The police chief in Oklahoma City wants pot busts downgraded, the US Sentencing Commission sets policy priorities for the next 18 months, marchers demand New York Gov. Andrew Cuomo take action on the state's overdose crisis, and more.

Gov. Andrew Cuomo was in the crosshairs Thursday as marchers demanded action on the state overdose crisis. (Creative Commons)

Oklahoma City Police Chief Wants to Quit Arresting Pot Possessors. Police Chief Bill Citty is calling for adjusting city ordinances so that police officers will not have to jail people caught with small amounts of marijuana. He is backing a move to reduce the penalty for possession from a $1,200 fine and up to six months in jail to just a $400 fine. "Right now, we're taking all possessions of marijuana, and it would be a Class B offense and it would actually, they would be arrested," said Citty. "We've been arresting every single one of them. This would stop that practice. By lowering it to $400, this allows us to basically take it out of that court of record trial and we're able to assign citations for the possession of marijuana. Now, that will be if they don't have a state permit or license that allows them to have it for medical use." The proposed ordinance will be up for discussion on September 11 and again on September 28.

Utah Governor Calls for Federal Rescheduling of Marijuana. As voters in the state prepare to give a thumbs up or thumbs down to a medical marijuana initiative in November, Gov. Gary Herbert (R) is calling on Congress to reschedule it. "I'd like to see the federal government get out of the way," he said on Thursday during his monthly news conference. "We ought to call upon our congressional delegation (to) take it off the Schedule I list. Let's do the studies, let's do the clinical trials. Are they not paying attention in Washington? Evidently not," he said.

Wisconsin Voters Will Have a Chance to Weigh in on Legalizing Marijuana. Voters in 16 counties and two cities will have a chance to vote on non-binding advisory referenda for or against legalizing marijuana for either medicinal or recreational purposes. The referenda are on local ballots scattered across the state, from Milwaukee and Dane to LaCrosse and Langlade counties, as well as the cities of Racine and Waukesha.

Harm Reduction

New York Activists March from City Morgue to Governor's Office to Call for Action on Overdose Crisis. Activists and family members who have lost loved ones to overdose marched through Manhattan on International Overdose Awareness Day to demand Gov. Cuomo (D) take action on the overdose crisis. Amid the seventh straight year of increased overdose deaths in NYC -- 2017 being the deadliest year on record -- the community brought pictures and stories of their loved ones to Governor Cuomo's Manhattan office and demanded he takes action with evidence-based public health interventions to end the crisis.

Sentencing

Sentencing Commission Finalizes 2018-2019 Priorities. In a notice printed in the Federal Register Thursday, the US Sentencing Commission laid out is policy priorities for the remainder of 2018 and into 2019. The priorities include reexamining sentencing guidelines in the wake of the Booker decision, implementing its 2016 recommendations on sentencing enhancements to focus on actual violent offenders, and continuing its efforts to implement reforms in mandatory minimum sentencing, among others.

The most recent data from the Centers for Disease Control and Prevention, released in mid-August, showed a record 72,000 drug overdose deaths last year, with 49,000 related to heroin, fentanyl and prescription opioids. According to the authors of a study released last week in the American Journal of Public Health, that could be the new normal.

The researchers said there are steps that can be taken to reduce the death toll, but also that some seemingly simple solutions, such as cracking down on opioid prescribing for chronic pain, could actually increase the toll. And even those policies that could cut the opioid death rate are likely to do so only marginally.

Using a mathematical model, the researchers estimate that some 510,000 people will die over the next decade because of opioid use. The number includes not only drug overdoses but also other opioid-related deaths, such as HIV infections caused by shared needles.

Even including the non-overdose deaths, the number is staggering. Last year was the worst year ever for opioid-related overdose deaths, but this research suggests we are going to see year after year of similar numbers.

Making the overdose reversal drug naloxone more widely available could cut opioid-related deaths by 21,200 over the next decade, allowing greater access to medication-assisted therapies with drugs such as buprenorphine and methadone would save another 12,500 lives, and reducing opioid prescribing for acute pain would prevent another 8,000 deaths, the researchers said. But those three policy moves combined would shave less than 10 percent off the overall death toll.

"No single policy is likely to substantially reduce deaths over 5 to 10 years," the researchers wrote.

While harm reduction interventions such as those above would save lives, some aspects of tightening opioid prescribing would actually increase opioid-related deaths by as much as the tens of thousands -- because they increase heroin deaths more than they cut painkiller deaths. Moves such as reducing prescribing for chronic pain, up-scheduling pain relievers to further restrict their prescribing, and prescription drug monitoring programs all tend to push existing prescription opioid users into the illicit heroin and fentanyl markers all end up contributing to net increases in opioid deaths over the 10-year period, the researchers found.

On the other hand, other interventions on the prescribing front, such as reducing acute prescribing for acute pain (pain that may be signficant but is short-term), reducing prescribing for transitional pain, reformulating drugs to make them less susceptible to misuse, and opioid disposal programs, appear to prevent more deaths than they cause.

Ultimately, reducing the opioid death toll includes reducing the size of the opioid-using population, the researchers say. That implies making addiction treatment more available for those currently using and preventing the initiation of a new generation of opioid users. Restrictions on prescribing, while possibly driving some current users to dangerous illicit markets, can have a long-term impact by reducing the number of people who develop a dependence on opioids.

Whether that's a tolerable tradeoff for those pain patients who don't get the relief they need from other medications -- or for patients and others who end up dying from street heroin but might have lived despite their prescription opioid use -- is a different question.

