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This Year's Top Ten Domestic Drug Policy Stories [FEATURE]

The good, the bad, and the ugly in US domestic drug policy this year.

Drug overdoses hit a record high in 2022, but may have peaked. (Creative Commons)
1. Overdose Deaths Appear to Have Peaked but Are Still at Horrid Levels

According to Provisional Drug Overdose Death Counts released by the Centers for Disease Control and Prevention (CDC) in December, the nation's fatal drug overdose epidemic has peaked. After reaching a record high of more than 110,000 fatal overdoses in the 12-month period ending in March, that number declined to 107,735 in the 12-month period ending in July, the last month for which data is available. That is a two percent decline from the March high.

While the decline is welcome, drug overdose numbers are still 25 percent higher than they were two years ago and double what they were five years ago. According to the CDC, synthetic opioids, mainly fentanyl, were implicated in more than two-thirds of overdose deaths and stimulants such as methamphetamine and cocaine were involved in nearly one-third. But some fraction of stimulant-implicated overdose deaths are not caused by the stimulants themselves but by stimulant users being exposed to drugs cut with fentanyl.

2. Neither Marijuana Legalization nor Banking Access Pass Congress

Senate Majority Leader Chuck Schumer (D-NY) vowed to make passage of a marijuana legalization bill a priority in this Congress, but it didn't happen. While the House passed a legalization bill, the Marijuana Opportunity Reinvestment and Expungement (MORE) Act (HR 3617) in April, Schumer and congressional allies didn't even roll out a draft version of their Cannabis Administration and Opportunity Act until this July -- 18 months after this Congress began -- and it never exhibited enough bipartisan support to go anywhere in the evenly divided Senate.

Schumer and his Senate allies also repeatedly blocked efforts to get a bill to allow state-legal marijuana businesses access to financial services through the Senate. The Secure and Fair Enforcement (SAFE) Banking Act (HR 1996) passed the House in April, and Senate allies tried repeatedly to attach it as an amendment to various spending bills, only to be stymied by Schumer and his holdouts for full-blown legalization. At year's end, though, while Schumer was finally ready to move forward with it, Senate Minority Leader Mitch McConnell (R-KY) came out in opposition, helping to scuttle one last effort to tie it to a defense appropriations bill.

3. With Biden's Signature, A Standalone Marijuana Reform Bill Becomes Law for The First Time Ever

For the first time ever, Congress passed and in December the president signed into law a stand-alone marijuana reform bill, the bipartisan Medical Marijuana and Cannabidiol Research Expansion Act (HR 8454). Some marijuana reform measures have been passed before, but only as part of much broader appropriations bills. The aim of the bill is to facilitate research on marijuana and its potential health benefits. The bill will accomplish this by streamlining the application process for scientific marijuana studies and removing existing barriers for research by allowing both private companies and research universities to seek DEA licenses to grow their own marijuana for research purposes.

4. Three More States Legalize Marijuana

In May, Rhode Island became the 19th state to legalize marijuana when the General Assembly passed and Gov. Dan McKee signed into law the Rhode Island Cannabis Act. Sales to any adult over 21 at medical marijuana dispensaries that acquired "hybrid retail licenses" began in December.

And in November, voters in Maryland and Missouri approved marijuana legalization initiatives. Maryland's Question 4 came not from the people but from the legislature and amends the state constitution and mandates that the General Assembly "shall provide for the use, distribution, possession, regulation and taxation of cannabis within the state." Missouri's Amendment 3 overcame multi-sided opposition not only from the usual suspects in law enforcement and the political establishment but also from civil rights groups and marijuana industry insiders to eke out a narrow victory. As of December 8, possession of up to three ounces by adults is no longer a crime, but sales to adults will not begin until next year.

But there were also losses at the ballot box this year. The Arkansas Adult Use Cannabis Amendment garnered only 43.8 percent of the vote, while North Dakota's Initiated Statutory Measure No. 1 managed only 45.1 percent, and South Dakota's Initiated Measure 27 came up short with only 46.6 percent of the vote. The South Dakota defeat was especially bitter, given that just two years ago, voters there approved a broader marijuana legalization initiative with 54 percent of the vote only to see it invalidated by the state Supreme Court.

5. The Year of Fentanyl Test Strip Decriminalization

Fentanyl test strips, which detect the presence of the powerful synthetic opioid in all different kinds of drugs (cocaine, heroin, methamphetamine, etc.) and formulations (pills, powders, and injectables) are recognized by the Centers for Disease Control and Prevention as a valuable harm reduction strategy and are increasingly seen by the states as a crucial tool in the fight to reduce drug overdose deaths. When the Biden White House first endorsed their use in 2021, they were considered illegal drug paraphernalia in a majority of states.

Not anymore. As of the end of 2022, 31 states have now legalized or decriminalized fentanyl test strips, with Alabama, Georgia, New Mexico, Tennessee, and Wisconsin doing so this year alone. But that leaves 19 states, mostly in the South and including Florida and Texas where they remain banned.

6. Colorado Becomes Second State to Approve Natural Psychedelic Reforms

Three years after voters in Denver opened the door to psychedelic reform by approving a municipal initiative that made possession of psilocybin mushrooms the lowest law enforcement priority, voters statewide have approved an initiative that decriminalizes plant- and fungi-derived psychedelics and creates a program for the therapeutic administration of such substances. On Election Day, voters approved Proposition 122, the Natural Medicine Health Act, with 53.55 percent of the vote. The victory makes Colorado the second state to enact reforms decriminalizing a natural psychedelic and setting up a program for therapeutic use. Oregon voters led the way on that by approving Measure 109 in 2020.

Proposition 122 has two main prongs: First, it decriminalizes the personal use, possession, and cultivation by people 21 and over of dimethyltryptamine (DMT), ibogaine, mescaline (not derived from peyote), psilocybin, and psilocyn, as well as providing for the sealing of conviction records of people who have completed sentences for the use or possession of those substances. The measure sets no personal possession limits. Second, it creates a "natural medicine services" program for the therapeutic administration of the specified psychedelics and creates a rubric for regulated growth, distribution, and sales of those substances to entities within the program. Only psilocybin and psilocin would be okayed for therapeutic use until 2026. Then regulators could decide on whether to allow the therapeutic use of DMT, ibogaine, and mescaline.

