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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: SITSA Act Draws Opposition, Congress MedMJ Protections Advance, More... (6/15/18)

The Justice Department is once again likely to be barred from using its funds to go after state-legal medical marijuana, a broad coalition opposes the fast-moving SITSA Act, Portugal's parliament approves medical marijuana products, and more.

Congress is moving once again to bar the Justice Department from spending funds to go after state-legal medical marijuana.
Medical Marijuana

Senate Panel Approves Medical Marijuana Protections. The Senate Appropriations Committee on Thursday approved an amendment that shields legal medical marijuana operations from federal interference. The amendment to the Justice Department appropriations bill bars the department from using its funds to go after state-legal medical marijuana. A similar measure was approved in the House version of the bill.

Maine Supreme Court Rules Workmen's Compensation Doesn't Cover Medical Marijuana. In a ruling Thursday, the state Supreme Court held that employers do not have to pay for medical marijuana under the state's workers' compensation system. In a 5-2 ruling, the court held that federal law takes precedence and that making employers pay for medical marijuana would force them to violate federal law.

Drug Policy

Broad Coalition Opposes SITSA Act. A coalition of human rights, civil liberties, civil rights, religious, and drug policy reform groups have come out strongly in opposition to HR 2851, the Stop Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017. The fast-moving bill has already passed out of committee and awaits a House floor vote. The bill is an old-school drug war response to new psychoactive substances that relies heavily on the criminal justice system. "If passed, HR 2851 will broadly expand penalties for drug offenses, concentrate power within the Department of Justice, punish people who lack criminal intent, and overcriminalize certain behavior," the groups said in a letter released on Thursday. "The legislation attempts to address the very real problem of synthetic opioid overdoses in the United States, but we believe that its methods are misguided. Instead of punishing people who use drugs and low-level dealers, legislation should focus on expanding treatment opportunities and targeting the international drug trade."

Sentencing

Rhode Island House Passes Law Lengthening Prison Sentences for Dealers Who Sold Drugs in Fatal Overdoses. The House on Thursday approved "Kristen's Law," House Bill 7715, which creates a new crime of drug-related homicide and imposes penalties of up to life in prison for people who sell drugs linked to fatal drug overdoses. The bill now heads to the Senate.

International

Portugal Parliament Approves Marijuana-Based Medicines. The parliament on Friday overwhelmingly approved a bill to allow marijuana-based medicines, but only after earlier rejecting a proposal to allow patients to grow their own medicine. While Portugal decriminalized drug possession in 2001, it has lagged behind the US and other European countries when it comes to medical marijuana. The bill now goes to President Marcelo Rebelo de Souza to be signed into law.

Chronicle AM: CA Pays for Fentanyl Test Strips, CA Marijuana Banking Bill Advances, More... (6/1/18)

The California Senate approves a bill to create financial services for the pot industry, the California public health department is paying needle exchanges to hand out fentanyl test strips, a New York bill would allow the use of CBD oil instead of opioids to treat pain, and more.

Marijuana Policy

California Marijuana Banking Bill Passes Senate. The state Senate voted 29-6 Wednesday to approve Senate Bill 930, which would allow financial institutions to offer limited banking services to legal marijuana businesses. The bill would create limited-charter licenses for banks and credit unions allowing them to issue special checks that could be used by the industry. The measure now goes to the Assembly.

Three Out of Four Florida Democratic Gubernatorial Contenders Support Legalization. Florida Democrats are seeing a near consensus for marijuana legalization among the current crop of gubernatorial candidates. Tallahassee Mayor Andrew Gillum, Winter Park entrepreneur Chris King and former Miami Beach Mayor Philip Levine all back legalization. Former Congresswoman Gwen Graham is the outlier; she only backs decriminalization.

Medical Marijuana

New York Bill Would Allow CBD Cannabis Oil to Be Used Instead of Opioids for Pain. State Sen. George Amedore (R) on Thursday filed Senate Bill 8820, which would allow the use of CBD cannabis oil in place of opioids. Amedore is co-chair of the Senate Task Force on Opioid and Heroin Addiction and said that the evidence is clear marijuana is less harmful and addictive than opioid painkillers.

Harm Reduction

California Paying Needle Exchanges to Provide Fentanyl Test Strips. For a year now, the state public health department has been paying needle exchanges to distribute fentanyl test strips to their clients in a bid to lower overdose deaths. The tests cost $1 each. Users mix a bit of their drugs in water and then dip the strip in for a few seconds and they get results back within five minutes. About half of the state's 45 needle exchanges are distributing the strips. The state has spent $57,000 on the project so far.

(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.)

