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Chronicle AM: Ontario Goes With State-Owned Pot Shops, DEA Agent's Sordid Affair, More... (9/11/17)

Canada's most populous province is going with a state monopoly on legal marijuana sales, the CARERS Act is back, last week's surprise budget deal preserves protections for legal medical marijuana states for a few more months, and more.

Medical Marijuana

Congressional Budget Deal Preserves Medical Marijuana Protections -- For Now. The budget deal agreed to last week between President Trump and congressional leaders extends federal protections to state-legal medical marijuana programs through December 8. This provides an opportunity for House GOP leaders to rectify their decision last week not to allow a vote on the amendment that for the past four years has blocked the Justice Department from spending federal funds to go after medical marijuana in states where it is legal.

Bipartisan Group of Senators Reintroduce CARERS Act. Sens. Cory Booker (D-NJ), Al Franken (D-MN), Kirsten Gillibrand (D-NY), Lisa Murkowski (R-AK), and Rand Paul (R-KY) refiled the CARERS Act (Senate Bill 1764) last Wednesday. The bill aims to "extend the principle of federalism to State drug policy, provide access to medical marijuana, and enable research into the medicinal properties of marijuana."

Iowa Attorney General Cites Fed Fears to Block CBD from Out of State Dispensaries. The attorney general's office has advised the Department of Public Health not to implement a part of the state's CBD medical marijuana law that would have licensed two dispensaries from bordering states to supply CBD to Iowa patients. "It is possible that state's program may come under increased scrutiny from the federal government," a spokesman told the Des Moines Register, adding that the halt would remain "until the federal government provides further guidance regarding state medical marijuana programs."

Drug Policy

Florida Attorney General Pam Bondi Joins Trump's Drug Task Force. A Republican and Trump supporter, Bondi has been appointed to the Presidential Commission on Drug Addiction and the Opioid Crisis, her office announced last Friday. The other commission members are chairman and New Jersey Gov. Chris Christie (R), Massachusetts Gov. Charlie Baker (R), North Carolina Roy Cooper (D), former US Rep. Patrick Kennedy (D-MA), and Harvard professor Dr. Bertha Madras. The commission is supposed to issue a final report by October 1.

Heroin and Prescription Opioids

New York Congressman Files Bill to Broaden Medication Assisted Treatment. Rep. Paul Tonko (D-NY) has filed House Resolution 3692 to "amend the Controlled Substances Act to provide additional flexibility with respect to medication-assisted treatment for opioid use disorders."

Law Enforcement

DEA Agent's Scandalous Affair Unveiled. A Justice Department inspector general's report released last Thursday revealed one bit of juicy scandal: A DEA agent carried on a wild affair with a convicted drug criminal for five years, and let her listen to active wiretaps, roam the evidence room unattended, and had sex with her in his office and official vehicle. The whole thing unraveled when she got pregnant, he reacted unfavorably, and she ratted him out to superiors. The unnamed agent was originally only suspended for 45 days, but was eventually fired.

International

Ontario Will Only Allow Legal Pot Sales in Government Monopoly Shops. Canada's most populous province announced last Friday that it will open 150 standalone pot shops operated by the Liquor Control Board of Ontario (LCBO), as well as eventually allowing an online order service. Dispensaries that have sprouted up in the province are out of luck: "Illicit cannabis dispensaries are not and will not be legal retailers," the province explained in a news release. "The province will pursue a coordinated and proactive enforcement strategy, working with municipalities, local police services, the OPP and the federal government to help shut down these illegal operations."

Canadian Prime Minister Just Says No to Drug Decriminalization. Prime Minister Justin Trudeau has rejected calls from British Columbia public health and political figures to embrace drug decriminalization as part of a solution to the country's opioid crisis. "We are making headway on this and indeed the crisis continues and indeed spreads across the country but we are not looking at legalizing any other drugs than marijuana for the time being," Trudeau told a news conference in BC last Thursday.

German Poll Finds Solid Majority for Marijuana Legalization. A Mafo Market Research Institute poll has found signs of a rapid shift in support for freeing the weed in Germany. Polls going back to 2001 have had support hovering around 19%, but things began to change around 2014. That year, a poll had 30% supporting legalization. In November 2015, another poll had support at 42%. The new Mafo poll has support at 57.5%.

Chronicle AM: BC Calls for Radical Opioid Response, 2nd MI MJ Init, More... (8/17/17)

BC health officials present some revolutionary recommendations for dealing with the opioid crisis, Alaska officials defend marijuana legalization, a second Michigan legalization initiative is okayed for signature gathering, and more.

British Columbia health officials say users should be provided drugs to take home, be able to grow opium poppies. (Wikimedia)
Marijuana Policy

Alaska Officials Defend Legalization in Letters to Sessions. Gov. Bill Walker (I) and Attorney General Jahna Lindemuth have sent two letters to Attorney General Sessions defending their state's marijuana law and the wishes of state voters. Their letters are a response to a letter Sessions sent to governors of legalization states in July. "Marijuana regulation is an area where states should take the lead," they said in the first letter, dated August 1. "We ask that the DOJ maintain its existing marijuana policies because the State relied on those assurances in shaping our regulatory framework, and because existing policies appropriately focus federal efforts on federal interests," they said in the second letter, dated August 14.

Second Michigan Legalization Initiative Gets Okay for Signature Gathering. The state Board of Canvassers on Thursday approved a second marijuana legalization initiative for signature gathering. The initiative, from a group called Abrogate Prohibition Michigan, would end "all prohibitions on the use of cannabis in any form by any person" and specify that no taxes could be imposed. Another group, MI Legalize, is already halfway through the signature gathering phase for its initiative, which envisions legalization, taxation, and regulation.

Los Angeles Gets a Cannabis Czar. The city council voted on Wednesday to approve Cat Packer as executive director of the city's newly fashioned Department of Cannabis Regulation. Packer is a former Drug Policy Alliance state policy coordinator for California. She was also a campaign coordinator for Californians for Responsible Marijuana Reform, part of the Prop 64 campaign. She will be charged with rolling out regulations for legal marijuana in the city.

Harm Reduction

Washington King County Initiative to Ban Safe Injection Sites Likely Won't Make Ballot. A measure to ban safe injection sites in Seattle's suburban King County is unlikely to be on the November ballot. Petition organizers handed in sufficient signatures on time, but it took two weeks for the petitions to get from the King County Council clerk to King County Elections, so the initiative has missed an August 1 deadline to be certified for the ballot. It could go on the ballot in a February special election, but initiative sponsors say they fear it will be too late to prevent safe injection sites by then.

