Overdose Prevention

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More Than 300,000 Pot Arrests in 2020, FDA Points Toward OTC Naloxone, More... (11/17/22)

Congress passes a marijuana research bill, a bipatisan pair of senators file a psychedelic research and rescheduling bill, and more,

The FDA is moving to make the opioid overdose reversal drug naloxone over-the-counter. (Creative Commons)
Marijuana Policy

Despite Legalization in Nearly Half the Country, More Than 300,000 People Were Arrested for Marijuana in 2020. Some 317,79 people were arrested on marijuana charges in 2020, according to the FBI. That is a 36 percent decline from 2019, but it still the equivalent of arresting every resident of a mid-size city such as Orlando, Corpus Christi, or Riverside, California. The marijuana arrest figure is also for the first time not the most common cause for a drug arrest, with 36 percent of drug arrests for stimulants such as cocaine and methamphetamine, compared to 27 percent for arresting marijuana. Black Americans continued to bear the brunt of marijuana law enforcement, accounting for 38 percent of all pot arrests despite making up only 13 percent of the population.

Congress Passes Marijuana Research Bill. With a final vote in the Senate Wednesday, both houses of Congress have approved the Medical Marijuana and Cannabidiol Research Expansion Act (HR 8454). The bill now goes to the desk of President Joe Biden (D). If he signs it, it will open the way to further research into the medical benefit of marijuana and CBD. Under the bill, the DEA must allow registered entities to manufacture, distribute, dispense, and possess marijuana for research purposes. "There is substantial evidence that marijuana-derived medications can and are providing major health benefits. Our bill will make it easier to study how these medications can treat various conditions, resulting in more patients being able to easily access safe medications,: said Sen. Dianne Feinstein (D-CA), who introduced the bill along with Sens. Chuck Grassley (R-IA) and Brian Schatz (D-HI). Oregon Rep. Earl Blumenauer (D) introduced the bill in the House.

Harm Reduction

FDA Announces Preliminary Assessment that Certain Naloxone Products Have the Potential to be Safe and Effective for Over-the-Counter Use. The US Food and Drug Administration on Wednesday issued a Federal Register notice, Safety and Effectiveness of Certain Naloxone Hydrochloride Drug Products for Nonprescription Use, that may help facilitate the development and approval of certain nonprescription naloxone drug products, including through the switch of certain naloxone drug products from prescription status to nonprescription status. Naloxone is a medicine that can help reduce opioid overdose deaths and when administered timely, usually within minutes of the first signs of an opioid overdose, can counter the overdose effects. "Today’s action supports our efforts to combat the opioid overdose crisis by helping expand access to naloxone," said FDA Commissioner Robert M. Califf, M.D. "The agency will keep overdose prevention and reduction in substance use disorders as a key priority and area of intense strategic focus for action as rapidly as possible."

Psychedelics

Cory Booker, Rand Paul File Bill to Reschedule Psychedelic Breakthrough Therapies and Remove Research Barriers. Sens. Cory Booker (D-NJ) and Rand Paul (R-KY) filed a bill on Thursday that would require the Drug Enforcement Administration (DEA) to transfer breakthrough therapies like psilocybin and MDMA from Schedule I to II, while also removing research barriers for strictly controlled substances, the Breakthrough Therapies Act. The move came on the same day that House lawmakers announced the formation of psychedelic caucus aimed at promoting new treatments from currently controlled substances. The bill would amend the Controlled Substances Act to create a procedure where current Schedule I drugs could be designated as breakthrough therapies could be transferred to a lower schedule that would make it easier to research them and promote drug development.

KY Governor Signs MedMJ Executive Order, AMA Endorses Fentanyl Test Strips, More... (11/16/22)

A congressional committee takes up marijuana legalization, Pennsylvania's governor signs a fentanyl test strip bill into law, and more.

Marijuana got a hearing on the Hill Tuesday. (Creative Commons)
Marijuana Policy

Congressional Committee Holds Hearing on Marijuana Legalization. The House Oversight Subcommittee on Civil Rights and Civil Liberties held a hearing Tuesday on marijuana legalization. Led by Chairman Jamie Raskin (D-MD), the committee examined "Developments in State Cannabis Laws and Bipartisan Cannabis Reforms at the Federal Level," using a joint memo published last Friday to lay out the main points of discussion.

Witnesses included Woodfin (Mayor of Birmingham, Alabama), Paul Armentano (Deputy Director of NORML), Andrew Freedman (Executive Director of Coalition for Cannabis Policy, Education, and Regulation [CPEAR]), Eric Goepel (Founder and CEO of Veterans Cannabis Coalition), Keeda Haynes (Senior Legal Advisor of Free Hearts), Amber Littlejohn (Policy Advisor of Global Alliance for Cannabis Commerce), and Jillian Snider (Policy Director of Criminal Justice & Civil Liberties). Among topics covered were the failed war on drugs, the need for state-level action to accompany President Biden's marijuana pardon announcement, veterans' access to medical marijuana, and hemp's potential as a building material. No votes were taken.

