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Where Marijuana Legalization Could Win at the Statehouse in 2022 [FEATURE]

Nearly a decade after voters in Colorado and Washington led the way, marijuana is now legalized for adult use in 18 states, the District of Columbia, and the territory of Guam. In nearly every state where it is not yet legal, there are efforts underway to change the status quo. With support for marijuana legalization at a record high 68 percent in the most recent Gallup poll, one would be forgiven for thinking that more states are ready.

In some states, activists following the well-worn path of the voter initiative to free the weed; in others, legislators are pursuing a hybrid strategy combining legislative and voter approval. See our earlier rundown of initiative and hybrid efforts here.

But in a number of remaining pot prohibition states, it is up solely to the legislature to get legalization done, whether directly via legislation or by initiating a voter referendum. While legalization bills have been filed in most, if not all, prohibition states, many will fail to pass the legislature, win a chamber floor vote, or even get a committee vote. So, who is going to get it done in 2022? With a big tip of the hat to Ballotpedia, Marijuana Moment, and NORML, who are all keeping an eye on the action, here are some of he states where the odds are best:

Delaware

Last week, a marijuana legalization bill cleared the last hurdle before a House floor vote when the House Appropriations Committee advanced House Bill 305. The bill would allow legal personal possession of 1 ounce of marijuana for adults ages 21 or older and set up a framework for its taxation and sale. It allocates 30 retail sale licenses, 30 manufacturing licenses, 60 cultivation licenses and five testing licenses to be issued within 16 months of the bill's approval.

The committee "walked the bill," which allowed it to advance without a public hearing. The bill had already been approved by the House Health and Human Services Committee. The last time a legalization bill got a House floor vote, back in 2018, it lost by four votes.

This time, the Democrats control both the House and the Senate, as well as the governorship. In the House, Democrats have 26 seats to the GOP's 15, while in the Senate, Democrats have 14 seats to the GOP's seven. And they are going to need virtually all of them to get the bill through owing to a 60 percent super-majority vote requirement because the bill deals with licensing and fees. That same super-majority for legalization may be needed to get the bill past Governor John Carney, who publicly opposed marijuana legalization last year and reiterated that last month,

Maryland

Delegate Luke Clippinger (D), chairman of legislative group studying the issue of marijuana legalization, has filed House Bill 1, which, if passed, would place before voters the following question: "Do you favor the legalization of adult -- use cannabis in the State of Maryland?" If voters approved it, the General Assembly would then be charged with writing the rules covering "use, distribution, possession, regulation, and taxation of cannabis."

The bill is moving, pushed along by powerful legislators. It was House Speaker Adrienne Jones (D) who formed the marijuana working group, and Clippinger is not only chairman of the group but also chairman of the Judiciary Committee, which advanced the bill to the House floor this week. There, it passed a second floor reading and is now headed for a final House floor vote as early as Friday.

Also headed for a final House floor vote is an accompanying bill sponsored by Clippinger, House Bill 837, that includes measures to implement legalization if voters approve it. It sets 1.5 ounces as the legal possession limit for adults and decriminalizes between 1.5 and 2.5 ounces, as well as automatic expungement for past conduct made legal by the law.

If passed by the House, the measures would still have to be approved by the Senate. Senate President Bill Ferguson (D), though, seems more inclined to support getting a straight legalization bill passed before November than going down the referendum route. One bill that would do that, Senate Bill 692, from Sen. Jill Carter (D), would legalize up to four ounces and allow home cultivation of up to six cannabis plants. Possession in excess of those limits would carry no more than a $150 fine, and past criminal records would be cleared for certain cannabis-related charges.

But there is also a Senate bill that parallels the House measure by seeking voter approval of a marijuana legalization constitutional amendment. That bill, Senate Bill 833, would allow home grows of up to four plants. Either way would work.

Minnesota

After a torturous process that saw it move through a dozen House committees, a marijuana legalization bill, House Fill 600, passed the House in May 2021, only to be stalled in the Senate. It is still alive in this, the second year of the bicameral session, and the House may even revisit it for refinements, but the question is whether the GOP-controlled Senate will be more eager to engage this year.

So far, there is little sign of that, as even Democratic legislative leaders concede. As for the companion to the House bill, Senate File 757, the legislative website reports that "No Senate Committee Hearing or Action has Been Recorded." Still, it ain't over until it's over.

New Hampshire

In January, the Republican-dominated House passed a bill, House Bill 629-FN, that would legalize the possession and unremunerated gifting of up to three-quarters of an ounce of marijuana but would not allow commercial production and sales. That vote came after defeating a broader legalization bill that would have allowed such commerce.

And then this month, the House approved another marijuana legalization bill, House Bill 1598, that would legalize the possession of up to four ounces and allow for sales through state-run pot shops but not allow for home cultivation. But because that bill has fiscal components, it must go back to the House Finance Committee and then be approved once more by the House before heading to the Senate.

The Senate, though, is where New Hampshire legalization bills go to die. That has been the fate of all four previous legalization bills passed by the House, but with the state surrounded by legal marijuana states and the issue garnering overwhelming popular support in the Granite State, this year could be different. But the legislature would have to pass any bill with a veto-proof majority, given the longstanding opposition of Gov. Chris Sununu (R).

Rhode Island

Rhode Island is close. The Senate passed a legalization bill last June, Senate Bill 568, and Gov. Dan McKee (D) included legalization in his budget proposalin the form of House Bill 7123. Lawmakers are reportedly working on a compromise between the Senate bill, which envisioned up to 150 retail outlets, and the governor's initial plan, which called for only 25 retail licenses. Both the Senate bill and the governor's plan include social equity provisions.

A key player, House Speaker Joe Shekarchi (D) says there is only one issue holding up a final agreement: who will regulate the legal marijuana market? Will it be an independent commission or the State Bureau of Business Regulation? But Shekarchi also said the issue now is not whether to legalize but how to, and that legalization is "inevitable."

NY Marijuana Licensing and Equity Bill Goes to Governor, Italian High Court Throws Out Plants Referendum, More... (2/17/22)

An Alabama marijuana decriminalization bill advances, so does a Hawaii bill that would legalize marijuana for people over 65, and more.