Four Ways Fentanyl Could Radically Disrupt the Global Drug Trade

The synthetic opioid fentanyl isn't just killing American drug users by the thousands. Its emergence also signals a shift in the decades-old contours of the global drug trade, with ramifications not only for traditional drug-producing countries and drug trafficking networks but also for US foreign policy.

Black market fentanyl is not just wreaking havoc on the streets of American cities. (Creative Commons)
Synthesized from chemicals -- not from papaver somniferum, the opium poppy -- fentanyl is about 50 times stronger than heroin and is severely implicated in the country's drug overdose crisis, accounting for almost 20,000 deaths in 2016.

Illicit fentanyl is typically mixed with other opiates, such as heroin, resulting in much stronger doses of opioids than users expect, thus leading to opioid overdoses. But it is also increasingly also showing up in non-opiate drugs, resulting in fentanyl overdose deaths among unsuspecting methamphetamine and cocaine users.

But the havoc super-potent fentanyl is wreaking among drug users pales in comparison with the dramatic changes it could prompt in the global illicit drug production industry. As academic researchers Vanda Felbab-Brown, Jonathan Caulkins, and Keith Humphreys write in the current issue of Foreign Affairs, fentanyl's rise has the potential to cause disruption and innovation in black markets.

Here are four ways fentanyl alters the illegal drug production and distribution status quo:

1. It doesn't require an agricultural base. Virtually all of the other opioids on the black market, from heroin to morphine, oxycodone, and hydrocodone, require land to grow poppies on. And they require land that is outside cdthe effective control of the state. Non-state actors who can control such areas, whether it's the Taliban in Afghanistan or the drug cartels in southern and western Mexico, reap the profits and power of that control. With the ascent of lab-produced fentanyl made out of chemicals, traditional opiate producers should see their profits and their influence undermined.

2. It doesn't require a large workforce. Traditional opium production requires a large seasonal workforce of people to plant and tend the poppies, score the pods and scrape off the leaking opium, and then process and package the raw opium. Other workers will get jobs processing raw opium into heroin. All of those jobs bring money into the hands of poor agricultural families and political capital to the traffickers, whether it's the Taliban in Afghanistan or the cartels in Mexico. With fewer job opportunities to offer up, the traffickers lose clout.

3. It doesn't require an elaborate smuggling infrastructure. Because fentanyl is so potent, small amounts of the drug can contain huge numbers of doses, and that means it doesn't require transportation networks of trucks, planes, and boats to get an agricultural crop from the valleys of Afghanistan or the mountains of Mexico to consumers in the US Fentanyl is so potent, medicinal doses are measured in micrograms, and packages of it worth hundreds of thousands of dollars can fit inside a Priority Mail envelope. With smuggling fentanyl as easy as dropping a package in the mail, international drug smuggling organizations now have competition they never had before.

4. All of this can change the dynamics of US foreign policy. If plant-based opiates lose market share to synthetics in the future, this can weaken both insurgencies (Afghanistan) and criminal networks (Mexico). Ever since the US invasion of Afghanistan in 2001, drug warriors have been constrained in their efforts to go after the Afghan opium crops because of fears it would drive poppy-dependent peasants into the hands of the Taliban. If opium production becomes relatively less important vis-à-vis fentanyl production, that constraint on an aggressive US response to Afghan opium production is weakened. Similarly, in Mexico, to the degree that fentanyl displaces peasants and processors and weakens the link between drug cartels and rural populations, it increases the ability of the Mexican government and its American backers to crack down even harder on the cartels.

Under drug prohibition, there is a strong impetus to come up with more pure, more potent, and more compact products. Fentanyl is the ultimate expression of that imperative, and its arrival is changing the contours of the global drug industry. Who knows how it will play out?

Chronicle AM: Decrim Vote in Albuquerque, Bad "Fake Weed" in Illinois, More... (4/3/18)

A legalization bill fails in Arizona, another one sputters in Connecticut, a bad batch of synthetic cannabinoids is wreaking havoc in Illinois, and more.

Apparently contaminated synthetic cannabinoids in Illinois have left two dead, dozens injured. (Wikimedia)
Marijuana Policy

Arizona Legalization Fails Dies in Statehouse. There will be no legalization via the legislature in Phoenix this year after lawmakers refused to act on a measure that would have put the issue before the voters. HCR 2037 had been assigned to three different committees, but never got any action in any of them. Sponsors Reps. Todd Clodfelter (R-Phoenix) and Mark Cardenas (D-Phoenix) vow to try again next year.

