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How to Prevent Opioid Overdoses? Provide Hard-Core Addicts Free Pharmaceutical Heroin

With Ohio beset by a massive public health crisis around opioid use and overdoses -- more than 4,000 Ohioans died of opioid overdoses in 2016 -- the Cleveland Plain Dealer sent travel editor Susan Glaser to Amsterdam in search of innovative approaches to the problem. While there, she rediscovered Holland's longstanding, radical, and highly-effective response to heroin addiction and properly asked whether it might be applied to good effect here.

The difference in drug-related death rates between the two countries is staggering. In the US, the drug overdose death rate is 245 per million, nearly twice the rate of its nearest competitor, Sweden, which came in second with 124 per million. But in Holland, the number is a vanishingly small 11 per million. In other words, Americans are more than 20 times more likely to die of drug overdoses than Dutch.

For Plain Dealer readers, the figures that really hit home are the number of state overdose deaths compared to Holland. Ohio, with just under 12 million people, saw 4,050 drug overdose deaths in 2016; the Netherlands, with 17 million people, saw only 235.

What's the difference? The Dutch government provides free heroin to several score hardcore heroin addicts and has been doing so for the past 20 years. Public health experts there say that in addition to lowering crime rates and improving the quality of life for users, the program is one reason overdose death rates there are so low. And the model could be applied here, said Amsterdam heroin clinic operator Ellen van den Hoogen.

"It's been an enormous success. I think it would work elsewhere," she told Glaser.

It already has. The Dutch program was modeled on a similar effort in Switzerland, which has also proven successful. Germany and Canada are among the several other countries with similar programs.

The Dutch approach is an example of the country's policy of gedogen (pragmatic tolerance), the same principle that led the Dutch to pioneer quasi-legal access to marijuana in the 1980s. It is also rooted in the notion that, for some, drug addiction is a chronic disorder, not a condition to be "cured," and one that can be treated with supervised drug use under clinical supervision. And the complete cessation of drug use need not be the ultimate goal; rather, the Dutch look for reductions in criminal activity and increases in the health and well-being of the drug users.

"It's not a program that is meant to help you stop," acknowledged van den Hoogen. "It keeps you addicted."

That's not a sentiment sits well with American moralizers, such as George W. Bush's drug czar, John Walters, whom Glaser consulted for the story. He suggested that providing addicts with drugs was immoral and not "real treatment," but he also resorted to lies about what the Dutch are doing.

He claimed the Dutch are "keeping people addicted for the purpose of controlling them" and that the Dutch have created "a colony of state-supported, locked-up addicts."

Actually, the Dutch are dealing with older, hardcore addicts who have repeatedly failed to quit after repeated stints in treatment, including methadone maintenance therapy, and they are neither "controlling them" or locking them up. Instead, the people in the program show up at the clinic twice a day, get their fix, then go about their business. This heroin-assisted treatment (HAT) allows those hardcore users to live less chaotic and more productive lives.

And heroin-assisted treatment is "real treatment," said Peter Blanken, a senior researcher with the Parnassia Addiction Research Centre in Rotterdam. He pointed out that one-quarter of program participants make a "complete recovery," including better health and quitting illegal drugs and excessive drinking. Many others continue to use heroin, but do so with better outcomes, he said.

There is also a real safety benefit to using state-supplied pharmaceutical heroin. It's potent, but it's a known quantity. Users face no risk of adulteration with more dangerous drugs, such as fentanyl, which is deeply implicated in the current US overdose crisis.

In the current political atmosphere in the United States, providing heroin to hardcore addicts is a hard sell indeed. Other, lesser, harm reduction interventions, such as needle exchanges remain controversial, and the country has yet to see its first officially sanctioned safe injection site. And drug decriminalization, which has led to a dramatic reduction in heroin addiction and overdose deaths in Portugal, remains off the table here, too. But with an annual drug overdose death toll of more than 50,000 people a year, it may time to start asking how many more Americans we are willing to sacrifice on the altar of moralistic drug prohibition.

Chronicle AM: Gallup: Pot Use "Morally Acceptable," Bangladeshi Drug War Killings, More... (6/4/18)

Two polls illustrate the rising social acceptability of marijuana, Louisiana's medical marijuana program expands, the Bangladeshi drug war could be a cover for political assassinations, and more.

Most people don't think people who smoke pot are moral lepers, a new Gallup poll finds. (Creative Commons)
Marijuana Policy

Gallup Poll: Two-Thirds Say Consuming Marijuana "Morally Acceptable." A large majority of Americans -- 65% -- say consuming marijuana is "morally acceptable." An even larger majority -- 78% -- say drinking alcohol is "morally acceptable." This is the first time Gallup has asked the question.

