Fewer people are getting arrested for marijuana possession in Washington state after legalization -- imagine that! -- Kansas legislators want to drug test teachers, a New Jersey heroin and opiates panel has recommendations, Russell Brand goes to Vienna, and more. Let's get to it:

Marijuana Policy

Oregon GOP Gubernatorial Candidate Says Legalize It. Republican gubernatorial candidate Tim Carr says he favors legalizing and taxing recreational marijuana use and would spend the proceeds on helping the homeless and others in need. Carr is one of six Republicans running in the primary to determine who takes on incumbent Democrat John Kitzhaber. He's not the front-runner; that distinction goes to state Rep. Dennis Richardson.

Massachusetts Poll Has Near Majority for Legalization.A new WBUR TV poll shows increased support for marijuana legalization, with 48% in favor and 41% opposed. A Boston Herald/Suffolk University poll showed majority support for the first time. These two polls suggest that attitudes toward legalization in the Bay State have moved in a positive direction in the past year.

Washington State ACLU Reports Big Drop in Pot Arrests. Misdemeanor marijuana possession arrests plummeted last year, the ACLU of Washington reported today. There were just 120 such arrests last year after legalization went into effect, compared to 5,531 the year before. But black people are still getting arrested for pot possession more often. They're getting popped at a rate three times that of whites, the ACLU said.

National Cannabis Industry Association to Host Marijuana Business Summit. The NCIA will hold its first national conference, the Cannabis Business Summit, June 24-25 in Denver. Click on the links for more details.

Medical Marijuana

Alabama CBD Medical Marijuana Bill Advances. A bill that would study the impact of using a marijuana derivative to treat seizures is one step closer to becoming state law. Senate Bill 174 passed the House Judiciary Committee after it was amended in the Senate last week.

Drug Testing

Kansas School Teacher Drug Testing Bill Passes Senate. A bill that requires drug testing of school employees and affirms the firing of educators convicted of DUI, drug crimes, and other offenses passed the state Senate Tuesday. Senate Bill 335 was approved after Senate Democrats successfully offered an amendment that would subject members of the House and Senate to treatment requirements and financial sanctions mirroring those in state law for the unemployed or those on cash aid. The welfare drug testing law passed last year also included elected representatives, but contained no provisions for sanctioning them or requiring they seek help. The bill now goes to the House.

Heroin

Kentucky Omnibus Heroin Bill Stuck in House. A bill that would both enact harm reduction measures and crack down on heroin-selling offenses is stuck in the House Judiciary Committee. Senate Bill 5 would let drug dealers be charged with murder if the sale of Schedule I drugs results in death and increases penalties for high-volume heroin dealers. It also seeks increased Medicare funds for drug treatment, access to the overdose reversal drug naloxone, and a 911 Good Samaritan provision. The Senate passed the bill in January.

New Jersey Heroin Task Force Calls for Broad Reforms. A governor's task force on heroin and opiate use called for a wide array of reforms, saying it is "time to confront our demons." According to The Newark Star-Ledger, which obtained an advance copy, the panel's report calls for tighter prescription pill monitoring laws, changes in the state's insurance system to make treatment more available, and expanded use of drug treatment recovery communities.

Sentencing

California Bill Would Equalize Crack and Powder Cocaine Sentences. A bill filed by state Sen. Holly Mitchell (D-Culver City) would cut prison sentences for people convicted of selling crack to bring them in line with sentences for people convicted of selling powder cocaine. Senate Bill 1010 was introduced last month, but amended Monday. It is before the Senate Rules Committee.

International

In Vienna, Russell Brand Joins "Support, Don't Punish" Campaign. British actor and comedian Russell Brand spoke at the UN Commission on Narcotic Drugs in Vienna today and publicly joined forces with the Support, Don't Punish campaign to decriminalize drug possession and end the imprisonment and punishment of people who use drugs.

