing illicit drug consumption in America," ONDCP had set use reduction goals to be achieved by 2015. It sought to reduce last month drug use by teens by 15%, but has achieved no movement. Similarly, it sought a 15% reduction in past month use by young adults, but has achieved no movement. It also sought to reduce lifetime use of drugs, alcohol, and tobacco by 8th graders by 15%, and was making progress toward its goal with alcohol and tobacco, but not with illegal drugs.

Likewise, under ONDCP's broad goal of "improving the public health and public safety of the American people by reducing the consequences of drug use," ONDCP identified goals of reducing overdose deaths, drug-related hospital emergency room visits, and drug-related HIV infections by 15% by 2015, but showed "movement away from goal" between 2010 and 2012.

Drug czar Gil Kerlikowske is talking up a "21st Century Approach" to drug use with a heavy emphasis on treatment and prevention, but the latest national drug budget still allocates 58% of funding to law enforcement and interdiction. And those remaining funds for treatment and prevention are "fragmented" across 15 federal agencies, with much overlapping. GAO reviewed 76 federal drug treatment and prevention programs and found 59 of them overlapped.

GAO did note that while ONDCP was not showing progress in most of its goals, it had implemented 107 of the 112 "action items" contemplated to meet those goals. The auditors noted that "ONDCP officials stated that implementing these action items is necessary, but may not be sufficient to achieve Strategy goals."

The XIX International AIDS Conference took place in Washington, DC, last week, bringing more than 20,000 scientists, activists, government officials, and journalists to assess the science and determine best practices for reducing the spread of the HIV virus. The US was able to host the conference for the first time in 22 years after it finally repealed a law denying people with HIV admission to the country.

But other critical groups remained excluded -- drug users and sex workers. Although they make up a majority of people living with HIV in many countries, people who admit to ever using drugs or engaging in prostitution within the past 10 years are inadmissible under US immigration laws. The State Department could have issued a blanker waiver of inadmissibility for people attending the conference, but declined to do so.

Drug users and sex workers who wanted to attend the conference were thus faced with a dilemma: Tell the truth and be barred or lie on the visa application, which in itself is a violation of US immigration law. As a result, representatives of some of the groups most affected -- and most likely to be affected in the future -- were unable to attend.

"People do not want to run the risk of attending the conference in a country where they are told they are not wanted or desired," said Allan Clear, the executive director of the Harm Reduction Coalition. "It sends the message that people who have a history of drug use or sex work are not actually included in the dialog at all, and is a serious setback in the fight against AIDS. I don't think the US government has any particular interest in actually involving sex workers or drug users in policy or programming."

The exclusion of drug users and sex workers hasn't gone down well with activists. As far back as two years ago at the Vienna AIDS conference, Indian activist Meena Seshu called for a boycott of AIDS 2012, pointing out that it was unethical three decades into the AIDS epidemic to discuss AIDS policy without including those most affected. Some have boycotted the conference, opting instead to attend a Kiev conference that began July 9 for drug users and people living with HIV from Eastern Europe. Sex workers and their allies followed with a side meeting in Kolkata this week. While those two events are officially considered "hubs" of the International AIDS Conference, many attended them as a means of protesting the exclusion of drug users and sex workers in Washington.

Unhappiness broke into the open in Washington Monday when dozens of drug user and sex workers activists disrupted the conference's opening press event. They leapt from their seats unexpectedly and marched through the room, waving banners and shouting slogans such as "No drug users? No sex workers? No International AIDS conference!"

Discontent with AIDS policies that marginalize drug users and sex workers escaped from the conference rooms and onto the streets again on Tuesday, as hundreds marched to the White House chanting "No More Drug War" in a rally timed to coincide with the conference. The march broadened the scope of protest, linking the battle against AIDS with the war on drugs and corporate domination of US political life.

On the way to the White House, protestors stopped at UPS and Wells Fargo facilities to chide those corporations for unhelpful practices. UPS took heat for donating to politicians who voted to restore the federal ban on needle exchange funding, and Wells Fargo for investing in private prisons.

"Wells Fargo is literally invested in locking more people up," said Laura Thomas of Drug Policy Alliance (DPA).

Activism around drug users and AIDS also took place in the conference's Global Village, including the installation of a model of Vancouver's Insite supervised injection site and tours of a local needle exchange outreach van courtesy of DC's Family and Medical Counseling Services. The Harm Reduction and Global Drug Policy Zone in the village also featured special events and presentations put on by groups including the Harm Reduction Coalition, Harm Reduction International, the Hungarian Civil Liberties Union, the Eurasian Harm Reduction Network, and the International Network of People Who Use Drugs.

