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Safer Injection Sites

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Chronicle AM: DOJ Takes Aim at SISes, States Demand Congress Act on Pot Banking, More... (8/28/18)

Even as a California safer injection site bill approaches final passage, the Justice Department takes aim at the harm reduction practice; state financial regulators want Congress to act on marijuana banking, and more.

Vancouver's InSite safer injection site. Coming soon to San Francisco? (Creative Commons)
Marijuana Policy

State Financial Regulators Call on Congress to Deal With Marijuana Banking Problems. The top financial regulators in 13 states sent a letter last week to congressional leaders demanding that they take action to protect banks working with marijuana businesses. The conflicts between state-level legalization and federal prohibition have created confusion in the financial sector and jeopardized public safety, the regulators said. "It is incumbent on Congress to resolve the conflict between state cannabis programs and federal statutes that effectively create unnecessary risk for banks seeking to operate in this space without the looming threat of civil actions, forfeiture of assets, reputational risk, and criminal penalties," the regulators wrote. "While Congress has taken some action, such as the Rohrabacher amendment prohibiting federal funds being used to inhibit state medicinal marijuana programs, this has been an impermanent approach that requires a permanent resolution." Regulators from Alaska, Connecticut, Hawaii, Louisiana, Michigan, Montana, Nevada, New York, Oklahoma, Oregon, Pennsylvania, Utah and Washington State signed the letter.

Medical Marijuana

Oklahoma Proposed Medical Marijuana Regulations Now Open for Public Comment. State officials are now asking the public for its input on the regulation and implementation of medical marijuana in the state. "Lawmakers in the legislative working group are seeking a path forward to implement State Question 788 in a way that conforms to the desires of voters who passed the law," said Speaker Charles McCall (R-Atoka). "To do that effectively, the working group needs as much input as possible from citizens -- supporters, advocates, patients, health-care providers, public safety and law enforcement officers and even those who have concerns. I would encourage all Oklahomans who have an interest in this issue to use this opportunity to share input and have their voices heard." Comments can be sent to [email protected]. Messages will then be shared with members of the working group.

Harm Reduction

Justice Department Attacks Safer Injection Sites. In an op-ed in the New York Times titled "Fight Drug Abuse, Don't Subsidize It," Deputy Attorney General Rod Rosenstein attacked safer injection sites as "very dangerous" and argued they would "only make the opioid crisis worse." He also points out that they are federally illegal and warns that violations are punishable by up to 20 years in federal prison. His op-ed comes as cities such as New York, Seattle, and San Francisco advance plans to open such facilities in a bid to reduce harms.

California Safer Injection Site Bill Passes Senate. The Senate voted Monday to approve Assembly Bill 186, which will allow the city of San Francisco to undertake a three-year, pilot safer injection site program. The bill now goes back to the Assembly for a final concurrence vote before heading to the desk of Gov. Jerry Brown (D).

Chronicle AM: CA Senate Passes SIS Bill, Black Vets More Likely to Be Drug Tested, More... (8/22/18)

Louisiana doctors could soon treat more medical marijuana patients, black VA patients on opioid therapy are more likely to be drug tested and have their treatment halted for illicit drug use than whites, a Georgia judge throws out a heroin murder conviction, and more.

A facility like Vancouver's InSite could be coming to San Francisco. A bill to make it happen is moving in Sacramento. (CC)
Medical Marijuana

Louisiana Regulators Weight Raising Limit on Number of Patients Doctors Can Treat. The state Board of Medical Examiners is set to boost the number of medical marijuana patients a single doctor can treat. The board set a limit of 100 patients per doctor in 2016, but Vincent Culotta, the board's executive director, said the limit will be raised at the board's meeting next month. "We realize we're going to have to increase that number," he said.

Oklahoma Judge Rules Implementation of Medical Marijuana Rules Can Proceed. Cleveland County District Court Judge Michael Tupper ruled Tuesday that the Board of Health can proceed with implementing the state's medical marijuana rules and regulations. He ruled against a lawsuit by more than a dozen Oklahoma patients and businesses who challenged the rules. The decision Tuesday does not end the case. The judge could still throw out some or all the challenged rules at a later date or choose to leave them alone again. Another legal challenge is still pending in Oklahoma County District Court.

