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Chronicle AM: Federal Marijuana Bill Filed, Ciudad Juarez Drug War Killings Surge, More... (1/4/19)

Wow, that was fast: The first marijuana bill of the new Congress has already been filed, an Arizona sheriff finally hops on board the naloxone train, Ciudad Juarez drug war killings are way up, and more.

Deputies in Pima County, Arizona, will finally start carrying the overdose reversal drug naloxone. (pa.gov)
Marijuana Policy

The New Congress Just Saw Its First Marijuana Bill Filed. That didn't take long. Reps. Steve Cohen (D-TN) and Don Young (R-AK) on Thursday reintroduced the Compassionate Access, Research Expansion and Respect States (CARERS) Act. The bipartisan bill would protect state medical marijuana programs from federal interference and open the way for doctors at the Veterans Administration to recommend medical marijuana. The bill is not yet available on the congressional website, but you can view last year's version here. Sen. Cory Booker (D-NJ) is expected to file the Senate version soon.

Heroin and Prescription Opioids

Georgia Joins List of States Suing Opioid Makers for Fueling Drug Crisis. Georgia has now become the latest of more than 30 states that have filed lawsuits against pharmaceutical companies for what they say is their role in fueling the opioid crisis. The state is suing nine opioid makers and distributors in state court for what it calls racketeering and for creating the crisis. "We have over a 1,000 Georgians that died last year, more Georgians dying every day. We have over 1,000 Georgians right now that are suffering from an opioid misuse disorder," said Attorney General Chris Carr. The state is seeking both monetary damages to repay it for costs incurred fighting the epidemic, as well as punitive damages.

Harm Reduction

Arizona's Pima County Sheriff Finally Gets on Board With Deputies Carrying Naloxone. Pima County, home to the state's second largest city, Tucson, has gotten with the program and the sheriff's department will now issue the overdose reversal to deputies. Deputies in eleven of the state's 15 counties already carry it. Department officials had previously argued it was necessary for deputies because paramedics already carried it and because it might become unstable in the Arizona summer heat, but Sheriff Mark Napier admitted Wednesday that medical experts had told him the worse that could happen was that it might not work.

International

Mexico's Ciudad Juarez Had Nearly 1,250 Murders Last Year. The border city just across the Rio Grande from El Paso saw a big spike in murders last year, most of them drug prohibition-related. The state attorney general's office reported 1,247 killings last year, a big increase from the 772 people killed in 2017 and nearly triple the number killed in 2014. Most of the violence is related to the revival of the Juarez Cartel and to the defection of a key Los Aztecas leader to La Linea. Los Aztecas are also in the midst of internal factional strife. But wait, there's more: There's also a factional fight within Los Artistas Asesinos (Assassin Artists), a street enforcement gang with links to the Sinaloa Cartel, which is also working in the area.

Chronicle AM: Judiciary Committee Change, Massachusetts Marijuana Sales, More... (11/19/18)

There's a changing of the guard at the top of the Senate Judiciary Committee, a Pennsylvania medical marijuana patient sues over gun access, a new report finds fake and counterfeit drugs killing tens of thousands each year in Africa, and more.

Massachusetts will see its first marijuana stores open this week. (Sondra Yruel/Drug Policy Alliance)
Marijuana Policy

Graham to Replace Anti-Marijuana Hardliner Grassley as Head of Senate Judiciary Committee. Sen. Chuck Grassley (R-IA) announced last Friday that he is stepping down as chairman of the Senate Judiciary Committee. He will be replaced by Sen. Lindsey Graham (R-SC), who, while not exactly a friend of marijuana law reform, is not nearly as oppositional as Grassley. While Grassley has stifled marijuana bills during his tenure as chair, Graham has cosponsored bills to protect legal medical marijuana states from federal interference, reschedule marijuana, and remove CBD from the list of banned substances. (Grassley has also been a champion late in his career for enacting at least modest criminal justice and sentencing reform.)

Massachusetts's First Marijuana Stores to Open Tuesday. Slightly more than two years after voters approved marijuana legalization, the state's first retail marijuana outlets are set to open their doors tomorrow. The state Cannabis Control Commission announced last Friday that retail shops in Leicester and Northampton had received final sign-offs to start selling recreational weed.

