Pennsylvania takes a step toward legalizing fentanyl test strips, Thailand moves to block minors from using marijuana or hemp, and more.

Marijuana Policy

Texas GOP's New Platform Opposes Marijuana Legalization. At its state convention in Houston last weekend, the Texas Republican Party adopted a platform plank opposing marijuana legalization, even though recent polling shows two-thirds of all Texans and 51 percent of Republicans favor it. The convention did, however, endorse moving marijuana from Schedule I to Schedule II of the federal Controlled Substances Act. The party also adopted several other drug policy planks, including opposing needle exchange programs, requiring drug testing for welfare recipients, designating Mexican drug trafficking organizations as "terrorist organizations," and encouraging "faith-based rehabilitation."

Psychedelics

Missoula, Montana, City Council Ponders Psychedelic Decriminalization Resolution. Two members of the city council filed a resolution to decriminalize "entheogenic plants," including peyote and magic mushrooms, last Wednesday. The council members are Daniel Carlino and Kristen Jordan. It was a grassroots efforts backed by "many Missoulians," said Carlino. "We’ve heard comments in support of this resolution from veterans who have experience with this in treating PTSD. We’ve heard comments of support from therapists, doctors and dozens and dozens of community members." The council has yet to act on the resolution, which would block Missoula police from arresting people for growing, possessing, or gifting entheogens. The police department adamantly opposes the move.

Harm Reduction

Pennsylvania House Passes Fentanyl Test Strip Bill. The House has unanimously approved a bill to legalize fentanyl strips, House Bill 1393. It does so by removing the test strips from the state's definition of drug paraphernalia. Supporters say the change in the law will allow drug users to avoid overdoses by testing their drugs without fear of being arrested for possessing drug paraphernalia. Philadelphia Mayor John Kenney (D) decriminalized fentanyl test strips in that city in August 2021 and Attorney General Josh Shapiro (D) has said his office "will not prosecute individuals simply for possessing fentanyl test strips." This legislation would bring state law in line with what is increasing becoming public policy in the state. Companion legislation is now set to move in the Senate.

International

Thailand to Restrict Marijuana Use to Adults After Complaints. Facing with a rising chorus of complaints after the country liberalized its marijuana laws earlier this month, Thai officials announced last Thursday that they will issue rules limiting access to marijuana and hemp to people 20 years of age and older. People under that age will need permission from a doctor to use such products. The move came amid media  reports that two teenage students were hospitalized for marijuana "overdoses." The government is also going to move to limit marijuana consumption in public and to control cannabis in food.

British Prescription Heroin Shortage Wreaking Havoc with People on Maintenance Regime. British drug non-profits are warning that people on prescription heroin (diamorphine) maintenance are now relapsing because of a nationwide shortage of all doses of the prescription drug. Pharmacists are reporting that patients who had been stable on prescription heroin for 10 or 15 years are deteriorating because they cannot access their medication. The Department of Health and Social Care has confirmed that

5mg, 30mg, 100mg and 500mg injections of diamorphine are currently out of stock. "These are patients that have been on prescriptions for 20 years and have been very stable and working, living their lives, and are closely monitored to ensure they’re not on other drugs," said Clare Robbins of the drug charity Release. "The majority we are supporting at the moment have now relapsed, often for the first time in 10 or 15 years and that’s really devastating for them," she said. "These people have built relationships with their pharmacists over 10 to 15 years and I’ve had pharmacists on the phone who are quite distressed about seeing their patient deteriorate." Only two companies supply prescription heroin in the United Kingdom, and the supply chain has been wobbly since the coronavirus pandemic took hold in early 2020. 

Five Texas cities will vote on non-binding marijuana reform measures this fall, the New York legislative session ends without passing a safe injection site bill, and more.

Marijuana Policy

New York Bill to Crack Down on Illicit Marijuana Possession and Sales Dies. The Senate last week approved Senate Bill 9452, which would expand the state Office of Cannabis Management's authority to seize illicit marijuana and the Department of Taxation and Finance's authority to civilly penalize people for selling marijuana illegally. But the bill died without action in the Assembly as the legislative session came to an end. The bill aimed at "grey market" operators -- retail outlets that are selling weed without being licensed. No licenses for pot shops have been issued yet. The bill would have made it a Class A misdemeanor for distributors and retailers to sell weed without a license. Fines for possession of illicit marijuana would have doubled to $400 per ounce of flower and $1,000 for each illicit plant.

