Public Health

RSS Feed for this category

The Opioid Crisis Could Cost a Half Million Lives in the Next Decade

The most recent data from the Centers for Disease Control and Prevention, released in mid-August, showed a record 72,000 drug overdose deaths last year, with 49,000 related to heroin, fentanyl and prescription opioids. According to the authors of a study released last week in the American Journal of Public Health, that could be the new normal.

The study, by Stanford researchers Allison Pitt, Keith Humphreys, and Margaret Brandeau, attempts to assess the number of opioid-related deaths we could expect to see over the next decade, as well as the impact of different policy responses on reducing the death toll.

The researchers said there are steps that can be taken to reduce the death toll, but also that some seemingly simple solutions, such as cracking down on opioid prescribing for chronic pain, could actually increase the toll. And even those policies that could cut the opioid death rate are likely to do so only marginally.

Using a mathematical model, the researchers estimate that some 510,000 people will die over the next decade because of opioid use. The number includes not only drug overdoses but also other opioid-related deaths, such as HIV infections caused by shared needles.

Even including the non-overdose deaths, the number is staggering. Last year was the worst year ever for opioid-related overdose deaths, but this research suggests we are going to see year after year of similar numbers.

Making the overdose reversal drug naloxone more widely available could cut opioid-related deaths by 21,200 over the next decade, allowing greater access to medication-assisted therapies with drugs such as buprenorphine and methadone would save another 12,500 lives, and reducing opioid prescribing for acute pain would prevent another 8,000 deaths, the researchers said. But those three policy moves combined would shave less than 10 percent off the overall death toll.

"No single policy is likely to substantially reduce deaths over 5 to 10 years," the researchers wrote.

While harm reduction interventions such as those above would save lives, some aspects of tightening opioid prescribing would actually increase opioid-related deaths by as much as the tens of thousands -- because they increase heroin deaths more than they cut painkiller deaths. Moves such as reducing prescribing for chronic pain, up-scheduling pain relievers to further restrict their prescribing, and prescription drug monitoring programs all tend to push existing prescription opioid users into the illicit heroin and fentanyl markers all end up contributing to net increases in opioid deaths over the 10-year period, the researchers found.

On the other hand, other interventions on the prescribing front, such as reducing acute prescribing for acute pain (pain that may be signficant but is short-term), reducing prescribing for transitional pain, reformulating drugs to make them less susceptible to misuse, and opioid disposal programs, appear to prevent more deaths than they cause.

Ultimately, reducing the opioid death toll includes reducing the size of the opioid-using population, the researchers say. That implies making addiction treatment more available for those currently using and preventing the initiation of a new generation of opioid users. Restrictions on prescribing, while possibly driving some current users to dangerous illicit markets, can have a long-term impact by reducing the number of people who develop a dependence on opioids.

Whether that's a tolerable tradeoff for those pain patients who don't get the relief they need from other medications -- or for patients and others who end up dying from street heroin but might have lived despite their prescription opioid use -- is a different question.

By all appearances, when it comes to the loss of life around opioids, it looks like a pretty sad decade ahead of us.

This article was produced by Drug Reporter, a project of the Independent Media Institute.

Chronicle AM: DOJ Takes Aim at SISes, States Demand Congress Act on Pot Banking, More... (8/28/18)

Even as a California safer injection site bill approaches final passage, the Justice Department takes aim at the harm reduction practice; state financial regulators want Congress to act on marijuana banking, and more.

Vancouver's InSite safer injection site. Coming soon to San Francisco? (Creative Commons)
Marijuana Policy

State Financial Regulators Call on Congress to Deal With Marijuana Banking Problems. The top financial regulators in 13 states sent a letter last week to congressional leaders demanding that they take action to protect banks working with marijuana businesses. The conflicts between state-level legalization and federal prohibition have created confusion in the financial sector and jeopardized public safety, the regulators said. "It is incumbent on Congress to resolve the conflict between state cannabis programs and federal statutes that effectively create unnecessary risk for banks seeking to operate in this space without the looming threat of civil actions, forfeiture of assets, reputational risk, and criminal penalties," the regulators wrote. "While Congress has taken some action, such as the Rohrabacher amendment prohibiting federal funds being used to inhibit state medicinal marijuana programs, this has been an impermanent approach that requires a permanent resolution." Regulators from Alaska, Connecticut, Hawaii, Louisiana, Michigan, Montana, Nevada, New York, Oklahoma, Oregon, Pennsylvania, Utah and Washington State signed the letter.

