The Biden White House sent its first National Drug Control Strategy to Congress on April 21. It breaks positive new ground by explicitly acknowledging harm reduction measures to prevent overdose and blood-borne diseases among drug users. At at the same time, though, it also relies heavily on the destructive and counterproductive pursuit of failed prohibitionist drug policies -- and funds more law enforcement much more heavily than harm reduction.

"The strategy focuses on two critical drivers of the epidemic: untreated addiction and drug trafficking," the White House said. "It instructs federal agencies to prioritize actions that will save lives, get people the care they need, go after drug traffickers' profits, and make better use of data to guide all these efforts. Saving lives is our North Star, and the 2022 National Drug Control Strategy calls for immediate actions that will save lives in the short term and outlines long-term solutions to reduce drug use and its associated harms, including overdose."

While the strategy includes long-familiar categories such as drug treatment, prevention, supply reduction, and criminal justice and public safety, it also emphasizes an evidence-based approach, "building a recovery-ready nation," and for the first time, harm reduction.

"The Biden-Harris Administration's efforts focus on meeting people where they are and building trust and engagement with them to provide care and services," the White House said. "Specifically, the strategy calls for greater access to harm reduction interventions including naloxone, drug test strips, and syringe services programs. It directs federal agencies to integrate harm reduction into the US system of care to save lives and increase access to treatment. It also calls for collaboration on harm reduction between public health and public safety officials, and changes in state laws and policies to support the expansion of harm reduction efforts across the country."

The strategy calls for "the coordinated use of federal grant funds for harm reduction," and the administration last year broke new ground with a $30 million grant program for harm reduction providers. But in a sign of continued reliance on traditional law enforcement priorities, the strategy also envisions a $300 million increase for Customs and Border Patrol and another $300 million increase for the DEA. Those figures were released as part of the White House's FY 2023 budget released last month.

"Responding effectively to the illicit production, trafficking, and distribution methods of domestic criminal organizations and Transnational Criminal Organizations (TCOs) is a significant challenge and remains a Biden-Harris Administration priority," the White House said.

That kind of talk suited mainstream Democrats just fine.

"Illicit drugs cause immeasurable pain and loss in our communities. As the Chairman of the Senate Caucus on International Narcotics Control, I've pressed for an updated federal plan to tackle them," said Sen. Sheldon Whitehouse (D-RI). I've been clear that the plan must include a more coordinated approach to cracking down on drug trafficking and transnational criminal organizations, especially the ways in which they launder and protect their ill-gotten gains using US rule of law and financial networks; and more and better cooperation with our international partners to reduce the supply of precursor chemicals used to manufacture illicit drugs and to levy tougher sanctions against transnational drug syndicates. I'm pleased to see my priorities reflected in this new strategy, and I look forward to working with the Biden administration to deliver on those priorities."

Whitehouse also lauded the strategy's "tearing down barriers to treatment, including expanding access to life-saving naloxone and medication-assisted treatment; improving our data collection systems to better understand the effects of our intervention efforts."

Reform advocates offered praise -- sometimes lukewarm -- for the administration's tentative embrace of harm reduction, but blasted its reliance on tired, failed drug war paradigms.

In its analysis of the strategy, the Washington Office on Latin America (WOLA) called it "a major step forward" and lauded the administration for "focusing on ensuring access to treatment for substance use disorders and highlighting the crucial role of harm reduction services." But WOLA also noted that, "when measured against the scale of the nation's overdose problems and the urgency of the needs, Biden's new plan appears quite timid."

WOLA also warned that the strategy's "positive innovations regarding investment in treatment and harm reduction strategies risk being undermined by a continued commitment to the kinds of policies that have exacerbated the present crisis and that continue to absorb the lion's share of resources, namely, drug criminalization at home and wildly exaggerated expectations for what can be achieved through supply control efforts abroad."

Similarly, the libertarian-leaning Cato Institute called the attention to harm reduction a "positive," but noted steps that it did not take, such as making the opioid overdose reversal drug naloxone available over-the-counter and repealing the so-called Crack House Statute that stands in the way of federal approval of safe injection sites.