7. Marijuana Social Consumption Lounges Spread

Ever since the first states legalized marijuana a decade ago, one question for users was where to go to smoke their newly legal product. Most states ban smoking outdoors in public or indoors pretty much anywhere except one's home -- and even that can be an issue if your landlord isn't down with it. One solution is allowing places for marijuana users to toke up in a convivial setting, the marijuana social consumption lounge, whether as part of a retail shop or as a standalone business.

Social consumption lounges are now legal in 11 states -- Alaska, California, Colorado, Illinois, Massachusetts, Michigan, Missouri, New Jersey, New Mexico, New York, and Nevada -- although they are not actually up and running yet in some of them. Massachusetts has two lounges now operating; in New Jersey, regulators just approved rules for them; in Nevada, regulators just issued 20 provisional licenses; in New York, they're still waiting for regulators to act; and in California, the state's dozen or so lounges are set to double in number as more localities okay them. Meanwhile, the nation's capital could be next: In the District of Columbia, the city council just approved a bill allowing them.

8. Safe Injection Sites Are Operating in the United States

Safe injection sites, the harm reduction intervention proven to save lives after years of operation in more than a hundred cities in Australia, Canada, and Europe, are finally getting a toehold in the US. New York City's two safe injection sites have just celebrated their first birthdays after opening in late 2021, and in Rhode Island, a two-year pilot program is underway.

But there will be no safe injection sites in California after Gov. Gavin Newsom (D) vetoed a bill that would have allowed pilot programs in major cities across the state. And the fate of a proposed Philadelphia safe injection site -- and the Biden administration's attitude toward them -- remains in doubt. That facility was initially blocked by the Trump Justice Department, and two years later, the Biden Justice Department has yet to substantively respond to lawsuit from the site's would-be operators. Just this month, a federal judge gave DOJ just 30 more days to respond. A positive response would remove the obstacle to further expansion of such sites that fear of federal prosecution brings. Meanwhile, the Congressional Research Service has thoughtfully released a report about other options for getting them up and running, such as passing budget amendments similar to those blocking the Justice Department from interfering in marijuana laws.

9. In DC and New York City, Gray Market Weed Finds a Way

In both the nation's capital and the nation's largest city, unregulated marijuana vendors have popped up to supply pent up demand as both cities endure legalization without legal marijuana sales. In New York City, it's only a matter of time before taxed, licensed, and regulators marijuana retailers are able to open, but in the interregnum between legalization and legal access, the pot scene has gone hog wild with marijuana being sold everywhere -- head shops, bodegas, even from folding tables on street corners -- with one particularly hysterical estimate putting the number at "likely tens of thousands of illicit cannabis businesses." The market isn't waiting for the regulators, and its emergence could undercut the legal businesses waiting in the wings. The city has undertaken limited enforcement efforts, but to little effect so far.

In Washington, DC, a congressional rider barring taxed and regulated marijuana sales has seen something similar, but with a DC twist: a multitude of shops that will "gift" you marijuana when you purchase some other item. The stores call themselves I-71 shops, after the 2014 initiative that legalized marijuana in the city and they even have their own industry association, which estimates there are a hundred or so of them. The city vowed a crackdown in August, but put that on hold the following month.

10. For the First Time, SAMSHA Funds Harm Reduction

In December 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced that it would for the first time ever make grants available to harm reduction groups to "help increase access to a range of community harm reduction services and support harm reduction service providers as they work to help prevent overdose deaths and reduce health risks often associated with drug use." SAMSHA would make available $10 million a year in grants for the next three years.

And this year, the first tranche went out. Some 25 different programs from the Lost Dreams Awakening Center in New Kensington, Pennsylvania, to the Mile High Council on Alcoholism and Drug Abuse in Denver, to the Los Angeles County Health Department got grants this year, almost all of them for $398,960. It's a drop in the bucket compared to federal spending on prohibition -- and compared to harm reduction's full funding needs -- but it's a start.

Colombia President's Drug War Heterodoxy Draws Critics, Belgian Drug Trafficker Threats, More... (9/27/22)

Singapore arrests its citizens for doing drugs outside the country, Colombian President Petro's frank talk about the need for a new model drug policy is activating critics, and more.

Cocaine prohibiion is getting some renewed attention these days. (Pixabay)
Foreign Policy

Pair of GOP Senators Question Colombian President's Commitment to Cooperating with US on Drugs. Senators Charles Grassley (R-IA) and Marco Rubio (R-FL) have sent a letter to Dr. Rahul Gupta, Director of the White House Office of National Drug Control Policy (ONCDP -- the drug czar's office), expressing their concerns with Colombian President Gustavo Petro's drug policy changes and intentions to modify extradition policy with the United States. They are upset that Petro has initiated peace talks with the National Liberation Army (ELN), which they specify is "a left-wing Foreign Terrorist Organization" and that he has resumed diplomatic relations with neighboring Venezuela, or "the Maduro narco-regime," as they put it.

"Petro's favorable actions toward actors working closely with drug traffickers in our hemisphere call into question the Colombian president's commitment to cooperating with the United States to prevent the flow of drugs crossing our border," they charged. They also took issue with Petro's proposal to limit extradition to people who refused to cooperate with the Colombian state, saying it "incentivizes criminals to avoid extradition by bribing or coercing the sitting political regime."

The Colombian president has vocally called for an end to the US's current drug policy in Colombia and his government is considering -- but has not yet enacted -- significant drug policy reforms, such as decriminalizing small-scale coca production.

Colombia Ex-President Warns Petro's Call to Change Course in Drug War Could Make Country a "Narco-State." Ivan Duque, the rightist predecessor to current Colombian President Gustavo Petro, has warned that Petro's call to make a radical change in the war on drugs could turn the country into a "narco-state" that could threaten the security of the US and other countries in the region.

"Now, what worries me is that there is now the possibility of getting into the permission, or the legalization of cocaine and consumption," said Duque. "I think that it will be very bad for Colombia and that will be very bad for the countries in the hemisphere, and I think that could generate also a major security threat to the United States. So by no means I'm in favor of the legalization of the cocaine trade… But I also have to say it, Colombia cannot turn into a narco state. I think the world now has unified in the concept of prohibition, and I think if just one country, let's say Colombia, decides to legalize cocaine, it'll turn itself into a narco state."

The Petro government has so far rejected cocaine legalization, but it is considering the decriminalization of small-scale peasant coca cultivation.