International

British Columbia Health Authorities Call for Revolutionary Approach to Opioid Crisis. The BC Center for Disease Control has issued a set of recommendations for dealing with opioid use and overdoses that includes providing users with drugs they can take home with them and allowing people to grow their own opium. The current approach to addiction is backwards, BCCDC Executive Medical Director Mark Tyndall told the Globe and News: "We strongly advise people to stop using street drugs, and if they can't do that, then we offer them… Suboxone or methadone, and if that doesn't work, we basically tell them to go and find their own drugs even though there is a very real possibility of dying," he said. "What we should be doing -- especially in an environment of a poisoned drug supply -- is to start with access to uncontaminated drugs so at least people don't die, then move on to substitution therapy and eventually recovery."

Chronicle AM: WH Opioid Panel Calls for Declaration of National Emergency, More... (8/1/2017)

Federal bills to legalize marijuana and allow drug testing of people seeking unemployment benefits get filed, the presidential commission on opioids issues a preliminary reports, the NFL offers to work with the players' union on medical marijuana, and more.

Marijuana Policy

With overdoses at record levels, Trump's presidential commission takes a largely public health approach to the crisis.
Corey Booker Files Federal Marijuana Legalization Bill. Sen. Cory Booker (D-NJ) filed the Marijuana Justice Act on Tuesday. The bill would remove marijuana from the Controlled Substances Act, punish states for disproportionately arresting or imprisoning poor people or minorities for marijuana offenses, prevent deportation for marijuana offenses, provide for resentencing of federal marijuana prisoners, and create a $500 million "Community Reinvestment Fund" for communities most negatively impacted by the war on drugs.

South Dakota Legalization Initiative Imperiled by Wording Error. A legalization initiative sponsored by New Approach South Dakota could be in trouble over a wording error. The way the measure is worded, it would, according to Legislative Council analysts, only legalize pot paraphernalia, not marijuana itself. The campaign said the problem is only a "typo" and can be fixed. Friendly legislators have offered to author a legislative fix if the initiative passes. Because of state initiative deadlines, it is too late for petitioners to start over in time to get on the November 2018 ballot.

Medical Marijuana

NFL Offers to Work With Players Union on Marijuana for Pain Management. The NFL has sent a letter to the NFL Players Association offering to work together with the union to study the possibility of marijuana as a pain management tool for players. The NFLPA is already conducting its own study and has yet to respond to the league's offer.

Ohio Medical Marijuana Rules Get Settled. A bipartisan legislative panel has decided not to modify more than a hundred separate rules proposed by the state Pharmacy Board and Department of Commerce to govern the state's nascent medical marijuana industry. That means medical marijuana growers, processers, sellers, testers, and users can now begin to get down to business. Growing operations are expected to start being licensed next month, and the whole system is supposed to be up and running by September 1, 2018.

Utah Poll Finds "Supermajority" Support for Medical Marijuana. Nearly four out of five (78%) Utahns favor a medical marijuana initiative now in the signature gathering phase of its campaign, according to a Dan Jones & Associates poll commissioned by the Salt Lake Tribune. The campaign is headed by the Utah Patients Coalition, which is acting after the state legislature baling at approving medical marijuana.

Drug Testing

Federal Unemployment Drug Testing Bill Filed. Rep. Buddy Carter (R-SC) has filed the Ensuring Quality in the Unemployment Insurance Program (EQUIP) Act, which would require people applying for unemployment assistance to undergo substance abuse screening and possible drug testing to receive benefits. "Unemployment is not for people who are abusing drugs and using that money to buy drugs but instead to help them get back on their feet," said Rep. Carter. "And we want to make sure that is what they are doing with it." People applying for those benefits have been laid-off from jobs for lack of work, not let go for drug abuse.

Heroin and Prescription Opioids

Presidential Commission Issues Belated Preliminary Report, Calls for Declaration of National Emergency. The presidential Commission on Combating Drug Addiction and the Opioid Crisis led by Gov. Chris Christie (R-NJ) issued a preliminary report on Monday whose lead recommendation is for the president "to declare a national emergency under either the Public Service Act or the Stafford Act." The report largely takes a public health approach to the issue, calling as well for expanding drug treatment capacity under Medicaid, increasing the use of medication-assisted treatment for opioid disorders, mandating that all police officers carry the opioid overdose reversal drug naloxone, broadening Good Samaritan laws, and encouraging the development of non-opioid pain relievers.

America, We Can Fix This: 24 Ways to Reduce Opioid Overdoses and Addiction [FEATURE]

Drugs, mainly opioids, are killing Americans at a record rate. The number of drug overdose deaths in the country quadrupled between 1999 and 2010 -- and compared to the numbers we're seeing now, those were the good old days.

Some 30,000 people died of drug overdoses in 2010. According to a new estimate from the New York Times, double that number died last year. And the rate of increase in overdose deaths was growing, up a stunning 19% over 2015.

The Times' estimate of between 59,000 and 65,000 drug overdose deaths last year is greater than the number of American soldiers killed during the entire Vietnam War, greater than that number of people killed in the peak year for car crash deaths, greater than the number of people who died in the year the AIDS epidemic peaked, and higher than the peak year for gun deaths.

In the first decade of the century, overdoses and addiction rose in conjunction with a dramatic increase in prescription opioid prescribing; since then, as government agents and medical professionals alike sought to tamp down prescribing of opioids, the overdose wave has continued, now with most opioid OD fatalities linked to illicit heroin and powerful black market synthetic opioids, such as fentanyl and carfentanil.

The Centers for Disease Control and Prevention says we are in the midst of "the worst drug overdose epidemic in history," and it's hard to argue with that.

So, what do we do about it? Despite decades of failure and unintended consequences, the prohibitionist reflex is still strong. Calls for more punitive laws, tougher prosecutorial stances, and harsher sentences ring out from state houses across the land to the White House. But tough drug war policies haven't worked. The fact that the overdose and addiction epidemic is taking place under a prohibition regime should make that self-evident.

More enlightened -- and effective -- approaches are now being tried, in part, no doubt, because today's opioid epidemic is disproportionately affecting white, middle class people and not the inner city black people identified with heroin epidemics of the past. But they are also being tried because for the past quarter-century an ever-growing drug reform movement has articulated the failures of prohibition and illuminated more effective alternatives.

The drug reform movement's most powerful organization, the Drug Policy Alliance, this spring published A Public Health and Safety Approach to Problematic Opioid Use and Overdose, which lays out more than two dozen specific policy prescriptions in the realms of addiction treatment, harm reduction, prevention, and criminal justice that have been proven to save lives and reduce dependency on opioids. These policy prescriptions are doable now -- and some are being implemented in some fashion in some places -- but require that political decisions be made, or that forces be mobilized to get those decisions made. Some would require a radical divergence from the orthodoxies of drug prohibition, but that's a small price to pay given the mounting death toll.

