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Most Heroin Addicts Didn't Start By Being Prescribed Pain Pills, Despite Drug Czar's Claims [FEATURE]

As part of its campaign to stem opioid addiction and overdoses, the White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) has launched an education campaign called The Truth About Opioids, but some of the material it is presenting has more than a whiff of spin to it -- and could imperil the ability of pain patients to get the relief they need.

Most addicts didn't go from the doctor's office to the needle and spoon, a new study reports. (Wikimedia)
The web site declares in big, bold letters that "80% of heroin users started with a prescription painkiller," and highlights the words "80%," "heroin," "started," and "prescription" in lurid purple. The graphic suggests that heroin users were prescribed opioids, developed a habit, and then went on to junk, with the further implication that a way to reduce heroin addiction is to tighten and reduce the prescribing of opioids.

The web site then asks readers if they are "shocked," "ah-ha," "outraged," or "fired up" by the information. It is only if readers scroll down the page that they are informed that the basis for the statistic is a 2013 study of "Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers." (Emphasis added.)

That's right, even though the graphic shouts out that people prescribed opioids then went on to become heroin addicts, the science it uses to back its claim is about recreational pain pill users. That's deceptive.

Misleading claims about prescribing opioids and the potential for opioid addiction are, of course, nothing new. Twenty years ago, PurduePharma infamously claimed that the risk of addiction from OxyContin was so low as to be negligible, a marketing tactic that helped kick into overdrive the pain pill phase of the current wave of opioid use.

But the drug czar's office, with its misleading suggestion that being prescribed opioids leads to heroin addiction, tips the pendulum too far in the other direction. There are real world consequences to using such faulty information. The Drug Enforcement Administration cited that 80% figure last year when it ordered steep decreases in the supply of prescription opioids, and it claimed in the Federal Register that patients got addicted "after first obtaining these drugs from their health care providers."

"The 80% statistic is misleading and encourages faulty assumptions about the overdose crisis and medical care," Pain News Network columnist Roger Chriss argued in a column last year.

And now, a new study from researchers at Penn State University published in the Journal of Addictive Studies bolsters that claim. Concentrating on southwestern Pennsylvania, an area with high levels of addiction, the researchers conducted surveys and in-depth interviews with drug users to determine their drug using histories. The sample size was small, with 125 people surveyed and 30 interviewed, but the results were illuminating.

The researchers found that two out of three of those interviewed got their first prescription opioids not from a doctor's prescription, but either bought or stole it from a family member or friend. Another 7 percent bought their drugs from a stranger or a dealer. And only one out of four (26 percent) began with opioid medications prescribed by a doctor.

"What emerged from our study -- and really emerged because we decided to do these qualitative interviews in addition to a survey component -- was a pretty different narrative than the national one. There's a lot about that narrative that I think is an overly simplistic way of thinking about this," said lead author Ashton Verdery, PhD, an assistant professor of sociology, demography and social data analytics at Penn State.

"We found that most people initiated through a pattern of recreational use because of people around them. They got them from either siblings, friends or romantic partners," he continued. "Participants repeatedly reported having a peer or caregiver in their childhood who had a substance use problem. Stories from childhood of witnessing one of these people selling, preparing, or using drugs were very common. Being exposed to others' substance use at an early age was often cited as a turning point for OMI (opioid misuse) and of drug use in general."

Among study participants, recreational drug use -- or polysubstance abuse, in public health speak -- was common, Verdery noted, and usually began not with prescription opioids but with drugs such as alcohol, marijuana, cocaine, methamphetamine, and prescription sedatives and stimulants.

"It is important to note that interviewees universally reported initiating OMI only after previously starting their substance use career with another drug (e.g., alcohol, marijuana, cocaine). Opioids were never the first drug used, suggesting that OMI is likely associated with being further along in one's drug using career," he added.

Researchers studying opioid addiction need to be aware of the role other substances play in the process, Verdery said. Understanding how opioid addiction is intertwined with other drug use is necessary to figure out the correct steps to take to prevent addiction before it takes hold.

"We think that understanding this mechanism as a potential pathway is worth further consideration," said Verdery. "It's not just that people were prescribed painkillers from a doctor for a legitimate reason and, if we just crack down on the doctors who are prescribing in these borderline cases, we can reduce the epidemic."

It's not nice for the drug czar's office to promulgate deceptive and misleading information about why people are getting strung out on heroin. It results both in limitation on access to opioid pain medications for those who need them and in obfuscating the realities of how heroin addiction happens -- and how best to deal with it.

Chronicle AM: Marijuana Descheduling Bill Filed, Model West African Drug Law Presented, More... (5/22/19)

A federal marijuana descheduling bill picks up some cosponsors who want to be president, the California Senate approves a bill to allow special banks to deal with state-legal pot businesses, the drug czar announces a new initiative, and more.