Heroin and Prescription Opioids

Study Finds African-American VA Patients More Likely to Be Drug Tested, Have Prescriptions Stopped. Black VA patients on long-term opioid therapy are more likely to be drug tested by their doctors and much more likely to have their opioid prescriptions halted if any illegal drug use is found, a new study finds. About 25% of black patients were tested within six months of being prescribed opioids, while only 16% of whites were. Black patients were twice as likely as white ones to have their opioid therapy halted if they tested positive for marijuana and three times as likely if they tested positive for cocaine. The findings were published in the journal Drug and Alcohol Dependence.

Georgia Judge Dismisses Indictment in Heroin Overdose Death. A Georgia judge has dismissed a murder indictment against a man accused of injecting heroin into another man who overdosed and died. In the case, Superior Court Judge John Goger found that the defendant injected the fatal dose at the victim's request and that the victim had purchased the drug himself. Goger held that that didn't amount to heroin distribution by the defendant, and without the underlying drug felony, there is no felony murder.

Harm Reduction

California Senate Passes Bill to Permit Safe Injection Sites in San Francisco. The state Senate Wednesday approved Assembly Bill 186, which would allow San Francisco to implement a safe injection site. AB 186 permits San Francisco to establish facilities where individuals can use controlled substances under the supervision of staff that are trained to treat and prevent drug overdose and link people to drug treatment, housing, healthcare, and other services. Mayor London Breed, the San Francisco Board of Supervisors, as well as a significant majority of the San Francisco electorate, support piloting safe injection sites in San Francisco.

Chronicle AM: Key NJ Pol Now Supports Legal Pot, UK Drug Deaths Spark Criticism, More... (8/6/18)

New Jersey's assembly speaker gets behind marijuana legalization, Ted Cruz attacks Beto O'Rourke as a drug legalizer, record-breaking British drug deaths spark a critique of government drug policy, and more.

Fentanyl deaths nearly doubled last year in Great Britain. (Creative Commons)
Marijuana Policy

Key New Jersey Politico Now Supports Marijuana Legalization. Assembly Speaker Chris Coughlin (D-Middlesex), a key player in the legislature, said Friday he supported making the state the next one to legalize marijuana. Both Gov. Phil Murphy (D) and Senate President Stephen Sweeney (D-Gloucester) have both been more enthusiastic about legalization than Coughlin up until now. "For folks who don't want to legalize it, I understand their view. But I would ask, are we satisfied with the status quo," Coughlin said on his regular "Speak to the Speaker" radio program. "Use of marijuana is still a constant. Three out of five drug arrests are for marijuana. African Americans are three times more likely to get arrested for marijuana," Coughlin said. "We're trying to address those things and I think, if you got the right bill, we'll go ahead and try to pass it."

Medical Marijuana

Ohio Awards First Medical Marijuana Processing Licenses. The state Department of Commerce on Friday issued seven provisional licenses to aspiring medical marijuana processors. This is just the first round of licensing for processors; the state could license up to 40 such operations.

Drug Policy

Ted Cruz Attack Ad Slams Beto O'Rourke as Drug Legalizer. With the underdog Democrat nipping at his heels -- a recent poll has the Texas senate race as a statistical dead heat -- incumbent GOP Sen. Ted Cruz is using an ad that accuses O'Rourke of being a drug legalizer. "Beto O'Rourke said we should consider legalizing all narcotics, including heroin," says one ad running in Lubbock. The O'Rouke campaign said that is not true -- that O'Rourke supports marijuana legalization and says we need a larger discussion about ending the war on drugs. The campaign also warned supporters more than a month ago such attacks would be forthcoming. "It is these kinds of mischaracterizations of our positions, preying on the fears and anxieties of our fellow Texans, that they will try to use as they have used in the past," O'Rourke said on June 29.

International

British Drug Deaths at Record High (Again), Fentanyl Toll Doubles. The British government has reported 3,756 drug deaths in 2017, making the year the fifth in a row to see increases in drug deaths. The 2017 figure is the highest since comparable records began in 1993. The most dramatic drug death increases were around fentanyl and its analogs, which nearly doubled in the space of a year.

