Public Health

RSS Feed for this category

Chronicle AM: Yang on Safe Injection Sites, Bloomberg on Marijuana, More... (12/5/19)

Michigan pot shops see high demand on opening day, Democratic contenders stake out drug policy positions, Maine finally has all pot business applications ready, and more.

Andrew Yang wants to decriminalize opiates and fund safe injection sites like this one in Vancouver. (vch.ca)

Marijuana Policy

Michael Bloomberg Backs Decriminalization as Marijuana Views Evolve Amid Presidential Run. Faced with criticism over his past positions on marijuana, former New York City mayor and Democratic presidential contender Michael Bloomberg has now come out in support of decriminalization, which still leaves him lagging behind most of the Democratic pack. "He believes no one should have their life ruined by getting arrested for possession, and, as a part of his reform efforts that drove incarceration down by 40 percent, he worked to get New York State laws changed to end low-level possession arrests," a spokesman said. "He believes in decriminalization and doesn’t believe the federal government should interfere with states that have already legalized."

Maine Says All Marijuana Licenses are Now Available. More than three years after voters legalized marijuana, the state has finally made available all applications for marijuana cultivation, products manufacturing and retail facilities. That means the state could see pot shops open by the spring.

Michigan Pot Shops Forced to Impose Purchase Limits as Demand Overwhelms. High customer volume is forcing marijuana retailers to limit purchases so there will be enough weed to go around. The four shops that opened Sunday saw combined sales of $221,000 that first day. Each of the four shops has had to turn customers away, too. Some customers waited as long as four hours to get inside.

Medical Marijuana

Florida Senator Introduces Bill Providing Broad Employment Protections to Medical Marijuana Users. A bill recently introduced by state Sen. Lori Berman (D) Would provide various protections to job applicants and employees who use medical marijuana. The measure is Senate Bill 962.

Harm Reduction

Andrew Yang Calls for Investments in Safe Injection Sites. Entrepreneur and Democratic presidential contender Andrew Yang says he supports government funding for safe injections sites as part of an effort to counter the country's overdose epidemic. "I would not only decriminalize opiates for personal use but I would also invest in safe consumption sites around the country," Yang said Thursday.

(This article was prepared by StoptheDrugWar.org's 501(c)(4) lobbying nonprofit, the Drug Reform Coordination Network, which also pays the cost of maintaining this website. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

CO Pot Sales Declining for Months, Biden Orders More Colombia Drug War, More... (8/11/22)

An Ohio harm reduction group is suing a state board over how $400 million in opioid settlement money is spent, an Uruguayan meth bust signals a possible shift in drug trafficking between Europe and South America, and more.

Joe Biden and new Colombian President Petro are not on the same page when it comes to drug policy. (Creative Commons)
Marijuana Policy

Colorado Marijuana Sales Decline for Fourth Straight Month. For the fourth month in a row, marijuana sales in Colorado have declined. Sales in June were just $146 million, a 1% decline from the previous month, but a 22 percent decline from June 2021. So far this year, pot shops sold more than $906 million worth of weed, down from $1.1 billion during the same period last year. This is not the first time there has been a four-month decline in sales; it also happened between August and November 2020. The state has collected more than $30 million in sales tax revenues in only two months so far this year. It collected more than $30 million every month last year.

Opioids

Ohio Harm Reduction Group Sues State Board Over Opioid Settlement Money. Harm Reduction Ohio has filed a lawsuit against a foundation set up by the state to spend more than $400 million that it won in settlements with opioid makers and distributors for drug treatment programs. The lawsuit demands that the foundation, the OneOhio Recovery Foundation, be more transparent about how it will spend that money. The state received $808 million in settlements, and the OneOhio Recovery Foundation gets half (the rest goes to state and local governments). Harm Reduction Ohio President Dennis Cauchon said the foundation's board is not following the state's open meetings law, and that could lead to future problems. "I say preschedule the indictments because in year eleven, if you’ve got $100 million to spend in a year, don’t have to follow ethics law, you can spend on whatever you want,"Cauchon said. "It’s a formula for cronyism written all over it." Cauchon also cited the board's makeup, which consists of appointees of Gov. Mike DeWine  (R), state lawmakers, and local government leaders, saying it’s important to include people with treatment and recovery program experience. "The combination of people in this case needs to include people who have suffered from opioids, the reason this money exists, and they have essentially been excluded entirely,"Cauchon said. "If you don’t know the population and you don’t know the issue, you can’t spend a half billion dollars wisely."

Foreign Policy

Biden Orders Continuation of Colombian Drug Interdiction Assistance. President Joe Biden has issued a memo directing the State and Defense departments to continue assisting Colombia to interdict aircraft "reasonably suspected to be primarily engaged in illicit drug trafficking in that country’s airspace," given the "extraordinary threat posed by illicit drug trafficking to the national security of that country." The president noted that Colombia "has appropriate procedures in place to protect against innocent loss of life in the air and on the ground in connection with such interdiction," and which includes "effective means to identify and warn an aircraft before the use of force is directed against the aircraft." The memo was issued Wednesday, just three days after Colombian President Gustavo Petro was sworn-in. Petro has called the US-led war on drugs "a complete failure and has pledged to maintain a ban on spraying coca crops with the herbicide glyphosate, putting the two countries at odds around drug policy.