Medical Marijuana

Kentucky Governor Signs Executive Order Allowing Some Residents to Use Medical Marijuana. Gov. Andy Beshear (D) on Tuesday signed an executive order allowing patients who meet certain requirements to use and possess medical marijuana. Those eligible must suffer from one of 21 specified medical conditions. The medicine must be purchased in a state where it is legal (and keep your receipt!) and will be limited to eight ounces. Patients must get a letter from a physician certifying that they suffer from one of the specified conditions. The plan goes into effect on January 1.

Harm Reduction

AMA Reiterates Call for Harm Reduction Measures to Attack Overdose Problem. At its annual interim meeting this month, the American Medical Association passed a resolution encouraging the use of harm reduction practices to reduce overdose deaths in the county. The resolution called on city and state medical societies to advocate for harm reduction policies that create immunity for "drug paraphernalia" used in harm reduction, such as fentanyl test strips. "Fentanyl test strips are a point-of-care test that identifies fentanyl contamination in a drug supply with a specificity of 87.5% and a sensitivity of 95.2%," the resolution notes, but also notes that "possession of fentanyl test strips is explicitly legal in only 22 states."

But it is not just fentanyl test strips that the AMA wants to see: "The AMA has strongly supported increased use of a broad array of harm-reduction efforts to reduce death and other harms from nonmedical use of drugs, including for people who inject drugs," the group said. "These efforts include greater access to naloxone, syringe services programs and pilot programs for overdose prevention sites/supervised injection-use facilities. Fentanyl strips are part of this effort, and we urge states to take steps to help a vulnerable population."

Pennsylvania Governor Signs Fentanyl Test Strip Legislation in Bid to Reduce Overdoses. Gov. Tom Wolf (D) held a ceremonial signing Wedmesday for a new law (Act 111) that legalizes the use of fentanyl test strips and other forms of drug checking to prevent overdose deaths. The legislation passed the state House and Senate unanimously before going to the Governor's desk. The most recent data show Pennsylvania had the third highest number of overdose deaths of any state in the country for the 12-month period ending May 2022. Fentanyl test strips allow people who use drugs to easily test the drugs for the presence of fentanyl.

Arkansas Legalization Init Cleared for November, Colorado Psilocybin Init Trailing, More... (9/23/22)

Republicans seek political advantage by calling Mexican cartels "terrorist organizations," the FDA eases rules for groups distributing the opioid overdose reversal drug nalxone, and more.

Colorado magic mushroom proponents have an uphill fight ahead of them, a new poll suggests. (Greenoid/Flickr)
Marijuana Policy

Arkansas Supreme Court Okays Marijuana Legalization Initiative for November Ballot. The state Supreme Court on Thursday held that the Responsible Growth Arkansas marijuana legalization initiative will be counted after all. The move comes after the Board of Election Commissioners ruled that the measure's ballot title was misleading, but the high court disagreed, holding that "initiative power lies at the heart of our democratic institutions" and that the board and prohibitionist groups who had intervened in the case "have not met their burden of proving that the ballot title is insufficient."

Psychedelics

Colorado Poll Has Psilocybin Initiative Trailing. A new poll has the magic mushroom decriminalization initiative, Proposition 122, well south of the 50 percent plus one votes needed to pass in November. The Fox 31/Chennel2/Emerson College/The Hill poll had only 36 percent supporting the measure, with 41 percent opposed and 23 percent undecided. While the large number of undecideds leaves room for hope, they would have to break pretty decisively in favor of the initiative for it to get over the top. Only Democrats favored the initiative (53 percent), while 61 percent of Republicans opposed it. Two racial/ethnic groups emerge as opponents: 64 percent of Blacks oppose it, as do 63 percent of multiracial voters.

Harm Reduction

Opioid Reversal Drug Access to Ease Under Relaxed FDA Rules. The Food & Drug Administration (FDA) announced Thursday that harm reduction programs distributing the opioid overdose reversal drug naloxone will not have to comply with certain federal product tracing requirements. The agency said it would not enforce certain Drug Supply Chain Security Act requirements on programs that are distributing the drug to at-risk communities while an opioid public health emergency exists. "Combating the opioid overdose epidemic is an urgent public health priority for FDA," the agency wrote in the guidance. The FDA "is committed to advancing solutions to reduce opioid overdose deaths in the United States, including by supporting efforts to increase public availability of and access to naloxone."