International

Belgian Prime Minister Condemns Threats Against Justice Minister from Drug Traffickers. Belgian Prime Minister Alexander De Croo on Saturday condemned serious threats against the country's justice minister as "totally unacceptable" after a car containing firearms was found near his home. Belgian media says the threats could involve kidnapping by drug traffickers, who have been angered by a recent ramping up of Belgian enforcement activity after an unprecedented flare-up of violence among traffickers this summer. Belgium and the neighboring Netherlands are the main European hubs for cocaine trafficking, with 90 tons of the drug being seized in the Belgian port of Antwerp last year.

Singapore Arrests Citizens for Using Drugs in Other Countries. The city-state's Central Narcotics Bureau announced Saturday that authorities had arrested 41 citizens so far this year for using drugs outside the country. Under Singaporean law, citizens who use drugs outside the country face the same punishment as those caught using drugs inside the country. A first offense can garner up to 10 years in prison, but most people charged with the crime are sent to rehabilitation if there are no other charges against them. The policy is in line with the city-state's draconian drug policies, which include the death penalty for trafficking as little as 15 grams of heroin or 500 grams of marijuana.

RI Marijuana Legalization Push Hits Bump, UN Warns Pandemic Could Propel Drug Use, Cultivation, More... (6/25/21)

There's progress on medical marijuana this week in the South, a key Rhode Island lawmaker slams the brakes on a marijuana legalization push, and more.

The coronavirus pandemic could propel new cultivation of illegal drug crops, the UNODC reports. (dea.gov)
Marijuana Policy

Rhode Island Key Lawmakers Slams Brakes on Legalization Effort. On the day after the state Senate passed a marijuana legalization bill, an amended version of Senate Bill 568, House Speaker K. Joseph Shekarchi (D-Warwick) signaled he was in no hurry to finish the job. He said the state could afford to wait to legalize it while authorities consider diverging proposals, that a proper regulatory structure needed to be created, and that he wanted to ensure that the state gets adequate revenues from legalization. "If we're going to legalize recreational use of marijuana, we want to make sure that the state gets its fair share," he said. He said he had seen "six or seven legitimate proposals" for marijuana legalization that are "very divergent." But the Senate has only passed the one.

Medical Marijuana

Alabama Governor Signs Medical Marijuana Bill into Law. Governor Kay Ivey (R) has signed into law a medical marijuana bill, Senate Bill 46. The new law allows people suffering from a specified list of medical conditions to use medical marijuana with a physician's recommendations. The state had enacted a law allowing for the use of CBD in 2014 and broadened that law in 2016, but now has enacted a full-fledged medical marijuana law. But patients will not be allowed to use smokable marijuana nor grow their own. Instead, 12 commercial growers and 12 dispensaries will be authorized to cultivate and distribute medical marijuana. The system is expected to be up and running by the fall of 2022.

Louisiana Governor Signs Bill Allowing Smokable Medical Marijuana. Governor John Bel Edwards (D) has signed into law House Bill 391, which will allow patients to use smokable medical marijuana. The bill passed non-controversially, and its sponsor, Rep. Tanner Magee (D-Houma) said its purposes was to drive down costs and respond to popular demand. "Having the raw form of it, which the public has shown they really want, will allow them to drive down their costs so they can pass on to the consumer and have a real alternative to opioids," Magee said. Smokable medical marijuana will not be available for purchase until January because of time lags with the two state universities who are currently the only institutions authorized to produce medical marijuana.

International

UNODC Releases Annual Report, Warns That Fallout from Pandemic Could Last for Years. The UN Office on Drugs and Crime (UNODC) released the 2021 World Drug Report Thursday and warned that the coronavirus pandemic is propelling more people into drug use, has caused drug trafficking groups to adapt to changed conditions, and sowed economic hardship that could lead to increased cultivation of illicit drug crops. "[D]rug markets have swiftly resumed operations after the initial disruption at the onset of the pandemic; a burst that has triggered or accelerated certain pre-existing trafficking dynamics across the global drug market," UNODC said. "Among these are: increasingly larger shipments of illicit drugs, a rise in the frequency of overland and water-way routes used for trafficking, greater use of private planes for the purpose of drug trafficking, and an upsurge in the use of contactless methods to deliver drugs to end-consumers. The resilience of drug markets during the pandemic has demonstrated once again traffickers' ability to adapt quickly to changed environments and circumstances." On the potential increase in drug crops, UNODC said: "While the impact of COVID-19 on drug challenges is not yet fully known, the analysis suggests that the pandemic has brought increasing economic hardship that is likely to make illicit drug cultivation more appealing to fragile rural communities. The social impact of the pandemic -- driving a rise in inequality, poverty, and mental health conditions particularly among already vulnerable populations -- represent factors that could push more people into drug use."

UN For First Time Engages with Marijuana Regulations. In the 2021 World Drug Report released Thursday, the UN Office on Drugs and Crime called for a global ban on marijuana advertising, saying "a comprehensive ban on advertising, promoting and sponsoring cannabis would ensure that public health interests prevail over business interests." While the call is in line with the UN's long-standing opposition to marijuana legalization, it also marks the first time the anti-drug agency has engaged with the notion of regulating -- not merely prohibiting -- marijuana use and production.

NY Syringe Legalization Passes Senate, Portugal Ponders Marijuana Legalization, More... (6/10/21)

Marijuana legalization bills in Delaware and Rhode Island get delayed, Morocco's parliament has approved the legalization of hemp and medical marijuana, and more.

Even though coca planting in Colombia was down last year, cocaine production was up, UNODC says. (Creative Commons)
Marijuana Policy

Federal Bill to Let Researchers Study Marijuana from Dispensaries Wins Committee Vote. Tucked inside an omnibus transit bill is a provision that would let researchers study marijuana from state-legal marijuana shops instead of relying on marijuana from the only currently federally authorized source. That bill and its marijuana research provision passed the House Transportation and Infrastructure Committee this week and now heads for a House floor vote.

Delaware Marijuana Legalization Vote Delayed. The House was set to vote on a marijuana legalization bill, House Bill 150, Thursday, but that didn't happen. Bill sponsor Rep. Edward Osienski (D) said lawmakers needed more time to consider proposed changes in the bills. "House Bill 150 is an extremely important piece of legislation with many complicated moving parts," he said. "In recent days, a number of amendments have been filed by myself and other legislators that would make significant changes to the bill as written. Accordingly, my colleagues and I need time to consider the implications of these various amendments before bringing the bill to the House floor for a vote."

