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Harm Intensification

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Biden Vows to Continue Pressure on China over Opioids, Chiapas Militia Emerges to Fight Cartels, More... (7/23/21)

Rep. Alexandria Ocasio-Cortez files an amendment to encourage psychedelic research, President Biden says he will stay tough on Chinese opioid exports, and more.

President Biden vows to keep pressuring China on opioids, but a better approach may be to ramp up harm reduction here.
Psychedelics

AOC Files Amendment to Promote Psychedelic Research in Omnibus Appropriations Bill. Rep. Alexandria Ocasio-Cortez (D-NY) has for the second time filed an amendment to a multi-agency appropriations bill that aims to promote research into psychedelics such by removing a rider than has been in effect since 1996 that bars the use of federal dollars "any activity that promotes the legalization of any drug or other substance in Schedule I." A description of the amendment says it is designed to allow "United States researchers to study and examine the potential impacts of several schedule I drugs, such as MDMA, psilocybin, and or ibogaine, that have been shown to be effective in treating critical diseases. She introduced an earlier version of the amendment in 2019 only to see it voted down in a bipartisan and overwhelming fashion, but has a lot has changed in the realm of psychedelics since then.

Foreign Policy

Biden Vows to Continue Pressure on China over Opioids. At a town hall meeting in Cincinnati Wednesday, President Joe Biden vowed to continue "this encounter with China" over opioids, saying that his administration is "addressing the opioid issue" by increasing the number of people in the Justice Department. Biden has repeatedly criticized China, which is a major source of fentanyls and precursor chemicals that go into Mexico and from there into the US, accusing it of failing to crack down on drug trafficking. China banned two fentanyl precursors in 2018, but has not taken additional steps since then.

"I don't think we can do much to delay the export of these drugs in these countries, said Ben Westhoff, author of Fentanyl, Inc., arguing instead for enhanced harm reduction measures at home. In that book, Westhoff put the number of Chinese chemical companies at more than 400,000.

International

Mexico's Chiapas State Sees Formation of Militia to Counter Drug Cartels. A newly formed and heavily armed indigenous militia announced its presence by marching masked and armed through the streets of Pantelho in the southern Mexican state of Chiapas last weekend. The militia, calling itself "El Machete," said in an online manifesto that it is a "David" fighting against the "Goliath" of drug cartels and their assassins, and that it seeks peace, democracy, and justice. While self-defense militias to fend off organized crime have been sporadically active in states such as Michoacan and Guerrero for years, "El Machete" is the first such group to emerge in Chiapas, which attracts competing drug trafficking groups because of its location on the Guatemalan border, and which was the birthplace of the Zapatista uprising back in 1994.

US Prison, Parole, Probation Population Continues Slow Decline; $26 Billion Opioid Settlement, More... (7/22/21)

Florida's Republican establishment may not be ready for marijuana legalization but the public is, the Justice Department drops an effort to send some First Step Act releasees back to prison, and more.

Drug distributors agree to pay out big-time for their role in the opioid crisis. (Pixabay)
Marijuana Policy

Florida Poll Shows Strong Support for Marijuana Legalization. A new poll from Public Policy Polling has support for marijuana legalization at 59%. Two different efforts to get an initiative before the voters last year were quashed by the state Supreme Court, and the Republican-led state legislature this year passed a bill making it more difficult to finance initiatives, which Republican Gov. Ron DeSantis signed into law. Translating public support into marijuana reform is going to be more difficult than ever now.

Opioids

Major Drug Distributors Reach Agreement on $26 Billion Opioid Settlement. The three largest US pharmaceutical drug distributors -- McKesson, Cardinal Health, and AmerisourceBergen -- and drugmaker Johnson & Johnson have reached an agreement with a group of state attorneys general to pay out $26 billion to settle lawsuits related to their roles in the widespread prescribing of prescription opioids and the subsequent wave of addiction and overdose deaths. "The numerous companies that manufactured and distributed opioids across the nation did so without regard to life or even the national crisis they were helping to fuel," said New York Attorney General Letitia James, one of the attorneys general from 15 states involved in the deal. "Today, we are holding these companies accountable and infusing tens of billions of dollars into communities across the nation." Responding to that wave of addiction and overdoses, the states and the federal government have moved to restrict opioid prescribing, even though chronic pain patients have found their access to their medications more difficult.

Sentencing

US Correctional Population Drops for 12th Straight Year. The Bureau of Justice Statistics (BJS) reports that in 2019, the number of people in the US in jail or prison or on probation or parole was 6,344,000, down 65,200, or 1%, over the previous year and marking the 12th year in a row that that figure has declined. At the end of 2019, 4,357,700 people were under community supervision (probation or parole), while there were 2,086,000 people behind bars in jails or prisons. The BJS report did not discuss the types of offenses for which people were under correctional supervision, but a 2020 Prison Policy Initiative report found 190,000 doing time for drug offenses in state prisons, 157,000 in local jails, and 78,000 in the federal prison system, meaning drug prisoners account for about one-fifth of the US incarcerated population.