Senior Mexican Anti-Drug Official Resigns. Manuel Mondragón y Kalb, Mexico's national security commissioner and one of the most senior officials in charge of the country's counternarcotics fight, has resigned "for personal reasons." The National Security Commission (CNS), which falls under the Interior Ministry, was created by President Enrique Peña Nieto in January 2013 to replace the Secretariat of Public Security. The CNS, which is in charge of the Federal Police, is behind schedule in its task to create a National Gendarmerie to bolster the country's counter-narcotics fight, which is one of Peña Nieto's campaign promises.

(This article was published by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also shares the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Marijuana legalization in the District of Columbia hits a bump, the Epilepsy Foundation comes out for medical marijuana, India passes landmark access to pain medication legislation, and more. Let's get to it:

Marijuana Policy

DC's Top Lawyer Says Proposed Legalization Ordinance Can't Go to Voters. District of Columbia Attorney General Irvin Nathan issued a formal opinion yesterday saying the proposed DC marijuana legalization initiative should not go before the voters because it violates federal law. His opinion is not binding, but carries weight with the Board of Elections, which meets on the issue next Tuesday. Initiative backers are scrambling to see if they can't fix the language in question before then.

New Mexico House Approves Study of Legalization Effects. The state House late Wednesday passed a nonbinding memorial (bill) that calls for studying the effects of marijuana legalization in Colorado and Washington. Under the measure, the Legislative Finance Committee would conduct the study and report its findings later this year. The committee will be looking specifically at state revenue and agricultural production levels as well as addiction rates and the availability of law enforcement resources. The bill is House Memorial 38.

Medical Marijuana

Epilepsy Foundation Calls for Access to Medical Marijuana, Tells DEA to Back Off. "The Epilepsy Foundation supports the rights of patients and families living with seizures and epilepsy to access physician directed care, including medical marijuana. Nothing should stand in the way of patients gaining access to potentially life-saving treatment," said Epilepsy Foundation President and CEO Philip M. Gattone and Epilepsy Foundation Board of Directors Chairman Warren Lammert. "If a patient and their healthcare professionals feel that the potential benefits of medical marijuana for uncontrolled epilepsy outweigh the risks, then families need to have that legal option now -- not in five years or ten years. For people living with severe uncontrolled epilepsy, time is not on their side." The foundation said it was moved to act after getting repeated inquiries about the use of medical marijuana, especially high CBD cannabis oils. It also urged the DEA to get out of the way. Click on the link to read the press release.

New Jersey Patients Air Grievances Before Assembly Committee. Medical marijuana patients and advocates got a chance to lay out their problems with the state's medical marijuana program Thursday at a hearing of the Assembly Regulatory Oversight Committee. Click on the link to get all the details.

Maryland Medical Marijuana Program Still 18 Months Away, Official Says. Dr. Paul Davies, head of the commission set up to oversee the implementation of a medical marijuana program told lawmakers Thursday that the initiative is at least 18 months away from offering pain relief to the first patients. And that's the best-case scenario.

Harm Reduction

Naloxone (Opioid Overdose Reversal Drug) Bills Move in Ohio, Wisconsin. Bills that would expand access to the opioid overdose reversal drug naloxone (Narcan) are moving in Ohio and Wisconsin. The Christian Science Monitor mentions these bills in a broader article on states moving to respond opioid overdoses. Click on the link to read the whole thing.

International

India's Rajya Sabha Passes Bill to Increase Access to Opiate Pain Medications. India's parliament has passed a bill that will ease access to opiate pain medications. The Narcotic Drugs and Psychotropic Substances (Amendment) Bill, 2014, was passed by the Rajya Sabha, or upper house Friday. It had passed the Lok Sabha, or lower house, the day before. The law will bring relief to thousands of cancer patients in the country who use opiates for acute and chronic pain relief. It had been pushed by the Indian Association for Palliative Care, among other groups.

Canadian Pro-Legalization Group Seeks Candidates to Support in Next Year's Elections. A new organization, Legalize Canada, has popped-up with the intent of "supporting strong and vocal pro-legalization candidates for public office" in the 2015 federal election. The group said it had identified 95 to 100 ridings (legislative districts) out of 338 in the country where support for legalization could be a critical, election-winning issue. The group says it is aiming for a $7 million budget.