There are moves afoot to ease access to medical marijuana for senior citizens. (Sandra Yruel/DPA)
Marijuana Policy

Alabama Marijuana Decriminalization Bill Wins Senate Committee Vote. The Senate Judiciary Committee on Wednesday approved Senate Bill 160 on a 5-4 vote. The bill, filed by Sen. Bobby Singleton (D), would decriminalize the possession of up to two ounces and make possession of more than two ounces a misdemeanor punishable only by a maximum fine of $250. A second offense would net a $500 fine, while a third offense would be considered a Class D felony, but still punishable only by a $750 fine. The bill also provides a mechanism for expungement of past offenses. A similar measure passed the committee last year, only to die without a floor vote.

New York Legislature Approves Marijuana Licensing and Equity Bill. The Senate and the Assembly have both approved Assembly Bill 1248, the Marihuana Regulation and Taxation Act. The measure provides provisional marijuana cultivation and processing licenses for existing hemp businesses if they take steps to promote equity in the nascent industry. The measure passed the Senate on a 50-13 vote Tuesday and passed the Assembly on a 99-43 vote Wednesday. The bill now goes to the desk of Gov. Kathy Hochul (D).

Medical Marijuana

Hawaii Senate Committee Approves Bill to Legalize Marijuana for People 65 and Over. In a bid to ease access to medical marijuana for senior citizens, the Senate Health Committee approved a bill that would allow people 65 and over to automatically qualify for medical marijuana regardless of whether they have a qualifying condition, in effect legalizing possession for seniors. The bill passed the committee on a 3-0 vote. It would alter the state's medical marijuana law by adding to the language requiring that patients be diagnosed "as having a debilitating medical condition" that medical marijuana will be available to anyone "who has reached the age of sixty-five."

DC Mayor Signs Bill to Let People Over 65 Get Medical Marijuana Without a Doctor's Recommendation. Mayor Muriel Bowser (D) has signed into law the Medical Marijuana Patient Access Extension Emergency Amendment Act of 2022, which will allow people 65 and over to self-certify their eligibility for medical marijuana without getting a doctor's recommendation. The bill also creates a medical marijuana tax holiday coinciding with 4/20 and extends the registration renewal deadline for patients.

International

Italian Constitutional Court Vetoes Plants Referendum. The Constitutional Court on Wednesday threw out a proposed referendum to decriminalize marijuana, psilocybin and some other plants, with cultivation legalized, saying that it included other substances considered to be hard drugs. "This is enough to make us violate multiple international obligations," said Giuliano Amato, the Constitutional Court president. The decision prompted the ire of referendum advocates, who had gathered more than half a million signatures in just about one week to place the measure before voters. The decision was "a terrible blow to democracy," said lawmaker Riccardo Magi, a leading advocate.

Psychedelic Reform Possibilities in 2022 [FEATURE]

Activists in Denver opened psychedelic floodgates for the United States with their successful psilocybin decriminalization initiative in 2019. Since that time, the trickle of bills and initiatives seeking to undo the criminalization of psychedelics has turned into a torrent.

Is it the year of the magic mushroom? (Creative Commons)
In 2020, Oregon and Washington, DC broke things open even wider with Oregon's therapeutic psilocybin initiative and DC's entheogenic plant decrim. (Oregon also passed the broader general drug decrim initiative). A number of towns and cities, most notably in California, Massachusetts, and Michigan, have subsequently enacted psychedelic reforms.

This year, psychedelic reform measures are popping up like mushrooms after a rain shower, with serious decriminalization or legalization efforts in several states, and either therapeutic or study efforts (or therapeutic study efforts) in many more. Many, perhaps most, of these bills will not pass this year, but then, legislating controversial topics is seldom a single-year process. Initiatives probably have a better chance of success -- provided they can make it to the ballot.

With a big tip of the hat to Ballotpedia and Marijuana Moment, here's is what we've got going in 2022:

California

There are two different paths to psychedelic legalization this year, one via the legislature and one as a potential November ballot initiative.

Senate Bill 519 would legalize the possession and unremunerated sharing of psilocybin (2 grams, or 4 grams of magic mushrooms), psilocin, DMT (2 grams), LSD (0.01 gram), MDMA (4 grams), and mescaline for people 21 and older. The bill passed the Senate last year, but sponsor Sen. Scott Weiner (D-San Francisco) put it on pause, signaling he needed more time to build support in the Assembly.

Regardless of what happens in Sacramento, activists with Decriminalize California have drafted the California Psilocybin Initiative of 2022 , which "decriminalizes under state law the cultivation, manufacture, processing, distribution, transportation, possession, storage, consumption, and retail sale of psilocybin mushrooms, the hallucinogenic chemical compounds contained in them, and edible products and extracts derived from psilocybin mushrooms."

Whether the initiative will qualify for the ballot will be known soon; campaigners have only until March 13 to come up with 623,212 valid voter signatures. As of mid-February, they had not reported gathering 25 percent of the signatures, as is required when that benchmark is reached, so that is not a good sign.

Colorado

New Approach PAC, which supported the Oregon therapeutic psilocybin initiative in 2020, as well as various marijuana legalization initiatives, is supporting a pair of psychedelic reform initiatives, both known as the Natural Medicine Healing Act. The first would legalize the possession, cultivation and an array of entheogenic substances, as well as establish a regulatory model for psychedelics therapy. The other would initially legalize psilocybin and psilocin alone for personal adult use while and allow for their sale and administration in a therapeutic setting.

Meanwhile, activists with Decriminalize Nature Boulder County have filed the Legal Possession and Use of Entheogenic Plants and Fungi initiative, which would allow people 21 and over to possess, cultivate, gift and deliver psilocybin, psilocyn, ibogaine, mescaline and DMT. The initiative would also allow psychedelic services for therapeutic, spiritual, guidance, or harm reduction purposes with or without accepting payment.

Both initiatives will need 124,632 valid voter signatures by August 8 to qualify for the November ballot.