Medical Marijuana

Indiana Poll Finds Strong Support for Medical Marijuana. Even in red-state Indiana, they like their medical marijuana, a new poll finds. The poll from Ball State University finds that 81% of Hoosiers believe marijuana should be legal for medical reasons. The poll had support for full legalization at only 39%.

Pennsylvania Doctor and Medical Marijuana Patient Sues for Right to Own a Gun. A Philadelphia physician who is also a medical marijuana patient filed a lawsuit in federal court last Thursday challenging a federal law that prevents him from owning a firearm because he uses medical marijuana. Dr. Matthew Roman was blocked from buying a gun earlier this year when he honestly answered a question about marijuana use. Roman's lawsuit claims that the blanket prohibition against marijuana users violates the constitutional rights of tens of thousands of nonviolent, law-abiding American citizens. The filing, in US District Court for the Eastern District of Pennsylvania, claims the law violates both the Second and Fifth Amendments of the Constitution.

Harm Reduction

Opioid Reversal Drug Company Gouged Taxpayers With 600% Price Increase. A new report from the Senate's Permanent Subcommittee on Investigations finds that a pharmaceutical company "exploited the opioid crisis" to gouge taxpayers by increasing the price of its overdose reversal drug by 600% between 2014 and 2017. The report found that the company Kaléo raised the price of its drug EVZIO from $575 in 2014 to $4,100 in 2017. EVZIO is an auto-injector form of the drug naloxone. The price hikes cost taxpayers more than $142 million over the past four years in Medicare and Medicaid charges.

International

Fake and Counterfeit Drugs Are Killing Thousands in Africa, Report Finds. A new European Union-funded report finds that tens of thousands of Africans are dying because of fake and counterfeit drugs. Fake or substandard anti-malarial drugs alone were linked to anywhere between 64,000 and 158,000 deaths each year, the report found. The fake drugs are especially entrancing to the region's poor, who often cannot afford prescribed drugs and turn to the streets to buy cheaper alternatives. "So this is a criminal activity, you can focus on and try to find the source of this. The problem is also the access of the real medicine, the cost to buy them is too high so poor people are just despaired (they despair) to find something, anything that they think could help them," said Ruth Dreifuss, Chair of the Global Commission on Drug Policy.

Mexico Supreme Court Rejects Law Regulating Tr0ops Fighting Drug Cartels. In a 9-2 decision last Thursday, the nation's highest court threw out a new law aimed at regulating the use of the military to fight drug cartels. The law was meant to set out rules of engagement for the armed forces in their fight with organized crime, but human rights groups warned it could clear the way for more military human rights abuses. The court ruled that Congress does not have the power to legislate on "domestic security" and only the executive can dispatch troops. The court ruling came a day after incoming security minister Alfonso Durazo said there was "no way" to withdraw the military from the fight because it is more trustworthy than the police.

Chronicle AM: Opioid Overdoses Decline, But Cocaine ODs at Record High, CDC Reports, More... (10/24/18)

The CDC's latest drug overdose numbers are out, Arizona's attorney general retreats on hashish, the Justice Department clears the way for harm reduction measures at music venues, and more.

Overall drug overdose deaths are finally declining, but cocaine deaths are rising, the CDC reports. (Creative Commons)
Marijuana Policy

New Jersey Marijuana Legalization Delayed Again, New Target is By Year's End. Top lawmakers now say they are no longer aiming at approving marijuana legalization by October 29, but are now looking at doing so before year's end. State Senate President Stephen Sweeney (D-Woodstown) and state Assembly Speaker Craig Coughlin (D-Middlesex) say they still need to iron out differences with Gov. Phil Murphy (D). It's not clear what those differences are.

Medical Marijuana

Arizona Attorney General Withdraws Arguments Saying Hash Isn't Medical Marijuana. Citing fears of unintended consequences for patients, Attorney General Mark Brnovich (R) on Monday withdrew his agency's arguments that the state's medical marijuana law doesn't include hashish. The state was responding to an appeal by a medical marijuana patient who was convicted of a felony for possessing 0.05 ounces of hash. "The last thing the attorney general wants is to deny medicine to legitimate patients that may be ingesting their marijuana an in extract or a tincture-type of a form," said his spokesman Ryan Anderson.

Cocaine

Cocaine Overdose Deaths at Record High, CDC Reports. The Centers for Disease Control and Prevention report that 14,205 Americans died of overdoses involving cocaine in the past 12 months, an all-time high. The country is awash in Colombian cocaine after two years of large coca crops there, but the CDC also warned that more and more cocaine is being laced with fentanyl, which is likely driving up overdoses.