Canada's Trailer Park Boys Say Don't Legalize It. Canada's cult TV and movie phenomenon, Trailer Park Boys, is back with a new sequel, Trailer Park Boys 3: Don't Legalize It. Ricky, Julian, Bubbles, and the rest of the crew have too much invested in their latest criminal pot growing scheme to put up with legal weed.

Seven Killed in Philippines Drug Raid. Philippines anti-drug police killed seven suspected drug dealers and arrested several more in a Friday raid on the outskirts of Davao City. "They put up a fight and were killed in the process," Mayor Rodrigo Duterte said here when asked about the deaths. Duterte has long been suspected of being behind extrajudicial killings in Davao City, an accusation the Aquino administration ally has repeatedly denied.

The news last Sunday that acclaimed actor Phillip Seymour Hoffman had died of an apparent heroin overdose has turned a glaring media spotlight on the phenomenon, but heroin overdose deaths had been on the rise for several years before his premature demise. And while there has been much wailing and gnashing of teeth -- and quick arrests of low-level dealers and users -- too little has been said, either before or after his passing, about what could have been done to save him and what could be done to save others.

There are proven measures that can be taken to reduce overdose deaths -- and to enable heroin addicts to live safe and normal lives, whether they cease using heroin or not. All of the above face social and political obstacles and have only been implemented unevenly, if at all. If there is any good to come of Hoffmann's death it will be to the degree that it inspires broader discussion of what can be done to prevent the same thing happening to others in a similar position.

Hoffman, devoted family man and great actor that he was, died a criminal. And perhaps he died because his use of heroin was criminalized. Criminalized heroin -- heroin under drug prohibition -- is of uncertain provenance, of unknown strength and purity, adulterated with unknown substances. While we don't know what was in the heroin that Hoffman injected, we do know that he maintained his addiction and went to meet his maker with black market dope. That's what was found beside his lifeless body.

In a commentary published by The Guardian, actor Russell Brand, a recovered heroin addict, laid the blame for Hoffman's demise on the drug laws. "Addiction is a mental illness around which there is a great deal of confusion, which is hugely exacerbated by the laws that criminalise drug addicts," Brand wrote, calling prohibitionists' methods "so gallingly ineffective that it is difficult not to deduce that they are deliberately creating the worst imaginable circumstances to maximise the harm caused by substance misuse." As a result, "drug users, their families and society at large are all exposed to the worst conceivable version of this regrettably unavoidable problem."

We didn't always treat our addicts this way. Even after the passage of the Harrison Act in 1914, doctors continued for years to prescribe maintenance doses of opiates to addicts -- and hundreds of them went to jail for it as the medical profession fought, and ultimately lost, a battle with the nascent drug prohibition bureaucracy over whether giving addicts their medicine was part of the legitimate practice of medicine.

The idea of treating heroin addicts as patients instead of criminals was largely vanquished in the United States, but it never went away -- it lingers with methadone substitution, for example. But other countries have for decades been experimenting with providing maintenance doses of opioids to addicts, and to good result. It goes by various names -- opiate substitution therapy, heroin-assisted theatment, heroin maintenance -- and studies from Britain and other European countries, such as Germany, the Netherlands, and Switzerland, as well as the North American Opiate Medications Initiative (NAOMI) and the follow-up Study to Assess Long-Term Opiate Maintenance in Canada have touted its successes.

Those studies have found that providing pharmaceutical grade heroin to addicts in a clinical setting works. It reduces the likelihood of death or disease among clients, as well as allowing them to bring some stability and predictability to sometimes chaotic lives made even more chaotic by the demands of addiction under prohibition. Such treatment has also been found to have beneficial effects for society, with lowered criminality among participants and increased likelihood of their integration as productive members of society.

The dry, scientific language of the studies obscures the human realities around heroin addiction and opioid maintenance therapy. One NAOMI participant helps put a human face on it.

"I want to tell you what being a participant in this study did for me," one participant told researchers. "Initially it meant 'free heroin.' But over time it became more, much more. NAOMI took much of the stress out of my life and allowed me to think more clearly about my life and future. It exposed me to new ideas, people (staff and clients) that in my street life (read: stressful existence) there was no time for."