Medical Marijuana

Oklahoma Proposed Medical Marijuana Regulations Now Open for Public Comment. State officials are now asking the public for its input on the regulation and implementation of medical marijuana in the state. "Lawmakers in the legislative working group are seeking a path forward to implement State Question 788 in a way that conforms to the desires of voters who passed the law," said Speaker Charles McCall (R-Atoka). "To do that effectively, the working group needs as much input as possible from citizens -- supporters, advocates, patients, health-care providers, public safety and law enforcement officers and even those who have concerns. I would encourage all Oklahomans who have an interest in this issue to use this opportunity to share input and have their voices heard." Comments can be sent to [email protected]. Messages will then be shared with members of the working group.

Harm Reduction

Justice Department Attacks Safer Injection Sites. In an op-ed in the New York Times titled "Fight Drug Abuse, Don't Subsidize It," Deputy Attorney General Rod Rosenstein attacked safer injection sites as "very dangerous" and argued they would "only make the opioid crisis worse." He also points out that they are federally illegal and warns that violations are punishable by up to 20 years in federal prison. His op-ed comes as cities such as New York, Seattle, and San Francisco advance plans to open such facilities in a bid to reduce harms.

California Safer Injection Site Bill Passes Senate. The Senate voted Monday to approve Assembly Bill 186, which will allow the city of San Francisco to undertake a three-year, pilot safer injection site program. The bill now goes back to the Assembly for a final concurrence vote before heading to the desk of Gov. Jerry Brown (D).

Chronicle AM: NY Gov Signs Opioid Bill, VT Dems Want Full MJ Legalization, More... (8/27/18)

An Arizona prosecutor gets challenged for trying to profit off small-time pot offenders, Oregon regulators slash the daily purchase amounts for medical marijuana patients, a Louisiana prisoner featured in the Chronicle years ago gets a break, and more.

Oregon patients will only be able to buy one ounce a day under new emergency rules. (Creative Commons)
Marijuana Policy

Arizona County Attorney Sued Over Drug Court Diversion Program for Smalltime Marijuana Offenders. The Civil Rights Corps, a Washington, DC-based advocacy group, and a local law firm have sued Maricopa County (Phoenix) Attorney Bill Montgomery. They allege that he and the county drug court diversion program are preying on and profiting off people charged with minor pot possession offenses. Under the state's harsh laws, possession of even small amounts is a felony, but first- and second-time offenders are eligible for a diversion program. The problem is the diversion program has a $1,000 fee, and those who cannot pay the entire fee linger in the program, paying $15 to $20 fees for drug testing as often as several times a week and face being tried as felons if they fail to complete the program. "The complaint explains that the marijuana diversion program operated by TASC Inc. and the Maricopa County Attorney's Office represents a two-tiered legal system," Civil Rights Corps Attorney Dami Animashaun said in a statement. "Wealthy people buy their way off diversion quickly, while poor people risk being expelled from the program and prosecuted for a felony solely because they cannot afford to pay."

Vermont Democrats Call for Taxed, Regulated Legal Marijuana Sales. Vermont has already legalized the personal possession and home cultivation of marijuana, and now the state's Democratic Party has formally endorsed expanding legalization to include taxed and regulated legal marijuana sales. "We believe that marijuana should be legal, taxed and regulated in the interests of consumer and public health, and economic opportunity," reads a platform plank adopted by delegates at the Vermont Democratic Party's platform convention on Sunday.

Medical Marijuana

Oregon Regulators Slash Daily Purchase Limit for Patients. In a bid to reduce leakage into the black market, the Oregon Liquor Control Commission last Thursday dramatically reduced the amount of medical marijuana patients can purchase each day. Medical cardholders may now buy only one ounce a day, not the 24 ounces that had been the limit. The emergency change is in effect until December 27.