Youth Support for Marijuana Legalization at All-Time High, Poll Finds. The annual Monitoring the Future survey of secondary school students finds that 49% of 12th graders supported marijuana legalization last year, a figure the survey called a "historic high." Just a decade earlier, only 29% favored legalization, but support has grown every year since then, except for a one-point downward blip in 2015.

Medical Marijuana

Louisiana Governor Signs Second Medical Marijuana Expansion Bill. Gov. John Bel Edwards (D) has signed into law House Bill 579, which adds Parkinson's, glaucoma, severe muscle spasms, chronic pain and post-traumatic stress disorder to the 10 conditions currently qualifying for medical marijuana. Days earlier, he signed into law a second bill that added autism to the list of qualifying disorders.

International

Bangladeshi Drug War Used to Hide Political Assassinations. The death toll from the Bangladeshi government's bloody drug crackdown has risen to 120, and claims are coming that some of the victims are not drug users or dealers at all, but political opponents of the government. One case is that of Habibur Rahman, who police said had been killed in a gunfight with officers, but his family said Rahman, an activist with the leading opposition party, was last seen being taken away from a local mosque by men thought to be plainclothes police officers. "He was neither a drug seller nor a drug addict. It was because he was involved in politics against the government and protested about land affairs," said a relative who declined to be named for fear of retaliation.

British Home Office Scotches Plans for Glasgow Safe Injection Site. The British Home Office has refused to approve a safe injection site in Glasgow -- even though it acknowledges they are an effective harm reduction intervention. The Home Office said there is no legal framework for setting up safe injection sites and there are no plans to amend the law to do so.

Chronicle AM: NY Dems Endorse Marijuana Legalization, Surgeon General Talks Harm Reduction, More... (5/24/18)

The US Surgeon General has some surprisingly frank words about harm reduction and evidence-based drug policy, Cory Booker's Marijuana Justice Act picks up another sponsor, Arizona's Supreme Court throws out a state law criminalizing the use and possession of medical marijuana on campus and more.

The section on the Surgeon General's comments has an update, including a statement from the Department of Health and Human Services on the safe injection sites mention.

US Surgeon General Jerome Adams talks harm reduction and evidence-based opioid treatment. (Creative Commons)
Marijuana Policy

Jeff Merkley Signs on to Federal Marijuana Justice Act. And then there were five. Sen. Jeff Merkley (D-OR) has become the fifth cosponsor of Sen. Cory Booker's Marijuana Justice Act (S. 1689). The other cosponsors are Sens. Kirsten Gillibrand (D-NY), Kamala Harris (D-CA), Bernie Sanders (I-VT), and Ron Wyden (D-OR). Representatives Barbara Lee (D-CA) and Ro Khanna (D-CA) introduced a companion measure, H.R. 4815, in the House of Representatives earlier this year that has 35 cosponsors.

New York Democratic Party Officially Endorses Marijuana Legalization. Delegates to the state Democratic convention Wednesday adopted a resolution supporting marijuana legalization: "The New York State Democratic Committee supports the legalization of marijuana which should be regulated and taxed in a manner similar to alcohol," reads a resolution. The resolution adds that legalization is "an important social justice issue."

Medical Marijuana

Arizona Supreme Court Okays Medical Marijuana on College Campuses. The court ruled Wednesday that the state can't criminally charge card-carrying medical marijuana patients for possessing and using their medicine on campus. In Arizona v. Maestas, the court held that a 2012 law banning medical marijuana on campus violated the state's protections for voter-approved laws. The Supreme Court ruling upholds an appellate court ruling that also found in Maestas' favor.

Ohio Dispensary License Announcement Delayed. The state Board of Pharmacy announced Tuesday that its planned announcement of dispensary license awards Wednesday has been postponed and that provisional licenses will instead be issued in June. Legal medical marijuana sales are supposed to begin on September 8. Stay tuned.

Pennsylvania Judge Halts Medical Marijuana Research Program. A Commonwealth Court judge has granted a temporary injunction sought by numerous dispensaries and growers and processors to halt the state's medical marijuana research program. The plaintiffs worry that the regulations for the clinical research programs would give an unfair advantage to clinical research partners and growers. The Health Department is now pondering next steps.

Hemp

Illinois Governor Gets Bill Legalizing Industrial Hemp. With a 106-3 House vote Wednesday, the legislature has approved a bill legalizing industrial hemp, Senate Bill 2298. Now it's up to Gov. Bruce Rauner (R) to sign it.