Connecticut Legalization Bill Gets Committee Hearing. The House Finance, Revenue and Bonding Committee held a hearing on a legalization bill, House Bill 5582, on Monday, making it the fourth committee to hold a hearing on marijuana legalization this session. But the bill is unlikely to pass this year since one committee has already rejected it and another will not be voting on whether to advance it. At the hearing, the Office of Fiscal Analysis reported that the state could expect tax revenues from pot at between $30 million and $63 million, depending on the tax model used.

Albuquerque City Council Votes to Decriminalize Marijuana Possession. City council members voted Monday night on a party line vote to decriminalize the possession of up to an ounce of marijuana. Offenders would be hit with a $25 fine on a first offense. A similar measure passed in 2015, only to be vetoed by the mayor. But now there's a new mayor, so stay tuned.

New Psychoactive Substances

Illinois Sees Bad Synthetic Cannabinoids Kill Two, Leave Dozens Bleeding. Synthetic cannabinoids apparently cut with rat poison have killed two people in Illinois and left 56 others experiencing severe bleeding. The bad dope has shown up in Chicago and the central part of the state, the Department of Public Health said Monday.

Asset Forfeiture

Kansas Governor Signs Minor Asset Forfeiture Reform Bill. Gov. Jeff Colyer (R) has signed into law House Bill 2459, which would make small reforms in the state's civil asset forfeiture law. Under the bill, police who seize property will have to report on what they took and how they used the seized property.

Chronicle AM: Bernie Sanders Marijuana Petition, Dutch Bank Gets Huge Money Laundering Fine, More... (2/9/18)

A Bernie Sanders petition calls for marijuana legalization and an end to the drug war, a Dutch bank gets hit with a massive fine for cartel money laundering, New York's governor takes flak from drug reform groups on a couple of fronts, and more.

Bernie Sanders launches a petition calling for marijuana legalization and end to the drug war. (Wikimedia)
Marijuana Policy

Bernie Sanders Petition Asks Congress to Legalize Marijuana. Sen. Bernie Sanders (I-VT) has sent out an online petition to his email list subscribers asking Congress to legalize marijuana and "end the war on drugs." In 2015, Sanders filed the first ever marijuana legalization bill in Congress. Even though the petition is unlikely to lead to any results while Republicans control the Congress, it will help Sanders burnish his credentials as a leader of the progressive wing of the Democratic Party.

Arizona Legalization Bill Filed. Reps. Mark Cardenas (D-Phoenix) and Todd Clodfelter (R-Tucson) filed a marijuana legalization bill Thursday. HCR 2037 would legalize the possession of up to an ounce of pot, allow for the cultivation of up to six plants, and create a system of taxed and regulated marijuana production and sales. Voters narrowly rejected a legalization initiative there in 2016.

New Jersey Legalization Hearing Set for Next Month. Assemblyman Joseph Danielsen (D-Somerset), chairman of the Assembly Regulatory Oversight and Reform and Federal Relations Committee, said Thursday the committee will hold a hearing on marijuana legalization on March 5. Gov. Phil Murphy (D) campaigned on marijuana legalization and reiterated that pledge during his inaugural address last month.

Seattle to Expunge Past Marijuana Convictions. Following the lead of San Francisco, Seattle Mayor Jenny Durkan said Thursday the city is moving to automatically clear past misdemeanor convictions for marijuana possession. "For thousands of people in Washington state, a misdemeanor marijuana conviction had huge implications: It could be a barrier to housing, to getting credit, to getting good jobs and education," Mayor Jenny Durkan told a news conference. "It is a necessary step to right the wrongs of what was a failed war on drugs." Voters in Washington state approved marijuana legalization in 2012.

Medical Marijuana

Illinois Bill to Let People Prescribed Opioids Get Temporary Medical Marijuana Cards Advances. The Senate Executive Committee approved Senate Bill 336 on Wednesday. The bill would allow people who have been prescribed opioids to apply for a temporary medical cannabis card. If passed, those prescribed opioids would be able to participate in the program if their applications are approved by the state. The background check and fingerprinting process normally required for applicants of the program would also be waived that first year because of the urgency of the crisis.

Heroin and Prescription Opioids

New York Drug Reform, Harm Reduction Groups Criticize Governor's Move to Stiffen Fentanyl Analog Penalties. The Harm Reduction Coalition, the Drug Policy Alliance, and VOCAL-NY are among the organizations calling out Gov. Andrew Cuomo (D) over his move to add 11 fentanyl analogs to the state's controlled substances schedule, a change that would increase the number of fentanyl varieties that would garner top felony charges. "The governor boasts about giving law enforcement the tools they need to make more arrests, but says nothing about providing people at risk of overdose the tools they need to survive," Daniel Raymond of the Harm Reduction Coalition said Thursday. "We won't end the overdose crisis by filling up jail cells."

