Overdoses

RSS Feed for this category

Chronicle AM: Yang on Safe Injection Sites, Bloomberg on Marijuana, More... (12/5/19)

Michigan pot shops see high demand on opening day, Democratic contenders stake out drug policy positions, Maine finally has all pot business applications ready, and more.

Andrew Yang wants to decriminalize opiates and fund safe injection sites like this one in Vancouver. (vch.ca)

Marijuana Policy

Michael Bloomberg Backs Decriminalization as Marijuana Views Evolve Amid Presidential Run. Faced with criticism over his past positions on marijuana, former New York City mayor and Democratic presidential contender Michael Bloomberg has now come out in support of decriminalization, which still leaves him lagging behind most of the Democratic pack. "He believes no one should have their life ruined by getting arrested for possession, and, as a part of his reform efforts that drove incarceration down by 40 percent, he worked to get New York State laws changed to end low-level possession arrests," a spokesman said. "He believes in decriminalization and doesn’t believe the federal government should interfere with states that have already legalized."

Maine Says All Marijuana Licenses are Now Available. More than three years after voters legalized marijuana, the state has finally made available all applications for marijuana cultivation, products manufacturing and retail facilities. That means the state could see pot shops open by the spring.

Michigan Pot Shops Forced to Impose Purchase Limits as Demand Overwhelms. High customer volume is forcing marijuana retailers to limit purchases so there will be enough weed to go around. The four shops that opened Sunday saw combined sales of $221,000 that first day. Each of the four shops has had to turn customers away, too. Some customers waited as long as four hours to get inside.

Medical Marijuana

Florida Senator Introduces Bill Providing Broad Employment Protections to Medical Marijuana Users. A bill recently introduced by state Sen. Lori Berman (D) Would provide various protections to job applicants and employees who use medical marijuana. The measure is Senate Bill 962.

Harm Reduction

Andrew Yang Calls for Investments in Safe Injection Sites. Entrepreneur and Democratic presidential contender Andrew Yang says he supports government funding for safe injections sites as part of an effort to counter the country's overdose epidemic. "I would not only decriminalize opiates for personal use but I would also invest in safe consumption sites around the country," Yang said Thursday.

(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.)

Cheaper and More Accessible Naloxone In the Works, Colombian Drug War Critic is Now President, More... (8/8/22)

A Congressional Research Service report zeroes in on the Jalisco New Generation Cartel, the Remedy Alliance is easing naloxone bottlenecks, and more.

Colombian President Gustavo Petro (Creative Commons)
Harm Reduction

Naloxone Access About to Get Easier. Thanks to an informal buyers' club for naloxone that has morphed into an entity known as the Remedy Alliance, access to inexpensive naloxone -- the opioid overdose reversal drug -- is getting easier. The Alliance credits two major developments for the urgently needed breakthrough. First, they have managed to reach agreements with drug manufacturers to get the drug at a discount rate, and second, they have restructured to a system that allows local harm reduction groups to order the drug through an online store, getting around a labyrinthine web of federal regulations that has bottlenecked the flow of the drug amidst the ongoing overdose crisis.

"We think this will totally change the landscape of naloxone in the United States,: said Nabarun Dasgupta, the nonprofit's board president and a scientist at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. The group, formerly known as the Opioid Safety and Naloxone Network Buyers Club, has already reversed thousands of opioid overdoses and distributed 1.3 million doses of naloxone last year. Now, the Alliance expects to distribute 2 million doses this year.

International

Ex-Leftist Rebel, Drug War Critic Assumes Office as Colombia's President. Gustavo Petro, a former member of the leftist M-19 guerrilla army, was sworn into office Sunday, helping to cement an emerging leftist bloc around the region, consisting of Bolivia, Chile, Mexico, Peru, Venezuela and, most likely, Brazil after its October election. He said Colombia was getting a "second chance" to fight violence and poverty. He also said he was preparing to start peace talks with various armed groups around the country, and he called on the United States to change its prohibitionist approach to drug policy. "It's time for a new international convention that accepts that the war on drugs has failed," he said. "Of course, peace is possible. But it depends on current drug policies being substituted with strong measures that prevent consumption in developed societies."

Jalisco New Generation Cartel Present in 27 of Mexico's 37 States, Congressional Report Finds. The Jalisco New Generation Cartel (CJNG), the country's most powerful, now operates in 27 states and Mexico City, according to a new report from the Congressional Research Service (CRS). The report, "Mexico: Organized Crime and Drug Trafficking Organizations," says that the CJNG is the dominant criminal force in six states: Jalisco, Nayarit, Colima, Guerrero, Mexico, and Veracruz. It is weakest in Mexico's northwest, where the Sinaloa Cartel still dominates. CRS described the CJNG as an "extremely powerful cartel" that has a "reputations for extreme and intimidating violence." It also noted that the DEA "considers the CJNG a top US threat and Mexico's best-armed criminal group." "The CJNG built its dominance internationally first through extending its presence through a rapid expansion inside Mexico," CRS said. "In 2016, many analysts maintained the CJNG controlled a territory equivalent to almost half of Mexico. The group has battled Los Zetas and Gulf Cartel factions in Tabasco, Veracruz, and Guanajuato, as well as the Sinaloa… [Cartel] in the Baja Peninsula and Chihuahua." The CJNG's ambitious expansion campaign was characterized by high levels of violence, particularly in Ciudad Juárez and Tijuana.

By taking over key ports on both the Atlantic and Pacific coasts, the CJNG has consolidated "important components of the global narcotics supply chain," the CRS said. "In particular, the CJNG maintains reported control over the ports of Veracruz, Manzanillo, and Lázaro Cárdenas, which has given the group access to precursor chemicals that flow into Mexico from China and other parts of Latin America," the report said. As a result, according to some analysts, the CJNG has pursued an aggressive growth strategy underwritten by US demand for Mexican methamphetamine, heroin, and fentanyl… Despite leadership losses, the CJNG has extended its geographic reach and maintained its own cohesion while exploiting the infighting among factions of the Sinaloa organization."