Justice Department Drops Appeal of First Step Act Releases. The Justice Department has dropped an effort to re-imprison four New Jersey men who were released from prison under the First Step Act's retroactive crack cocaine sentencing provision. The men had been released in November 2019 after serving more than 20 years on crack charges, but the Trump Justice Department then sought to send them back to prison. The Biden Justice Department had been under pressure from groups such as Families Against Mandatory Minimums (FAMM), which applauded the decision, saying: "We raised this case among others with the Biden transition team as an appeal that should be dropped right away. It would have been cruel and unjust it would be to send these guys back."

CA Psilocybin Legalization Initiative Gets Underway, House Spending Bill Includes Needle Exchange Funding, More...7/16/21)

Maryland legislative leaders are lining up to support a voter referendum on marijuana legalization next year, the House Appropriations Committee is passing spending bills that include marijuana and other drug provisions, and more.

Psilocybin mushrooms could be legalized under a California initiative now getting underway. (Creative Commons)
Marijuana Policy

House Appropriations Committee Approves Spending Bills with Marijuana, Other Drug Provisions. The House Appropriations Committee on Thursday passed spending bills and related reports that include several marijuana and other drug policy provisions. The bill would extend a provision that blocks the Justice Department from intervening in state-legal medical marijuana programs, and advocates hope to broaden that to include state recreational marijuana programs later in the process. The bill also includes language to protect universities conducting marijuana research from being penalized and to encourage research on Schedule I drugs, as well as reports noting the pain-relieving qualities of kratom, the life-saving potential of safe injection sites (see below), and urging further work on developing THC impairment testing.

Key Maryland Politician Supports Marijuana Legalization Voter Referendum Next Year. State House Speaker Adrienne Jones (D-District 10) has announced she will support a proposed voter referendum on marijuana legalization next year. In a statement, she said voters should decide on whether to legalize it. And she announced the formation of bipartisan working group to hash out details: "The House will pass legislation early next year to put this question before the voters but we need to start looking at changes needed to state law now," she said. Senate President Bill Ferguson (D-Baltimore) has also expressed interest in legalization and previously chaired a joint House-Senate committee to explore the nitty-gritty of legalization.

Psychedelics

California Psilocybin Legalization Initiative Gets Underway. Activists with the group Decriminalize California submitted a petition to state authorities Monday to legalize psilocybin mushrooms for "personal, medical, therapeutic, religious, spiritual, and dietary use" for adults 21 and older. The California Psilocybin Initiative would set no limits on personal possession -- an issue that has bedeviled the psychedelic decriminalization bill currently before the Assembly -- and would allow no sales or excise taxes except for mushrooms sold for dietary purposes. The initiative would also allow for full-fledged commerce in psilocybin mushrooms, including on-site consumption sites and would mandate that magic mushrooms be regulated as much as possible like other mushrooms, except for specialized labeling, and not subject to fees or licensing requirements beyond other mushrooms.

The state Attorney General's Office now has 30 days to review the initial petition. If and when it is accepted and assigned a ballot title and summary, the campaign will have 180 days to gather 623,212 valid voter signatures to qualify for the November 2002 ballot.

Harm Reduction

House Appropriations Committee for First Time Approves Funding for Needle Exchanges. The House Appropriations Committee has voted to allocate $69.5 million for needle exchange programs under the CDC[s Infectious Diseases and Opioid Epidemic Program, marking the first time it has explicitly funded such programs. The funding for the CDC program has also been boosted four-fold over the $13 million it was allocated last year. The move comes as the CDC announced this week that drug overdose deaths in the past year reached a record high of 93,000. Syringe services and harm reduction programs effectively help prevent drug overdoses. They have the knowledge, contacts, and ability to reach people who use drugs and provide naloxone and other overdose prevention resources. They also connect people to medical care and support, including substance use disorder treatment. This funding would assist these programs in preventing and reducing overdose deaths nationwide.

Here is what the committee said in an accompanying report:> "Overdose Prevention Centers. -- The Committee recognizes that overdose prevention centers, or supervised consumption sites, are part of a larger effort of harm reduction interventions intended to reduce the risk of drug overdose death and reduce the spread of infectious disease. The Committee directs NIH, in consultation with CDC, to provide a report to the Committee no later than 180 days after the enactment of this Act that provides an updated literature review and evaluation on the potential public health impact of overdose prevention centers in the US."

Free Drugs Handed Out in Vancouver, NJ Dismisses Nearly 88,000 Marijuana Cases with More to Come, More... (7/15/21)

Ohio sees its first full-fledged marijuana legalization bill, Mississippi is moving toward a legislative special session to address medical marijuana, legalization in Israel gets stalled, and more.