Heroin and Prescription Opioids

US Surgeon General Urges ER Docs to Advocate for Evidence-Based Opioid Treatment. US Surgeon General Dr. Jerome Adams called Wednesday on emergency room physicians to advocate more vigorously for evidence-based opioid treatment, including harm reduction measures. Adams supported such harm reduction interventions as needle exchanges and safe injection sites. [The Department of Health and Human Services has issued a statement claiming that Dr. Adams does not support safe injection sites, and contesting the evidence on them. See update below.] He urged doctors to reach out to and educate stakeholders in their communities. "We have to understand that these policy interventions look different in different parts of the country," Adams said. "We have to understand that public policy means public and that we have to be able to go there and show them that we care before we can share what we know."

Update: A Department of Health and Human Services officer contacted us on Saturday, March 26th, claiming that the report news outlets relied on, including the one we linked to, was inaccurate in stating that Dr. Adams supports safe injection sites. We do not have other reports on his speech at this time to go on. The article linked above has been updated to include a copy of the HHS statement:

"The Administration and the Surgeon General do not support so-called 'safe' injection sites as a means to combat the opioid epidemic and its consequences. In addition, there is no evidence to demonstrate that these illegal sites reduce drug use or significantly improve health outcomes for those with opioid use disorder. So-called 'safe' injection sites lack the necessary scientific support to be considered a standardized evidence-based practice in the U.S."

Another article states that Adams mentioned safe injection sites as being "part of the conversation" in some communities.

Ed: We are in a position to address the administration's characterization of the evidence on safe injection sites, and it is false to the point of absurdity. There is significant evidence that safe injection sites improve health outcomes for persons with opioid use disorders. In fact, multiple journal articles to this effect are available on the website of the National Institutes of Health, a division of Health and Human Services. Here are a few of them:

  • A 2017 study in Canadian Family Physician found that "SISs are associated with lower overdose mortality (88 fewer overdose deaths per 100 000 person-years [PYs]), 67% fewer ambulance calls for treating overdoses, and a decrease in HIV infections."
  • A 2017 article in Harm Reduction Journal notes with citations that evaluation of Vancouver's Insite program showed it was "meeting its objectives of reducing public disorder, infectious disease transmission, and overdose and was successfully referring individuals to a range of external programs, including detoxification and addiction treatment programs.". The article further states that "over 40 peer-reviewed studies have been published which speak to the many benefits and lack of negative impacts of this site."
  • A 2008 article in the American Journal of Public Health reported that the supervised injection facilities in Sydney and Vancouver were "negatively associated with needle sharing... and positively associated with less-frequent reuse of syringes... less outdoor injecting... using clean water for injection... cooking or filtering drugs prior to injecting... and injecting in a clean location," that "[b]oth... were effective gateways for addiction treatment, counseling, and other services," and that there were no "reported overdose deaths in a SIF."
  • A 2014 article in Drug and Alcohol Dependence found that "[s]eventy-five relevant articles... converged to find that SISs were efficacious in attracting the most marginalized PWID, promoting safer injection conditions, enhancing access to primary health care, and reducing the overdose frequency" and that "SISs were found to be associated with reduced levels of public drug injections and dropped syringes."
  • A 2008 article in the Canadian Medical Association Journal found "Vancouver's supervised injection site is associated with improved health and cost savings."
  • A 2010 article in Addiction found that if Vancouver's supervised injection facility "were closed, the annual number of incident HIV infections among Vancouver IDU would be expected to increase from 179.3 to 262.8. These 83.5 preventable infections are associated with $17.6 million (Canadian) in lifetime HIV-related medical care costs, greatly exceeding Insite's operating costs, which are approximately $3 million per year."

Chronicle AM: Hemp News, San Antonio Could Finally Get a Legal Needle Exchange, More... (5/17/18)

There's good and bad news on hemp today, a new Rhode Island marijuana legalization bill is filed, San Antonio moves toward the first legal needle exchange in Texas, and more.

Hemp fields are starting to pop up. (Vote Hemp)
Marijuana Policy

Rhode Island Marijuana Legalization Bill Introduced. Sen. Joshua Miller (D-Providence) Thursday filed a bill to tax and regulate marijuana. He's been introducing similar bills since 2014. The bill would tax pot at 10% in addition to the state's 7% sales tax, as well as allowing up to another 3% in local taxes. Adults could possess up to an ounce and grow up to two plants. The bill is not yet available on the legislative web site.