Chronicle Book Review: American Cartel

American Cartel: Inside the Battle to Bring Down the Opioid Industry, by Scott Higham and Sari Horwitz (2022, Twelve Press, 400 pp., $30.00 HB)

Phillip S. Smith, with contributions from David Borden

https://stopthedrugwar.org/files/americancartel.jpg
Pulitzer Prize-winning Washington Post investigative reporters Scott Higham and Sari Horwitz have been on the opioid beat for years, teaming up (with others) on the Post's "The Opioid Files" series, which was nominated for a Pulitzer in 2020. Now, with American Cartel, the pair provide a deeply-sourced account of how opioid manufacturers, distributors, and pharmacies waged an all-out campaign to fend off DEA efforts to stanch the flow of billions of opioid pain pills, and to evade any culpability, even as the overdose death toll mounted year by year.

The picture Higham and Horwitz paint of corporate and political malfeasance is damning. But the laser sharp focus with which they paint it, omits much of the context in which the opioid crisis has unfolded. And that context is also very important.

An article in yesterday's Guardian shows one of the reasons why. In much of the world, very few pain patients are able to access opioids at all. Much suffering results, sometimes leading to suicide attempts. Dr. MR Rajagopal, chair of Pallium India, told the Guardian, "Pain is not visible. It happens in hospital beds or patients' rooms and is not visible to the world. Addiction, on the other hand, is very visible in headlines which quote the US epidemic and overdose deaths. No one talks about the western European success over decades; all the news is about the opioid crisis in the USA. This means that when we try to have discussions, our work becomes harder because many minds are primed against opioids."

In other words, by speaking too solely to one side of an issue, one risks adversely impacting the other sides. Whether "opiophobia" is real or significant in the US is another question. Higham and Horwitz don't venture a view on this, at least not in American Cartel.

One entity that has warned about opiophobia (without using the term) is the US Centers for Disease Control. In a 2019 memo, CDC writes that a 2016 guidance the agency issued on prescribing opioids for chronic pain had seen "misapplication[s]" by some physicians that put patients at risk. The memo cites a New England Journal of Medicine commentary by the authors of the 2016 guidance. It warns against "hard limits" on opioid dosages or cutting patients off; abrupt tapering of prescriptions; applying the guidance to acute pain situations patients face in situations like active treatment for cancer or sickle cell anemia or post-operative care; and applying it to medication-assisted treatment prescriptions for addiction.

Technically the CDC memo addressed a period of a few years beginning in 2016. But the dynamics it describes are inherent risks in a situation where providers are charged with supplying a substance that's useful but also addictive and potentially deadly if misused, and for which they can be sanctioned professionally or even prosecuted and imprisoned if things go wrong or someone disagrees. Pharma-driven promotion of their new opioid products was a factor in driving up prescribing rates to where they reached. But a part of the increase was also the medical community reacting to a real problem of under-treatment or non-treatment of pain for some patients, a problem that coexists with over-prescribing to some other patients. That increase in turn came with a learning curve.

The authors also give short shrift to the impact of today's woes and inequalities in driving the so-called deaths of despair -- a concept coined by Princeton professors Anne Case and Angus Deaton -- alienation and anomie, helplessness and hopelessness afflicting many Americans who have been left behind in the modern economy, especially in the opioid use heartlands of the Midwest and Appalachia. The Midwest deindustrialized beginning in the 1970s, and both regions largely missed out on the tech boom of the '90s and '00s. Then came even more pain with the Great Recession, followed by COVID and more economic and social disruption. People there (and elsewhere) are dying not just of opioids, but of smoking, drinking, and suicide. Big Pharma is easily (and oh so deservingly) demonized, but the laser focus on the companies allows us not to have to look in the mirror about the pain our society produces.

That factors like these should play a role in the opioid crisis, though, doesn't exonerate Big Pharma. Rather, the misleading promotions of their products carried out by pharma, took an even greater toll due to the vulnerabilities those other factors had brought to the fore.

Meanwhile, the death toll continues to mount -- over 100,000 per year, and with a new record high every year. Prescription opioids still figure prominently in overdoses. But the greatest part of the problem by far is black-market fentanyl, used deliberately by some high tolerance heavy users of opioids, but primariy causing overdose as an adulterant in heroin, counterfeit prescription pills, and other street drugs, essentially a poisoning crisis. But as Higham and Horwitz note, that is part of a wave of opioid use that began with pharmaceutical companies such as Purdue Pharma taking Oxycontin onto the market in the late 1990s. The first decade of this century also saw other prescription opioids -- oxycodone, hydrocodone, Vicodin, Percocet, Opana, et al. -- hit the market.

Higham and Horwitz are fond of tossing around astounding numbers of pills produced by manufacturers or sold by certain pharmacies, such as Mallinckrodt producing 3.5 billion 30 milligram hydrocodone pills in one year, and critics could protest that those numbers need context, too. A prescription for a medication doesn't just have a number of pills to take. It specifies how large a dosage there is inside each pill. A smaller number of pills that each contain a higher dose might mean more than a larger number that each contain a smaller dose. And a higher dose prescription sometimes reflects a patient's tolerance to opioids built up through past medical (or non-medical) use. Maybe West Virginia didn't really need 81 million pain pills during a five-year span. But maybe it did. Without more information, it's just not clear what these numbers mean.