Welcome to the land of expungement. Nearly 88,000 old pot cases dismissed so far, with more to come. (Creative Commons)
Marijuana Policy

New Jersey Dismisses Nearly 88,000 Marijuana Cases. In accordance with the state's marijuana legalization law approved by voters last November, the New Jersey Courts announced Monday that they have vacated or dismissed nearly 88,000 marijuana cases, and that is only the first batch. Superior and municipal courts have identified another 270,000 cases eligible to be vacated, dismissed, and expunged.

Ohio Sees First Marijuana Legalization and Regulation Bill Filed. For the first time, the state legislature has a marijuana legalization bill before it after Reps. Casey Weinstein (D-Hudson) and Terrence Upchurch (D-Cleveland) have filed a bill that would allow for both personal and commercial cultivation, regulate marijuana commerce, and expunge the records of people previously convicted of low-level marijuana offenses. It's been five years since the Republican-dominated legislature passed a medical marijuana law to head off a proposed legalization initiative. Another bill filed this year, House Bill 210, would have allowed personal cultivation of marijuana plants and expungement of certain marijuana offenses, but not taxed and regulated marijuana commerce. That bill has not moved. Gov. Mike DeWine (R) remains opposed to legalization.

Medical Marijuana

Mississippi Legislature Could Hold Special Session on Medical Marijuana Next Month. Mississippi House Speaker Pro Tempore Jason White (R-District 48) said Wednesday that the legislature could be ready as early as next month to go into a special session to pass a medical marijuana bill. The legislature is acting after the state Supreme Court threw out a voter-approved medical marijuana initiative because of a technical issue the legislature has failed to address for 20 years, essentially invalidating the state's initiative process. Gov. Tate Reeves (R) has said he would call a special session only after lawmakers have reached an agreement on a bill in advance. White said both the House and the Senate have been working on the issue, and he believes they would have an agreement by mid-August.

International

Vancouver City Councilwoman, Activists Hand Out Free Drugs to Highlight Problem of "Safe Supply." Vancouver Councilwoman Jean Swanson and a pair of drug user advocacy groups, Drug User Liberation Front (DULF) and the Vancouver Area Network of Drug Users (VANDU), joined forces Wednesday to hand out free cocaine, heroin, and methamphetamine to drug users in the city's Downtown Eastside. The drugs had been pre-tested to ensure they did not contain contaminants such as fentanyl. The move was undertaken to highlight the problem of the city's toxic illicit drug supply. Between January and May of this year, 851 people died of drug overdoses in the city, the highest number ever reported in the first five months of a calendar year. The city and the province of British Columbia are moving toward drug decriminalization and providing a "safe supply" of drugs to users, but activists accuse them of not doing enough. In a statement handed out at the event, the groups said the free drug handout was to "raise awareness of the deeply flawed aspects of the Vancouver Model of decriminalization, including disproportionate influence of the Vancouver Police Department, unreasonably low drug thresholds, and lack of provisions for safe supply."

Israel Marijuana Legalization Bill Vote Postponed as Arab Coalition Party Says It is Not Yet Ready to Support It. Israel's fractious and narrowly divided politics is having an impact on marijuana legalization legislation, as the ruling coalition has had to put off a Wednesday vote on a marijuana legalization bill after the Islamist Ra'am Party, which for the first time is part of a governing coalition, has said it needed more time to study the bill. Ra'am head Mansour Abbas asked bill sponsor New Hope Member of the Knesset Sharren Haskel for a two-week delay while his party studies the bill. It has been approved Sunday by Ministerial Committee for Legislation on Sunday, but now faces at least the two-week delay and, if Ra'am cannot be convinced to support it, dying in the Knesset.

Fatal Drug ODs Hit Record Last Year, Senate Majority Leader Rolls Out Draft Marijuana Legalization Bill, More... (7/14/21)

There is now a marijuana legalization bill from the Senate majority leader, New York prisons face a second lawsuit over their crackdown on pain pill prescribing for inmates, and more.

CDC preliminary data has drug overdose deaths at more than 90,000 last year. (Creative Commons)
Marijuana Policy

Senate Majority Leader Rolls Out Draft Marijuana Legalization Bill. Senate Majority Leader Chuck Schumer (D-NY) and colleagues Cory Booker (D-NJ) and Ron Wyden (D-OR) held a press conference Wednesday to unveil their first draft of a bill to federally legalize marijuana. The bill would federally legalize marijuana by removing it from the Controlled Substances Act, let states set their own marijuana policies, expunge prior convictions and allow people to apply for resentencing, and end collateral consequences, such as people being deported for marijuana possession offenses. The bill, known as the Cannabis Administration and Opportunity Act, faces uncertain prospects in the narrowly divided Senate, and just minutes after the Wednesday press conference, White House Press Secretary Jen Psaki said the President Biden remains opposed to marijuana legalization. If the bill were to pass, it would have to be reconciled with the marijuana legalization bill passed by the House in December, the MORE Act (HR 3884). Look for out feature article on the rollout coming shortly.