Heroin and Prescription Opioids

Opioid Overdose Deaths Finally Declining, CDC Reports. The Centers for Disease Control and Prevention report that from April 2017 to March 2018, the number of fatal opioid overdoses declined by 2.3 percent compared to the 12 months ending in September 2017. "There are two major takeaways," said Leo Beletsky, a drug policy expert at Boston-based Northeastern University. "One is that we are not out of the woods yet, since these rates are still sky high. [And] we need to be doing much more of what works to get the rates down further."

President Trump Signs Opioid Package Today; Drug Policy Alliance Responds. President Trump Wednesday signed into law the omnibus opioid package aimed at curbing the overdose crisis. The package is the product of bipartisan efforts to pass opioid legislation in both the House and Senate in recent months. "This legislation takes some critical steps toward making lifesaving medication-assisted treatment more accessible, but should be seen as only one small step toward addressing overdose deaths rather than a comprehensive plan," said Grant Smith, deputy director of national affairs for the Drug Policy Alliance. "Missing from the package is a sustained commitment from Congress and the Administration to deliver funding for evidence-based treatments, like methadone and buprenorphine, at the levels needed to meet the demand. For decades our nation's treatment infrastructure has been short-changed, while billions of dollars have been poured into arresting and incarcerating people who use drugs. Trump's opioid package doesn't even begin to close this gap. The opioid package could do much more to expand life-saving tools, like naloxone distribution and supervised consumption services. While Congress should be applauded for not including new mandatory-minimum sentences in this package, it doesn't reflect the kind of bold and innovative action needed to address the crisis."

Harm Reduction

Justice Department Clarifies That Harm Reduction Measures at Music Events Don't Violate Federal Drug Laws. The Justice Department has conceded that the Illicit Drug Anti-Proliferation (IDAP) Act of 2003, which aims to punish people who operate facilities that knowingly allow or facilitate drug use, does not prevent venue owners from providing harm reduction services at their events. The clarification came after Virginia US Sens. Tim Kaine (D) and Mark Warner (D), acting on the request of harm reduction activist Deirdre Goldsmith, whose daughter died of heat stroke after taking MDMA, asked the DOJ to clarify.

Chronicle AM: Gallup Has MJ Legalization at 66%, UN Drug War "A Failure," Report Says, More... (10/23/18)

A new Gallup poll shows still rising support for marijuana legalization, a new report from the IDPC calls for a radical shift in UN drug control policies, Bangladesh moves toward passing a bill mandating the death penalty or life in prison for even possessing small amounts of some drugs, and more.

Marijuana Policy

Gallup Poll: Two in Three Americans Now Support Legalizing Marijuana. Sixty-six percent of Americans now support legalizing marijuana, another new high in Gallup's trend over nearly half a century. The latest figure marks the third consecutive year that support on the measure has increased and established a new record. The poll is in line with other recent polls that have shown support for marijuana legalization above 60%. Gallup found last year that a slim majority of Republicans supported legal marijuana for the first time, and this year's figure, 53%, suggests continued Republican support. Views that pot should be legalized have also reached new peaks this year among Democrats (75%) and independents (71%). Democrats reached majority-level support for legalization in 2009, and independents did so in 2010.

North Dakota Poll Has Legalization Initiative Leading. A poll commissioned by LegalizeND, the group behind the Measure 3 legalization initiative, has support for the measure at 51%, with 36% opposed. The poll has a 4.9% margin of error, so support could actually be under 50%. What is encouraging is that undecideds would have to break pretty decisively against the measure for it to be defeated.

Medical Marijuana

New Jersey Ponders Allowing Medical Marijuana to Treat Opioid Addiction. The state Health Department has proposed a rule change that would make medical marijuana available to potentially thousands of opioid users. "Physicians should consider marijuana as another appropriate treatment for patients with many medical conditions, especially diseases for which conventional therapies aren't working for their patients," Dr. Shereef Elnahal, the state health commissioner, said in a statement. Current rules allow only people who became addicted to opioids while trying to manage chronic pain from a musculoskeletal to qualify for medical marijuana, but the proposed new rule would allow anyone with an opioid use disorder to use it.