Hemp

House Republicans Block Votes on Hemp Amendments. The House Republican leadership has blocked several proposed industrial hemp amendments from being considered on the House floor. Proponents had hoped to add the amendments to the farm bill now under consideration, but the House Rules Committee put the kibosh on that. Chairman Rep. Pete Sessions (R-TX) has a reputation for blocking marijuana-related measures, and he just upheld it again.

Arizona Governor Signs Hemp Bill. Gov. Doug Ducey (R) has signed into law Senate Bill 1098, which will create a state pilot program allowing the study and cultivation of industrial hemp. Growing, processing, and transporting hemp will require permits from the state Department of Agriculture.

Indiana Lawmakers Will Study Hemp -- Not Medical Marijuana -- This Summer. An interim legislative committee will spend the summer considering the legalization of hemp, but the panel "will not look into issues related to medical marijuana."

Harm Reduction

Ithaca Mayor Calls on New York Governor to Approve Safe Injection SitesThere. Mayor Svante Myrick (D) has asked Gov. Andrew Cuomo (D) to approve a safe injection site in Ithaca. The move comes after New York City announced a plan for four safe injection sites there. "The overdose crisis is statewide and the pilot intervention should be too," Myrick wrote to Cuomo. "This epidemic is also a rural epidemic and our solutions will need to address that reality. Start with Ithaca." The Ithaca Municipal Drug Policy Committee recommended in February 2016 that a supervised consumption pilot program should be implemented in Ithaca.

San Antonio Could Become First Legal Needle Exchange Site in Texas. A decade after a local prosecutor arrested three volunteers for a clean needle program, city officials are set to sing a different tune. Next week, city and county officials, health care providers, drug treatment providers, law enforcement, and nonprofits will meet to discuss how to make San Antonio the first city in the state to have a legal needle exchange program. Stay tuned.

Law Enforcement

Justice Department to Add More Than 300 New Prosecutors. DOJ announced Thursday that it is creating 311 new assistant US attorney positions, the largest increase in prosecutors in decades. More than half will focus on violent crime, 86 on civil enforcement, and 35 on immigration-related crime. Most of the new positions in civil enforcement will be focused on his department's newly created task force targeting opioids. "Under President Trump's strong leadership, the Department of Justice is going on offense against violent crime, illegal immigration, and the opioid crisis -- and today we are sending in reinforcements," Attorney Geneal Sessions said in a statement.

International

Thai Interim Cabinet Approves Medical Marijuana, Decriminalizes Hemp, Kratom, Opium. The interim cabinet has approved a bill that would allow the use of marijuana for medical reasons, as well as decriminalizing the consumption of hemp, kratom, and opium. "The approval of this bill is an important matter," government spokesman Sansern Kaewkamnerd said. "Class 5 narcotics were allowed for cultivation and extraction… but not for consumption, which made it impossible to use them for research on humans. The bill now goes before the interim assembly.

Chronicle AM: McConnell Just Says No to Legal Weed, Walmart Tightens Prescribing, More... (5/9/18)

Mitch McConnell just says no, a House committee advances a VA medical marijuana bill, Pennsylvania's governor and attorney general aren't down with a Philadelphia safe injection site, and more.

Mitch McConnell is down with hemp, but not pot. (Flickr/Gage Skidmore)
Marijuana Policy

Mitch McConnell Confirms GOP Still the Party of "No" on Legal Marijuana. Senate Majority Leader Mitch McConnell (R-KY) said he was not interested in legalizing marijuana, even though his Democratic counterpart, Minority Leader Chuck Schumer (D-NY) has endorsed it. "I do not have any plans to endorse legalization of marijuana," McConnell said. McConnell is pushing for the legalization of hemp, though: "These are two entirely separate plants," McConnell said. "I hope everybody understands that. It is a different plant. It has an illicit cousin which I choose not to embrace."

Medical Marijuana

House Committee Advances Veterans Affairs Medical Marijuana Research Bill. The House Veterans' Affairs Committee Tuesday unanimously approved a measure that aims to increase VA research on medical marijuana. The bill would specify that the agency has the ability to research the herb for conditions including PTSD. The measure is part of a package of bills lawmakers hope to pass this month.

Missouri Senate Gives Initial Approval to Medical Marijuana Bill. The Senate Tuesday gave initial approval to House Bill 1554, which would allow people suffering from specified serious illnesses to use non-smokeable medical marijuana. The bill has already passed the House and now goes to the Senate Committee on Health and Pensions for a second reading. If it survives that, it then goes to the full Senate for a floor vote.

