Stories pile up when you spend a week at the drug reform conference: Trump's choice for drug czar is out, the NFL endorses sentencing reform, California's governor signs a sentencing reform bill, and more.

The National Football League has formally endorsed a federal sentencing reform bill. (Flickr)

Mississippi Supreme Court Overturns Marijuana Conviction of Vehicle Passenger. The state Supreme Court last Thursday threw out the marijuana possession conviction of a car passenger, saying the mere fact that he was in the vehicle didn't mean he actually possessed the drug. Marvin Carver had been charged after the car his half-brother was driving was pulled over and marijuana was found. The half-brother said the marijuana was his, and prosecutors never proved that Carver knew about or intended to possess the pot, the court noted.

New Hampshire Marijuana Study Group Holds First Meeting, No Legalizers Included. A commission charged with studying the potential impact of marijuana legalization is holding its first meeting today. Created by the legislature, the commission includes lawmakers and representatives of several state agencies, including banking, law enforcement, and the medical community. Of the legislators, several have voiced opposition to legalization and none are on record in support of it.

Maine Legalizers Reject Legislative Rewrite of Marijuana Law. Legalize Maine, the group behind last year's successful legalization initiative, has come out against the proposed legislative rewrite of the law, saying it "isn't ready for prime time." The group strongly objects to bill language requiring localities to "opt in" to the legal marijuana business instead of having to "opt out." Such a provision will only create chaos and encourage the black market, the group says.

Pennsylvania ACLU Report Finds Large Racial Disparities in Marijuana Arrests. In an analysis of 2016 arrest data, the ACLU found that black adults in the state were eight times more likely to be arrested for pot possession than whites. Marijuana arrests in the state have increased in recent years, and so has the racial disparity in arrests. It was less than six to one in 2011. The arrest figures don't include Philadelphia, which decriminalized in 2014 and saw arrests plummet 88%. But even in Philly, blacks were still three times more likely to be arrested for pot than whites.

Medical Marijuana

Pennsylvania Issues First Medical Marijuana Grow License. The state Department of Health has approved Cresco Yeltrah's 40,000-plus-square-foot indoor grow operation, making it the first medical marijuana grow in the state to be approved. The planting of seeds should commence shortly, with the first crop ready in about four months.

Drug Policy

Trump Drug Czar Nominee Withdraws in Wake of Report He Pushed Bill to Hinder DEA Opioid Pill Enforcement Efforts. Pennsylvania US Rep. Tom Marino (R), who President Trump nominated last month to head the Office of National Drug Control Policy (ONDCP -- the drug czar's office), has withdrawn his nomination in the wake of reports that he shepherded through Congress legislation lobbied for by drug companies and pharmaceutical chains that decreased the DEA's ability to stop suspect shipments of prescription opioids. Marino had come under fire from Democratic lawmakers after the report went public Sunday.

McCaskill Will File Bill to Undo 2016 Law Marino Pushed. Sen. Claire McCaskill said Monday she would fill a bill to repeal the 2016 law Rep. Marino shepherded through Congress at the behest of deep-pocketed drug companies and pharmaceutical chains.

Drug Testing

Wisconsin Moves a Step Closer to Drug Testing Food Stamp Recipients. The state Health Department announced last Friday that it has submitted its plans for the drug testing of food stamp recipients to the office of Gov. Scott Walker (R). Critics of the plan say it requires getting a waiver from the US Department of Agriculture, but the Walker administration disagrees. Look for a court challenge.

Law Enforcement

Justice Department Announces First Ever Indictments Against Chinese Fentanyl Makers. The DOJ announced Tuesday that federal grand juries in Mississippi and North Dakota had returned indictments against two Chinese nationals and their US-based traffickers and distributors for separate conspiracies to peddle large quantities of fentanyl, fentanyl analogues, and other opioids in the United States. These are the first indictments returned against Chinese nationals for manufacturing and distributing fentanyl destined for the US.