They do provide some context, though, for example by comparing pain pill sales across all drug stores in a region and pointing out anomalies not easily explainable by, say, differing rates of cancer or other serious illness. And they demonstrate that plenty of businesses -- from Big Pharma to the drug store chains and individual pharmacies -- were either in it for the money or at best screwed up, both through detailed analysis and telling anecdote. For example, there was the guileless Florida pharmacist who explains to investigators that she fills pain pill prescriptions all day long, but always keeps a certain number of pills on reserve "for my real pain patients."

When the DEA cracked down first on Wild West internet sales of opioids and then on the "pill mills," medical practices with perfunctory examinations and huge numbers of opioid prescriptions whose entire business model seemed to be writing opioid prescriptions, it succeeded in reducing access to those drugs. But the people using opioids didn't stop; they went to black market drugs, fueling first a resurgence in heroin use and now an opioid crisis driven by fentanyl.

A key figure in the tale is Joe Rannazzisi, who as head of DEA's Office of Diversion Control from 2006 to 2015 oversaw the agency's endless effort to ensure that prescribed opioids are only prescribed for legitimate medical purposes and not leaking into the black market. We are inclined to think of the DEA as a prohibitionist agency, but in this case, it is acting as a regulatory agency. And what Higham and Horwitz uncover is a case of regulatory capture -- when the industry being regulated manages to set the terms under which it is regulated, for its own benefit, not that of the public.

Rannazzisi and his team of DEA lawyers spent years going after opioid manufacturers, distributors, and pharmacy chains who were repeatedly (administratively) busted for failing to do due diligence about just who was buying their products. The companies would pay huge fines, promise not to do it again, and then continue to pump massive amounts of opioids through the supply chain.

The companies mobilized against Rannazzissi and his campaign, forming industry front groups, undertaking lobbying efforts, hiring legions of high-priced law firms, and crafting legislation that would rein in what they saw as an out-of-control agency. As Higham and Horwitz document in great detail, it worked.

Sponsored by Rep. Tom Marino (R-PA) and Sen. Marsha Blackburn (R-TN), both of whom received substantial contributions from the industry, but written by industry lobbyists, the nicely named Ensuring Patient Access and Effective Drug Enforcement Act removed from the DEA tools that Ranizzisi had been using to try to force drug distributors to monitor and report suspicious orders, such as the 1.2 million oxycodone tablets one distributor bought from Mallinckrodt in one day, only to order another 1.2 million the next day.

The bill passed, only to be drastically revised amidst scandal after an earlier Post report on the opioid bill derailed then-President Trump's effort to name Marino drug czar. But Higham and Horwitz also detail rot inside the DEA, where the industry managed to get to high-ranking officials who sidelined Rannazzisi, forcing him into retirement and forcing many of his team members into bureaucratic Siberia. It's an ugly little story of money and power, the sort that is all too common in Washington.

If the first part of American Cartel reads like a detective novel, the second part is more like a legal thriller, It covers the massive wave of civil lawsuits filed against the drug companies, and it is not particularly edifying reading. You see hundreds of high-powered attorneys from the country's top litigating firms -- including dozens of former DEA attorneys working now working for the industry they regulated -- facing off against armies of lawyers for the thousands of states, cities, and counties. You see massive settlements from the companies and massive damages wrested from companies that went to court and lost. While it is unclear just how the moneys won or negotiated by the various plaintiffs is actually being used to help people who suffered from the opioid crisis, what is clear is that it has been a bonanza for the legal profession, with winnings -- excuse me, earnings -- by attorneys reaching well over a billion dollars.

They weren't all in it for the money, though. Some, like West Virginia attorney Paul Farrell, whose state was one of the epicenters of the pain pill epidemic, were sickened by the toll of addiction they saw all around them. Not willing to settle for the pittance the town and county he represented would receive under a massive settlement agreed to by most of the suing entities, he gambled on going it alone against the drug distributors. As this book went to print in April, he was still waiting for a decision. Earlier this month, he lost, with a federal judge ruling that drug distributors were not responsible for the area's opioid crisis.

The litigation goes on, and the dying goes on. Sometimes the drug companies settle, sometimes they lose and have to pay even more. But sometimes they win.

The profit-driven wave of opioids that engulfed the country in the last couple of decades is not an anomaly. The pharmaceutical companies have a historical pattern of creating and marketing drugs that later wreak havoc. That's what they did with amphetamines, that's what they did with barbiturates, that's what they did with benzodiazepines. It's almost enough to make one wonder if profit-driven capitalist enterprises should be in charge of the nation's drug supply.

Read Higham and Horwitz's book. But read Case and Deaton's too. And when you see the next "pill mill" story, don't assume that it is, or isn't, what it seems.

California is One Signature Away from Okaying Safe Injection Sites [FEATURE]

The nation's most populous state is on the verge of approving safe injection sites in some of its largest cities. A bill that would do just that, Senate Bill 57, narrowly won its final vote in the legislature Monday, and Gov. Gavin Newsom (D) has previously signaled that he was "very open" to the law.

Vancouver's InSite safe injection site. Such facilities could be coming soon to some California cities. (vch.ca)
The bill authored by Sen. Scott Wiener (D-San Francisco) authorizes what it calls "overdose prevention programs" (or safe injection sites) as pilot programs in San Francisco, Oakland, the city of Los Angeles, and Los Angeles County. In each of those jurisdictions, city councils or boards of supervisors have requested inclusion in the bill and will decide whether and how to participate. The pilot program will run for five years, through January 1, 2028.

The legality of safe injection sites under federal law remains unclear. During the Trump administration, the Justice Department strongly opposed them and successfully blocked an effort to open one in Philadelphia, but the Biden administration Justice Department has expressed openness to the harm reduction intervention.

That uncertainty did not stop New York City from opening the first government-approved safe injection sites last November or Rhode Island passing legislation and following suit in March, although the Rhode Island sites are being hobbled by a lack of funding after legislators mandated that no government funds be used to operate them. And that uncertainty has not deterred lawmakers in Sacramento, either.