Missouri Activists Take Initial Steps for 2022 Marijuana Legalization Initiative. A group calling itself Fair Access Missouri filed a petition Tuesday for a marijuana legalization initiative aimed at the 2022 ballot. The initiative would take the form of a constitutional amendment that would legalize the possession of up to eight ounces for people 21 and over and allow residents to cultivate up to 25 square feet of flowering marijuana. It would also set up a system of licensed cultivation, manufacturing, and sales. Previous marijuana legalization initiative campaigns in the state have failed to meet signature-gathering requirements. This one is at the very beginning of the process, with the state now having 65 days to review the initial petition.

Heroin and Prescription Opioids

Former New York Prison Doctor Sues Over Restrictive Painkiller Policy. A doctor who formerly worked in the state prison system and says he faced harassment and was forced to quit for seeking appropriate pain relief for his inmate patients has filed a federal lawsuit against the state Department of Corrections, saying its policies leave patients suffering unnecessary agony. Four years ago, the department tightened its opioid prescribing policies amidst the ongoing opioid crisis, requiring prison doctors to get permission from medical administrators for prescribing certain medications, including not just opioids, but all gabapentine, Claritin-D, Robitussin DM, and the diarrhea drug Imodium. Dr. Michael Salvana charges in the lawsuit that the department violated his right to speak out against the policy and said his superiors' "inhumane” interference in his patients' care caused him to leave his role as facility director in central New York at Walsh Regional Medical Unit in Rome, New York, that has 125 beds for prisoners with complicated medical needs." The policy led to the "abrupt" cut off of "effective treatments for hundreds of inmates." Inmates in the state prison system have also failed a lawsuit charging they are being forced to live with untreated chronic pain because medications are now so difficult to obtain.

Psychedelics

California Psychedelic Decriminalization Bill Wins Another Committee Vote. Sen. Scott Wiener's (D-San Francisco) psychedelic decriminalization bill, SB 519, has won a second committee vote in the Assembly after successfully passing out of the Senate. The Assembly Public Health Committee voted 8-4 Tuesday to advance the measure, which would remove criminal penalties for possessing psychedelics including psilocybin. But the committee amended the bill to set specific personal possession limits, leading the pro-psychedelic group Decriminalize Nature to call for it to be tabled, arguing that it is 'just a creative way to say when can law enforcement arrest you." The bill now awaits an Assembly floor vote.

Drug Policy

Drug Overdose Deaths Jumped to More Than 90,000 Last Year. The Centers for Disease Control and Prevention released preliminary statistics Wednesday showing that drug overdose deaths totaled more than 90,000 last year, the largest single-year increase ever recorded. Drug overdoses increased in every state except New Hampshire and South Dakota, with big jumps in the South and the West. The year also saw the most fatal opioid overdoses in a year, the most fatal methamphetamine overdoses in a year, and the most deaths from fatal fentanyl overdose deaths in a year. "It’s huge, it’s historic, it’s unheard of, unprecedented, and a real shame," said Daniel Ciccarone, a professor of medicine at the University of California, San Francisco, who studies heroin markets. "It’s a complete shame." Social isolation, disrupted drug markets, and hampered access to drug treatment during the pandemic are getting some of the blame, but the pre-pandemic increase in fentanyl availability is also playing a role, as is the country's refusal to embrace harm reduction measures, such as safe injection sites and safe drug supplies.

British Columbia Set to Begin "Safe Supply" of Drugs for Street Users, Biden Nominates New Drug Czar, More... (7/13/21)

Marijuana protections are advancing in congressional appropriations bills, former Drug Police Alliance executive director Ethan Nadelman starts a provocative new podcast on drugs, and more.

Dr. Rahul Gupta, nominated by President Biden to serve as drug czar. (March of Dimes)
Marijuana Policy

Congressional Committees Advance Marijuana Protections for Medical Programs and Universities in New Spending Bills. The House Appropriations Committee will take up a spending bill Thursday that includes riders that provide protections for states with medical marijuana programs and universities that conduct marijuana research after they were approved in subcommittee on Monday. The rider protecting has been approved in each Congress since 2014. The House in 2019 and 2020 also approved a rider protecting state recreational marijuana programs, but it is not clear yet whether that will be the case this year. Meanwhile, the Commerce, Justice, Science and Related Agencies appropriations bill now includes a longstanding provision barring the DEA from interfering in hemp programs and a new provision that bars certain law enforcement grants to states and localities if they allow no-knock searches in drug cases.

Drug Policy

Biden Nominates Former West Virginia Health Official Rahul Gupta as Drug Czar. Ending months of speculation, President Biden has nominated Dr. Rahul Gupta to lead the White House Office on National Drug Control Policy (ONDCP—the drug czar's office). Currently the top health official at March of Dimes, Gupta is a primary care physician who previously served as West Virginia health commissioner. Drug reformers applauded his role in implementing and overseeing that state's medical marijuana program as head of the state Bureau for Public Health, but some harm reductionists have criticized him for overseeing the decertification of a needle exchange program that aimed to reduce the spread of blood-borne diseases, such as Hepatitis C and AIDS. Others, though, do not hold him responsible for the circumstances that led to the shutdown. He has not taken a public position on marijuana legalization.