New Synthetic Substances

New York Drug Reform Groups Criticize Governor's Move to Further Criminalize Synthetic Cannabinoids. The Manhattan-based Drug Policy Alliance and the drug user group VOCAL-NY are opposing Gov. Andrew Cuomo's (D) call to further criminalize the sale of synthetic cannabinoids, also referred to as "synthetic marijuana" or "K2." Such laws do little to curb use, do nothing to increase public health and safety in New York State, and undermine the ability of the state to effectively prevent minors from obtaining the substances, the groups said. The state should just legalize marijuana instead, the groups said.

International

Dutch Bank Hit With $369 Million Fine for Laundering Mexico Drug Cartel Money. The Dutch bank Rabobank has been fined $369 million by the US government after it admitted handling millions in illicit funds, the Justice Department announced Wednesday. The bank also pleaded guilty to obstructing the investigation in trying to avoid repeating sanctions imposed on it in 2006 and 2008 for "nearly identical failures," DOJ said. "When Rabobank learned that substantial numbers of its customers' transactions were indicative of international narcotics trafficking, organized crime, and money laundering activities, it chose to look the other way and to cover up deficiencies in its anti-money laundering program," Acting Assistant Attorney General John Cronan said. A former Rabobank vice president, George Martin, entered into a deferred prosecution agreement with the US concerning his role in the case, according to the DOJ. He admitted -- in a federal court in San Diego in December -- to playing a role in setting up the policies that prevented additional controls. The bank will also have to pay a $50 million penalty to the Office of the Comptroller of the Currency.

Chronicle AM: VT Legalizes Without Sales, Sentencing Commission Proposes Upped Fentanyl Penalties, More... (1/22/18)

Vermont becomes the 9th legal marijuana state, Illinois lawmakers take up legalization, the US Sentencing Commission proposing increasing fentanyl penalties, and more.

Vermont just turned New England a little greener. (Wikimedia)
Marijuana Policy

Another National Poll Has a Strong Majority for Marijuana Legalization. A new poll from NBC News and the Wall Street Journal has support for marijuana legalization at 60% nationwide, up from 55% the last time the media outlets asked the question, in 2014.

Illinois Lawmakers Hold Hearing on Marijuana Legalization. A joint legislative committee began a hearing on marijuana legalization Monday morning. Cook County Board President Toni Preckwinkle told legislators she supported it: "Legalizing marijuana is an important step in right-sizing our criminal justice system, reducing racial disparities in prosecuting non-violent drug offenses, targeting our scarce resources on prosecuting violent crime and lessening the social dislocation we see in too many of our communities," Preckwinkle said. The only relevant bill currently before the legislator is Senate Bill 2275, which would authorize a non-binding statewide referendum on the topic of legalization.

Vermont Legalizes Marijuana; Becomes First State to Do So Via Legislative Process. With Gov. Phil Scott's (R) signature on House Bill 511 Monday, the state legalized the possession and cultivation of small amounts of marijuana, becoming the first state to free the weed via the legislature. The new law goes into effect July 1. The new law does not legalize the taxed and regulated commercial production and sale of marijuana. Instead, the bill calls for a task force appointed by the governor to study the issue and recommend "legislation on implementing and operating a comprehensive regulatory and revenue system for an adult marijuana market" by December 31. Then lawmakers would have to go to work again to get that passed.

Buffalo Campaigners Call for Police to Deprioritize Marijuana Possession Arrests. A nonprofit group called Open Buffalo has begun a petition campaign to urge Mayor Byron Brown to tell the police department to deprioritize enforcement of marijuana possession laws. The group is close to its goal of 600 signatures; when it hits that goal, it will deliver the petition to the mayor.

Sentencing

US Sentencing Commission Proposes Stiffening Fentanyl Penalties. Last Friday, the Sentencing Commission announced it was proposing to increase penalties for fentanyl offenses by setting the offense level for fentanyl equal to the higher offense level currently assigned to fentanyl analogs. The commission is also proposing a sentencing guidelines enhancement for misrepresenting fentanyl or fentanyl analogs as another substance. The commission also proposed a class-based approach to synthetic cathinones and cannabinoids and established a single marijuana equivalency for each class. Public comment on the proposals is open until March 6, and the commission will hold public hearings in February and March. The commission is expected to vote on the proposals before May 1.