Utah "Right To Try" CBD Medical Marijuana Law Now in Effect. A limited medical marijuana law is now in effect. Under House Bill 195, which passed in March, terminally ill patients will be able to access CBD cannabis oil under a provision that expands the state's 2015 Right to Try Act. Also now in effect is House Bill 197, which establishes a medical marijuana cultivation program in the state. Both of these laws could soon be irrelevant, though: A much broader medical marijuana initiative will be on the ballot in November.

Heroin and Prescription Opioids

Study: Prescription Drug Monitoring Programs Have Little Effect on Overdose Deaths. A new study from Columbia University's Mailman School of Public Health finds that prescription drug monitoring programs may be only "marginally effective" in reducing drug overdose deaths. "What it really offers is this cautionary tale that says a few things. One, the amount of money and resources that are going into these programs need to be evaluated to understand what their ultimate costs are," social epidemiologist David Fink said. "Studies have come out in the past looking at reduced prescribing behavior, but we're taking it to the next level -- looking at fatal or nonfatal overdoses. And what we're seeing is that when you actually look at the literature, it isn't that strong to support" the programs. The study also found that half the studies looking at heroin overdose rates found a significant increase after prescription drug monitoring programs were implemented.

Walmart Tightens Opioid Prescription Policies. The nation's largest pharmacy chain announced Monday that beginning within 60 days, it will only fill first-time acute opioid prescriptions for a week or less nationwide. It will also limit dosages to 50 morphine milligram units per day. Walmart didn't say what it would do about patients who require greater dosages than that.

Harm Reduction

Officials in Philadelphia want a safe injection site in a bid to reduce drug overdoses that killed more than 1,200 people in the city last year, but the Democratic governor and attorney general aren't on board. A spokesman for Gov. Tom Wolf said the idea "presents a number of serious public health and legal concerns, while a spokesman for Attorney General Josh Shapiro said changes in federal law would have to come before he could support a safe injection site.

Chronicle AM: NYC Mayor Endorses SIFs, CO Cannabis Tasting Room Bill Passes, More... (5/4/18)

Colorado could become the first state with a marijuana social consumption law, a new poll suggests New Yorkers are ready to free the weed, New York City's mayor gets behind safer injection facilities, a leading Colombian presidential contender trashes the drug war, and more.

Vancouver's InSite safe injection site. Could New York City be next? (Wikimedia)
Marijuana Policy

Colorado Marijuana "Tasting Rooms" Bill Goes to Governor. A groundbreaking bill that would allow customers at pot shops to consume small amounts of marijuana through edibles or vaping has passed out of the legislature and is now at the desk of Gov. John Hickenlooper (D). The measure, House Bill 1258, would, if signed into law, make Colorado the first state to adopt some sort of social consumption provision for marijuana.

New York Poll Shows Strong Support for Legalization. A Quinnipiac poll released Thursday has support for legalization among New Yorkers at 63%. That's the highest ever for Quinnipiac in the state, and it's up seven percentage points from a February Siena College Research Institute poll that had support at 56%.

Medical Marijuana

Louisiana House Kills Medical Marijuana Expansion Bill. The House on Thursday voted down House Bill 826, which would have allowed any pharmacist in the state to open a medical marijuana dispensary. Instead, the state will maintain the status quo, which allows only nine pharmacies in the state to dispense medical marijuana.

New Hampshire Senate Delays Bill to Allow Patients to Grow Their Own. The Senate on Thursday refused to pass a bill that would allow medical marijuana patients to grow their own plants. Instead, the body voted to send House Bill 1476 to interim study, effectively killing it for the session.

Harm Reduction

New York City Mayor Endorses Safer Injection Facilities. Bowing to growing pressure from community activists and public health specialists, Mayor Bill de Blasio on Thursday endorsed a plan to set up at least four safe injection site pilot projects in the city after a year's worth of consultations with stakeholders. The nation's largest city now joins Philadelphia, San Francisco, and Seattle in racing to be the first to open a permitted safe injection site in the US.

International

Leading Colombian Presidential Candidate Calls for End to Drug War. Gustavo Petro, the former mayor of Bogotá and one of the leading contenders in presidential elections set for the end of this month, has denounced Colombia's militarized drug war and its subservience to US drug war interests. "The militaristic approach to drugs has been effective," he said on May Day, adding that the country should instead implement "social policies in the regions where drugs are cultivated and help people escape the mafia."