Ethan Nadelman's New Podcast on Drugs Set to Begin. Ethan Nadelman, the founder and former longtime executive director of the Drug Policy Alliance before stepping down in 2017, is rolling out a new podcast series on drug policy, Psychoactive. The aim of the podcast is to open a deep national conversation about drugs, drug policy, and the human experience. The podcast, on IHeartRadio, launches on Thursday.

International

British Columbia Will Provide "Safe Supply" of Illicit Drugs to Street Users. A provincial policy directive in British Columbia will require all local health authorities to develop programs to provide pharmaceutical quality opioids and stimulants to street drug users in a bid to reduce overdose deaths. But which drugs are offered and who gets them will be at the discretion of local programs and doctors, which could be a barrier to expanding access. And they can only be provided in clinical or programmatic settings—no takeaway drugs. There are also signs some health care providers are reluctant to participate. 'Some key partners, including some prescribers, have expressed reservations about the approach outlined in this document, and others have noted that an approach that begins with programmatic settings will not provide broad access for people who use substances," the directive says. "We recognize that we have been unable to address all concerns, but we also recognize that we must start somewhere." The drugs will be covered by the province's prescription drug plan and will not be forced to enter into drug treatment. Safe supply is the idea that health care providers can lower or eliminate a person's dependence on illicit black market drugs and thus reduce overdose deaths and other harms.

CA Safe Injection Site Bill Delayed to Next Year, Drug Czar's Office Seeks Input on Harms of Drug Policies, More... (7/7/21)

The punishment of Olypmic athlete Sha'carri Richardson for testing positive for marijuana draws intense interest and criticism, New Mexico drug dogs are getting laid off in the wake of legal pot, and more.

New Mexico drug dogs are being forced into retirement by marijuana legalization. (Creative Commons)
Marijuana Policy

New Mexico Drug Dogs Face Retirement in Wake of Marijuana Legalization. Drug-sniffing police dogs in the state are being forced into retirement because they have been trained to alert on any drug, including marijuana, and cannot be retrained. As the Tucumcari Police Department noted as it announced the retirement of its drug dog, Aries: "With the legalization of recreational marijuana, K9 Aries is unable to continue his function as a narcotics detection dog." Other cities and towns are doing the same thing, and so is the State Police, which will be retiring all nine of its current drug dogs. "Once the new canines are trained, the handlers will have the option of retiring their current assigned canine to their home, or we will look at other options to the likes of donating them to other law enforcement entities outside of the state of New Mexico who have yet to legalize marijuana," the State Police said.

Drug Policy

Drug Czar's Office Seeks Comment on How Drug Policies Create Systemic Barriers for Underserved Communities. In a notice published in the Federal Register Wednesday, the Office of National Drug Control Policy (ONDCP -- the drug czar's office) said it is seeking comment on whether existing federal drug control policies create "systemic barriers to opportunities for underserved communities" and to better promote equity in future programs. Although the agency has embraced some progressive drug policy positions, such as pushing for broader access to buprenorpine, this level of acknowledgment of harms caused by drug policy marks a change of direction.

The agency didn't take the action independently. Rather, it is part of a broader executive order requiring agencies to seek feedback and "assess whether, and to what extent, its programs and policies perpetuate systemic barriers to opportunities and benefits for people of color and other underserved groups. Such assessments will better equip agencies to develop policies and programs that deliver resources and benefits equitably to all," ONDCP explained. Comments on how ONDCP can better achieve equity are being accepted at [email protected] through August 6.

Drug Testing

Sha'Carri Richardson Out of Olympics After Positive Marijuana Test. Star athlete Sha'Carri Richardson was disqualified last week from the Tokyo Olympics' women's 100 meter race after testing positive for marijuana after the qualifying run, and now will completely miss the games after being left off the team chose for the women's relay race. Her disqualification has caused howls of outrage, with some commentators calling it racist, and even President Biden, who initially responded with "the rules are the rules," suggesting the rules need to change. Richardson said she smoked marijuana to cope with the death of her biological mother and did so in Oregon, where it is legal, but she took responsibility for her actions: "I know what I did," Richardson said. "I know what I'm supposed to do... and I still made that decision."

Harm Reduction

California Safe Injection Site Bill Delayed to Next Year. The Assembly Health Committee has informed Senator Scott Weiner (D-San Francisco) that his bill to allow a safe injection site pilot program, Senate Bill 57, which is billed as an "overdose prevention program," will not get a hearing until January. The state is in the first year of its two-year legislative session, so the bill is not dead, just delayed. "While I'm extremely disappointed that we are experiencing another delay in passing this life-saving legislation -- which has passed both the Senate and Assembly twice in different forms over the past five years -- I continue to be optimistic that we'll pass SB 57 and get it signed into law," said Weiner. "San Francisco and other California cities are experiencing record overdose deaths, and safe consumption sites are a proven strategy to save lives and help people into recovery. I am deeply committed to this legislation -- as is our broad coalition -- and I look forward to moving SB 57 forward in January." The bill has already passed the Senate.