Foreign Policy

GOP Senators File Bill Designating Drug Cartels as Terrorist Organization. Sens. Roger Marshall (R-KS) and Rick Scott (R-FL) filed a bill Tuesday to formally designate Mexican drug cartels as foreign terrorist organizations. The Drug Cartel Terrorist Designation Act. "The illicit drugs and other deadly activities being carried out by cartels are killing Americans at record rates. Since Joe Biden and the Democrats continue to turn a blind eye, we are going to do something about it by designating the drug cartels as Foreign Terrorist Organizations," said Sen. Marshall. "As these cartels continue to invade our porous southern border in an increasingly militarized approach, this designation is needed to ramp up our efforts to combat them. We will not rest in our fight to stop fentanyl's terrible scourge wreaking havoc in Kansas and across the US." Nonetheless, Mexican cartels are not foreign terrorist organizations; they are drug trafficking organizations.

GOP Texas Governor Designates Mexican Cartels as Terrorist Organizations. Gov. Gregg Abbott issued an executive order Tuesday that designated specified Mexican drug cartels as foreign terrorist organizations, although since Texas does not set US foreign policy it is not clear just exactly what that means. The order instructs the state Department of Public Safety (DPS) "to take immediate action to keep Texans safe amid the growing national fentanyl crisis." Abbott also directed DPS to identify Texas gangs that support the cartels and seize their assets.

The Public Stands Behind Oregon's Drug Decrim and Addiction Funding Law [FEATURE]

It has been nearly two years since Oregon voters approved Measure 110, a sweeping drug decriminalization and public health services funding initiative, and it still has strong public support. That could be because it is producing the kinds of results Oregonians want to see.

Measure 110 is bringing addiction recovery services not just to Portland, but to places like this, too. (Pixabay)
In voting for Measure 110, Oregonians sought to move the emphasis of drug policy from law enforcement to a public health approach, and that is what they are getting. Drug possession arrests, which had already dropped by half in 2020 because of the pandemic, significantly decreased after Measure 110 took effect on February 1, 2021, according to data from the Oregon Criminal Justice Commission, falling another 65 percent from the 2020 levels in the first six months of 2022.

And Measure 110, which tapped into marijuana tax revenues to fund a broad spectrum of addiction services -- from low-barrier drug treatment and peer support and recovery to overdose prevention and housing and employment support (but not drug treatment covered by Medicaid or insurance) -- is setting the stage for a massive expansion of those services by pumping hundreds of millions of dollars into the field.

Late last month, the Oversight & Accountability Council, the body tasked with overseeing the distribution of the funding, approved the remainder of the initial $302 million made available under Measure 110, and on Tuesday, the Oregon Health Authority announced that it had finished awarding that money to more than 237 service providers in the form of grants.

With the state suffering more than a thousand overdose deaths in the past year, there is criticism that authorities have moved too slowly. Oregon Health Authority behavioral health director Steve Allen acknowledged as much, saying the agency had learned it needed to give more support and technical assistance to the volunteer committee tasked with grantmaking decisions.

"We understand the frustration this caused in our communities," Allen said. "When you do something for the first time you're going to make mistakes."

But now the money is out there, and it will help fund 237 service providers in 36 Behavioral Health Regional Networks (BHRNs), aimed at ensuring that help is available in even the most remote rural corners of the state. That includes 111 groups providing screening and behavioral health needs assessments, 112 groups doing individual intervention planning, 113 groups doing low-barrier drug treatment, 172 groups doing peer support and mentoring, 88 groups providing housing services, 84 groups providing harm reduction services, and 51 groups doing job support.

The money is going to allow these groups to expand their services by hiring and training new staff, securing additional facilities, buying vehicles for mobile support services, and even purchasing housing.

"Measure 110 changes the system so that there is no wrong door to access services," said Tera Hurst, Executive Director of the Health Justice Recovery Alliance. "Thanks to Measure 110, you don't have to get arrested before you are maybe offered help. Measure 110 is changing the addiction recovery service landscape so that regardless of the path, supportive services will be more readily available closer to home."

"It's been a long road, but we're ecstatic to see all of the Measure 110 funding for the 2021-2023 biennium finally being approved and going out to service providers to expand critical addiction services in Oregon communities. This is the first step in ensuring Oregon delivers on its promise of replacing a criminal legal approach to drugs with a public health approach and offering the rest of the country a glimpse of what is ultimately possible when we offer people support instead of punishment," said Kassandra Frederique, Executive Director of the Drug Policy Alliance, which was a key supporter of Measure 110 and which is partnering with the Health Justice Recovery Alliance on implementation.

Even with the slow rollout, Oregonians are liking what they are seeing. A poll released this month by Data for Progress found majority support for Measure 110 in every region of the state -- even the conservative eastern an southwestern areas -- and a strong bipartisan majority who agree that problematic drug use should be treated as a public health issue, not one for the criminal justice system.