British Reform Advocates Rip Government Policies over Drug Deaths. "After five years of record or near-record drug-related deaths, the UK Government has nowhere left to hide. They are responsible for vulnerable people dying in droves, because they are blocking, or refusing to fund, measures proven to save lives in other countries," said Martin Powell of the Transform Drug Policy Foundation. "No one has ever died from an overdose in a supervised drug consumption room or heroin prescribing clinic, anywhere. In Portugal -- where drug use is decriminalized -- the drug death rate is less than a tenth of ours. So Government claims that these deaths are all the result of an aging population of drug users is a lie. The Government must fully fund drug treatment, stop criminalizing people who use drugs, and allow supervised drug consumption rooms now. Longer term, all political parties should back legal regulation of the drug market to take it out of the hands of criminals, save lives, reduce crime, and protect our communities." Also commenting was Rose Humphries of the Anyone's Child Project, who lost two sons to heroin overdoses: "It upsets me to see the figures for drug deaths at record levels year after year. The government is complicit in these deaths because it will not try the successful measures that work in other countries to reduce drug deaths and crime. Those of us in the Anyone's Child campaign can see the evidence of what works -- including legally regulating drugs. Why can't the government?" she asked.

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

How to Prevent Opioid Overdoses? Provide Hard-Core Addicts Free Pharmaceutical Heroin

With Ohio beset by a massive public health crisis around opioid use and overdoses -- more than 4,000 Ohioans died of opioid overdoses in 2016 -- the Cleveland Plain Dealer sent travel editor Susan Glaser to Amsterdam in search of innovative approaches to the problem. While there, she rediscovered Holland's longstanding, radical, and highly-effective response to heroin addiction and properly asked whether it might be applied to good effect here.

The difference in drug-related death rates between the two countries is staggering. In the US, the drug overdose death rate is 245 per million, nearly twice the rate of its nearest competitor, Sweden, which came in second with 124 per million. But in Holland, the number is a vanishingly small 11 per million. In other words, Americans are more than 20 times more likely to die of drug overdoses than Dutch.

For Plain Dealer readers, the figures that really hit home are the number of state overdose deaths compared to Holland. Ohio, with just under 12 million people, saw 4,050 drug overdose deaths in 2016; the Netherlands, with 17 million people, saw only 235.

What's the difference? The Dutch government provides free heroin to several score hardcore heroin addicts and has been doing so for the past 20 years. Public health experts there say that in addition to lowering crime rates and improving the quality of life for users, the program is one reason overdose death rates there are so low. And the model could be applied here, said Amsterdam heroin clinic operator Ellen van den Hoogen.

"It's been an enormous success. I think it would work elsewhere," she told Glaser.

It already has. The Dutch program was modeled on a similar effort in Switzerland, which has also proven successful. Germany and Canada are among the several other countries with similar programs.

The Dutch approach is an example of the country's policy of gedogen (pragmatic tolerance), the same principle that led the Dutch to pioneer quasi-legal access to marijuana in the 1980s. It is also rooted in the notion that, for some, drug addiction is a chronic disorder, not a condition to be "cured," and one that can be treated with supervised drug use under clinical supervision. And the complete cessation of drug use need not be the ultimate goal; rather, the Dutch look for reductions in criminal activity and increases in the health and well-being of the drug users.

"It's not a program that is meant to help you stop," acknowledged van den Hoogen. "It keeps you addicted."

That's not a sentiment sits well with American moralizers, such as George W. Bush's drug czar, John Walters, whom Glaser consulted for the story. He suggested that providing addicts with drugs was immoral and not "real treatment," but he also resorted to lies about what the Dutch are doing.

He claimed the Dutch are "keeping people addicted for the purpose of controlling them" and that the Dutch have created "a colony of state-supported, locked-up addicts."

Actually, the Dutch are dealing with older, hardcore addicts who have repeatedly failed to quit after repeated stints in treatment, including methadone maintenance therapy, and they are neither "controlling them" or locking them up. Instead, the people in the program show up at the clinic twice a day, get their fix, then go about their business. This heroin-assisted treatment (HAT) allows those hardcore users to live less chaotic and more productive lives.

And heroin-assisted treatment is "real treatment," said Peter Blanken, a senior researcher with the Parnassia Addiction Research Centre in Rotterdam. He pointed out that one-quarter of program participants make a "complete recovery," including better health and quitting illegal drugs and excessive drinking. Many others continue to use heroin, but do so with better outcomes, he said.

There is also a real safety benefit to using state-supplied pharmaceutical heroin. It's potent, but it's a known quantity. Users face no risk of adulteration with more dangerous drugs, such as fentanyl, which is deeply implicated in the current US overdose crisis.