International

Report Calls UN's Global War on Drugs a Failure. A major new report from the International Drug Policy Consortium says the last decade of UN anti-drug strategy has been a failure and calls for a major rethinking of global drug policy. The report argues that the UN's "war on drugs" approach has had little impact on global drug supply while generating significant negative impacts on public health, human rights, security, and development. "This report is another nail in the coffin for the war on drugs," said Ann Fordham, the Executive Director of IDPC, in a prepared statement. "The fact that governments and the UN do not see fit to properly evaluate the disastrous impact of the last ten years of drug policy is depressingly unsurprising. Governments will meet next March at the UN and will likely rubber-stamp more of the same for the next decade in drug policy. This would be a gross dereliction of duty and a recipe for more blood spilled in the name of drug control." [Disclosure: StoptheDrugWar.org is an IDPC member group and provided feedback for the report.]

Canada's Ontario to Move Forward on Safe Injection Sites. The provincial government has decided to keep its overdose prevention sites open and repurpose them as "consumption and treatment centers," Health Minister Christine Elliott announced Monday. Premier Doug Ford had been opposed but said he would listen to advice from experts. Apparently, he has. Overdose-prevention sites are temporary facilities approved by the province to address an immediate need in a community, while supervised-drug-use sites are more permanent locations approved by the federal government after a more extensive application process.

Vanuatu to Legalize Medical Marijuana. The Republic of Vanuatu, a 277,000-person South Pacific nation, has taken the first step toward legalized medical marijuana. "I confirm that the council of ministers on Sept. 20 passed a policy paper to change the laws of Vanuatu to permit the cultivation and use of cannabis for medicinal and research purposes in Vanuatu by licensed parties," Vus Warorcet Nohe Ronald Warsal, the country's acting deputy prime minister and minister for trade, tourism, commerce, and Ni-Vanuatu business, said in a letter. The government will present legislation to the parliament later this year, with licenses expected to be issued by December.

Bangladesh Moves Forward With Death Penalty Drug Bill. The government has sent to parliament a bill that contains provisions mandating the death penalty or a life sentence for possessing, producing, or distributing more than five grams of methamphetamine or more than 25 grams of heroin and cocaine. Under current law, there is no provision for the death penalty or life sentence for heroin and cocaine offenses.

Chronicle AM: ND MJ Init Makes November Ballot, Colombia to Forcibly Uproot Coca, More... (8/13/18)

North Dakota becomes the second state (after Michigan) to qualify a marijuana legalization initiative this year, Denver's mayor comes around on legal pot, the UN will review marijuana's status under international law, and more.

Denver's mayor opposed marijuana legalization, but now has seen the light. (Creative Commons)
Marijuana Policy

North Dakota Legalization Initiative Qualifies for November Ballot. The secretary of state's office announced Monday organizers of a marijuana legalization initiative had handed in enough valid voter signatures to qualify their measure for the November ballot. That makes North Dakota the second state to qualify a legalization initiative for November: Michigan activists did so earlier this year.

Denver Mayor Changes Tune on Legalization. Mayor Michael Hancock campaigned against the state's successful 2012 legalization initiative, but after five years of legal weed, he's singing a different tune. Prompted by a recent report that touted the city's accomplishments with legal marijuana, Hancock now says the city's approach "is working." He noted that the city was the first large city in the country to take on the "daunting challenge" of legalization, "and we are having success."

International

UN Launches First-Ever Full Review Of Marijuana's Status Under International Law. The World Health Organization's (WHO) Expert Committee on Drug Dependence (ECDD) will launch a first-ever in-depth review of whether marijuana is properly scheduled under international drug control treaties. The group held a "pre-review" earlier this year. "A pre-review is the first step of the ECDD's assessment process, where it is determined whether there is enough robust scientific information to proceed to the next step, called a critical review. This initial evaluation is also an opportunity to identify gaps in the available scientific data. A critical review is carried out when there is sufficient scientific evidence to allow the ECDD to make an informed recommendation that the substance be placed under international control, or if its level of control should be changed."

Canada's British Columbia Begins Drug Testing in Provincial Cities. Responding to a large number of opioid overdose deaths in the province, BC Interior Health has begun funding full-time drug testing services in seven cities in the province. The program provides fentanyl testing strips to local service providers.