When asked whether Measure 110 should remain in place, 58 percent said yes. That included 82 percent of Democrats and 56 percent of independents, but only 31 percent of Republicans.

The polling suggests that tying drug decriminalization to the expansion of recovery services is key to getting it over the finish line. When asked about individual components of the program, 91 percent supported peer mentoring, 90 percent supported employment help, 86 percent supported funding addiction recovery, 84 percent supported housing assistance, but only 62 percent supported harm reduction measures and only 61 percent supported decriminalization itself.

It is almost as if Oregonians made a bargain with themselves: Give us strong measures to aid recovery and we will grudgingly accept such vanguard measures as harm reduction and decriminalizing drugs. These pollsresults should send a clear message to people contemplating future decrim initiatives about how to broaden support for them.

CA Governor Signs Fentanyl Test Strip Bill, FL Sets MedMJ Rules, More... (9/30/22)

Residents of La Paz, Bolivia, are growing weary of coca grower clashes, Colombia's new president calls for a regional assembly to plot alternatives to the war on drugs, and more.

Colombian President Gustavo Petro at the Andean Presidential Council in Lima Monday. (Presidency of the Republic, Peru)
Medical Marijuana

Florida Sets Limits on Medical Marijuana Dosage, Supply. State health officials have released a rule setting THC dosage amounts and supply limits on medical marijuana products. The emergency rule sets a 70-day cap of 24,500 milligrams of THC for non-smokable marijuana. It also sets dosage caps for other forms of ingestion, such as edibles, inhalation, and tinctures. The rule additionally caps purchases of smokable marijuana at 2.5 ounces over a 35-day period. It also creates a process for doctors to seek an exemption to quantity limits for patients they believe need to exceed those limits.

Harm Reduction

California Governor Signs Bill Decriminalizing Fentanyl Test Strips. Gov. Gavin Newsom (D) on Monday signed into law Assembly Bill 1598, which er decriminalizes the possession of fentanyl test strips. The bill from Assemblymember Laurie Davies (R-Laguna Niguel) amends the state's controlled substances law by removing drug testing equipment from its definition of drug paraphernalia. Similar bills have passed in numerous states this year. 

International

Bolivia Coca Conflict Spurs Protests by Residents Tired of Clashes. Activists and residents of the La Paz neighborhoods of Villa El Carmen, Villa Fatima, and Periferica were set to hit the streets to day to demand an end to the coca grower conflict that has disrupted normal life there for nearly the past month. The conflict pits two factions of the Adepcoca coca growers union, one pro-government and one anti-government, against each other and has resulted in weeks of clashes on the streets of the capital, especially around a disputed coca market in Villa El Carmen. Residents were planning to stage protests and erect roadblocks in all three neighborhoods today. They are demanding the government resolve the coca grower dispute.

Colombian President Seeks Regional Assembly to Rethink Drug Policy. At the Andean Presidential Council in Lima on Monday, Colombian President Gustavo Petro called for a regional assembly to come up with alternatives to what he called the "failed" war on drugs. "We have failed in something called the war on drugs and its toll is a million dead Latin Americans, most of them Colombians, and more and more Mexicans and Central Americans," he said. “If we project further forward, we would have another million Latin Americans killed by homicide, millions of Latin Americans and North Americans in prison, most of black race, and there would be 2,800,000 Americans dying of overdoses from something we don't produce: fentanyl," he warned. Instead Petro proposed convening an assembly of Latin American countries to discuss alternative drug policies. In addition to the Colombian president and his Peruvian host, the leaders of two of the world's largest coca and cocaine producing countries, the Lima meeting was also attended by the presidents of Ecuador an Bolivia, the third largest coca and cocaine producer. 

Gallup Poll Has Pot Use at All-Time High, DEA Walks Back Proposed Ban on Two Psychedelics, More... (8/29/22)

A trio of marijuana bills are on the California governor's desk, New York City cocaine users are adopting fentanyl test strips, Colombia's new president announces a coca growers' assembly, and more.

Everybody's doing it. Well, not everybody, but more people than ever. (Creative Commons)
Marijuana Policy

Gallup Poll Finds Marijuana Use at All-Time High. A new Gallup poll has marijuana use at a record high—and for the first time, more Americans reported smoking marijuana than smoking cigarettes. The new poll has 16 percent of respondents smoking marijuana within the past week, up from 12 percent a year ago and more than double the historic low of seven percent. The number of people who reported cigarette smoking in the past week was 11 percent. That's down from 16 percent last year and a whopping 45 percent during cigarette smoking's peak in the 1950s.