In the current political atmosphere in the United States, providing heroin to hardcore addicts is a hard sell indeed. Other, lesser, harm reduction interventions, such as needle exchanges remain controversial, and the country has yet to see its first officially sanctioned safe injection site. And drug decriminalization, which has led to a dramatic reduction in heroin addiction and overdose deaths in Portugal, remains off the table here, too. But with an annual drug overdose death toll of more than 50,000 people a year, it may time to start asking how many more Americans we are willing to sacrifice on the altar of moralistic drug prohibition.

Chronicle AM: Gallup: Pot Use "Morally Acceptable," Bangladeshi Drug War Killings, More... (6/4/18)

Two polls illustrate the rising social acceptability of marijuana, Louisiana's medical marijuana program expands, the Bangladeshi drug war could be a cover for political assassinations, and more.

Most people don't think people who smoke pot are moral lepers, a new Gallup poll finds. (Creative Commons)
Marijuana Policy

Gallup Poll: Two-Thirds Say Consuming Marijuana "Morally Acceptable." A large majority of Americans -- 65% -- say consuming marijuana is "morally acceptable." An even larger majority -- 78% -- say drinking alcohol is "morally acceptable." This is the first time Gallup has asked the question.

Youth Support for Marijuana Legalization at All-Time High, Poll Finds. The annual Monitoring the Future survey of secondary school students finds that 49% of 12th graders supported marijuana legalization last year, a figure the survey called a "historic high." Just a decade earlier, only 29% favored legalization, but support has grown every year since then, except for a one-point downward blip in 2015.

Medical Marijuana

Louisiana Governor Signs Second Medical Marijuana Expansion Bill. Gov. John Bel Edwards (D) has signed into law House Bill 579, which adds Parkinson's, glaucoma, severe muscle spasms, chronic pain and post-traumatic stress disorder to the 10 conditions currently qualifying for medical marijuana. Days earlier, he signed into law a second bill that added autism to the list of qualifying disorders.

International

Bangladeshi Drug War Used to Hide Political Assassinations. The death toll from the Bangladeshi government's bloody drug crackdown has risen to 120, and claims are coming that some of the victims are not drug users or dealers at all, but political opponents of the government. One case is that of Habibur Rahman, who police said had been killed in a gunfight with officers, but his family said Rahman, an activist with the leading opposition party, was last seen being taken away from a local mosque by men thought to be plainclothes police officers. "He was neither a drug seller nor a drug addict. It was because he was involved in politics against the government and protested about land affairs," said a relative who declined to be named for fear of retaliation.

British Home Office Scotches Plans for Glasgow Safe Injection Site. The British Home Office has refused to approve a safe injection site in Glasgow -- even though it acknowledges they are an effective harm reduction intervention. The Home Office said there is no legal framework for setting up safe injection sites and there are no plans to amend the law to do so.

Chronicle AM: NY Dems Endorse Marijuana Legalization, Surgeon General Talks Harm Reduction, More... (5/24/18)

The US Surgeon General has some surprisingly frank words about harm reduction and evidence-based drug policy, Cory Booker's Marijuana Justice Act picks up another sponsor, Arizona's Supreme Court throws out a state law criminalizing the use and possession of medical marijuana on campus and more.

The section on the Surgeon General's comments has an update, including a statement from the Department of Health and Human Services on the safe injection sites mention.

US Surgeon General Jerome Adams talks harm reduction and evidence-based opioid treatment. (Creative Commons)
Marijuana Policy

Jeff Merkley Signs on to Federal Marijuana Justice Act. And then there were five. Sen. Jeff Merkley (D-OR) has become the fifth cosponsor of Sen. Cory Booker's Marijuana Justice Act (S. 1689). The other cosponsors are Sens. Kirsten Gillibrand (D-NY), Kamala Harris (D-CA), Bernie Sanders (I-VT), and Ron Wyden (D-OR). Representatives Barbara Lee (D-CA) and Ro Khanna (D-CA) introduced a companion measure, H.R. 4815, in the House of Representatives earlier this year that has 35 cosponsors.

New York Democratic Party Officially Endorses Marijuana Legalization. Delegates to the state Democratic convention Wednesday adopted a resolution supporting marijuana legalization: "The New York State Democratic Committee supports the legalization of marijuana which should be regulated and taxed in a manner similar to alcohol," reads a resolution. The resolution adds that legalization is "an important social justice issue."

Medical Marijuana

Arizona Supreme Court Okays Medical Marijuana on College Campuses. The court ruled Wednesday that the state can't criminally charge card-carrying medical marijuana patients for possessing and using their medicine on campus. In Arizona v. Maestas, the court held that a 2012 law banning medical marijuana on campus violated the state's protections for voter-approved laws. The Supreme Court ruling upholds an appellate court ruling that also found in Maestas' favor.