"On a negative note," Cato observed, "the remainder of the new report calls for doubling down on interdiction, border control, and other law enforcement measures aimed at curtailing the supply of illicit drugs -- as if repeating the same failed strategies of the past half century, only with more gusto, will somehow work."

So there it is: The Biden administration's first crack at a national drug strategy deserves kudos for its embrace of harm reduction and evidence-based approaches, but beyond that, it is pretty much more of the same old same old.

A pair of companion marijuana legalization initiatives are cleared for singature-gathering in Oklahoma, SAMSHA mantains a firm line on drug testing rules, and more.

A needle exchange. The White House is emphasizing harm reduction measures to take on the overdose crisis. (Creative Commons)

New Hampshire Senate Committee Votes to Kill Marijuana Legalization Bill. The Senate Ways and Means Committee voted unanimously Wednesday to kill a bill that would have legalized marijuana and had it sold at state-owned retail outlets, House Bill 1598. The bill could still come up for a Senate floor vote, but the committee vote likely signals the end of the road for this legislative session. The House has repeatedly passed marijuana legalization bills in recent years, only to see them die in the Senate. And even if something were to make it to the desk of Gov. Chris Sununu (R), he remains opposed to legalization. At least one senator indicated he was stuck in a time warp: "Why would we want to join the herd of introducing to our culture legalization of a substance that is unquestionably a gateway drug?" asked Sen. Bob Giuda (R-Warren).

Ohio Lawmakers File Marijuana Legalization Bill That Mirrors Ongoing Legalization Initiative. Two Democratic lawmakers, Reps. Casey Weinstein and Terrance Upchurch, have filed a marijuana legalization bill with the same language as the legalization initiative from the Coalition to Regulate Marijuana Like Alcohol (CRMTA). CRMTA's initiative passed an initial signature threshold, starting a process where the legislature has four months to either pass legalization or let it go to the voters in November (provided CRMTA succeeds in another round of signature-gathering), but there is little indication that the Republican-controlled legislature is going to act on it.

Oklahoma Marijuana Legalization Initiatives Okayed for Signature-Gathering. The state Supreme Court has cleared the way for two companion marijuana legalization initiative campaigns to begin signature-gathering. State Question 819 and the companion State Question 818, would amend the state constitution to protect the right of residents age 21 and older to use marijuana. Because they amend the constitution, they face a higher signature-gathering hurdle than State Question 820, which has already been cleared for signature-gathering. It needs about 90,000 signatures within 90 days to qualify for the ballot, while State Questions 819 and 820 will need about 178,000 valid voter signatures.

Drug Policy

Biden Administration Releases 2022 National Drug Control Strategy. The White House released the 2022 National Drug Control StrategyThursday, focusing on treating drug addiction and fighting drug trafficking. The strategy calls for expanded harm reduction interventions, such as drug test strips, needle exchanges, and access to the opioid overdose reversal drug naloxone. The new strategy is “the first-ever to champion harm reduction to meet people where they are and engage them in care and service,” the White House said. But the strategy also envisions a $300 million increase for Customs and Border Patrol and another $300 million increase for the DEA, maintaining a law enforcement emphasis. Those figures were released as part of the FY 2023 budget released last month.

Drug Testing

SAMSHA Cuts No Slack for Medical Marijuana, Accidental Exposures in Updated Federal Drug Testing Rules. In a pair of notices published in the Federal Register earlier this month, the Substance Abuse and Mental Health Services Administration (SAMSHA) published a pair of notices about proposed changes to drug testing policies. One new notice clarifies that having a doctor's recommendation for medical marijuana is not a valid excuse for a positive drug test. The secondnew notice states that passive exposure to secondhand marijuana smoke or accidental ingestion of foods containing marijuana are not a legitimate medical explanation for a positive drug test. These are proposed rules, and  there is a 60-day public comment period on the proposals is open until June 6.

New polls of American and European voters show support for marijuana legalization, Massachusetts prisoners are suing over unreliable drug tests, and more. 

The opioid overdose reversal drug naloxone. Lawmakers want drug companies to seek over-the-counter status for it.