NYC Mayor de Blasio Endorses Safe Injection Site Plan

Just a day after close to a hundred community activists, reform advocates, and local elected officials took to the streets outside New York City's City Hall Wednesday to demand that Mayor Bill de Blasio (D) move on a long-delayed feasibility study on safe injection sites, the mayor has moved -- and further than they expected.

New York City Mayor Bill de Blasio comes out for safe injection sites. (Flickr)
On Thursday evening, the mayor's office announced de Blasio's support for a plan to open four of the sites, which the office refers to as Overdose Prevention Centers, a year from now, after a period of consultation with stakeholders.

"After a rigorous review of similar efforts across the world, and after careful consideration of public health and safety expert views, we believe overdose prevention centers will save lives and get more New Yorkers into the treatment they need to beat this deadly addiction," de Blasio said in a statement.

Safe injection sites (SISs) -- or safe injection facilities or supervised injection facilities or supervised consumption sites or overdose prevention centers -- allow drug users to inject (or sometimes inhale) their own drugs under medical supervision. They typically also have a social services component that aims to assist drug users in finding drug treatment and other services.

Operating in around 90 cities in Europe, Australia, and Canada, they are a proven harm reduction intervention. Numerous peer-reviewed scientific studies have shown they reduce public disorder; increase access to treatment, reduce the risk of HIV, Hep C, and bacterial infections; reduce drug overdose deaths; and reduce medical costs thanks to a reduction in disease and overdose, while at the same time increasing access to cost-saving preventive healthcare. What SISs don't do, the studies have found, is increase crime, injection drug use, or the initiation of new drug users.

Yet no such sites operate in the United States. Pushes are underway in several cities, including Philadelphia, San Francisco, and Seattle, but all have faced challenges ranging from moralism and NIMBYism to the fact that they would appear to violate federal law. Just this week, DEA spokesman Melvin Patterson said they violate the Controlled Substances Act and are "subject to being prosecuted." Given the proclivities of the Trump administration, that is probably not a threat to be taken lightly.

Still, the cities are willing to push on the issue, the American Medical Association has endorsed the notion, and legislatures in a number of states are pondering bills to allow them. And now, with the country's largest city coming on board, momentum for the sites is only growing stronger.

In New York City, where the SIF NYC Campaign, a coalition of dozens of community, drug reform, public health, medical, and religious groups has been pressuring the administration to act for months, the mayor's announcement was greeted with relief.

"Mayor de Blasio's embrace of safer consumption spaces is a critical step forward in preventing overdose deaths in New York City. We know that safer consumption spaces are an evidence-based solution that can help dramatically in saving lives, reducing criminalization, and improving public health," said Kassandra Frederique, New York state director at the Drug Policy Alliance. "New York can and must be a leader now in saving lives by opening safer consumption spaces swiftly."

That will take some political acumen in dealing with city district attorneys and the state Health Department, which answers to Gov. Andrew Cuomo, with whom de Blasio's relations are strained at best. It will also take some political fortitude in taking on the Sessions Justice Department and the DEA.

De Blasio's announcement marks the successful culmination of the campaign to bring the city on board with safe injection sites as a harm reduction and overdose prevention measure, but it's just the beginning of the fight to actually get them up and running.

Chronicle AM: Workplace Drug Testing for Marijuana Begins to Fade, NYC Safer Injection Site Rally, More... (5/3/18)

Pre-employment workplace drug testing for marijuana appears to be going out of style, a federal appeals court disappoints on scheduling cannabinoids, a Vermont saliva drug testing bill is killed, and more.

NYC protesters demand Mayor De Blasio move on a long-delayed safe injection site report. (Drug Policy Alliance)
Marijuana Policy

Clock Ticking on Connecticut Marijuana Legalization Study Bill. With the state's legislative session set to end next Wednesday, time is running out for House Bill 5394, which directs state agencies to develop a plan to legalize and regulate marijuana sales. The bill has passed out of the Appropriations Committee and awaits a House floor vote. Activists are urging state residents to contact their legislators this week to prod them.

Medical Marijuana

Federal Appeals Court Upholds DEA Rule on Marijuana Extracts. A three-judge panel on the US 9th Circuit Court of Appeals has upheld a DEA rule stating that marijuana extracts, including non-psychoactive CBD, are Schedule I substances. The Hemp Industries Association and others had challenged the rule, arguing that DEA overstepped its bounds by scheduling substances, such as cannabinoids, that were not classified as illicit under the Controlled Substances Act.

Louisiana Medical Marijuana Expansion Bill Advances. A bill that would allow the use of medical marijuana for children with severe autism has passed the House and, now, a vote in the Senate Health and Welfare Committee. House Bill 627 now heads for a Senate floor vote.