The California bill overcame extensive pushback, primarily from law enforcement, which argued that the sites failed to provide a strong enough path to drug treatment. Similar objections killed three previous attempts to pass safe injection site legislation by Sen. Susan Eggman (D-Stockton), including a 2018 bill that passed the legislature only to be vetoed by then-Gov. Jerry Brown (D).

It was supported by a broad coalition of organizations including the Drug Policy Alliance, San Francisco AIDS Foundation, California Society of Addiction Medicine, National Harm Reduction Coalition, Healthright 360, Tarzana Treatment Center, and the California Association of Alcohol & Drug Program Executives.

Support for the bill was also heightened by significant increases in drug use and overdoses since the beginning of the coronavirus pandemic. San Francisco saw a record number of overdose deaths in 2020, with 711 deaths total. In 2021, 640 people died of overdoses, and the city is on track to exceed that number this year. Statewide, approximately 10,000 people died of drug overdoses from April 2020 to April 2021.

"California -- like our nation as a whole -- is experiencing a dramatic and preventable increase in overdose deaths, and we need every available tool to help people stay alive and get healthy," said Senator Wiener after the final vote. "Safe consumption sites are a proven model to help people avoid overdose deaths, reduce HIV and hepatitis transmission, reduce syringe litter, and help people access treatment. This legislation isn't about whether we want people to use drugs. Rather, it's an acknowledgment that people *are* using drugs, and our choice is whether we want to make every effort to help them survive and get healthy. The time has come for California to adopt this proven overdose death prevention strategy."

Safe injection sites have been operating for decades in Europe, Canada, and Australia and have a proven safety track record. At the 170 safe injection sites that have operated around the world, not a single overdose death has been reported. In New York City, in the first three months of operation, staff at these sites were able to halt over 150 overdoses.

Safe injection sites are a proven harm reduction intervention that saves lives without increasing crime or disorder. The Biden administration does not appear to be inclined to claim they violate federal law and has made no move against the sites operating in New York and Rhode Island. It appears the path is open. All Gov. Newsom has to do is pick up his pen and sign the bill.

Australia's First Drug Checking Site Opens This Week, TX Bill Would Make Legal Pot a Local Option, More... (7/19/22)

There are marijuana reform rumblings in the Lone Star State, Ohio becomes the latest state to see a fentanyl test strip decrim bill, and more.

Texas State Capitol (Daniel Mayer, Wikimedia)
Marijuana Policy

Texas Bill Would Let Cities, Counties Legalize Marijuana. State Rep. Jessica Gonzalez (D-Dallas) has filed a bill, House Bill 3248, that would let cities and counties the option of locally legalizing recreational marijuana use, possession, and sales. The bill would also impose a 10 percent tax on marijuana products, with 10 percent of that going to pay for regulation, another 10 percent to pay for marijuana testing and quality control, 20 percent to participating local governments for oversight, and the rest would go into the state school fund. "While Texas has made progress with the Compassionate Use Act, we have been left behind on a potential revenue source that would increase investments in public education, stop the unnecessary arrests for cannabis possession and create jobs in our state," González said. "We should allow our local communities to make the best decision for themselves in regards to cannabis legalization, and HB 3248 would allow that for adults 21 years or older." The bill faces long odds in the GOP-dominated legislature.

Medical Marijuana

Texas Agriculture Commissioner Calls for Expanded Medical Marijuana Access. State Agriculture Commissioner Sid Miller (R) says he supports the expansion of medical marijuana access and nodded toward other conservative states that have fully legalized medical use. Governments should only be able to make something illegal "for a powerful reason or set of fact," he wrote in a letter, comparing pot prohibition to the alcohol Prohibition of the 1920s. "As I look back, I believe that cannabis prohibition came from a place of fear, not from medical science or the analysis of social harm. Sadly, the roots of this came from a history of racism, classism, and a large central government with an authoritarian desire to control others. It is as anti-American in its origins as could be imaginable,"he wrote. It is time for all of us, including the Governor, members of the Texas Legislature and others to come together and set aside our political differences to have an honest conversation about cannabis: where we have been, where we are going and what role government should properly play," Miller ended his letter. "We owe it to our fellow Texans, especially those who are suffering, to lead or just get out of the way if we cannot formulate effective cannabis policy for Texas."

Harm Reduction

Ohio Bill Would Decriminalize Fentanyl Test Strips. Ohio could become the latest state to decriminalize or legalize fentanyl test strips as a harm reduction measure aimed at reducing overdose deaths. State Rep. Kristin Boggs (D-Columbus) has filed House Bill 456 would decriminalize fentanyl drug testing strips. They are currently classified as drug paraphernalia, but that hasn't stopped them from beginning to pop up in bar bathrooms in Cincinnati. Fentanyl, a synthetic opioid, is increasingly adulterating other illicit drugs or appearing as counterfeit prescription opioids. In Ohio, nearly two-thirds of 1,497 cocaine overdose deaths last year were caused by drugs laced with fentanyl. The bill has just been filed, but has garnered no opposition so far.

International

Australia's First Fixed Drug Checking Site to Open This Week in Canberra. Beginning on Thursday, Australia's capital city, Canberra, will host the country's first fixed location drug checking site. Previously, drug testing has twice been done at music festivals. The move comes as the Australian Capital Territory prepares to implement drug decriminalization. "This Australian-first program will help people who use drugs better understand or avoid unknown and potentially dangerous substances in illicit drugs," said ACT Health Minister Rachel Stephen-Smith.

"We know the safest option is not to take drugs and this will always be our advice to the community. However we recognize some people will choose to use drugs and there is a need for initiatives that reduce the harms associated with drug use."

