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ND Legal Pot Initiative Qualifies for Ballot, Appalachian Senators Call for More Drug War, More.. (8/16/22)

A South Dakota marijuana legalization initatiive draws organized opposition, Mexico's week of cartel violence raises questions, and more.

North Dakota's Theodore Roosevelt National Park. (Creative Commons)
Marijuana Policy

North Dakota Becomes Fifth State to Put a Marijuana Legalization Initiative on the Ballot This Year. The secretary of state's office announced Tuesday that a marijuana legalization initiative sponsored by New Approach North Dakota has qualified for the November ballot. Similar measures have already qualified for the ballot in Arkansas, Maryland, Missouri, and South Dakota, while an effort in Oklahoma awaits a final signature count. The initiative would legalize marijuana for people 21 and over. They would be able to purchase, possess, transport, and distribute up to an ounce and 500 milligrams of THC. There is also a home grow provision allowing for up three plants. The initiative also envisions a commercial sector licensed by the Department of Health and Human Services.

South Marijuana Legalization Initiative Campaigns Sees Organized Opposition Emerge. Even as the sponsors of the IM 27 marijuana legalization initiative gear up to free the weed for the second time in two years (the 2020 victory was annulled by the state Supreme Court at the behest of GOP Gov. Kristi Noem), organized opposition is emerging. In late July, a group calling itself Protecting South Dakota's Kids filed paperwork with the state as a statewide ballot question committee. It is led by Jim Kinyon, with Fred Deutsch as treasurer. Deutsch is a Republic legislator who is fiercely anti-marijuana. "Legal marijuana will destroy our communities," says the group's website. "Protecting South Dakota Kids is a grassroots coalition made up of concerned citizens, healthcare professionals, pastors, educators, treatment providers, law enforcement, and other professionals." But IM 27 backers don’t seem too concerned: "Quite a few politicians, including Governor Noem, have realized that disrespecting the will of the people is not a great political strategy," said campaign spokesman Matt Schweich. "We want to earn every vote we can and we want to exceed the 54% outcome in 2020." 

Law Enforcement

Appalachian Senators Call for More Drug War. In a Tuesday letter to Dr.Rahul Gupta, Director of the Office of National Drug Control Policy (ONDCP—the drug czar's office), a bipartisan group of senators from Appalachian states called for "additional assistance to combat drug-trafficking in the Appalachian region." The letter was signed by U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA), Sens. Joe Manchin (D-WV) and Shelley Moore Capito (R-WV), and Sens. Marsha Blackburn and Bill Hagerty (both R-TN). They want more resources and more designations of High Intensity Drug Trafficking Areas (HIDTAs). "These additional federal resources, allocated to areas deemed as critical drug trafficking regions, are essential in eliminating drug trafficking and its harmful consequences. ONDCP has the statutory authority to create new HIDTAs and add new counties to existing HIDTAs once it has received a formal petition from a coalition of law enforcement agencies," the senators said in a press release. "Despite the enormous need, historically the Appalachian HIDTA has only gained approval for approximately 30 percent of petitions submitted. In the most recent round of designations, no counties within the Appalachian HIDTA – which encompasses Tennessee, Kentucky, West Virginia, and Southwest Virginia – received the sought-after designation. This fact, juxtaposed with the region’s manifest need, suggests strongly that the process of awarding needs to be revisited."

International

Mexico's Week of Cartel Violence Shakes Administration. Last week was a week of chaos as  Mexican drug cartels ran amok in Tijuana and Ciudad Juarez as well as in the states of Coahuila, Guanajauto, and Jalisco, and that has left the government of President Andres Manuel Lopez Obrador (AMLO) looking for answers. AMLO himself suggested the attacks were part of a political conspiracy: "I don’t know if there was a connection, a hidden hand, if this had been set up,” he said. “What I do know is that our opponents, the corrupt conservatives, help in the black propaganda." And Defense Secretary Luis Crescencio Sandoval claimed the cartels lashed out because they feel they have been weakened. That may be a more plausible explanation than AMLO's. While AMLO took office in 2018 pledging "hugs not bullets" for violent drug trafficking organizations, in the past year his strategy has shifted Last year, Mexican soldiers were criticized for simply sitting in their bases and watching as cartels battled each other, but this year has seen more attempt to capture major traffickers, including the capture of Rafael Caro Quintero, and more meth lab busts. "There has been a change in the strategy in fighting drug cartels. Andrés Manuel has been very much criticized recently for his ‘hugs, not bullets’ strategy," security analyst David Saucedo said. "I think that due to pressure from Joe Biden, he is changing that and agreeing to capture high-profile drug traffickers. The narco-terrorism of the Jalisco New Generation Cartel is a reaction to the president’s change in strategy," Saucedo said. "If the Mexican president continues with this strategy of capturing high-ranking members of the Jalisco cartel, the Jalisco cartel is going to respond with acts of narcoterrorism in the states it controls as part of its vast empire."

Chronicle Book Review: American Cartel

American Cartel: Inside the Battle to Bring Down the Opioid Industry, by Scott Higham and Sari Horwitz (2022, Twelve Press, 400 pp., $30.00 HB)

Phillip S. Smith, with contributions from David Borden

https://stopthedrugwar.org/files/americancartel.jpg
Pulitzer Prize-winning Washington Post investigative reporters Scott Higham and Sari Horwitz have been on the opioid beat for years, teaming up (with others) on the Post's "The Opioid Files" series, which was nominated for a Pulitzer in 2020. Now, with American Cartel, the pair provide a deeply-sourced account of how opioid manufacturers, distributors, and pharmacies waged an all-out campaign to fend off DEA efforts to stanch the flow of billions of opioid pain pills, and to evade any culpability, even as the overdose death toll mounted year by year.