Advocates also took advantage of the AIDS conference to unleash a campaign on the theme of "You Can't End AIDS Unless You End the Drug War." Articles to that effect appeared on Alternet and the Huffington Post (and were picked up elsewhere), while Global Commission on Drug Policy member Richard Branson penned a USA Today op-ed piece on how drug prohibition contributes to the spread of HIV. As part of the same campaign, Politico ran a full-page ad signed by Global Commission members and other notables, repeating the message and directly challenging both President Obama and Gov. Romney to "do the right thing." Giants in AIDS advocacy like Michael Kazatchkine and Stephen Lewis joined the calls in speeches given during the conference.

In an unexpected cap to things, former President Bill Clinton called for drug use to be treated as a public health issue, not a criminal justice one, in remarks at the closing plenary. Clinton cited The Huffington Post and Alternet op-eds, coauthored by the Drug Policy Alliance's Ethan Nadelmann and American Foundation for AIDS Research founder Matthilde Krim.

Activists demanding a larger role for drug users and sex workers in setting the policies that are supposed to help them fight AIDS came armed with powerful ammunition. Two recent reports clearly lay out how criminalizing drug use helps spread the disease and how many countries are failing to adequately deal with the spread of HIV among injection drug users.

The first report, from the Global Commission on Drug Policy, makes its findings clear in its title: "The War on Drugs and HIV/AIDS: How Criminalization of Drug Use Fuels the Global Pandemic." In the report, the commission noted that injection drug use now accounts for one-third of new HIV infections outside of sub-Saharan Africa, including some 354,000 people in the US.

"Throughout the world, research has consistently shown that repressive drug law enforcement practices force drug users away from public health services and into hidden environments where HIV risk becomes markedly elevated," the commission said. "Mass incarceration of nonviolent drug offenders also plays a major role in spreading the pandemic."

The commission also remarked on "the remarkable failure" of drug prohibition in reducing the global drug supply. The worldwide supply of illicit opiates, such as heroin, has increased almost four-fold in recent decades, the commissioners noted. They also noted the drug war's contribution to the growth of organized crime and violence.

The commission identified proven addiction treatment and evidence-based public health measures that countries should put in place to reduce the spread of HIV and protect community health and safety. They include needle exchange programs, safer injecting facilities, and prescription heroin programs.

"Failure to take these steps is criminal," the commission said.

In the second report, "The Global State of Harm Reduction 2012: Towards an Integrated Response," from the London-based Harm Reduction International (formerly the International Harm Reduction Association), researchers found that while injection drug use has been identified in 158 countries, only half of them have any programs aimed at preventing the spread of HIV among injectors, and the situation internationally is not improving. Even in countries that are addressing the problem, programs suffer from lack of funding and donor support is decreasing. That is undermining the global response to AIDS, the report concluded.

"In the last two years, we have seen a significant scale-down of services in countries with some of the highest HIV burdens among people who inject drugs," said Rick Lines, the group's executive director. "As tens of thousands gather in Washington this week to call for an end to AIDS, it is becoming increasingly clear that governments have neither the will nor the intention of ending the spread of HIV among people who use drugs."

"We have seen the number of needle exchange programs in Russia drop for 70 in 2010 to only six in 2012. This is made worse by a retreat of many bilateral and multilateral donors to funding effective harm reduction interventions in many countries," said Claudia Stoicescu, public health analyst at Harm Reduction International and author of the report. "Such developments significantly limit progress toward global commitments to halve HIV transmission related to unsafe injecting by 2015, let alone any hope of achieving universal access to HIV prevention, treatment, care and support for people who inject drugs."

"The reluctance of governments to fund an adequate response to HIV and injecting drug use stands in stark contrast to the seemingly limitless budgets for ineffective and punitive law enforcement responses," said Lines. "Governments care more about fighting a losing war on drugs than they do about winning the fight against HIV."

As the world enters its fourth decade of living -- and dying -- with HIV/AIDS, this week's conference and its barriers to participation by and concern for some of those most directly affected by the crisis -- drug users and sex workers -- demonstrate how far we still have to go. They also make achingly clear the destructive role that drug prohibition and the criminalization of marginalized populations play in perpetuating the epidemic.

Maybe next time the International AIDS Society will hold its conference someplace where drug users and other marginalized groups can attend and be heard. Or maybe the United States will alter its harsh visa requirements aimed at drug users and sex workers. Either one would be good. Ending drug prohibition, the stigma it generates, and the obstacles to fighting disease it engenders would be better.