Big Increase in Injection Drug Use, House Passes Another Spending Bill with SAFE Banking, More... (7/18/22)

British Tories audition a new scheme for punishing drug users that effectively decriminalizes somebody's first two drug busts, a new study finds racial disparities in Pennsylvania marijuana arrests are increasing, and more.

The number of Americans injecting drugs increased five-fold in the past decade. (Creative Commons)
Marijuana Policy

House Passes Defense Spending Bill with Marijuana Amendments. The House last Thursday approved the National Defense Authorization Act, which includes nine amendments pertaining to marijuana and other drug policies. Included in the House version of the bill is language from the Secure and Fair Enforcement (SAFE) Banking Act, language allowing Department of Veterans Affairs doctors to allow medical marijuana recommendations, and two psychedelic research amendments. The SAFE language, which the legal marijuana industry is clamoring for, has been passed in the House as part of several earlier omnibus spending bills, only to be killed in the Senate by Majority Leader Charles Schumer (D-NY) and his allies, who have been holding out for passage of a full-blown marijuana legalization bill. We shall see if it turns out any differently this time.

Black Pennsylvanians See More Racial Bias in Marijuana Arrests. A new study from the National Organization for the Reform of Marijuana Laws (NORML) finds that racial disparities in marijuana arrests jumped upward in 2020, even though overall pot arrests declined. Black Pennsylvanians were five times more likely to be arrested for marijuana statewide. The largest disparity was in Cumberland County, where Blacks were 18 times more likely to be arrested for pot than Whites. "I will say that the numbers moving in the wrong direction is certainly a concern," said Executive Director of the Pennsylvania Cannabis Coalition Meredith Buettner. "This is all the more reason that we really need to dig into adult use policy here in Pennsylvania, Pennsylvanians." The Republican-controlled state legislature has so far blocked any moves toward legalization.

Drug Policy

CDC Finds Huge Increase in Number of People Injecting Drugs. A new study from the Coalition for Applied Modeling for Prevention (CAMP) and funded by the Centers for Disease Control and Prevention (CDC) shows a rapid increase in the number of people shooting up drugs in the past decade. The most recent data, from 2018, put the number of injection drug users at about 4 million, five times the number in 2011, the last previous estimate. The study also found that overdoses -- both fatal and non-fatal -- had also increased dramatically, with deaths related to injection drug use rising threefold during that period, which was before the current spike in overdose deaths, now around 100,000 a year. For every fatal injection drug overdose, there were 40 non-fatal ones, the study found. The CDC estimates that a third of people who inject drugs share syringes, needles or other drug injection equipment.

International

British Tories Plan to Punish Drug Users, Could Seize Their Drivers' Licenses, Passports. The Home Office has announced a scheme to punish drug users in a bid to "tackle the scourge of drug abuse in society." Under the "three-strikes" proposal, first-time illicit drug offenders, including marijuana offenders, would have to pay for and attend a drug awareness course. A second offense would merit a formal warning, another drug awareness course, and up to three months of mandatory random drug testing. For a third offense, people would be criminally charged and, upon conviction, could be banned from nightclubs and other entertainment venues and could have their drivers' licenses and passports confiscated. But, hey, that is effectively decriminalization for the first two offenses. The proposal will now undergo a three-month consultation period before being amended or implemented as is.

New Poll Could Bolster Vermont Drug Decrim Push [FEATURE]

A recent poll could help breathe new life into a Vermont campaign to decriminalize the possession of small amounts of drugs that died in the House earlier this year. The poll, from Data for Progress and the Drug Policy Alliance (DPA) found a whopping 84 percent of Vermont voters support removing criminal penalties for small-time drug possession.

The legislature didn't get a decrim bill done this year, but a new poll bodes well for the future. (Creative Commons)
Support for decriminalization included a majority of voters across all major demographic groups and party affiliations. The poll also found that 81 percent of voters support reframing the state's approach to drug use as a health issue with a focus on reducing the harms of addiction and offering health and recovery services.

"With Vermont having one of the highest increases in overdoses in the country last year, it's clear that the existing approach of criminalizing people who use drugs isn't working to keep people safe. In fact, it has only made things worse," said DPA senior staff attorney Grey Gardner. "This survey makes it abundantly clear that Vermont voters want a different approach - one focused on health rather than arrest and punishment."

Overdoses are not the only issue plaguing the state's enforcement of drug prohibition. Last November, the Council of State Governments (CSG) issued a report on Vermont prosecutions and court outcomes that found pronounced racial disparities in charging and sentencing decisions. That report found that Black people are over 14 times more likely to be charged with drug felonies that White people. The report also found that Black people are six times more likely to be sent to prison for certain felony offenses -- including drug offenses -- while White defendants more often receive alternatives to imprisonment.

That CSG report was buttressed by years of statewide police data that consistently shows Black motorists being stopped, searched, and cited at higher rates even though they are less likely to be found with contraband than Whites.

"For anyone committed to advancing racial justice in their communities, these findings are critically important and should be acted on immediately," ACLU of Vermont (ACLU-VT) Advocacy Director Falko Schilling said at the time. "They show that extreme racial disparities in Vermont state prosecutions and sentencing decisions are real, and can't be attributed to racist tropes about 'out-of-state drug dealers' when they are, in fact, the result of systemic racism in state prosecutors' offices and courthouses. These findings also help to explain why, year after year, Vermont's prisons have some of the worst racial disparities in the country.

That report helped spur both the creation of broad coalition to push for drug decriminalization, @DecriminalizeVermont, which consists of the ACLU-VT, Better Life Partners, End Homelessness Vermont, Ishtar Collective, Law Enforcement Action Partnership (LEAP), Next Generation Justice, Pride Center of Vermont, Recovery Vermont, Rights and Democracy (RAD), Vermont Cares, Vermont Legal Aid, Vermont Network Against Domestic and Sexual Violence, Vermonters for Criminal Justice Reform, Vermont Interfaith Action, and the Women's Justice and Freedom Initiative.