Florida

State Senate Minority Leader Lauren Brook (D) has filed Senate Bill 348, which would require the state to research the medicinal benefits of psychedelic substances such as ketamine, MDMA, and psilocybin. The bill directs the state Health Department to "conduct a study evaluating the therapeutic efficacy of alternative therapies" such as those substances, "in treating mental health and other medical conditions," such as anxiety, depression, bipolar disorder, and PTSD. A companion version of the bill, House Bill 193 has been filed in the House. Neither has moved since last fall, though.

Hawaii

A bill to set up a state working group to study the therapeutic effects of psilocybin mushrooms, Senate Bill 3160, won approval in the Senate Health Committee this month and now awaits a Senate floor vote. Companion legislation, House Bill 2400, is awaiting action in the House.

Meanwhile, Senate Bill 738 would decriminalize psilocybin by removing from the state's schedule of controlled substances and requiring the establishment of therapeutic psilocybin treatment centers, which was filed more than a year ago, awaits action in the Senate Judiciary Committee.

Iowa

There are a trio of psilocybin bills that are all technically still alive, although they were filed a year ago and have yet to see action. House File 549 would deschedule psilocybin, but a Public Safety subcommittee recommended indefinite postponement last March, and it remains postponed indefinitely. House File 636 would set up a regime for therapeutic psilocybin, and House File 480 would decriminalize certain psychedelics for use by a patient diagnosed with a terminal illness or a life-threatening disease or condition. Neither of those bills have moved out of committee.

Kansas

House Bill 2465 would decriminalize the possession of less than 100 grams of psilocybin and make possession of more than 100 grams a misdemeanor. The bill would also legalize the home cultivation of psilocybin mushrooms. Introduced last month, the bill is now before the House Committee on Corrections and Juvenile Justice.

Maine

Legislative Document 1582 would enact "the Maine Psilocybin Services Act, which establishes a regulatory framework in order to provide psilocybin products to clients in Maine." Although it is not yet officially dead, it failed to get reported out of the House Health and Human Services Committee earlier this month.

Maryland

A pair of complementary bills, House Bill 1367and Senate Bill 709, would create "the Post-Traumatic Stress Disorder Alternative Therapies Fund to support the study of the effectiveness of and improving access to alternative therapies for post-traumatic stress disorder in veterans." While there has been a Senate hearing on its bill, neither bill has moved out of committee yet.

Massachusetts

House Bill 1494would establish an interagency task force to study the public health and social justice implications of legalizing the possession, consumption, transportation, and distribution of naturally cultivated entheogenic plants and fungi. It is currently before the Judiciary Committee.

Michigan

Sen. Jeff Irwin (D) filed Senate Bill 631 last September. It would legalize the possession, cultivation, and delivery of plant- and fungi-derived psychedelics, such as mescaline and psilocybin. The bill would free people from criminal liability except for "receiving money or other valuable consideration for the entheogenic plant or fungus." In other words, no commercial sales, but people can charge a "reasonable fee for counseling, spiritual guidance, or a related service that is provided in conjunction with the use of an entheogenic plant or fungus under the guidance and supervision of an individual providing the service."

Meanwhile, activists with Decriminalize Nature, Decriminalize Nature Michigan, and Students for Sensible Drug Policy earlier this month filed the Michigan Initiative for Community Healing, which would legalize the use and possession of a broad range of natural entheogens and allow for "supervision, guidance, therapeutic, harm reduction, spiritual, counseling, and related supportive services with or without remuneration."

The measure has yet to be approved for signature gathering -- a decision on that will come next month -- and if and when it is, it will need 340,047 valid voter signatures by May 27 to qualify for the November ballot.

New Hampshire

A bipartisan group of legislators have filed House Bill 1349-FN, which would decriminalize the possession of psilocybin mushrooms. The bill would decriminalize the possession of up to 12 grams of 'shrooms, enough for several psychedelic experiences. The clock is ticking on this one; it must clear Criminal Justice and Public Safety Committee by March 10 or it dies.

New York

Assemblyman Pat Burke (D) has filed a bill, Assembly Bill 8569, that would legalize psilocybin mushrooms for therapeutic purposes and create facilities where the mushrooms could be grown and provided to patients. It is a set-up similar to what Oregon voters approved last year. The bill provides a list of qualifying medical conditions but also says psilocybin could be recommended "for any conditions" certified by a practitioner. The Department of Health would be responsible for providing a training course for practitioners and licensing the psilocybin centers.

Meanwhile, Assemblymember Linda Rosenthal (D/WF) has filed Assembly Bill 6065, which decriminalizes psilocybin. That bill has been referred to Assembly Health Committee.

Oklahoma

State Reps. Daniel Pae (R) and Logan Phillips (R) have filed a pair of bills that would promote research into psilocybin's therapeutic potential, and one of them would also decriminalize small-time possession of the drug. The bills are designed to give lawmakers different options to reach similar objectives, but Pae's bill would also decriminalize the possession of up to an ounce and half of psilocybin. Pae's bill, House Bill 3414, has been referred to House Public Health Committee, while Phillips' bill, House Bill 3174, =has been referred to House Rules Committee.

Pennsylvania

Rep. Tracy Pennicuick (R-Montgomery County) filed House Bill 1959, "Providing for research and clinical studies of psilocybin, for duties of Department of Health, for duties of institutional review boards, for duties of authorized psilocybin manufacturers, for duties of approved investigators and for reports" last October. It was referred to the House Health Committee, where it has remained ever since.

Utah

Rep. Brady Brammer (R-Highland) has filed House Bill 167, which would create a Mental Illness Psychotherapy Drug Task Force that would "study and make recommendations on drugs that may assist in treating mental illness." Although not mentioned specifically in the bill, supporters say psilocybin, the psychoactive compound in magic mushrooms, is the drug most likely to be considered by the task force. The bill passed the House last week and now heads for the Senate.

Vermont

Rep. Brian Cins (D/P) filed House Bill 309, "An act relating to decriminalizing certain chemical compounds found in plants and fungi that are commonly used for medicinal, spiritual, religious, or entheogenic purposes" 51 weeks ago. It has sat in the House Judiciary Committee without moving ever since, although it did get a hearing in January.