Illinois Governor Signs Hemp Bill. Gov. Bruce Rauner (R) on Saturday signed a bill legalizing industrial hemp, the Illinois Hemp Act. "Legalizing the farming of industrial hemp just makes good sense," Rauner said in a statement. "Roughly 38 states -- including our neighbors in Wisconsin, Kentucky, Indiana, Missouri and Tennessee -- have allowed or are considering allowing cultivation of this crop for commercial, research or pilot programs. Our farmers should have this option as well." The state Department of Agriculture will issue licenses to farmers who want to grow it, and regulators will establish rules for THC-level testing of industrial hemp crops.

Heroin and Prescription Opioids

New York Governor Signs Legislation To Expand Use Of Rehabilitation And Diversion Services To Combat Heroin And Opioid Epidemic. Governor Andrew Cuomo (D) last Friday signed legislation (A.10403/S.8760) to help in the fight against the heroin and opioid epidemic by diverting substance-dependent individuals who are involved in the criminal justice system. This legislation provides another form of support to prosecutors and law enforcement officers as they seek treatment and counseling for people who are addicted to opioids. These diversion models include law enforcement assisted diversion, known as LEAD, and other programs treating substance abuse and addiction. The legislation expands the allowable use of funding from seized or forfeited assets by law enforcement and the Office of Alcoholism and Substance Abuse."We must use every tool at our disposal to combat this nation's opioid epidemic and the underlying issues that lead people to commit crime, and this legislation makes available additional funding to help New Yorkers in need," Governor Cuomo said. "By helping New Yorkers turn their lives around, this program helps strengthen communities, increase public safety and break the vicious cycle of recidivism once and for all."

Sentencing

One Louisiana Man Gets a Sentence Cut. A Louisiana man sentenced to life in prison for marijuana possession as a habitual offender has received a sentence reduction that will allow him to go free in a matter of weeks. Jody Butler's case was covered by the Chronicle's Clarence Walker back in 2013, but it took until now for justice to be done. New Orleans Parish District Attorney, who made a career of imposing long sentences on small-time drug offenders, raised no objection to a sentence reduction in Butler's case, the latest in which he has backpedaled away from his earlier, harsher stance.

Chronicle AM: Good NJ, WI Pot Polls; OH Drug Defelonization Initiative, More... (8/24/18)

New polls in New Jersey and Wisconsin show solid support for marijuana legalization, Chicago harm reduction pioneer Dan Big has died too early, the FDA approves clinical trials of psilocybin for treatment-resistant depression, an Ohio drug defelonization initiative is on the November ballot, and more.

magic mushrooms (Flickr/Green)
Marijuana Policy

California Legislature Passes Bill to Overturn Old Marijuana Convictions. The state Senate Wednesday approved Assembly Bill 1793, which directs prosecutors throughout the state to overturn convictions for acts that are no longer illegal under the state's Prop 64 marijuana legalization initiative. The bill would also reduce many felony convictions for marijuana-related crimes to misdemeanors. It was approved by the Assembly in May and now goes to the desk of Gov. Jerry Brown (D).

New Jersey Poll Shows Strong Support for Legalization. A Quinnipiac poll released Wednesday has support for marijuana legalization at 62%. Among respondents between 18 and 34, that figure was 90%. The poll comes as Gov. Phil Murphy (D) and legislative leaders push to get a legalization bill passed next month.

Wisconsin Poll Shows Strong Support for Legalization. A new Marquette Law poll has support for legalization in the Dairy State at 61%. Gov. Scott Walker (R) is opposed to marijuana legalization, calling it a gateway drug. He's polling at 46% in the same poll.

Medical Marijuana

Mormon Church Sends Out Letter Opposed Utah Medical Marijuana Initiative. The Salt Lake City-based Church of Latter Day Saints has mailed a letter to church members urging a "no" vote on the state's November medical marijuana initiative. The letter claims the measure would create "a serious threat to health and public safety, especially for our youth and young adults, by making marijuana generally available with few controls."

Psychedelics

FDA Approves Psychedelic Magic Mushrooms Ingredient Psilocybin for Depression Trial. The Food & Drug Administration has approved the use of psilocybin for a drug trial in treatment-resistant depression. Compass Pathways, a life sciences firm, now has a green light to perform the clinical trials. The phase two trial with 216 patients will get underway next month.