Heroin and Prescription Opioids

Iowa Legislature Approves Prescription Monitoring Bill. The House on Wednesday gave final approval to the legislature's policy response to the opioid crisis, passing a bill that will require doctors to register prescriptions with the state's drug monitoring program within 24 hours. The bill now goes to the governor's desk.

Drug Testing

Employment Drug Testing for Marijuana Going Out of Favor. The Associated Press is reporting that numerous employers are "dropping marijuana from the drug tests they require of prospective employees." Testing for pot excludes too many potential workers, employers told the AP. Companies in labor-intensive industries -- hoteliers and home health care providers and employers with many warehouse and assembly jobs -- are most likely to drop marijuana testing. By contrast, businesses that contract with the government or that are in regulated industries, like air travel, or that have safety concerns involving machinery, are continuing marijuana tests, employment lawyers said.

Vermont Saliva Drug Testing Bill Dies. A bill that would have allowed police to obtain saliva for testing from motorists suspected of drugged driving is dead for the year. House Bill 237 had passed the House with law enforcement support, but was killed on a 4-1 vote in the Senate Judiciary Committee Wednesday. Both the Vermont ACLU and the state's Defender General Office had threatened legal action if it became law.

Harm Reduction

NYC Council Member Arrested in Protest Calling for Action on Safer Injection Sites. Dozens of community activists, social advocates, and elected political figures rallied outside New York City's City Hall Wednesday to demand the long-delayed release of a feasibility study on safe injection sites in the city. As many as a dozen people were arrested for obstructing traffic, including NYC Council Member Stephen Levine.

Chronicle AM: Opioid Prescriptions Drop, Trump Repeats False Border Wall Claims, More... (4/20/18)

A California marijuana banking bill advances, a Colorado marijuana deliveries bill dies, opioid prescriptions are declining, Trump repeats false claims about the border wall and drug smuggling, and more.

opioid prescriptions go down, down, down (IQVIA Institute)
Marijuana Policy

California Bill to Create Marijuana Banks Wins Committee Vote. A bill that would license special banks to handle billions of dollars from the legal marijuana market was approved by the Senate Banking and Financial Institutions Committee on a 7-0 vote Wednesday. The measure, Senate Bill 930, now heads to the Senate Government and Finance Committee. Companion legislation has been filed in the Assembly.

Colorado Marijuana Delivery Bill Killed. A bill that would have allowed pot shops to make deliveries got through the House only to die in a Senate committee Wednesday. House Bill 1092 was killed by a 3-2 vote of the Senate Judiciary Committee.

Ohio Attorney General Rejects Legalization Amendment Petition. State Attorney General Mike DeWine (R) rejected a petition for a proposed marijuana legalization amendment Thursday. DeWine wrote that he rejected the petition because its summary language did not match the actual amendment language. Campaign organizers can refile the petition if they wish.

Heroin and Prescription Opioids

Opioid Prescriptions Dropped In Every State Last Year. The number of opiod painkiller prescriptions dropped 10.2% in 2017, according to a new report from the ICVIA Institute, which collects data on pharmaceutical prescriptions from retail pharmacies. The number of high-potency opioid prescriptions declined even more, by 16.1% And using a measure called the morphine milligram equivalent saw a 12% decrease, the largest in a quarter century. "We're seeing declines across every state," said Murray Aitken, executive director of the IQVIA Institute. "The states that have the highest per capita consumption are also the states with the highest decline."

Drug Testing

Massachusetts High Court Rules Against State in PrisonVisitor Drug Dog Policy Fight. The state Supreme Judicial Court ruled Thursday that the Department of Corrections exceeded its authority when it started using drug dogs to search prison visitors without giving the public a chance to weigh in. The court held that the department should have followed a regulatory process that allows interested parties an opportunity to present their views. Still, the court is allowing the department to continue the drug dog searches while it follows the proper regulatory process.

Harm Reduction

Missouri Safe Injection Site Bill Filed. St. Louis state Rep. Karla May (D) has filed House Bill 2367, which "authorizes local health departments and community-based organizations to establish Safe Consumption Facilities." It is aimed at reducing overdoses and infectious diseases linked to injection drug use.

The Border

Trump Again Falsely Claims Border Wall Needed to Stop Drug Smuggling. The president is at it again: On Thursday, President Trump traveled to the Florida Keys to be briefed by the Joint Interagency Task Force South and said he received "a great education" about drugs flowing into the country, but then proceeded to make the errant claim that a border wall is needed to stop the flow of drugs. "Drugs are flowing into our country," Trump said. "We need border protection. We need the wall. We have to have the wall." But border experts, drug experts, and even the DEA all agree that the vast majority of drugs smuggled from Mexico go through ports of entry, not through the vast and barren unfenced expanses of the border.