Federal Appeals Court Taps the Brakes on Drug Induced Homicide Prosecutions of Drug Users [FEATURE]

A woman who bought heroin with a pair of friends, one of whom shortly afterward suffered a fatal overdose on the drug, is not a murderer, at least according to the US 3rd Circuit Court of Appeals. That was the June 1 ruling in US v. Semler, a case that may not set binding precedent, but does send a signal to the prosecutors and the judiciary that the federal courts do not want to see a federal law aimed at so-called drug kingpins applied to mere drug users.

As described in the decision, the case began when two heroin-addicted Philadelphia women, Emma Semler and her old drug rehab buddy Jennifer Werstler, went to score heroin together at Wertsler's request. They were joined by Semler's sister Sarah, who drove them to the West Philadelphia locale where they bought their heroin. It is unclear who actually purchased and then shared the heroin. The trio then shot up in the restroom of a nearby KFC restaurant. Werstler began to show signs of overdosing, and the Semler sisters "attempted to revive Werstler by splashing cold water on her, then left the bathroom and called their mother for a ride home. They did not call 911 or alert anyone to Werstler's condition."

Werstler was later discovered by a KFC employee, who called 911, but EMTs arrived too late to save her and she was pronounced dead. Her official cause of death was "adverse reaction to heroin."

Semler was then indicted by a federal grand jury in the Eastern District of Pennsylvania with "distribution of heroin resulting in death," punishable by a 20-year mandatory minimum prison sentence. As an added bonus, she was also charged with doing so within 1,000 feet of a school, as well as aiding and abetting on both counts. She was found guilty at trial and sentenced to 21 years in prison.

Semler appealed, arguing that friends sharing jointly procured drugs did not qualify as drug distribution and that the district court had erred in refusing to allow a jury instruction to that effect, as well as erring in failing to instruct the jury that there had to be a "proximate cause" for it to convict.

Scott Burris, JD, is a professor of both law and public health at Temple University and directs Temple's Center for Public Health Law Research. He is also Semler's appellate counsel and coauthor of an amicus curiae brief supporting Semler, which nicely laid out the issues at play.

"This case presents the Court with an opportunity to determine the proper scope of the Drug Distribution Resulting in Death (DDRD) sentencing enhancement provision," the abstract explains. "The provision, its parent statute, and the totality of modern federal law and policy to stem the overdose crisis are intended to target major drug traffickers. Research suggests that DDRD prosecutions routinely pervert this intent, indiscriminately deploying DDRD and similar provisions to target end consumers of illicit drugs affected by addiction. Rather than deterring drug trafficking, such prosecutions deter help-seeking during overdose events and interfere with overdose prevention measures. This cuts at cross purposes to overdose crisis response, leading to more, not fewer deaths."

The 3rd District Court of Appeals agreed, vacating Semler's conviction and sending her case back for retrial using proper legal instructions for jurors. "We hold that the definition of 'distribute' under the Controlled Substances Act does not cover individuals who jointly and simultaneously acquire the possession of a small amount of a controlled substance solely for their personal use," wrote Judge Jane Richard Roth.

It was a victory, if not a complete exoneration, for Emma Semler and any other drug user federal prosecutors in the 3rd Circuit might have been thinking about charging under that statute. Hopefully it also serves as a distant early warning signal for states that have passed drug induced homicide laws, as well as for state-level prosecutors, who are zealously embracing them to convict low-level drug users as murderers.

The Health in Justice Action Lab at Northeastern University School of Law reported that the number of states with such laws jumped from 15 to 25 in from 2009 to 2019, while the number of drug induced homicide prosecutions hovered at near zero from the 1970s until the early 2000s. Then, as overdose deaths jumped, so did prosecutions, rising to 100 per year by 2011 before skyrocketing to nearly 700 per year by 2018.

In a 2019 Utah Law Review article, Northeastern law professor and faculty director of the Health in Justice Action lab faculty adviser Leo Beletsky found while the laws are ostensibly aimed at drug dealers, "half of those charged with drug induced homicide were not, in fact, 'dealers' in the traditional sense, but friends and relatives of the deceased." He also found that in cases that involved a traditional "drug dealer," half of those prosecuted were black or brown people who sold drugs to whites -- a fact he noted does not fit the demographics of the United States or of drug dealers.

"In view of that context," he wrote, "these findings suggest that drug-induced homicide charges are being selectively and disproportionately deployed to target people of color. This disparate application can further reinforce already dire racial disparities, particularly in the enforcement of drug laws and the length of sentencing for drug-related crimes."