Harm Reduction

Chicago Harm Reduction Pioneer Dan Bigg Dead at 59. Dan Bigg, a co-founder of the Chicago Recovery Alliance and a long-time activist died Tuesday at his home. The cause of death remains undetermined pending further tests. He was a pioneering needle exchange worker in the 1990s and pushed for putting naloxone in the hands of drug users and their loved ones as opioid overdose deaths began to soar more than a decade ago. Friends and colleagues said that thousands of people who could have died from overdoses or infectious disease are alive today because of Bigg's stalwart activism. He will be missed.

Sentencing

Ohio Initiative Would Defelonize Drug Possession, Cut Sentences. Voters in the Buckeye State will vote on a constitutional amendment that would reduce penalties for non-violent drug crimes by making drug use and possession a misdemeanor instead of a felony. Issue 1 also bars the jailing of probationers merely for drug use or possession and allows sentence reductions of up to 25% for inmates who participate in rehabilitation, work, or educational programming.

Chronicle AM: CA Senate Passes SIS Bill, Black Vets More Likely to Be Drug Tested, More... (8/22/18)

Louisiana doctors could soon treat more medical marijuana patients, black VA patients on opioid therapy are more likely to be drug tested and have their treatment halted for illicit drug use than whites, a Georgia judge throws out a heroin murder conviction, and more.

A facility like Vancouver's InSite could be coming to San Francisco. A bill to make it happen is moving in Sacramento. (CC)
Medical Marijuana

Louisiana Regulators Weight Raising Limit on Number of Patients Doctors Can Treat. The state Board of Medical Examiners is set to boost the number of medical marijuana patients a single doctor can treat. The board set a limit of 100 patients per doctor in 2016, but Vincent Culotta, the board's executive director, said the limit will be raised at the board's meeting next month. "We realize we're going to have to increase that number," he said.

Oklahoma Judge Rules Implementation of Medical Marijuana Rules Can Proceed. Cleveland County District Court Judge Michael Tupper ruled Tuesday that the Board of Health can proceed with implementing the state's medical marijuana rules and regulations. He ruled against a lawsuit by more than a dozen Oklahoma patients and businesses who challenged the rules. The decision Tuesday does not end the case. The judge could still throw out some or all the challenged rules at a later date or choose to leave them alone again. Another legal challenge is still pending in Oklahoma County District Court.

Heroin and Prescription Opioids

Study Finds African-American VA Patients More Likely to Be Drug Tested, Have Prescriptions Stopped. Black VA patients on long-term opioid therapy are more likely to be drug tested by their doctors and much more likely to have their opioid prescriptions halted if any illegal drug use is found, a new study finds. About 25% of black patients were tested within six months of being prescribed opioids, while only 16% of whites were. Black patients were twice as likely as white ones to have their opioid therapy halted if they tested positive for marijuana and three times as likely if they tested positive for cocaine. The findings were published in the journal Drug and Alcohol Dependence.

Georgia Judge Dismisses Indictment in Heroin Overdose Death. A Georgia judge has dismissed a murder indictment against a man accused of injecting heroin into another man who overdosed and died. In the case, Superior Court Judge John Goger found that the defendant injected the fatal dose at the victim's request and that the victim had purchased the drug himself. Goger held that that didn't amount to heroin distribution by the defendant, and without the underlying drug felony, there is no felony murder.

Harm Reduction

California Senate Passes Bill to Permit Safe Injection Sites in San Francisco. The state Senate Wednesday approved Assembly Bill 186, which would allow San Francisco to implement a safe injection site. AB 186 permits San Francisco to establish facilities where individuals can use controlled substances under the supervision of staff that are trained to treat and prevent drug overdose and link people to drug treatment, housing, healthcare, and other services. Mayor London Breed, the San Francisco Board of Supervisors, as well as a significant majority of the San Francisco electorate, support piloting safe injection sites in San Francisco.

Chronicle AM: Overdose Deaths at Record High, DEA Cuts Opioid Production Quotas, More... (8/16/18)

Drug overdose deaths hit another record high last year, the DEA is cutting prescription opioid quotas again, California pot tax revenues are not meeting expectations, and more.

According to the CDC, more than 72,000 Americans died of drug overdoses last year. (Creative Commons)
Marijuana Policy

California Pot Tax Revenues Still Sluggish. The state has taken in $82 million in marijuana tax revenues in the first six months of 2018, finance officials reported. That's less than half the $185 million anticipated. Politicians and industry figures say that's because illicit sales still flourish and because many localities in the state don't allow retail marijuana sales. At a meeting with state regulators Tuesday, fingers were also pointed at a shaky supply chain, a shortage of licenses, testing problems and restrictions on retail sales and deliveries.

