There are signs of dissension around the ReformCA legalization initiative, Oklahoma medical marijuana supporters are searching for signatures, a federal bill to require police to report lethal force incidents is introduced, and more.

Heroin killed a record number of people in Florida last year, but more died of prescription drug overdoses. (NJ State Police)

Last Minute Uncertainties for California's ReformCA Initiative. There are signs the unified front behind the pending ReformCA legalization initiative isn't as unified as was thought. The LA Weekly is reporting that one of its key backers, the Drug Policy Alliance, might go its own way. "We want to have a plan B option that's ready to go in case [another] initiative doesn't represent and uphold the values and principles," said Lynne Lyman, the DPA's California director. "We're most concerned about a case where it doesn't move forward." DPA, NORML, and the Marijuana Policy Project had been listed on the ReformCA website as supporters; now they're not. MPP has confirmed that it asked for its name to be removed. But Dale Gieringer, a spokesman for ReformCA, downplayed the situation. "It's not that chaotic. It will all be clear in a few days. It's about last-minute negotiation."

Medical Marijuana

Oklahoma Initiative Signature Gathering Goes Forward. The Green the Vote medical marijuana initiative campaign was doing signature gathering in Ardmore Thursday. The group has 90 days to gather 130,000 valid voter signatures to qualify for the November 2016 ballot.

Heroin and Prescription Opiates

Florida Heroin Deaths at All-Time High. Heroin was detected in 447 fatalities last year, according to state medical examiners. That's more than double the 199 people who died with heroin in their bodies in 2013. Fentanyl was also surging; there were 538 deaths of people who had the powerful prescription opioid in their systems, nearly double the 292 from the previous year. While heroin deaths were at record levels, more than twice as many (978) people died with oxycodone in their systems. There were 8,587 fatal drug overdoses reported in Florida last year; many of them included multiple substances.

Drug Policy

New Hampshire GOP Lawmakers Want Online Drug Dealer Registry. Three GOP lawmakers have presented slightly different bills that would create an online drug dealer registry similar to sex offender registries, but advocacy groups said such a move is unfair and unnecessary. "It's a stupid, gratuitous and entirely unnecessary proposal," said Ethan Nadelmann, executive director of the Drug Policy Alliance. ''It reminds me of the sort of foolish rhetoric and foolish laws that flowed from back at the height of the drug war." Click on the title link for more detail.

Law Enforcement

Federal Bill Requiring Police to Report Use of Lethal Force Filed. Sen. Tim Scott (R-SC) Thursday filed S. 2112, "a bill to require law enforcement agencies to report the use of lethal force, and for other purposes."

A Wisconsin tribe may legalize marijuana, Ohio foes line up against the legalization initiative there, more Washington state dispensaries will be forced to close, a Utah SWAT reporting law shows what those squads are up to -- and it isn't hostage situations or "active shooters" -- Bolivia coca growing down, and more.

Bolivian President Evo Morales had a few choice words for US drug policy. (wikimedia.org)

Ohio Legalization Initiative Foes Get Organized. Business, children's advocacy, parents, religious groups, and other groups organizing to defeat the ResponsibleOhio marijuana legalization initiative have formed an opposition organization, No on 3. Some are opposing it because of its limitations on who could grow commercial marijuana; others, like the Ohio Children's Hospital Association, have more traditional plaints: "The legalization of marijuana in Ohio at this time and the way issue three proposes would set too dangerous of a precedent and put at risk the other three million kids in the state," said Nick Lashutka, president of the association.

Wisconsin's Menominee Tribe to Vote on Legalizing Marijuana. The Menominee, one of the poorest tribes in the country, are set to vote this week on whether to legalize and sell marijuana. The move comes after the state rejected the tribe's plan to build a casino in Kenosha. The Menominee say they are interested in marijuana to "Explore all opportunities to diversify the tribe's economy, create jobs, and provide revenue to the tribe necessary to fund health, education, social, law enforcement and and other important services."