"After NAOMI, I was offered oral methadone, which I refused. After going quickly downhill, I ended up hopeless and homeless. I went into detox in April 2007, abstained from using for two months, then relapsed. In July 2008 I again went to detox and I am presently in a treatment center... I am definitely not "out of the woods" yet, but I feel I am on the right path. And this path started for me at the corner of Abbott and Hastings in Vancouver... Thank you and all who were involved in making NAOMI happen. Without NAOMI, I wouldn't be where I am today. I am sure I would be in a much worse place."

Arnold Trebach, one of the fathers of the drug reform in late 20th Century America, has been studying heroin since 1972, and is still at it. He examined the British system in the early 1970s, when doctors still prescribed heroin to thousands of addicts, and authored a book, The Heroin Solution, that compared and contrasted the US and UK approaches. Later this month, the octogenarian law professor will be appearing on a panel at the Vermont Law School to address what Gov. Peter Shumlin (D) has described as the heroin crisis there.

"The death of Phillip Seymour Hoffman is a tragedy all the way around," Trebach told the Chronicle. "It's a bad idea to use heroin off the street, and he shouldn't have been doing that."

That said, Trebach continued, it didn't have to be that way.

"If we had had a sensible system of dealing with this, he would have been in treatment under medical care," he said. "If he was going to inject heroin, he should have been using pharmaceutically pure heroin in a medical setting where he could also have been exposed to efforts to straighten out his personal life, and he could have access to vitamins, weight control advice, and the whole spectrum of medical care. And if he had had access to opioid antagonists, he could still be alive," he added.

While Hoffman may have made bad personal choices, Trebach said, we as a society have made policy choices seemingly designed to amplify the prospects for disaster.

"This is a sad thing. He is just another one of the many victims of our barbaric drug policy," he said. "This was a totally unnecessary death at every level. He shouldn't have been using, but we should have been taking care of him."

The stuff ought to be legalized, Trebach said.

"I'm an advocate of full legalization, but if we can't go that far, we need to at least provide social and psychological support for these people," he said. "And even if we were to decriminalize or legalize, I would still want to figure out ways to provide support and love and kindness to people using the stuff. I advise you not to do it, but if you're going to use it, I want to keep you alive. I remember talking to people from Liverpool [a famous heroin maintenance clinic covered in the '90s by Sixty Minutes, linked above] about harm reduction around heroin use back in the 1970s. One of the ladies said it is very hard to rehabilitate a dead addict."

"There are plenty of things we can be doing," said Hilary McQuie, Western director for the Harm Reduction Network, reeling off a list of harm reduction interventions that are by now well-known but inadequately implemented.

"We can make naloxone (Narcan) more available. We need better access to it. It should be offered to people like Hoffman when they are leaving treatment programs, especially if they've been using opiates, just as a safeguard," she said. "Having treatment programs as well as harm reduction programs distribute it is important. We can cut the overdose rate in half with naloxone, but there will still be people using alone and people using multiple substances."

There are other proven interventions that could be ramped up as well, McQuie said.

"Safe injection sites would be very helpful, so would more Good Samaritan overdose emergency laws, and more education, not to mention more access to methadone and buprenorphine and other opioid substitution therapies (OST)," she said, reeling off possible interventions.

Dr. Martin Schechter, director of the School of Population and Public Health at the University of British Columbia in Vancouver, knows a thing or two about OST. The principal study investigator for the NAOMI and the follow-up SALOME study, Schechter has overseen research into the effectiveness of treating intractable addicts with pharmaceutical heroin, as well as methadone. The results have been promising.

"What we're using is medically prescribed pharmaceutical diacetylmorphine, the active ingredient in heroin," he explained. "It's what you have when you strip away all the street additives. This is a stable, sterile medication from a pharmaceutical manufacturer. We know the precise dose tailored for each person. With street heroin, not only is it adulterated and injected in unsterile situations, but people really don't know how strong it is. That's probably what happened to Mr. Hoffman."

In NAOMI, 90,000 injections were administered to study participants, and only 11 people suffered overdoses requiring medical attention.