Here are 24 concrete policy proposals that can save lives and reduce addiction right now. All the facts and figures are fully documented in the heavily-annotated original. Consult it if you want to get down to the nitty-gritty. In the meantime:

Addiction Treatment

1. Create Expert Panel on Treatment Needs: States should establish an expert panel to address effective treatment needs and opportunities. The expert panel should evaluate barriers to existing treatment options and make recommendations to the state legislature on removing unnecessary impediments to accessing effective treatment on demand. Moreover, the panel should determine where gaps in treatment exist and make recommendations to provide additional types of effective treatment and increased access points to treatment (such as hospital-based on demand addiction treatment). The expert panel must also set evidence-based standards of care and identify the essential components of effective treatment and recovery services to be included in licensed facilities, especially with regards to medication-assisted treatment, admission requirements, discharge, continuity of care and/or after-care, pain management, treatment programming, integration of medical and mental health services, and provision of or referrals to harm reduction services. The expert panel should identify how to improve or create referral mechanisms and treatment linkages across various healthcare and other providers. The panel should establish clear outcome measures and a system for evaluating how well providers meet the scientific requirements the panel sets. And, finally, the expert panel should evaluate opportunities under the ACA to expand coverage for treatment.

2. Increase Insurance Coverage for Medication-Assited Treatment (MAT): Seventeen state medical plans under the Patient Protection and Affordable Care Act (ACA) do not provide coverage for methadone or buprenorphine for opioid dependence. Moreover, the Veterans Administration's (VA's) insurance system has explicitly prohibited coverage of methadone and buprenorphine treatment for active duty personnel or for veterans in the process of transitioning from Department of Defense care. As a result, veterans obtaining care through the VA are denied effective treatment for opioid dependence. Insurance coverage for these critical medications should be standard practice.

3. Establish and Implement Office-Based Opioid Treatment for Methadone: Currently, with a few exceptions, methadone for the treatment of opioid dependence is only available through a highly regulated and widely stigmatized system of Opioid Treatment Programs (OTPs). Moreover, several states have imposed moratoriums on establishing new OTPs that facilitate methadone treatment despite large, unmet treatment needs for a growing opioid-dependent population. Patients enrolled in methadone treatment in many communities are often limited to visiting a single OTP and face other inconveniences that make adherence to treatment more difficult. Initial trials have suggested that methadone can be effectively delivered in office-based settings and that, with training, physicians would be willing to prescribe methadone to their patients to treat their opioid dependence. Office-based methadone may help reduce the stigma associated with methadone delivered in OTPs as well as provide a critical window of intervention to address medical and psychiatric conditions. Office-based opioid treatment programs offering methadone have been implemented in California, Connecticut, and Vermont.

4. Provide MAT in Criminal Justice Settings, Including Jails/Prisons and Drug Courts: Individuals recently released from correctional settings are up to 130 times more likely to die of an overdose than the general population, particularly in the immediate two weeks after release. Given that approximately one quarter of people incarcerated in jails and prisons are opioid-dependent, initiating MAT behind bars should be a widespread, standard practice as a part of a comprehensive plan to reduce risk of opioid fatality. Jails should be mandated to continue MAT for those who received it in the community and to assess and initiate new patients in treatment. Prisons should initiate methadone or buprenorphine prior to release, with a referral to a community-based clinic or provider upon release. In addition, drug courts should be mandated to offer participants the option to participate in MAT if they are not already enrolled, make arrangements for their treatment, and should not be permitted to make discontinuation of MAT a criterion for successful completion of drug court programs. The Substance Abuse and Mental Health Services Administration will no longer provide federal funding to drug courts that deny the use of MAT when made available to the client under the care of a physician and pursuant to a valid prescription. The National Association of Drug Court Professionals agrees: "No drug court should prohibit the use of MAT for participants deemed appropriate and in need of an addiction medication."

Medication-Assisted Treatment (MAT) can help.
5. Offer Hospital-Based MAT: Emergency departments should be mandated to inform patients about MAT and offer buprenorphine to those patients that visit emergency rooms and have an underlying opioid use disorder, with an appointment for continued treatment with physicians in the community. Hospitals should also offer MAT within the inpatient setting, and start MAT prior to discharge with community referrals for ongoing MAT.

6. Assess Barriers to Accessing MAT to Increase Access to Methadone and Buprenorphine: A number of known barriers prevent MAT from being as widely accessible as it should be. The federal government needs to reevaluate the need for and effectiveness of the OTP model and make necessary modifications to ensure improved and increased access to methadone. And, while federal law allows physicians to become eligible to prescribe buprenorphine for the treatment of opioid dependence, it arbitrarily caps the number of opioid patients a physician can treat with buprenorphine at any one time to 30 through the first year following certification, expandable to up to potentially 200 patients thereafter. Moreover, states need to evaluate additional barriers created by state law, including, among others, training and continuing education requirements, restrictions on nurse practitioners, insurance enrollment and reimbursement, and lack of provider incentives.

7. Establish and Implement a Heroin-Assisted Treatment Pilot Program: Heroin-assisted treatment (HAT) refers to the administering or dispensing of pharmaceutical-grade heroin to a small and previously unresponsive group of chronic heroin users under the supervision of a doctor in a specialized clinic. The heroin is required to be consumed on-site, under the watchful eye of trained professionals. This enables providers to ensure that the drug is not diverted, and allows staff to intervene in the event of overdose or other adverse reaction. Permanent HAT programs have been established in the United Kingdom, Switzerland, the Netherlands, Germany and Denmark, with additional trial programs having been completed or currently taking place in Spain, Belgium and Canada. Findings from randomized controlled studies in these countries have yielded unanimously positive results, including: 1) HAT reduces drug use; 2) retention rates in HAT surpass those of conventional treatment; 3) HAT can be a stepping stone to other treatments and even abstinence; 4) HAT improves health, social functioning, and quality of life; 5) HAT does not pose nuisance or other neighborhood concerns; 6) HAT reduces crime; 7) HAT can reduce the black market for heroin; and, 8) HAT is cost-effective (cost-savings from the benefits attributable to the program far outweigh the cost of program operation over the long-run). States should consider permitting the establishment and implementation of a HAT pilot program. Nevada and Maryland have introduced legislation of this nature and the New Mexico Legislature recently convened a joint committee hearing to query experts about this strategy.