Rhode Island House Speaker Says Marijuana Legalization Bill Could Be Taken Up in Summer or Fall. Marijuana legalization won't be taken up during the remaining days of the regular legislative session, House Speaker Joseph Shekarchi (D) said. "Marijuana legalization will not be decided until after the budget is adopted this month," Shekarchi said Wednesday. "It is possible we will return sometime in the summer or fall."

Harm Reduction

New York Senate Approves Bill Decriminalizing Needle Possession. The state Senate this week approved Senate Bill 2523, which would decriminalize the sale and possession of needles for injecting drugs. The bill now goes to the Assembly, where it is expected to pass.

International

Colombia Coca Planting Shrank Last Year but Cocaine Output Increased, UNODC Says. The UN Office of Drugs and Crime (UNODC) says in a new report that Colombia managed to reduce the area of coca planting by 7% in 2020, but that the potential production of cocaine derived from coca grew by 8%. That means the country produced more than 1,228 metric tons of cocaine last year. UNODC said the increase in production despite the decrease in cultivation was because farmers are sowing more productive varieties of coca, using more efficient agricultural techniques, and planting multiple crops in the same year.

Morocco Parliament Approves Hemp, Medical Marijuana Legalization -- But Not Recreational Marijuana. The upper house of Parliament has approved a bill to legalize the cultivation and sale of cannabis for industrial and medicinal purposes, but as Interior Minister Abdeluafi Laftit said, "the illegal use and consumption of marijuana is still prohibited in the country." The bill has already passed the lower house.

Portuguese Parliament to Debate Proposed Marijuana Legalization Bills. Portugal decriminalized drug possession two decades ago, but has never gotten around to legalizing marijuana. That could be about to change. Parliament will meet soon to debate two draft laws that would legalize marijuana.

Biden's Drug Policy Priorities Are a Small Step in the Right Direction, But Old Attitudes Linger [FEATURE]

On April 1, the Biden administration gave us the first big hint of what its drug policy will look like as it released the congressionally-mandated Statement of Drug Policy Priorities for Year One. The result is a definite mixed bag: a heavy dose of drug prevention, treatment, and recovery, along with an acknowledgement of harm reduction and a nod in the direction of racially-sensitive criminal justice reform, but also a reflexive reliance on prohibitionist drug war policies both at home and abroad.

And nothing about the most widely used illicit drug by far: marijuana. The word "marijuana" appears not once in the heavily annotated 11-page document, and the word "cannabis" only once, in the title of an academic research paper about the onset of teen drug use in the footnotes. That's perhaps not so surprising, given that, in response to a reporter's question, Vice President Harris said last week the administration was too busy dealing with other crises to worry about making good its campaign pledges about marijuana reform.

What is on the administration's mind is "the overdose and addiction crisis." Citing ever-increasing drug overdose deaths, the statement says "addressing the overdose and addiction epidemic is an urgent priority for [the] administration." But the solution is not to imprison drug users, with the statement noting that "President Biden has also said that people should not be incarcerated for drug use but should be offered treatment instead." (Underlying that seemingly humane approach is the errant presumption that all or most drug users are addicts in need of treatment when, depending on the drug, only between one in five and one in 10 drug users fit that dependent or problematic drug user description.)

Here are the Biden administration's drug policy priorities, all of which are gone into in detail in the statement:

  • Expanding access to evidence-based treatment;
  • Advancing racial equity issues in our approach to drug policy;
  • Enhancing evidence-based harm reduction efforts;
  • Supporting evidence-based prevention efforts to reduce youth substance use;
  • Reducing the supply of illicit substances;
  • Advancing recovery-ready workplaces and expanding the addiction workforce; and
  • Expanding access to recovery support services.

Prioritizing treatment, prevention, and recovery is bound to be music to the ears of advocacy groups such as Faces and Voices in Recovery (FAVOR), whose own federal policy and advocacy priorities, while focusing on specific legislation, lean in the same direction. But the group also advocates for harm reduction practices the administration omits, particularly supervised consumption sites. FAVOR noted the administration's statement without comment.

As with the failure to even mention marijuana, the Biden administration's failure to include supervised consumption sites in its embrace of harm reduction -- it is wholeheartedly behind needle exchanges, for example -- is another indication that the administration is in no hurry no rush down a progressive drug reform path. And its prioritizing of supply reduction implies continued drug war in Latin America ("working with key partners like Mexico and Colombia") and at home, via support of High Intensity Drug Trafficking Areas (HIDTA) and "multi-jurisdictional task forces and other law enforcement efforts to disrupt and dismantle transnational drug trafficking and money laundering organizations." Prohibition is a hard drug to kick.

Still, naming advancing racial equity issues as a key priority is evidence that the Biden administration is serious about getting at some of the most perverse and corrosive outcomes of the war on drugs and is in line with its broader push for racial justice, as exemplified by Executive Order 13985, "Advancing Racial Equity and Support for Underserved Communities Through the Federal Government," issued on Biden's first day in office. And it is in this context that criminal justice system reform gets prioritized, although somewhat vaguely, with the promise of the creation of an "interagency working group to agree on specific policy priorities for criminal justice reform."

The Drug Policy Alliance (DPA) has some specific policy priorities for criminal justice reform, too, and they go far beyond where the administration is at. In its 2020 Roadmap for the incoming administration released in November, the group calls for federal marijuana legalization, drug decriminalization, and a slew of other criminal justice and policing reforms ranging from ending mandatory minimum sentencing and the deportation of non-citizens for drug possession to barring no-knock police raids, ending the transfer of military surplus equipment for counter-narcotics law enforcement, and dismantling the DEA. And the federal government should get out of the way of supervised consumption sites, or in DPA's politically attuned language "overdose prevention centers."

"We're glad the administration is taking important steps to address the overdose crisis -- by increasing access and funding to harm reduction services and reducing barriers to life-saving medications -- especially as people are dying at an alarming rate. We also appreciate their commitment to studying how to advance racial equity in our drug policies and best implement innovative practices on the ground. But it's clearly not enough. We need action," DPA Director of the Office of National Affairs Maritza Perez said in a statement responding to the administration's statement. "Black, Latinx and Indigenous people continue to lose their lives at the hands of law enforcement in the name of the drug war, and yet, the administration has chosen to prioritize increased funding for law enforcement. We need supervised consumption sites, not more money for police."

"And while we commend the Administration for taking steps to reduce employment discrimination, unless we address the biggest barrier for people trying to get a job -- past drug convictions and arrests -- we will still be left with significant inequities and racial disparities in the workplace," Perez continued. "It's time we get serious about saving lives and repairing the damage that has been caused by the drug war, particularly on Black, Latinx and Indigenous communities. We can start by passing federal marijuana reform and ending the criminalization of people for drugs in all forms."