Majority of Democrats Say Marijuana Legalization Should Be a Top Priority for Congress. A new poll from Morning Consult and Politico finds that more than half (52 percent) of Democratic voters say marijuana legalization should be a top or important priority for Congress. Only 29 percent of Republican voters felt the same. Overall, 41 percent of voters now see marijuana legalization as a top or important congressional priority. The poll comes with the House having already passed a marijuana legalization bill and with the Senate waiting on Majority Leader Chuck Schumer (D-NY). Meanwhile, desperately needed interim measures, such as providing industry access to financial services, languish.

Drug Testing

Massachusetts Prisoners Sue Over Prison System's "Unreliable" Drug Tests Despite Court Order. Attorneys representing state prisoners have filed a lawsuit against the Department of Correction charging that it continues to use an unreliable drug test to screen prisoners' mail, violating an earlier court order. The lawsuit alleges that prisoners have been punished for sneaking drugs through the mail based on dubious drug tests and that some of the mail improperly seized as containing drugs were sent by the prisoner's own attorneys, the courts, and the attorney general's office. A judge last December ordered the department to quit using the NARK II drug test device. The attorneys are asking a judge to hold the department in contempt of court. A hearing is set for next Tuesday. "The DOC's actions were not only interfering with the attorney-client relationships of the people whose mail was seized and photocopied, but were chilling the ability of all incarcerated people to communicate with counsel for fear of being subjected to this arbitrary and severe punishment," the complaint said.

Harm Reduction

Bipartisan Lawmakers Call on Drug Makers to Apply to FDA to Make Overdose Reversal Drugs Available Over-the-Counter. Some 30 members of the House and Senate have sent a letter to drug companies who manufacture the opioid overdose reversal drug naloxone calling on them to apply to the Food and Drug Administration (FDA) for over-the-counter status for their products. The move comes amidst a raging opioid overdose epidemic that is killing tens of thousands of Americans each year. "It has never been more important to adopt opioid overdose prevention and reversal strategies on a wide scale," the letter said. This includes "steps to increase access to affordable naloxone, which is a proven, effective tool to reduce medical emergencies, drug overdoses, and deaths." Signatories included Sens. Joe Manchin (D-WV), Elizabeth Warren (D-MA), and Lisa Murkowski (R-AK) and Reps. Alexandria Ocasio-Cortez (D-NY) Rashida Tlaib (D-MI), and Brian Fitzpatrick (R-PA).

International

Poll Found Majority of Europeans Support Marijuana Legalization. A poll from  London-based Hanway Associates that surveyed eight different European countries found majority support for marijuana legalization, with 55 percent favoring it and only 25 percent opposing it. Italy led the way with support at 60 percent. Portugal, Switzerland, Spain, and the United Kingdom all polled between 55 and 59 percent, while Germany came in at 50 percent. Surprisingly, the Netherlands, which has allowed legal retail sales for more than 30 years, had the lowest level of support, at 47 percent. 

A Maryland marijuana legalization bill advances, New Mexico pot shops will open starting Friday, a Georgia therapeutic psychedelic study bill advances, and more.

The House is set to vote on the MORE Act this week. (Creative Commons)

Lawmakers File Various Amendments to House Marijuana Legalization Bill. With a House floor vote on the Marijuana Opportunity, Reinvestment and Expungement (MORE) Act (HR 3617) set for this week, proposed amendments are coming fast and furious. They will be taken up by the House Rules Committee Wednesday. Most of the proposed amendments seek to impose restrictions on the bill, such as requiring completion of various certain studies before legalization, limiting expungement provisions, or maintaining certain penalties. One, though, would provide relief for people denied security clearances because of past marijuana convictions.

Maryland Marijuana Legalization Bill Advances. The Senate Finance Committee on Tuesday approved a marijuana legalization bill, Senate Bill 833, that would only take effect if voters approved a related ballot question in November. A slightly different version of the bill passed the House last month, so a conference committee will have to hash out the differences. The panel did not act on House Bill 1, which would establish the November referendum. The legislature faces a deadline at the end of the week. Lawmakers will only have the chance to override a possible veto by Gov. Larry Hogan (R) if they get bills to his desk this week.