There is getting to be an awful lot of marijuana bills floating around the Capitol these days. Now, there's one more. (CC)
Marijuana Policy

Four Democratic Presidential Contenders Sign on to Federal Descheduling Bill. Sens. Bernie Sanders (I-VT), Elizabeth Warren (D-MA), Kirsten Gillibrand (D-NY) and Rep. Tulsi Gabbard (D-HI) are all cosponsors of companion marijuana rescheduling bills filed Monday by Senate Majority Leader Chuck Schumer (D-NY) and Rep. Hakeem Jeffries (D-NY). The bills would remove marijuana from the federal Controlled Substances Act and use some funds from marijuana taxes to help socially disenfranchised individuals find a role in the legal industry.

California Senate Approves Special Banks for Marijuana Retailers. The state Senate voted 35-1 Tuesday to approve a bill that would allow people to start banks and credit unions that could accept cash from state-legal marijuana businesses. SB 51 would allow those banks to issue special checks to retailers that could only be used for certain purposes, such as paying state taxes and state-based vendors. The bill now goes to the Assembly.

New Jersey Decriminalization, Expungement Bills Held Up. A last-minute move to pass decriminalization and expungement bills after legalization was stifled in the legislature is itself now stalled. A vote that was set for Thursday has been canceled after Senate President Steve Sweeney (D) said he was not in favor of the legislation.

Hemp

Louisiana Hemp Bill Advances, But Is Encumbered by Regulations. A bill to legalize hemp farming in the state, HB 491, has passed out of the Senate Agriculture Committee, but only after committee chair Sen. Francis Thompson (R), an avowed hemp skeptic, tacked a series of amendments on the measure that imposes a "tremendous amount" of regulation, according to Agriculture Commissioner Mike Strain, who supports the bill. The measure has already passed the House and now goes to the full Senate. Gov. John Bel Edwards (D) has said he will sign it if it makes it to his desk.

Drug Policy

ONDCP Director Carroll to Convene Emerging Threats Committee. White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) Director Jim Carroll announced Tuesday the formation of an Emerging Threats Committee to identify and respond to evolving and emerging drug threats in the United States. "The drug threats facing the United States are constantly changing and more complex than ever before. It is critical we not only meet the challenges of today, but also prepare to address the threats of tomorrow. By bringing together those people on the front lines of this fight, we can position ourselves to proactively respond to these threats, and preserve the safety and security of American citizens," Carroll said. The committee consists of 14 representatives from National Drug Control Program agencies, state, local and tribal governments, and non-governmental agencies.

Foreign Policy

House Committee Votes to Increase Colombia Anti-Drug Aid. The House Appropriations Committee has approved a $40 million increase in development and counternarcotics assistance to Colombia. That would make next year's package worth $457 million, far more than the $344 million the Trump administration requested in its budget. "The committee is inclined to continue its partnership with Colombia and to build on the progress of recent years made possible by the adoption of the peace accord. The agreement, combined with a renewed initiative to fight illegal crop cultivation and drug trafficking, offers great hope for the social, economic and political future of the country," the committee said in a statement. $189 million of the funds would go to anti-drug efforts.

International

Model Drug Law for West Africa Presented to Health Ministers on Sidelines of 72nd Session of the World Health Assembly. The West Africa Commission on Drugs, UNAIDS and the Global Commission on Drug Policy presented the Model Drug Law for West Africa to ministers of health of the Economic Community of West African States on Wednesday. The model drug law provides concrete templates that countries can adapt to reform their drug laws -- legal provisions and how they relate to international legal obligations -- as well as useful commentary that explains different options and reasons for choosing the proposed legal solutions. The model drug law offers a measured way for decriminalizing drug use and possession for personal use by introducing thresholds, thereby allowing people who use drugs to access health services and seek support. The model drug law acknowledges that barriers must also be removed so that the millions of people in need of health services, including people living with cancer or with HIV, can access the treatment and care they need.

(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.)

Chronicle AM: Urge NC Gov to Veto Overdose Homicide Bill, Mexico Wants Out of Plan Merida, More... (5/9/19)

Congressmembers call on DEA to permit more research marijuana grows, the Denver magic mushroom initiative comes up short (or so we thought at publishing time), Mexico's president wants an end to Plan Merida and economic development help instead, and more.

Mexico wants less drug war aid, more economic development. (Borderland Beat)
Marijuana Policy

Majority of State Attorneys General Tell Congress to Pass Marijuana Banking Bill. Attorneys General from 38 states and territories have called on Congress to pass legislation that would allow marijuana businesses to gain access to the financial system. "Businesses are forced to operate on a cash basis. The resulting grey market makes it more difficult to track revenues for taxation and regulatory compliance purposes, contributes to a public safety threat as cash-intensive businesses are often targets for criminal activity, and prevents proper tracking of billions in finances across the nation," the attorneys general wrote in a letter to congressional leaders on Wednesday.

Medical Marijuana

Congress Members Call on DEA to Approve More Marijuana Growers. Some 30 members of Congress have sent a letter to the Justice Department and the DEA Tuesday asking the agencies to speed the process of approving new federally authorized marijuana growers. There is currently only one authorized cultivation facility, at the University of Mississippi. Although new applications are supposed to be approved, the representatives called the process "arduous and long."