The picture Higham and Horwitz paint of corporate and political malfeasance is damning. But the laser sharp focus with which they paint it, omits much of the context in which the opioid crisis has unfolded. And that context is also very important.

An article in yesterday's Guardian shows one of the reasons why. In much of the world, very few pain patients are able to access opioids at all. Much suffering results, sometimes leading to suicide attempts. Dr. MR Rajagopal, chair of Pallium India, told the Guardian, "Pain is not visible. It happens in hospital beds or patients' rooms and is not visible to the world. Addiction, on the other hand, is very visible in headlines which quote the US epidemic and overdose deaths. No one talks about the western European success over decades; all the news is about the opioid crisis in the USA. This means that when we try to have discussions, our work becomes harder because many minds are primed against opioids."

In other words, by speaking too solely to one side of an issue, one risks adversely impacting the other sides. Whether "opiophobia" is real or significant in the US is another question. Higham and Horwitz don't venture a view on this, at least not in American Cartel.

One entity that has warned about opiophobia (without using the term) is the US Centers for Disease Control. In a 2019 memo, CDC writes that a 2016 guidance the agency issued on prescribing opioids for chronic pain had seen "misapplication[s]" by some physicians that put patients at risk. The memo cites a New England Journal of Medicine commentary by the authors of the 2016 guidance. It warns against "hard limits" on opioid dosages or cutting patients off; abrupt tapering of prescriptions; applying the guidance to acute pain situations patients face in situations like active treatment for cancer or sickle cell anemia or post-operative care; and applying it to medication-assisted treatment prescriptions for addiction.

Technically the CDC memo addressed a period of a few years beginning in 2016. But the dynamics it describes are inherent risks in a situation where providers are charged with supplying a substance that's useful but also addictive and potentially deadly if misused, and for which they can be sanctioned professionally or even prosecuted and imprisoned if things go wrong or someone disagrees. Pharma-driven promotion of their new opioid products was a factor in driving up prescribing rates to where they reached. But a part of the increase was also the medical community reacting to a real problem of under-treatment or non-treatment of pain for some patients, a problem that coexists with over-prescribing to some other patients. That increase in turn came with a learning curve.

The authors also give short shrift to the impact of today's woes and inequalities in driving the so-called deaths of despair -- a concept coined by Princeton professors Anne Case and Angus Deaton -- alienation and anomie, helplessness and hopelessness afflicting many Americans who have been left behind in the modern economy, especially in the opioid use heartlands of the Midwest and Appalachia. The Midwest deindustrialized beginning in the 1970s, and both regions largely missed out on the tech boom of the '90s and '00s. Then came even more pain with the Great Recession, followed by COVID and more economic and social disruption. People there (and elsewhere) are dying not just of opioids, but of smoking, drinking, and suicide. Big Pharma is easily (and oh so deservingly) demonized, but the laser focus on the companies allows us not to have to look in the mirror about the pain our society produces.

That factors like these should play a role in the opioid crisis, though, doesn't exonerate Big Pharma. Rather, the misleading promotions of their products carried out by pharma, took an even greater toll due to the vulnerabilities those other factors had brought to the fore.

Meanwhile, the death toll continues to mount -- over 100,000 per year, and with a new record high every year. Prescription opioids still figure prominently in overdoses. But the greatest part of the problem by far is black-market fentanyl, used deliberately by some high tolerance heavy users of opioids, but primariy causing overdose as an adulterant in heroin, counterfeit prescription pills, and other street drugs, essentially a poisoning crisis. But as Higham and Horwitz note, that is part of a wave of opioid use that began with pharmaceutical companies such as Purdue Pharma taking Oxycontin onto the market in the late 1990s. The first decade of this century also saw other prescription opioids -- oxycodone, hydrocodone, Vicodin, Percocet, Opana, et al. -- hit the market.

Higham and Horwitz are fond of tossing around astounding numbers of pills produced by manufacturers or sold by certain pharmacies, such as Mallinckrodt producing 3.5 billion 30 milligram hydrocodone pills in one year, and critics could protest that those numbers need context, too. A prescription for a medication doesn't just have a number of pills to take. It specifies how large a dosage there is inside each pill. A smaller number of pills that each contain a higher dose might mean more than a larger number that each contain a smaller dose. And a higher dose prescription sometimes reflects a patient's tolerance to opioids built up through past medical (or non-medical) use. Maybe West Virginia didn't really need 81 million pain pills during a five-year span. But maybe it did. Without more information, it's just not clear what these numbers mean.

They do provide some context, though, for example by comparing pain pill sales across all drug stores in a region and pointing out anomalies not easily explainable by, say, differing rates of cancer or other serious illness. And they demonstrate that plenty of businesses -- from Big Pharma to the drug store chains and individual pharmacies -- were either in it for the money or at best screwed up, both through detailed analysis and telling anecdote. For example, there was the guileless Florida pharmacist who explains to investigators that she fills pain pill prescriptions all day long, but always keeps a certain number of pills on reserve "for my real pain patients."