Young drug reformers also had a few bones to pick with the administration's priorities. In their own statement in response to the administration, Students for Sensible Drug Policy applauded priorities such as more access to treatment and more research on racial equity, it complained that the administration priorities "fail to provide adequate support to Young People Who Use Drugs (YPWUD) in this country" -- especially those who use drugs non-problematically.

"There are no steps being taken to support YPWUD that do not want to and will not stop using drugs," SSDP said. "Young people have feared and faced the consequences of punitive drug policies and shouldered the burden of caring for their peers who use drugs for far too long. Young leaders calling for drug policy reform recognize that simply using drugs is not problematic and that we can support the safe and prosperous futures of People Who Use Drugs (PWUD) without forcing them to stop as a pre-condition for compassion, care, and opportunity."

Although only time will tell, for drug reformers, the Biden administration is looking like a step in the right direction, but only a step, and its policy prescriptions are limited by a vision of drug use rooted in the last century. Perhaps they can be pressured and prodded to plot a more progressive drug policy path.

NM Legalizes Marijuana, Criminal Justice Reformer Named DEA Chief, More... (4/13/21)

A simple policy change causes a massive drop in pot arrests in San Antonio, the Maryland legislature has approved the legalization of drug paraphernalia, Vancouver sets proposed drug decriminalization quantities, and more.

New Mexico becomes the latest state to legalize marijuana, and the third in the past few weeks. (Creative Commons)
Marijuana Policy

Minnesota Marijuana Legalization Bill Advances Again. A marijuana legalization bill, House File 600, passed a fifth House committee Monday. The bill was approved by the House Environment and Natural Resources Finance and Policy Committee on an 11-7 vote. It now heads to the House Judiciary Finance and Civil Law Committee, which is scheduled to take up the measure on Wednesday.

New Mexico Legalizes Marijuana. With the signature Monday of Gov. Michelle Lujan Grisham (D) on a marijuana legalization bill, House Bill 2, New Mexico has legalized marijuana, becoming the 17th state to do so, the third to do so in the past few weeks, along with New York and Virginia, and the seventh to do since last November's elections.

San Antonio Pot Prosecutions Down 99% Since 2018. Under a cite and release policy instituted by Bexar County District Attorney Joe Gonzales (D), the number of people arrested for marijuana possession has dropped dramatically. In 2018, the DA's office prosecuted 4,515 misdemeanor marijuana possession cases, but in 2020, that number had dropped to 15. That's a 99.6% decrease.

Drug Policy

Biden Names Criminal Justice Reform Advocate Anne Milgram to Head DEA. President Joe Biden (D) has selected former New Jersey attorney general Anne Milgram, a longtime criminal justice system reform advocate, to head the Drug Enforcement Administration (DEA), the White House said Monday. The agency has been without a Senate-confirmed leader since the Obama administration.

Maryland Legislature Approves Bill to Legalize Drug Paraphernalia. The General Assembly on Monday approved a bill to legalize the possession of drug paraphernalia, Senate Bill 420. The bill has already passed the Senate, so it now heads to the desk of Gov. Larry Hogan (R). The House passed the bill by a veto-proof margin, but the Senate tally was one short of the number needed to override a veto.

Sentencing

California Bill to End Mandatory Minimums for Drug Offenses Passes Senate. A bill that seeks to end mandatory minimum sentences for nonviolent drug offenders, Senate Bill 73, passed the Senate Monday on a 25-10 vote. The bill now heads to the California State Assembly.

International

Vancouver Outlines Personal Possession Amounts for Drug Decriminalization Proposal. As part of its application to Health Canada for a federal exemption from federal drug laws to decriminalize drug possession in the city, Vancouver has outlined its recommendations for what amounts should be decriminalized. The city is recommending the decriminalization of one gram or 10 rocks for crack cocaine, 1.5 grams for amphetamines, two grams for opioids such as heroin and fentanyl, and three grams for cocaine. Mayor Kennedy Stewart said Monday the goal is remove criminal penalties and reduce stigma by focusing on a health-centered approach.

Fed Bill Would Protect Immigrants With Marijuana Records, ME Drug Reform Push, More... (3/9/21)

The South Dakota Senate throws the governor a curve ball, New Jersey lawmakers are considering lessening the penalties for home marijuana grows -- but not legalizing them -- and more.

A Maine bill would remove criminal penalties for the possession of drug paraphernalia. (Creative Commons)
Marijuana Policy

Marijuana Would Not Count Against Immigrants' 'Good Moral Character' Under New Congressional Bill. Immigrants who admit having used, possessed, or distributed marijuana in the past would no longer be denied US citizenship under a new bill, HR 1614 filed Monday by Rep. Brendan Boyle (D-PA). The bill would address the use of the "good moral character" requirement used to deny citizenship to people with marijuana histories. The bill is before the House Judiciary Committee.

Maryland Poll Has Strong Support for Marijuana Legalization.A Goucher College poll released Tuesday has a full two-thirds of Marylanders supporting marijuana legalization, an all-time high. And for the first time, even 50% of Republicans are in favor. The poll comes as the state legislature takes on the issue.

New Jersey State Senators Are Working on a Home Grow Bill, But Without Home Grows. Marijuana legalization advocate Sen. Nicholas Scutari (D-Linden) and Senate Majority Leader Steve Sweeney (D-West Deptford) are drafting a bill on home grown marijuana, but it looks like the bill won't actually allow home grows, only lessen the penalties for what is currently a 10-to-20-year felony for growing more than 10 plants and five years for growing a smaller number.

Rhode Island Marijuana Legalization Bill Filed. Senate Majority Leader Michael McCaffrey (D-Warwick) and Sen. Joshua Miller (D-Cranston) were set to file a marijuana legalization bill Tuesday, but no details have been released as of press time. Former Gov. Gina Raimundo (D) had called for marijuana legalization, but she is now out of office and serving as secretary of commerce in the Biden administration.

Hemp

Idaho House Approves Hemp Bill. The House on Monday overwhelmingly approved a bill to legalize hemp production in the state, HB 126. The bill now goes to the Senate. Idaho is the only state that has yet to legalize industrial hemp production.