Florida Man Wins Cash Settlement After Police Field Drug Test Mistook Sugar for Meth. In 2015, police arrested Daniel Rushing for meth possession after they mistook glaze from a Krispy Kreme donut for methamphetamine. Rushing was held in jail for 10 hours before bonding out. The charges were dropped when subsequent tests showed the substance was indeed glazed sugar. Last week, the city of Orlando agreed to pay him $37,500 to settle his wrongful arrest lawsuit.

Sentencing

In Midst of National Anthem Controversy, NFL Endorses Federal Sentencing Reform Bill. In a letter sent Monday to leading senators, the National Football League offered "full support" for the Sentencing Reform and Corrections Act (S. 1917). "Over the last two seasons, one particular issue that has come to the forefront for our players and our teams is the issue of justice for all," the league noted, obliquely addressing the controversy surrounding NFL players kneeling during the national anthem to protest racial inequality in the criminal justice system, while at the same time supporting progressive sentencing reform.

California Governor Signs Major Drug Sentencing Reform. Last Thursday, Gov. Jerry Brown signed into law Senate Bill 180, authored by State Senators Holly Mitchell (D-Los Angeles) and Ricardo Lara (D-Long Beach). With his signature, Brown repealed a three-year sentence enhancement that added additional years to a sentence for prior drug convictions, such as drug sales and possession of drugs for sales. SB 180, the RISE (Repeal of Ineffective Sentencing Enhancements) Act, was part of Mitchell and Lara's Equity and Justice Package, bills intended to address racially biased sentencing.

Massachusetts Takes Aim at Mandatory Minimums. State Senate leaders are rallying around a sentencing reform bill that would repeal mandatory minimum sentences for small-time drug offenses, lower probation fees, and up the threshold for felony larceny. Supporters of the proposal from Sen. William Brownberger (D-Belmont) rallied last Thursday to champion the bill, which the Senate should be taking up in the next few weeks.

Nevada sets legal marijuana sales records, Quebec will go with government marijuana shops, Seattle and the state of Washington file lawsuits over the opioid crisis, and more.

If you want to buy legal marijuana in Quebec, a government employee will sell you it. (Sandra Yruel/DPA)

Nevada Legal Sales Begin at Blistering Pace. Pot shops sold $27.1 million worth of products during July, the first month of legal sales in the state. That's nearly double what Colorado and Washington did in their first month of sales and nearly seven times what Washington did. And the state collected a cool $10.2 million in industry fees and taxes.

Rhode Island Appoints Members of Legalization Commission. The state has announced the naming of 19 members to the special legislative commission charged with studying the effects of potential marijuana legalization. The commission is the result of a bill passed by the legislature after legalization efforts fell short earlier this year. It will conduct a comprehensive review, study social and fiscal impacts, and make recommendations regarding pot policy.

Medical Marijuana

Georgia Lawmaker Mobilizes Supporters to Broaden State's Law. State Rep. Allen Peake (R-Macon) is calling on families and advocates to contact their legislators ahead of the upcoming legislative session to lay the groundwork for expanding the state's CBD medical marijuana law to allow limited cultivation and manufacturing in the state. The state legalized the use of CBD cannabis oil in 2013, but there is no legal way to obtain it. Peake wants to let one or two growers and manufacturers operate in the state. They would be limited to creating CBD cannabis oil.

Heroin and Prescription Opioids

Seattle, State of Washington Sue Opioid Manufacturers. The city and the state announced Thursday that they have filed two lawsuits against major drug companies they say fueled the opioid crisis by downplaying the risk of addiction with popular opioid pain pills. The city is suing Purdue Pharma, Teva Pharmaceuticals, Johnson & Johnson and Janssen Pharmaceuticals, among several others. The state named only Purdue, the maker of OxyContin, as a defendant. The state has seen a 60% increase in opioid-related hospitalizations between 2009 and 2014 and about 10,000 opioid overdose deaths since 2000.