Medical Marijuana

Most Tacoma Dispensaries to Be Shut Down. The city council this week decided to shut down most of the city's 60 unregulated medical marijuana dispensaries. The dispensaries have 45 days to close. After passage of Senate Bill 5052, which essentially folds the medical marijuana system into the recreational marijuana system, dispensaries and collective gardens will have to get licenses from the state beginning next July 1 or shut their doors.

Heroin and Opioids

Massachusetts Officials Want to Jack Up Penalties for Fentanyl. State Attorney General Martha Healey joined legislators and law enforcement officials at a press conference Tuesday to press for legislation that would double prison sentences for people caught in possession of more than 10 grams of the synthetic opioid fentanyl. People caught with large amounts of heroin face up to 30 years, but under a lacuna in state law, people caught with large amounts of synthetic opioids can only be charged with possession with intent to distribute, with a maximum sentence of 10 years. "By criminalizing the trafficking of fentanyl, we will give police and law enforcement the tools they need to get this deadly drug off the streets and out of the hands of those struggling with addiction," Healey said. Some 1,200 people died of drug overdoses in the state last year, and another 312 in the first quarter of this year. [Ed: Why 10 years isn't more than enough for almost any law enforcement purpose, especially in a time of mass incarceration when that type of sentencing is coming under increasing criticism from across the political aisle, is not clear. How sad that a Democrat and former civil rights official in a liberal state is campaigning for longer sentences.]

Law Enforcement

Utah SWAT Reporting Law Shows Overwhelming Majority of Deployments Were for Drug Raids. Utah passed a SWAT reporting law last year, and now the first numbers are in. They show that SWAT teams were deployed nearly twice a day (559 reported incidents, with 25% of agencies failing to report) and, most startlingly, 83% of all SWAT deployments were to serve search warrants for drug offenses. Two-thirds (65%) of the drug raid SWAT deployments either "no-knock" or "knock and announce" raids where police force entry into homes without giving residents a chance to just let them in. Much more at the link.

International

Bolivia Coca Production Falls for Fourth Straight Year. The UN Office on Drugs and Crime announced Monday that the amount of land devoted to coca production dropped by 11% last year, continuing a trend that has seen land devoted to coca drop by more than a third since 2010. President Evo Morales touted his government's approach as more effective than the US-led war on drugs. "Eradication and fighting a war on drugs with military bases is not the solution, as we've seen in some Andean countries, where there are US officials waging the war on drugs," he said. He was referring to the world's two largest coca and cocaine producers, Colombia and Peru, where eradication efforts have provoked sometimes bloody strife.

The DC marijuana legalization initiative picks up some welcomed support, there's a legal challenge to Washington state's ability to collect marijuana taxes, a Republican US senator talks drug reform and takes some jabs at Obama, fentanyl-laced heroin is killing people in Philadelphia, and more. Let's get to it:

Two Drug Reform Groups Get Behind DC Legalization Initiative. The Drug Policy Alliance has hired Dr. Malik Burnett as a full-time organizer in Washington, DC, to build support for Initiative 71, the DC marijuana legalization initiative. But his work in DC will also go beyond marijuana policy to include broader drug and social justice reform issues. Meanwhile, StoptheDrugWar.org (that's us) has endorsed the initiative and is seeking to deliver 5,000 of the 25,000 signatures needed. You can sign up to donate to our initiative effort here or sign up to volunteer here. Or click on the endorsement link for more information. Click the title link for more info about the DPA move.

Washington State Lawsuit Challenges State's Ability to Collect Marijuana Taxes. A Washington dispensary operator has filed a lawsuit attempting to stop the state from collecting taxes on marijuana sales. The operator, Martin Nickerson, is being prosecuted for the sale of medical marijuana he produced and argues that forcing him to pay taxes on his marijuana sales would violate his 5th Amendment right against self incrimination. He is represented by Douglas Hiatt, a Seattle marijuana and medical marijuana defense attorney and ardent foe of the I-502 legalization scheme. I-502's main proponent, Alison Holcomb, said she thinks the lawsuit has little chance of succeeding.