House Committee Votes on Veterans Medical Marijuana Bills Canceled. Rep. Mark Takano (D-CA), chair of the House Veterans Affairs Committee, cancelled votes on two bills concerning medical marijuana and veterans that were set for Wednesday. He said he now plans to hold a later hearing on the legislation but gave no reason for canceling the votes or the delay.

Texas House Passes Second CBD Medical Marijuana Bill. The House on Tuesday gave final approval to HB 3703, which would add multiple sclerosis, epilepsy and spasticity to the list of debilitating conditions that qualify for cannabis oil. It passed a similar bill, HB 1365, on Monday. Both now head to the Senate.

Heroin and Prescription Opioids

ONDCP Releases Report on the President's Commission on Combating Drug Addiction and the Opioid Crisis. The Office of National Drug Control Policy (ONDCP) released a report on the President's Commission on Combating Drug Addiction and the Opioid Crisis. The report "outlines the progress the Trump Administration has made to curb addiction and tackle drug demand and the opioid crisis through prevention, interdiction, and treatment." It cites an ad campaign, decreases in opioid prescribing, prosecutions of fentanyl traffickers, and an increase in access to buprenorphine, among other highlights.

Elizabeth Warren Unveils Opioid Package. Sen. Elizabeth Warren (D-MA) rolled out the CARE Act on Wednesday, a $100 billion plan to fight the opioid crisis. "The ongoing opioid crisis is about health care. But it's about more than that. It's about money and power in America -- who has it, and who doesn't. And it's about who faces accountability in America -- and who doesn't," Warren wrote. "If the CARE Act becomes law, every single person would get the care they need… We should pass it -- not in two years, not after the 2020 elections -- but immediately." The measure would provide $100 billion in federal funding over the next decade, with $2.7 billion annually for what Warren described as the "hardest hit" counties and cities, including those with the highest rates of overdoses. It would also give $500 million each year to expand access to the overdose reversal drug naloxone. Rep. Elijah Cummings (D-MD) filed a companion bill in the House.

Andrew Yang Calls for Opioid Decriminalization. Democratic presidential contender Andrew Yang is calling for the decriminalization of opioids as part of his platform. "We need to decriminalize the possession and use of small amounts of opioids," Yang says. "Other countries, such as Portugal, have done so, and have seen treatment go up and drug deaths and addiction go down. When caught with a small quantity of any opioid, our justice system should err on the side of providing treatment."

Psychedelics

Denver Magic Mushroom Initiative Narrowly Defeated. [Update: Last-minute mail-in ballots put the initiatve over the top by the following morning.] An initiative that would have effectively decriminalized the possession of magic mushrooms and psilocybin was defeated at the polls Tuesday. The initiative would have made the drugs law enforcement's lowest priority. It lost by a preliminary margin of 52% to 48%.

Sentencing

North Carolina Overdose Homicide Bill Goes to Governor. A bill that would make people who provide drugs to others who later overdose on them subject to murder charges has passed the legislature and is now on the desk of Gov. Roy Cooper (R). Harm reductionists are calling for the measure, HB 474, to be vetoed and urging folks to let the governor know their opposition.

International

Mexico President Wants End to Plan Merida, Economic Development Aid Instead. Mexican President Andres Lopez Manuel Obrador said Tuesday he wants the US to end the anti-drug Merida Initiative and instead invest in economic development in southern Mexico and Central America. "We want the Merida Initiative to be completely reoriented, because it hasn't worked. We don't want cooperation on the use of force, we want cooperation on economic development. We don't want the so-called Merida Initiative," Lopez Obrador told a press conference. "The proposal we're making is a development plan for southeastern Mexico and Central America. We want investment dedicated to productive activities and job creation. We don't want attack helicopters."

(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.)

Chronicle AM: MS MedMJ Petitioning On Track, Kamala Harris on Pardons for Drug Prisoners, More... (4/25/19)

Texas decriminalization gets walked back a step, a Mississippi medical marijuana initiative already has lots and lots of signatures, Kamala Harris talks pardons for drug war prisoners, and more.

The Texas decriminalization bill just became a misdemeanor and expungment bill.
Marijuana Policy

Texas Decriminalization Bill Modified to Not Quite Decriminalization. Ahead of House floor debate set for today, Rep. Joe Moody (D-El Paso), the author of the decriminalization bill, HB 63, has rewritten the measure so that possession of an ounce or less remains a misdemeanor, but with a near automatic expungement of any criminal record if the person completes probation. "Without leaving some criminal component in it, I probably couldn't get the bill through the process and across the governor's desk," Moody said. "I didn't want to come this far and make perfect the enemy of good."