Five Texas Cities Will Vote on Marijuana Reforms. Ground Game Texas, which is pushing for marijuana reform across the state, announced last Friday that it had gathered enough signatures to qualify a non-binding decriminalization initiative in the Central Texas town of Harker Heights, bringing to five the number of towns in the state that will have a chance to vote on marijuana reform this year. The other cities are Elgin, Killeen, and San Marcos in Central Texas and Denton in North Texas.

Harm Reduction

New York Safe Injection Site Bill Dies as Session Ends. A bill that would have paved the way for safe injection sites in the state, Assembly Bill 224, had died as the legislative session ends. The bill managed to win an Assembly committee vote, but went no further. Other harm reduction bills also died, including one that would require treatment providers to offer clients access to buprenorphine (Senate Bill 6746) and another that would have decriminalized buprenorphine (Assembly Bill 646). On the other hand, a bill that would eliminate copays at methadone clinics for people with private insurance (Senate Bill 5690) passed.

International

Afghan Taliban Launch Campaign to Eradicate Poppy Crop. Two months after issuing an edict banning opium poppy cultivation in the country, the Taliban has announced it has begun a campaign to eradicate poppy production, with the goal of wiping out the country's massive yield of opium and heroin. For all of this century, Afghanistan has been the world's leading opium and heroin producer, accounting for more than 80 percent of global output. People violating the ban "will be arrested and tried according to Sharia laws in relevant courts," said Taliban deputy interior minister for counternarcotics, Mullah Abdul Haq Akhund. But with the country in profound economic crisis after the departure of Western troops and economic aid last summer, the ban threatens one of the country's most vibrant economic sectors and the livelihoods of millions of poor farm and day laborer families. "If we are not allowed to cultivate this crop, we will not earn anything," one farmer told the Associated Press. Nonetheless, "We are committed to bringing poppy cultivation to zero," said Interior Ministry spokesman Abdul Nafi Takor.

The Louisiana House approves a bill to protect state workers who use medical marijuana, a South Dakota marijuana legalization initiative has qualified for the November ballot, and more.

Marijuana Policy

South Dakota Will Vote on Marijuana Legalization in November -- Again. Secretary of State Steve Barnett (R) announced Wednesday that a marijuana legalization initiative sponsored by South Dakotans for Better Marijuana Laws has qualified for the November ballot. Initiative 27 will give voters a second chance to vote for marijuana legalization. In 2020, the same group sponsored a legalization initiative that won with 54 percent of the vote, only to see the will of the voters overturned by the state Supreme Court at the behest of Republican Gov. Kristi Noem.

Another Texas City Will Vote on Marijuana Decriminalization in November. After Austin voters earlier this month overwhelming approved a marijuana decriminalization measure, the Central Texas town of Killeen is now set to vote on a similar measure in November. Ground Game Texas, the progressive group behind both efforts, said Wednesday it had collected enough signatures to make the ballot.

Medical Marijuana

Louisiana House Approves Bill to Protect State Workers Who Use Medical Marijuana. The House on Tuesday voted 60-32 to approve House Bill 988, which would protect state employees from negative consequences for legal medical marijuana use. The bill would bar employees being fired for medical marijuana use and would prevent discrimination against potential hires for medical marijuana use. Public safety employees such as police and firefighters are not included, though. The bill now goes to the Senate.

Opiates and Opioids

Colorado Governor Signs Bill Increasing Fentanyl Penalties. Gov. Jared Polis (D) on Wednesday signed into law House Bill 22-1326, the "Fentanyl Accountability and Prevention Act." The bill lowers the threshold for a felony fentanyl possession charge from four grams to one and includes counterfeit pills that may contain only small amounts of the drug. As a last-minute change, lawmakers added a provision that will allow people to argue in court they did not "knowingly" possess fentanyl, which is a common phenomenon because the drug is often used in counterfeit pills. The bill also allocates $10 million for emergency health services and more than $25 million in harm reduction spending, primarily for overdose reversal drugs, but also for fentanyl test strips and a three-year education campaign.

On May 11, the Centers for Disease Control and Prevention (CDC) released data showing that more than 107,000 people died of drug overdoses in 2021, the most overdose deaths ever recorded in a single year. The figure marks a 15 percent increase over 2020, with the number of overdose deaths more than quadrupling since 1999. And this is only provisional data; the actual death toll could be even higher.