International

Uruguay Makes Historic Seizure of European Meth. Uruguayan authorities seized 43 kilograms of methamphetamine on August 5 in what is believed to be the largest-ever shipment of European meth to reach Latin America. It is a bust that marks a potential shift in the trade in synthetic drugs between the two continents. Underground labs in Europe have traditionally shipped MDMA to Latin America (among other markets), while Europe has imported cocaine and methamphetamine from Latin America. But Mexican chemists may have accompanied Mexican meth going to Europe and shared their manufacturing skills with underground chemists there. Europe's meth production is still small compared to the mountains of meth produced in Mexico, but it is now competing in South American markets. And because of high prices for European meth, it is likely it is being traded for cocaine destined for Europe. 

Cheaper and More Accessible Naloxone In the Works, Colombian Drug War Critic is Now President, More... (8/8/22)

A Congressional Research Service report zeroes in on the Jalisco New Generation Cartel, the Remedy Alliance is easing naloxone bottlenecks, and more.

Colombian President Gustavo Petro (Creative Commons)
Harm Reduction

Naloxone Access About to Get Easier. Thanks to an informal buyers' club for naloxone that has morphed into an entity known as the Remedy Alliance, access to inexpensive naloxone -- the opioid overdose reversal drug -- is getting easier. The Alliance credits two major developments for the urgently needed breakthrough. First, they have managed to reach agreements with drug manufacturers to get the drug at a discount rate, and second, they have restructured to a system that allows local harm reduction groups to order the drug through an online store, getting around a labyrinthine web of federal regulations that has bottlenecked the flow of the drug amidst the ongoing overdose crisis.

"We think this will totally change the landscape of naloxone in the United States,: said Nabarun Dasgupta, the nonprofit's board president and a scientist at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. The group, formerly known as the Opioid Safety and Naloxone Network Buyers Club, has already reversed thousands of opioid overdoses and distributed 1.3 million doses of naloxone last year. Now, the Alliance expects to distribute 2 million doses this year.

International

Ex-Leftist Rebel, Drug War Critic Assumes Office as Colombia's President. Gustavo Petro, a former member of the leftist M-19 guerrilla army, was sworn into office Sunday, helping to cement an emerging leftist bloc around the region, consisting of Bolivia, Chile, Mexico, Peru, Venezuela and, most likely, Brazil after its October election. He said Colombia was getting a "second chance" to fight violence and poverty. He also said he was preparing to start peace talks with various armed groups around the country, and he called on the United States to change its prohibitionist approach to drug policy. "It's time for a new international convention that accepts that the war on drugs has failed," he said. "Of course, peace is possible. But it depends on current drug policies being substituted with strong measures that prevent consumption in developed societies."

Jalisco New Generation Cartel Present in 27 of Mexico's 37 States, Congressional Report Finds. The Jalisco New Generation Cartel (CJNG), the country's most powerful, now operates in 27 states and Mexico City, according to a new report from the Congressional Research Service (CRS). The report, "Mexico: Organized Crime and Drug Trafficking Organizations," says that the CJNG is the dominant criminal force in six states: Jalisco, Nayarit, Colima, Guerrero, Mexico, and Veracruz. It is weakest in Mexico's northwest, where the Sinaloa Cartel still dominates. CRS described the CJNG as an "extremely powerful cartel" that has a "reputations for extreme and intimidating violence." It also noted that the DEA "considers the CJNG a top US threat and Mexico's best-armed criminal group." "The CJNG built its dominance internationally first through extending its presence through a rapid expansion inside Mexico," CRS said. "In 2016, many analysts maintained the CJNG controlled a territory equivalent to almost half of Mexico. The group has battled Los Zetas and Gulf Cartel factions in Tabasco, Veracruz, and Guanajuato, as well as the Sinaloa… [Cartel] in the Baja Peninsula and Chihuahua." The CJNG's ambitious expansion campaign was characterized by high levels of violence, particularly in Ciudad Juárez and Tijuana.

By taking over key ports on both the Atlantic and Pacific coasts, the CJNG has consolidated "important components of the global narcotics supply chain," the CRS said. "In particular, the CJNG maintains reported control over the ports of Veracruz, Manzanillo, and Lázaro Cárdenas, which has given the group access to precursor chemicals that flow into Mexico from China and other parts of Latin America," the report said. As a result, according to some analysts, the CJNG has pursued an aggressive growth strategy underwritten by US demand for Mexican methamphetamine, heroin, and fentanyl… Despite leadership losses, the CJNG has extended its geographic reach and maintained its own cohesion while exploiting the infighting among factions of the Sinaloa organization."

Chronicle Book Review: American Cartel

American Cartel: Inside the Battle to Bring Down the Opioid Industry, by Scott Higham and Sari Horwitz (2022, Twelve Press, 400 pp., $30.00 HB)

Phillip S. Smith, with contributions from David Borden

https://stopthedrugwar.org/files/americancartel.jpg
Pulitzer Prize-winning Washington Post investigative reporters Scott Higham and Sari Horwitz have been on the opioid beat for years, teaming up (with others) on the Post's "The Opioid Files" series, which was nominated for a Pulitzer in 2020. Now, with American Cartel, the pair provide a deeply-sourced account of how opioid manufacturers, distributors, and pharmacies waged an all-out campaign to fend off DEA efforts to stanch the flow of billions of opioid pain pills, and to evade any culpability, even as the overdose death toll mounted year by year.

The picture Higham and Horwitz paint of corporate and political malfeasance is damning. But the laser sharp focus with which they paint it, omits much of the context in which the opioid crisis has unfolded. And that context is also very important.