California Interstate Marijuana Commerce, Other Pot Bills Go to Governor's Desk. Bills to create a framework for interstate marijuana commerce, streamline expungement for past marijuana convictions, and safeguard companies providing insurance to the legal marijuana industry have all passed out of the legislature and are on the desk of Gov. Gavin Newsom (D). A passel of other marijuana bills are also advancing as the session end approaches. The interstate commerce bill is Senate Bill 1326, the marijuana convictions bill is Assembly Bill 1706, and the insurance bill is Assembly Bill 2568.

Harm Reduction

Fentanyl Test Strips Are ‘Catching On’ Among Cocaine Users. Rising overdoses are prompting some drug users to make testing their stashes for the presence of fentanyl a regular part of their drug-taking ritual. New York City cocaine users say their fear of overdosing on fentanyl-contaminated cocaine has made them wary of using any cocaine that has not been tested. Dozens of bars, clubs, and restaurants in the city are now offering fentanyl test strips as well. A Lower East Side taco restaurant owner said he began stocking the strips this spring after two people he knew died from fentanyl-adulterated cocaine. "It was a no-brainer for us," he said. "When we first put them out, we had customers say, ‘What is that?’ They were like, ‘Let me get one for my friend,’" Mr Tirado said. "It’s catching on."

New Mexico Now Providing Fentanyl Test Strips. Thanks to a change in the state's Harm Reduction Act, state officials are now distributing fentanyl test strips by the thousands. The Department of Health has handed out 15,000 test strips since May and has already ordered another 30,000. At least 1,215 people in the state have died from an overdose involving fentanyl since 2019, but more than 12,000 people have been saved from overdoses by the opioid overdose reversal drug naloxone.

Psychedelics

DEA Walks Back Plan to Ban Two Obscure Psychedelics. The DEA has backed away from plans to place two obscure psychedelics, DOI (dimethoxy-4-iodoamphetamine) and DOC (dimethoxy-4-chloroamphetamine), on Schedule I of the Controlled Substances Act. The retreat came after the proposal encountered strong opposition about psychedelic companies and academic researchers. The Panacea company filed a motion requiring the DEA to respond by today, with the possibility of a public hearing to defend its proposal. Instead, the DEA folded without stating any specific reasons.

International

Colombia President Announces First Assembly of Coca Growers.  President Gustavo Petro announced last Friday that the country's first assembly of coca growers will be held in the Catatumbo region in the northwest of the country. "I propose you to get out of that first place (in hectares of coca) last year and build the peace capital of Colombia. That here in Catatumbo the talks of society can be developed and that somewhere talks can begin to leave the weapons behind and move to the era of peace," he said. "I have admitted the idea of carrying out in Catatumbo the first assembly of coca leaf farmers (…) with one intention: to show this government the ways (…) that allow us to achieve that a peasant family that today is dedicated to coca leaf can substitute this for an activity that guarantees them more quality of life", he explained to local residents. Colombia is the world's largest coca and cocaine producer. 

OK Legalization Init Has Enough Signatures, CA Governor Vetoes Safe Injection Sites, More... (8/23/22)

Prohibitionists file a legal challenge to a Missouri legalization initiative, a Nebraska medical marijuana initiative signature-gathering campaign comes up short, and more.

Marijuana is going to be on the ballot in a number of states, but it is not all set yet. (Creative Commons)
Marijuana Policy

Missouri Marijuana Legalization Initiative Hit by Legal Challenge from Prohibitionists. The Colorado-based Protect Our Kids PAC, a marijuana prohibitionist group, filed a lawsuit Monday against Legal Missouri's marijuana legalization initiative, which qualified for the ballot last week. The lawsuit charges that the initiative violates the state constitution's single-subject rule. It also argues that the initiative did not really collect enough signatures to qualify and that the state wrongly certified the measure. The lawsuit was filed by a staff member of the Community Anti-Drug Coalitions of America (CADCA), but on behalf of the Colorado-based Protect Our Kids PAC. It was filed on the last day of the 10-day window to file challenges. A similar legal challenge to a legalization initiative is already underway in Arkansas.

Oklahoma Marijuana Legalization Initiative Has Enough Signatures to Make Ballot, But Hurdles Remain. The SQ 820 marijuana legalization has been certified as having collected enough signatures to qualify for the November ballot, but hurdles remain before it becomes official. The state Supreme Court still has to approve the signatures and if and when that happens, the secretary of state will put out a notice that opponents then have 10 days to challenge the validity of the petition. Those two things need to be accomplished by the end of September or the measure will not make the November ballot. If it doesn't make the November ballot, voters will take it up at a later election.

Medical Marijuana

Nebraska Medical Marijuana Initiatives Campaign Comes Up Short on Signatures. An initiative to legalize medical marijuana in the state will not go before voters in November because cash-strapped activists came up short on valid voter signatures. Activists had hoped to put a complementary pair of initiatives on the ballot, but the campaign came up short both on the statewide number and on the number of counties where a 5 percent of the voters threshold was met. Each initiative needed 87,000 valid voter signatures, but one came up with only 77,843 and the other with 77,119 valid voter signatures. Both needed to get 5 percent of the registered voters in 38 of the state's counties, but one achieved that goal in only 26 counties and the other in 27.