Looking Back: The Biggest International Drug Policy Stories of the Past 20 Years [FEATURE]

With a thousand issues of Drug War Chronicle under our belts, we look back on the biggest international drug and drug policy stories of the past 20 years. (A companion piece looks at the biggest US domestic drug policy stories.) Here's what we find:

The 1998 UN General Assembly Special Session on Drugs. We've made some progress since then. (Creative Commons)
1. Global Prohibitionist Consensus Starts to Crumble

In 1998, the UN General Assembly Special Session on Drugs (UNGASS), with anti-prohibitionist voices in the room but metaphorically on the outside, pledged itself to eradicating drugs in 10 years. That didn't happen. Now, nearly 20 years later, it is duly chastened, and the chorus of critics is much louder, but the UN still remains a painfully slow place to try to make change in global drug policy.

Yet, despite the foot-dragging in Vienna and New York, albeit at a glacial pace. The 2016 UNGASS couldn't bring itself to actually say the words "harm reduction," but acknowledged the practice in its documents. It couldn't bring itself to resolve to be against the death penalty in drug cases, but a large and growing number of member states spoke out against it. It couldn't officially acknowledge that there is "widespread recognition from several quarters, including UN member states and entities and civil society, of the collateral harms of current drug policies, and that new approaches are both urgent and necessary," even though that's what the UN Development Program said. And the UN admitted to having dropped the ball on making opioid analgesics available in the developing world.

It certainly wasn't ready to talk about drug legalization in any serious fashion. But despite the rigidity within the global anti-drug bureaucracy, driven in part by the hardline positions of many Asian and Middle Eastern member states, the global prohibitionist consensus is crumbling. Many European and Latin America states are ready for a new direction, and some aren't waiting for the UN's imprimatur. Bolivia has rejected the 1961 Single Convention on Narcotic Drugs' provision criminalizing the coca plant, and Canada and Uruguay have both legalized marijuana with scant regard for UN treaty prohibitions. And of course there is Portugal's broad decriminalization system, encompassing all drugs.

There's a real lesson in all of this: The UN drug treaties, the legal backbone of global drug prohibition, have proven to be toothless. There is no effective mechanism for punishing most countries for violating those treaties, at least not relative to the punishing effects they suffer from prohibition. Other countries will take heed.

2. Afghanistan Remains the World's Opium Breadbasket

When the US invaded Afghanistan in late 2001, it entered into a seemingly endless war to defeat the Taliban and, along with it, the opium trade. Sixteen years and more than a trillion dollars later, it has defeated neither. Afghanistan was already the world's leading producer of opium then, and it still is.

According to the UN Office on Drugs and Crime, in 2000, the country produced more than 3,000 tons of opium. The following year, with the Taliban imposing a ban on poppy planting in return for US aid and international approval, production dropped to near zero. But in 2002, production was back to more than 3,000 tons, and Afghan poppy farmers haven't looked back since.

In the intervening years, Afghanistan has accounted for the vast majority of global opium production, reaching 90% in 2007 before plateauing to around 70% now (as production increases in Latin America). It has consistently produced at least 3,000 tons a year, with that amount doubling in selected years.

For years, US policymakers were caught in a dilemma, and drug war imperatives were subordinated to anti-Taliban imperatives. The problem was that any attempt to go after opium threatened to push peasants into the hands of the Taliban. Now, the Trump administration is bombing Taliban heroin facilities. But it hasn't bombed any heroin facilities linked to corrupt Afghan government officials.

Holland's famous cannabis cafes were the first break with global marijuana prohibition. (Creative Commons)
3. Movement Toward Acceptance of Recreational Marijuana

Twenty years ago, only the Netherlands had come to terms -- sort of -- with marijuana, formally keeping it illegal, but, in a prime example of the Dutch's policy of gedogen (pragmatic tolerance), with possession and sale of small amounts allowed. (The Dutch are only now finally dealing with the "backdoor problem," the question of where cannabis cafes are supposed to get their supplies if it can't be grown legally).

The first entities to legalize marijuana were the US states of Colorado and Washington in 2012, and Uruguay became the first country in the world to legalize marijuana in 2014. Canada will become the second country to do so next year. In the meantime, six more US states and the District of Columbia have also jumped on the bandwagon.

While full legalization may yet be a bridge too far for most European and Latin American countries, marijuana decriminalization has really taken hold there, with numerous countries in both regions having embraced the policy. Marijuana has now been decriminalized in Argentina, Austria, Belgium, Belize, Bolivia, Brazil, Chile, Colombia (you can possess up to 22 grams legally), Costa Rica, Croatia, the Czech Republic, Equador, Estonia, Georgia, Greece, Italy, Jamaica, Luxembourg, Malta, Mexico, Moldova, Paraguay, Peru, Portugal, Slovenia, Spain, Switzerland, and Ukraine, among others. Oh, and Iran, too.