An article in yesterday's Guardian shows one of the reasons why. In much of the world, very few pain patients are able to access opioids at all. Much suffering results, sometimes leading to suicide attempts. Dr. MR Rajagopal, chair of Pallium India, told the Guardian, "Pain is not visible. It happens in hospital beds or patients' rooms and is not visible to the world. Addiction, on the other hand, is very visible in headlines which quote the US epidemic and overdose deaths. No one talks about the western European success over decades; all the news is about the opioid crisis in the USA. This means that when we try to have discussions, our work becomes harder because many minds are primed against opioids."

In other words, by speaking too solely to one side of an issue, one risks adversely impacting the other sides. Whether "opiophobia" is real or significant in the US is another question. Higham and Horwitz don't venture a view on this, at least not in American Cartel.

One entity that has warned about opiophobia (without using the term) is the US Centers for Disease Control. In a 2019 memo, CDC writes that a 2016 guidance the agency issued on prescribing opioids for chronic pain had seen "misapplication[s]" by some physicians that put patients at risk. The memo cites a New England Journal of Medicine commentary by the authors of the 2016 guidance. It warns against "hard limits" on opioid dosages or cutting patients off; abrupt tapering of prescriptions; applying the guidance to acute pain situations patients face in situations like active treatment for cancer or sickle cell anemia or post-operative care; and applying it to medication-assisted treatment prescriptions for addiction.

Technically the CDC memo addressed a period of a few years beginning in 2016. But the dynamics it describes are inherent risks in a situation where providers are charged with supplying a substance that's useful but also addictive and potentially deadly if misused, and for which they can be sanctioned professionally or even prosecuted and imprisoned if things go wrong or someone disagrees. Pharma-driven promotion of their new opioid products was a factor in driving up prescribing rates to where they reached. But a part of the increase was also the medical community reacting to a real problem of under-treatment or non-treatment of pain for some patients, a problem that coexists with over-prescribing to some other patients. That increase in turn came with a learning curve.

The authors also give short shrift to the impact of today's woes and inequalities in driving the so-called deaths of despair -- a concept coined by Princeton professors Anne Case and Angus Deaton -- alienation and anomie, helplessness and hopelessness afflicting many Americans who have been left behind in the modern economy, especially in the opioid use heartlands of the Midwest and Appalachia. The Midwest deindustrialized beginning in the 1970s, and both regions largely missed out on the tech boom of the '90s and '00s. Then came even more pain with the Great Recession, followed by COVID and more economic and social disruption. People there (and elsewhere) are dying not just of opioids, but of smoking, drinking, and suicide. Big Pharma is easily (and oh so deservingly) demonized, but the laser focus on the companies allows us not to have to look in the mirror about the pain our society produces.

That factors like these should play a role in the opioid crisis, though, doesn't exonerate Big Pharma. Rather, the misleading promotions of their products carried out by pharma, took an even greater toll due to the vulnerabilities those other factors had brought to the fore.

Meanwhile, the death toll continues to mount -- over 100,000 per year, and with a new record high every year. Prescription opioids still figure prominently in overdoses. But the greatest part of the problem by far is black-market fentanyl, used deliberately by some high tolerance heavy users of opioids, but primariy causing overdose as an adulterant in heroin, counterfeit prescription pills, and other street drugs, essentially a poisoning crisis. But as Higham and Horwitz note, that is part of a wave of opioid use that began with pharmaceutical companies such as Purdue Pharma taking Oxycontin onto the market in the late 1990s. The first decade of this century also saw other prescription opioids -- oxycodone, hydrocodone, Vicodin, Percocet, Opana, et al. -- hit the market.

Higham and Horwitz are fond of tossing around astounding numbers of pills produced by manufacturers or sold by certain pharmacies, such as Mallinckrodt producing 3.5 billion 30 milligram hydrocodone pills in one year, and critics could protest that those numbers need context, too. A prescription for a medication doesn't just have a number of pills to take. It specifies how large a dosage there is inside each pill. A smaller number of pills that each contain a higher dose might mean more than a larger number that each contain a smaller dose. And a higher dose prescription sometimes reflects a patient's tolerance to opioids built up through past medical (or non-medical) use. Maybe West Virginia didn't really need 81 million pain pills during a five-year span. But maybe it did. Without more information, it's just not clear what these numbers mean.

They do provide some context, though, for example by comparing pain pill sales across all drug stores in a region and pointing out anomalies not easily explainable by, say, differing rates of cancer or other serious illness. And they demonstrate that plenty of businesses -- from Big Pharma to the drug store chains and individual pharmacies -- were either in it for the money or at best screwed up, both through detailed analysis and telling anecdote. For example, there was the guileless Florida pharmacist who explains to investigators that she fills pain pill prescriptions all day long, but always keeps a certain number of pills on reserve "for my real pain patients."

When the DEA cracked down first on Wild West internet sales of opioids and then on the "pill mills," medical practices with perfunctory examinations and huge numbers of opioid prescriptions whose entire business model seemed to be writing opioid prescriptions, it succeeded in reducing access to those drugs. But the people using opioids didn't stop; they went to black market drugs, fueling first a resurgence in heroin use and now an opioid crisis driven by fentanyl.