Harm Reduction

California Governor Vetoes Safe Injection Pilot Program Bill. Despite past comments that he was "very open" to allowing safe injection sites to operate in the state, California Gov. Gavin Newsom (D) on Monday vetoed a bill that would do just that, Senate Bill 57. He cited "concerns" about its implementation. In his veto message, Gov. Newsom maintained that he has "long supported the cutting edge of harm reduction strategies," but was "acutely concerned about the operations of safe injection sites without strong, engaged local leadership and well-documented, vetted, and thoughtful operational and sustainability plans."

Newson left open the possibility that he could support similar legislation in the future, saying "We should strive to ensure our innovative efforts are well planned, even when they start as pilots, to help mitigate the potential for unintended impacts. Therefore, I am instructing the Secretary of Health and Human Services to convene city and county officials to discuss minimum standards and best practices for safe and sustainable overdose prevention programs. I remain open to this discussion when those local officials come back to the legislature with recommendations for a truly limited pilot program -- with comprehensive plans for siting, operations, community partnerships, and fiscal sustainability that demonstrate how these programs will be run safely and effectively."

California Governor Vetoes Bill Allowing Safe Injection Site Pilot Programs [FEATURE]

Despite past comments that he was "very open" to allowing safe injection sites to operate in the state, California Gov. Gavin Newsom (D) on Monday vetoed a bill that would do just that, Senate Bill 57. He cited "concerns" about its implementation.

California Gov. Gavin Newsom (D) says he supports harm reduction but has "concerns." (gov.ca.gov)
Sponsored by Sen. Scott Wiener (D-San Francisco), the bill would have allowed for safe injection pilot programs in Los Angeles, Los Angeles County, Oakland, and San Francisco. In each of those jurisdictions, city councils or boards of supervisors had requested inclusion in the bill and were prepared to begin to implement the proven harm reduction intervention.

California embracing safe injection sites would have been a tremendous advance for harm reduction in the United States, where the first safe injection sites opened just months ago in New York City, and Rhode Island is the only other state to have okayed them. Such facilities have been operating for decades in Europe, Canada, and Australia and have a proven safety track record. At the 170 safe injection sites that have operated around the world, not a single overdose death has been reported. In New York City, in the first three months of operation, staff at these sites were able to halt over 150 overdoses.

The bill was supported by a broad coalition of organizations including the Drug Policy Alliance, San Francisco AIDS Foundation, California Society of Addiction Medicine, National Harm Reduction Coalition, Healthright 360, Tarzana Treatment Center, and the California Association of Alcohol & Drug Program Executives.

Support for the bill was also heightened by significant increases in drug use and overdoses since the beginning of the coronavirus pandemic. San Francisco saw a record number of overdose deaths in 2020, with 711 deaths in total. In 2021, 640 people died of overdoses, and the city is on track to exceed that number this year. Statewide, approximately 10,000 people died of drug overdoses from April 2020 to April 2021.

In his veto message, Gov. Newsom maintained that he has "long supported the cutting edge of harm reduction strategies," but was "acutely concerned about the operations of safe injection sites without strong, engaged local leadership and well-documented, vetted, and thoughtful operational and sustainability plans."

He also left open the possibility that he could support similar legislation in the future, saying "We should strive to ensure our innovative efforts are well planned, even when they start as pilots, to help mitigate the potential for unintended impacts. Therefore, I am instructing the Secretary of Health and Human Services to convene city and county officials to discuss minimum standards and best practices for safe and sustainable overdose prevention programs. I remain open to this discussion when those local officials come back to the legislature with recommendations for a truly limited pilot program -- with comprehensive plans for siting, operations, community partnerships, and fiscal sustainability that demonstrate how these programs will be run safely and effectively."

Sen. Wiener and his allies, however, were not assuaged by Newsom's leaving the door open for future action.

"Today, California lost a huge opportunity to address one of our most deadly problems: the dramatic escalation in drug overdose deaths. By rejecting a proven and extensively studied strategy to save lives and get people into treatment, this veto sends a powerful negative message that California is not committed to harm reduction," Wiener said in a statement Monday. "SB 57 is not a radical bill by any stretch of the imagination. It simply gives permission to cities -- each of which has requested that permission -- to pilot safe consumption sites and get people into treatment."

California risks being left in the lurch as other cities and states move to embrace the harm reduction intervention, he said.