When the DEA cracked down first on Wild West internet sales of opioids and then on the "pill mills," medical practices with perfunctory examinations and huge numbers of opioid prescriptions whose entire business model seemed to be writing opioid prescriptions, it succeeded in reducing access to those drugs. But the people using opioids didn't stop; they went to black market drugs, fueling first a resurgence in heroin use and now an opioid crisis driven by fentanyl.

A key figure in the tale is Joe Rannazzisi, who as head of DEA's Office of Diversion Control from 2006 to 2015 oversaw the agency's endless effort to ensure that prescribed opioids are only prescribed for legitimate medical purposes and not leaking into the black market. We are inclined to think of the DEA as a prohibitionist agency, but in this case, it is acting as a regulatory agency. And what Higham and Horwitz uncover is a case of regulatory capture -- when the industry being regulated manages to set the terms under which it is regulated, for its own benefit, not that of the public.

Rannazzisi and his team of DEA lawyers spent years going after opioid manufacturers, distributors, and pharmacy chains who were repeatedly (administratively) busted for failing to do due diligence about just who was buying their products. The companies would pay huge fines, promise not to do it again, and then continue to pump massive amounts of opioids through the supply chain.

The companies mobilized against Rannazzissi and his campaign, forming industry front groups, undertaking lobbying efforts, hiring legions of high-priced law firms, and crafting legislation that would rein in what they saw as an out-of-control agency. As Higham and Horwitz document in great detail, it worked.

Sponsored by Rep. Tom Marino (R-PA) and Sen. Marsha Blackburn (R-TN), both of whom received substantial contributions from the industry, but written by industry lobbyists, the nicely named Ensuring Patient Access and Effective Drug Enforcement Act removed from the DEA tools that Ranizzisi had been using to try to force drug distributors to monitor and report suspicious orders, such as the 1.2 million oxycodone tablets one distributor bought from Mallinckrodt in one day, only to order another 1.2 million the next day.

The bill passed, only to be drastically revised amidst scandal after an earlier Post report on the opioid bill derailed then-President Trump's effort to name Marino drug czar. But Higham and Horwitz also detail rot inside the DEA, where the industry managed to get to high-ranking officials who sidelined Rannazzisi, forcing him into retirement and forcing many of his team members into bureaucratic Siberia. It's an ugly little story of money and power, the sort that is all too common in Washington.

If the first part of American Cartel reads like a detective novel, the second part is more like a legal thriller, It covers the massive wave of civil lawsuits filed against the drug companies, and it is not particularly edifying reading. You see hundreds of high-powered attorneys from the country's top litigating firms -- including dozens of former DEA attorneys working now working for the industry they regulated -- facing off against armies of lawyers for the thousands of states, cities, and counties. You see massive settlements from the companies and massive damages wrested from companies that went to court and lost. While it is unclear just how the moneys won or negotiated by the various plaintiffs is actually being used to help people who suffered from the opioid crisis, what is clear is that it has been a bonanza for the legal profession, with winnings -- excuse me, earnings -- by attorneys reaching well over a billion dollars.

They weren't all in it for the money, though. Some, like West Virginia attorney Paul Farrell, whose state was one of the epicenters of the pain pill epidemic, were sickened by the toll of addiction they saw all around them. Not willing to settle for the pittance the town and county he represented would receive under a massive settlement agreed to by most of the suing entities, he gambled on going it alone against the drug distributors. As this book went to print in April, he was still waiting for a decision. Earlier this month, he lost, with a federal judge ruling that drug distributors were not responsible for the area's opioid crisis.

The litigation goes on, and the dying goes on. Sometimes the drug companies settle, sometimes they lose and have to pay even more. But sometimes they win.

The profit-driven wave of opioids that engulfed the country in the last couple of decades is not an anomaly. The pharmaceutical companies have a historical pattern of creating and marketing drugs that later wreak havoc. That's what they did with amphetamines, that's what they did with barbiturates, that's what they did with benzodiazepines. It's almost enough to make one wonder if profit-driven capitalist enterprises should be in charge of the nation's drug supply.

Read Higham and Horwitz's book. But read Case and Deaton's too. And when you see the next "pill mill" story, don't assume that it is, or isn't, what it seems.

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.

Trump Calls for Death Penalty for Drug Dealers, Senate Legalization Bill Gets Hearing, More... (7/27/22)

The House approves a medical marijuana research bill, Switzerland and Zimbabwe open up to medicinal cannabis, and more.

The ex-president offered a dark and dreary vision of America as he called for the death penalty for drug dealers. (CC)
Senate Democrats' Marijuana Legalization Bill Gets Hearing. Led by Sen. Cory Booker (D-NY), one of the original cosponsors of the Cannabis Administration and Opportunity Act, the Senate Judiciary Subcommittee on Crime and Terrorism held a hearing Tuesday on the bill and the broader topic of marijuana legalization. The bill would legalize marijuana by removing it from the Controlled Substances Act, expunge nonviolent marijuana convictions, and impose a federal tax on marijuana sales. Marijuana sales in states that have not legalized medical or recreational marijuana would remain a federal crime. States would still set their own marijuana policies. Sen. Booker said marijuana prohibition had "miserably failed," creating a "festering injustice" of racially disproportionate marijuana law enforcement. But Sen. Tom Cotton (R-AR) opposed the bill, bizarrely arguing that legalization would benefit "gangs and cartels." No vote was taken, and the bill's future remains uncertain.