And, as the Drug Policy Alliance (DPA) pointed out in its 2017 report, An Overdose Death is Not a Murder: Why Drug Induced Homicide Laws Are Ineffective and Inhumane, those laws don't work to reduce overdoses: "Prosecutors and legislators who champion renewed drug induced homicide enforcement couch the use of this punitive measure, either naively or disingenuously, as necessary to curb increasing rates of drug overdose deaths. But there is not a shred of evidence that these laws are effective at reducing overdose fatalities. In fact, death tolls continue to climb across the country, even in the states and counties most aggressively prosecuting drug-induced homicide cases."

"The Semler case is one more example of how the Drug War has warped our legal system and led to mass incarceration," DPA senior staff attorney Grey Gardner told the Chronicle in an email exchange. "Prosecutors twisted the law to criminalize this young woman and subject her to a more than 20-year sentence after several friends bought drugs to use together and one suffered a tragic fatal overdose. Urging the jury to convict one of them of drug distribution when each of these users were suffering from substance use disorder and using together was not only overreaching, it highlights the arbitrary nature of our drug laws."

It is also counterproductive, he added: "This prosecution and those like it do nothing to make people safer, but instead put people in greater danger. By elevating the threat of prosecution, they make it less likely that people close to an overdose victim will call for help," he pointed out.

"Thankfully in this case the Court of Appeals rejected the prosecution's overbroad definition of distribution, but what's clear is that we need an entirely new approach," said DPA's Gardner. "Instead of the failed War on Drugs, we need to stop turning to the criminal legal system and spending billions on these ineffective policing strategies. Instead we need better approaches -- such as investments in drug checking, overdose prevention centers, and expanded access to naloxone -- to protect those who are experiencing addiction and are at the greatest risk."

"The court seemed sympathetic to the view that criminal law is not the best way to get at substance use disorder and the behavior of people coping with it," Burris told the Chronicle in an email exchange.

The appeals court labeled its decision as non-precedential, meaning it is not binding on federal district courts in its region, but it still may have a broader impact in the federal courts, Burris explained.

"I think her lawyers are going to ask the court to reconsider that," he said. "It is at least what we call 'persuasive authority' in that its reasoning may be adopted voluntarily by other courts."

As for impact on state and local prosecutions, not so much, he added.

"It has no impact other than as persuasive authority," Burris said. "The state attorney general and local district attorneys pursuing these cases seem to think they are sensible and just, and they are hard to shake," he confessed.

"The overdose crisis is just one symptom of the fundamental disease of inequality and inequity in our country," was Burris's bottom line. "Getting at that root cause requires a sea change in policy such that government at all levels -- and the people who elect the government -- commit to ensuring the basics of decent life to everyone: good work, good housing, good education, good transportation, and a place of respect in the community. In this the 'deaths of despair' idea seems to be to get the problem just right. Of course, short of that, there are many things to do: stop criminalizing drug use; create safe injection sites everywhere they are needed; eliminate regulations that make methadone and buprenorphine harder to get than the drugs whose use they are meant to reduce."

CT Becomes Latest State to Legalize Marijuana, DEA Denies FL Church's Ayahuasca Exemption, More... (6/23/21)

House Democrats look to end the ban on legal marijuana sales in the nation's capital, the Rhode Island Senate approves a marijuana legalization bill, and more.

The InSite safe injection site in Vancouver. The Los Angeles city council supports a similar effort in California. (vch.ca)
Marijuana Policy

House Democrats File Bill to End DC Marijuana Sales Ban. House Appropriations Financial Services and General Government (FSGG) Subcommittee Chairman Mike Quigley (D-IL) filed a wide-ranging bill Wednesday that would lift the ban on legal marijuana sales in the District of Columbia, as well as providing protection to financial institutions doing business with state-legal marijuana firms. The ban, in the form of a rider to the annual DC appropriations bill in Congress, was imposed in 2014, with the effort led by Rep. Andy Harris (R-MD), before city residents even voted for marijuana legalization later that year. It has remained in place ever since.The move comes even though President Biden specifically did not remove the congressional rider banning sales in his budget proposal last month. The bill is set to be voted on in the subcommittee Thursday, with the full Appropriations Committee taking it up next Tuesday, setting up a potential conflict with the Biden administration.

Connecticut Legalizes Marijuana. Gov. Ned Lamont (D) on Tuesday signed a marijuana legalization bill, Senate Bill 1201, making the state the 19th to end marijuana prohibition and the fourth to do this year, after New Mexico, New York, and Virginia. The bill legalizes the possession of up to one and a half ounces by people 21 and over, as well as setting up a system of taxed and regulated marijuana commerce with strong social equity provisions. The law takes effect on July 1, when using recreational marijuana becomes legal, but marijuana business licenses are not expected to be issued until the end of next year.