International

Quebec Premier Sets Legal Pot Age at 18, Orders State Monopoly on Sales. Quebec Premier Philippe Couillard decided Thursday that the legal age for marijuana consumption in the province would be 18 and that the distribution and sale of marijuana will be under the control of the state. The province will create a crown corporation relying on the expertise of its alcohol regulators, the Société des alcools, to set up and run the system. Ontario, Canada's most populous province, has also opted for government monopoly pot shops, much to the dismay of entrepreneurs and some consumers.

Bostonians celebrate marijuana legalization, California calls for its rescheduling, state attorneys general urge health insurers to reduce opioid prescriptions, Maxine Waters files a bill to end mandatory minimums for drug sentences, and more.

California Officially Calls for Marijuana Rescheduling. The Assembly last Thursday passed a resolution calling on the federal government to reschedule marijuana. The Senate had approved the resolution earlier. "The Legislature urges the Congress of the United States to pass a law to reschedule marijuana or cannabis and its derivatives from a Schedule I drug to an alternative schedule, therefore allowing the legal research and development of marijuana or cannabis for medical use," reads the joint resolution.

Boston Freedom Rally Draws Thousands to Celebrate Legalization. For the first time since voters legalized marijuana last November, the annual event demanding legalization was held this past weekend. Thousands flocked to Boston Common for the 28th Annual Boston Freedom Rally for live music, speeches, educational panels, and -- of course -- plentiful pot-smoking. Even though public marijuana use is illegal, police reported no arrests.

Nevada Supreme Court Throws a Wrench in Marijuana Distribution Licensing. The state's highest court issued a temporary injunction last Friday barring the Department of Taxation from granting any more pot distribution licenses. This means supply chain issues will continue to plague pot shops in the near term. The initiative that legalized pot in the state reserved such licenses for liquor distributors for the first 18 months, but the Tax Commission had voted to allow other distributors to get in on the action after determining that the booze distributors couldn't keep up with demand. The liquor distributors took legal action to block the new licenses, and here we are. Oral arguments in the case are set for October 3.

Heroin and Prescription Opioids

State Attorneys General Urge Insurers to Seek Alternatives for Opioids. Attorneys general from 35 states, Washington, DC, and Puerto Rico announced a bipartisan coalition to fight opioid addiction on Monday and rolled out their effort by jointly calling on health insurers to review pain management treatment policies in a bid to promote more use of alternatives to prescription opioids. The AGs said they didn't want health insurers to unintentionally contribute to the crisis. News articles didn't indicate whether the AGs noted the need to ensure that patients who do need opioids receive them.

Harm Reduction

Philadelphia DA Candidates Are Open to Safe Injection Sites. Larry Krasner, the Democratic frontrunner to be the next district attorney, has come out in support of city-sanctioned safe injection sites for drug users. His Republican foe, Beth Grossman, wouldn't go that far, but said she is open to discussion on the issue. Safe injection sites were mentioned in Mayor Jim Kenney's opioid task force report in May, but they were the most controversial of the report's 18 recommendations. Although efforts are underway in several cities, including New York, San Francisco, and Seattle, no officially-sanctioned safe injection sites operate in the US, although one unsanctioned one is reportedly operating in an unnamed US city.

Sentencing

Maxine Waters Files Bill to End Mandatory Minimum Drug Sentences. Rep. Maxine Waters (D-CA) has filed House Resolution 3800 "to eliminate mandatory minimum sentences for all drug offenses." The bill text is not yet available on the congressional web site.

International

Toronto Pot Lounges Want Right to Exist Under Legalization. Faced with a provincial plan to impose a government monopoly on retail marijuana sales, Toronto's existing pot consumption lounges, some of which have been around since before the turn of the century, are asking the city's Municipal Licensing and Standards Committee to regulate them instead of shutting them down. They argue that the shops are needed in the city, which bans public pot smoking and where many renters and apartment dwellers have no legal place to indulge.

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

This article was produced in collaboration with AlterNet and first appeared here. 

Obamacare foes desperate for a new angle of attack on the increasingly popular health care program have come up with an intriguing new theory: The expansion of Medicaid to low-income adults under the Affordable Care Act (ACA) may be driving the opioid epidemic.

