Popularization of Worse Drugs

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Senate Names Meth an "Emerging Drug Threat," UFCW Marijuana Industry Unionization, More... (12/14/21)

A bad batch of synthetic cannabinoids is sickening people in Florida, Chicago is handing out fentanyl test strips in a bid to bring down record overdose numbers, and more.

Meth seized in Nebraska. No, it was not cooked by Breaking Bad's Heisenberg. (netnebraska.org)
Marijuana Policy

UFCW Gains Another Victory in Marijuana Industry Unionization Drive. An ongoing drive by the United Food and Commercial Workers (UFCW) gained another victory this week as 70 employees of the four-store Sweet Flower Cannabis chain in Southern California voted to join the union. The chain just got a license for a fifth shop in Culver City, and staff there will also be able to join the union under a labor peace agreement. The UFCW has won several other unionization votes in California this year, as well as at pot businesses in Illinois, Massachusetts, New Jersey, and New York. The union represents about 10,000 workers in the industry. The Teamsters are also active in unionizing the industry, winning victories in California and Illinois.

Methamphetamine

Senate Passes Grassley, Feinstein Methamphetamine Bill. The Senate on Monday passed the Methamphetamine Response Act of 2021 (S. 854), legislation introduced by Senators Dianne Feinstein (D-CA) and Chuck Grassley (R-IA). The bill designates methamphetamine as an emerging drug threat and directs the Office of National Drug Control Policy (ONDCP -- the drug czar's office) to implement a plan to address the rising use of methamphetamine. The bill "requires ONDCP to develop, implement and make public, within 90 days of enactment, a national emerging threats response plan that is specific to methamphetamine." The same bill passed the Senate last year but failed to move in the House.

Synthetic Cannabinoids

Severe Bleeding From 'Spice' Synthetic Cannabinoid Leaves 35 Hospitalized in Florida. At least 35 people in the Tampa Bay area have recently been hospitalized with severe bleeding after ingesting the synthetic cannabinoid "Spice," the state's poison control center reported. Victims have reported bruising, nosebleeds, bleeding gums, vomiting blood, blood in urine and stool, and heavy menstrual bleeding -- symptoms associated with a condition known as coagulopathy, where the blood's ability to clot is impaired.

The exact cause of the bleeding was not stated. According to the National Institute on Drug Abuse, "...chemicals [in synthetic marijuana] are often being changed as the makers of spice often alter them to avoid drug laws, which have to target certain chemicals." Similar reactions in a 2018 incident involving Spice were attributed to the chemical brodifacoum having been added.

Florida has not legalized marijuana and allows only limited access to medical marijuana.

Harm Reduction

Chicago Now Passing Out Free Fentanyl Test Strips. With fentanyl now linked to most opioid overdose deaths in the city, the Chicago Department of Health has begun offering free fentanyl test strips to the public. The program first began in October, and so far, more than 7,000 strips have been distributed, mostly through harm reduction organizations. The Cook County Department of Public Health is also distributing fentanyl test strips in the city and its suburbs. Cook County registered a record number of opioid-related deaths in 2020.

CA Psychedelic Decriminalization Bill Filed, NJ Marijuana Mess Continues, More... (2/18/21)

A Minnesota marijuana legalization bill moves, Wisconsin's governor calls for legal marijuana, the South Dakota House quashes telehealth for medical marijuana patients, and more.

(Creative Commons)
Marijuana Policy

Minnesota Marijuana Legalization Bill Wins First Committee Vote. The House Commerce Finance and Policy Committee voted 10-7 Wednesday to approve a marijuana legalization bill, House File 600. The bill advanced on a partisan vote, with all Republicans opposed. Republicans control the state Senate, making the bill's prospects cloudy.

New Jersey Marijuana Legalization Standoff. Efforts to advance marijuana legalization implementation legislation remained stymied Thursday after a Senate Judiciary Committee vote on a "cleanup" bill was cancelled for the second day in a row. Legislators and Gov. Phil Murphy (D) remain at loggerheads over how to handle underage marijuana possession. Now, Murphy will likely have to decide whether to approve two pending bills or veto them, which would contradict his campaign promise to legalize marijuana, as well as contradicting the will of the voters, who approved it in a referendum in November. "The governor has two bills on his desk that he has articulated problems with, and it doesn't appear that the Legislature is going to solve those problems," said Bill Caruso, an attorney and founding member of New Jersey United for Marijuana Reform. The governor's deadline to act is noon Friday, although that could be pushed back to Monday.

Wisconsin Governor's Budget Plan Calls for Marijuana Legalization. Gov. Tony Evers (D) on Tuesday released a budget plan that includes legalizing both medical and recreational marijuana. The move comes despite strong resistance in the Republican-controlled state legislature. "The Governor believes it is time to join other states, including two of our neighbors, who have legalized recreational marijuana," an explanatory document from his office said. The proposal would allow adults to possess up to two ounces and grow up to six plants at home.

Medical Marijuana

South Dakota House Votes to Deny Telehealth for Medical Marijuana. The House voted 38-30 on Wednesday to defeat House Bill 1147, which would have allowed medical marijuana patients to use telehealth to consult with practitioners in order to obtain recommendations. One Republican opponent called the idea "premature," while another called it "not ready for prime time." South Dakota okayed medical marijuana with 69% of the vote in November.

Psychedelics

California Psychedelic Decriminalization Bill Filed. State Sen. Scott Weiner (D-San Francisco) filed Senate Bill 519, which would decriminalize the use and possession of psychedelic drugs in the state. "People should not be going to jail for possessing or using drugs," Wiener said. "It's a health issue, not a criminal issue, and I hope that we get all the way there." The bill would also expunge criminal records for people convicted of psychedelic possession offenses and create a task force to address regulatory issues.