Medical Marijuana

South Dakota Senate Agrees to Medical Marijuana Program Delay, But Only with Decriminalization Now. The Senate approved a House bill to delay implementation of the state's voter-approved medical marijuana program, HB 1100, but only after dramatically amending it to include the immediate decriminalization of up to an ounce of marijuana and repeal of the state's unique felony drug ingestion law. Now, the House and Senate have to try to come to an accord over the bill, most likely in conference committee.

Drug Policy

Maine Lawmakers Aim to Decriminalize Drug Possession. Legislators have filed a number of bills this year aimed at undoing the state's hardline drug war approach. One bill, HP 713, would decriminalize drug possession; another, HP 732, would remove penalties for the possession or exchange of drug paraphernalia; while yet another, SP 223, would reform the state's drug sales law so that people could not be charged with distribution basely solely on the amount of drugs seized.

Norway Government Proposes Depenalization, ND House Approves MedMJ Edibles, More... (2/19/21)

Medical marijuana is receiving attention at various state houses, a trio of US senators warn the Philippine government on imprisoned drug war critic Sen. Leila De Lima, the Iowa Senate looks resolutely backwards, and more.

Medical marijuana is on people's minds in various state legislatures right now. (Creative Commons)
Medical Marijuana

North Dakota House Approves Medical Marijuana Edibles. The House has approved a measure, House Bill 1391, that would allow medical marijuana patients to use edibles. The bill would limit edibles to 10 milligrams of THC and allow patients to possess edibles with up to 500 milligrams.

New Jersey Medical Marijuana Licensing to Resume After Appellate Court Ruling. The state's appellate court ruled Thursday to uphold the denial of seven medical marijuana licenses, clearing the way for the state to begin dealing with nearly 150 license applications that have piled up while the case was being contested.

Virginia General Assembly Approves Sales of Buds for Medical Marijuana Patients. A bill that would allow medical marijuana patients to buy flowers, House Bill 221, has passed the General Assembly. Currently, only highly processed oils, tinctures and edibles are allowed to be sold. The bill now goes to Gov. Ralph Northam (D).

Oklahoma House Approves Expanding Non-Resident Medical Marijuana Patient Licenses. The House voted on Thursday to approve House Bill 2022, which would extend the length of medical marijuana licenses granted to out-of-state residents. The bill would lengthen the licenses' period of validity from 30 days to two years. The bill also would open up licenses to resident of all 50 states, not just those with existing medical marijuana. The bill must still be approved by the Senate.

Drug Paraphernalia

Iowa Senate Approves Bill to Crack Down on Meth Pipes. The Senate on Wednesday unanimously approved Senate File 363, which aims to crack down on businesses selling glass pipes for smoking meth by requiring them to pay a $1,500 licensing fee and charging a 40% surcharge tax on each pipe sold. The bill carries civil penalties for selling without a license and makes using the devices as drug paraphernalia a serious misdemeanor. The bill now goes to the House.

Drug Testing

Iowa Senate Approves Bill to Make Using Synthetic Urine to Defeat a Drug Test a Crime. The Senate voted on Wednesday to approve House File 283, which would make it a criminal offense for an employee to use synthetic urine to "defraud" a workplace drug test. A first offense would be a misdemeanor punishable by up to a year in jail. The bill now goes to the House.

Foreign Policy

US Senators Urge Full Exoneration and Release of Philippines Drug War Critic Senator Leila De Lima. On Thursday, Senators Edward J. Markey (D-MA) top Democrat on the East Asia and Pacific Subcommittee, Dick Durbin (D-IL), and Patrick Leahy (D-VT), released a statement regarding the acquittal of Senator Leila de Lima in one of three bogus charges filed against her by the Government of the Philippines. Senator de Lima has been unjustly detained for four years next week on politically-motivated charges, widely condemned by human rights organizations and governments around the world as an illegitimate response meant to punish her for criticizing the policies of President Rodrigo Duterte. "While we are pleased that one of the three illegitimate charges against Senator De Lima has been dropped, it is clearly not enough." said the Senators. "The Duterte administration has wrongfully detained Senator De Lima for four years under false charges because she is willing to speak out and stand up to the egregious abuses of the government. President Duterte has tried to silence his critics and the independent press through false and politically motivated charges, but his disdain for human rights, free speech, and democracy is on clear display to the world. We will continue to hold the Duterte government responsible for its abuses until Senator De Lima is released, all of the fabricated charges against her and other prisoners of conscience are dismissed, and the victims of President Duterte's campaign of abuse against the Filipino people have obtained justice."

International

Norwegian Government Proposes Drug Depenalization. Norway's center-right government proposed Friday a dramatic restructuring of its drug laws to focus on treatment rather than jail or fines for people found in possession of small quantities of drugs. "Decades of criminal punishment has not worked," said Liberal Party leader and Education Minister Guri Melby. "We will no longer stand by and watch people being stigmatised and called criminals when they are in fact ill." Drugs would remain illegal, but possession of small quantities would no longer be punished. Instead people would face mandatory drug counseling, and a fine for refusing to participate. The move comes as the government faces a rising challenge in the September parliamentary elections from the Center Party, which has criticized the plans as leading to more drug use, not less.

CT Governor Includes Marijuana Legalization in Budget Proposal, Baltimore Announces Policing Reform, More... (2/11/21)

The appetite for busting pot smokers grows weaker in Fort Lauderdale and Milwaukee, Idaho could this year finally legalize hemp, and more.

Baltimore police are reforming some of their stop and search practices. (Pixabay)
Marijuana Policy

Connecticut Governor Includes Marijuana Legalization Plan in Budget Proposal. Gov. Ned Lamont (D) on Wednesday released his budget request, which includes a plan to legalize marijuana. His plan would involve creating a "comprehensive framework for the cultivation, manufacture, sale, possession, use, and taxation of cannabis that prioritizes public health, public safety, and social justice," Lamont said. "The proposal builds on the significant work that the Legislature has done on adult-use cannabis in recent sessions and ensures alignment with the approaches pursued by regional states," a summary of the plan says.

Florida's Broward County Gives Up on Misdemeanor Pot Prosecutions. Broward County (Ft. Lauderdale) State Attorney Harold Pryor has told county police agencies not to bother referring misdemeanor marijuana possession cases for prosecution. "Prosecuting these cases has no public safety value and is a costly and counterproductive use of limited resources," Pryor wrote in a memo to the law enforcement agencies. He asked them to refer violators to drug-treatment programs instead of the criminal justice system. Possession of up to 20 grams is a misdemeanor under state law. Neighboring Miami-Dade County enacted a similar policy six months ago. Dade and Broward are the state's two most populous counties.