Medical Marijuana

Utah Medical Marijuana Foes Try Hail Mary Court Challenge to Block Initiative. Opponents of the Proposition 2 medical marijuana initiative filed a lawsuit in state court Wednesday seeking to remove the measure from the ballot. The opponents claim the initiative would tread on their freedom of religion because it violates the religious beliefs of a Mormon foe. "In the United States of America, members of all religions, including the Church of Jesus Christ of Latter Day Saints have a constitutional right to exercise their religious beliefs," the complaint reads. "This includes the right not to consort with, be around, or do business with people engaging in activities which their religion finds repugnant." Proponents of the initiative called the move "a wacky attempt" by foes to derail medical marijuana.

Heroin and Prescription Opioids

DEA Proposes Big Cuts in Opioid Manufacturing Next Year. The DEA has proposed decreasing the manufacturing quotas for the "six most frequently abused" opioids for next by 10%. That would be the third straight year of reductions. The move is described as part of President Trump's Safe Prescribing Plan, which seeks to "cut nationwide opioid prescription fills by one-third within three years." Neither this proposed cut nor the plan address whether bluntly tightening production quotas could lead to shortages for patients needing them for chronic pain.

Overdose Deaths At Record High Last Year, Driven By Opioids. The Centers for Disease Control and Prevention (CDC) reported Wednesday that preliminary figures showed that more than 72,000 Americans died of drug overdoses last year, up 7% over 2016. Opioids, which include prescription painkillers along with heroin and other illegal synthetic opioid drugs, contributed 49,068 to the total number of overdose deaths, the report indicates. From 2002 to 2017, the CDC estimates a 4.1-fold increase in the total number of deaths due to all types of opioid drugs.

Psychedelics Are Showing Real Promise for Treating Mental Disorders

Research presented at the American Psychological Association's annual meeting in San Francisco last weekend is illuminating the rapid advance of psychedelic science. New findings are adding to a growing mountain of evidence that psychedelics could be effective at treating a range of psychological problems, including post-traumatic stress disorder (PTSD), depression, and social anxiety.

The research could be laying the groundwork for legal prescribing of psychedelics including MMDA (ecstasy), ayahuasca, LSD, and psilocybin (magic mushrooms). But that's a way down the road: All of these drugs are currently illegal, classified as Schedule I under the Controlled Substances Act. (The two plants that combine to make ayahuasca are not illegal, but DMT, the mind-altering ingredient in ayahuasca, is.)

Researchers began studying psychedelics for their potential healing benefits after the discovery of LSD in 1943, but that research came to a screaming halt in the 1960s, when psychedelics were criminalized in the wake of their widespread adoption by the counterculture. Recent years, however, have seen an efflorescence of interest in the therapeutic benefits of the substances -- and it's starting to pay off.

"Combined with psychotherapy, some psychedelic drugs like MDMA, psilocybin, and ayahuasca may improve symptoms of anxiety, depression and post-traumatic stress disorder," said Cristina L. Magalhaes, Ph.D., of Alliant International University Los Angeles, and co-chair of a symposium on psychedelics and psychotherapy. "More research and discussion are needed to understand the possible benefits of these drugs, and psychologists can help navigate the clinical, ethical and cultural issues related to their use."

In one study, researchers questioned 159 participants about their spirituality, their relationship with their own emotion, and their use of hallucinogens. Laurentian University's Adele Lafrance, Ph.D., reported that psychedelic use correlated with higher levels of spirituality, which were associated with fewer symptoms of anxiety and depression and improved emotional stability.

"This study reinforces the need for the psychological field to consider a larger role for spirituality in the context of mainstream treatment because spiritual growth and a connection to something greater than the self can be fostered," said Lafrance.

An ayahuasca study found similar results. That study suggested the drug could help relieve addiction and depression, as well as helping people cope with trauma.

"We found that ayahuasca also fostered an increase in generosity, spiritual connection, and altruism," said Clancy Cavnar, Ph.D., with the Núcleo de Estudos Interdisciplinares sobre Psicoativos (Nucleus of Interdisciplinary Psychoactive Studies).