A key figure in the tale is Joe Rannazzisi, who as head of DEA's Office of Diversion Control from 2006 to 2015 oversaw the agency's endless effort to ensure that prescribed opioids are only prescribed for legitimate medical purposes and not leaking into the black market. We are inclined to think of the DEA as a prohibitionist agency, but in this case, it is acting as a regulatory agency. And what Higham and Horwitz uncover is a case of regulatory capture -- when the industry being regulated manages to set the terms under which it is regulated, for its own benefit, not that of the public.

Rannazzisi and his team of DEA lawyers spent years going after opioid manufacturers, distributors, and pharmacy chains who were repeatedly (administratively) busted for failing to do due diligence about just who was buying their products. The companies would pay huge fines, promise not to do it again, and then continue to pump massive amounts of opioids through the supply chain.

The companies mobilized against Rannazzissi and his campaign, forming industry front groups, undertaking lobbying efforts, hiring legions of high-priced law firms, and crafting legislation that would rein in what they saw as an out-of-control agency. As Higham and Horwitz document in great detail, it worked.

Sponsored by Rep. Tom Marino (R-PA) and Sen. Marsha Blackburn (R-TN), both of whom received substantial contributions from the industry, but written by industry lobbyists, the nicely named Ensuring Patient Access and Effective Drug Enforcement Act removed from the DEA tools that Ranizzisi had been using to try to force drug distributors to monitor and report suspicious orders, such as the 1.2 million oxycodone tablets one distributor bought from Mallinckrodt in one day, only to order another 1.2 million the next day.

The bill passed, only to be drastically revised amidst scandal after an earlier Post report on the opioid bill derailed then-President Trump's effort to name Marino drug czar. But Higham and Horwitz also detail rot inside the DEA, where the industry managed to get to high-ranking officials who sidelined Rannazzisi, forcing him into retirement and forcing many of his team members into bureaucratic Siberia. It's an ugly little story of money and power, the sort that is all too common in Washington.

If the first part of American Cartel reads like a detective novel, the second part is more like a legal thriller, It covers the massive wave of civil lawsuits filed against the drug companies, and it is not particularly edifying reading. You see hundreds of high-powered attorneys from the country's top litigating firms -- including dozens of former DEA attorneys working now working for the industry they regulated -- facing off against armies of lawyers for the thousands of states, cities, and counties. You see massive settlements from the companies and massive damages wrested from companies that went to court and lost. While it is unclear just how the moneys won or negotiated by the various plaintiffs is actually being used to help people who suffered from the opioid crisis, what is clear is that it has been a bonanza for the legal profession, with winnings -- excuse me, earnings -- by attorneys reaching well over a billion dollars.

They weren't all in it for the money, though. Some, like West Virginia attorney Paul Farrell, whose state was one of the epicenters of the pain pill epidemic, were sickened by the toll of addiction they saw all around them. Not willing to settle for the pittance the town and county he represented would receive under a massive settlement agreed to by most of the suing entities, he gambled on going it alone against the drug distributors. As this book went to print in April, he was still waiting for a decision. Earlier this month, he lost, with a federal judge ruling that drug distributors were not responsible for the area's opioid crisis.

The litigation goes on, and the dying goes on. Sometimes the drug companies settle, sometimes they lose and have to pay even more. But sometimes they win.

The profit-driven wave of opioids that engulfed the country in the last couple of decades is not an anomaly. The pharmaceutical companies have a historical pattern of creating and marketing drugs that later wreak havoc. That's what they did with amphetamines, that's what they did with barbiturates, that's what they did with benzodiazepines. It's almost enough to make one wonder if profit-driven capitalist enterprises should be in charge of the nation's drug supply.

Read Higham and Horwitz's book. But read Case and Deaton's too. And when you see the next "pill mill" story, don't assume that it is, or isn't, what it seems.

California is One Signature Away from Okaying Safe Injection Sites [FEATURE]

The nation's most populous state is on the verge of approving safe injection sites in some of its largest cities. A bill that would do just that, Senate Bill 57, narrowly won its final vote in the legislature Monday, and Gov. Gavin Newsom (D) has previously signaled that he was "very open" to the law.

Vancouver's InSite safe injection site. Such facilities could be coming soon to some California cities. (vch.ca)
The bill authored by Sen. Scott Wiener (D-San Francisco) authorizes what it calls "overdose prevention programs" (or safe injection sites) as pilot programs in San Francisco, Oakland, the city of Los Angeles, and Los Angeles County. In each of those jurisdictions, city councils or boards of supervisors have requested inclusion in the bill and will decide whether and how to participate. The pilot program will run for five years, through January 1, 2028.

The legality of safe injection sites under federal law remains unclear. During the Trump administration, the Justice Department strongly opposed them and successfully blocked an effort to open one in Philadelphia, but the Biden administration Justice Department has expressed openness to the harm reduction intervention.

That uncertainty did not stop New York City from opening the first government-approved safe injection sites last November or Rhode Island passing legislation and following suit in March, although the Rhode Island sites are being hobbled by a lack of funding after legislators mandated that no government funds be used to operate them. And that uncertainty has not deterred lawmakers in Sacramento, either.

The California bill overcame extensive pushback, primarily from law enforcement, which argued that the sites failed to provide a strong enough path to drug treatment. Similar objections killed three previous attempts to pass safe injection site legislation by Sen. Susan Eggman (D-Stockton), including a 2018 bill that passed the legislature only to be vetoed by then-Gov. Jerry Brown (D).