Colombia's Defense Minister Says Government Will Forcibly Eradicate Coca Crops. Defense Minister Guillermo Botero said last Friday the government has decided to forcibly eradicate coca crops in the country. Former President Juan Manuel Santos had ended forced eradication in a bid to reduce associated violence, but new President Ivan Duque will go ahead despite the potential for violence in a move that is sure to please the United States.

Chronicle AM: Key NJ Pol Now Supports Legal Pot, UK Drug Deaths Spark Criticism, More... (8/6/18)

New Jersey's assembly speaker gets behind marijuana legalization, Ted Cruz attacks Beto O'Rourke as a drug legalizer, record-breaking British drug deaths spark a critique of government drug policy, and more.

Fentanyl deaths nearly doubled last year in Great Britain. (Creative Commons)
Marijuana Policy

Key New Jersey Politico Now Supports Marijuana Legalization. Assembly Speaker Chris Coughlin (D-Middlesex), a key player in the legislature, said Friday he supported making the state the next one to legalize marijuana. Both Gov. Phil Murphy (D) and Senate President Stephen Sweeney (D-Gloucester) have both been more enthusiastic about legalization than Coughlin up until now. "For folks who don't want to legalize it, I understand their view. But I would ask, are we satisfied with the status quo," Coughlin said on his regular "Speak to the Speaker" radio program. "Use of marijuana is still a constant. Three out of five drug arrests are for marijuana. African Americans are three times more likely to get arrested for marijuana," Coughlin said. "We're trying to address those things and I think, if you got the right bill, we'll go ahead and try to pass it."

Medical Marijuana

Ohio Awards First Medical Marijuana Processing Licenses. The state Department of Commerce on Friday issued seven provisional licenses to aspiring medical marijuana processors. This is just the first round of licensing for processors; the state could license up to 40 such operations.

Drug Policy

Ted Cruz Attack Ad Slams Beto O'Rourke as Drug Legalizer. With the underdog Democrat nipping at his heels -- a recent poll has the Texas senate race as a statistical dead heat -- incumbent GOP Sen. Ted Cruz is using an ad that accuses O'Rourke of being a drug legalizer. "Beto O'Rourke said we should consider legalizing all narcotics, including heroin," says one ad running in Lubbock. The O'Rouke campaign said that is not true -- that O'Rourke supports marijuana legalization and says we need a larger discussion about ending the war on drugs. The campaign also warned supporters more than a month ago such attacks would be forthcoming. "It is these kinds of mischaracterizations of our positions, preying on the fears and anxieties of our fellow Texans, that they will try to use as they have used in the past," O'Rourke said on June 29.

International

British Drug Deaths at Record High (Again), Fentanyl Toll Doubles. The British government has reported 3,756 drug deaths in 2017, making the year the fifth in a row to see increases in drug deaths. The 2017 figure is the highest since comparable records began in 1993. The most dramatic drug death increases were around fentanyl and its analogs, which nearly doubled in the space of a year.

British Reform Advocates Rip Government Policies over Drug Deaths. "After five years of record or near-record drug-related deaths, the UK Government has nowhere left to hide. They are responsible for vulnerable people dying in droves, because they are blocking, or refusing to fund, measures proven to save lives in other countries," said Martin Powell of the Transform Drug Policy Foundation. "No one has ever died from an overdose in a supervised drug consumption room or heroin prescribing clinic, anywhere. In Portugal -- where drug use is decriminalized -- the drug death rate is less than a tenth of ours. So Government claims that these deaths are all the result of an aging population of drug users is a lie. The Government must fully fund drug treatment, stop criminalizing people who use drugs, and allow supervised drug consumption rooms now. Longer term, all political parties should back legal regulation of the drug market to take it out of the hands of criminals, save lives, reduce crime, and protect our communities." Also commenting was Rose Humphries of the Anyone's Child Project, who lost two sons to heroin overdoses: "It upsets me to see the figures for drug deaths at record levels year after year. The government is complicit in these deaths because it will not try the successful measures that work in other countries to reduce drug deaths and crime. Those of us in the Anyone's Child campaign can see the evidence of what works -- including legally regulating drugs. Why can't the government?" she asked.

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

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.

Making Matters Worse: DEA's Move to Restrict Opioid Prescriptions Pushed Users to the Dark Web

By the end of 2013, the country's quiet opioid addiction crisis was no longer so quiet. Opioid overdose deaths that year topped 16,000, more than four times the same statistic for 1999. That prompted a number of measures at the state and federal level to rein in opioid prescriptions, including a move by the DEA in October 2014 to tighten its policies around some of the most commonly prescribed opioids.