Ohio Dispensary License Announcement Delayed. The state Board of Pharmacy announced Tuesday that its planned announcement of dispensary license awards Wednesday has been postponed and that provisional licenses will instead be issued in June. Legal medical marijuana sales are supposed to begin on September 8. Stay tuned.

Pennsylvania Judge Halts Medical Marijuana Research Program. A Commonwealth Court judge has granted a temporary injunction sought by numerous dispensaries and growers and processors to halt the state's medical marijuana research program. The plaintiffs worry that the regulations for the clinical research programs would give an unfair advantage to clinical research partners and growers. The Health Department is now pondering next steps.

Hemp

Illinois Governor Gets Bill Legalizing Industrial Hemp. With a 106-3 House vote Wednesday, the legislature has approved a bill legalizing industrial hemp, Senate Bill 2298. Now it's up to Gov. Bruce Rauner (R) to sign it.

Heroin and Prescription Opioids

US Surgeon General Urges ER Docs to Advocate for Evidence-Based Opioid Treatment. US Surgeon General Dr. Jerome Adams called Wednesday on emergency room physicians to advocate more vigorously for evidence-based opioid treatment, including harm reduction measures. Adams supported such harm reduction interventions as needle exchanges and safe injection sites. [The Department of Health and Human Services has issued a statement claiming that Dr. Adams does not support safe injection sites, and contesting the evidence on them. See update below.] He urged doctors to reach out to and educate stakeholders in their communities. "We have to understand that these policy interventions look different in different parts of the country," Adams said. "We have to understand that public policy means public and that we have to be able to go there and show them that we care before we can share what we know."

Update: A Department of Health and Human Services officer contacted us on Saturday, March 26th, claiming that the report news outlets relied on, including the one we linked to, was inaccurate in stating that Dr. Adams supports safe injection sites. We do not have other reports on his speech at this time to go on. The article linked above has been updated to include a copy of the HHS statement:

"The Administration and the Surgeon General do not support so-called 'safe' injection sites as a means to combat the opioid epidemic and its consequences. In addition, there is no evidence to demonstrate that these illegal sites reduce drug use or significantly improve health outcomes for those with opioid use disorder. So-called 'safe' injection sites lack the necessary scientific support to be considered a standardized evidence-based practice in the U.S."

Another article states that Adams mentioned safe injection sites as being "part of the conversation" in some communities.

Ed: We are in a position to address the administration's characterization of the evidence on safe injection sites, and it is false to the point of absurdity. There is significant evidence that safe injection sites improve health outcomes for persons with opioid use disorders. In fact, multiple journal articles to this effect are available on the website of the National Institutes of Health, a division of Health and Human Services. Here are a few of them:

  • A 2017 study in Canadian Family Physician found that "SISs are associated with lower overdose mortality (88 fewer overdose deaths per 100 000 person-years [PYs]), 67% fewer ambulance calls for treating overdoses, and a decrease in HIV infections."
  • A 2017 article in Harm Reduction Journal notes with citations that evaluation of Vancouver's Insite program showed it was "meeting its objectives of reducing public disorder, infectious disease transmission, and overdose and was successfully referring individuals to a range of external programs, including detoxification and addiction treatment programs.". The article further states that "over 40 peer-reviewed studies have been published which speak to the many benefits and lack of negative impacts of this site."
  • A 2008 article in the American Journal of Public Health reported that the supervised injection facilities in Sydney and Vancouver were "negatively associated with needle sharing... and positively associated with less-frequent reuse of syringes... less outdoor injecting... using clean water for injection... cooking or filtering drugs prior to injecting... and injecting in a clean location," that "[b]oth... were effective gateways for addiction treatment, counseling, and other services," and that there were no "reported overdose deaths in a SIF."
  • A 2014 article in Drug and Alcohol Dependence found that "[s]eventy-five relevant articles... converged to find that SISs were efficacious in attracting the most marginalized PWID, promoting safer injection conditions, enhancing access to primary health care, and reducing the overdose frequency" and that "SISs were found to be associated with reduced levels of public drug injections and dropped syringes."
  • A 2008 article in the Canadian Medical Association Journal found "Vancouver's supervised injection site is associated with improved health and cost savings."
  • A 2010 article in Addiction found that if Vancouver's supervised injection facility "were closed, the annual number of incident HIV infections among Vancouver IDU would be expected to increase from 179.3 to 262.8. These 83.5 preventable infections are associated with $17.6 million (Canadian) in lifetime HIV-related medical care costs, greatly exceeding Insite's operating costs, which are approximately $3 million per year."