Ohio Supreme Court Forum to Discuss "Unintended Consequences" of Legalization Today. A discussion on "Marijuana Legalization and the Law of Unintended Consequences" moderated by state Supreme Court Justice Maureen O'Connor will take place today at 5:30pm at the Ohio Supreme Court in Columbus. Panelists are Colorado Deputy Atttorney General David Blake, Ohio State law professor and Sentencing Law and Policy blog author Douglas Berman, and Marijuana Policy Project director of federal policies Dan Riffle. Questions can be submitted via Twitter using hashtag #OhioFOTL.

Illinois Drug Policy Consortium to Discuss New Marijuana Policy Report Monday. The IDPC will have a panel discussing its new report on marijuana policy, Patchwork Policy: An evaluation of arrests and tickets in Illinois, next Monday, the day it is released. Click on the link for more info, including time and location details.

Medical Marijuana

Iowa Governor Likely to Sign Limited CBD Medical Marijuana Bill. Gov. Terry Brandstad (R) told a news conference Monday he has consulted with the governors of other states that have passed limited CBD medical marijuana bills and he thinks Iowa can move forward without "unintended consequences." He gave the legislature credit for crafting a very tight bill. "I think it's important that we respond to legitimate concerns from the public but we also have to protect against unforeseen consequences. I think the legislature in this case has tried to do that. My inclination at this point is to say that I'm inclined to think that it's likely that I will sign it," he said. The bill is Senate File 2360.

Drug Policy

Republican Senator Rob Portman Talks Drug Reform. Sen. Rob Portman (R-OH) is set to give a speech today at the American Enterprise Institute in Washington, DC, in which he will reportedly call for a reassessment of the decades long war on drugs. He will also reportedly criticize President Obama's plan to grant clemency to hundreds or thousands of convicted drug offenders, calling it a "band aid solution" that doesn't address deeper problems driving recidivism. He will also advocate for reauthorization of the Second Chance Act, which is aimed at reducing recidivism. Portman could have national ambitions in 2016.

Heroin

Fentanyl-Laced Heroin Killing People in Philly. At least 28 people in Philadelphia died from overdosing on fentany-laced heroin between March 3 and April 20, the Department of Behavioral Health and Intellectual Disability said Monday. The department is awaiting test results on seven more people. Fentanyl is a powerful narcotic many times more potent than heroin and is used to treat severe pain. An earlier wave of fentanyl-laced heroin killed 269 people in the city in 2006 and more than 2,000 people nationwide. The city health department has issued an alert.

International

Zetas Co-Founder Among Six Killed in Mexican Border Town Shootout. Gallando Mellado Cruz, one of the military deserters who helped found the gang of drug enforcers for the Gulf Cartel that morphed into the Zetas, was among six people killed in a gun battle between Mexican soldiers and cartel gunmen in the border town of Reynosa, Tamaulipas, just across the Rio Grande River from McAllen, Texas. Four other cartel gunmen and one soldier also died. Tamaulipas was the scene of bloody infighting between the Zetas and the Gulf cartel before calming down somewhat in 2012, but fighting has broken out again in recent weeks.

Canada's Sensible BC Announces Future Plans. The Canadian marijuana law reform group Sensible BC, which managed to gather more than 200,000 signatures for a provincial referendum to stop arrests for pot possession in BC, but still failed to make the ballot, has announced it will hold off on another referendum campaign until after the federal election in October 2015. Then, if Conservative Prime Minister Steven Harper wins reelection or if his replacement refuses to move forward on legalization, the group says it will launch a new referendum campaign in 2016. Until then, Sensible BC says it will focus on building its network and organization, keeping the issue alive in the media, and working on municipal elections coming in November.