Asset Forfeiture

South Dakota Bill Would Limit Asset Forfeiture in Drug Cases. The Senate Judiciary Committee voted Wednesday to approve Senate Bill 164, which would bar asset forfeiture in drug cases where the amount of the drug in question was no more than a personal use amount. The bill would originally have banned asset forfeiture without a criminal conviction but was amended in committee to strip out that section. Under the bill, it would take at least half a pound of marijuana to trigger asset forfeiture. The bill now heads for a Senate floor vote.

Harm Reduction

Arizona Senate Committee Approves Legalizing Drug Testing Strips. The Senate Health and Human Services Committee has approved Senate Bill 1486, which would legalize the use of test strips that can detect the presence of fentanyl, an extremely potent opioid which accounts for a majority overdose deaths in the US, mostly by people who didn't know they were taking it. The test strips are currently considered illegal drug paraphernalia. The bill now heads for a Senate floor vote.

Book Review: Drug Use for Grown-Ups

Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear, by Carl Hart (2021, Penguin Press, 290 pp., $28.00 HB)

Dr. Carl Hart is a one-man drug and drug user destigmatization machine. In his new book, Drug Use for Grown-Ups, the Columbia University psychology professor blasts drug prohibition as both an affront to the American dream of the pursuit of happiness and as a tool of racial oppression. And he makes a strong, informed argument that recreational drug use can be, and usually is, a good thing.

You could hardly find someone more qualified to make the case. Hart has spent years in the trenches of neuropsychopharmacology research, handed out drugs (or placebos) to thousands of research subjects, published numerous scientific papers and popular articles in the field, and risen to the top of his profession along the way. And here is his bottom line:

"[O]ver my more than 25-year career, I have discovered that most drug-use scenarios cause little or no harm and that some responsible drug-scenarios are actually beneficial for human health and functioning. Even 'recreational' drugs can and do improve day-to-day living... From my own experience -- the combination of my scientific work and my personal drug use, I have learned that recreational drugs can be used safely to enhance many vital human activities."

Hart is refreshingly -- and deliberately -- open about his own recreational drug use. Given the stigmatization and persecution of people identified as "drug users," he feels that justice demands privileged partakers come out of the closet and give voice to their own, non-destructive drug use histories as a necessary remedy for that demonization. He certainly does so himself, revealing a disciplined yet curious mind most definitely not averse to sampling various substances.

Those substances include heroin, which he describes as his current favorite drug, one that he's been using episodically for years now: "There aren't many things in life that I enjoy more than a few lines by the fireplace at the end of the day... Heroin allows me to suspend the perpetual preparation for battle that goes on in my head... The world is alright with me. I'm good. I'm refreshed. I'm prepared to face another day, another faculty meeting, another obligatory function. All parties benefit."

But Hart is not quite so mellow when it comes to people and institutions he sees as helping to perpetuate overly negative depictions of various drugs or the persecution of drug users. He rips into Dr. Nora Volkow, head of the National Institutes on Drug Abuse (NIDA) over her "addiction is a brain disease" mantra and the rigid ideological control she has over research funding. He rips into journalists for uncritically and sensationally reporting salacious scientific findings about the evils of drugs that he argues are not supported by the evidence they are supposedly based on. He even calls Bernie Sanders "ignorant" (that word shows up more than a few times) for complaining that marijuana shouldn't be in the same drug schedule as "killer drugs like heroin."

Dr. Carl Hart (Columbia University)
Hart doesn't deny the potential dangers of drug use but makes the case that they are dramatically overstated. In that sense, Drug Use for Grown-Ups is a corrective to more than a century of anti-drug propaganda. In a deep dive into opioids, for instance, he notes that most opioid overdose deaths are actually opioid/benzodiazepines/alcohol deaths, and that a large number of them are due to ignorance (there's that word again) -- in that, in the black market that currently exists, drug users do not and cannot know what exactly is in that pill or powder they purchased.

As long as we are in a prohibition regime, the least we can do is widespread drug testing for quality control, as is done at some European music festivals, Hart argues. But that's the only kind of drug testing he's down with; he calls the urine drug testing industry "parasitic," a sobriquet he also applies to the drug treatment industry.

But hang on, he's not done yet. Although he is an advocate for harm reduction practices, he has a bone to pick with the term itself: It's too damned negative! Drug use doesn't typically involve harm, he argues, but pleasure-seeking. As I pondered this, I came up with "benefit enhancement" as an upbeat alternative to harm reduction, but Hart went with "health and happiness."

And he's got a bone to pick with "psychedelic exceptionalism," the notion, dear to folks like Decriminalize Nature, that psychedelics, or better yet, "plant entheogens," are somehow "better" than dirty old drugs like meth or heroin and thus deserve to be treated differently, more gently. He also snarks at the notion that taking drugs for spiritual or religious purposes is of a higher order than taking them for fun and rebels at the notion of having a shaman or guide during a tripping session: "Some people find this comforting. I find it creepy and have never done so myself."

Drug Use for Grown-Ups is bracing, informative, and provocative contribution to the literature. Even the most ardent drug reformers and defenders would benefit from reading it and reexamining their own assumptions. Maybe Carl Hart is onto something.

Two Takes on the Global Drug War and Global Drug Cultures [FEATURE]

America shows signs of emerging from the century-long shadow of drug prohibition, with marijuana leading the way and a psychedelic decriminalization movement rapidly gaining steam. It also seems as if the mass incarceration fever driven by the war on drugs has finally broken, although tens if not hundreds of thousands remain behind bars on drug charges.

As Americans, we are remarkably parochial. We are, we still like to tell ourselves, "the world's only superpower," and we can go about our affairs without overly concerning ourselves about what's going on beyond our borders. But what America does, what America wants and what America demands has impacts far beyond our borders, and the American prohibitionist impulse is no different.

Thanks largely (but not entirely) to a century of American diplomatic pressure, the entire planet has been subsumed by our prohibitionist impulse. A series of United Nations conventions, the legal backbone of global drug prohibition, pushed by the US, have put the whole world on lockdown.