Medical Marijuana

House Approves Bipartisan Medical Marijuana Research Bill. The House on Tuesday approved HR 8454, the Medical Marijuana and Cannabidiol Research Expansion Act. The bill sponsored by Reps. Earl Blumenauer (D-OR) and Andy Harris (R-MD) passed on a vote of 325-95, exceeding the two-thirds supermajority required for a vote that takes place under a procedure known as suspension of the rules. Under suspension of the rules, no amendments are allowed and debate is limited. The bill passed with unanimous Democratic support, but Republicans were split over it. "This bill makes it easier to do the necessary, rigorous medical research -- just like is done for any other drug that has a claim of efficacy in this country," Harris, who opposes legalization but favors expanded studies, said on the floor. "The American public deserves to know what medical marijuana is useful for because, for anyone with those conditions where it is found to be useful, it could be a godsend -- but for other conditions where the claims won't be found to be valid with rigorous research, it would be found to be ineffective."

Drug Policy

Trump Calls for Death Penalty for Drug Dealers. Former President Donald Trump called Tuesday for the death penalty for drug dealers during a speech that painted a dark portrait of contemporary America. "The penalties should be very, very severe. If you look at countries throughout the world, the ones that don't have a drug problem are ones that institute a very quick trial death penalty sentence for drug 'dealers," Trump said at the America First Policy Institute. "It sounds horrible, doesn't it? But you know what? That's the ones that don't have any problem. It doesnt take 15 years in court. It goes quickly, and you absolutely -- you execute a drug dealer, and you'll save 500 lives," Trump continued. "It's terrible to say, but you take a look at every country in this world that doesn't have a problem with drugs, they have a very strong death penalty for people that sell drugs," he said.

The former president, who is now under investigation for various crimes related to his efforts to overturn the 2020 election results, unironically called for a broad and harsh crackdown on crime, including police cars parked on every corner, giving police greater qualified immunity, "We're living in such a different country for one primary reason: There is no longer respect for the law, and there certainly is no order. Our country is now a cesspool of crime," Trump said, calling for efforts to defeat violence and to "be tough and be nasty and be mean if we have to."

International

Switzerland Fully Legalizes Medical Cannabis and Allows Export. Beginning August 1, Swiss patients will be able to legally obtain medical marijuana with a medical prescription. Until now, patients were forced to seek individual permission from the Federal Office of Public Health. This comes after the Federal Council (the executive branch) amending the Swiss Narcotics Act approved by parliament in March 2021. Although cannabis for medical purposes will be legal next week, the law only allows products containing less than 1% THC, the limit set for the country's hemp industry. The new law also will allow for exports.

Zimbabwe Allows Cannabis Use in Medicines for First Time. The country's Medicines Control Authority has invited licenses cannabis and hemp producers, as well as importers, exporters, manufacturers, and retail pharmacists to apply for licenses to sell hemp-based products for use as medicines. "Unlicensed sellers of cannabis will be prosecuted for selling unapproved" medicines, the authority added. Would-be licensees must provide product samples and allow official inspections. The move is largely driven by the country's search for ways to boost income in its agricultural sector. The Treasury Department estimates the crop has the potential to reach $1.25 billion a year.

Senate Dems' Legalization Bill Gets Hearing Tomorrow, Senate Bill to Allow TV Pot Ads in Legal States Filed, More... (7/26/22)

Senate Majority Leader Schumer's marijuana legalization bill gets two new cosponsors and a hearing tomorrow, a Cannabis Resource Center to promote equity in the industry launches in New York, and more.

Marijuana Policy

Schumer's Marijuana Legalization Bill Gets Two More Cosponsors. The marijuana legalization bill backed by Senate Majority Chuck Schumer (D-NY) and cosponsored by Sens. Cory Booker (D-NJ) and Ron Wyden (D-OR) has picked up two more cosponsors. Assistant Democratic Leader Patty Murray (D-WA) and Sen. Gary Peters (D-MI) have now signed on to the Cannabis Administration and Opportunity Act (CAOA), which was released one week ago today. "It is long past time the federal government catches up to Washington state when it comes to cannabis laws,"Murray said. "This legislation is about justice, strengthening our economy, and bringing the federal government into the 21st century."

But Murray added that she wanted to see Secure and Fair Enforcement (SAFE) Banking Act (S.910) pass: "While the reforms we are pushing for are critical and long overdue -- I remain fully committed to passing SAFE Banking however possible -- including as a standalone bill,"Murray said. "It makes absolutely no sense that legal cannabis businesses are forced to operate entirely in cash, and my bill would bring them into the formal banking system where they belong."

Witnesses Picked for Senate Marijuana Legalization Hearing Tomorrow. Sen. Cory Booker (D-NJ), a cosponsor of the Cannabis Administration and Opportunity Act (CAOA), will chair a meeting of the Judiciary Subcommittee on Criminal Justice and Counterterrorism Friday on "Decriminalizing Cannabis at the Federal Level: Necessary Steps to Address Past Harms," and the witness list is now set. The witnesses on the majority side are Malik Burnett, a pro-legalization physicians who is now medical director of harm reduction services at the Maryland Department of Health; former federal marijuana prisoner Weldon Angelos, who was pardoned by then-President Trump and now advocates for clemency for federal marijuana prisoners via his nonprofit The Weldon Project; and Annapolis Police Chief Edward Jackson, a member of the Law Enforcement Action Partnership (LEAP). The minority witnesses are former federal prosecutor Steve Cook, a hardline drug warrior; and former New York Times reporter Alex Berenson, who has become a Fox News regular since penning the broadly criticized and questionably researched book "Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence."