"Reforming our criminal justice system requires a fundamental shift away from criminalizing behaviors that need not involve police, prosecutors, and incarceration," said the ACLU-VT. "While Vermont has decriminalized possession of marijuana, there is still progress to be made in finally treating substance use disorder as the public health issue that it is. Vermont needs to decriminalize other drug offenses and better account for substance abuse disorder in related offenses, such as trespassing, sex work, and writing bad checks."

The CSG report also prompted a push in the state legislature to get a decriminalization bill passed. That bill, H.644, was cosponsored by nearly one-third of the House, with 42 Democrats, Progressives, and Independents signing on. It was designed to set up a board of drug policy experts to determine threshold levels for personal use amounts, which would then be decriminalized, and to establish a drug treatment referral system to help people access treatment services.

"The whole question of arresting and prosecuting drug possession -- we're not seeing a lot of value. In fact, we're seeing a lot of harm historically," said bill cosponsor Rep. Selene Colburn (P-Burlington).

The bill was introduced on January 14 and got a series of House Judiciary Committee hearings in the next month at which several coalition members testified.

If passed, H.644 would eliminate criminal penalties for drug possession for personal use; establish a treatment referral system by which Vermonters who need help with substance use disorders can access treatment services; set up a board of drug policy experts to determine appropriate personal use threshold levels for each drug; and create a financial incentive for people with substance use disorder to participate in a health needs screening.

"Our current drug laws are overly punitive and deeply harmful. Decriminalize Vermont is working to support a new approach that prioritizes public health and social justice," said Tom Dalton, Executive Director of Vermonters for Criminal Justice Reform. "We are thrilled to see such a positive response to this bill so far this legislative session."

But that is as far as it went. After the hearings, House Judiciary Committee Chair Rep. Maxine Grad (D-Washington) never put the bill up for a committee vote. It died when the legislature adjourned in May.

But now, given that new polling data, there is more evidence than ever that Vermonters are ready for a change.

"What's clear from this poll is that Vermont voters want to prioritize preventing overdose and ending the harms of criminalization, and they want their elected officials to take leadership on this," said DPA's Gardner.

The push for decriminalization may have been thwarted this year, but it isn't going to go away. Look for another attempt next year, and those poll numbers can only help.

Fed Judge Rules for Opioid Distributors in WV Lawsuit, CA Kills Marijuana Cultivator Tax, More... (7/5/22)

A Washington state county commissioner demonstrates her cluelessness about harm reduction, Senate drug warriors file the END FENTANYL Act, and more.

pain pills (Creative Commons)
Marijuana Policy

California Governor Signs Bill Ending Cultivation Tax on Marijuana Growers. Gov. Gavin Newsom (D) has signed into law Assembly Bill 195, a wide-ranging bill to restructure the state's legal marijuana system whose most striking feature is the removal of the wholesale tax on marijuana growers. The aim of the bill is to provide relief to the struggling industry and further erode the marijuana black market. The bill also shifts collection of the state's 15 percent excise tax from the distributor level to the retail level, and it freezes the excise tax for at least the next three years. Aiming at unlicensed operators, the bill allows for fines of up to $10,000 per day for property managers who knowingly rent or lease space to unlicensed marijuana businesses. It also includes $40 million in tax credits, half for equity operators and half for microbusinesses. Social equity operators will also be eligible for a $10,000 tax credit and will be able to keep 20 percent of excise tax revenues for reinvesting in their businesses.

Opiates and Opioids

Bipartisan Group of Senate Drug Warriors File END FENTANYL Bill. Sens. Rick Scott (R-FL), Mike Braun (R-IN), Diane Feinstein (D-CA), and Maggie Hassan (D-NH) have filed the cutely-acronymed Eradicating Narcotic Drugs and Formulating New Tools to Address National Yearly Losses of Life (END FENTANYL) Act (Senate Bill 4440). The bill would require the Commissioner of US Customs and Border Protection (CBP) to update its policies at least once every three years to ensure drug interdiction guidance is up to date. The legislation was prompted by a 2019 GAO report, Land Ports of Entry: CBP Should Update Policies and Enhance Analysis of Inspections, which found drug interdiction guidance has not been updated in 20 years. Scott used a press release about the bill to slam President Biden for his "failed open border policies" even though DEA figures show that 80 percent of fentanyl comes through ports of entry, not in the backpacks of refugees, asylum seekers, and undocumented border crossers.

Federal Judge Rules for Opioid Distributors in West Virginia Lawsuit. A federal judge ruled against West Virginia plaintiffs in a lawsuit seeking damages from three major drug distributors who they accused of causing a public health crisis by distributing 81 million pills in eight years in one county hard hit by opioid addiction. Cabell County and the city of Huntington had sued AmerisourceBergen Drug Company, Cardinal Health, and McKesson Corp.

Plaintiffs argued that the companies sent a "tsunami" of prescription pain pills into the county and that their conduct was unreasonable, reckless, and disregarded the public health. "The opioid crisis has taken a considerable toll on the citizens of Cabell County and the City of Huntington. And while there is a natural tendency to assign blame in such cases, they must be decided not based on sympathy, but on the facts and the law," US District Judge David Faber wrote in the 184-page ruling. "In view of the court's findings and conclusions, the court finds that judgment should be entered in defendants' favor. Plaintiffs failed to show that the volume of prescription opioids distributed in Cabell/Huntington was because of unreasonable conduct on the part of defendants," Faber wrote, noting that the plaintiffs supplied no evidence that the companies distributed opioids to any entity that was not properly registered with the DEA or the state Board of Pharmacy. The city and the county had sought more than $2.5 billion that would have gone toward opioid efforts. The goal of the 15-year abatement plan would have been to reduce overdoses,

Harm Reduction

WA County Commissioner Fears "Normalization" of Naloxone. Amanda McKinney, a Republican Yakima County Commissioner, is concerned that the use of the opioid overdose reversal drug naloxone will be "normalized." She was responding to a presentation by the Board of Health about the increase in drug overdose deaths and the district's overdose awareness campaign, but zeroed in on one sentence: Among the goals of the campaign was "Increase awareness and education about the benefits of naloxone to normalize its use."