We here in the drug war homeland remain largely oblivious to the consequences of our drug policies overseas, whether it's murderous drug cartels in Mexico, murderous cops in the Philippines, barbarous forced drug treatment regimes in Russia and Southeast Asia, exemplary executions in China, or corrupted cops and politicians everywhere. But now, a couple of non-American journalists working independently have produced a pair of volumes that focus on the global drug war like a US Customs X-ray peering deep inside a cargo container. Taken together, the results are illuminating, and the light they shed reveals some very disturbing facts.

Dopeworld by Niko Vorobyov and Pills, Powder, and Smoke by Antony Loewenstein both attempt the same feat -- a global portrait of the war on drugs -- and both reach the same conclusion -- that drug prohibition benefits only drug traffickers, fearmongering politicians, and state security apparatuses -- but are miles apart attitudinally and literarily. This makes for two very different, but complementary, books on the same topic.

Loewenstein, an Australian who previously authored Disaster Capitalism and Profits of Doom, is -- duh -- a critic of capitalism who situates the global drug war within an American project of neo-imperial subjugation globally and control over minority populations domestically. His work is solid investigative reporting, leavened with the passion he feels for his subject.

In Pills, Powder, and Smoke, he visits places that rarely make the news but are deeply and negatively impacted by the US-led war on drugs, such as Honduras. Loewenstein opens that chapter with the murder of environmental activist Berta Caceres, which was not directly related to the drug war, but which illustrates the thuggish nature of the Honduran regime -- a regime that emerged after a 2009 coup overthrew the leftist president, a coup justified by then-Secretary of State Hillary Clinton, and which has received millions in US anti-drug assistance, mainly in the form of weapons and military equipment.

Honduras doesn't produce any drugs; it's only an accident of geography and the American war on drugs that we even mention the country in the context of global drug prohibition. Back in the 1980s, the administration of Bush the Elder cracked down on cocaine smuggling in the Caribbean, and as traffickers sought to evade that threat, Honduras was perfectly placed to act as a trampoline for cocaine shipments taking an alternative route through Mexico, which incidentally fueled the rise of today's deadly and uber-wealthy Mexican drug cartels.

The drug trade, combined with grinding poverty, huge income inequalities, and few opportunities, has helped turn Honduras into one of the deadliest places on earth, where the police and military kill with impunity, and so do the country's teeming criminal gangs. Loewenstein walks those mean streets -- except for a few neighborhoods even his local fixers deem too dangerous -- talking to activists, human rights workers, the family members of victims, community members, and local journalists to paint a chilling picture. (This is why Hondurans make up a large proportion of those human caravans streaming north to the US border. But unlike Venezuela, where mass flight in the face of violence and economic collapse is routinely condemned as a failure of socialism, you rarely hear any commentators calling the Honduran exodus a failure of capitalism.)

He reexamines one of the DEA's most deadly recent incidents, where four poor, innocent Hondurans were killed by Honduran troops working under DEA supervision in a raid whose parameters were covered up for years by the agency. Loewenstein engaged in extended communication with the DEA agent in charge, as well as with survivors and family members of those killed. Those people report they have never received an apology, not to mention compensation, from the Honduran military -- or from the United States. While the Honduran military fights the drug war with US dollars, Loewenstein shows it and other organs of the Honduran government are also deeply implicated in managing the drug traffic. And news headlines bring his story up to date: Just this month, the current, rightist president of Honduras, Juan Orlando Hernández, of meeting with and taking a bribe from a drug trafficker. This comes after his brother, former Honduran Senator Juan Antonio Hernández, was convicted of running tons of cocaine into the United States in a trial that laid bare the bribery, corruption, and complicity of high-level Hondurans in the drug trade, including the president.

Loewenstein also takes us to Guinea-Bissau, a West African country where 70 percent of the population subsists on less than $2 a day and whose biggest export is cashews. Or at least it was cashews. Since the early years of this century, the country has emerged as a leading destination for South American cocaine, which is then re-exported to the insatiable European market.

Plagued by decades of military coups and political instability, the country has never developed, and an Atlantic shoreline suited for mass tourism now serves mainly as a convenient destination for boatloads and planeloads of cocaine. Loewenstein visits hotels whose only clients are drug traffickers and remote fishing villages where the trade is an open secret and a source of jobs. He talks with security officials who frankly admit they have almost no resources to combat the trade, and he traces the route onward to Europe, sometimes carried by Islamic militants.

He also tells the tale of one exemplary drug bust carried out by a DEA SWAT team arguably in Guinean territorial waters that snapped up the country's former Navy minister. The DEA said he was involved in a "narco-terrorist" plot to handle cocaine shipments for Colombia's leftist FARC guerillas, who were designated as "terrorists" by the administration of Bush the Junior in a politically convenient melding of the wars on drugs and terror.

It turns out, though, there were no coke loads, and there was no FARC; there was only a DEA sting operation, with the conspiracy created out of whole cloth. While the case made for some nice headlines and showed the US hard at work fighting drugs, it had no demonstrable impact on the use of West Africa as a cocaine conduit, and it raised serious questions about the degree to which the US can impose its drug war anywhere it chooses.

Loewenstein also writes about Australia, England, and the United States, in each case setting the historical and political context, talking to all kinds of people, and laying bare the hideous cruelties of drug policies that exert their most terrible tolls on the poor and racial minorities. But he also sees glimmers of hope in things such as the movement toward marijuana legalization here and the spread of harm reduction measures in England and Australia.

He gets one niggling thing wrong, though, in his chapter on the US. He converses with Washington, DC, pot activists Alan Amsterdam and Adam Eidinger, the main movers behind DC's successful legalization initiative, but in his reporting on it, he repeatedly refers to DC as a state and once even mistakenly cites a legal marijuana sales figure from Washington state. (There are no legal sales in DC.) Yes, this is a tiny matter, but c'mon, Loewenstein is Australian, and he should know a political entity similar to Canberra, the Australian Capital Territory.