8. Evaluate the Use of Cannabis to Decrease Reliance on Prescription Opioids and Reduce Opioid Overdose Deaths: Medical use of marijuana can be an effective adjunct to or substitute for opioids in the treatment of chronic pain. Research published last year found 80 percent of medical cannabis users reported substituting cannabis for prescribed medications, particularly among patients with pain-related conditions. Another important recent study reported that cannabis treatment "may allow for opioid treatment at lower doses with fewer [patient] side effects." The result of substituting marijuana, a drug with less side effects and potential for abuse, has had profound harm reduction impacts. The Journal of the American Medical Association, for instance, documents a relationship between medical marijuana laws and a significant reduction in opioid overdose fatalities: "[s]tates with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws."Another working paper from the RAND BING Center for Health Economics notes that "states permitting medical cannabis dispensaries experienced a 15 to 35 percent decrease in substance abuse admissions and opiate overdose deaths." There is also some emerging evidence that marijuana has the potential to treat opioid addiction, but additional research is needed.

Harm Reduction

9. Establish and Implement Safe Drug Consumption Services: States and/or municipalities should permit the establishment and implementation of safe drug consumption services through local health departments and/or community-based organizations. California and Maryland have introduced legislation to establish safe drug consumption services, and the City of Ithaca, New York has included a proposal for a supervised injection site in their widely-publicized municipal drug strategy. In Washington State, the King County Heroin an Prescription Opiate Addiction Task Force has recommended the establishment of at least two pilot supervised consumption sites as part of a community health engagement program designed to reduce stigma and "decrease risks associated with substance use disorder and promote improved health outcomes" in the region that includes the cities of Seattle, Renton and Auburn.

10. Maximize Naloxone Access Points, Including Lay Distribution and Pharmacy Access, As Well As Immunities for Prescription, Distribution and Administration:Naloxone should be available directly from a physician to either a patient or to a family member, friend, or other person in a position to assist in an overdose, from community-based organizations through lay distribution or standing order laws, and from pharmacies behind-the-counter without a prescription through standing order, collaborative agreement, or standardized protocol laws or regulations. Though some states, including California, New York, Colorado and Vermont, among others, have access to naloxone at each of these critical intervention points, many others only provide naloxone through a standard prescription. Civil and criminal immunities should be provided to prescribers, dispensers and lay administrators at every access point. In addition, all first responders, firefighters and law enforcement should be trained on how to recognize an overdose and be permitted to carry and use naloxone. Naloxone should also be reclassified as an over-the-counter (OTC) medication. Having naloxone available over-the-counter would greatly increase the ability of parents, caregivers, and other bystanders to intervene and provide first aid to a person experiencing an opioid overdose. FDA approval of OTC naloxone is predicated on research that satisfies efficacy and safety data requirements. Pharmaceutical companies, however, have not sought to develop an over-the-counter product.88 Federal funding may be needed to meet FDA approval requirements.

11. Provide Dedicated Funding for Community-Based Naloxone Distribution and Overdose Prevention and Response Education: Few states provide dedicated budget lines to support the cost of naloxone or staffing for community-based opioid overdose prevention programs. The CDC, however, reports that, between 1996 and 2014, these programs trained and equipped more than 152,280 laypeople with naloxone, who have successfully reversed 26,463 opioid overdoses.89 Without additional and dedicated funding, community-based opioid overdose prevention programs will not be able to continue to provide naloxone to all those who need it, and the likelihood of new programs being implemented is slim. A major barrier to naloxone access is its affordability and chronic shortages in market supply, 90 which overdose prevention programs, operating on shoestring budgets, can have a difficult time navigating.

12. Improve Insurance Coverage for Naloxone: Individuals who use heroin and other opioids are often both uninsured and marginalized by the healthcare system.91 States should insure optimal reimbursement rates for naloxone to increase access to those who need it most – users themselves.

Overdose reversal drugs need to be made much more widely available -- and affordable. (health.pa.gov)
13. Provide Naloxone to Additional At-Risk Communities: People exiting detox and other treatment programs as well as periods of incarceration are at particularly high risk for overdose because their tolerance has been substantially decreased. After their period of abstinence, if they relapse and use the same amount, the result is often a deadly overdose. States should require overdose education and offer naloxone to people upon discharge from detox and other drug treatment programs and jails/prisons. The Substance Abuse and Mental Health Services Administration has declared that prescribing or dispensing naloxone is an essential complement to both detoxification services as well as medically supervised withdrawal. Vermont passed legislation making naloxone available to eligible pilot project participants who are transitioning from incarceration back to the community. In addition, there are other programs/studies that provide naloxone to recently released individuals on a limited basis, including in San Francisco, California, King County, Washington and Rhode Island.

14. Encourage Distribution of Naloxone to Patients Receiving Opioids: Physicians should be encouraged to prescribe naloxone to their patients and opioid treatment programs should inform their clients about naloxone, if prescribing or dispensing an opioid to them. Pharmacists should similarly be encouraged to offer naloxone along with all Schedule II opioid prescriptions being filled, for syringe purchases (without concurrent injectable medication), and for all co-prescriptions (within 30 days) of a benzodiazepine (such as Valium™, Xanax™ or Klonopin™) and any opioid medication. The Rhode Island Governor's Overdose Prevention and Intervention Task Force found that offering naloxone to those prescribed a Schedule II opioid or when co-prescribed a benzodiazepine and any opioid would have reached 86% of overdose victims who received a prescription from a pharmacy prior to their death, and could have prevented 58% of all overdose deaths from 2014 to 2015.

15. Expand Good Samaritan Protections: "Good Samaritan" laws provide limited immunity from prosecution for specified drug law violations for people who summon help at the scene of an overdose. But, protection from prosecution is not enough to ensure that people are not too frightened to seek medical help. Other consequences, like arrest, parole or probation violations, and immigration consequences, can be equal barriers to calling 911. States with Good Samaritan laws already on the books should evaluate the protections provided and determine whether expansion of those protections would increase the likelihood that people seek medical assistance.

16. End the Criminalization of Syringe Possession: Syringes should be exempt from state paraphernalia laws in order to provide optimal access to people who inject drugs. Twenty-two states criminalize syringe possession. Thus, even if there is a legal access point, such as pharmacy sales, paraphernalia laws still permit law enforcement to arrest and prosecute individuals in possession of a syringe. Public health and law enforcement authorities should not be working at cross-purposes.

17. Reduce Barriers to Over-The-Counter Syringe Sales and Permit Direct Prescriptions of Syringes: While the non-prescription, over-the-counter sale of syringes is now permitted in all but one U.S. state, access is still unduly restricted.States should evaluate the potential barriers to accessing syringes over-thecounter and implement measures to improve access. Moreover, doctors should be permitted to prescribe syringes directly to their patients, a practice few states currently permit.

18. Authorize and Fund Sterile Syringe Access and Exchange Programs; Increase Programs: States should explicitly authorize and fund sterile syringe access and exchange programs, and states that have already authorized them should evaluate how to increase the number or capacity of programs to ensure all state residents – whether in urban centers or rural communities -- have access to clean syringes, as well as evaluate any possible barriers to access such as unnecessary age restrictions.