Senate Bill Filed to Allow Marijuana TV, Radio Ads in States Where It is Legal. Sen. Ben Ray Lujan (D-NM) on Tuesday filed the Secure and Fair Enforcement (SAFE) Advertising Act, which would allow marijuana businesses in states where it is legal to advertise their products and services on TV and radio. The bill mirrors an amendment that was included in a recently passed spending bill in the House The bill would block the Federal Communications Commission (FCC) from penalizing TV and radio stations for running such ads as long as "the activities of the cannabis-related legitimate business or service provider were, at the time of the broadcast or other transmission of advertising," were legal in the state, tribe or territory.

New York Marijuana Resource Center Launched. Senate Majority Leader Chuck Schumer (D-NY) joined advocates and community leaders in New York City for the launch of a new marijuana resource center designed to promote equity in the state's marijuana industry. Schumer used the occasion to point out overlaps between the state's push for social justice in the industry and the need to federally legalize marijuana. Just last week, he filed such a legalization bill. "We're trying at the federal level to mimic what New York has done -- not just in legalization and ending criminalization but making sure social justice is an essential part of any legislation," Schumer said at the event, adding that he and colleagues are "making some progress" in building bipartisan buy-in on marijuana reform from "conservative Republicans and libertarians."

CO Psychedelic Legalization Init Qualifies, Singapore Hangs Fifth in Four Months for Drug Offenses, More... (7/22/22)

Iowa's Democratic attorney general calls for legalizing fentanyl test strips, GOP senators file a bill to go after drug cartel "spotters," and more.

The Rio Grande River marks the US-Mexico border in this remote region of Texas. Can you spot any spotters? (Pixabay)
Drug Policy

GOP Senators File Bill to Target Cartel Spotters. Sen. Joni Ernst (R-IA) and cosponsors Sens. John Cornyn (R-TX), Thom Tillis (R-NC) and James Lankford (R-OK) have filed the Transnational Criminal Organization Illicit Spotter Prevention and Elimination Act, which "increases penalties for those who aid cartels in illegal activity by transmitting information about the positions of Border Patrol or destroying Border Patrol communication devices." The bill would stiffen penalties on spotters by increasing fines and imposing a maximum prison term of 10 years on those convicted of helping cartels.

Harm Reduction

Iowa Attorney General Calls for Legalizing Fentanyl Test Strips. Faced with rising drug overdose deaths in the state, Attorney General Tom Miller (D) said Thursday he wants to see legislation introduced next year to legalize fentanyl test strips. He also said he wants to expand access to the overdose reversal drug naloxone. "There's no one thing that's going to solve this problem, but the pieces of different solutions are going to really, really make the difference," Miller said. Miller's remarks came a week after Gov. Kim Reynolds (R) held a news conference about rising fentanyl overdoses and offered up a public messaging campaign aimed at younger Iowans. Iowa saw 470 drug overdose deaths last year, up from 419 in 2020 and 350 in 2019.

Psychedelics

Colorado Psychedelic Legalization Psilocybin Therapy Initiative Qualifies for November Ballot. The Natural Medicine Health Act has qualified for the November ballot. The Natural Medicine Colorado campaign, backed by the national New Approach PAC, turned in about 100,000 more raw signatures than needed to qualify after a short, three-month signature-gathering campaign. The initiative would legalize possession of certain psychedelics, establish a therapeutic model for supervised psilocybin treatment and provide a pathway for record sealing for prior convictions. There are no explicit possession limits for natural psychedelics, including psilocybin, ibogaine, mescaline (not derived from peyote), DMT and psilocyn. There is no provision for recreational sales. A second psychedelic legalization initiative, sponsored by Decriminalize Nature Colorado, that would simply allow people 21 and over to possess, cultivate, gift and deliver psilocybin, psilocyn, ibogaine, mescaline and DMT is still in the signature-gathering phase.

International

Singapore Hangs Drug Offender, Fifth Execution in Four Months. Singapore authorities executed Nazeri bin Lajim for heroin trafficking on Friday. It was the fifth execution in less than four months, all of drug offenders. "Five people have been hanged this year in Singapore, in a period of less than four months. This relentless wave of hangings must stop immediately. The use of the death penalty in Singapore, including as mandatory punishment for drug-related offences, violates international human rights law and standards," Amnesty International's death penalty expert Chiara Sangorgio said. "Everyone executed in Singapore in 2022 has been sentenced to the mandatory death penalty for drug-related offenses. Rather than having a unique deterrent effect on crime, these executions only show the utter disregard the Singaporean authorities have for human rights and the right to life. We call on governments, the United Nations Office on Drugs and Crime, and the International Narcotics Control Board to increase pressure on Singapore so that international safeguards on the death penalty are respected and drug control policies are rooted in the promotion and protection of human rights. Singapore's highly punitive approach does neither."

Senate Democrats File Marijuana Legalization Bill, Bipartisan Psychedelics for Terminally Ill Bill Filed, More... (7/21/22)

Singapore is set to hang a drug offender today, Sensators Cory Booker (D-NJ) and Rand Paul (R-KY) filed a bill to allow the terminally ill to use certain psychedelics, and more.