That quibble aside, Loewenstein has made a hardheaded but openhearted contribution to our understanding of the multifaceted malevolence of the never-ending war on drugs. And I didn't even mention his chapter on the Philippines. It's in there, it's as gruesome as you might expect, and it's very chilling reading.

Vorobyov, on the other hand, was born in Russia and emigrated to England as a child. He reached adulthood as a recreational drug user and seller -- until he was arrested on the London Underground and got a two-year sentence for carrying enough Ecstasy to merit a charge of possession with intent to distribute. After that interval, which he says inspired him to write his book, he got his university degree and moved back to Russia, where he picked up a gig at Russia Today before turning his talents to Dopeworld.

Dopeworld is not staid journalism. Instead, it is a twitchy mish-mash, jumping from topic to topic and continent to continent with the flip of a page, tracing the history of alcohol prohibition in the US at one turn, chatting up Japanese drug gangsters at the next, and getting hammered by ayahuasca in yet another. Vorobyov himself describes Dopeworld as "true crime, gonzo, social, historical memoir meets fucked up travel book."

Indeed. He relates his college-boy drug-dealing career with considerable panache. He parties with nihilistic middle-class young people and an opium-smoking cop in Tehran, he cops $7 grams of cocaine in Colombia and tours Pablo Escobar's house with the dead kingpin's brother as a tour guide, he has dinner with Joaquin "El Chapo" Guzman's family in Mexico's Sinaloa state and pronounces them nice people ("really chill"), and he meets up with a vigilante killer in Manila.

Vorobyov openly says the unsayable when it comes to writing about the drug war and drug prohibition: Drugs can be fun! While Loewenstein is pretty much all about the victims, Vorobyov inhabits the global drug culture. You know: Dopeworld. Loewenstein would bemoan the utter futility of a record-breaking seizure of a 12-ton load of cocaine; Vorobyov laments, "that's 12 tons of cocaine that will never be snorted."

Vorobyov is entertaining and sometimes laugh-out-loud funny, and he brings a former dope dealer's perspective to bear. He's brash and breezy, but like Loewenstein, he's done his homework as well as his journalistic fieldwork, and the result is fascinating. To begin to understand what the war on drugs has done to people and countries around the planet, this pair of books makes an essential introduction. And two gripping reads.

Dopeworld: Adventures in the Global Drug Trade by Niko Vorobyov (August 2020, St. Martin's Press, hardcover, 432 pp., $29.99)

Pills, Powder, and Smoke: Inside the Bloody War on Drugs by Antony Loewenstein (November 2019, Scribe, paperback, 368 pp., $19.00)

How to Legalize Ecstasy -- and Why [FEATURE]

Every weekend, hundreds of thousands of young club- and concert-goers buy and consume black market pills and powders they hope are MDMA, the methamphetamine relative with a psychedelic tinge known on the streets as Ecstasy or Molly. A tiny percentage of them -- a few dozen each year in the United States or Britain -- die. It doesn't have to be that way.

Ecstasy pills (Erowid.org)
Granted, those numbers are miniscule when compared with the tens of thousands who die each year in the US using opioids, benzos, and stimulants like cocaine and meth, much less from the legal substances alcohol and tobacco. But that relative handful of deaths could almost certainly be eliminated by bringing Ecstasy in from the cold -- making it legal and regulated instead of subjecting its users to black market Russian roulette.

And now somebody has a plan for that. The British Beckley Foundation, which has been advocating for research into psychoactive substance and evidence-based drug policy reform for the past two decades, has just released a new report, Roadmaps to Regulation: MDMA, that takes a good, hard look at the drug and charts a path to a saner, less harmful way of handling Ecstasy than just prohibiting it, which, the report notes, "has never meaningfully disrupted its supply, nor its widespread use."

That's because, despite it being illegal, for many, many people, Ecstasy is fun. And the Beckley report does something rare in the annals of drug policy wonkery: it acknowledges that. "Hundreds of thousands of people break the law to access its effects, which include increased energy, euphoria, and enhanced sociability," the report says.

The authors concede that Ecstasy is not a harmless substance, and take a detailed dive into acute, sub-acute, and chronic harms related to its use. They point to overheating (hyperthermia) and excess water intake (hypnoatraemia) as the cause of most Ecstasy deaths, and they examine the debate over neurotoxicity associated with the drug, very carefully pointing out that "there is evidence to suggest that heavy use of MDMA may contribute to temporary impairments in neuropsychological functions."

But they also point out that most of the problems with Ecstasy are artifacts of prohibition: "Our evidence shows that many harms associated with MDMA use arise from its unregulated status as an illegal drug, and that any risks inherent to MDMA could be more effectively mitigated within a legally regulated market," they write.

The most serious harmful effect of treating Ecstasy use and sales as a criminal matter is that users are forced into an unregulated, no-quality-control black market and they don't know what they're getting. Tablets have been found with as little as 20 milligrams of MDMA and as much as 300 milligrams. And much of what is sold as MDMA is actually adulterated with other substance, including some much more lethal ones, such as PMA (paramethoxyamphetamine) and PMMA (paramethoxymethamphetamine). This is how people die. As the authors note:

"The variability in MDMA potency and purity is a direct result of global and national prohibitionist policies. Recent developments around in situ drug safety testing are an attempt to mitigate the risks of such variability. These risks, such as overdose and/or poisoning, are by no means inevitable or inherent to the drug. If MDMA were clinically produced and legally distributed, users would be assured of the product content and appropriate dosage and be able to make more informed decisions regarding their MDMA use. In this way the principal risks we associate with MDMA use would be greatly reduced."