Rhode Island Senate Approves Marijuana Legalization Bill. The state Senate voted Tuesday night to approve an amended version of Senate Bill 568, which would legalize the possession, purchase, and cultivation of cannabis for personal use for adults 21 and older.The bill would also create a Cannabis Control Commission to regulate the legal marijuana market, tax marijuana sales at 20%, and create a social equity program to aid communities disproportionately harmed by marijuana prohibition. A House marijuana legalization bill filed at the end of May remains stuck in the House Judiciary Committee. The clock is ticking: The session ends in one week on June 30.

Ayahuasca

DEA Denies Religious Use Exemption to Florida Ayahuasca Church. The Drug Enforcement Administration (DEA) has officially denied the Soul Quest Church's request for a religious exemption allowing it to continue to legally provide ayahuasca, a substance containing the Schedule I drug DMT, for religious purposes. The church has been distributing ayahuasca and other substances to paying customers and gained unwanted scrutiny after a man died during an ayahuasca retreat in 2018. After that death, the DEA ordered the church to shut down its ayahuasca distribution, but the church has refused, instead fighting the order in the courts. Now, after the DEA decision, a federal judge is expected to rule soon on that decision, which could end the church's run. The church is relying on a generous interpretation of the 1993 Religious Freedom Restoration Act, under which both peyote use by the Native American Church and ayahuasca use by the Brazil-based church the Union of the Vegetable has been allowed. 

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Harm Reduction

Los Angeles City Council Endorses Statewide Safe Injection Site Bill. The city council on Tuesday approved a resolution supporting a bill that would legalize pilot safe injection sites in a number of California cities, Senate Bill 57. The support comes as the city faces a drug overdose crisis, especially among the homeless, for whom the overdose rate jumped 33% in the first six months of last year. The bill has already passed the state Senate and is now before the Assembly Public Safety and Health committees. Even if the bill were to become law, it faces possible federal obstacles. When harm reductionists in Philadelphia sought to open a safe injection site, the Trump administration successfully blocked them in federal district court. The Biden administration has not made clear what its stance on the issue is.

Making a Better Good Samaritan Law in North Carolina [FEATURE]

The push is on in Raleigh to overhaul the state's Good Samaritan law, which protects from prosecution people who report a drug overdose to medical authorities. The state passed a limited Good Samaritan bill in 2013, but the North Carolina Harm Reduction Coalition calls it "currently one of the weakest in the country."

The current Good Samaritan law is unclear on whether its protective provisions apply to the person actually suffering the overdose, and as a result, people like Jordan Dean end up being arrested for suffering a heroin overdose. Dean, 27, and a buddy were both passed out in a car in a grocery store parking lot, an employee called it in, and although both EMS and police came to the scene, Dean ended up in the back of a squad car on the way to jail.

As North Carolina Health News reported, his case is not the only one. The state-level health media outlet cited similar cases of overdoses followed by arrests in Vance and Franklin counties.

Groups such as the North Carolina Harm Reduction Coalition (NCHRC) and the North Carolina AIDS Action Network (NCAAN) are now getting behind an effort to strengthen the law with House Bill 852. The bill specifies that immunity from prosecution applies to the overdose victim as well as the person who reports the overdose.

Similar legislation passed the Senate in 2019, but failed to get through the House.

HB 852 also extends that immunity to include all drug possession offenses. Under the current law, people who overdose and are in possession of more than one gram of heroin or cocaine can still be charged with drug possession. And it includes a broader range of substances, including most significantly, fentanyl, that would be subject to those same protections.

"Our [current] law is actually one of the most limited in the country," said NCAAN executive director Lee Storrow, who, along with members of the Department of Health and Human Services opioid overdose prevention team, is helping lead the push for the bill. "When the Good Samaritan Law was enacted, our drug supply looked very different," he added. "Right now the main case of drug overdose in North Carolina is fentanyl -- but possession of fentanyl is not protected under our Good Samaritan Law, so it's a real barrier for people calling 911."

Another provision in the bill applies those same protections to overdose calls involving underage drinking.

The two groups joined with family members of overdose victims for a press conference and rally outside the General Assembly on Tuesday to call on lawmakers to save lives by advancing the bill.

"If people fear that they're still going to be arrested, the idea that they're protected from prosecution doesn't necessarily feel all that helpful," said Lee Storrow, head of the North Carolina AIDS Action Network.

Families who have suffered overdose deaths also spoke out.

"There can't be any question when people are together and someone overdoses of whether or not they should dial 911," said Randy Abbott, who lost his 24-year-old daughter to a drug overdose in 2015, when her friends panicked instead of seeking help.

"We know they panicked, and we know the things that happened when they panicked, like getting stuff out of the house, putting it in her car, lots of different things that the detectives were able to figure out," Abbott said. "But they didn't dial 911."

"As a nurse practitioner that works in addiction medicine and who lost my younger brother to overdose, I felt called to come to the General Assembly to support HB 852. This bill would save countless lives," said Charlotte resident Elisa Edgerton.

NCHRC and the other advocates at the Tuesday press conference are working to make it so. After the media event, they headed inside to lobby members of the House Judiciary Committee.

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