Marijuana Policy

Senate Leadership Introduces Legislation to End Federal Marijuana Prohibition. Senate Majority Leader Chuck Schumer (D-NY), along with Sen. Cory Booker (D-NJ) and Sen. Ron Wyden (D-OR), today introduced the Cannabis Administration and Opportunity Act (CAOA). The legislation repeals the federal criminal prohibition of marijuana, provides deference to states' cannabis policies, and establishes mechanisms to help repair the harms associated with the racially and economically disparate enforcement of prohibition. The CAOA removes marijuana from the Controlled Substances Act schedule entirely, ending the threat of federal prosecution for possession and licensed commercial activity, and allows states to implement their own cannabis policies free of federal interference. It also eliminates many problems facing regulated state cannabis markets, including lack of access to financial services, the inability to deduct standard business expenses when filing federal taxes, and the lack of uniform national regulatory standards and guidelines. The legislation also directs funding to reinvest in communities that have been disproportionately impacted by prohibition and helps improve diversity and inclusion in regulated cannabis markets. The bill's prospects in the evenly-divided Senate are unclear, at best.

Psychedelics

Senators Cory Booker, Rand Paul Introduce Bipartisan Legislation to Amend the Right to Try Act to Assist Terminally Ill Patients. US Senators Cory Booker (D-NJ) and Rand Paul (R-KY) introduced legislation Thursday to clarify that the Right to Try Act should allow terminally ill patients to have access to Schedule I drugs for which a Phase 1 clinical trial has been completed. Specifically, the Right to Try Clarification Act would remove any obstacle presented by the Controlled Substances Act with respect to Schedule I substances when they are used by doctors and patients in accordance with the federal Right to Try law. Companion legislation will be introduced in the House by Representatives Earl Blumenauer (D-OR) and Nancy Mace (R-SC).

The federal Right to Try law permits patients who have been diagnosed with life-threatening diseases or conditions, and who have exhausted all approved treatment options, access to certain treatments that have not yet received final FDA approval. In general, a drug is eligible for Right to Try use after a Phase 1 clinical trial has been completed for that drug but prior to the drug being approved or licensed by the FDA for any use. In other words, in limited conditions involving life threatening illness and for drugs that have been proven to be safe, the federal Right to Try law removes the FDA out of doctor-patient decisions and reverts regulation back to the states. Under the terms of the federal Right to Try law, states remain free to permit or prohibit Right to Try use under their own laws.

International

Singapore Set to Hang Drug Offender Today. The city-state is set to hang 64-year-old Singaporean citizen Nazeri Lajim for drug trafficking today. This would be the fifth execution since March after a long pause in hangings during the coronavirus pandemic. He was handed the death sentence in 2017, some five years after being arrested during an anti-narcotics operation. Nazeri was found with two bundles of what was analyzed to be 35.41 grams of heroin, exceeding the 15 gram legal threshold for the imposition of the death penalty.

The country is increasingly out of step with its neighbors on drug policy. Thailand legalized most forms of marijuana last month, and Indonesia and Malaysia are discussing medical marijuana. The government defended its hardline approach: "It really is incumbent upon us to present the choices in very vivid terms and persuade our people, including young people, that we have to make the right choices for them and for society," said Law and Home Affairs Minister K. Shanmugam.

Sudan Defense Lawyers Charge Political Detainees Forced to Undergo Drug Tests. The legal group Sudan's Emergency Lawyers, which defends people seeking to protest against rule by the military-dominated government, is charging that people being arrested at protests are now being subjected to unlawful drug tests. Detainees including at least 15 minors and six women were released after being beaten, assaulted and subjected to drug tests, the group said.

The lawyers said "what is really disturbing is that these people are now subjected to a drugs test," which they stressed "is completely contrary to the law". The lawyers say that those detained were not in possession of drugs and were not found in any suspicious situation that necessitates this procedure or would give authorities common cause. They pointed to the fact that any referral for examination must be made by the prosecution. "This procedure is purely criminal, it violates the rights of the detained, and it is against the principle of assumption of the accused's innocence, and completely contrary to the law. It degrades dignity and has a profound psychological impact," the lawyers added.

Rumors have been circulating that young protesters are using drugs, meth in particular, because they don't seem to show hunger or fatigue, but there has been no evidence to back up the rumors.

Chronicle Book Review: Opium's Orphans

Chronicle Book Review: Opium's Orphans: The 200-Year History of the War on Drugs by P.E. Caquet (2022, Reaktion Books, 400 pp., $35.00 HB)

The history of drug prohibition is increasingly well-trodden territory, but with Opium's Orphans, British historian P.E. Caquet brings a fascinating new perspective embedded in a sweeping narrative and fortified with an erudite grasp of the broad global historical context. Although Asian bans on opium pre-dated 19th Century China (the Thai monarchy announced a ban in the 1400s), for Caquet, the critical moment in what became a linear trajectory toward global drug prohibition a century later came when the Qing emperor banned opium in 1813 and imposed severe penalties on anything to do with it, including possessing it. Precisely 100 years later, after two Opium Wars imposed opium on the empire followed by decades of diplomatic wrangling over how to suppress the trade (and for moralizing Americans, how to win favor with China), the 1913 Hague Opium Convention ushered in the modern war on drugs with its targeting not just of opium (and coca) producers or sellers but also of mere users for criminal prosecution. It urged countries to enact such laws, and they did.

What began at the Hague would eventually grow into an international anti-drug bureaucracy, first in the League of Nations and then in United Nations bodies such as the Commission on Narcotic Drugs and the International Narcotics Control Board. But it is a global prohibition regime that has, Caquet writes, straight-jacketed itself with an opium-based perspective that has proven unable or unwilling to recognize the differences among the substances over which it seeks dominion, reflexively resorting to opium and its addiction model. Drugs such as amphetamines, psychedelics, and marijuana don't really fit that model -- they are the orphans of the book's title -- and in a different world would be differently regulated.

