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

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.

Pennsylvania sees its first ever legislative debate on marijuana legalization, Tennessee sees a slew of marijuana-related bills, and more.

Marijuana Policy

Pennsylvania Sees First Legislative Debate on Marijuana Legalization. For the first time ever, Keystone State lawmakers took up the topic of marijuana legalization as the Senate Law & Justice Committee held a hearing on Monday. The hearing was on a proposal from committee Chair Sen. Mike Regan (R-York County), but focused largely on unsafe practices in the industry and products going through existing black markets. The committee heard from lawmakers, medical marijuana industry representatives, and law enforcement officials. Another, bipartisan marijuana legalization bill, Senate Bill 473, which includes expungement and social equity provisions, is also before the committee. No votes were taken. Regan said the committee would hold another hearing in coming months to see what "trials and tribulations" other states had endured.

Tennessee Marijuana Legalization, Medical Marijuana Bills Filed. Lawmakers in the Volunteer State are facing a slew of marijuana legalization, decriminalization, and medical marijuana bills filed this session. So far, the legislative web site shows at least 28 bills, most of them addressing legalization. The state is one of seven that have allowed for the use of CBD cannabis oil, but that is as far down the road as the legislature has gone so far. An attempt to decriminalize marijuana possession was killed last session, as was a broader medical marijuana bill.

Opioids

Congressional Commission Urges Five-Pronged Strategy to Confront Overdose Crisis. A bipartisan congressional commission. the Commission on Combating Synthetic Opioid Trafficking released a report Tuesday calling for a multipronged strategy to confront the nation's overdose crisis. The commission called for the strategy to be based around five pillars: Restoring the head of the Office of National Drug Control Policy to cabinet rank, disrupting the drug supply through better coordinated law enforcement, demand reduction through treatment and harm reduction measures, using diplomatic means to cut off the supply of fentanyl precursor chemicals, and developing surveillance tools to monitor new drug trends. In other words, new, improved drug war, albeit with a slightly gentler touch regarding harm reduction.

Harm Reduction

Justice Department Signals It Could Allow Safe Injection Sites. In a statement to the Associate Press, the Justice Department said it is "evaluating" the harm reduction intervention and seeking guidance from regulators on "appropriate guardrails." That is a drastic change from the Trump administration, under which the department successfully sued to block a Philadelphia safe injection site, and is the first hint, after months of silence, that DOJ is open to safe injection sites. "Although we cannot comment on pending litigation, the Department is evaluating supervised consumption sites, including discussions with state and local regulators about appropriate guardrails for such sites, as part of an overall approach to harm reduction and public safety," DOJ said in the statement last Friday.

DOJ isn't the only federal government entity to edge closer to supporting safe injection sites. In December, the National Institutes of Health mentioned them in a call for harm reduction research, and that same month, Office of National Drug Control Policy (ONDCP -- the drug czar's office) head Dr. Rahul Gupta said he was "interested in looking at the science and data behind all of the emerging harm reduction practices."

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

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.

The city of New York is about to embark on a new program aimed at reducing the toll of drug overdoses in the city: naloxone vending machines. Naloxone is an opioid overdose reversal drug that has saved tens of thousands of lives, and the city wants it to be conveniently and easily available.

In December 2020, the city's Department of Health and Mental Hygiene and the Fund for Public Health published a request for proposals (RFP) to install ten vending machines dispensing naloxone, as well as other wellness goods, such as safe sex items and toiletries, for its Public Health Vending Machine Initiative.

"The purpose of this RFP is to support low-barrier access to overdose prevention and harm reduction supplies," the department said.

Bids are due later this week, with a contract start-up date of February 7. The program will run through June at a cost of $730,000. The machines will be installed in all five boroughs of the city in neighborhoods most impacted by drug overdoses.

The priority neighborhoods mentioned in the RFP are scattered throughout the city's five boroughs and include East New York, Crotona-Tremont, Highbridge-Morrisania, Hunts Point-Mott Haven, Fordham- Bronx Park, Pelham-Throgs Neck, Central Harlem, East Harlem Union Square, Rockaway, Stapleton-St. George, and South Beach-Tottenville.

"Overdose deaths in New York City are not equally distributed citywide, with some groups and neighborhoods disproportionately experiencing increases in the rate of overdose death," the department explained in the RFP. "During the previous three years, overdose rates among White New Yorkers decreased; however, rates increased among Black New Yorkers during the past year and rates among Latinx New Yorkers have increased for five consecutive years. Structural racism in drug policy and enforcement has been linked to decreased access to services, poorer health outcomes, and increased overdose risk."

The department reported that opioid overdose deaths had reached "epidemic levels" by 2019, with 1,463 unintentional overdose deaths in the city. More than four out five of those overdose deaths involved opioids, with the fast-acting synthetic opioid fentanyl involved in more than two thirds of them.

The city's move is earning kudos from the Drug Policy Alliance (DPA), which says it supports the plan.

"This approach is consistent with harm reduction strategies that seek to meet people who use drugs where they're at and ensure that people have access to safe resources to prevent blood-borne illness and distributing naloxone to people who are the most likely to encounter an overdose and be able to save lives," said DPA director for civil systems reform Melissa Moore in an email with the Chronicle. "The free vending machines mean that people will be able to access these supplies on their schedule and on their timeline, and without the stigma or shame."

Moore noted that the city made the groundbreaking move of opening the nation's first officially sanctioned safe injection sites in December, but said there was still more to be done, especially around creating a safe drug supply.

"At this time there is a huge issue around poisoning and contamination in the drug supply (and significant disruption of the supply chain), so there is a need for more robust drug checking, especially for the amount of fentanyl in a substance, to save lives," she said. "This would include making sure that people who use drugs have access to this equipment at harm reduction programs. There can and should also be movement on safe supply options, as a way to further deal with the contamination and poisoning."

But's that is not all, she said.

"Additionally, if we want to save lives, reduce criminalization, and curb racial disparities, we need comprehensive, innovative, and forward-thinking approaches like decriminalizing personal possession of drugs. This would build on Measure 110, which was passed by two-thirds of voters in Oregon and codify proven public health approaches over criminalization and other failed enforcement tactics of the past."

New York City's naloxone vending machine program is a widely noted harm reduction innovation, but it is not the first in the country. That distinction may go to Las Vegas, which had naloxone vending machines in 2019. And last year, the city of Cincinnati rolled them out in March and the state of Indiana deployed 19 of them in December.

The overdose crisis requires innovation, and getting the opioid overdose reversal drug into the hands of people who could use it is a good example of that. It won't solve the problem -- that will require much more radical shifts in public policy -- but it will reduce the harm.