Chronicle AM: Hemp News, San Antonio Could Finally Get a Legal Needle Exchange, More... (5/17/18)

There's good and bad news on hemp today, a new Rhode Island marijuana legalization bill is filed, San Antonio moves toward the first legal needle exchange in Texas, and more.

Hemp fields are starting to pop up. (Vote Hemp)
Marijuana Policy

Rhode Island Marijuana Legalization Bill Introduced. Sen. Joshua Miller (D-Providence) Thursday filed a bill to tax and regulate marijuana. He's been introducing similar bills since 2014. The bill would tax pot at 10% in addition to the state's 7% sales tax, as well as allowing up to another 3% in local taxes. Adults could possess up to an ounce and grow up to two plants. The bill is not yet available on the legislative web site.

Hemp

House Republicans Block Votes on Hemp Amendments. The House Republican leadership has blocked several proposed industrial hemp amendments from being considered on the House floor. Proponents had hoped to add the amendments to the farm bill now under consideration, but the House Rules Committee put the kibosh on that. Chairman Rep. Pete Sessions (R-TX) has a reputation for blocking marijuana-related measures, and he just upheld it again.

Arizona Governor Signs Hemp Bill. Gov. Doug Ducey (R) has signed into law Senate Bill 1098, which will create a state pilot program allowing the study and cultivation of industrial hemp. Growing, processing, and transporting hemp will require permits from the state Department of Agriculture.

Indiana Lawmakers Will Study Hemp -- Not Medical Marijuana -- This Summer. An interim legislative committee will spend the summer considering the legalization of hemp, but the panel "will not look into issues related to medical marijuana."

Harm Reduction

Ithaca Mayor Calls on New York Governor to Approve Safe Injection SitesThere. Mayor Svante Myrick (D) has asked Gov. Andrew Cuomo (D) to approve a safe injection site in Ithaca. The move comes after New York City announced a plan for four safe injection sites there. "The overdose crisis is statewide and the pilot intervention should be too," Myrick wrote to Cuomo. "This epidemic is also a rural epidemic and our solutions will need to address that reality. Start with Ithaca." The Ithaca Municipal Drug Policy Committee recommended in February 2016 that a supervised consumption pilot program should be implemented in Ithaca.

San Antonio Could Become First Legal Needle Exchange Site in Texas. A decade after a local prosecutor arrested three volunteers for a clean needle program, city officials are set to sing a different tune. Next week, city and county officials, health care providers, drug treatment providers, law enforcement, and nonprofits will meet to discuss how to make San Antonio the first city in the state to have a legal needle exchange program. Stay tuned.

Law Enforcement

Justice Department to Add More Than 300 New Prosecutors. DOJ announced Thursday that it is creating 311 new assistant US attorney positions, the largest increase in prosecutors in decades. More than half will focus on violent crime, 86 on civil enforcement, and 35 on immigration-related crime. Most of the new positions in civil enforcement will be focused on his department's newly created task force targeting opioids. "Under President Trump's strong leadership, the Department of Justice is going on offense against violent crime, illegal immigration, and the opioid crisis -- and today we are sending in reinforcements," Attorney Geneal Sessions said in a statement.

International

Thai Interim Cabinet Approves Medical Marijuana, Decriminalizes Hemp, Kratom, Opium. The interim cabinet has approved a bill that would allow the use of marijuana for medical reasons, as well as decriminalizing the consumption of hemp, kratom, and opium. "The approval of this bill is an important matter," government spokesman Sansern Kaewkamnerd said. "Class 5 narcotics were allowed for cultivation and extraction… but not for consumption, which made it impossible to use them for research on humans. The bill now goes before the interim assembly.

Chronicle AM: McConnell Just Says No to Legal Weed, Walmart Tightens Prescribing, More... (5/9/18)

Mitch McConnell just says no, a House committee advances a VA medical marijuana bill, Pennsylvania's governor and attorney general aren't down with a Philadelphia safe injection site, and more.