It was supported by a broad coalition of organizations including the Drug Policy Alliance, San Francisco AIDS Foundation, California Society of Addiction Medicine, National Harm Reduction Coalition, Healthright 360, Tarzana Treatment Center, and the California Association of Alcohol & Drug Program Executives.

Support for the bill was also heightened by significant increases in drug use and overdoses since the beginning of the coronavirus pandemic. San Francisco saw a record number of overdose deaths in 2020, with 711 deaths total. In 2021, 640 people died of overdoses, and the city is on track to exceed that number this year. Statewide, approximately 10,000 people died of drug overdoses from April 2020 to April 2021.

"California -- like our nation as a whole -- is experiencing a dramatic and preventable increase in overdose deaths, and we need every available tool to help people stay alive and get healthy," said Senator Wiener after the final vote. "Safe consumption sites are a proven model to help people avoid overdose deaths, reduce HIV and hepatitis transmission, reduce syringe litter, and help people access treatment. This legislation isn't about whether we want people to use drugs. Rather, it's an acknowledgment that people *are* using drugs, and our choice is whether we want to make every effort to help them survive and get healthy. The time has come for California to adopt this proven overdose death prevention strategy."

Safe injection sites have been operating for decades in Europe, Canada, and Australia and have a proven safety track record. At the 170 safe injection sites that have operated around the world, not a single overdose death has been reported. In New York City, in the first three months of operation, staff at these sites were able to halt over 150 overdoses.

Safe injection sites are a proven harm reduction intervention that saves lives without increasing crime or disorder. The Biden administration does not appear to be inclined to claim they violate federal law and has made no move against the sites operating in New York and Rhode Island. It appears the path is open. All Gov. Newsom has to do is pick up his pen and sign the bill.

CA Safe Injection Site Bill Goes to Governer, WV Cities and Counties Settle with Opioid Distributors, More... (8/2/22)

Louisiana police can no longer search homes based on the odor of marijuana without a warrant, there is good polling for marijuana legalization in Missouri, and more.

The Vancouver safe injection site. California cities could soon follow suit. (vch.ca)
Marijuana Policy

Louisiana Cops Can No Longer Use Marijuana Odor as Excuse to Search Homes. As of Monday, police in the state are prohibited from searching people's residences based on the odor of marijuana unless they have a warrant. That is because the legislature this year passed and the governor signed into law Act 473, which mandates that: "Notwithstanding any provision of law to the contrary, the odor of marijuana alone shall not provide a law enforcement officer with probable cause to conduct a search without a warrant of a person's place of residence." Another new law, this one banning vaping or smoking marijuana in a vehicle, also went into effect Monday.

Missouri Poll Shows Strong Support for Marijuana Legalization. A new SurveyUSA poll of registered voters has support for marijuana legalization at 62 percent, including majorities of every demographic group except those over 65 and Republicans. While GOP voters did not show majority support, more Republicans supported legalization (47 percent) than opposed it (40 percent). The poll comes as marijuana legalization initiative awaits a decision a week from today on whether it has turned in enough valid voter signatures to qualify for the November ballot.

Opioids

West Virginia Cities and Counties Settle with Drug Firms Over Opioid Crisis. A group of cities and counties that sued drug distribution firms, accusing them of fueling a deadly wave of opioid use, have settled with three distributors for $400 million. The companies, AmerisourceBergen, Cardinal Health, and McKesson, were facing imminent trial in state court when they settled. Last month, a federal judge ruled against Cabell County and Huntington in similar claims. They are not included in the settlement announced Monday and plan to appeal the ruling that rejected most arguments made against the drug companies.

Harm Reduction

California Safe Injection Site Bill Heads to Governor's Desk. A bill that would allow four safe injection site pilot programs to get underway is now on the desk of Gov. Gavin Newsom (D). Sponsored by Sen. Scott Wiener (D-San Francisco), Senate Bill 57 got final approval in the Senate Monday. It had already passed the Senate earlier, but was amended in the House, necessitating a final concurrence vote. Under the bill, Los Angeles, Los Angeles County, Oakland, and San Francisco could open harm reduction centers as pilot programs lasting through January 1, 2028. "We're seeing an escalation in overdose deaths," Wiener said after Monday's vote. "These sites are a proven strategy to save lives and get folks into treatment. It's time." A similar bill passed in 2018, only to be vetoed by then-Gov. Jerry Brown (D). If Gov. Newsom signs the bill, California would follow Rhode Island as states that have okayed safe injection sites. A municipal safe injection site program is currently underway in New York City.

Poll Finds Support for Psychedelic Research for Military Members, Federal Marijuana Expungement Bill Filed, More... (8/1/22)

Last weekend's Lollapalooza festival in Chicago featured not only music but harm reduction measures, a new poll finds support for federal -- as opposed to state-level -- marijuana legalization, and more.

Chicago officials handed out Narcan and fentanyl test strips at last weekend's Lollapalooza festival. (Creative Commons)
Marijuana Policy

Bipartisan Federal Marijuana Expungement Bill Filed. Reps. Troy A. Carter, Sr. (D-LA) and Rodney Davis (R-IL) filed a bill last Friday that would pave the way for federal misdemeanor marijuana offenses to be expunged. The bill is the Marijuana Misdemeanor Expungement Act. "These misdemeanors -- even without a conviction -- can result in restrictions to peoples' ability to access educational aid, housing assistance, occupational licensing and even foster parenting," said Carter. "Delivering justice for our citizens who have been impacted by marijuana-related misdemeanors is a key component of comprehensive cannabis reform."