By all appearances, when it comes to the loss of life around opioids, it looks like a pretty sad decade ahead of us.

This article was produced by Drug Reporter, a project of the Independent Media Institute.

Drug overdose deaths hit another record high last year, the DEA is cutting prescription opioid quotas again, California pot tax revenues are not meeting expectations, and more.

According to the CDC, more than 72,000 Americans died of drug overdoses last year. (Creative Commons)

California Pot Tax Revenues Still Sluggish. The state has taken in $82 million in marijuana tax revenues in the first six months of 2018, finance officials reported. That's less than half the $185 million anticipated. Politicians and industry figures say that's because illicit sales still flourish and because many localities in the state don't allow retail marijuana sales. At a meeting with state regulators Tuesday, fingers were also pointed at a shaky supply chain, a shortage of licenses, testing problems and restrictions on retail sales and deliveries.

Medical Marijuana

Utah Medical Marijuana Foes Try Hail Mary Court Challenge to Block Initiative. Opponents of the Proposition 2 medical marijuana initiative filed a lawsuit in state court Wednesday seeking to remove the measure from the ballot. The opponents claim the initiative would tread on their freedom of religion because it violates the religious beliefs of a Mormon foe. "In the United States of America, members of all religions, including the Church of Jesus Christ of Latter Day Saints have a constitutional right to exercise their religious beliefs," the complaint reads. "This includes the right not to consort with, be around, or do business with people engaging in activities which their religion finds repugnant." Proponents of the initiative called the move "a wacky attempt" by foes to derail medical marijuana.

Heroin and Prescription Opioids

DEA Proposes Big Cuts in Opioid Manufacturing Next Year. The DEA has proposed decreasing the manufacturing quotas for the "six most frequently abused" opioids for next by 10%. That would be the third straight year of reductions. The move is described as part of President Trump's Safe Prescribing Plan, which seeks to "cut nationwide opioid prescription fills by one-third within three years." Neither this proposed cut nor the plan address whether bluntly tightening production quotas could lead to shortages for patients needing them for chronic pain.

Overdose Deaths At Record High Last Year, Driven By Opioids. The Centers for Disease Control and Prevention (CDC) reported Wednesday that preliminary figures showed that more than 72,000 Americans died of drug overdoses last year, up 7% over 2016. Opioids, which include prescription painkillers along with heroin and other illegal synthetic opioid drugs, contributed 49,068 to the total number of overdose deaths, the report indicates. From 2002 to 2017, the CDC estimates a 4.1-fold increase in the total number of deaths due to all types of opioid drugs.

Oregon's US Attorney fires a warning shot over pot, three different Missouri medical marijuana initiatives qualify for the November ballot, a House panel wants answers on opioids from three big pharmaceutical companies, and more.

Show Me State voters will be voting on three separate medical marijuana initiatives in November. (Creative Commons)

Oregon US Attorney Says Marijuana Industry There Is Out of Control. Oregon US Attorney Billy J. Williams fired a warning shot across the bow of the state's pot industry on Thursday. Responding to a High-Intensity Drug Trafficking Area (HIDTA) report this week that accused the state's marijuana growers of overproduction, Williams minced few words: "The recent HIDTA Insight Report on marijuana production, distribution, and consumption in Oregon confirms what we already know -- it is out of control," he said. "The industry's considerable and negative impacts on land use, water, and underage consumption must be addressed immediately. State officials should respond quickly and in a comprehensive manner to address the many concerns raised by this assessment," said Williams. "To date, we've seen insufficient progress from our state officials. We are alarmed by revelations from industry representatives, landowners, and law enforcement partners describing the insufficient and underfunded regulatory and enforcement structure governing both recreational and medical use. A weakly-regulated industry will continue to detract from the livability and health of communities throughout the state."

Medical Marijuana

Illinois Governor Signs Bill Allowing Medical Marijuana Administration in Schools. Gov. Bruce Rauner (R) has signed into law a bill that requires public schools to allow the parents of sick children to administer medical marijuana to them at school. The law allows parents to administer "cannabis-infused products" if both the child and the parents have been approved under the state's medical marijuana law.

Missouri Will Vote on Not One, Not Two, But Three Medical Marijuana Initiatives. The secretary of state's office on Thursday certified three different medical marijuana initiatives for the November ballot. There is a constitutional amendment from New Approach Missouri, as well as a constitutional amendment from Find the Cures and an easier to amend statutory initiative from Lowell Pearson, a Jefferson City attorney.

Oklahoma Health Board Approves New Medical Marijuana Rules. The Board of Health on Wednesday adopted new rules to govern the state's medical marijuana system. The new rules amend or totally revoke the original proposed rules, which included a ban on the sale of smokeable marijuana, a requirement that a pharmacist be present at dispensaries, and a requirement that women of childbearing age take a pregnancy test before using medical marijuana. Also gone are guidelines that limited THC levels.

Heroin and Prescription Opioids

House Panel Presses Drug Companies on Opioid Crisis. The leaders of the House Energy and Commerce Committee have sent letters to three companies that manufacture opioids requesting they appear before the committee to answer questions about how they marketed opioids and whether they ignored evidence of abuse of their products. The companies are Insys Therapeutics, Mallinckrodt Pharmaceuticals, and Purdue Pharma. The letters make no mention of ensuring that chronic pain patients continue to receive adequate supplies of opioids.