Medical Marijuana

Mississippi Medical Marijuana Initiative Signature-Gathering in Good Shape. Medical Marijuana 2020, the group behind a state medical marijuana initiative campaign, has already collected 96,000 raw signatures with months to go. The campaign needs 86,000 verified voter signatures to qualify for the November 2020 ballot. The campaign will likely need to collect several tens of thousands more signatures, in order to have that many left after the inevitable disqualifications. But things appear to be on track.

North Dakota Governor Signs Medical Marijuana Bill Package. Gov. Doug Burgum (R) has signed into law four bills related to the state's medical marijuana program: HB 1417 will allow greater amounts of marijuana for cancer patients; HB 1519 expands qualifying conditions to include (among others) anorexia, bulimia, and brain injury; HB 1119 provides for the removal of social security numbers from program documents and declares an emergency to do so; and HB 1283 amends parts of the written certification requirements.

Heroin and Prescription Opioids

Trump Defends Administration Opioid Policy. Addressing the Rx Drug Abuse and Heroin Summit in Atlanta Wednesday, President Trump said his administration had made "tremendous progress" on the issue in the face of critics who argue that the drug czar's office (ONDCP) has done little to combat the crisis and that a law passed last year did not adequately fund drug treatment.

Pardons and Commutations

Kamala Harris Says She Will Pardon Low-Level Drug Prisoners If Elected. Sen. Kamala Harris (D-CA) said Wednesday she would pardon low-level drug prisoners if she becomes president. "Absolutely," she said when asked about using the power of commutation. "We have to have the courage to recognize that there are a lot of folks who have been incarcerated who should not have been incarcerated and are still in prison because they were convicted under draconian laws that have incarcerated them… for what is essentially a public health issue." Her remarks came at a She the People town hall in Houston.

(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.)

Chronicle AM: AK Okays Pot Social Consumption, Trump Slashes Drug Czar Budget, More... (3/13/19)

Alaska gives final approval for on-site consumption at pot shops, San Francisco approves pot smoking at events where people like to smoke pot, President Trump ponders designating Mexican cartels as terrorists, South Dakota legislators come up short in a bid to override the veto of a hemp bill, and more.

The drug czar's office is on the budgetary cutting block again.
Marijuana Policy

Alaska Social Consumption Gets Final Approval. Lt. Gov. Kevin Meyer (R) Tuesday signed off on new regulations allowing on-site marijuana use in retail pot shops, the final step in approving social consumption in the state. This makes Alaska the first state to approve such use statewide. Consumers can’t bring their own but will have to purchase the pot on-site and consumption areas will have to be ventilated and separated from other parts of the store. The first on-site consumption should come by mid-July, state officials said.

New York Black Lawmakers Won’t Vote for Legalization Without Racial Equity. Black lawmakers are demanding that racial equity provisions be written into any legalization bill or they won’t vote for it. Gov. Andrew Cuomo (D) mentioned racial injustice in pot law enforcement in calling for legalization, but lawmakers representing minority communities say his proposal doesn’t go far enough in addressing how racial inequities would be repaired.

San Francisco to Allow Pot Smoking at Events Where People Like to Smoke Pot. Seems like common sense. The Board of Supervisors voted Tuesday to create a special permit to allow people to sell and smoke marijuana at public events that have traditionally seen a lot of pot smoking, such as the 4/20 celebration on Hippie Hill and the Outside Lands music festival, both in Golden Gate Park. The ordinance gives the Office of Cannabis the authority to grant temporary waivers to the city’s tough no-smoking laws.

Hemp

South Dakota Lawmakers Fall Short on Bid to Override Hemp Bill Veto. After Gov. Kristi Noem (R) vetoed a bill to legalize industrial hemp production over the weekend, lawmakers sought to override the veto. In votes Tuesday, the House supported the override on a 55-11 vote, but the Senate came up short, voting 20-13 to override when it needed 24 votes to be successful.

Drug Policy

Trump’s Drug Budget Again Slashes Funding for Drug Czar’s Office. For the second year in a row, the White House’s proposed drug budget for Fiscal Year 2020 virtually zeroes out funding for the Office of National Drug Control Policy (ONDCP—the drug czar’s office). Congress restored the funding for ONDCP last year, allotting it slightly more than $120 million, about the same as the previous year. But this year’s proposed budget allocates only $14.9 million.

Foreign Policy

Trump Thinking “Very Seriously” About Designating Mexican Drug Cartels as Terrorists. In an interview published Tuesday in Breitbart News, President Trump is thinking “very seriously” about designating Mexican drug cartels as terrorists. "We are. We are," Trump said. "We're thinking about doing it very seriously. In fact, we've been thinking about it for a long time. . . . As terrorists - as terrorist organizations, the answer is yes. They are."

Harm Reduction

North Carolina Senate Approves Good Samaritan Expansion Bill. The Senate on Tuesday approved a bill, SB 106, that would clarify the state’s 2013 Good Samaritan law to specify that the people who actually suffer drug overdoses have the same legal immunity from criminal charges as the people who call for help. The bill now heads to the House.