But the report also addresses a whole litany of other prohibition-related harms around Ecstasy that exacerbate the risks of its use. From making users less likely to seek medical help for fear of prosecution to making venues adopt "zero tolerance" policies that actually increase risks (such as drug dog searches that encourage users to take all their drugs at once before entering the venue) to the rejection of pill testing and other harm reduction measures, prohibition just makes matters worse.

In addition to harms exacerbated by prohibition, there are harms created by prohibition. These include "a lucrative illegal MDMA market that generates wealth for entrenched criminal organizations," the saddling of young users with criminal records, the risk that people who share or sell drugs among their friends could be charged as drug dealers, and the development of black markets for new psychoactive substances (NSPs), many of which are more dangerous than Ecstasy. Also not to be forgotten is the loss of decades of research opportunities into the therapeutic use of MDMA, research that was showing tremendous potential before the drug was prohibited in the mid-1980s.

Prohibition of Ecstasy is not only not working but is making matters worse. So what should we do instead? Beckley is very clear in its conclusions and recommendations. First, these preliminary steps:

  • Reschedule MDMA from Schedule I to Schedule II of the Controlled Substances Act (the Misuse of Drugs Regulations in Britain) in order to reduce barriers to research and to improve our understanding of its physiological effects.
  • "Decriminalize the possession of MDMA and all drugs to remove the devastating social and economic effects of being criminalized for drug possession or limited social supply."
  • Use decriminalization to comprehensively roll out drug safety testing (pill testing) and other proven harm reduction measures.

Once those preliminary steps are done, it's time to break big:

  • Award licenses to selected pharmaceutical manufacturers to produce MDMA under strict manufacturing requirements.
  • Allow licensed MDMA products to be sold at government licensed MDMA outlets. The report suggests pharmacies in the first instance.
  • For harm reduction purposes, retail outlet staff would need to be specially trained to educate users on the risks associated with MDMA.
  • Users who wish to purchase licensed MDMA products would be required to obtain a "personal license" to do so. Such a license would be granted after an interview with trained sales staff demonstrates that the would-be user understands the risks and how to reduce them.
  • Develop adults-only MDMA-friendly spaces where the risks associated with the drug can be combatted with the full panoply of harm reduction measures.
  • "User controls" to encourage responsible MDMA use. These would include "a strictly enforced age limit, pricing controls, mandated health information on packaging and at point of sale, childproof and tamperproof packaging, a comprehensive ban on marketing and advertising, and a campaign to minimize the social acceptability of driving under the influence of MDMA and to promote alternatives such as designated drivers."
  • "Sales of MDMA would be permitted to adults over 18 years of age. Prohibitive penalties would be in place to restrict underage sales."
  • Education campaigns focusing on MDMA safety and responsible use that would cover sales outlets and schools and universities. Such campaigns would include information about how to recognize and manage adverse events related to MDMA products.
  • Monitor and evaluate the impact of these changes to continue an evidence-based approach and allow feedback into policymaking.

There you have it, a step-by-step plan to break with prohibitionist orthodoxy and create a legal, regulated market for a popular recreational drug. Whether you or I agree with every plank of the plan, it is indeed a roadmap to reform. The evidence is there, a plan is there; now all we need is the political pressure to make it happen somewhere. It could be the United Kingdom, it could be the United States, it could be the Netherlands, but once somebody gets it done, the dam will begin to burst.

Chronicle AM: No CBD for Military Members, Hawaii Decriminalizes Pot Possession, More... (8/22/19)

The Defense Department makes it crystal clear that service members can't use CBD products, Hawaii's governor fails to veto a decriminalization bill -- thus allowing it to become law -- and more.

The drug czar's office has announced new moves against fentanyl. (Creative Commons)
Marijuana Policy

Hawaii Decriminalizes as Governor Fails to Veto Bill. A decriminalization bill passed earlier this year by the legislature became law on Tuesday without the signature of Gov. David Ige (D). Ige didn't sign the bill, but neither did he veto it, so now it has become law. The bill decriminalizes the possession of up three grams of marijuana with a fine of up to $130. The new law will go into effect on January 11, 2020.

Hemp

Defense Department Bars Service Members from Using Hemp-Derived CBD. The Defense Department is making crystal clear that members of the armed forces are not allowed to use cannibidiol (CBD). "It's completely forbidden for use by any service member in any of the services at this point of time," said Patricia Deuster, director of the Human Performance Laboratory at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

Heroin and Prescription Opioids

White House Announces Actions to Crack Down on Trafficking of Fentanyl and Synthetic Opioids. The Office of National Drug Control Policy (ONDCP -- the drug czar's office) announced Wednesday that it had sent a series of advisories to help domestic and foreign businesses protect themselves from being used to traffic illicit fentanyl and "foster deeper public-private collaboration to curb the production and sale of illicit fentanyl, fentanyl analogues, and other synthetic opioids." The advisories are focused on four facets of the trafficking of illicit fentanyl, fentanyl analogues, and synthetic opioids destined for the United States: manufacturing, marketing, movement and money. It also announced that it is "identifying two Chinese nationals and a China-based Drug Trafficking Organization as significant foreign narcotics traffickers pursuant to the Foreign Narcotics Kingpin Designation Act (Kingpin Act) and designated one associate and a China-based entity for being owned or controlled by one of the Chinese nationals."

DHS Considers Classifying Fentanyl as a Weapon of Mass Destruction [FEATURE]

The military affairs and news web site Task & Purpose has obtained an internal memo from the Department of Homeland Security (DHS) that shows the agency is considering designating the powerful synthetic opioid fentanyl as a weapon of mass destruction (WMD) "when certain criteria are met."

fentanyl (Creative Commons)
Typically produced in China and then smuggled through Mexico or sent directly to the US via package delivery services, fentanyl has been implicated in tens of thousands of drug overdose deaths in recent years. The drug is doubly dangerous because not only is it dozens of times stronger than heroin, it is all too often mixed in with other drugs so that consumers ingest it unwittingly.