19. Provide Free Public, Community-Level Access to Drug Checking Services: Technology exists to test heroin and opioid products for adulterants via GC/MS analysis, but it has so far been unavailable at a public level in the US (aside from a mail-in service run by Ecstasydata.org). Making these services available in the context of a community outreach service or academic study would lower the number of deaths and hospitalizations and also allow for real-time tracking of local drug trends.

Prevention

20. Establish Expert Panel on Opioid Prescribing: Though the CDC has issued guidelines for prescribing opioids for chronic pain, the guidelines are voluntary and are likely to exacerbate disparities in treatment that already exist. Research has shown, for example, that African Americans are less likely than whites to receive opioids for pain even when being treated for the same conditions. Moreover, the CDC guidelines only address prescribing practices for chronic pain, not prescribing practices more broadly. States should accordingly establish an expert panel to undertake an assessment as to whether prescribing practices, such as co-prescriptions for benzodiazepines and opioids or overprescribing of opioids, have contributed to increased rates of opioid dependence, and, if so, the expert panel should develop a plan to address any such linkages as well as any treatment disparities. The plan must account for the potential negative effects of curtailing prescribing practices or swiftly reducing prescription opioid prescribing volume. A task force in Rhode Island found that while changes in opioid supply can have the intended effect of reducing availability of abuse-able medications, they have also been linked to an increase in transition to illicit drug use and in more risky drug use behaviors (e.g., snorting and injecting pain medications). The plan must also account for chronic pain patients, particularly those already underserviced, and not unduly limit their access to necessary medications. Finally, to the extent prescribing guidelines are issued as part of the plan, they should be mandatory and applied across the board.

21. Mandate Medical Provider Education: States should mandate that all health professional degree-granting institutions include curricula on opioid dependence, overdose prevention, medication-assisted treatment, and harm reduction interventions, and that continuing education on these topics be readily available.

22. Develop Comprehensive, Evidence-Based Health, Wellness, and Harm Reduction Curriculum for Youth: State education departments, in conjunction with an expert panel consisting of various stakeholders that ascribe to scientific principles of treatment for youth, should develop a comprehensive, evidence-based health, wellness, and harm reduction curriculum for use in schools that incorporates scientific education on drugs, continuum of use, and contributors to problematic drug use (e.g., coping and resiliency, mental health issues, adverse childhood experiences, traumatic events and crisis), as well as how reduce harm (e.g., not mixing opioids with benzodiazepines). Education departments should also establish protocols and resources for early intervention, counseling, linkage to care, harm reduction resources, and other supports for students.

CRIMINAL JUSTICE

23. Establish Diversion Programs, Including Law Enforcement Assisted Diversion (LEAD): LEAD is a pre-booking diversion program that establishes protocols by which police divert people away from the typical criminal justice route of arrest, charge and conviction into a health-based, harm-reduction focused intensive case management process wherein the individual receives support services ranging from housing and healthcare to drug treatment and mental health services. Municipalities should create and implement LEAD programs and states and the federal government should provide dedicated funding for such programs. Various other forms of diversion programs exist and can be implemented should LEAD prove unsuitable to a particular population or municipality.

24. Decriminalize Drug Possession: Decriminalization is commonly defined as the elimination of criminal penalties for drug possession for personal use. In other words, it means that people who merely use or possess small amounts of drugs are no longer arrested, jailed, prosecuted, imprisoned, put on probation or parole, or saddled with a criminal record. Nearly two dozen countries have taken steps toward decriminalization. Empirical evidence from the international experiences demonstrate that decriminalization does not result in increased use or crime, reduces incidences of HIV/AIDs and overdose, increases the number of people in treatment, and reduces social costs of drug misuse. All criminal penalties for possession of small amounts of controlled substances for personal use should be removed.

Chronicle AM: Senators' Sessions Forfeiture Letter, Canada Legalization Debate, More... (5/31/17)

A bipartisan group of US senators has sent Attorney General Sessions a letter asking him to rein in federal civil asset forfeiture, the Rhode Island House is voting on a pot legalization study commission, the Canadian parliament begins debating the government's legalization bill, and more.

Marijuana Policy

California Senate Votes to Make Marijuana Use in Cars an Infraction. The state Senate on Tuesday approved Senate Bill 65, which would prohibit the use of marijuana in automobiles because of concerns over drugged driving. The bill would make the offense a violation, punishable by no more than a fine. The bill now goes to the Assembly.

Rhode Island House to Vote Today on Legalization Study Commission. The House is set to vote today on a bill creating a 17-member panel to "conduct a comprehensive review and make recommendations regarding marijuana and the effects of its use." The commission would have until March 1, 2018 to report its findings to the General Assembly. Adopting the bill effectively blocks legalization in the state until next year at the earliest. This measure is supported by anti-reform state Attorney General Peter Kilmartin and Smart Approaches to Marijuana. If the measure passes the House, it then goes to the Senate.

Wisconsin Decriminalization Bill Gets Lone Republican Supporter. Legislative proponents of marijuana decriminalization held a press conference on Tuesday to rally support for a bill that would remove criminal penalties for possession of 10 grams or less. Three Democratic cosponsors were joined by Republican Rep. Adam Jarchow (District 28) at the presser, where they conceded their bill was unlikely to pass this year, but was intended to get the ball rolling.

Medical Marijuana

Arkansas Regulators Delay Voting on Final Rules for Another Week. The state Medical Marijuana Commission needs another week to finalize some rules, commission Chairwoman Dr. Ronda Henry-Tillman said Tuesday. If it indeed finalizes rules next week, applications for medical marijuana businesses will open up on June 30.

Asset Forfeiture

Bipartisan Group of Senators Ask Session to Rein In Asset Forfeiture. Six US senators have sent a letter to Attorney General Jeff Sessions asking him to change Justice Department policy on civil asset forfeiture. "We encourage the Department of Justice to revise its civil asset forfeiture practices to reflect our nation's commitment to the rule of law and due process," Sens. Mike Lee (R-UT), Rand Paul (R-KY), Mike Crapo (R-ID), Martin Heinrich (D-NM), Tom Udall (D-NM) and Angus King (I-ME) wrote to Sessions. "We encourage the Department of Justice to revise its civil asset forfeiture practices to reflect our nation's commitment to the rule of law and due process." Noting that Supreme Court Justice Clarence Thomas had recently expressed skepticism about the practice, they added: "You need not wait for Supreme Court censure before reforming these practices, and, in any event, the Department of Justice should err on the side of protecting constitutional rights."

International

Canada Begins Debating Government's Marijuana Legalization Bill. Parliamentary debate on the C-45 legalization bill got underway Tuesday. Supported by Prime Minister Justin Trudeau, the bill is expected to pass, making Canada the second country after Uruguay to legalize marijuana.