4. Andean Whack-A-Mole: The Fruitless Quest to Quash Cocaine

The United States, and to a much lesser degree, the European Union, have spent billions of dollars trying to suppress coca leaf cultivation and cocaine production in Bolivia, Colombia, and Peru. It hasn't worked.

According to the UN Office on Drugs and Crime (UNODC), coca leaf cultivation was just under 500,000 acres in 1998; this week, UNODC reported that coca leaf cultivation was at 470,000 acres last year -- and that's not counting the 75,000 acres under legal cultivation in Bolivia.

When it comes to actual cocaine production, it's pretty much the same story: Again according to the UNODC, cocaine production was at 825 tons in 1998, peaked at just over a million tons a year in 2004-2007, and is now at just under 800 tons. There have been peaks and troughs, but here we are, pretty much in the same place we started.

Military intervention didn't stop it. Military and anti-drug assistance hasn't stopped it. Alternative development programs haven't stopped it. The global cocaine market is insatiable, and nothing has been able to tear Andean peasant farmers from what is by far their best cash crop. Bolivia, at least, has largely made peace with coca -- although not cocaine -- providing a legal, regulated market for coca farmers, but in Peru and Colombia eradication and redevelopment efforts continue to spark conflict and social unrest.

5. Mexico's Brutal Drug Wars

During the 1980s and 1990s, accusations ran rampant that in a sort of pax mafiosi, the Mexican government cut deals with leading drug trafficking groups to not so much fight the drug trade as manage it. Those were the days of single party rule by the PRI, which ended with the election of Vicente Fox in 2000. With the end of single party rule, the era of relative peace in the drug business began to unravel.

As old arrangements between drug traffickers and political and law enforcement figures fell apart, so did the informal codes that governed trafficker behavior. When once a cartel capo would accept his exemplary arrest, during the Fox administration, the gangsters began shooting back at the cops -- and fighting among themselves over who would control which profitable franchise.

Things took a turn for the worse with the election of Felipe Calderon in 2006 and his effort to burnish his political credentials by sending in the army to fight the increasingly wealthy, violent, and brazen cartels. And they haven't gotten any better since. While American attention to Mexico's drug wars peaked in 2012 -- a presidential election year in both countries -- and while the US has thrown more than a billion dollars in anti-drug aid Mexico's way in the past few years, the violence, lawlessness, and corruption continues. The death toll is now estimated to be around 200,000, and there's no sign anything is going to change anytime soon.

Well, unless we take leading 2018 presidential candidate Andres Manuel Lopez Obrador (AMLO) at his word. This week, AMLO suggested a potential amnesty for cartel leaders, indicating, for some, at least, a pax mafiosi is better than a huge, endless pile of corpses.

6. Latin America Breaks Away from US Drug War Hegemony

The US imports its drugs and exports its prohibition-related violence, and the region grows tired of paying the price for America's war on its favorite vices. When once Latin American leaders quietly kowtowed to drug war demands from Washington, at least some of them have been singing a different tune in recent years.

Bolivia under Evo Morales has resolutely followed its own path on legalizing coca cultivation, despite bellows from Washington, successive Mexican presidents weary of the bloodshed turn an increasingly critical eye toward US drug war imperatives, Colombian President Juan Manuel Santos sees what Washington-imposed prohibitionist policies have done to his county and cries out for something different, and so did Guatemalan President Otto Perez Molina before he was forced out of office on corruption charges.

Latin American countries are also increasingly pursuing their own drug policies, whether it's constitutionally protected legalization of personal use amounts of drugs in Colombia, decriminalization of marijuana across the continent, or downright legalization in Uruguay, Latin American leaders are no longer taking direction from Washington -- although they generally remain happy to take US anti-drug dollars.

A North American first: Vancouver's safe injection site opened in 2003. (Creative Commons)
7.Safe Injection Sites Start Spreading

The notion of providing a place where intravenous drug users could shoot up under medical supervision and get access to referrals to public health and welfare services was derided by foes as setting up "shooting galleries" and enabling drug use, but safe injection sites have proven to be an effective intervention, linked to reduced overdoses, reduced crime, and moving drug users toward treatment.

These examples of harm reduction in practice first appeared in Switzerland in the late 1980s; with facilities popping up in Germany and the Netherlands in the 1990s; Australia, Canada, Luxembourg, Norway, and Spain in the 2000s; and, most recently, Denmark and France.

By now, there are nearly a hundred safe injection sites operating in at least 61 cities worldwide, including 30 in Holland, 16 in Germany, and eight in Switzerland. We are likely to see safe injection sites in Ireland and Scotland very soon.