Chronicle AM: Drug Czar's Office Shuttered in Shutdown, DC Full Pot Legalization Bill Filed, More... (1/9/19)

The federal government shutdown shutters the drug czar's office, Trump again mischaracterizes the nature of border drug smuggling, New Jersey's highest court lends a hand to drug court graduates seeking expungement, and more.

closed down in the shutdown
Marijuana Policy

New Hampshire Lawmaker Files Expungement Bill. Rep Renny Cushing (D) has filed a bill, HB 399, that would let people with convictions for possessing less than three-fourths of an ounce of weed before September 2017 have their records cleared. That date is when the state law decriminalizing pot possession went into effect.

DC Lawmaker Files Full Legalization Bill. Councilmember David Grosso (I) has reintroduced the Marijuana Legalization and Regulation Act, which would allow the city to establish a system of retail marijuana sales. Such a move has been blocked by House Republicans, and its prospects this year remain uncertain, but Grosso is moving ahead anyway.

Medical Marijuana

New Hampshire Lawmaker Files Pair of Medical Marijuana Bills. Rep. Renny Cushing (D) has filed two bills related to medical marijuana. HB 366 would add opioid addiction as a qualifying condition, while HB 364 would allow patients and caregivers to grow their own medicine.

Asset Forfeiture

North Dakota Lawmaker Files Bill to End Civil Asset Forfeiture. Rep. Rick Becker (R-Bismarck) has filed House Bill 1286, which would end civil asset forfeiture in the state. He filed a similar bill in 2017 that passed the House, but got zero votes in the Senate after it was opposed by Attorney General Wayne Stenehjem, who remains in office but has refused so far to comment on this year's bill.

Drug Policy

Trump Once Again Misstates How Drugs Cross the Border With Mexico. In his oval office speech Tuesday night making his case for a border wall, President Trump once again mischaracterized the nature of drug smuggling across the Mexican border. While he was correct in stating that the vast majority of drugs coming into the country come through Mexico, his own DEA reported in November that "only a small percentage" of heroin and other drugs comes through areas outside of ports of entry.

Federal Government Shutdown Shutters Drug Czar's Office. Among the casualties of the shutdown is the Office of National Drug Control Policy (ONDCP -- the drug czar's office). If the shutdown continues up to the end of the month, funding for important grant programs involving law enforcement and prevention could be jeopardized.

Expungement

New Jersey Supreme Court Eases Requirements for Drug Court Graduates. The state Supreme Court ruled 7-0 Tuesday that drug offenders who have successfully completed a court-ordered treatment program do not have to prove that expunging their criminal records of those offenses is in the public interest. Instead, the high court ruled, the burden to demonstrate that the public interest requirement was not met should fall on the state. "In light of the rigorous monitoring that is the hallmark of drug court, as well as the new law's overall policy in favor of expungement for successful graduates, we find that participants are entitled to a rebuttable presumption that expungement is consistent with the public interest," the court held.

Chronicle AM: James Carroll Approved as Drug Czar, Tijuana's Bloody 2018, More... (1/3/19)

Pennsylvania lawmakers are moving on marijuana legalization, the Trump administration finally gets a permanent drug czar, Tijuana saw a bloody year last year, and more.

Colombian coca farmers have been busy expanding their crop, and the US is concerned. (DEA)
Marijuana Policy

Pennsylvania Lawmakers Get Moving on Legalization. On Wednesday, legalization proponent Sen. Daylin Leach (D) revealed that he and Sen. Sharif Street (D) are in the final stages of preparing a bill to legalize marijuana. On Thursday, Rep. Jake Wheatley Jr. (D) sent out a cosponsorship memo seeking support for a soon-to-filed House bill he described as "the most comprehensive legalization legislation to date."

Drug Policy

Senate Approves James Carroll as Drug Czar. James Carroll, who has been acting head of the Office of National Drug Control Policy (ONDCP -- the drug czar's office) since February, was confirmed as director Wednesday in one of the last acts of the lame duck Senate. Now, after nearly two years without a drug czar, the White House finally has a top drug policy advisor other than Kellyanne Conway.

Foreign Policy

Pompeo "Concerned" Over Colombia Coca Cultivation Increase. In a meeting with Colombian President Ivan Duque Wednesday, Secretary of State Mike Pompeo said the US is deeply concerned about rising levels of coca cultivation there. He also said the US would work with Colombia to cut production in half within five years.

International

Tijuana Saw 2,500 Murders Last Year as Drug Wars Raged. The state attorney general's office released a year-end report on December 31 saying that Tijuana had seen 2,499 registered homicides in 2018, but more bodies were found before day's end, bringing the toll past 2,500. The report said about 85% of the killings were related to the drug trade, especially a turf war between the New Generation Tijuana Cartel (aligned with the New Generation Jalisco Cartel) and the Sinaloa Cartel. But some of the killings are a result of factional fights within the Sinaloa Cartel over lucrative street-level markets and smuggling routes to the US.