But Opium's Orphans isn't just dry diplomatic history. Caquet delves deep into the social, cultural, and political forces driving drug use and drug policies. His description of the spread of opium smoking among Chinese elites before it spread into the masses and became declasse is both finely detailed and strangely evocative of the trajectory of cocaine use in the United States in the 1970s, when it was the stuff of rock musicians and Hollywood stars before going middle class and then spreading among the urban poor in the form of crack.

Along the way, we encounter opium merchants and colonial opium monopolies, crusading missionary moralists, and early Western proponents of recreational drug use, such as Confessions of an English Opium Eater author Thomas De Quincey and the French habitues of mid-19th Century hashish clubs. More contemporaneously, we also meet the men who achieved international notoriety in the trade in prohibited drugs, "drug lords" such as Khun Sa in the Golden Triangle, Pablo Escobar in Colombia and El Chapo Guzman in Mexico, as well as the people whose job it is to hunt them down. Caquet notes that no matter how often a drug lord is removed -- jailed or killed, in most cases -- the impact on the trade is negligible.

For Caquet, drug prohibition as a global phenomenon peaked with the adoption of the 1961 Single Convention on Narcotic Drugs. Coming as it did amidst a post-World War II decline in drug use around the world, the treaty criminalizing coca, cocaine, opium and opioids, and marijuana seemed to ratify a successful global prohibitionist effort. (In the US, in the 1950s, when domestic drug use was at low ebb, Congress passed tough new drug laws.) But before the decade was over, drug prohibition was under flamboyant challenge from the likes of LSD guru Timothy Leary and a horde of hippie pot smokers. The prohibitionist consensus was seeing its first cracks.

And the prohibitionist response was to crack down even harder, which in turn begat its own backlash. Drug use of all sorts began rising around the world in the 1960s and hasn't let up yet, and the increasingly omnivorous drug war machine grew right along with it, as did the wealth and power of the illicit groups that provided the drugs the world demanded. As the negative impacts of the global drug war -- from the current opioid overdose crisis in the US to the prisons filled with drug offenders to the bloody killing fields of Colombia and Mexico -- grew ever more undeniable, the critiques grew ever sharper.

In recent years, the UN anti-drug bureaucrats have been forced to grudgingly accept the notion of harm reduction, although they protest bitterly over such interventions as safe injection sites. For them, harm reduction is less of an erosion of the drug war consensus than all that talk of drug legalization. As Caquet notes, perhaps a tad unfairly, harm reduction doesn't seek to confront drug prohibition head-on, but to mitigate its harms.

The man is a historian, not a policymaker, and his response to questions about what to do now is "I wouldn't start from here." Still, at the end of it all, he has a trio of observations: First, supply reduction ("suppression" is his word) does not work. Sure, you can successfully wipe out poppies in Thailand or Turkey, but they just pop up somewhere else, like the Golden Triangle or Afghanistan. That's the infamous balloon effect. Second, "criminalization of the drug user has been a huge historical blunder." It has no impact on drug use levels, is cruel and inhumane, and it didn't have to be that way. A century ago, countries could have agreed to regulate the drug trade; instead, they tried to eradicate it in an ever-escalating, never-ending crusade. Third, illicit drugs as a group should be seen "as a historical category, not a scientific one." Different substances demand different approaches.

Opium's Orphans is a fascinating, provocative, and nuanced account of the mess we've gotten ourselves into. Now, we continue the work of trying to get out of that mess.

AZ Churches Sue Feds Over Ayahuasca Seizures, Schumer's Legalization Bill Coming Within Days, More... (7/20/22)

Indonesia's Constitutional Court rejects medical marijuana but calls for "immediate" study, DC Mayor signs bill providing workplace protections for marijuana users, more.

Weed will be on the Senate's mind next week. (Creative Commons)
Marijuana Policy

Senate Hearing on Marijuana as Filing of Legalization Bill Looms. The Senate Judiciary Subcommittee on Crime and Terrorism has scheduled a hearing for next Tuesday on "Decriminalizing Cannabis at the Federal Level: Necessary Steps to Address Past Harms." The hearing, led by Sen. Cory Booker (D-NJ), a strong proponent of Senate Majority Leader Chuck Schumer's pending legalization bill, the Cannabis Administration and Opportunity Act, comes amid word that the bill will drop any day now. Schumer has blocked incremental marijuana reforms, such as the SAFE Banking Act, saying he wants a full-blown legalization bill.

Kentucky Democrats Announce Plan for Legalization Bill. Frustrated by the failure of the Republican-controlled state legislature to act even on medical marijuana, state Democrats announced Thursday they will be filing legislation to legalize marijuana for both medical and recreational use. They said they would fill "LETT's Grow" bills in both house. LETT is short for Legalizing sales, Expunging crimes, Treating medical needs, and Taxing sales. "Our legislation is the comprehensive plan that Kentuckians deserve, and it builds on what's worked in other states while avoiding their mistakes," said Rep. Roberts of Newport. "This would be a boon for our economy and farmers alike, plus give state and local governments a major new source of revenue."