The memo obtained by Task & Purpose was dated February 22, 2019 and titled "Use of counter-WMD authorities to combat fentanyl." It was prepared for then-DHS Secretary Kirstjen Nielsen by DHS Assistant Secretary for Countering Weapons of Mass Destruction James F. McConnell, who sketched the background of the drug and noted how some members of the federal government see it as a potential "mass casualty weapon."

McConnell is a long-time homeland security official who has led the Countering Weapons of Mass Destruction office since he was appointed by President Trump in May 2018.

"Fentanyl's high toxicity and increasing availability are attractive to threat actors seeking nonconventional materials for a chemical weapons attack," he wrote. "In July 2018, the FBI Weapons of Mass Destruction Directorate assessed that '...fentanyl is very likely a viable option for a chemical weapon attack by extremists or criminals'," he wrote.

But other parts of the memo suggest DHS is considering the move not only as part of a war on fentanyl but as a means of obtaining more funding for the agency's WMD activities. Indeed, funding for the counter-WMD program has declined under Trump, whose homeland security priorities are focused on the US-Mexico border, despite crime rates at the border being lower than in other parts of the country.

"[Counter-WMD] Office efforts will focus on quantities and configurations that could be used as mass casualty weapons," McDonnell wrote as he tried to sell the idea. "However, many activities, such as support to fentanyl interdiction and detection efforts, would tangentially benefit broader DHS and interagency counter-opioid efforts. Within the past couple years, there has been a reinvigorated interest in addressing fentanyl and its analogues as WMD materials due to the ongoing opioid crisis," he added.

The Counter-WMD office could help in the fight against fentanyl by developing and managing new technologies, deploying sensors, and helping other agencies in the field, McDonnell told Nielsen. He also claimed that senior Defense Department leaders "had proposed formally designating fentanyl as a WMD material."

Neither the Defense Department nor DHS would comment to Task & Purpose on the report, but members of the counter-WMD community contacted by the web site reacted with bemusement and skepticism.

Fentanyl as a WMD is a "fringe scenario," chemical, biological, radiological, and nuclear defense expert Dan Kaszeta reacted. There are "literally dozens" of toxic chemicals that could be easily weaponized, he said.

"This is like declaring ecstasy as a WMD," said another member of the Defense Department's counter-WMD team speaking on condition of anonymity.

"It reads like somebody is laying the administrative background for trying to tap into pots of money for detecting WMD and decontaminating WMD," Kaszeta told Task & Purpose. "It's an interdepartmental play for money, that's all it is."

But McConnell is planning to move ahead. In the memo, he said his office would continue to brief DHS on fentanyl-related counter-WMD efforts and would schedule an interagency planning event on fentanyl.

An unnamed senior Defense official told Task & Purpose that while such a meeting was probably "a good idea," it was far more likely that someone seeking a chemical WMD would instead turn to sarin or mustard gas. "Anybody with a college level degree in chemistry can manufacture chemical weapons agents," he said.

"I cannot see any scenario where a nation-state would use fentanyl on the battlefield, or for that matter, a terrorist using a really toxic chemical like fentanyl in an attack when they could just sell it for funding the purchase of firearms and explosives or steal an industrial chemical instead," the official added.

In that light, McConnell's memo appears more as a cynical bureaucratic exercise aimed at increasing program budgets rather than a serious effort to address homeland security.

What's Killing Us: The Ten Drugs Most Implicated in Overdose Deaths [FEATURE]

While there are signs that the country's drug overdose crisis may have plateaued, the number of people dying from drug overdoses continues to be unconscionably high. Shockingly, the number of overdose deaths has increased tenfold since 1980 when there were only 6,000 nationwide and nearly doubled just in the past decade to more than 72,000 last year.

The number of drug overdose deaths remains unconscionably high.
Now, in a new report, the Centers for Disease Control and Prevention (CDC) sheds some new light on precisely which drugs are most implicated in these deaths. While the report examines overdose deaths from 2011 to 2016, we're going to zero in on the 2016 data to get as close as possible to the present.

Three drug classes are involved: prescription and non-prescription opioids, benzodiazepines, and stimulants. Often, fatal overdoses involve more than one drug, whether it is drugs in the same class (heroin and fentanyl) or combinations of drug classes (heroin and benzos or fentanyl and cocaine.

Before we get into the number-crunching, it's worth taking a moment to consider that each single overdose death is a tragedy. A human life has been lost prematurely, the potential snuffed out, and friends and family members suffer greatly. It doesn't have to be that way. While we're going to look at deadly drugs, it behooves us to remember that many of these deaths are a function not just of the drugs themselves, but of drug prohibition.

People overdose on fentanyl, for example, because in a black market there is no packaging, no quality control, no dosage information to inform them of just how powerful is that powder they're snorting or injecting. Added to heroin or crafted into counterfeit prescription opioids by unscrupulous black market operators, fentanyl kills people who didn't even know they were taking it. Even more insidiously, fentanyl is turning up in black market cocaine and methamphetamine, whose users aren't even looking for an opioid high and haven't developed any tolerance to them (although some may be speedballing, that is, taking both an upper and a downer at the same time.

That said, here are the drugs making the greatest contributions to the 63,352 overdose deaths in 2016. (The numbers add up to more than that figure because in some overdoses, more than one drug is mentioned.)

1. Fentanyl -- 18,335

In 2016, fentanyl vaulted into first place in the deadly drug sweepstakes. As recently as 2011, the synthetic opioid was in 10th place, with some 1,660 overdose deaths attributed to it, but the death toll has increased more than tenfold in just five years. More than two-thirds of fentanyl overdose deaths also involved other drugs, and fentanyl is involved in more than a quarter (28.5 percent) of all overdose deaths, including 40 percent of cocaine overdose deaths and nearly a third (32 percent) of heroin deaths.