The Year in Drugs II: Good, Bad, and Ugly Global Drug Policy in 2018 [FEATURE]

(See our Top Domestic Drug Stories of 2018 piece here.)

It's been a year we couldn't wait to put behind us, but as 2018 comes to an end, we can look back on some advances on the international drug policy front, as well as continued brutal and regressive responses from some quarters. Here are 10 of the global drug policy stories that shaped the year, for better or worse:

Iranian drug executions have come to a screeching halt in one of the good news stories of 2018. (handsoffcain.info)
1. Drug Death Penalty Reforms Cause Massive Drop in Executions

Early this year, it became official: Iran had reformed its death penalty statutes to radically reduce the number of people facing execution for drug offenses, and it had done so retroactively, saving the lives of thousands already on death row. By mid-year, it was clear that the move was having an impact, as human rights observers reported a 99% reduction in drug executions, with only one person being executed for drugs as of June, compared to more than a hundred during the same period in 2017.

2. Canada Becomes the First G8 Country to Legalize Marijuana

Justin Trudeau pledged that he was elected prime minister, his government would legalize marijuana. It didn't happen as fast as he would have liked, but the Liberals' legalization bill passed parliament in June and went into effect on October 17. So far, the sky has not fallen.

3. Medical Marijuana Earns Growing Acceptance

The year began with Thailand announcing a plan to allow medical marijuana and ended with Thailand approving it and becoming the first Southeast Asian country to do so. But in the meantime, Israeli pharmacies began selling medical marijuana in April, Zimbabwe legalized it in May, and Portugal and Luxembourg followed suit in June. In November, Great Britain joined the club, and Greece issued its first medical marijuana production licenses. Late in the year, in South Korea, the National Assembly approved an amendment to the country's drug laws that will pave the way for the use of medical marijuana by prescription, and New Zealand also approved it in December Not a bad year for medical marijuana.

Canadian Senate
4. The Philippines Drug War Continues, But Pressures Mount…

The bloody drug war of Philippines President Rodrigo Duterte continued apace in 2018, with a death toll now put at 12, 000 (20,000 by some estimates), but Duterte has come under increasing pressure both domestically and internationally. In February, both Amnesty International and Human Rights Watch aimed broadsides at the Philippines even as the International Criminal Court began "preliminary examinations" of whether there is sufficient evidence to bring a case before the court. In March, activists called out drug war human rights abuses at the embassy in Washington, DC. By July, an unbowed Duterte was vowing to continue a "relentless and chilling" drug war even as national human rights groups said he was using it as a cover for assassinating political opponents. In September, he unleashed an attack on a second drug war critic, Senator Antonio Trillanes, after last year imprisoning critic Senator Leila de Lima on trumped up drug charges. She is still imprisoned.

5.. ...and the Rot Spreads in the Region

Following the lead of the Philippines, other countries in the region have also embraced drug war thuggery and human rights abuses. In May, the Bangladeshi opposition warned of a wave of police killings of drug suspects, and within weeks, more than a hundred were killed and 20,000 arrested, even as evidence emerged that the crackdown was being used to hide political assassinations. The situation was fraught enough that the UN human rights head and even the US State Department expressed concern. Drug war killings were also reported in Indonesia, although there were mixed signals about moves toward reforms there, and Sri Lanka vowed to begin hanging drug dealers. Paradoxically though, a Malaysian court's imposition of a death sentence on a man for providing cannabis oil to patients now appears to have resulted in a moratorium on the death sentence and could end the death penalty in its entirety in the county.

6. The US President Aligns Himself With Global Drug War Authoritarians

President Donald Trump was a baleful presence on the global drug policy stage this past year, sympathizing with drug war authoritarians such as Philippines President Rodrigo Duterte and Turkish Prime Minister Erdogan, as well as drug death penalty countries such as China and Singapore. He said early in the year he wants to execute all drug dealers and admires the Singapore approach (mandatory death penalty for drug trafficking), a statement that moved more than 150 organizations to condemn his call. At year's end, he was singing a similar tune with a ghoulish call for more Chinese drug executions. In between, he went to the United Nations to try to gin up a reinvigorated global drug war.

coca leaves drying by highway
7. South Africa Legalizes Marijuana

In a case brought by three marijuana users, the country's Constitutional Court ruled that the private possession, cultivation, and consumption of marijuana is legal. "It will not be a criminal offense for an adult person to use or be in possession of cannabis in private for his or her personal consumption," Deputy Chief Justice Raymond Zondo wrote in his ruling. It will, however, remain illegal to use cannabis in public and to sell and supply it. The ruling did not set allowable quantities, with the court saying parliament had two years to come up with a new law that reflected the ruling.