It looks like they will soon be appearing in the United States, too. Officials in at least two cities, San Francisco and Seattle, are well on the way to approving them, although the posture of the federal government could prove an obstacle.

8. And Heroin Maintenance, Too

Even more forward looking as a harm reduction measure than safe injection sites, heroin maintenance (or opiate-assisted treatment) has expanded slowly, but steadily over the past two decades. The Swiss did the first trials in 1994, and now such programs are available there (after decisively winning a 2008 referendum on the issue), as well as Germany and the Netherlands.

Such programs have been found to reduce harm by helping users control their drug use, reducing overdoses, reducing drug-related disease, and promoting overall health and well-being, while also reducing social harms by reducing crime related to scoring drugs, reducing public use and drug markets, and promoting less chaotic lifestyles among participants, leading to increased social integration and better family life and employment prospects.

A Canadian pilot program, the North American Opiate Medication Initiative (NAOMI) produced similar results. Maybe the United States will be ready to get it a try one of these years.

9. New Drugs, New Markets

So far, this has been the century of new drugs. Known variously as "research chemicals," "designer drugs," or fake this and that, let's call them new psychoactive substances (NSPs). Whether it's synthetic cannabinoids, synthetic cathinones, synthetic benzodiazepines, synthetic opioids, or something entirely novel, someone somewhere is producing it and selling it.

In its 2017 annual review, the European Monitoring Center on Drugs and Drug Addictions (EMCDDA) reported in was monitoring 620 NSPs, up from 350 in 2013, and was adding new ones at the rate of over one a week.

These drugs, often of unknown quality or potency, in some cases have wreaked havoc among drug users around the world and are a prime example of the bad things that can happen when you try to suppress some drugs: You end up with worse ones.

The communications technology revolution that began with the world wide web impacts drug policy just as it impact everything else. Beginning with the infamous Silk Road drug sales website, the dark web and the Tor browser have enabled drug sellers and consumers to hook up anonymously online, with the drugs delivered to one's doorstep by Fedex, UPS, and the like.

Silk Road has been taken down and its proprietor, Ross Ulbricht, jailed for decades in the US, but as soon as Silk Road was down, new sites popped up. They got taken down, and again, new sites popped up. Rinse and repeat.

European authorities estimate the size of the dark web drug marketplace at about $200 million a year -- a fraction of the size of the overall trade -- but warn that it is growing rapidly. And why not? It's like an Amazon for drugs.

10.Massacring Drug Suspects in Southeast Asia

Philippines President Rodrigo Duterte has drawn international condemnation for the bloody war he unleashed on drug suspects upon taking office last year. Coming from a man who made his reputation for leading death squads while Mayor of Davao City, the wave of killings is shocking, but not surprising. The latest estimates are that some 12,000 people have been killed.

What's worse is that Duterte's bad example seems to be gaining some traction in the neighborhood. Human rights groups have pointed to a smaller wave of killings in Indonesia, along with various statements from Indonesian officials expressing support for Duterte-style drug executions. And most recently, a Malaysian member of parliament urged his own country to emulate Duterte's brutal crackdown.

This isn't the first time Southeast Asia has been the scene of murderous drug war brutality. Back in 2003, then Thai Prime Minister Thaksin Shinawatra launched a war on drugs that saw 2,800 killed in three months.

Chronicle AM: ME MedMJ Crackdown, Duterte Faces Heat Over Human Rights Abuses, More... (11/10/17)

The DEA will enact an emergency ban on fentanyl analogs, Maine officials try to tighten up the medical marijuana market, NGOs and individuals target Filipino President Duterte ahead of the ASEAN Summit, and more.

Filipino President Duterte remains defiant in the face of rising calls for an investigation into human rights abuses. (Wikimedia
Marijuana Policy

North Dakotans Gear Up for Legalization Initiative Campaign. Coming off a successful medical marijuana initiative campaign last year, state activists are eyeing a full-blown legalization initiative for 2018. The Recreational Marijuana/Expungement initiative campaign is expected to file with the secretary of state's office next week. If approved there, the measure could then move on to the signature gathering phase.

Medical Marijuana

Georgia Poll Has Strong Support for Medical Marijuana. A new Georgia College poll has support for medical marijuana at 77%, up 13 points from the same poll two years ago. Rep. Allan Peake (R-Macon) has been pushing for medical marijuana for several years; this poll should give a boost to his efforts in 2018.