South African Opioid Substitution Program Underway. The city of Tshwane and the University of Pretoria are collaborating on a pilot opioid substitution therapy (OST) program in seven clinics in central Pretoria and Tshwane townships. Doctors are prescribing drugs such as methadone and buprenorphine to be consumed under direct supervision of health workers. The program also links patients to counseling and job skills, as well as testing for HIV and Hep C.

Chronicle AM: Philippines Prez in Hot Seat Over Drug War, WV Legalization Bill, More... (3/16/17)

The Philippines' bloody-handed president is facing harsh criticism as the UN Commission on Narcotic Drugs meets in Vienna, West Virginia gets a marijuana legalization bill, New York City Mayor Bill de Blasio rolls out a plan to fight opioid addiction and overdoses, and more.

Filipino President Rodrigo Duterte is under attack at home and abroad over drug war abuses. (The Fix)
Marijuana Policy

West Virginia Legalization Bill Filed. Delegate Sean Hornbuckle (D-Cabell County) introduced House Bill 3035 Tuesday. The bill would tax and regulate marijuana like alcohol. It has been sent to the House Health and Human Resource Committee. If it gets through there, it must then go to the House Judiciary Committee before heading for a House floor vote.

Medical Marijuana

Arkansas Bill to Ban Edibles, Public Smoking Wins Committee Vote. A bill that would bar medical marijuana patients from consuming edibles or from smoking their medicine in public was approved Wednesday by the House Rules Committee. But the measure, House Bill 1400, faces an uphill battle to win final approval because any changes to the voter-approved medical marijuana law require a two-thirds vote to pass.

Massachusetts Bills Would Protect Patients' Employment Rights. Even as the state Supreme Court Thursday heard a case on employment rights for medical marijuana patients, two bills alive in the state legislature would do just that. Rep. Frank Smizik (D-Brookline) has introduced House Bill 2385, which would explicitlyprotect the rights of a medical marijuana patient to use the drug without facing discrimination in hiring, firing or terms of employment. The bill would also protect medical marijuana patients from discrimination in education, housing and child welfare and custody cases. That bill is currently before the Committee on Marijuana Policy. A similar bill was filed last sessions, but didn't pass. A second bill, House Bill 113, is aimed mostly at updating state law to bring it in line with the Americans With Disabilities Act, but one provision clarifies that employers cannot take adverse employment action against someone for using medical marijuana. That bill is before the Joint Committee on Children, Families, and Persons with Disabilities.

Nebraska Medical Marijuana Bill Gets Charged Hearing. At a hearing in the Judiciary Committee Wednesday, law enforcement, the state attorney general's office, and the state's top doctor all came out in opposition to a medical marijuana bill, Legislative Bill 622, but legislators also heard emotional testimony in favor of the bill from Army veterans and others who said they would benefit from access to medical marijuana. Five of the bill's sponsors sit on the eight-member Judiciary Committee, so the bill is likely to make it to a House floor vote, where opposition has killed similar measures in past years.

Heroin and Prescription Opioids

New York City Mayor Reveals Plans to Fight Opioid Addiction. Mayor Bill de Blasio said Monday that the city planned to spend as much as $38 million a year on a broad array of measures aimed at reducing opioid addiction and overdoses. Among the measures mentioned were expanded methadone and buprenorphine treatment, the distribution of the overdose reversal drug naloxone to all 23,000 city patrol officers, a focus on city hospitals on dealing with addiction and overdoses, and increased prosecution of opioid dealers. De Blasio mentioned outreach, treatment, and law enforcement, but not harm reduction.

International

Bolivia Says It Does Not Need US or European Help to Fight Drug Trafficking. Bolivian Vice President Alvaro Garcia Lima said Wednesday that his country doesn't need help or advice from the US or Europe on its coca policies or its fight with drug traffickers. "We fight against drug trafficking with Bolivian money, we do not depend on the European Union (EU) to fight against drug trafficking. Before when we depended on the United States, Bolivia received about USD $100 million. We have set aside that aid," he said. Garcia Lima's remarks came in response to European Union criticism of a new Bolivian law nearly doubling legal coca cultivation. The EU suggested that perhaps its aid to Bolivia should be "refocused." Garcia Lima retorted that Bolivia is "not begging money" from the EU.

Philippines Vice-President Condemns Duterte's Drug War. In an interview with Time magazine ahead of a speech set for Thursday at the Commission on Narcotic Drugs in Vienna, Philippine Vice President Leni Robredo condemned President Rodrigo Duterte's bloody drug war and said she was "inspired" by growing opposition to it. She also said she was "encouraged" that the international community is speaking out. "We hope that in the next few months we, together with the international community, can convince the current administration to focus its efforts in ending human-rights violations and extrajudicial killings," she said. "In addition, let us work together to strengthen the existing accountability mechanisms in the Philippines in order for us to have those responsible brought to justice. We hope that we can persuade the administration to concentrate more on the bigger war we are facing -- the war on poverty."

Philippines Lawmaker Files Impeachment Complaint Against Duterte, Cites Drug War Killings. Philippines Rep. Gary Alejano has filed an impeachment complaint against President Rodrigo Duterte, calling for his removal for high crimes, abuses of power, and betrayal of public trust. The complaint lists drug-related murders, the operation of death squads while Duterte was mayor of Davao City, and conflicts of interest among the impeachable offenses. Pro-Duterte lawmakers said the complaint "will not fly," but Alejano was undaunted. "Our goal with this complaint is to be a vehicle for Filipinos to have a voice to oppose and fight against the abuses and crimes of President Duterte," Alejano told a televised news conference. "We know it's an uphill battle... but we believe that many will support this."

Chronicle AM: Marijuana Legal in MA Thursday, Canada Moving Forward, More... (12/13/16)

There's a lot of international news today, plus Colorado pot sales pass the $1 billion mark this year, Massachusetts politicians get out of the way of legalization, and more.

Philippines President Duterte isn't satisfied with mass killing of drug suspects. He wants the death penalty, too. (Wikimedia)
Marijuana Policy

Colorado Marijuana Sales Hit $1 Billion Mark This Year. The state Department of Revenue reports that marijuana sales through October exceeded the billion dollar mark, coming in at $1.09 billion. That figure could hit $1.3 billion by year's end, according to marijuana industry attorney Christian Sederberg.

Massachusetts Officials Won't Delay Marijuana Legalization. Possession of small amounts of marijuana will become legal Thursday. There had been fears of a delay after loose talk in the legislature, but legislative leaders made it clear Monday they will not seek to delay the start of the new law.