2. Heroin -- 15,961

At the tail end of the prescription opioid phase of the current overdose crisis in 2011, more people died from oxycodone than heroin, but between 2012 and 2015, heroin resumed its role as the leading opioid linked to fatal overdoses, only to be overtaken by fentanyl in 2016. The vast majority -- 70 percent -- of people who died from heroin were also using other drugs. More than a third were also using fentanyl, while nearly a quarter (23.8 percent) were also using cocaine. As prescription opioids became more difficult to obtain, the number of people dying from heroin skyrocketed, nearly tripling in the five years ending in 2016.

3. Cocaine -- 11,316

Cocaine deaths rose dramatically beginning in 2015 and by 2016 the annual death toll was double what it had been five years earlier. With bumper crops in Colombia in recent years, cocaine is cheap and plentiful. It is also increasingly being cut with fentanyl, which is implicated in 40 percent of cocaine deaths, and mixed with heroin, which is implicated in a third of them. Cocaine is named in 17.8 percent of all overdose deaths.

4. Methamphetamine -- 6,762

Meth-related overdose deaths tripled between 2011 and 2016, a dramatic increase in what has become America's forgotten drug problem. In 2016, slightly more than one out of ten drug overdose deaths involved meth. Of the top ten overdose drugs, meth is by far the one most likely to have been the sole drug implicated in the death, but even so, fentanyl was implicated in one out five meth deaths and heroin in one out of ten.

5. Alprazolam -- 6,209You know it as Xanax. This short-acting benzodiazepine is a favorite of stimulant users seeking to take the edge off, but also often forms part of a sedative cocktail with opioids or other benzos. About three-quarters of Xanax overdose deaths involve other drugs, with fentanyl, heroin, and oxycodone each involved in about one-quarter of Xanax deaths. Xanax deaths increased by about 50 percent over the five year period.

6. Oxycodone -- 6,199

It's most infamous formulation is OxyContin, but it is also sold as Roxicodone, Xtampza ER, and Oxaydo. It may have been the primary killer opioid a decade ago, but has chugged along at around 5,000 deaths a year before going over 6,000 in 2016. Four out of five people who overdose on oxycodone were also using another drug, most often Xanax (25.3 percent), followed by fentanyl (18.6 percent).

7. Morphine -- 5,014

The granddaddy of opioids. Morphine deaths increased slowly beginning in 2011, but have still increased by about 40 percent since then. More than eight out of 10 morphine deaths involve other drugs as well, particularly fentanyl, which is involved in one out three morphine deaths. Cocaine (16.9 percent) and heroin (13.7 percent) are also frequent contributors to morphine ODs.

8. Methadone -- 3,493

Prescribed as an opioid maintenance drug, methadone is one of the few drugs on this list to have seen the number of deaths decline between 2011 and 2016. They've dropped from more than 4,500 a year down to less than 3,500, a drop of roughly a quarter. Nearly three-fourths of all methadone deaths implicate other drugs, with Xanax being most common (21.5 percent), followed by fentanyl (15.1) and heroin (13.8).

9. Hydrocodone -- 3,199

This semi-synthetic opioid is sold under a variety of brand names, including Vicodin and Norco, and has proven remarkably stable in its overdose numbers. Between 2011 and 2016, it never killed fewer than 3,000 or more than 4,000, almost always (85 percent of the time) in concert with other drugs. Xanax was implicated in one-quarter of all hydrocodone overdoses, followed by oxycodone (17.2 percent) and fentanyl (14.9 percent).

10. Diazepam -- 2,022

The most well-known diazepam is Valium. Like Xanax, this anti-anxiety drug can be used to take the edge off a stimulant binge, but it's not coke heads and speed freaks who are dying from it. In more than nine out of 10 fatal Valium overdoses, other drugs are involved, most commonly the opioids oxycodone and fentanyl, each implicated in about a quarter of the deaths, and heroin, implicated in a fifth.

Using these drugs is dangerous. Using them under a prohibition regime is even more so. Users don't always know what they're getting, and that lack of knowledge can be fatal. If you're going to be messing with these substances, be extremely cautious. Try a test dose first. And don't do it alone. Stay safe out there.

This article was produced by Drug Reporter, a project of the Independent Media Institute.

Study: Crackdowns on Heroin, Pain Pills Gave Rise to Fentanyl Overdose Epidemic [FEATURE]

A new report on illicit US drug markets from researchers at the University of San Francisco has found that that the spread of fentanyl, a powerful synthetic opioid implicated in nearly 29,000 overdose deaths last year alone, is tied to enforcement-driven shortages of heroin and prescription opioids, as well simple economics for drug distributors -- not because users particularly desire the drug.

meet the law of unintended consequences (Creative Commons)
Illicit fentanyl has swept through American drug markets in waves -- the super strong "China white" heroin of the 1970s was actually a heroin-fentanyl mixture -- most recently in the past decade after rising levels of opioid addiction and the spread of "pill mills" prompted multifaceted moves to restrict opioid prescribing.

From a drug distributor's perspective, fentanyl is a most excellent substitute for heroin or prescription pain pills. Produced entirely in labs or chemical factories, it is far more powerful and cheaper to produce than heroin. Because it's more potent, it is easier to smuggle -- often coming into the US via postal and delivery service parcels, not by the semi load. And it doesn't require months of growing time and period of intense peasant labor in lawless regions of weak states.

Fentanyl is typically sold deceptively -- marketed as heroin or prescription drugs such as OxyContin or Xanax -- and users and street-level dealers often don't even know that the drugs they are using or selling contain fentanyl, the researchers found. Fentanyl is making its way into the supply chain at the wholesale, not the retail level. That, the researchers said, suggests that demand is not the key driver in the drug's spread.