DC Mayor Signs Bill Providing Workplace Protections for Marijuana Users, Mayor Muriel Bowser (D) has signed into law a bill that most employers from firing or refusing to hire workers because they use marijuana. The bill would "prohibit employers from firing, failing to hire, or taking other personnel actions against an individual for use of cannabis, participating in the medical cannabis program, or failure to pass an employer-required or requested cannabis drug test, unless the position is designated safety sensitive or for other enumerated reasons." There are exceptions for police, safety-sensitive construction workers, people whose jobs require a commercial drivers' license, and people who work with children or medical patients. The new law must still be approved by Congress before it can go into effect.

Psychedelics

Arizona Churches Sue Over Seizure of Sacramental Ayahuasca. Two Arizona churches, the Arizona Yagé Assembly and the Church of the Eagle and the Condor, have filed suit in federal court over the seizure of ayahuasca, a key element in their religious practice, by federal agencies. In separate lawsuits, the two churches charge that the federal government has violated the constitutional right to the free exercise of religion, citing the Religious Freedom Restoration Act. That law bars the government from burdening the exercise of religion unless there is a compelling government interest and only if that action if the least restrictive means of furthering that interest.

The Church of the Eagle and the Condor says that US Customs and Border Protection has been seizing and destroying its ayahuasca since 2020. The churches say drinking ayahuasca is "an essential mode of worship" for members, but federal agencies say any possession of ayahuasca, a Schedule I substance, violates the Controlled Substances Act. "The church and its members are aware that their sacrament is proscribed by law, but they have partaken in their sacrament both before and after the United States made a credible threat of enforcement of the CSA against them," the suit says. "Plaintiffs are violating and intend to continue to violate applicable law, rather than compromise or terminate their sincerely held religious beliefs and practices."

International

Indonesia High Court Rejects Medical Marijuana But Calls for Immediate Study. The Constitutional Court on Wednesday nixed a judicial review of the country's drug law that could have opened the door for medical marijuana. Three mothers of children with cerebral palsy backed by civil society groups had sought the review, arguing that marijuana could be used medicinally to treat medical conditions. The court held there was insufficient research to rule in favor of the plaintiffs, but called on the government to "immediately" conduct research on the medicinal use of the herb… The results of which can be used to determine policies, including in this case the possibility of changing the law," said judge Suhartoyo.

Big Increase in Injection Drug Use, House Passes Another Spending Bill with SAFE Banking, More... (7/18/22)

British Tories audition a new scheme for punishing drug users that effectively decriminalizes somebody's first two drug busts, a new study finds racial disparities in Pennsylvania marijuana arrests are increasing, and more.

The number of Americans injecting drugs increased five-fold in the past decade. (Creative Commons)
Marijuana Policy

House Passes Defense Spending Bill with Marijuana Amendments. The House last Thursday approved the National Defense Authorization Act, which includes nine amendments pertaining to marijuana and other drug policies. Included in the House version of the bill is language from the Secure and Fair Enforcement (SAFE) Banking Act, language allowing Department of Veterans Affairs doctors to allow medical marijuana recommendations, and two psychedelic research amendments. The SAFE language, which the legal marijuana industry is clamoring for, has been passed in the House as part of several earlier omnibus spending bills, only to be killed in the Senate by Majority Leader Charles Schumer (D-NY) and his allies, who have been holding out for passage of a full-blown marijuana legalization bill. We shall see if it turns out any differently this time.

Black Pennsylvanians See More Racial Bias in Marijuana Arrests. A new study from the National Organization for the Reform of Marijuana Laws (NORML) finds that racial disparities in marijuana arrests jumped upward in 2020, even though overall pot arrests declined. Black Pennsylvanians were five times more likely to be arrested for marijuana statewide. The largest disparity was in Cumberland County, where Blacks were 18 times more likely to be arrested for pot than Whites. "I will say that the numbers moving in the wrong direction is certainly a concern," said Executive Director of the Pennsylvania Cannabis Coalition Meredith Buettner. "This is all the more reason that we really need to dig into adult use policy here in Pennsylvania, Pennsylvanians." The Republican-controlled state legislature has so far blocked any moves toward legalization.

Drug Policy

CDC Finds Huge Increase in Number of People Injecting Drugs. A new study from the Coalition for Applied Modeling for Prevention (CAMP) and funded by the Centers for Disease Control and Prevention (CDC) shows a rapid increase in the number of people shooting up drugs in the past decade. The most recent data, from 2018, put the number of injection drug users at about 4 million, five times the number in 2011, the last previous estimate. The study also found that overdoses -- both fatal and non-fatal -- had also increased dramatically, with deaths related to injection drug use rising threefold during that period, which was before the current spike in overdose deaths, now around 100,000 a year. For every fatal injection drug overdose, there were 40 non-fatal ones, the study found. The CDC estimates that a third of people who inject drugs share syringes, needles or other drug injection equipment.

International

British Tories Plan to Punish Drug Users, Could Seize Their Drivers' Licenses, Passports. The Home Office has announced a scheme to punish drug users in a bid to "tackle the scourge of drug abuse in society." Under the "three-strikes" proposal, first-time illicit drug offenders, including marijuana offenders, would have to pay for and attend a drug awareness course. A second offense would merit a formal warning, another drug awareness course, and up to three months of mandatory random drug testing. For a third offense, people would be criminally charged and, upon conviction, could be banned from nightclubs and other entertainment venues and could have their drivers' licenses and passports confiscated. But, hey, that is effectively decriminalization for the first two offenses. The proposal will now undergo a three-month consultation period before being amended or implemented as is.

Drug War Issues

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