That set off McKinney: I'm really concerned about that last slide where it says normalize use. I would really like for us to expand on what that means," McKinney said. "I'm just wondering if there is a better term than normalize, 'cuz normalize to me means we're accepting this and promoting this as part of our daily lives and I think that that word is inappropriate."

Apparently unfamiliar with the notion of harm reduction, she also questioned the effectiveness of needle exchanges and fentanyl test strips. "I'd really like to know what the effectiveness is of fentanyl testing strips and syringe exchange services for actually successfully getting people off and away from being someone who is a habitual drug user," McKinney said. "I question those methods as being methods that are successful in getting people actually off the drugs." Following McKinney's comments, Health District Director Andre Fresco explained that harm reduction's primary goal is not to end drug use, but to save lives, and added that the district is involved in efforts to get people off drugs.

CA Safe Injection Site Bill Nears Final Passage, PA MedMJ DUI Bill Advances, More... (6/30/22)

North Carolina permanently legaizes hemp at the last minute, a Missoula, Montana, entheogen decriminalization resolution is withdrawn for lack of support, and more.

The safe injection site in Vancouver. Similar facilities could be coming soon to California cities. (vcha.ca)
Medical Marijuana

Pennsylvania Bill to Protect Patients from DUI Charges Advances. The Senate Transportation Committee has approved Senate Bill 167, which would protect state medical marijuana patients from wrongful convictions for driving under the influence. The bill advanced Tuesday on a unanimous vote. The bill would treat medical marijuana like any other prescription drug, requiring proof of impairment that interferes with a person's ability to safely operate a motor vehicle before he could be charged with DUI. The state currently has a zero-tolerance DUI law that could expose patients to such charges for taking their medicine. There are some 700,000 medical marijuana patients in the state.

Hemp

North Carolina Approves Permanent Hemp Legalization. Just two days before a previous law temporarily legalizing hemp production was set to expire, leaving an estimated 1,500 state hemp farmers in the lurch, the legislature gave final approval to a bill to make hemp legalization permanent, Senate Bill 455 on Wednesday. Gov. Roy Cooper (D) signed the bill into law Thursday. The old law was set to expire Friday.

Psychedelics

Missoula, Montana, Psychedelic Decriminalization Resolution Shelved. A pair of city council members, Daniel Carlino and Kristen Jordan, earlier this month introduced a resolution to decriminalize entheogenic plants in the city, but they have now shelved it after failing to gain enough support on the council to move it. Other council members cited scarce research on the plants' benefits, unresolved questions about law enforcement, and the potential threat to youth as reasons to oppose the resolution. The sponsors now say they will now regroup and seek to build council support before trying again.

Harm Reduction

California Safe Injection Site Bill Passes Assembly. The Assembly has approved Sen. Scott Weiner's (D-San Francisco) bill to allow safe injection site pilot programs in San Francisco, Oakland, Los Angeles, and Los Angeles County. The bill foresees a five-year pilot program for each of those locales, all of which have formally requested to be included. The bill now goes back to the Senate for a final concurrence vote after changes were made in the Assembly and then to the desk of Gov. Gavin Newsom (D). "Every overdose death is preventable," said Sen. Wiener. "We have the tools to end these deaths, get people healthy, and reduce harm for people who use drugs. Right now, we are letting people die on our streets for no reason other than an arbitrary legal prohibition that we need to remove. SB 57 is long overdue and will make a huge impact for some of the most vulnerable people in our community."

British Columbia to Become First Canadian Province to Decriminalize Drug Possession [FEATURE]

Faced with an unrelenting drug overdose crisis, British Columbia (BC) is now set to become the first Canadian province to decriminalize the possession of small amounts of drugs, effective for a three-year period beginning January 31, 2023, Health Canada announced Tuesday. The agency has approved a request from BC for an exemption under the Controlled Drugs and Substances Act (CDSA) to remove criminal penalties for small-time drug possession.

Vancouver, epicenter of British Columbia's drug overdose crisis. (Creative Commons)
The move will decriminalize the possession of up to 2.5 grams of cocaine, MDMA, methamphetamines, and opioids (including fentanyl and heroin). People found with these personal use amounts of drugs will no longer be arrested, charged or have their drugs seized. Instead of handcuffs, drug users will be offered information on health and social services available, as well as referrals. Provincial officials had sought a higher threshold of 4.5 grams.

"The shocking number of lives lost to the overdose crisis requires bold actions and significant policy change. I have thoroughly reviewed and carefully considered both the public health and public safety impacts of this request," said Carolyn Bennett, federal Minister of Mental Health and Addictions and Associate Minister of Health. "Eliminating criminal penalties for those carrying small amounts of illicit drugs for personal use will reduce stigma and harm and provide another tool for British Columbia to end the overdose crisis."

"Substance use is a public health issue, not a criminal one," said Sheila Malcolmson, BC's Minister of Mental Health and Addictions. "By decriminalizing people who use drugs, we will break down the stigma that stops people from accessing life-saving support and services."

The province faces a true public health emergency around overdoses, with the BC government reporting at least 2,224 overdose deaths in 2021, an all-time high and a 26 percent increase over 2020. The last two months of 2021 also saw record overdose numbers. Some 85 percent of the reported overdose deaths involved fentanyl.