Medical Marijuana

Arkansas Medical Marijuana Commissioners Sworn In. In the first meeting of a commission established to create a state medical marijuana system after voters approved a constitutional amendment last month, five commissioners were sworn in. The members of the state Medical Marijuana Commission are Dr. Ronda Henry-Tillman of Little Rock, lobbyist James Miller of Bryant, Dr. Carlos Roman of Little Rock, pharmacy executive Stephen Carroll of Benton and attorney Travis Story of Fayetteville. Henry-Tillman was unanimously elected Monday afternoon as the commission's chairman.

Kentucky Medical Marijuana Bill Filed. State Sen. Perry Clark (D-Louisville) has filed the Cannabis Compassion Act of 2017 (BR 409), which would allow patients with a specified list of diseases and medical conditions access to their medicine. The bill would allow patients to possess up to three ounces and grow up to 12 plants and envisions a system of regulated cultivators and "compassion centers."

Michigan Medical Marijuana Fees Fund State's War on Drugs.Medical marijuana fees have fattened the Michigan Medical Marijuana Fund, and state law enforcement has been tapping into that fund to aggressively go after marijuana. Local sheriffs in the Detroit area have spent more than $600,000 raiding dispensaries in the past year, and there's more where that came from since the fund has raised $30 million. "I really don't think it's appropriate to fund law enforcement on the backs of medical marijuana patients," medical marijuana attorney Matt Abel told the Detroit News. "… It's really a hidden tax on patients."

International

Canada Marijuana Task Force Advises Wide-Ranging Legalization. The task force charged with shaping the country's looming marijuana legalization has recommended that pot be sold in retail stores and by mail order, that possession of 30 grams and cultivation of four plants be legalized, that the minimum age be set at 18, and that pot not be sold along with alcohol. The commission is also recommending that high-potency products be more heavily taxed to discourage their use. The Liberals are expected to file their legalization bill this coming spring.

Canada Releases New Comprehensive Drug Strategy. Health Minister Jane Philpott Monday unveiled the Canadian Drug and Substances Strategy, which will replace the existing National Anti-Drug Strategy of the Conservatives. The new strategy restores harm reduction as a core pillar of Canadian drug policy, along with prevention, treatment, and law enforcement, and insists on a "strong evidence base."

British Drug Advisers Call for Prescription Heroin, Safe Injection Sites. The official Advisory Council on the Misuse of Drugs has recommending allowing hard-core heroin users to get the drug via prescription and called for the opening of supervised injection facilities. Both moves come as a response to a soaring number of drug overdose deaths. "The ACMD is of the view that death is the most serious harm related to drug use," commission head Les Iversen said in a letter to the Home Secretary. "The most important recommendation in this report is that government ensures that investment in OST [opioid substitution therapy] of optimal dosage and duration is, at least, maintained," he added.

Philippines Drug War Death Toll Nearing 6,000. According to statistics released Monday by the Philippines National Police, some 5,927 deaths have been linked to President Rodrigo Duterte's war on drugs since he took office at the beginning of July. Nearly 2,100 were killed in police operations, while more than 3,800 deaths were blamed on vigilantes or death squads.

Effort to Block Philippines Death Penalty Bill. In addition to widespread extra-judicial executions of drug suspects, President Duterte wants to reinstate the death penalty, including for drug offenses. ASEAN Parliamentarians on Human Rights is leading the campaign against the bill and wants people to contact Philippines lawmakers. Click on the link for more info.

Chronicle AM: Organic Foods Group Disses Kratom, DPA Releases Opioids Plan, More... (12/7/16)

An organic foods group says allowing kratom would be "dangerous," the Drug Policy Alliance comes out with a plan for heroin and prescription opioids, Iowa shuts down its asset forfeiture unit, and more.

The Natural Products Association says allowing kratom would be "dangerous." (Creative Commons/Wikimedia)
Marijuana Policy

Virginia Marijuana Arrests Plummet. Marijuana arrests have dropped 14% in the state over the past two years, the largest decline this century, and they appear headed for further declines this year. Changes in prosecutorial priorities appear to be behind the fall, with some prosecutors saying they need to husband their resources for felony prosecutions.

Heroin and Prescription Opioids

Drug Policy Alliance Releases Public Health and Safety Plan to Address Problematic Opioid Use and Overdose. The Drug Policy Alliance, the nation's leading proponent of drug policy reform, is releasing a plan to address increasing rates of opioid use and overdose (now the leading cause of accidental death in the United States). The plan marks a radical departure from the punitive responses that characterize much of US drug policy and instead focuses on scientifically proven harm reduction and public health interventions that can improve treatment outcomes and reduce the negative consequences of opioid misuse, such as transmission of infectious diseases and overdose. The plan has 20 specific recommendations, including establishing safe injection sites, moving ahead with prescription heroin (heroin-assisted treatment), and embracing Law Enforcement Assisted Diversion (LEAD) to keep people out of the criminal justice system and bring them in contact with social services.

Kratom

Natural Products Association Says Allowing Kratom Would Be "Dangerous." The largest trade group representing the organic and natural foods industry and dietary supplements makers has commented on the DEA's proposed ban on kratom, saying that "adding kratom to the US food supply could likely be dangerous and lead to serious unintended consequences." Kratom products have not met the strict standards for new items to be marketed to the public or undergone FDA approval, the group said. "Adding an untested and unregulated substance such as kratom to our food supply without the application of longstanding federal rules and guidelines would not only be illegal," said Daniel Fabricant, PhD, NPA's CEO and executive director. "It could likely be dangerous, leading to serious unintended consequences as our nation struggles with the crisis of opioid addiction."

Asset Forfeiture

Iowa Disbands State Asset Forfeiture Team, Returns $60,000 Taken From Travelers. Under increasing fire over asset forfeiture practices that saw a thousand seizures a year, the state Attorney General's Office announced Monday that the Department of Public Safety had disbanded its Interstate 80 drug interdiction and forfeiture team. The move came because of increased personnel demands and the need to focus on reducing traffic deaths, the office said, and had nothing to do with the recently announced settlement of a lawsuit brought by a pair of California gamblers who had $100,000 seized after they were stopped and a small amount of marijuana was found. That settlement resulted in the men getting most of their money back.

Law Enforcement

Justice Department Probing Possible Criminal Charges Over Atlanta DEA Informants. A DEA official told a congressional committee last week that the agency has referred "potential criminal charges" to the Justice Department over an Atlanta DEA supervisor who allegedly was in sexual relationships with two informants, one of whom was paid $212,000 for helping to bust four St. Louis drug traffickers. There are allegations of false documentation of payments to the snitch, who got $2,500 a month for two years, along with two "bonuses" of $55,000 and $80,750. The monthly payments apparently covered the rent for apartment near the DEA supervisor's home in the Atlanta metro area.