International

Indonesia's New Anti-Drug Head Signals Softer Approach. New anti-drug chief Heru Winarko called Wednesday for an expansion of drug treatment centers in the country, signaling a new approach to the war on drugs there. Police would maintain their "stern" approach to drug traffickers and their "shoot to kill" policy toward armed suspects resisting arrest, he said, but added that Indonesia would not mimic the bloody drug policies of the neighboring Philippines under President Rodrigo Duterte.

Chronicle AM: Hash Bash Looks to November, Philly Safe Injection Site Proposed, More... (4/9/18)

Marijuana social consumption gets delayed in Alaska and rebuffed in Colorado, Ann Arbor's annual Hash Bash draws politicians this year, the US is ramping up its bombing campaign against Taliban drug labs, and more.

Vancouver's InSite safe injection site. Could one be coming to Philadelphia? (Wikimedia)
Marijuana Policy

Alaska Regulators Postpone Discussion on Social Consumption. The state's Marijuana Control Board has postponed until June any further discussion of draft rules that would allow people to consume marijuana at authorized pot shops. Although the Alcohol and Marijuana Office had recommended that the board release the draft rules for public comment, the board decided to wait until it was back to full strength. One of the board's five members resigned last month.

Colorado Social Consumption Bill Killed. The General Assembly last week killed Senate Bill 211, which would have allowed businesses to obtain a marijuana consumption club license. The move came after both the Department of Revenue and the Marijuana Enforcement Division lobbied against it because of what they called "significant law enforcement challenges and health and safety risks." But the city of Denver is going ahead with licensing social consumption clubs.

Michigan's Hash Bash Becomes a Campaign Event. The 47th annual Hash Bash had a slightly different flavor this year: With a legalization initiative poised to appear on the November ballot and with opinion polls showing majority support for legalization, this year's event was all about imminent legalization -- and getting on the right side of the issue. Two Democratic gubernatorial candidates, Gretchen Whitmer and Abdul El-Sayed showed up to support the issue, as did Democratic attorney general candidate Dana Nessel.

Medical Marijuana

Pennsylvania Advisory Board Recommends Allowing Dry Leaf or Plant Form Medical Marijuana. The medical marijuana advisory board voted Monday to allow the use of "dry leaf or plant form for administration by vaporization." The vote is only a recommendation; the final decision is up to state Secretary of Health Dr. Rachel Levine. The vote was 11-0.

Heroin and Prescription Opioids

Democratic Senators Want to Know What Happened to Trump's Opioid Commission. Democratic Sens. Patty Murry (WA) and Elizabeth Warren (MA) sent a letter to the White House Monday asking the administration to update on progress made on implementing recommendations made by its opioid commission last November. "We are concerned by reports that in spite of the opioid epidemic's devastating impact on American communities, your Administration has failed to act aggressively to combat it," Warren and Murray wrote. "You declared the opioid epidemic a national public health emergency on October 26, 2017, but there has been little evidence that your Administration has taken advantage of the supplemental executive branch authorities and resources provided by this designation."

Foreign Policy

US Expands Air Strikes Aimed at Taliban Drug Labs. US and Afghan government forces have expanded their campaign of air strikes aimed at Taliban opium processing labs, hitting 11 sites in the past week. These latest strikes were in Farah and Nimroz provinces in western Afghanistan and were the first in the region. So far this year, the about of bombs dropped is triple the number dropped in the first part of last year. The strikes are aimed at hurting Taliban finances, but analysts warn the could kill or injure civilians and are unlikely to have a major impact on the Taliban.

Harm Reduction

Philadelphia Joins List of Cities Pondering Safe Injection Sites. City officials are moving to make the city one of the first in the country to have a safe injection site. A public hearing to discuss the notion took place last Wednesday. "We have a crisis here in Philadelphia," said Dr. Tom Farley, Philadelphia Health Commissioner. "These facilities look sort of like a clinic. If they're simply there to inject, they bring in their own drugs that they have bought on the street, they're given sterile equipment and they inject at the site. If they were to overdose on site, there are medical staff on site who can revive them." But this is just a first step; actually getting one or more up and running in the city could take months or years. Other US cities pondering the harm reduction move include Boston, New York, San Francisco, and Seattle.

(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 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.)

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