Virginia

In January, the House Courts of Justice Subcommittee voted to delay consideration of a bill to decriminalize a wide range of psychedelics, House Bill 898, until 2023. The move came even after the bill was amended by its sponsor, Del. Dawn Adams (D), to only apply to medical practitioners and people using psychedelics with a practitioner. The object for the delay is to build support and try again next year. A similar bill in the Senate, Senate Bill 262, remains alive.

Washington

State Senators Jesse Salomon (D) and Liz Lovelett (D) have introduced a bill that would allow people to use psilocybin and psilocin, the psychoactive ingredients in magic mushrooms, with the assistance of a trained and state-licensed psilocybin services administrator. The bill, Senate Bill 5660, is titled the Psilocybin Wellness and Opportunity Act. People would have to go to a licensed service center to partake, unless they suffer certain medical conditions or are unable to travel, in which case they could receive psilocybin at home and meet remotely with a facilitator. The bill got a Senate Health and Long Term Care Committee hearing earlier this month, but remains in committee.

There is also likely to be a ballot initiative to broadly decriminalize drugs in 2022, similar to what neighboring Oregon voters passed in 2020. That effort, which was foiled in 2020 because of the pandemic, is being led by Commit to Change WA.

MD Lawmakers Take Up Marijuana Legalization, Former Honduras Prez Detained on US Drug Charges, More... (2/15/22)

The Oregon Health Authority has released draft rules for therapeutic psilocybin, the New Mexico legislature approves legalizing fentanyl test strips, and more.

Former Honduran President Juan Orlando Hernandez (Creative Commons)
Marijuana Policy

Alabama Marijuana Decriminalization Bill Filed. Senator Rick Singleton (R) has filed a bill to decriminalize the possession of small amounts of marijuana. Senate Bill 160 would make first offense possession of more than two ounces a misdemeanor but with a maximum penalty of a $250 fine, a second offense would be a $500 fine, and a third offense would merit a felony charge and a $750 fine but no jail time. Possession of less than two ounces would also be subject to a $250 fine but would only be an infraction. Under current state law, possession of any amount of marijuana is a misdemeanor punishable by up to a year in jail.

Maryland Lawmakers Begin Work on Marijuana Legalization as Plans for Referendum Quicken. Lawmakers in Annapolis have begun working on a pair of bills aimed at legalizing marijuana in the state. The first bill, House Bill 1, sponsored by Del. Luke Clippinger (D), chair of the House Judiciary Committee, would put the question of legalization before the voters in November, while the second bill, House Bill 837, also from Clippinger, provides a framework for lawmakers to come up with a scheme for taxation and regulation.

If the referendum bill is approved by both lawmakers and voters, possession of up to 1.5 ounces of marijuana would become a civil violation punishable by only a $100 fine starting January 1, 2023. And expungement of past possession convictions would be automatic. The legislation would also require the state to conduct a "disparity study" to evaluate barriers groups may face in gaining access to the legal industry.

Psychedelics

Oregon Releases Draft Rules for Therapeutic Use of Psilocybin. The state health department has released draft rules for the therapeutic use of psilocybin. The move is in response to the passage of Measure 109 in November 2020, which gave the state two years to come up with a framework for regulating magic mushrooms for therapeutic purposes. While most of the draft rules deal with how to credential and evaluate training programs for those administering psilocybin, one rule specifies that only one species of mushroom, psilocybe cubensis, will be allowed. Growers would not be allowed to use dung or wood chips to cultivate mushrooms or make synthetic psilocybin and would also not be able to make products that might appeal to children, such as "products in the shape of an animal, vehicle, person or character."

Harm Reduction

New Mexico Legislature Approves Fentanyl Test Strip Bill. The state Senate on Monday gave final approval to House Bill 52, which legalizes test strips that can detect the presence of fentanyl. The move is a bid to reduce overdoses. Overdoses linked to fentanyl began climbing in the state in 2019. The bill has already passed the House and now goes to the desk of Gov. Michelle Lujan Grisham (D), who supports it.

International

Former Honduran President Detained on US Drug Charges. Former Honduran President Juan Orlando Hernandez, who left office less than a month ago, has been detained by Honduran authorities to face extradition to the US to face drug charges. An extradition request presented to the Honduran Supreme Court accuses Hernandez of participating in a "violent drug-trafficking conspiracy" that transported 500 tons of cocaine from Colombia and Venezuela to the US since 2004. His brother, Juan Antonio Hernandez, is already doing a life sentence in the US for drug trafficking, and so is another trafficker, Geovanny Fuentes, who implicated Hernandez in the conspiracy. It is not clear if or when Hernandez will be extradited; the Supreme Court judge who will hear his case is affiliated with his political party and has a history of freeing suspects in corruption cases.

CDC Prepares New Opioid Prescribing Guidelines, OH Senate Won't Take Up Legalization Voter Init, More... (2/10/22)

The South Carolina Senate approves a medica marijuana bill, a new Rand study tracks opioid prescribing declines, and more.

Opioid pain prescribing practices are in the news. (Creative Commons)
Marijuana Policy

Ohio GOP Senate Leader Says He Will Not Bring Marijuana Legalization Initiative to a Vote. State Senate President Matt Huffman (R-Lima) says he will not bring the Coalition to Regulate Marijuana Like Alcohol's marijuana legalization initiative to a vote in the Senate. Under Ohio law, petitioners who collect the requisite number of valid voter signatures for a ballot initiative then place the proposal before the legislature, which has four months to act on it. If the legislature refuses to act on the proposal or rejects it, petitioners can undertake a second round of signature gathering and, if successful, present the issue to directly to the voters.

"I don't want anybody to misunderstand my position," Huffman said. "I'm not going to bring it to the Senate floor. And if that means people want to go put it on the ballot, have at it." While the Coalition has yet to comment on Huffman's remarks, it has previously indicated it will indeed proceed to that second round of signature gathering. They will need to come up with 132,887 valid voter signatures to make the November ballot.