8. Glimmers of Hope in Mexico

then-President Felipe Calderon unleashed the latest chapter of the country's drug wars, bringing violence to levels not seen before in the country, Mexico is showing signs it is ready for change. The death toll from prohibition-related violence is higher than ever, and that is impelling a psh for change, most notably with the election of Andres Manuel Lopez Obrador, who is very open to finding exits from the drug war, whether it's legalized opium production in Guerrero, granting amnesty for non-violent drug trafficking offenders, or legalizing marijuana. And speaking of legalizing marijuana, the Mexican Supreme Court in November struck down the ban on marijuana possession, cultivation, and use. Now, Lopez Obrador's governing MORENA Party has filed a bill to legalize marijuana sales. Tackling the violence, may be a bit more difficult.

9. Colombia Sees a Record Coca Crop as US Cocaine Deaths Rise

Efforts to reduce coca cultivation and cocaine production in the country after the peace agreement with the FARC rebels have not gone well, and that's causing rising worry in Washington. In June, the UN Office on Drugs and Crime reported that 2017 production was at an all-time high, prompting expressions of concern from the drug czar's office and support from President Trump for new rightist Colombian President Ivan Duque's "head-on fight against drug trafficking." That could include a renewed resort to aerial fumigation, even drones, as well as forced eradication of coca crops, leading to renewed conflict in cultivation zones. Meanwhile, cocaine is now the third leading cause of drug overdose deaths, trailing only fentanyl and heroin.

Vienna International Centre, home to the UN drug agencies
10. Historic UN Cannabis Review Hits Last-Minute Procedural Delay

In June and again in November, the Expert Committee on Drug Dependence (ECDD) of the World Health Organization (WHO) met to consider the evidence on cannabis (marijuana) and its placement in the UN drug scheduling system, which determines whether or what level of control the UN drug conventions mandate that countries maintain for the substance. The conventions specify that substances should receive such an evaluation before being scheduled, but that never happened for marijuana. Observers believe the process should lead to marijuana being moved to a less restrictive schedule than it is in currently -- if the Commission on Narcotic Drugs (CND) votes to adopt such a recommendation from ECDD.

That didn't happen when, earlier this month, WHO voted to delay release of ECDD's recommendations until January, for unexplained reasons. That may mean they get taken up at the main annual CND meeting in Vienna in March, rather than December's intersessional. The delay seems unusual, and probably political, but its intent is unclear.

The next few months may tell. In the meanwhile, ECDD says that CBD shouldn't be scheduled at all. But that didn't stop the US FDA from saying that treaties require it be scheduled, even though they also think it shouldn't be.

Chronicle AM: Legal MJ Shortages, Mexico to Move Toward Legal MJ Market, More... (11/3/18)

The Granite State has a new guide to marijuana legalization, ONDCP releases coca cultivation and cocaine production figures for Peru and Bolivia, Canada suffers legal pot shortages, and more.

North America is becoming a very weed-friendly continent. (Creative Commons)
Marijuana Policy

New Hampshire Commission Issues Marijuana Legalization Report. The Commission to Study the Legalization, Regulation, and Taxation of Marijuana has released its report, complete with 54 separate recommendations on how legalization should be implemented. Among them are creating a state-level Cannabis Commission to regulate it, similar to the way the state regulates alcohol. The group estimated that legalization could bring in revenue of $36.6 million a year once the market stabilizes, and possibly reaching $47 million. The report is designed to help guide any legislative moves toward legalization.

Medical Marijuana

Iowa Regulators Reject Bid to Raise THC Cap on New Medications. The state's Medical Cannabinoid Board voted unanimously last Friday to rebuff an effort to raise the 3% THC cap on new medications. Proponents argued that more THC is more effective in treating some conditions, while critics worried that lifting the limit could encourage abuse. "I'd like to get another year or two under our belts and see how people respond with the current THC cap," said board member Lonny Miller, a family physician from Creston.

Foreign Policy

ONDCP Releases Data on Coca Cultivation and Cocaine Production in Peru and Bolivia. The White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) released the US government's annual estimates of coca cultivation and cocaine production for Bolivia and Peru last Friday. Although Peru produces more coca and cocaine than Bolivia, and although Peru's coca cultivation and potential cocaine production are trending up while Bolivia's are trending down, ONDCP was more critical of Bolivia. "The ongoing coca --cultivation in both Peru and Bolivia pose a threat for us as a nation, and aggravates our domestic drug addiction crisis," said ONDCP Deputy Director Jim Carroll. "It is important that our governments work together to take action against cultivation and production, and to save lives of those affected by drug trafficking. Peru continues to be a great partner and we have a shared responsibility to address this problem. In Bolivia, we would like to see real efforts against cultivation and production."

International

Canada Struggles to Meet Huge Demand for Legal Marijuana. Just two weeks after legal retail marijuana sales began, Canadian pot retailers -- both physical and online -- are having problems dealing with unexpectedly high demand. In much of the country, the legal supply has almost entirely dried up. "There is not enough legal marijuana to supply all of recreational demand in Canada," said Rosalie Wyonch, a policy analyst at the CD Howe Institute. "The shortages are happening faster than I would have expected, but our research suggested quite strongly that there would be shortages in the first year of legalization."