Seattle Aims to Open the First Safe Injection Sites in the US [FEATURE]

Seattle and surrounding King County are on a path to establish the country's first supervised drug consumption sites as part of a broader campaign to address heroin and prescription opioid misuse. A 99-page report released last week by the Heroin and Prescription Opiate Addiction Task Force calls for setting up at least two of the sites, one in the city and one in the suburbs, as part of a pilot project.

The facilities, modeled on the Canadian government-funded InSite supervised injection site in Vancouver, just 140 miles to the north, would be places where users could legally inject their drugs while under medical supervision and be put in contact with treatment and other social services. There have been no fatal overdoses in the 13-year history of InSite.

Although such facilities, which also operate in various European countries and Australia, have been proven to reduce overdose deaths and drug use-related disease, improve local quality of life, and improve the lives of drug users, they remain controversial, with foes accusing them of "enabling" drug use. Thus, the report refers to them not as "safe injection sites," or even "supervised consumption sites," but as the anodyne "Community Health Engagement Locations" (CHELs).

"If it's a strategy that saves lives then regardless of the political discomfort, I think it is something we have to move forward," said County Executive Dow Constantine, discussing the plan at a news conference last week.

The safe sites will address the region's high levels of opioid and heroin use, or what the task force called "the region's growing and increasingly lethal heroin and opioid epidemic." As the task force noted, the number of fatal overdoses in the county has tripled in recent years, with the rate of death rising from roughly one a week (49) in 2009 to one very other day (156) in 2014. The current wave of opioid use appears centered on young people, with the number of people under 30 seeking treatment doubling between 2006 and 2014, and now, more young people are entering detox for heroin than for alcohol.

Outside Vancouver's InSite (vch.ca)
Overdose deaths actually dropped last year to 132, thanks to Good Samaritan laws that shield people who aid overdose victims from prosecution and to the wider use of the opioid overdose reversal drug naloxone. But that's still 132 King County residents who needn't have died. Task force members said the CHELs would help reduce that number even further.

"The heroin epidemic has had a profound effect not just on our region, but across our country as a whole," said Seattle Mayor Ed Murray. "It is critical that we not only move forward with meaningful solutions that support prevention and treatment, but that we remove the stigma surrounding addiction that often creates barriers to those seeking help.

Not only are key local elected officials on board, so is King County Sheriff John Urquhart. He said the safe site plan was workable.

"As long as there was strong, very strong, emphasis on education, services, and recovery, I would say that yes, the benefits outweigh the drawbacks," he said. "We will never make any headway in the war on drugs until we turn the war into a health issue."

The region may willing to embrace this ground-breaking harm reduction measure, but it is going to require some sort of federal dispensation to get around the Controlled Substances Act and the DEA. How that is going to happen remains to be seen, but Seattle is ready.

The task force wasn't just about CHELs. In fact, the safe sites are just a small, if key, component of a broad-based, far-ranging strategy to attack the problem. The task force report's recommendations come in three categories:

Inside Vancouver's InSite (vch.ca)
Primary Prevention

  • Increase public awareness of effects of opioid use, including overdose and opioid-use disorder.
  • Promote safe storage and disposal of medications.
  • Work with schools and health-care providers to improve the screening practices and better identify opioid use.

Treatment Expansion and Enhancement

  • Make buprenorphine more accessible for people who have opiate-use disorders.
  • Develop treatment on demand for all types of substance-use disorders.Increase treatment capacity so that it’s accessible when and where someone is ready to receive help.

Health and Harm Reduction

  • Continue to distribute more naloxone kits and making training available to homeless service providers, emergency responders and law enforcement officers.
  • Create a three-year pilot project that will include at least two locations where adults with substance-use disorders will have access to on-site services while safely consuming opioids or other substances under the supervision of trained healthcare providers.

Will Seattle and King County be able to actual implement the CHELs? Will the federal government act as obstacle or facilitator? That remains to be seen, but harm reductionists, policymakers, and drug users in cities such as Portland, San Francisco, and New York will be watching closely. There have been murmurs about getting such sites up and running there, too.

Chronicle AM: Seattle Call for Injection Sites, Duterte Wants More Lethal Drug War, More... (9/20/16)

A Seattle/King County heroin task force has recommended two safe injection sites be established, a California bill to let landlords ban medical marijuana smoking dies, Nevada legalization foes get organized, and more.

from the anti-legalization Protecting Nevada's Children website
Marijuana Policy

Nevada Legalization Foes Get Organized. Opponents of the Question 2 legalization initiative have organized as Protecting Nevada's Children, complete with a slick website that warns that "legalizing marijuana… like giving candy to a baby." Officials with the no campaign are also worrying about "a well-prepared workforce" if Las Vegas becomes "the Amsterdam of the West." The group refuses to divulge its funding, saying it would be revealed in mid-October, when campaign finance reports are due.

Medical Marijuana

California Bill to Let Landlords Ban Medical Marijuana Smoking Dies. Assemblyman Jim Wood (D-North Coast) has dropped his bill that would let landlords ban smoking medical marijuana after he conceded he was unable to figure out how to meet the needs of medical marijuana patients.

Harm Reduction

Seattle Heroin and Opioid Task Force Issues Report, Calls for Two Safe Injection Sites. The King County Heroin and Opiate Addiction Task Force has issued a final report calling on increased prevention and access to treatment for addicted users. Among other recommendations, the report calls for authorities to "Create a three-year pilot project that will include at least two locations where adults with substance-use disorders will have access to on-site services while safely consuming opioids or other substances under the supervision of trained healthcare providers." Look for a detailed article on the task force recommendations tomorrow.

Sentencing Reform

North Dakota Legislature Squabbles Over Drug Sentences. Legislators are working off-session on a pair of criminal justice reform bills aimed at curbing a growing prison population, but some are reluctant to embrace reductions in drug sentences that experts said were necessary to actually achieve prison population cuts. There was support for reducing some sentences for drug possessors, but not for drug sellers. A proposal from the Department of Corrections and Rehabilitation to eliminate mandatory minimums for people dealing drugs was rejected. But a proposal from the Council of State Governments to make probation the presumptive sentence for first-time, low-level felonies was accepted. The bills will be introduced at the beginning of the next session.

International

Philippines President Wants Six More Months of Drug War Because He "Cannot Kill Them All" Fast Enough. Even as the death toll from President Rodrigo Duterte's slow motion massacre of drug suspects tops 3,000, the hardline leader is saying he wants to extend his crusade another six months. "I did not realize how severe and how serious the drug menace was in this republic until I became president," Duterte said. "Even if I wanted to I cannot kill them all because the last report would be this thick," he said, referring to a new police list of people including top officials suspected of being involved in the drugs trade.

Drug War Issues

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