Medical Marijuana

South Carolina Senate Approves Medical Marijuana Bill. After the debate on medical marijuana made it to the Senate floor last week, the Senate on Wednesday approved the South Carolina Compassionate Care Act (Senate Bill 150). The bill gets a final vote in the Senate Thursday, before heading to the House, where its fate is unclear. Whether House Speaker Jay Lucas (R) will let the bill move in his chamber remains uncertain. And Gov. Henry McMaster (R) remains noncommittal on whether he would sign the bill, saying "that would depend on a lot of things."

Opioids

Opioid Prescribing Declines, but Cuts Are Not Uniform Across Locations, Age Groups, or Type of Prescriber. The volume of prescription opioids dispensed from retail pharmacies declined by 21% from 2008 to 2018, but the decline was not uniform across geographic areas, among types of patients, or by type of prescriber, according to a new RAND Corporation study. The study, published by the Annals of Internal Medicine, is the first to examine the decline in opioid prescriptions filled at retail pharmacies based on both volume and potency of the drugs dispensed.

The study found that over the study period, per capita MME (morphine milligram equivalents) volume declined the most in metropolitan counties (more than 22%) and in counties with higher rates of fatal opioid overdoses (a 35% decline). Substantial variation existed both within and across states. In some states, MME volume per capita increased in multiple counties. In many other states, there were both counties with increases and others with substantial decreases. Counties that experienced substantial decreases in per capita MME often were adjacent to counties with per capita increases.

Most clinical specialties recorded declines in the MME volume per practicing clinician. The greatest decrease in MME volume per practicing clinician was among adult primary care physicians (40% decline) and pain specialists (15% decline) -- the clinicians with the highest MME volume per clinician in 2008 -- 2009. The greatest percentage decrease was among emergency physicians (71% decline) -- clinicians who are likely prescribing opioids predominantly to patients experiencing acute pain in acute care settings.

"These results suggest the effects of clinician and policymaker efforts to reduce opioid prescribing have affected populations differently," Stein said. "Future efforts to enhance clinically appropriate opioid prescribing may need to be more clinically nuanced and targeted for specific populations."

CDC Proposes New, Slightly Looser Opioid Prescribing Guidelines. The Centers for Disease Control and Prevention (CDC) on Thursday released new draft guidelines for prescribing opioids for pain relief. The new guidelines remove previously recommended ceilings on doses for chronic pain patients, leaving it instead for doctors to use their own best judgment. But they also urge doctors to first resort to "nonopioid therapies" for both chronic and acute pain.

The new guidelines are the first comprehensive revisions of the CDC's 2016 guidelines, and attempt to find the proper balance between alleviating severe pain and exposing patients to the perils of opioids. The new guidelines have now been published in the Federal Register and are open for comments. Comment here.

These States Could Still Approve Medical Marijuana in 2022 [FEATURE]

In the space of a quarter-century, the United States went from having no state where medical marijuana was legal to seeing it become the law of the land in three dozen states. The passage of Prop 215 by California voters in 1996 ushered in an era of rapid expansion of medical marijuana, first primarily via the initiative process, but also increasingly by state legislators attuned to the will of the public.

Mississippi became the 37th state to legalize medical marijuana just this month as lawmakers in Jackson and a very cautious governor finally agreed on a bill to enact the will of the people as expressed in a 2020 initiative that was thwarted by a state Supreme Court ruling. But there are still seven states that allow only CBD oil (Georgia, Indiana, Iowa, Kentucky, Tennessee, Texas, Wisconsin) and six more states that don't allow any form of medical marijuana (Idaho, Kansas, Nebraska, North Carolina, South Carolina, Wyoming).

Moves are afoot in nearly all of them to catch up to the rest of the country this year. In some states, it is through the initiative process; in others, through the legislative process. But some states are already a lost cause for the year or face insurmountable odds: Georgia (bills filed, but set to die), Iowa (no bills filed), Indiana (bill never made it out of committee). Texas (no bills filed), and Wyoming (initiative did not qualify, no bills filed).

With a big tip of the hat to Ballotpedia, Marijuana Moment, and NORML, who are all keeping an eye on the action, here's the list of states working to legalize it at the ballot box this year, here are the states where hope still lives for medical marijuana in 2022:

Idaho

With a state legislature and governor stubbornly against marijuana in any form, the only medium-term prospect for medical marijuana is through the initiative process. One group, Kind Idaho, tried going down that path in 2020 but called off the effort in the midst of the coronavirus pandemic. They are back this year with the Idaho Medical Marijuana Act of 2022, which envisions a full-fledged program complete with long lists of qualifying conditions and taxed and licensed cultivation, production, and sales, as well as allowing patients or caregivers to possess up to four ounces. Only patients who qualify for a "hardship exemption" -- financial hardship, lack of access to transportation, lack of a dispensary "within a reasonable distance" -- could grow their own, up to six plants.

But the clock is ticking. The campaign said just last month that it had gathered only 10,000 raw signatures so far. It needs 64,945 valid voter signatures to qualify for the ballot and the mainly volunteer effort only has until May 1 to come up with them.

Kansas

The House last year passed a medical marijuana bill, House Substitute for SB 158, and that bill is still alive in the Senate, where it got hearings -- but no vote -- in the Committee on Interstate Cooperation in mid-January. The Senate is controlled by Republicans, who have resisted reform, but so is the House, which got the bill through. And Gov. Laura Kelly (D) also supports medical marijuana.

Legislative Democrats, meanwhile, introduced a pair of constitutional amendments to put the issues of marijuana legalization and access to medical marijuana directly to the voters. Democratic lawmakers next door in Iowa announced a similar move earlier this week. The Democrats are hoping that even if Republicans remains resistant to marijuana reform, they would at least pass the measures and let the voters decide.

Kentucky

Rep. Jason Nemes (R) got a medical marijuana bill passed in the House in 2020, but it died without a Senate vote in the midst of the pandemic. He tried again in 2021, but the bill stalled. After scaling back his bill in a bid to win conservative support, he is back this year with House Bill 136, which also has 40 cosponsors.

Under this year's version of the bill, there would be no home cultivation by patients or caregivers and there would be no smokeable medical marijuana allowed. Patients could consume flowers but would have to vape them. The bill leaves specific rules on qualifying conditions and possession limits up to regulators, but specifies that qualifying conditions will includecancer, epilepsy and seizure disorders, multiple sclerosis, nausea or vomiting and chronic, severe, intractable or debilitating pain.