Milwaukee County Board to Consider $1 Fine for Pot Possession. Board Supervisor Sylvia Ortiz-Velez has proposed an ordinance that would make the maximum penalty for possession of up to 25 grams of marijuana a $1 fine. Currently, possession is punished with fines of between $250 and $500. The board's Judiciary Committee will take up the ordinance on March 11.

Hemp

Idaho House Committee Files Hemp Bill. Acting on the behest of the state Farm Bureau, the House Agriculture Committee voted unanimously Wednesday to file legislation to legalize industrial hemp in the state -- the only state yet to do so. The committee vote sets the stage for a full hearing on the bill, which agriculture leaders say they hope will end years of debate on legalizing the crop.

Drug Testing

Utah Bill Would Ban Hair Follicle Drug Tests in Child Welfare Cases. Rep. Christine Watkins (R-Price) has filed House Bill 73, which would ban the use of hair follicle drug tests in child welfare cases. "It discriminates against people with dark hair," she said in a House Judiciary Committee hearing Tuesday. "This is very, very disturbing," Watkins said. "Melanin in dark hair binds with the drugs for a longer time." That means Black and Hispanic parents disproportionately test positive in those tests, she added. The bill has the support of the state Department of Child and Family Services, which said it had been moving away from using the tests.

Law Enforcement

Baltimore Police Unveil New Stop and Search Policies to Comply with Federal Consent Decree. Police Commissioner Michael Harrison announced Wednesday that the department has implemented a new "stops, searches and arrests" policy as the department seeks to comply with a federal consent decree and eliminate unconstitutional interactions with the public. Under the policy, officers will be trained in what constitutes "reasonable, articulable suspicion" for stopping a citizen. The new policy makes clear that someone fleeing when he sees police is not an adequate reason to stop and investigate him. Police had frequently resorted to "jump outs at corners," jumping out of their vehicles at corners known for drug trafficking and detaining anyone who ran away. No more.

Book Review: Three Takes on the Opioid Crisis [FEATURE]

RX Appalachia: Stories of Treatment and Survival in Rural Kentucky, by Lesly-Marie Buer (2020, Haymarket Books, 264 pp., $22.95 PB)

Death in Mud Lick: A Coal Country Fight Against the Drug Companies That Delivered the Opioid Epidemic, by Eric Eyre (2020, Scribner, 289 pp., $28.00 HB)

White Market Drugs: Big Pharma and the Hidden History of Addiction in America, by David Herzberg (2020, University of Chicago Press, 365 pp., $27.50 HB)

America remains in the grip of what is arguably its third great opioid addiction and overdose crisis. It began in the late 1990s as doctors tried to address an historic problem of under-prescribing and unavailability of opioids for chronic pain treatment that affected many patients. But mistakes were made along the way, and a massive tide of not always well targeted prescription opioids swamped the country. As regulators and law enforcement cracked down on pain pills, that morphed into a deadly wave of heroin addiction. And then we got fentanyl, which quickly took first place as a cause for overdose deaths. Produced mostly in China and Mexico, fentanyl is used by some hardcore addicts with high tolerance, but mainly appears as an adulterant added to heroin or in counterfeit prescription pills.

The authors of the three books reviewed here take on various aspects of the phenomenon, from the granular nitty-gritty of the lives of poor, white, female drug users ensnared in the treatment and rehab system in present-day Appalachia, to a state-level look at how drug distribution companies flooded West Virginia with literally billions of prescription opioids, to a long-term overview of the effort to regulate drugs and the subsequent -- and enduring -- historic division of drug use and users into markets black and white. (And by white markets, we are referring not only to legality but also, sadly yet unsurprisingly, skin color.)

Taken together, the three books weave a damning indictment of pharmaceutical companies, the people and entities that are supposed to regulate them, and the moral crusaders who -- too often, successfully -- use the issue of drug use to call for repressive policies, especially aimed at people who aren't "good people;" that is, poor and/or non-white people.

There are also some things the books don't do more than tangentially. They don't touch on the issue of access to pain medications for chronic pain patients. These are people who often suffer not from too-easy access to prescription opioids, but from obstacles to access, and who have suffered even more as politicians and regulators moved to rein in what they argue is massive overprescribing of such medications.

Whether it's being prosecuted for seeking their medicine in the black market or being forced to jump through hoops to obtain their medicine or being refused it altogether in the white market, these are people whose access to the medicines they need is encumbered. Their story is an important part of the debate over opioids (and drug policy more generally), but it gets only a side mention in one of these three works. But over-prescribing of opioids and under-prescribing of them continue to coexist.

The books also don't attempt to disentangle supply-driven opioid abuse, from the so-called "deaths of despair." The same social and economic factors that have driven up the suicide rate in recent decades, and which arguably helped to elect Donald Trump, increase the rates at which drugs are used and abused, including opioids. That in turn leads to more overdose deaths, and some apparent overdoses actually are suicides.

And the authors don't ask their readers to question whether any given "pill mill" or seemingly too large prescription, is really what it looks like. If we accept that abuses in the supply system have played a role in the opioid crisis, that doesn't mean that any given doctor or pharmacist or distributor is guilty as charged. A medical practice with patients treating patients from hundreds of miles away, could be a "pill mill," but it could also have the one doctor who understands pain treatment and is willing to work with poor people whom other doctors view as too risky. A prescription that seems huge because of the number of pills, could represent diversion to the underground market – or it could mean that a long-term pain patient who needs a large dosage because of tolerance built up over time, and who doesn't use technology like a medically-inserted morphine pump, is reliant on pills and their standard-sized dosages that are designed for less tolerant patients. Without considering those contexts, pill numbers can be a misleading metric, at least some of the time.

The books do discuss some options for making effective opioid addiction treatments more easy for more patients to obtain, or for reducing the likelihood of a user coming to serious harm. But the most effective treatment for this type of addiction is the use of other opioids, in what's known as Medication Assisted Treatment (MAT). Through controlled use of methadone or buprenorphine supplied by clinics, people with opioid addictions are able to stabilize their lives and avoid catastrophic physical harms, while maintaining responsibilities like work and family needs. Making MAT available through a doctor's office, while training doctors in their use, would reduce the harm of opioid addiction by providing a legal alternative that works -- in this case a quality-controlled opioid. Offering HAT, too -- heroin assisted treatment, or heroin maintenance, as Canada and some European countries do for people who have tried methadone or buprenorphine without succeeding -- would do more.