"Other states and cities in the US are already moving forward with this proven health model. New York City, with the vocal support of Mayor Eric Adams, has successfully implemented safe consumption sites. Indeed, Mayor Adams is advocating to expand the sites to operate 24 hours a day, due to their success in reducing public drug use. Rhode Island passed a law authorizing safe consumption sites, and Massachusetts is moving in that direction. Philadelphia is on the verge of settling with the Biden administration to potentially allow it to open safe consumption sites consistent with federal law," Wiener said.

"Today's veto is tragic," Wiener continued. "For eight years, a broad coalition has worked to pass this life-saving legislation. Each year this legislation is delayed, more people die of drug overdoses -- two per day in San Francisco alone. While this veto is a major setback for the effort to save lives and connect people to treatment, we must not -- and will not -- let it end this movement. We'll continue to fight for an end to the War on Drugs and a focus on drug use and addiction as the health issues they are."

Wiener's allies in the coalition pushing for safe injection sites were equally appalled by Newsom's veto.

"We are incredibly disappointed and heartbroken that Gov. Newsom has put his own political ambitions ahead of saving thousands of lives and vetoed this critical legislation," said Jeannette Zanipatin, California state director for the Drug Policy Alliance, which sponsored the bill. "Despite the governor's remarks, LA, San Francisco and Oakland have already designated this a priority by authorizing the programs locally and have been standing ready to implement them quickly. We have already engaged local stakeholders in a robust process and they have taken active steps towards implementation in order to be part of the pilot SB 57 would have put in place. We don't need additional processes. What we need is action. Without action, people are going to die," she said.

"While Newsom plays on the fears that an 'unlimited' number of Overdose Prevention Programs could have been opened, this would have been a limited pilot program that was only for five years and three jurisdictions, with an extremely thorough evaluation process. In 2021 alone, California lost over 10,000 residents to the overdose crisis, and we are continuing to see it disproportionately claim the lives of people of color throughout the state. Make no mistake, these deaths are 100 percent avoidable through common-sense, cost-effective measures, like SB 57, but because of his veto, people will continue to die alone and in the shadows."

"Harm reduction programs in three California cities were poised and ready to implement overdose prevention programs. Oakland, Los Angeles and San Francisco have done the groundwork, have local support, and this veto leaves entire communities of people who use drugs, the majority of them unhoused, without an essential lifesaving tool," said Laura Guzman, senior director of Capacity Building and Community Mobilization at the National Harm Reduction Coalition. "Newsom's veto of SB 57 comes at a time when we lose over 10,000 Californians every year to overdose and have skyrocketing racial disparities in deaths. This veto is completely unjustified."

"We are outraged that Governor Newsom has vetoed SB 57," said Tyler TerMeer, PhD, CEO of San Francisco AIDS Foundation. "Given the number of fatal overdoses that continue to happen every day in San Francisco and across California, now is the time for us to take bold action in establishing lifesaving overdose prevention programs. We are sending an urgent message to our elected officials that preventing these programs from operating will cost lives."

The coalition formed to pass SB 57 isn't going anywhere, and this fight is far from over. Look for renewed efforts on both the legislative and consultative fronts to make California safe injection sites a reality.

Cheaper and More Accessible Naloxone In the Works, Colombian Drug War Critic is Now President, More... (8/8/22)

A Congressional Research Service report zeroes in on the Jalisco New Generation Cartel, the Remedy Alliance is easing naloxone bottlenecks, and more.

Colombian President Gustavo Petro (Creative Commons)
Harm Reduction

Naloxone Access About to Get Easier. Thanks to an informal buyers' club for naloxone that has morphed into an entity known as the Remedy Alliance, access to inexpensive naloxone -- the opioid overdose reversal drug -- is getting easier. The Alliance credits two major developments for the urgently needed breakthrough. First, they have managed to reach agreements with drug manufacturers to get the drug at a discount rate, and second, they have restructured to a system that allows local harm reduction groups to order the drug through an online store, getting around a labyrinthine web of federal regulations that has bottlenecked the flow of the drug amidst the ongoing overdose crisis.

"We think this will totally change the landscape of naloxone in the United States," said Nabarun Dasgupta, the nonprofit's board president and a scientist at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. The group, formerly known as the Opioid Safety and Naloxone Network Buyers Club, has already reversed thousands of opioid overdoses and distributed 1.3 million doses of naloxone last year. Now, the Alliance expects to distribute 2 million doses this year.

International

Ex-Leftist Rebel, Drug War Critic Assumes Office as Colombia's President. Gustavo Petro, a former member of the leftist M-19 guerrilla army, was sworn into office Sunday, helping to cement an emerging leftist bloc around the region, consisting of Bolivia, Chile, Mexico, Peru, Venezuela and, most likely, Brazil after its October election. He said Colombia was getting a "second chance" to fight violence and poverty. He also said he was preparing to start peace talks with various armed groups around the country, and he called on the United States to change its prohibitionist approach to drug policy. "It's time for a new international convention that accepts that the war on drugs has failed," he said. "Of course, peace is possible. But it depends on current drug policies being substituted with strong measures that prevent consumption in developed societies."