The Food & Drug Administration (FDA) is beginning a "massive new program" to reduce overdoses, diversion, and inappropriate use of powerful opioid pain relievers, especially targeting extended-release and patch formulations of fentanyl, methadone, morphine, oxycodone, and oxymorphone. On Monday, the FDA announced it had sent letters to 16 drug companies who produce the 24 listed products informing them they would now have to create a Risk Evaluation and Management Strategy (REMS) "to ensure that the benefits of the drugs continue to outweigh the risks."

That means physicians are likely to face new procedures in prescribing the drugs, and patients are likely to face more hurdles in obtaining them, an FDA official said at a Monday press conference. But pain patients already face serious obstacles in obtaining relief. The FDA action comes in the context of a campaign by the DEA to crack down on doctors it deems to have improperly prescribed large amounts of opioid pain medication -- even though prescribing what at first glance appear to be extremely large amounts is well with standard pain relief practice. Physician's fears of being prosecuted have contributed to what pain patient advocates describe as a crisis in chronic pain relief.

"Pain patients aren't drug abusers looking for a prescription fix," said Gregory Conko, senior fellow at the Competitive Enterprise Institute, which teamed up with the Pain Relief Network last May to create the Politics of Pain campaign to fight for patients' access to sufficient pain medications. "It's a genuine tragedy that the DEA often treats them and their doctors as if they were. It's as though the agency just doesn't care whether its single-minded waging of the war on drugs imposes collateral damage."

The Politics of Pain campaign has collected personal stories from physicians and patients who have explained firsthand how difficult it can be to either offer or find sufficient treatment for pain conditions. In one video interview, Gulf War veteran James Fernandez and his wife tell their story of how he, once a robustly healthy US Marine, is now virtually confined to his home because of severe, ongoing pain that has been under-treated for years.

In another interview, Dr. Alexander DeLuca, a board-certified specialist in addiction medicine, describes the obstacles faced by a physician trying to deliver the "standard of care" called for by his own medical training. According to DeLuca, virtually no patients in the country today receive proper treatment for chronic pain.

Still, there are a lot of pain pills out there. Last year, US pharmacies dispensed 21 million prescriptions for the 24 medications listed to 3.7 million patients. "This is a very extensively used group of medications," said Dr. John Jenkins, director of the FDA's Office of New Drugs at its Center for Drug Evaluation and Research. "This will be a massive new program."

Jenkins said that abuse, misuse, and accidental overdoses involving those products had been on the rise over the last decade, and the agency is concerned about doctors inappropriately prescribing them for patients who are not suffering moderate or severe chronic pain.

"We continue to see case reports where someone with a sprained ankle receives a fetanyl patch or extended-release opioid," Jenkins said.

Dr. Bob Rappaport, director of FDA's division of anesthesia, analgesia, and rheumatology products, told the press conference the agency was also deeply concerned with the rising non-medical use of the opioids. He cited a Substance Abuse and Mental Health Services Administration (SAMHSA) report released Monday that showed some 5.2 million people said they had used prescription opioids for non-medical purposes in the past month, and that the figure among 18-to-24-year-olds had increased from 4.1% in 2002 to 4.6% in 2007.

"This is an ongoing problem, and it's getting worse," Rappaport said.

Forcing the drug manufacturers to submit REMS plans is "our attempt to ensure the benefits outweigh the risks," Jenkins said. The agency will seek to find an "appropriate balance between legitimate patient need for such drugs and the threats caused by the abuse and misuse," he added.

But tighter regulation isn't going to happen right away; a series of meetings with various stakeholders over the coming months are being set up to arrive at final regulations, said Jenkins. They will include patient advocates, health care professionals, the pharmaceutical companies, and law enforcement. The first meeting with manufacturers is set for March 3. Hopefully the concerns of patient advocates get heeded and successfully addressed, but it's not clear whether that is even possible with a venture of this nature given the current enforcement climate.