Maine Cracks Down on Medical Marijuana. The state Health Department issued new rules Wednesday that tighten the state's medical marijuana market. Under the new rules, authorities can conduct surprise inspections of grows, and the department is implementing a new patient tracking system. The changes will go into effect on February 1.

Industrial Hemp

Wisconsin Senate Passes Hemp Bill. The Senate has unanimously approved a measure that would legalize the production and cultivation of industrial hemp. The bill would create a system of state licenses for farmers to legally grow hemp. The measure now goes to the Assembly, which is also expected to pass the bill.

Heroin and Prescription Opioids

DEA Will Enact Emergency Ban on Fentanyl Analogs.The Department of Justice Thursday announced that the Drug Enforcement Administration (DEA) intends to take immediate action against the flow of illicit fentanyl analogues into this country and the alarming increase in overdose deaths linked to synthetic opioids by scheduling all fentanyl-related substances on an emergency basis. When the DEA's order takes effect, anyone who possesses, imports, distributes, or manufactures any illicit fentanyl analogue will be subject to criminal prosecution in the same manner as for fentanyl and other controlled substances. The action announced Thursday will make it easier for federal prosecutors and agents to prosecute traffickers of all forms of fentanyl-related substances.

International

On Eve of ASEAN Summit, Hundreds of Groups Call for UN Probe of Philippines Drug War Killings. More than 280 nongovernmental organizations and individuals have renewed calls for a UN-led investigation into the thousands of deaths linked to the Philippines drug war as the country prepares to host the Association of Southeast Asian Nations (ASEAN) summit this weekend. They all signed onto a statement coordinated by Stopthedrugwar.org executive director David Borden and "organized by a coalition including the leading human rights organizations in the Philippines, Filipino-American advocacy groups, drug policy reform, recovery, (and) HIV/AIDS groups," among others. The move came after President Duterte again insisted he would brook no criticism of his human rights record, warning that he would tell US President Trump to "lay off" if he brought up the issue. But Trump has given no indication he has any concerns about human rights abuses in the Philippines.

Chronicle AM: DEA Annual Threat Assessment Released, Trump Opium Event Thursday, More... (10/24/17)

The White House could announce a national opioid emergency on Thursday, the DEA releases its annual drug threat assessment, the Maine legislature approves a marijuana regulation bill, and more.

The opioid epidemic is front and center in the drug policy debate, and in the eyes of the DEA. (wikimedia.org)
Marijuana Policy

Maine Legislature Passes Marijuana Regulation Bill, Governor May Veto. The legislature approved a bill to regulate the state's impending legal marijuana market Monday, but not by big enough a margin to withstand an expected veto by Gov. Paul LePage (R). The bill would set up a licensing system and set a 10% sales tax and a weight-based excise tax for transactions between growers and retailers. If LePage vetoes the bill, the result could be "chaos" that would throw "oxygen onto the fire of the black market," said Sen. Roger Katz (R-Augusta) in remarks reported by the Bangor Daily News. LePage has said he wants to postpones retail sales until next year.

Heroin and Prescription Opioids

White House to Host Opioid Event on Thursday. The White House Office of National Drug Control Policy has announced that it will host an event Thursday on "the nationwide opioid crisis." The announcement did not make clear what the event will be, but could be the declaration of a national emergency around the opioid crisis. President Trump surprised his advisors last week by saying he would make such an announcement this week.

Trump Opioid Commission Member Not Optimistic. In an interview Monday, Trump opioid commission member former Rep. Patrick Kennedy (D-RI) said he was not optimistic that any recommendations from the commission will lead to any effective action to ameliorate the opioid crisis. Kennedy told the Washington Post "the worry is that" the commission's final recommendations, set for release next week, "won't be adopted."

Drug Store Group Offers Recommendations to Ease Opioid Crisis. The National Association of Chain Drug Stores, which has been criticized on some fronts for contributing to the crisis, has suggested four public policy initiatives that could help rein it in. Among the policy prescriptions are a seven-day limit for initial opioid prescriptions, nationwide electronic prescription monitoring, the use of manufacturer-funded envelopes to return unused opioids, and regulation of synthetic opioids. The association did not address the impact such policy prescriptions could have on chronic pain patients.

Law Enforcement

DEA Releases 2017 National Drug Threat Assessment. The agency released its annual report Monday, and it concentrates on the opioid crisis. The report notes the high number of prescription opioid overdose deaths, warns that heroin is a "serious public health and safety threat," notes the rise of fentanyl, says "the methamphetamine threat remains prevalent," "the cocaine threat continues to rebound," and that the emergence of new psychoactive substances remains "a challenge," among other findings. It qualifies Mexican drug trafficking organizations as "the greatest criminal drug threat in the United States."

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