Americans Favor Federal Marijuana Legalization Mandate in Polling. Support for marijuana legalization remains high, but a new poll from The Economist and YouGov.com shows an increasing number of people want legalization to come from the federal government. Some 45 percent said the federal government should legalize it, while another 21 percent said legalization should primarily be left up to the states. Between them, that's two-thirds support for some form of freeing the weed. Only 20 percent thought "marijuana should be banned nationally."

Psychedelics

Poll Finds Majority Support Psychedelic Research for Military Members. A new poll from YouGov.com finds that 54 percent of respondents said they support "allowing research into the therapeutic potential of certain psychedelic substances for active-duty military members with post-traumatic stress disorder (PTSD)." Support was strongest among Democrats (60 percent), followed by independents (54 percent) and Republicans (45 percent). Reps. Alexandria Ocasio-Cortez (D-NY) and Dan Crenshaw (R-TX) both sponsored psychedelic research amendments that made it into the 2023 Fiscal Year National Defense Authorization Act (NDAA), which passed the House earlier this month.

Opioids

City of Chicago Warned Lollapalooza Festivalgoers About Fentanyl. The city's Department of Public Health last Friday issued an alert on its social media accounts warning fans of the massive Lollapalooza music festival that ended Sunday that fentanyl can easily cause an overdose and that they should take steps to know what is in their drugs. The city cautioned that fentanyl is being found not only in heroin, but also non-opioid drugs such as meth, Ecstasy, and cocaine. "Every year, we see young people end up admitted to the hospital because they've experimented -- at a time when we really want people to have fun, but have fun safely," said Public Health Commissioner Dr. Allison Arwady.

White House Preps for MDMA Therapy Approval, MO Legalization Init Could Come Up Short, More... (7/28/22)

South Dakota's first state-licensed medical marijuana dispensary opens, the FDA is moving toward approval of MDMA-assisted therapy for PTSD, and more.

Psilocybin mushrooms. Legalizing them could be on the ballot in Medford, Oregon, this November. (Pixabay)
Marijuana Policy

Missouri Marijuana Legalization Initiative Campaign Needs More Signatures as Deadline Looms. Legal Missouri, the group behind an initiative to legalize marijuana in the state, handed in more than twice the number of signatures needed to qualify for the November election, but may still come up short because of the state's requirement that it meet signature thresholds in each of the state's congressional districts. The group is 1,144 signatures short in the 7th Congressional District and 1,573 short in the 6th. The campaign says it is double-checking signature counts from local election authorities in hopes of making up the shortfall. Secretary of State John Ashcroft (R) will announce by August 9 whether or not the campaign has qualified.

Medical Marijuana

South Dakota's First State-Licensed Medical Marijuana Dispensary Opens. The Unity Road Dispensary in the small town of Hartford opened its doors for business Wednesday, becoming the first state-licensed dispensary to open after voters approved a medical marijuana initiative in 2020. But it is not the first dispensary in the state: The Flandreau Santee Sioux Tribe opened Native Nations Cannabis in July 2021, saying it did not need to wait for the state to license it because it is on sovereign Native American territory. Another has since opened on the Pine Ridge reservation.

Psychedelics

Biden Administration Preparing for FDA Approval of MDMA-Assisted Therapy for PTSD. The Department of Health and Human Services released a letter Wednesday that described the Food and Drug Administration's "anticipated approval… within approximately 24 months" of psychedelic-assisted therapies. The letter said that the Substance Abuse and Mental Health Services Administration is exploring establishment of a Federal Task Force to address the complex issues associated with the commercialization of psychedelic medicines, including clinical, regulatory, and public policy matters.

The Multidisciplinary Association for Psychedelic Studies (MAPS), which has pioneered clinical trials on MDMA, was pleased: "We applaud the Biden Administration for taking psychedelic-assisted therapies, and their potential to treat life-threatening mental health conditions, seriously. A Federal Task Force on psychedelic-assisted therapies should take a multidisciplinary approach to ensuring that red tape, administrative delays, or insurance coverage questions don't leave Americans suffering as they seek to access approved treatments," said MAPS founder and executive director Rick Doblin.

Doblin continued, "For the first time, research that has been driven by philanthropists could additionally be supported by the same types of Federal grants that have funded other health care revolutions and develop patient access strategies that prioritize public benefit over profit. For decades, we have been making the case for what the Administration is now acknowledging: psychedelic-assisted therapies may become a key in addressing the most urgent mental health challenges of our time and reducing needless suffering."

Medford, Oregon, City Council Ponders Psilocybin Legalization. In a surprise move, the city council has scheduled a study session about psilocybin for tonight's meeting. No vote on an ordinance is expected, but the city council said it wants the study session to make an informed decision about putting an ordinance on the November ballot.

Chronicle Book Review: Opium's Orphans

Chronicle Book Review: Opium's Orphans: The 200-Year History of the War on Drugs by P.E. Caquet (2022, Reaktion Books, 400 pp., $35.00 HB)

The history of drug prohibition is increasingly well-trodden territory, but with Opium's Orphans, British historian P.E. Caquet brings a fascinating new perspective embedded in a sweeping narrative and fortified with an erudite grasp of the broad global historical context. Although Asian bans on opium pre-dated 19th Century China (the Thai monarchy announced a ban in the 1400s), for Caquet, the critical moment in what became a linear trajectory toward global drug prohibition a century later came when the Qing emperor banned opium in 1813 and imposed severe penalties on anything to do with it, including possessing it. Precisely 100 years later, after two Opium Wars imposed opium on the empire followed by decades of diplomatic wrangling over how to suppress the trade (and for moralizing Americans, how to win favor with China), the 1913 Hague Opium Convention ushered in the modern war on drugs with its targeting not just of opium (and coca) producers or sellers but also of mere users for criminal prosecution. It urged countries to enact such laws, and they did.