The bill has a good shot of passing the House and even in the Senate if it is allowed to come up for a vote, but faces an obstacle in the person of Senate President Robert Stivers (R), who has "concerns" and wants "more studies."

Nebraska

After the state Supreme Court invalidated a 2020 medical marijuana initiative because it violated the state's single-subject rule for initiatives, initiative sponsors State Senators Anna Wishart (D) and Adam Morfeld (D) came back this year with a set of three separate initiatives to create a medical marijuana program. One is a constitutional amendment and two are statutory initiatives.

The Medical Marijuana Constitutional Amendment simply states that "Persons in the State of Nebraska shall have the right to cannabis in all its forms for medical purposes, while the Medical Cannabis Patient Protection Act protects patients from arrest for using medical marijuana and the Medical Cannabis Commission Act would regulate medical marijuana businesses that provide it to qualified patients.

An activist group, Nebraskans for Medical Marijuana (NMM) is in the middle of a signature gathering drive now. It has until July 7 to come up with approximately 86,000 valid voter signatures for the initiatives and 112,000 signatures for the constitutional amendment.

South Carolina

Senator Tom Davis (R-Beaufort) has been trying for seven years to get some sort of medical marijuana bill through the legislature, and just this week, this year's version, Senate Bill 150, saw a medical marijuana bill get a Senate floor debate for the first time ever, and then pass the Senate Wednesday night. Its fate in the House, though, is unclear; whether House Speaker Jay Lucas (R) will let the bill move in his chamber remains uncertain. And Gov. Henry McMaster (R) remains noncommittal on whether he would sign the bill, saying "that would depend on a lot of things."

Honed to advance in the conservative state, Davis's bill is also conservative. It bars the use of smokable marijuana, requires an in-patient doctor's visit and a written treatment plan, and limits the conditions that can be treated to a specified list including cancer, multiple sclerosis, glaucoma. sickle cell anemia and autism. And not only is home cultivation not allowed; possessing the plant form of marijuana would remain a misdemeanor.

Tennessee

State Rep. Jason Powell (D-Nashville) earlier this month introduced a bill that would create a medical marijuana program, House Bill 2458, which awaits committee assignment. Its companion legislation, Senate Bill 2477, has been referred to the Senate Judiciary Committee.

Whether these bills will go anywhere remains to be seen. Medical marijuana bills have all died in the past, and last year, the legislature voted down decriminalization. Republicans are in a solid majority in both the state House of Representatives and the Senate, but the year is young.

Washington Drug Decrim Init Ready for Signature Gathering, Crack Pipe Funding Furor, More... (2/9/22)

Thailand removes cannabis from its schedule of controlled substances (but marijuana legalization is still down the road a bit), a Washington state drug decriminalization initiative is cleared to begin signature gathering, and more.

A broken crack pipe. Bowing to noise from the right, the Biden administration won't fund harm reduction kits with them. (CC)
Marijuana Policy

Colorado Bill Would Protect Workers from Being Fired for Off-Job Marijuana Use. Rep. Brianna Titone (D-Arvada) has filed a bill, House Bill 1152, that would bar employers from either refusing to hire or firing workers because of their off-duty marijuana use. The measure also includes a provision requiring employers to consumer medical marijuana at work, with some exemptions for safety-sensitive positions. "Marijuana is legal in Colorado," said state Rep. Titone. "And what people do in their spare time that doesn't impact their work shouldn't really be a problem for them. They should be able to enjoy the legal things that we have here in Colorado and not be penalized for it." The state Supreme Court has previously ruled on the side of employers on the issue, particularly in the 2015 case of Brandon Coats v. Dish Network.

Drug Policy

Washington Drug Decriminalization, Treatment Initiative Ready to Begin Signature Gathering. A drug decriminalization and treatment funding initiative that was filed last month by the group Commit to Change WA, which is backed by the state ACLU, is ready to begin signature gathering in a bid to qualify for the November ballot. The move comes after a Monday deadline for challenges to its ballot title passed without any challenges. The initiative would remove the state's existing penalties for drug use and possession, expunge past drug use and possession convictions, and appropriate more than $100 million a year for drug prevention, treatment, outreach, and recovery, including at least $10 million a year for harm reduction. The campaign now has until July 8 to come up with 324,516 valid voter signatures to make the ballot.

Harm Reduction

Cowed by Criticism from the Right, Biden Administration Drops Funding for Safer Crack Pipes. Office of National Drug Control Policy (ONDCP -- the drug czar's office) head Dr. Rahul Gupta announced that a harm reduction grant program for drug users will not fund safer pipes for crack or meth smokers. "No federal funding will be used directly or through subsequent reimbursement of grantees to put pipes in safe smoking kits," Gupta and Health and Human Services Secretary Xavier Becerra said in a statement.

There is $30 million in federal funding for harm reduction, and the Substance Abuse and Mental Health Services Administration had listed "safe smoking kits/supplies" among the items that could be purchased with taxpayer money. Other items included included overdose prevention drugs, medication lockboxes, test kits for infectious diseases, and syringe disposal containers. The tender did not actually mention pipes, but it did trigger online reports that the Biden administration was using taxpayer dollars to buy "crack pipes."

International

Thailand Officially Drops Cannabis from List of Controlled Substances. As of today, cannabis is no longer a Category 5 controlled substance. Public Health Minister Anutin Charnvirakul signed a ministerial announcement officially removing it on Tuesday. The delisting means that all parts of the plant can be legally consumed, but THC extracts above 0.2 THC will remain illegal. The change will go into effect in 120 days. This means that production of hemp and hemp-based CBD products can commence, but it will still be against the law to grow and consume marijuana until a bill is submitted to parliament in order to establish a regulatory framework for production and sales.