Dark Web fentanyl sales rose after the DEA restricted some prescription opioids. (Creative Commons)
The new DEA policy -- aimed at popular opioids such as Vicodin and Lortab -- imposed restrictions on doctors' prescribing and made it more difficult for patients to get refills. In one sense, the policy was a success: Prescriptions for those drugs decreased almost immediately. But new research adds to an increasing body of evidence that restricting opioid prescribing has not solved the opioid crisis but instead worsened it.

Since the DEA policy shift, opioid overdose deaths continued to grow with more than 40,000 fatal opioid overdoses in 2016. And while prescription opioid overdose deaths have slightly decreased -- there were about 14,000 that year -- overdose deaths from heroin and non-prescription synthetic opioids such as fentanyl went through the roof. Heroin and illicit synthetics accounted for nearly two-thirds of all opioid overdose deaths in 2016.

In the new study, published this week in the British Medical Journal, researchers examining the impact of the DEA policy shift found evidence that while the change indeed lowered prescribing rates for the opioids in question, it was also linked to an increase in illicit online sales of those drugs in Dark Web drug markets.

The researchers used software called DATACRYPTO to crawl encrypted Dark Web marketplaces where people can anonymously buy damned near anything, from drugs to guns to credit card numbers. DATACRYPTO harvested data on which drugs were for sale, their country of origin, and the number of customer comments on each seller's comments page. Researchers used that last figure as a proxy for how much of a drug that seller sold. They examined sales of prescription opioids, sedatives, stimulants, and steroids, as well as heroin. It was only with prescription opioids that they found a significant Dark Web sales bump.

Here's what they found: "The sale of prescription opioids through US cryptomarkets increased after the schedule change, with no statistically significant changes in sales of prescription sedatives, prescription steroids, prescription stimulants, or illicit opioids."

According to their data, prescription opioids doubled their market share of U.S. Dark Web drug sales thanks to the DEA policy change. By July 2016, opioids represented 13.7% of all drug sales in U.S. cryptomarkets, compared with a modeled estimate of 6.7% of all sales.

While the researchers were careful to not make claims of causation -- only correlation -- their conclusion speaks for itself: "The scheduling change in hydrocodone combination products coincided with a statistically significant, sustained increase in illicit trading of opioids through online US cryptomarkets. These changes were not observed for other drug groups or in other countries. A subsequent move was observed towards the purchase of more potent forms of prescription opioids, particularly oxycodone and fentanyl."

Not only is the DEA policy change linked to increased Dark Web opioid sales, it is also linked to a move toward more powerful, and thus more dangerous, opioids. The researchers noted that while fentanyl was the least purchased Dark Web opioid in the summer of 2014, it was the second most frequently purchased by the summer of 2016. Fentanyl killed as many people as prescription opioids that year.

This study -- one of the few that examines supply reduction (as opposed to demand reduction) as a means reducing drug use -- strongly suggests that supply-side interventions carry unintended consequences, especially the resort to more dangerous and more powerful substitutes. The study's authors refer to this effect as "the iron law of prohibition, whereby interventions to reduce supply, such as increased enforcement and changes to drug scheduling, lead to illicit markets dominated by higher potency products."

Perhaps better than restricting opioid prescriptions, which has deleterious impacts on the tens of millions of Americans suffering chronic pain, or other supply-side interventions, would be increased access to addiction treatment, as well as greatly expanded harm reduction measures to try to get people off opioids and keep them alive in the meantime.

Chronicle AM: St. Louis Ends Small MJ Prosecutions, House Passes Opioid Package, More... (6/13/18)

St. Louis prosecutors will no longer go after people with less than 100 grams of marijuana, a Delaware legislator amends her legalization bill to address concerns, the House passes an opioid package, the Canadian federal government rejects some Senate marijuana amendments, and more.

Marijuana Policy

Delaware Legalization Bill Amended. State Rep. Helene Keeley (D-Wilmington) has filed an amendment to her legalization bill, House Bill 110, aimed at addressing concerns around regulations and public safety. The amendment would more tightly regulate legal marijuana production and distribution and prohibit products that look like candy or cartoon characters. The amendment also clarifies employer protections and sets aside 10% of tax revenues to pay for drugged driving enforcement. The bill has already passed committee votes and now awaits a House floor vote.