What began at the Hague would eventually grow into an international anti-drug bureaucracy, first in the League of Nations and then in United Nations bodies such as the Commission on Narcotic Drugs and the International Narcotics Control Board. But it is a global prohibition regime that has, Caquet writes, straight-jacketed itself with an opium-based perspective that has proven unable or unwilling to recognize the differences among the substances over which it seeks dominion, reflexively resorting to opium and its addiction model. Drugs such as amphetamines, psychedelics, and marijuana don't really fit that model -- they are the orphans of the book's title -- and in a different world would be differently regulated.

But Opium's Orphans isn't just dry diplomatic history. Caquet delves deep into the social, cultural, and political forces driving drug use and drug policies. His description of the spread of opium smoking among Chinese elites before it spread into the masses and became declasse is both finely detailed and strangely evocative of the trajectory of cocaine use in the United States in the 1970s, when it was the stuff of rock musicians and Hollywood stars before going middle class and then spreading among the urban poor in the form of crack.

Along the way, we encounter opium merchants and colonial opium monopolies, crusading missionary moralists, and early Western proponents of recreational drug use, such as Confessions of an English Opium Eater author Thomas De Quincey and the French habitues of mid-19th Century hashish clubs. More contemporaneously, we also meet the men who achieved international notoriety in the trade in prohibited drugs, "drug lords" such as Khun Sa in the Golden Triangle, Pablo Escobar in Colombia and El Chapo Guzman in Mexico, as well as the people whose job it is to hunt them down. Caquet notes that no matter how often a drug lord is removed -- jailed or killed, in most cases -- the impact on the trade is negligible.

For Caquet, drug prohibition as a global phenomenon peaked with the adoption of the 1961 Single Convention on Narcotic Drugs. Coming as it did amidst a post-World War II decline in drug use around the world, the treaty criminalizing coca, cocaine, opium and opioids, and marijuana seemed to ratify a successful global prohibitionist effort. (In the US, in the 1950s, when domestic drug use was at low ebb, Congress passed tough new drug laws.) But before the decade was over, drug prohibition was under flamboyant challenge from the likes of LSD guru Timothy Leary and a horde of hippie pot smokers. The prohibitionist consensus was seeing its first cracks.

And the prohibitionist response was to crack down even harder, which in turn begat its own backlash. Drug use of all sorts began rising around the world in the 1960s and hasn't let up yet, and the increasingly omnivorous drug war machine grew right along with it, as did the wealth and power of the illicit groups that provided the drugs the world demanded. As the negative impacts of the global drug war -- from the current opioid overdose crisis in the US to the prisons filled with drug offenders to the bloody killing fields of Colombia and Mexico -- grew ever more undeniable, the critiques grew ever sharper.

In recent years, the UN anti-drug bureaucrats have been forced to grudgingly accept the notion of harm reduction, although they protest bitterly over such interventions as safe injection sites. For them, harm reduction is less of an erosion of the drug war consensus than all that talk of drug legalization. As Caquet notes, perhaps a tad unfairly, harm reduction doesn't seek to confront drug prohibition head-on, but to mitigate its harms.

The man is a historian, not a policymaker, and his response to questions about what to do now is "I wouldn't start from here." Still, at the end of it all, he has a trio of observations: First, supply reduction ("suppression" is his word) does not work. Sure, you can successfully wipe out poppies in Thailand or Turkey, but they just pop up somewhere else, like the Golden Triangle or Afghanistan. That's the infamous balloon effect. Second, "criminalization of the drug user has been a huge historical blunder." It has no impact on drug use levels, is cruel and inhumane, and it didn't have to be that way. A century ago, countries could have agreed to regulate the drug trade; instead, they tried to eradicate it in an ever-escalating, never-ending crusade. Third, illicit drugs as a group should be seen "as a historical category, not a scientific one." Different substances demand different approaches.

Opium's Orphans is a fascinating, provocative, and nuanced account of the mess we've gotten ourselves into. Now, we continue the work of trying to get out of that mess.

Australia's First Drug Checking Site Opens This Week, TX Bill Would Make Legal Pot a Local Option, More... (7/19/22)

There are marijuana reform rumblings in the Lone Star State, Ohio becomes the latest state to see a fentanyl test strip decrim bill, and more.

Texas State Capitol (Daniel Mayer, Wikimedia)
Marijuana Policy

Texas Bill Would Let Cities, Counties Legalize Marijuana. State Rep. Jessica Gonzalez (D-Dallas) has filed a bill, House Bill 3248, that would let cities and counties the option of locally legalizing recreational marijuana use, possession, and sales. The bill would also impose a 10 percent tax on marijuana products, with 10 percent of that going to pay for regulation, another 10 percent to pay for marijuana testing and quality control, 20 percent to participating local governments for oversight, and the rest would go into the state school fund. "While Texas has made progress with the Compassionate Use Act, we have been left behind on a potential revenue source that would increase investments in public education, stop the unnecessary arrests for cannabis possession and create jobs in our state," González said. "We should allow our local communities to make the best decision for themselves in regards to cannabis legalization, and HB 3248 would allow that for adults 21 years or older." The bill faces long odds in the GOP-dominated legislature.