House Advances SAFE Banking Act (Again), MI Psychedelic Legalization Initiative Filed, More... (2/3/22)

Mountains of meth are being cooked up in Myanmar's Shan state, UNODC reports. (dea.gov)
Marijuana Policy

House Approves Marijuana Banking on Voice Vote, Final Approval with Roll Call Vote Expected Today. The House on Wednesday gave preliminary approval to a marijuana banking amendment to a science and technology bill, with a roll call voice vote expected Thursday. The amendment is the SAFE Banking Act, which is aimed at providing access to financial services for state-legal marijuana businesses. The measure has repeatedly been approved by the House, most recently as part of a defense appropriations bill, but Senate negotiators more interested in passing a full-on marijuana legalization bill killed it then.

Bipartisan Coalition of House Members Call for Quick Vote on Marijuana Legalization. A bipartisan group of House members sent a letter to congressional leaders Wednesday demanding that Congress move "expeditiously" to pass a bill to legalize marijuana. The bill in question is the Marijuana Opportunity, Reinvestment and Expungement (MORE) Act (HR 3617), which passed the House in 2020 and passed the House Judiciary Committee this session, but has yet to be scheduled for a floor vote.

The MORE ACT is "is foundational in righting systemic injustices and removing barriers for families and individuals nationwide" and so it should be "expeditiously considered by the House and Senate," the letter said. The letter was led by Rep. Marilyn Strickland (D-WA) and cosigned by Reps. Nikema Williams (D-GA), Matt Gaetz (R-FL), Marie Newman (D-IL), Ted Lieu (D-CA), Dina Titus (D-NV), Dean Phillips (D-MN), Salud Carbajal (D-CA), Lou Correa (D-CA), Angie Craig (D-MN) and Bonnie Watson Coleman (D-NJ).

Drug Policy

Grassley, Whitehouse Implore Biden Administration to Quickly Release National Drug Control Strategy for 2022. On Wednesday, Sens. Chuck Grassley (R-IA) and Sheldon Whitehouse (D-RI), co-chairs of the Senate Caucus on International Narcotics Control, pushed the Biden administration to finish its work on and release the 2022 National Drug Control Strategy. Their bipartisan letter comes after Dr. Rahul Gupta -- Director of the White House Office of Drug Control Policy (ONDCP) -- indicated last week that their 2022 strategy could be delayed until the end of June, far past the statutorily required date of February 7, 2022.

"We are pleased that your office is taking a thoughtful look and share your sentiments, especially in light of the record overdose deaths. Despite this, we are disappointed in the delay. The Strategy is critical in informing the federal government's approach to drug enforcement, prevention, and treatment. Now more than ever, a timely and whole-of-government Strategy is necessary," the senators wrote.

Psychedelics

Michigan Activists File Psychedelic Legalization Ballot Initiative. The national group Decriminalize Nature, its state affiliate, and Students for Sensible Drug Policy (SSDP) have filed paperwork for an initiative to legalize the possession, cultivation, and non-remunerated sharing of psychedelics, as well as setting up a system to enable therapeutic and spiritual use. The measure would legalize a broad range of psychedelics for people 18 and over. Sales would be allowed to provide psychedelics to people whose doctors have issued written recommendations for them.

International

Colombian Army Kills Nine in Raid on Gulf Clan Cartel. Defense Minister Diego Molina announced late Tuesday evening that at least nine people were killed in an army raid on the Gulf Clan Cartel in northwest Colombia. The raid took place in Ituango, a Gulf Clan stronghold. The Gulf Clan is a major drug trafficking organization, considered responsible for about a third of the cocaine being smuggled out of the country. It's leader, Dario Antonio Usuga, also known as Otoniel, was arrested in October in a raid involving 500 police and military, an event that President Ivan Duque said marked "the end" of the Guld Clan. Apparently not quite yet.

Myanmar Illicit Drug Production Surges Since Coup. The UN Office on Drugs and Crime (UNODC) said this week that political turmoil and instability in the wake of a military coup has resulted in massive increases in drug production and trafficking in the country. Last month alone, authorities in Laos, Thailand, and Myanmar seized a mind-boggling 90 million methamphetamine tablets and 4.4 tons of crystal meth, with the bulk of it reportedly produced in Myanmar's Shan state. "Meth production increased last year from already extreme levels in northern Myanmar and there is no sign it will slow down," said Jeremy Douglas, the UNODC's regional representative in Southeast Asia.

Mississippi Becomes Latest State to Legalize Medical Marijuana [FEATURE]

With the signature of Gov. Tate Reeves (R) on a compromise medical marijuana bill on Wednesday, Mississippi becomes the 37th state to legalize the use of marijuana for medicinal purposes.

Mississippians should see dispensaries operating before year's end. (Sondra Yruel/Drug Policy Alliance)
Mississippi voters had overwhelmingly approved medical marijuana at the polls in November 2020, passing a broad medical marijuana measure, Initiative 65, with 74% of the vote (and rejecting a more restrictive legislative alternative, Initiative 65A.) But that victory was nullified by the state Supreme Court, which ruled that the state's signature gathering requirements for initiatives could not be complied with, invalidating not only Initiative 65 but also the whole initiative process in the state.

Heedful of the will of the people, both the legislature and the governor vowed to get a medical marijuana bill passed. The Supreme Court ruling was in May 2021; it took until now for the executive branch and the legislative branch to come to agreement on how to replace what the judicial branch threw out. Meanwhile, patients waited increasingly impatiently.

They got medical marijuana, but in a more restrictive form that what the voted for back in 2020. The Mississippi Medical Cannabis Act (Senate Bill 2095) allows patients to purchase smokeable marijuana, but only ¾ of an ounce per week, and there is no provision for home cultivation. Marijuana flower must be no more than 30 percent THC, while concentrates must be no more than 60 percent.

People with a specified list of conditions -- cancer, Parkinson's, Huntington's, muscular dystrophy, glaucoma, spastic quadriplegia, HIV, AIDS, hepatitis, amyotrophic lateral sclerosis (ALS), Crohn's, ulcerative colitis, sickle cell anemia, Alzheimer's, agitation of dementia, PTSD, autism, pain refractory to opioid management, diabetic/peripheral neuropathy, spinal cord disease, or severe injury -- qualify for medical marijuana.

People with chronic medical conditions that produce wasting, severe nausea, seizures, severe muscle spasms, and chronic pain also qualify, but chronic pain is narrowly defined as "a pain state in which the cause of the pain cannot be removed or otherwise treated, and which in the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible, or none has been found after reasonable efforts by a practitioner."