Jalisco New Generation Cartel Present in 27 of Mexico's 37 States, Congressional Report Finds. The Jalisco New Generation Cartel (CJNG), the country's most powerful, now operates in 27 states and Mexico City, according to a new report from the Congressional Research Service (CRS). The report, "Mexico: Organized Crime and Drug Trafficking Organizations," says that the CJNG is the dominant criminal force in six states: Jalisco, Nayarit, Colima, Guerrero, Mexico, and Veracruz. It is weakest in Mexico's northwest, where the Sinaloa Cartel still dominates. CRS described the CJNG as an "extremely powerful cartel" that has a "reputations for extreme and intimidating violence." It also noted that the DEA "considers the CJNG a top US threat and Mexico's best-armed criminal group."

"The CJNG built its dominance internationally first through extending its presence through a rapid expansion inside Mexico," CRS said. "In 2016, many analysts maintained the CJNG controlled a territory equivalent to almost half of Mexico. The group has battled Los Zetas and Gulf Cartel factions in Tabasco, Veracruz, and Guanajuato, as well as the Sinaloa… [Cartel] in the Baja Peninsula and Chihuahua." The CJNG's ambitious expansion campaign was characterized by high levels of violence, particularly in Ciudad Juárez and Tijuana.

By taking over key ports on both the Atlantic and Pacific coasts, the CJNG has consolidated "important components of the global narcotics supply chain," the CRS said. "In particular, the CJNG maintains reported control over the ports of Veracruz, Manzanillo, and Lázaro Cárdenas, which has given the group access to precursor chemicals that flow into Mexico from China and other parts of Latin America," the report said. As a result, according to some analysts, the CJNG has pursued an aggressive growth strategy underwritten by US demand for Mexican methamphetamine, heroin, and fentanyl… Despite leadership losses, the CJNG has extended its geographic reach and maintained its own cohesion while exploiting the infighting among factions of the Sinaloa organization."

Poll Finds Support for Psychedelic Research for Military Members, Federal Marijuana Expungement Bill Filed, More... (8/1/22)

Last weekend's Lollapalooza festival in Chicago featured not only music but harm reduction measures, a new poll finds support for federal -- as opposed to state-level -- marijuana legalization, and more.

Chicago officials handed out Narcan and fentanyl test strips at last weekend's Lollapalooza festival. (Creative Commons)
Marijuana Policy

Bipartisan Federal Marijuana Expungement Bill Filed. Reps. Troy A. Carter, Sr. (D-LA) and Rodney Davis (R-IL) filed a bill last Friday that would pave the way for federal misdemeanor marijuana offenses to be expunged. The bill is the Marijuana Misdemeanor Expungement Act. "These misdemeanors -- even without a conviction -- can result in restrictions to peoples' ability to access educational aid, housing assistance, occupational licensing and even foster parenting," said Carter. "Delivering justice for our citizens who have been impacted by marijuana-related misdemeanors is a key component of comprehensive cannabis reform."

Americans Favor Federal Marijuana Legalization Mandate in Polling. Support for marijuana legalization remains high, but a new poll from The Economist and YouGov.com shows an increasing number of people want legalization to come from the federal government. Some 45 percent said the federal government should legalize it, while another 21 percent said legalization should primarily be left up to the states. Between them, that's two-thirds support for some form of freeing the weed. Only 20 percent thought "marijuana should be banned nationally."

Psychedelics

Poll Finds Majority Support Psychedelic Research for Military Members. A new poll from YouGov.com finds that 54 percent of respondents said they support "allowing research into the therapeutic potential of certain psychedelic substances for active-duty military members with post-traumatic stress disorder (PTSD)." Support was strongest among Democrats (60 percent), followed by independents (54 percent) and Republicans (45 percent). Reps. Alexandria Ocasio-Cortez (D-NY) and Dan Crenshaw (R-TX) both sponsored psychedelic research amendments that made it into the 2023 Fiscal Year National Defense Authorization Act (NDAA), which passed the House earlier this month.

Opioids

City of Chicago Warned Lollapalooza Festivalgoers About Fentanyl. The city's Department of Public Health last Friday issued an alert on its social media accounts warning fans of the massive Lollapalooza music festival that ended Sunday that fentanyl can easily cause an overdose and that they should take steps to know what is in their drugs. The city cautioned that fentanyl is being found not only in heroin, but also non-opioid drugs such as meth, Ecstasy, and cocaine. "Every year, we see young people end up admitted to the hospital because they've experimented -- at a time when we really want people to have fun, but have fun safely," said Public Health Commissioner Dr. Allison Arwady.

Drug War Issues

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