Mitch McConnell is down with hemp, but not pot. (Flickr/Gage Skidmore)
Marijuana Policy

Mitch McConnell Confirms GOP Still the Party of "No" on Legal Marijuana. Senate Majority Leader Mitch McConnell (R-KY) said he was not interested in legalizing marijuana, even though his Democratic counterpart, Minority Leader Chuck Schumer (D-NY) has endorsed it. "I do not have any plans to endorse legalization of marijuana," McConnell said. McConnell is pushing for the legalization of hemp, though: "These are two entirely separate plants," McConnell said. "I hope everybody understands that. It is a different plant. It has an illicit cousin which I choose not to embrace."

Medical Marijuana

House Committee Advances Veterans Affairs Medical Marijuana Research Bill. The House Veterans' Affairs Committee Tuesday unanimously approved a measure that aims to increase VA research on medical marijuana. The bill would specify that the agency has the ability to research the herb for conditions including PTSD. The measure is part of a package of bills lawmakers hope to pass this month.

Missouri Senate Gives Initial Approval to Medical Marijuana Bill. The Senate Tuesday gave initial approval to House Bill 1554, which would allow people suffering from specified serious illnesses to use non-smokeable medical marijuana. The bill has already passed the House and now goes to the Senate Committee on Health and Pensions for a second reading. If it survives that, it then goes to the full Senate for a floor vote.

Utah "Right To Try" CBD Medical Marijuana Law Now in Effect. A limited medical marijuana law is now in effect. Under House Bill 195, which passed in March, terminally ill patients will be able to access CBD cannabis oil under a provision that expands the state's 2015 Right to Try Act. Also now in effect is House Bill 197, which establishes a medical marijuana cultivation program in the state. Both of these laws could soon be irrelevant, though: A much broader medical marijuana initiative will be on the ballot in November.

Heroin and Prescription Opioids

Study: Prescription Drug Monitoring Programs Have Little Effect on Overdose Deaths. A new study from Columbia University's Mailman School of Public Health finds that prescription drug monitoring programs may be only "marginally effective" in reducing drug overdose deaths. "What it really offers is this cautionary tale that says a few things. One, the amount of money and resources that are going into these programs need to be evaluated to understand what their ultimate costs are," social epidemiologist David Fink said. "Studies have come out in the past looking at reduced prescribing behavior, but we're taking it to the next level -- looking at fatal or nonfatal overdoses. And what we're seeing is that when you actually look at the literature, it isn't that strong to support" the programs. The study also found that half the studies looking at heroin overdose rates found a significant increase after prescription drug monitoring programs were implemented.

Walmart Tightens Opioid Prescription Policies. The nation's largest pharmacy chain announced Monday that beginning within 60 days, it will only fill first-time acute opioid prescriptions for a week or less nationwide. It will also limit dosages to 50 morphine milligram units per day. Walmart didn't say what it would do about patients who require greater dosages than that.

Harm Reduction

Officials in Philadelphia want a safe injection site in a bid to reduce drug overdoses that killed more than 1,200 people in the city last year, but the Democratic governor and attorney general aren't on board. A spokesman for Gov. Tom Wolf said the idea "presents a number of serious public health and legal concerns, while a spokesman for Attorney General Josh Shapiro said changes in federal law would have to come before he could support a safe injection site.

Chronicle AM: NYC Mayor Endorses SIFs, CO Cannabis Tasting Room Bill Passes, More... (5/4/18)

Colorado could become the first state with a marijuana social consumption law, a new poll suggests New Yorkers are ready to free the weed, New York City's mayor gets behind safer injection facilities, a leading Colombian presidential contender trashes the drug war, and more.

Vancouver's InSite safe injection site. Could New York City be next? (Wikimedia)
Marijuana Policy

Colorado Marijuana "Tasting Rooms" Bill Goes to Governor. A groundbreaking bill that would allow customers at pot shops to consume small amounts of marijuana through edibles or vaping has passed out of the legislature and is now at the desk of Gov. John Hickenlooper (D). The measure, House Bill 1258, would, if signed into law, make Colorado the first state to adopt some sort of social consumption provision for marijuana.

New York Poll Shows Strong Support for Legalization. A Quinnipiac poll released Thursday has support for legalization among New Yorkers at 63%. That's the highest ever for Quinnipiac in the state, and it's up seven percentage points from a February Siena College Research Institute poll that had support at 56%.

Medical Marijuana

Louisiana House Kills Medical Marijuana Expansion Bill. The House on Thursday voted down House Bill 826, which would have allowed any pharmacist in the state to open a medical marijuana dispensary. Instead, the state will maintain the status quo, which allows only nine pharmacies in the state to dispense medical marijuana.