It would be a nice little argument for cutting Medicaid -- if only it were true. But there's little evidence to suggest it is true and a lot of evidence to suggest it isn't.

The notion began circulating in the conservative media echo chamber after the Health and Human Services Department did a private analysis for Sen. Ron Johnson (R-WI) that said the opioid overdose rate rose nearly twice as much in states that expanded Medicaid under the ACA than those that didn't.

"These data appear to point to a larger problem," Johnson wrote. "Medicaid expansion may be fueling the opioid epidemic in communities across the country." Johnson pulled up just short of blaming Medicaid, saying more research is needed.

But if Johnson was looking for help from fellow Obamacare foe and Health and Human Services Secretary Tom Price, it wasn't exactly forthcoming. HHS wouldn't address questions about Johnson's analysis and instead issued a statement saying "correlation does not necessary prove causation," but that, yes, more research would be helpful.

But based on what we know so far, here are four reasons the charge that Medicaid is fueling the opioid epidemic is bogus:

1. Medicaid is actually increasing treatment for opioid addiction.

That's according to Temple University economist Catherine Maclean and Brendan Saloner of Johns Hopkins Bloomberg School of Public Health, who recently published a paper on Medicaid expansion and drug treatment: "Medicaid-reimbursed prescriptions for medications used to treat Substance Use Disorders in outpatient settings increased by 33% in expanding states relative to non-expanding states. Among patients admitted to specialty SUD treatment, we find that in expanding states Medicaid insurance and use of Medicaid to pay for treatment increased by 58% and 57% following the expansion. In an extension to the main analyses we find no evidence that the expansions affected fatal alcohol poisonings or drug-related overdoses," they wrote.

"Medicaid is doing its job," she told the Associated Press last week. "As more time passes, we may see a decline in overdoses in expansion states relative to non-expansion states."

2. States that expanded Medicaid did so in part because they already suffered higher overdose rates.

That same research by Maclean and Saloner also found that overdose rates were higher to begin with in states that expanded Medicaid. That suggests that pre-existing drug problems may have played a role in states deciding to expand Medicaid so they could leverage more federal money to fight addiction.

Republican labor economist Craig Garthwaite of Northwestern University's Kellogg School of Management told the AP that such a desire helped propel Ohio Republican Gov. John Kasich toward expanding Medicaid. When Kasich talks about why, he said, "it has a lot to do with mental health and substance use disorders." The claim that Medicaid is fueling opioid overdoses is "fundamentally flawed," Garthwaite added.

In other words, overdoses aren't increasing because of Medicaid; instead, Medicaid is expanding in part because of an effort to reduce overdoses.

3. Counties where insurance coverage has expanded the most have seen smaller increases in overdose deaths than those with smaller coverage gains.

A recent analysis by Vanderbilt University economist Andrew Goodman-Bacon and Harvard researcher Emma Sandoe compared trends in drug-related deaths at the county level, contrasting counties that had high levels of uninsured residents pre-ACA with those that didn't. Under the theory that Medicaid expansion is causing increased overdose deaths, we would expect to see the largest increase in deaths in those high-insured counties because that's where more people took advantage of expanded Medicaid. But that wasn't the case:

"Drug-related deaths increased at a lower rate in high-uninsurance counties than in low-uninsurance counties," the researchers found. "This does not support the notion that the ACA worsened the opioid epidemic."

In other words, the more people on expanded Medicaid, the lower the rate of increase in overdose deaths.

4. The Medicaid theory lumps all opioid overdose deaths together when many are not caused by prescription opioids.

This is bad science. If you want to measure prescription opioid deaths, you need to measure only prescription opioid deaths. But the HHS analysis for Sen. Johnson didn't do that. Instead, it lumped in deaths from non-prescription street drugs, such as heroin or illicitly manufactured fentanyl. Having a Medicaid card doesn't provide access to street drugs, and it is precisely heroin and illicit fentanyl that are driving the surge in opioid deaths since 2010.

"It's worrisome because this is the type of numerical evidence that's used to propose bad policy," Garthwaite told the AP.