"Over the past seven years, our province has experienced a devastating loss of life due to a toxic illicit drug supply," said Lisa Lapointe, BC's chief coroner. "This public health emergency has impacted families and communities across the province and shows no sign of abating. In the past seven years, the rate of death due to illicit drug toxicity in our province has risen more than 400%. Drug toxicity is now second only to cancers in BC for potential years of life lost. We cannot simply hope that things will improve. It is long past time to end the chaos and devastation in our communities resulting from the flourishing illicit drug market, and to ensure, on an urgent basis, access across the province to a safe, reliable regulated drug supply."

Decriminalization is not quite safe drug supply, although Health Canada and BC are working on that, too, but it will help, said Dr. Bonnie Henry, BC's provincial health officer.

"This exemption is a vital step to keeping people alive and help connect them with the health and social support they need," said Henry. "By removing the fear and shame of drug use, we will be able to remove barriers that prevent people from accessing harm reduction services and treatment programs."

"Decriminalizing possession of drugs is an historic, brave, and groundbreaking step in the fight to save lives from the poison drug crisis. Today marks a fundamental rethinking of drug policy that favors healthcare over handcuffs, and I could not be more proud of the leadership shown here by the Governments of Canada and British Columbia", said Vancouver Mayor Kennedy Stewart.

But while government officials were congratulating themselves on their bold move, critics such as the Canadian Drug Policy Coalition said it was not nearly bold enough. In a statement released Tuesday they called for "decriminalization for all."

"The government of Canada's latest move to decriminalize drug possession should go further to protect everyone, in particular those most endangered by drug prohibition and the drug toxicity crisis," the coalition maintained. "We support policy that moves the needle forward; however, it is disappointing that decriminalization under the model announced on May 31st will not protect all people who use drugs from the harms of criminalization. We support progress, but we dream bigger. We want full decriminalization for all."

The coalition took special issue with the 2.5 gram threshold, calling it "a missed opportunity."

"A cumulative threshold quantity of 2.5 grams leaves many people who use drugs behind, namely those living in rural and remote communities who already bear the disproportionate brunt of drug prohibition and the drug toxicity crisis," the coalition protested. "People purchase larger quantities of drugs for myriad reasons: geographic restrictions, personal mobility reasons, and to limit interactions with the illicit drug market." Concerns over too-low threshold quantities were expressed repeatedly to BC and Health Canada by BC's own Core Planning Table for Decriminalization and the Board of the Vancouver Network of Drug Users (VANDU) -- to no avail.

The coalition also questioned the timing of the announcement, coming just one day ahead of a vote on a private member's decriminalization bill, Bill C-216, which was defeated Wednesday. "It is clear that the timing of the announcement is meant to hamper the progression of that bill through to committee stage, whereupon it could be further strengthened," the group noted.

The coalition called federal inaction on decriminalization "shameful," adding that "the piecemeal approach the government of Canada is now clearly taking does not adequately address the urgency of the drug poisoning crisis in the country."

Still, drug possession is about to be decriminalized in a Canadian province. Even with its shortcomings, that marks a striking conceptual shift in Canada's approach to drugs. And Toronto could be next. It has a similar exemption request pending.

Drug War Issues

Criminal JusticeAsset Forfeiture, Collateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Court Rulings, Drug Courts, Due Process, Felony Disenfranchisement, Incarceration, Policing (2011 Drug War Killings, 2012 Drug War Killings, 2013 Drug War Killings, 2014 Drug War Killings, 2015 Drug War Killings, 2016 Drug War Killings, 2017 Drug War Killings, Arrests, Eradication, Informants, Interdiction, Lowest Priority Policies, Police Corruption, Police Raids, Profiling, Search and Seizure, SWAT/Paramilitarization, Task Forces, Undercover Work), Probation or Parole, Prosecution, Reentry/Rehabilitation, Sentencing (Alternatives to Incarceration, Clemency and Pardon, Crack/Powder Cocaine Disparity, Death Penalty, Decriminalization, Defelonization, Drug Free Zones, Mandatory Minimums, Rockefeller Drug Laws, Sentencing Guidelines)CultureArt, Celebrities, Counter-Culture, Music, Poetry/Literature, Television, TheaterDrug UseParaphernalia, Vaping, ViolenceIntersecting IssuesCollateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Violence, Border, Budgets/Taxes/Economics, Business, Civil Rights, Driving, Economics, Education (College Aid), Employment, Environment, Families, Free Speech, Gun Policy, Human Rights, Immigration, Militarization, Money Laundering, Pregnancy, Privacy (Search and Seizure, Drug Testing), Race, Religion, Science, Sports, Women's IssuesMarijuana PolicyGateway Theory, Hemp, Marijuana -- Personal Use, Marijuana Industry, Medical MarijuanaMedicineMedical Marijuana, Science of Drugs, Under-treatment of PainPublic HealthAddiction, Addiction Treatment (Science of Drugs), Drug Education, Drug Prevention, Drug-Related AIDS/HIV or Hepatitis C, Harm Reduction (Methadone & Other Opiate Maintenance, Needle Exchange, Overdose Prevention, Pill Testing, Safer Injection Sites)Source and Transit CountriesAndean Drug War, Coca, Hashish, Mexican Drug War, Opium ProductionSpecific DrugsAlcohol, Ayahuasca, Cocaine (Crack Cocaine), Ecstasy, Heroin, Ibogaine, ketamine, Khat, Kratom, Marijuana (Gateway Theory, Marijuana -- Personal Use, Medical Marijuana, Hashish), Methamphetamine, New Synthetic Drugs (Synthetic Cannabinoids, Synthetic Stimulants), Nicotine, Prescription Opiates (Fentanyl, Oxycontin), Psilocybin / Magic Mushrooms, Psychedelics (LSD, Mescaline, Peyote, Salvia Divinorum)YouthGrade School, Post-Secondary School, Raves, Secondary School