New Mexico Recreational Pot Shops Can Open Their Doors on Friday. The state legislature legalized marijuana last year, and beginning on Friday, the first recreational marijuana sales in the state can begin. New Mexicans could legally possess and use marijuana since last June, but had no place to legally purchase recreational marijuana—until now. State officials have issued more than 200 licenses for retail pot shops. When they open later this week, adults will be able to purchase two ounces of weed at a time.

Opiates and Opioids

California Fentanyl Crisis Prompts Flurry of Bills. Lawmakers are responding to a surge in fentanyl-related overdoses with a number of bills, some punitive, but others embracing harm reduction interventions. Assembly Member Cottie Petrie-Norris (D-Irvine) has filed Assembly Bill 2246, which would increase penalties for possession and distribution, including a sentence of 20 years to life for someone who sold fentanyl that resulted in a fatal overdose. Assembly Member James Ramos (D-Highland) has field Assembly Bill 1628, which would require companies such as Snapchat to implement policies that prohibit the sale of fentanyl and other controlled substances on their platforms. Senate Bill 864 would require hospitals to test drug screening urine samples for fentanyl, Senate Bill 1350 would require warnings to people convicted of drug distribution offenses that they could be charged with manslaughter of murder in the event of a fatal overdose, while Assembly Bill 1673 would set up a California Fentanyl Task Force to produce statewide statistics and ramp up public awareness. On the harm reduction side, Sen. Scott Weiner's (D-San Francisco) Senate Bill 57 would authorize pilot safe injection site program in San Francisco, Oakland, and Los Angeles. That bill has passed the Senate and is now before the Assembly Public Safety Committee.

Psychedelics

Georgia Therapeutic Psychedelic Study Bill Advances. The House Appropriations Public Safety Subcommittee voted Tuesday to approve House Resolution 896, which would create a House study committee to investigate the therapeutic potential of psychedelics such as psilocybin and make recommendations for legislation. The bill is couched as an effort to address the need for effective treatments for depression and PTSD for military veterans. It now heads to the House Defense and Veteran Affairs Committee.

International

Colombia Coca Zone Battle Sees 11 FARC Dissidents Killed. The Colombia Army said Tuesday its soldiers had killed at least 11 FARC dissidents in open combat n Puerto Leguizamo municipality in Putumayo province near the borders with Ecuador and Peru. The area has extensive coca plantings and cocaine-producing laboratories and is contested by various armed actors. The FARC dissidents are former members of the Revolutionary Armed Forces of Colombia (FARC), who rejected the FARC's demobilization under a 2016 peace deal with the government.

Mexico Attack Leaves at Least 20 Dead in Michoacan. Presumed cartel gunmen attacked spectators at a cockfighting pit in the town of Las Tinajas Sunday, leaving at least 20 people dead and several more wounded. "It was a massacre of one group by another," President Andres Manuel Lopez Obrador told a news conference, expressing his regret at the deaths. The state of Michoacan and neighboring Guanajuato have been plagued by cartel violence for years, with the most recent mass killing leaving 17 people dead only weeks ago. Earlier this month, the mayor of Aguilla, Michoacan, was gunned down, and days later, journalist Armando Linares was killed in Zitacuaro. Most of the violence is between the Jalisco New Generation Cartel and local gangs, but some of it is between different factions of that same cartel.

Singapore Hangs Man for Drug Trafficking. Closing its ears to pleas for leniency, including from the UN Human Rights Office, Singapore on Wednesday executed Abdul Kahar Othman, 68, for drug trafficking. The hanging marked the first execution in the country since it halted them due to the coronavirus pandemic. The last execution took place in November 2019. Kahar, from a poor family, had struggled with addiction all his life and spent much of his adult life behind bars. He was convicted of drug trafficking in 2013. Another execution may be looming. A Malaysian man with mental disabilities, Nagaenthran K. Dharmalingam, has been on death row since 2010 for trying to smuggle 1.5 ounces of heroin into the city-state. He lost his final appeal on Tuesday.