"Fentanyl is rarely sold as fentanyl," said Sarah Mars, PhD, a researcher in the Department of Family and Community Medicine at UCSF. "The dealers selling fentanyl directly to the users often don't know what's in it. Not only is this particularly dangerous, but it also means penalizing low-level dealers isn't going to make any difference in the fentanyl poisoning epidemic."

According to Mars, users are split on fentanyl, which produces a more sudden and powerful high than heroin, but one that fades faster. Some said fentanyl brought back the euphoria they had lost the ability to feel with long-term heroin use, but others said they feared fentanyl and found its effects too harsh.

"Whether or not they prefer fentanyl, users don't have any influence over what drugs are being sold," Mars said. "Without accurate information about these drugs, they can't make an informed choice about what they are buying. Also, very little drug slang has developed to describe fentanyl, which lends support to the notion that this is not a demand-driven epidemic."

The presence of drugs adulterated with fentanyl is uneven, Mars said.

"Most of the illicit fentanyl has been in the Northeast and Midwest," she specified. And that's where opioid overdose death rates are the highest.

Another contributing factor to the fentanyl overdose toll is that it has dozens of analogs with wildly varying potency. Some, like carfentanil, are amazingly powerful, as much as 10,000 times as potent as morphine. Some are so new they have not yet been made illegal.

"We believe it's the fluctuation in the potency of the drugs containing fentanyl that makes them so dangerous," said Daniel Ciccarone, MD, MPH, a professor of family and community medicine at UCSF and senior author of an ongoing National Institutes of Health-funded study, Heroin in Transition. "You might have one dose that had hardly any fentanyl in it or none at all. Then, you might have one with a different fentanyl analog, of different potency, or even mixtures of multiple fentanyls and heroin."

Here is the paradox of drug prohibition: Trying to crack down on drugs tends to lead not to less drug use but to more dangerous drugs, and in the case of opioids, tens of thousands of dead drug users. There is an inexorable logic at play: The more law enforcement comes down on a drug, the greater the tendency for suppliers to make it more potent and compact -- and dangerous.

Perhaps that's why we now see mainstream calls for a radically different approach, such as the one from Washington Post columnist Megan McArdle earlier this week. In her column "The Incredibly Unpopular Idea That Could Stem Heroin Deaths," McArdle argues that current drug policy is only running up the overdose death toll and that we need "to start talking about ways to make safe, reliable doses of opiates available to addicts who aren't ready to stop."

That would involve increasing access to opioid substitutes such as methadone and buprenorphine, "but lowering the death toll may require a more drastic step: legalizing prescriptions of stronger opiates," McArdle writes.

"Prescription heroin?" she continues. "Remember, I said you might not like the solution. I don't like it, either -- and frankly, neither do the drug policy researchers who told me it may be necessary. But when fentanyl took over the US illicit drug markets, it also got a lot of addicts as hostages. We'll never be able to rescue them unless we can first keep them alive long enough to be saved."

There is a better way to deal with the opioid crisis than relegating tens of thousands of American opioid users to early, preventable deaths. We know what it is. Now it's a matter of implementing smarter, more humane policies, and that's an ongoing political struggle -- one where lives are literally at stake.

Chronicle AM: Denver to Expunge Pot Convictions, Columnist Calls for Prescription Heroin, More... (12/5/18)

 A Washington Post columnist calls for prescription heroin, the federal hemp bill will apparently ban the participation of people with drug felonies, Denver joins the movement to expunge old pot convictions, and more.

Prescription heroin--Washington Post columnist suggests it could save lives in the face of fentanyl. (Creative Commons)
Marijuana Policy

Denver Becomes Latest City to Expunge Low-Level Marijuana Offenses. Mayor Michael Hancock announced Tuesday that his administration will "move to vacate low-level marijuana convictions for Denver residents." The move comes after months of preliminary work by the Office of Marijuana Policy and the City Attorney's Office. "For too long, the lives of low-income residents and those living in our communities of color have been negatively affected by low-level marijuana convictions," Hancock said in a press release. "This is an injustice that needs to be corrected, and we are going to provide a pathway to move on from an era of marijuana prohibition that has impacted the lives of thousands of people."

Industrial Hemp

Federal Bill to Legalize Hemp Bans Drug Felons from Participating. Congressional negotiators have agreed on compromise language for the hemp provision of the farm bill that would ban people with felony drug convictions from participating in the hemp industry. The ban was inserted into the Senate version of the bill late in the process and over the objections of drug policy reformers. It's not quite a done deal—the language could be changed in conference committee—but at this point, it looks like the ban is in.

Heroin and Prescription Opioids

Washington Post Columnist Calls for Prescription Heroin. In a piece published Tuesday, Washington Post columnist Megan McArdle has called for access to prescription heroin in a bid to prevent fentanyl-related overdose deaths. In the column titled An Incredibly Unpopular Idea That Could Stem Heroin Deaths, McArdle notes that "most people don't want addiction made safer or easier; they want it stopped, cold…but you don’t free slaves by killing them, and as long as fentanyl suffuses the illicit drug markets, that’s what a 'tough love' policy amounts to." Harm reduction measures and increased access to treatment would help, McArdle writes, but "lowering the death toll may well require a more drastic step: legalizing prescriptions of stronger opiates. Prescription heroin? Remember, I said you might not like the solution. I don’t like it, either — and frankly, neither do the drug policy researchers who told me it may be necessary. But when fentanyl took over the U.S. illicit drug markets, it also got a lot of addicts as hostages. We’ll never be able to rescue them unless we can first keep them alive long enough to be saved."

Asset Forfeiture

Nashville Bends to Police Pressure, Extends Federal "Equitable Sharing" Program. Under pressure from local law enforcement and seeking to avoid raising taxes, the Nashville Metro Council voted 25-5 to renew its participation in the federal asset forfeiture equitable sharing program, which allows state and local law enforcement agencies to divert drug-related cash seizures to the federal government, which in turn returns 80% of the booty back to the seizing agency. 

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