And that begs the question about prohibition itself. Though some may find it counterintuitive to talk about legalization as a solution to a problem driven by increased drug availability, it is the case that this opioid crisis in its entirety has transpired under the current system – a system in which all drugs of this type are illegal unless one has a prescription, and in which most people are usually not supposed to be given prescriptions. Fentanyl, which today accounts for 2/3 of US opioid deaths and has room to spread geographically and increase further, is a textbook example of the consequences of prohibition -- most people taking it, and nearly all of those who die from it, thought they were taking something else. If people who developed addiction problems had access to predictable, (relatively) safe, easy to access and financially affordable options, that might be better even than a less heavy-handed system but still prohibition-based system.

All that said, there is an opioid crisis. These three books provide an eye-opening and important look at some critical sides of the phenomenon.

Lesly-Marie Buer is a Knoxville-based harm reductionist and medical anthropologist whose RX Appalachia is a compelling examination of the socially constructed suffering of mainly poor, white women who use drugs in a cluster of eastern Kentucky counties. She spent months living in the area, followed the women to court, to drug treatment, and opioid maintenance programs, and interviewed them extensively over time.

The result is a nuanced portrayal of these women's lives and struggles as they contend with the demands of institutions of social control even as they have to deal with poverty, child custody issues, and their stigmatization as drug users and therefore bad mothers. In that very important sense, RX Appalachia gives voice to the voiceless.

It also voices an unrelenting critique of a social and political system that provides unequal access to resources, chronically underfunds services to the poor and needy -- including but not limited to drug treatment and mental health services -- and is more willing to impose social controls on these women than to help them deal with the complexities of their lives. Appalachia RX is an important contribution to our understanding of the way drug policies, as well as broader social and economic trends, play out on the bodies of these multiply oppressed women.

How some of those women got strung out in the first place is the subject matter of Death in Mud Lick, still in Appalachia and just across the West Virginia line from those Kentucky women. Charleston Gazette-Mail reporter Eric Eyre won a Pulitzer Prize for his years of doggedly chasing down the story of how drug distribution companies pumped billions of opioid pain pills into the state in just a few years, and here, he puts that reporting in book form. It's quite a tale.

Eyre starts with a single drug overdose death, and by the time he's done, has unraveled a tangled tale of negligence, indifference, and profit-driven decision-making that left 1,728 West Virginians dead of drug overdoses in a six-year period. Thanks to Eyre's journalistic persistence and to a legal team determined to get to the bottom of the flood of pain pills that overwhelmed the state (and the region and the nation), we now know that drug companies dumped some 780 million hydrocodone and oxycodone tablets into the state during that same period.

There's plenty of blame to go around. Pharmaceutical corporations such as Purdue aggressively promoted their opioid products, doctors turned medical practices into pill-prescribing machines, pharmacies blithely filled numberless prescriptions, and drug distribution companies such as Cardinal and McKesson just as blithely delivered all those pills to the pharmacies, despite warning signs.

And regulators failed to regulate. Whether it was the state Board of Pharmacy or the DEA, regulators were asleep at the switch as an opioid epidemic grew right in front of them. And state officials were compromised by ties with the pharmaceutical industry and the distributors.

Eyre tells his tale with journalistic panache, taking the reader with him as he and his struggling newspaper take on the state political establishment and the distributors in the court battles that ultimately forced the companies and the DEA to release the records that documented the deluge of opioids. Death in Mud Lick is a real eye-opener.

But for David Hertzberg, an associate professor of history at the University of Buffalo and author of White Market Drugs, Eyre's story is just the latest chapter in the long history of America's effort to control drugs. Hertzberg begins with the opioid crisis of the late 19th Century and ably describes how the competing forces seeking to deal with it -- therapeutic reformers, repressive moral entrepreneurs, pharmaceutical companies, the medical profession -- created a class- and race-based bifurcation of the world of psychoactive substances into "medicines" and "drugs."

If it was prescribed by a physician, it was medicine. If not, not. The world of legal, regulated drugs became Hertzberg's white market. The world of repressed, prohibited drugs is the familiar black market. One serves middle-class white people and is concerned with consumer safety. The other serves the poor, the unconnected, the immigrant, the people of color, whose drug use and sales are considered crimes.

The history of drugs in America is well-trodden ground, but Hertzberg brings both new revelations and a new perspective to the subject. The drug reform movement's archvillain, Harry Anslinger, the master of Reefer Madness propaganda, becomes more than one-dimensional as Hertzberg tells the story of his strict scientific approach to opioids. As head of the Federal Bureau of Narcotics, Anslinger enlisted a Committee on Drug Addiction to closely study opioids, and those scientists even developed their own new opioids (they were market flops), as well as closely measuring the addictive potential of other potential new opioid products. Here, Anslinger was acting not as the heavy-handed lawman, but as the protector of white market consumers.

And as he tells the story of pharmaceutical companies continually coming up with new psychoactive products, patterns begin to occur. After the original drug prohibition laws a century ago effectively suppressed opioid use for decades, the pharmaceutical companies came up with barbiturates in the 1930s, amphetamines in the 1940s and 1950s, benzodiazepines in the 1970s and 1980s, before hitting it big again with opioids in the OxyContin-led bonanza beginning in the 1990s and lingering like a bad hangover to the present day. In all those cases, the profit motives of the drug makers overwhelmed regulatory structures designed to protect those good, deserving consumers of the white market -- even as the drug companies demonized black market drug users for causing the problems.

Given this history of pharmaceutical and regulatory fecklessness, Hertzberg comes to a shocking, but not really surprising conclusion: Left to their own devices, profit-drive drug companies peddling addictive products will function in ways that are incompatible with the public health. In Hertzberg's words:

"Profit-driven drug markets follow a predicably damaging cycle. Companies hype new medicines as safe and beneficial and sell with insufficient regard for consumer safety; a health crisis ensues as consumers are left ill-equipped to make informed decisions; authorities respond with consumer protections and destructive drug wars; the pharmaceutical industry devises strategies to circumvent the new restrictions and start the cycle again. After umpteen repetitions of this cat and mouse game, it may be time to acknowledge the impossibility of establishing a safe, for-profit market for addictive drugs. Alternatives exist: state monopolies, for example, or public utility models. We need to consider these and other creative ideas for dramatically minimizing or even eliminating profit from psychoactive capitalism."

Whether a shift to models of that type is what's needed, or just better regulation, is a question for debate. But it's clear that ending drug prohibition isn't enough. Reimagining the white market is necessary, too.

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