St. Louis Ends Marijuana Prosecutions for Less Than 100 Grams. St. Louis Circuit Attorney Kim Gardner announced Tuesday that her office will stop prosecuting marijuana possession cases involving less than 3 ½ ounces (100 grams) of the weed. "Effective immediately we will no longer issue possession of marijuana cases under 100 grams as the lead charge!" Gardner wrote. Gardner said her staff would also begin reviewing and dismissing pending pot cases.

Medical Marijuana

South Carolina Voters Approve Medical Marijuana Question On Democratic Ballot. Voters in the state's Democratic primary overwhelmingly approved a non-binding question asking if they supported passing a law to allow doctors to prescribe marijuana to patients. The question passed with 81% of the vote. While medical marijuana bills have moved in the legislature, none has yet passed.

Heroin and Prescription Opioids

House Passes Package of 25 Bills Addressing Opioid Crisis. The House on Tuesday approved a package of 25 bills that nibble at the edge of the nation's opioid-related public health crisis. The bills range from addressing the disposal of opioid medications after a patient's death to encouraging overdose awareness in hospital emergency rooms to raising awareness of synthetic opioids and more. For a complete list of the bills and what they do, click on the title link.

Harm Reduction

Delaware Law Giving First Responders Immunity from Lawsuits for Administering Opioid Overdose Reversal Drug Goes into Effect. Gov. John Carney (D) on Tuesday signed into law Senate Bill 147, which provides immunity from lawsuits for public safety personnel for trying to save lives by administering Naloxone. Paramedics and police had previously been granted immunity, and laypersons also have immunity under the state's Good Samaritan law. This bill specifies that volunteer firefighters and other emergency responders will also have immunity.

International

Canadian Federal Government Rejects Some Senate Marijuana Legalization Bill Amendments. The federal government has said it accepts some 26 technical proposed amendments to the C-45 legalization bill but rejects amendments to allow provinces to bar home cultivation and prohibit producers from handing out branded merchandise. "We have looked carefully at all of the amendments that have been brought forward and today we respectfully submit to the Senate the amendments that we've accepted, and the ones that we haven't," Health Minister Ginette Petitpas Taylor told reporters Wednesday. Now, it will be up to the Senate to accept the government's position. If not, the legislative haggling could continue for some time.

Chronicle AM: CO Gov. Vetoes Pot Tasting Rooms, WV First Responders Get Naloxone, More... (6/5/18)

Colorado's governor vetoes a pot tasting room bill and signs a medical marijuana in schools bill, Canada's legalization bill overcomes a last-ditch attempt to block it, and more.

West Virginia first responders will now be carrying the opioid overdose reversal drug naloxone. (PA Health Dept.)
Marijuana Policy

Colorado Governor Vetoes Marijuana "Tasting Rooms" Bill. Gov. John Hickenlooper (D) has vetoed House Bill 18-1258, which would have allowed customers at marijuana retailers to consume edibles or vape on premises. Hickenlooper said the bill violated Amendment 64, which said marijuana consumption could not be done "openly" or "publicly." Hickenlooper also cited fears of stoned driving.

Medical Marijuana

Colorado Governor Signs Medical Marijuana at School Bill. Gov. John Hickenlooper (D) has signed into law House Bill 18-1286, which will allow school nurses to administer medical marijuana to students with medical marijuana patient cards. Hickenlooper said that bill would expand current law to "allow school personnel to administer medical marijuana in a non-smokable form to students qualifying for medical marijuana use."

Harm Reduction

West Virginia Begins Statewide Distribution of Naloxone to First Responders. The state Department of Health and Human Services announced Tuesday that it is beginning the distribution of the opioid overdose reversal drug to first responders. Naloxone is going out to the state police, the fire marshal's office, and emergency medical service providers, with eight high priority counties also being allocated additional doses.

 

 

 

 

International

Canada's Conservatives Thwarted in Bid to Block Legalization Bill. An attempt by Conservative senators to slow down the marijuana legalization bill failed on Monday night on 50-29 vote. Sen. Leo Housakos (C) had filed an amendment to delay passage until the government releases a report on how it will deal with marijuana-related border issues. Now, the bill is set for a final Senate vote Thursday.

 

 

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