Doctors, certified nurse practitioners, physician assistants, and optometrists can all sign recommendations for patients if they believe the patient "would likely receive medical or palliative benefit" from medical marijuana. But before they can do that, they have to have completed eight hours of continuing medical education courses on medical marijuana (and five hours each year after that) and have performed an in-person examination of the patient.

People who want to get in the medical marijuana business can obtain licenses if they pay nonrefundable application fees ranging from $1,500 for a 1,000-square foot canopy micro-cultivator license to $100,000 for the largest operators. There is no cap on the number of medical marijuana businesses. There will be a wholesale tax of 5 percent in addition to the state sales tax of 7 percent.

Marijuana reform advocates generally praised the passage of the bill, though with some reservations.

"With this victory, tens of thousands of Mississippians with debilitating health conditions will finally be able to safely and legally access something that can alleviate their pain and improve their quality of life. Mississippi now serves as the latest example that medical cannabis legalization is possible in any state in the country. We are hopeful that this move will add to the growing momentum towards cannabis policy reform in the South," said Toi Hutchinson, president and CEO of the Marijuana Policy Project (MPP) in a press release.

"Marijuana access is long overdue for Mississippi's patients," NORML's State Policies Manager Jax James said in a blog post. "The overwhelming majority of voters decided in favor of this policy change over a year ago, and for the past 14 months the will of the people has been denied."

But James also expressed disappointment in some of both what the bill does contain and what it does not.

"We remain concerned that lawmakers saw fit to add unnecessary taxes on cannabis products, that patients are prohibited from home-cultivating limited amounts of cannabis for their own personal use, and that those with chronic pain are restricted from accessing cannabis products until first using more dangerous and addictive substances like opioids," she said.

For MPP, though, the bottom line was that another state now allows patients access to medical marijuana.

"Despite tremendous support, Mississipians faced an uphill battle for a medical cannabis program. With this new law, justice has finally prevailed. Patients in Mississippi who are seriously ill will no longer be subject to arrest and criminal penalties for using medical cannabis and instead will be met with compassion. We applaud the legislature for working to restore the will of the voters in one of the most conservative states in the nation and Gov. Reeves for signing it into law," said Kevin Caldwell, MPP Southeast legislative manager.

The state Department of Health will begin issuing patient registry cards in 60 days, begin accepting applications from practitioners and begin licensing marijuana businesses other than dispensaries within 120 days, and licensing dispensaries within 150 days. The clock is ticking.

Officials Now Say Fentanyl-Tainted Marijuana Scare a False Alarm, Competing CO Psychedelic Inits, More...(2/1/22)

A Calfornia Republican lawmaker wants to go back to the bad old days, Colorado now sees competing psychedelic legalization initiatives, and more.

fentanyl (Creative Commons)
Marijuana Policy

California GOP Bill Would Make Unlicensed Marijuana Cultivation a Felony Again. Assemblyman Thurston Smith (R-Riverside) has filed a bill that would recriminalize growing marijuana plants without a license, Assembly Bill 1725. The bill would make growing more than six plants without a license a felony punishable by up to three years in jail. Smith said his bill was aimed at enormous illegal grow operations. "These illicit growers have been operating with impunity, knowing that the law allows them to grow with barely a hindrance. For far too long, (state lawmakers in) Sacramento (have) been soft on crime, and the illicit market has exploded with massive unlicensed grows popping up all around the state." The bill faces long odds in the Democratic-controlled legislature.

Massachusetts Marijuana Host Community, Social Equity Bill Advances. The Joint Committee on Cannabis Policy took up legislation aimed at putting tighter rules on legally required contracts between hosts communities and marijuana businesses and establishing a Cannabis Social Equity Trust Fund. The measure, House Bill 174 faced no opposition in the committee. The bill is a priority of House Speaker Ron Mariano (D), and takes on aspects of the state's pot laws that both regulators and the industry have said need to be addressed.

"The gap between the law's stated commitment to equity and the on-the-ground reality of the industry shows just how much work we have left to do," Sen. Sonia Chang-Diaz, co-chair of the Joint Committee on Cannabis Policy, said. "There's universal agreement about the problems: high costs of entry and lack of access to capital create a near-impossible barrier for many talented entrepreneurs. This bill addresses both sides of that coin. I'm thrilled we're finally advancing it."

Opioids

Connecticut Scare on Fentanyl-Tainted Marijuana Mostly Unfounded, State Says. The state Department of Health reported in November that nearly 40 overdoses were linked to fentanyl-tainted marijuana, but it now turns out that there was only one case -- and that case was most likely caused by accidental contamination. In the original report, the state said there had been 39 overdoses believed linked to fentanyl-tainted marijuana, that the patients required revival with naloxone, and they "denied any opioid use and claimed to have only smoked marijuana." But the health department says at least 30 of the 39 had histories of opioid use.

The department also said that only one marijuana sample tested positive for fentanyl. "Based on the information gathered since the positive confirmation of marijuana with fentanyl, the CT ORS [Connecticut Overdose Response Strategy] assesses that the positive confirmation of marijuana with fentanyl was likely accidental contamination and an isolated incident," a department spokesman said. Boyle wrote in an email to Hearst Connecticut Media. The contamination likely occurred when the dealer "failed to clean their instruments before processing the marijuana and cross-contaminated it with fentanyl," he said.

Psychedelics

Colorado Sees Second Psychedelic Initiative Filed. Activists with Decriminalize Nature Boulder County have filed an initiative that would allow people 21 and over to possess, cultivate, gift and deliver psilocybin, psilocyn, ibogaine, mescaline and DMT. The initiative would also allow psychedelic services for therapeutic, spiritual, guidance, or harm reduction purposes with or without accepting payment. A separate psychedelic initiative backed by New Approach PAC and David Bronner of Dr. Bronner's liquid soap company, the Natural Medicine Health Act, envisions a two-tiered regulatory model where only psilocybin would be legalized and regulated for therapeutic purposes until June 2026, after which regulators could add other psychedelics.

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