Colombia Announces New Strategy to Disrupt Drug Trade. Last Thursday, Colombian Attorney General Nestor Humberto Martinez announced a new "disruption policy" of going after the cocaine trade by cutting access to alkaloids and power sources in rural areas. He called for "petrochemical innovation" so that fuels stop yielding the factors needed to create cocaine hydrochloride, as well as restricting the sale of government-subsidized gasoline in cocaine and marijuana producing regions. But one analysis says the proposals "might sound innovative on paper but are unlikely to have a major impact on the drug trade and may end up hurting long-suffering residents."

Mexico's Ruling Party Plans Legislation To Legalize Marijuana Sales. Less than a week after the country's Supreme Court ruled that laws barring the personal use, possession, and cultivation of marijuana are unconstitutional, key figures in the ruling MORENA Party are already moving to craft legislation to create a legal marijuana market. First, they say, they will move to repeal the now null and void criminal laws against marijuana, and then, "We are going to take a step forward in the regulation that may already involve the production, marketing and distribution of marijuana," said Olga Sánchez Cordero, a senator who is expected to become interior secretary in the incoming government of President-elect Andrés Manuel López Obrador. "I say it from the heart: we celebrate it, the Court is setting a marvelous precedent for us to walk in that direction," Sánchez added.

Medical Marijuana Update

The DEA last week rescheduled the marijuana-based drug Epidiolex, California's governor vetoes a compassionate access bill, Michigan dispensaries must have licenses by Halloween or be shut down, and more.

National

DEA Reschedules Marijuana-Derived Drug Epidiolex. The DEA has rescheduled Epidiolex, a marijuana-derived drug manufactured by GW Pharmaceutical. The move comes after the FDA approved the drug in June and clears the way for GW to begin selling the drug. Epidiolex is the first FDA-approved drug derived from marijuana.

Congresspersons Want to Know Why DEA is Importing Research Marijuana. Fifteen members of Congress led by Reps. Matt Gaetz (R-FL) and Eric Swalwell (D-CA) sent a letter Monday to the DEA and Attorney General Sessions expressing "deep concern" over delays in approving domestic marijuana cultivation for research purposes even as the DEA has approved the importation of marijuana from Canada for research purposes.

Protestors Target Rep. Andy Harris Over Opposition to Using Medical Marijuana as Opioid Treatment. Red-capped protestors affiliated with the marijuana reform group DCMJ protested outside the office doors of Rep. Andy Harris (R-MD) Tuesday. DCMJ said the protestors were there to protest his opposition to using medical marijuana as a treatment for the opioid crisis. After Harris refused to meet with them, as fellow protestors waved signs accusing Harris of working for "Big Pharma," two women laid down in the hallway to represent friends who had fatally overdosed. One of the women was temporarily handcuffed. The smell of marijuana wafted through the air. Harris later complained that: "Today's aggression by protesters who disagree with my position on the legalization of recreational marijuana demonstrates the problem with political discourse today. We all must agree to have a civilized debate when disagreement occurs. My parents fled communist Eastern Europe where people with different political opinions were harassed and punished, and it has no place in America."

California

California Governor Vetoes Compassionate Access Bill. Gov. Jerry Brown (D) has vetoed Senate Bill 829, which would have allowed licensed marijuana retailers to "offer free cannabis or cannabis goods" to low-income medical marijuana payments. In his veto statement, Brown said the bill would violate the state's recreational marijuana law, but that logic left advocates confounded. "Nowhere does Prop. 64 say that it is intended to impede free donations of medicine to needy patients," commented CA NORML head Dale Gieringer. "The purposes and intents section of the initiative is clear that it pertains only to adult-use marijuana, and does not override Prop 215 [California's original medical marijuana law, passed in 1996]."

Florida

Florida Moves to Block Licensing Lawsuit. The state Department of Health is asking an appeals court to block a district judge from moving forward with a lawsuit where a nursery operator who was denied a cultivation license. The appeals court on Friday put the case on hold temporarily, with the nursery operator given until the end of the month to respond to the state's arguments that the lawsuit should be thrown out.

Michigan

Michigan Dispensaries Must Have Licenses by Halloween, Regulators Say. The state Department of Licensing and Regulatory Affairs has issued new emergency rules for dispensaries saying that if they haven't received a license by Halloween they could be forced to shut their doors. Also, any product not received in compliance with the Marihuana Facilities Licensing Act will have to be destroyed.

Utah

Utah Medical Marijuana Initiative Opponents Pony Up Cash. Opponents of the Prop 2 medical marijuana initiative are ponying up big bucks in a bid to defeat the measure. As of last weekend, wealthy Utahns have contributed $230,000 to the opposition group Drug Safe Utah in recent months and $65,000 to another anti group, the Truth About Proposition 2, while initiative sponsors the Utah Patients Coalition has raised only $68,000, with $50,000 of that coming from the Marijuana Policy Project.

[For extensive information about the medical marijuana debate, presented in a neutral format, visit MedicalMarijuana.ProCon.org.]

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