New Hampshire Senate Delays Bill to Allow Patients to Grow Their Own. The Senate on Thursday refused to pass a bill that would allow medical marijuana patients to grow their own plants. Instead, the body voted to send House Bill 1476 to interim study, effectively killing it for the session.

Harm Reduction

New York City Mayor Endorses Safer Injection Facilities. Bowing to growing pressure from community activists and public health specialists, Mayor Bill de Blasio on Thursday endorsed a plan to set up at least four safe injection site pilot projects in the city after a year's worth of consultations with stakeholders. The nation's largest city now joins Philadelphia, San Francisco, and Seattle in racing to be the first to open a permitted safe injection site in the US.

International

Leading Colombian Presidential Candidate Calls for End to Drug War. Gustavo Petro, the former mayor of Bogotá and one of the leading contenders in presidential elections set for the end of this month, has denounced Colombia's militarized drug war and its subservience to US drug war interests. "The militaristic approach to drugs has been effective," he said on May Day, adding that the country should instead implement "social policies in the regions where drugs are cultivated and help people escape the mafia."

NYC Mayor de Blasio Endorses Safe Injection Site Plan

Just a day after close to a hundred community activists, reform advocates, and local elected officials took to the streets outside New York City's City Hall Wednesday to demand that Mayor Bill de Blasio (D) move on a long-delayed feasibility study on safe injection sites, the mayor has moved -- and further than they expected.

New York City Mayor Bill de Blasio comes out for safe injection sites. (Flickr)
On Thursday evening, the mayor's office announced de Blasio's support for a plan to open four of the sites, which the office refers to as Overdose Prevention Centers, a year from now, after a period of consultation with stakeholders.

"After a rigorous review of similar efforts across the world, and after careful consideration of public health and safety expert views, we believe overdose prevention centers will save lives and get more New Yorkers into the treatment they need to beat this deadly addiction," de Blasio said in a statement.

Safe injection sites (SISs) -- or safe injection facilities or supervised injection facilities or supervised consumption sites or overdose prevention centers -- allow drug users to inject (or sometimes inhale) their own drugs under medical supervision. They typically also have a social services component that aims to assist drug users in finding drug treatment and other services.

Operating in around 90 cities in Europe, Australia, and Canada, they are a proven harm reduction intervention. Numerous peer-reviewed scientific studies have shown they reduce public disorder; increase access to treatment, reduce the risk of HIV, Hep C, and bacterial infections; reduce drug overdose deaths; and reduce medical costs thanks to a reduction in disease and overdose, while at the same time increasing access to cost-saving preventive healthcare. What SISs don't do, the studies have found, is increase crime, injection drug use, or the initiation of new drug users.

Yet no such sites operate in the United States. Pushes are underway in several cities, including Philadelphia, San Francisco, and Seattle, but all have faced challenges ranging from moralism and NIMBYism to the fact that they would appear to violate federal law. Just this week, DEA spokesman Melvin Patterson said they violate the Controlled Substances Act and are "subject to being prosecuted." Given the proclivities of the Trump administration, that is probably not a threat to be taken lightly.

Still, the cities are willing to push on the issue, the American Medical Association has endorsed the notion, and legislatures in a number of states are pondering bills to allow them. And now, with the country's largest city coming on board, momentum for the sites is only growing stronger.

In New York City, where the SIF NYC Campaign, a coalition of dozens of community, drug reform, public health, medical, and religious groups has been pressuring the administration to act for months, the mayor's announcement was greeted with relief.

"Mayor de Blasio's embrace of safer consumption spaces is a critical step forward in preventing overdose deaths in New York City. We know that safer consumption spaces are an evidence-based solution that can help dramatically in saving lives, reducing criminalization, and improving public health," said Kassandra Frederique, New York state director at the Drug Policy Alliance. "New York can and must be a leader now in saving lives by opening safer consumption spaces swiftly."

That will take some political acumen in dealing with city district attorneys and the state Health Department, which answers to Gov. Andrew Cuomo, with whom de Blasio's relations are strained at best. It will also take some political fortitude in taking on the Sessions Justice Department and the DEA.

De Blasio's announcement marks the successful culmination of the campaign to bring the city on board with safe injection sites as a harm reduction and overdose prevention measure, but it's just the beginning of the fight to actually get them up and running.

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