"Never did we have a fatal overdose," Schechter said. "Because it was in a clinic, nurses and doctors are right there. We administer Narcan (naloxone), and they wake up."

Heroin maintenance had even proven more effective than methadone in numerous studies, Schechter said.

"There have been seven randomized control trials across Europe and in Canada that have shown for people who have already tried treatments like methadone, that medically prescribed heroin is more effective and cost effective treatment than simply trying methadone one more time."

Those studies carry a lesson, he said.

"We have to start looking at heroin from a medicinal point of view and treat it like a medicine," he argued. "The more we drive its use underground, the more overdoses we get. We need to expand treatment programs, not only with methadone, but with medically prescribed heroin for people who don't respond to other treatments."

Safe injection sites are also a worthwhile intervention, Schechter said, although he also noted their limitations.

"Injecting under supervision is much safer; if there is an overdose, there is prompt attention, and they provide sterile equipment, reducing the risk of HIV and Hep C," he said. "But they are still injecting street heroin."

He would favor decriminalizing heroin possession, too, he said.

Harm reduction measures, opioid maintenance treatments, and the like are absolutely necessary interventions, said McQuie, but there is a larger issue at hand, as well.

"We still need to look at the overall issue of the stigmatization of drug users," she said. "People aren't open about their use, and that puts them in a more dangerous situation. It's really hard in a criminalized environment."

Stigmatization means to mark or brand someone or something as disgraceful and subject to strong disapproval. Defining an activity, such as heroin possession, as a crime is stigmatization crystallized into the legal structures of society itself.

"The ultimate harm reduction solution," McQuie argued, "is a regulated, decriminalized environment where it is available by prescription, so people know what they're getting, they know how much to use, and it's not cut with fentanyl or other deadly adulterants. People wouldn't have to deal with all the collateral damage that comes from being defined as criminals as well as dealing with the consequences of their drug use. They could deal with their addictions without having to worry about losing their homes, their families, and their freedoms."

While such approaches have a long way to go before winning wide popular acceptance, policymakers should at least be held to account for the consequences of their decision-making, McQuie said, suggesting that the turn to heroin in recent years was a foreseeable result of the crackdown on prescription opioid pain medication beginning in the middle of the last decade.

"They started shutting down all those 'pill mills' and people should have anticipated what would happen and been ready for it," she said. "What we have seen is more and more people turning to injecting heroin, but nobody stopped to do an impact statement on what would be the likely result of restricting access to pain pills."

The impact can be seen in the numbers on heroin use, addiction, and overdoses. While talk of a "heroin epidemic" is overblown rhetoric, the number of heroin users has increased dramatically in the past decade. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the number of past year users grew by about 50% between 2002 and 2011, from roughly 400,000 to more than 600,000. At the same time, the number of addicted users increased from just under 200,000 to about 370,000, a slightly lesser increase.

If there is any good news, it is that, according to the latest (2012) National Household Survey of Drug Use and Health, the number of new heroin users has remained fairly steady at around 150,000 each year for the past decade. That suggests, however, that more first-time users are graduating to occasional and sometimes, dependent user status.

And some of them are dying of heroin overdoses, although not near the number dying from overdoses from prescription opioids. Between 1999 and 2007, heroin deaths hovered just under 2,000, even as prescription drug deaths skyrocketed, from around 2,500 in 1999 to more than 12,000 just eight years later. But, according to the Centers for Disease Control, by 2010, the latest year for which data are available, heroin overdose deaths had surpassed 3,000, a 50% increase in just three years.

While the number of heroin overdose deaths is still but a fraction of those attributed to prescription opioid overdoses and the numbers since 2010 are spotty, the increase that showed up in 2010 shows no signs of having gone away. Phillip Seymour Hoffman may be the most prominent recent victim, but in the week since his death, another 50 or 60 people have probably followed him to the morgue due to heroin overdoses.

There are ways to reduce the heroin overdose death toll. It's not a making of figuring out what they are. It's a matter of finding the political and social will to implement them, and that requires leaving the drug war paradigm behind.