Another study, led by Alicia Danforth, Ph.D., of the Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center, found that a combination of psychotherapy and MMDA could treat social anxiety in adults on the autism spectrum. In that study, 12 participants with moderate to severe social anxiety twice given doses of MMDA and treated with psychotherapy, and they showed significant, long-lasting reductions in anxiety.

"Social anxiety is prevalent in autistic adults and few treatment options have been shown to be effective," said Danforth. "The positive effects of using MDMA and therapy lasted months, or even years, for most of the research volunteers."

Yet another study examined the use of psilocybin in reducing stress and anxiety in people suffering from terminal cancer. In that study, 13 subjects were given psilocybin in conjunction with psychotherapy. Researchers found that the experience helped subjects grapple with their feelings about death and develop new understandings of dying.

"Participants made spiritual or religious interpretations of their experience and the psilocybin treatment helped facilitate a reconnection to life, greater mindfulness and presence and gave them more confidence when faced with cancer recurrence," said Gabby Agin-Liebes, a doctoral candidate in psychology at Palo Alto University, who conducted the research.

After a decades-long lacuna, psychedelic science is back. How long that will take to translate into psychedelics becoming legally available by prescription remains to be seen, but the groundwork is being laid right now.

Saying Goodbye to Mr. Methadone: Dr. Bob Newman Dead at Age 80

Dr. Robert Newman died earlier this month after being struck by an automobile earlier this summer. He was 80 years old.

Bob Newman at a Beth Israel staff meeting in 1985 (Arthur H. Aufses Jr. MD Archives at Mt. Sinai)
If any one man can be credited with carving out a space for the use of methadone as a treatment for heroin addiction, he is that man. Working as a New York City public health doctor in the 1960s, he was given the task of ensuring that heroin addicts who wanted treatment could get treatment with methadone. His boss, city health department head Gordon Chase, told him he would be known as "Mr. Methadone."

While he did not achieve the goal of providing treatment to everyone who wanted it, Newman oversaw the rapid expansion of the city's fledgling methadone program in the early 1970s. The number of patients on methadone went from a handful to more than 10,000 in two years, and 35,000 by 1975.

And he stood up for those patients. When the NYPD wanted Newman to turn over patients' methadone records, he refused. Instead, he took to the courts to defend his patients' right to privacy -- and he won.

After that, he devoted his career to advocating for evidence-based treatment, traveling the country and the world and picking up a second moniker, "the methadone pope," as he advanced harm reduction ideas decades before they became popularized.

He faced opposition from abstinence and 12-step proponents, as well as from elected officials like New York City Mayor Rudy Giuliani, who in 1998 tried to shut down the city's methadone program on the moralistic grounds that it merely substituted one addiction for another. The diplomatic Newman didn't challenge Giuliani head on but instead used interviews to make his case that methadone treatment allowed addicts to lead productive lives.

Newman also advocated for a humane approach toward addicted mothers and pregnant women, supporting groups such as National Advocates for Pregnant Women in their fight against the demonization and criminalization of those women. He was a drug policy reformer who served for decades on the board of the Drug Policy Foundation and then its successor the Drug Policy Alliance.

As this century's opioid epidemic deepened, Newman was cautiously optimistic that the work he had begun decades earlier would help further destigmatize addiction. "I'm hoping that pragmatism will win out," he said. "As more and more Congresspeople, people in the general community and physicians have children who develop a problem with prescription drug use and can't get treatment for it, I think it will make people more receptive to opening doors to treatment."

Newman was not only an influential physician in addiction issues, he was a giant in the hospital world as a whole. He served as President of Beth Israel Medical Center in New York, and then of the entity that acquired Beth Israel along with other facilities -- and then of the entity that acquired that entity. But one could still talk him at a drug policy conference, or send him an email, and you'd get an email back.

Dr. Robert Newman's contribution to an enlightened approach to addiction cannot be overstated. He will be missed, but his legacy lives on.

(Read Bob Newman's 1998 interview with this newsletter here.)