Medical Marijuana

Texas Agriculture Commissioner Calls for Expanded Medical Marijuana Access. State Agriculture Commissioner Sid Miller (R) says he supports the expansion of medical marijuana access and nodded toward other conservative states that have fully legalized medical use. Governments should only be able to make something illegal "for a powerful reason or set of fact," he wrote in a letter, comparing pot prohibition to the alcohol Prohibition of the 1920s. "As I look back, I believe that cannabis prohibition came from a place of fear, not from medical science or the analysis of social harm. Sadly, the roots of this came from a history of racism, classism, and a large central government with an authoritarian desire to control others. It is as anti-American in its origins as could be imaginable,"he wrote. It is time for all of us, including the Governor, members of the Texas Legislature and others to come together and set aside our political differences to have an honest conversation about cannabis: where we have been, where we are going and what role government should properly play," Miller ended his letter. "We owe it to our fellow Texans, especially those who are suffering, to lead or just get out of the way if we cannot formulate effective cannabis policy for Texas."

Harm Reduction

Ohio Bill Would Decriminalize Fentanyl Test Strips. Ohio could become the latest state to decriminalize or legalize fentanyl test strips as a harm reduction measure aimed at reducing overdose deaths. State Rep. Kristin Boggs (D-Columbus) has filed House Bill 456 would decriminalize fentanyl drug testing strips. They are currently classified as drug paraphernalia, but that hasn't stopped them from beginning to pop up in bar bathrooms in Cincinnati. Fentanyl, a synthetic opioid, is increasingly adulterating other illicit drugs or appearing as counterfeit prescription opioids. In Ohio, nearly two-thirds of 1,497 cocaine overdose deaths last year were caused by drugs laced with fentanyl. The bill has just been filed, but has garnered no opposition so far.

International

Australia's First Fixed Drug Checking Site to Open This Week in Canberra. Beginning on Thursday, Australia's capital city, Canberra, will host the country's first fixed location drug checking site. Previously, drug testing has twice been done at music festivals. The move comes as the Australian Capital Territory prepares to implement drug decriminalization. "This Australian-first program will help people who use drugs better understand or avoid unknown and potentially dangerous substances in illicit drugs," said ACT Health Minister Rachel Stephen-Smith.

"We know the safest option is not to take drugs and this will always be our advice to the community. However we recognize some people will choose to use drugs and there is a need for initiatives that reduce the harms associated with drug use."

Drug War Issues

Criminal JusticeAsset Forfeiture, Collateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Court Rulings, Drug Courts, Due Process, Felony Disenfranchisement, Incarceration, Policing (2011 Drug War Killings, 2012 Drug War Killings, 2013 Drug War Killings, 2014 Drug War Killings, 2015 Drug War Killings, 2016 Drug War Killings, 2017 Drug War Killings, Arrests, Eradication, Informants, Interdiction, Lowest Priority Policies, Police Corruption, Police Raids, Profiling, Search and Seizure, SWAT/Paramilitarization, Task Forces, Undercover Work), Probation or Parole, Prosecution, Reentry/Rehabilitation, Sentencing (Alternatives to Incarceration, Clemency and Pardon, Crack/Powder Cocaine Disparity, Death Penalty, Decriminalization, Defelonization, Drug Free Zones, Mandatory Minimums, Rockefeller Drug Laws, Sentencing Guidelines)CultureArt, Celebrities, Counter-Culture, Music, Poetry/Literature, Television, TheaterDrug UseParaphernalia, Vaping, ViolenceIntersecting IssuesCollateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Violence, Border, Budgets/Taxes/Economics, Business, Civil Rights, Driving, Economics, Education (College Aid), Employment, Environment, Families, Free Speech, Gun Policy, Human Rights, Immigration, Militarization, Money Laundering, Pregnancy, Privacy (Search and Seizure, Drug Testing), Race, Religion, Science, Sports, Women's IssuesMarijuana PolicyGateway Theory, Hemp, Marijuana -- Personal Use, Marijuana Industry, Medical MarijuanaMedicineMedical Marijuana, Science of Drugs, Under-treatment of PainPublic HealthAddiction, Addiction Treatment (Science of Drugs), Drug Education, Drug Prevention, Drug-Related AIDS/HIV or Hepatitis C, Harm Reduction (Methadone & Other Opiate Maintenance, Needle Exchange, Overdose Prevention, Pill Testing, Safer Injection Sites)Source and Transit CountriesAndean Drug War, Coca, Hashish, Mexican Drug War, Opium ProductionSpecific DrugsAlcohol, Ayahuasca, Cocaine (Crack Cocaine), Ecstasy, Heroin, Ibogaine, ketamine, Khat, Kratom, Marijuana (Gateway Theory, Marijuana -- Personal Use, Medical Marijuana, Hashish), Methamphetamine, New Synthetic Drugs (Synthetic Cannabinoids, Synthetic Stimulants), Nicotine, Prescription Opiates (Fentanyl, Oxycontin), Psilocybin / Magic Mushrooms, Psychedelics (LSD, Mescaline, Peyote, Salvia Divinorum)YouthGrade School, Post-Secondary School, Raves, Secondary School