More people died of drug overdoses last year than from gunfire and traffic accidents combined, and the ever-rising death toll is leading to ever-louder calls for effective policy prescriptions and harm reduction interventions to reduce the carnage.

Opioids were implicated in nearly 80,000 overdose deaths, with synthetic opioids, primarily fentanyl and its derivatives, involved in more than 68,000. Cocaine was mentioned in more than 23,000 overdose deaths and psychostimulants, primarily methamphetamine, mentioned in more than 30,000.

To its credit, the Biden administration has recognized the urgency of the problem, embracing harm reduction interventions such as needle exchanges, drug testing, and access to the opioid overdose reversal drug naloxone in its 2022 National Drug Control Strategy. The strategy includes $30 million for harm reduction grants, but also $300 million increases for the DEA and Customs and Border Patrol. While the prohibitionist impulse remains strong, at least the administration has explicitly recognized the need for harm reduction.

But that isn't enough, advocates say.

"New data from CDC has confirmed our worst fears. The combined pressures of the COVID-19 pandemic, an increasingly potent illicit drug supply, and an overwhelmed and under-resourced public health system have driven the overdose crisis to catastrophic levels," said Daliah Heller, Vice President of Drug Use Initiatives at Vital Strategies, in a statement.

>Vital Strategies is a global public health organization that in February, launched "Support Harm Reduction," a campaign to highlight five key interventions for preventing overdose that many people in the United States still don’t have access to: naloxone, drug checking resources, medications for opioid use disorder, safer drug use supplies, and overdose prevention centers. 

>"What we’re doing now isn’t working, because the decades-old punitive response to drug use still predominates: The transition to a health-first, harm reduction approach has been slow and piecemeal," Heller continued. "Anemic levels of funding and policy support are woefully insufficient to stem the tide of overdose we are experiencing. These data are an urgent call to action for government at all levels: we need to mount a massive public health response to overdose that centers harm reduction and support instead of criminalization and punishment for people who use drugs.  

"Far too few people have access to any of the five key interventions we know will reduce overdose deaths," Heller added. "Most of these services are available in some form, in some locations in the majority of states, but they all need to be massively scaled up with an emergency investment. Until such actions are taken, the continued escalation of this overdose crisis seems inevitable," she said.

"The devastating rise in overdose deaths is falling most heavily on Black and Indigenous communities, where the need for relief now is more urgent than ever before," Heller noted. "A massive surge in funding and support for a harm reduction public health response will save lives immediately, engaging people who use drugs with lifesaving resources and support. The time for action is now."

Likewise, the new CDC numbers prompted the Drug Policy Alliance (DPA) to call on Congress to urgently support harm reduction services and move toward drug decriminalization.

"Once again, we are devastated by these numbers," said Jules Netherland, DPA Managing Director of the Department of Research & Academic Engagement. "Over 107,000 of our friends, family and neighbors lost their lives to drug overdose last year. And sadly, we know the numbers will only continue to climb unless our policymakers actually do what is necessary to curb them. The United States has spent over 50 years and well over a trillion dollars on criminalization - and this is where it has gotten us. It's clearly not working. It's time we start investing where it actually matters - in our communities, specifically Black, Latinx and Indigenous communities where we are now seeing the sharpest rise in overdose deaths. The evidence shows us, that in order to actually make a difference, we have to replace these approaches with those centered in public health, such as drug decriminalization coupled with increased access to evidence-based treatment and harm reduction services, overdose prevention centers, and legal regulation and safer supply to reduce the likelihood of accidental overdose," Nederland said.

It is time for safe injection sites, too, DPA insisted.
 
"We are grateful that the Biden Administration has embraced harm reduction as part of their National Drug Control Strategy, but we need to see that commitment met with Congressional funding and a massive scaling up of these health services," Nederland said. "It's also essential that Overdose Prevention Centers be implemented, which decades of evidence-based, peer-reviewed studies and utilization in over 14 countries show us are one of the most effective ways to save lives now. While it may not always be politically convenient, it’s time to be guided by the evidence about what works. Overdose deaths are avoidable and a policy failure—it’s time we stop recycling the same policies that got us here and take the actions that are necessary to save lives."