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: Norway Heroin-Assisted Treatment Plan, NJ Pol Says Marijuana Legalization "Soon," More... (8/10/18)

New Jersey's Senate president says marijuana legalization is coming "soon," the Norwegians begin moving toward heroin-assisted treatment, and more.

diacetylmorphine AKA pharmaceutical heroin -- coming soon to Norway to treat hardcore addicts (Creative Commons)
Marijuana Policy

Key New Jersey Pol Says Legalization Coming "Soon." "I think it's gonna happen soon," State Senate President Stephen Sweeney (D-Gloucester) told NJ Advance Media Thursday, saying it could happen as early as next month. "We'll have the legislation done. Then you have to do the regulations and everything else." He said he hoped to see a final draft of the bill, next week, hold hearings quickly, and vote in September. "We're getting much closer," Sweeney said.

International

British Police Commissioner Calls for Marijuana Freedom. Police and Crime Commissioner for North Wales Arfon Jones has called for marijuana users to be able to grow and sell the plant without fear of arrest in cannabis clubs. He is calling for the country to adopt Spanish-style marijuana "collectives" where members sell homegrown weed to each other. At least 75 cannabis clubs currently exist in Britain, all operating with a wink and a nod from local police.

Norway to Begin Providing Free Heroin to Hardcore Addicts. Norwegian Health Minister Bent Hoie has asked the Directorate of Health to create a list of heroin addicts must suitable for receiving heroin-assisted treatment and to assess the economic consequences of creating such a program. "We want to help those addicted who are difficult to reach, those who are not part of LAR (drug-assisted rehabilitation) and who are difficult to treat," he said. The pilot program is set to start in 2020 or 2021. Local governments in Oslo and Bergen are reportedly applying to participate.

Drug War Issues

Criminal JusticeAsset Forfeiture, Collateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Court Rulings, Drug Courts, Due Process, Felony Disenfranchisement, Incarceration, Policing (2011 Drug War Killings, 2012 Drug War Killings, 2013 Drug War Killings, 2014 Drug War Killings, 2015 Drug War Killings, 2016 Drug War Killings, 2017 Drug War Killings, Arrests, Eradication, Informants, Interdiction, Lowest Priority Policies, Police Corruption, Police Raids, Profiling, Search and Seizure, SWAT/Paramilitarization, Task Forces, Undercover Work), Probation or Parole, Prosecution, Reentry/Rehabilitation, Sentencing (Alternatives to Incarceration, Clemency and Pardon, Crack/Powder Cocaine Disparity, Death Penalty, Decriminalization, Defelonization, Drug Free Zones, Mandatory Minimums, Rockefeller Drug Laws, Sentencing Guidelines)CultureArt, Celebrities, Counter-Culture, Music, Poetry/Literature, Television, TheaterDrug UseParaphernalia, ViolenceIntersecting IssuesCollateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Violence, Border, Budgets/Taxes/Economics, Business, Civil Rights, Driving, Economics, Education (College Aid), Employment, Environment, Families, Free Speech, Gun Policy, Human Rights, Immigration, Militarization, Money Laundering, Pregnancy, Privacy (Search and Seizure, Drug Testing), Race, Religion, Science, Sports, Women's IssuesMarijuana PolicyGateway Theory, Hemp, Marijuana -- Personal Use, Marijuana Industry, Medical MarijuanaMedicineMedical Marijuana, Science of Drugs, Under-treatment of PainPublic HealthAddiction, Addiction Treatment (Science of Drugs), Drug Education, Drug Prevention, Drug-Related AIDS/HIV or Hepatitis C, Harm Reduction (Methadone & Other Opiate Maintenance, Needle Exchange, Overdose Prevention, Pill Testing, Safer Injection Sites)Source and Transit CountriesAndean Drug War, Coca, Hashish, Mexican Drug War, Opium ProductionSpecific DrugsAlcohol, Ayahuasca, Cocaine (Crack Cocaine), Ecstasy, Heroin, Ibogaine, ketamine, Khat, Kratom, Marijuana (Gateway Theory, Marijuana -- Personal Use, Medical Marijuana, Hashish), Methamphetamine, New Synthetic Drugs (Synthetic Cannabinoids, Synthetic Stimulants), Nicotine, Prescription Opiates (Fentanyl, Oxycontin), Psilocybin / Magic Mushrooms, Psychedelics (LSD, Mescaline, Peyote, Salvia Divinorum)YouthGrade School, Post-Secondary School, Raves, Secondary School