Addiction

RSS Feed for this category

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.

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: 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.

Chronicle AM: OK Medical Marijuana Muddle, Toronto Health Board Says Decriminalize, More... (7/17/18)

The uproar in Oklahoma grows louder after the state health board messes with the medical marijuana initiative, Toronto's health board endorses drug decriminalization, and more.

A battle is brewing in Oklahoma after the state health board messes with the voter-approved medical marijuana initiative. (DPA)
Medical Marijuana

Oklahoma Pressure Mounts for Special Session on Medical Marijuana. Amid growing outrage over the Board of Health's imposition of restrictive and controversial changes to State Question 788, approved last month by voters, legislators and others are demanding Gov. Mary Fallin (R) call a special session of the legislature to ensure the will of the voters is upheld. Among other changes, the Board banned the sale of smokable marijuana and required pharmacists to be present at dispensaries. "This is not what the voters voted for," said state Rep. Jason Lowe (D-Oklahoma City). "We must adhere to the will of the people. The governor's signing of the emergency rules adopted by the Oklahoma State Health Department is an affront to democracy, an insult to the law-abiding citizens that showed up to vote for this initiative."

Drug Testing

Massachusetts High Court Holds Judges Can Require Drug Users to Remain Drug-Free. The state's Supreme Judicial Court ruled Monday that a judge can require a drug user to stay drug-free as a condition of probation. The case involved Julie Eldred, who was on probation for a larceny charge when she was jailed for failing a drug test. Her attorney argued that her relapse was a symptom of her disease of addiction and that it was unconstitutional to punish someone for a medical condition. But the court disagreed: "In appropriate circumstances, a judge may order a defendant who is addicted to drugs to remain drug-free as a condition of probation, and that a defendant may be found to be in violation of his or her probation by subsequently testing positive for an illegal drug."

International

Toronto Public Health Board Calls for Drug Decriminalization. The health board in Canada's largest city has called on the federal government to decriminalize all drugs. The board voted unanimously Monday to endorse the recommendation from the city's top health officer, Dr. Eileen de Villa. "The potential harms associated with any of these drugs is worsened when people are pushed into a position where they have to produce, obtain and consume those drugs illegally, so that's what we're trying to address," de Villa said, with a call for a "public health approach" focused on treatment and harm minimization rather police, courts and jail. Officials in Vancouver have also called for drug decriminalization, but the federal government of Prime Minister Justin Trudeau hasn't shown any appetite for it.

Different Psychedelics Share a Common Trait: Enhancing ‘Neural Plasticity"

New research suggests that different classes of psychedelic drugs all share the tendency to promote the growth of new brain cells, especially the kind that reach out and forge connections with other brain cells. This finding could help explain both the mind-expanding properties of the drugs and the mechanisms by which they appear to act as valuable treatments for a broad range of psychiatric disorders.

Earlier research had identified the dissociative anesthetic ketamine as promoting growth in key brain cells (as well as being a fast-acting and effective treatment for depression), but this new research finds similar effects in amphetamine-based psychedelics such as DOI (2,5-dimethoxy-4-iodoamphetamine), ergoline psychedelics (such as LSD), and tryptamines (such as DMT).

Using experiments in cell culture and with animals, researchers led by Dr. David Olson of the University of California at Davis found that various classes of hallucinogenic drugs acted on the structure and function of cortical neurons using the same mechanisms as ketamine. The findings could point to new treatment approaches for depression, anxiety, PTSD, and addiction, the researchers wrote last Tuesday in the peer-reviewed journal Cell Reports.

"The state-of-the-art, prototypical, fast-acting antidepressant is ketamine -- a compound that promotes neural plasticity and repairs circuits involved in mood and anxiety disorders," Olson told MedPage Today. "Our work demonstrates that psychedelics produce comparable effects on neuronal structure and function, providing a potential explanation for why MDMA, psilocybin, and ayahuasca seem to have antidepressant and anxiolytic effects in the clinic."

Using test tubes, as well as rats and fruit fly larvae, the researchers found that all of these classes of psychedelics increased "neural plasticity," the ability to create new connections among brain cells. The drugs all excited the growth of dendritic spines and axons, the cerebral hangers-on that brain cells use to reach out and create connections, or synapses, with other brain cells.

That's the opposite of what happens with depression, anxiety, PTSD, and addiction. The current theory is that these disorders may occur when neurites retract, not allowing brain cells to connect at synapses.

"One of the hallmarks of depression is that the neurites in the prefrontal cortex -- a key brain region that regulates emotion, mood, and anxiety -- those neurites tend to shrivel up," Olson said in a statement.

Olson's research found that the neural plasticity effect found with ketamine was also "remarkably potent" with even very small doses of LSD, which could help explain the popularity of "microdosing" among people seeking happier and more creative lives. Chemical compounds that mimicked psilocybin and MDMA also increased neural plasticity on the same level as ketamine, and that could mean new opportunities for researchers working with psychiatric disorders.

The studies also showed that the effect outlasted the action of the drugs. In rats, for example, psilocybin produced results that lasted for hours after the drug had left the body. Similarly, rats given a single dose of DMT not only saw an increase in dendritic spines similar to ketamine but saw that effect last for 24 hours when the drug itself had been eliminated within one hour.

This is potentially very good news for researchers working on treatments for anxiety, depression, and addiction, which all seem to act on the same brain circuits.

"Prior to this study, there was only one player in town and that was ketamine. This opens up some new doors," Olson said. "As the diversity of chemical structures capable of producing ketamine-like plasticity effects continues to grow, so does my hope that we will find a safe and effective fast-acting treatment for depression," he said.

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

You'll Never Believe What Country Just Enacted a Massive, Meaningful Drug Reform

For years, Iran has been one of the world's leading executioners of drug offenders, with hundreds of people hung from the gallows annually for drug smuggling and trafficking. But in a remarkable turnabout, that is no longer the case.

Executions for drug offenses have come to an almost total halt in Iran. (IHR)
After the Iranian parliament amended the country's drug laws in November 2017, drug executions have all but halted, according to a new report from Iran Human Rights (IHR). The non-profit group found that only one person had been executed for a drug offense this year in Iran, compared to 112 during the same period last year and nearly 500 for all of 2017.

That's a 99% reduction in the resort to the death penalty for drugs in the Islamic Republic.

The changes to Iran's drug laws didn't remove the death penalty from the books -- it remains one of 33 countries, including the United States, that mete out the ultimate punishment for drug offenses -- but it dramatically raised the quantities of drugs needed to merit the death penalty.

Under the old law, being caught with a little more than an ounce (30 grams) of drugs such as cocaine or heroin could bring a death sentence. Now, it takes nearly 4 ½ pounds (2 kilograms). Similarly, for plant-based drugs such as cannabis and opium, the death penalty threshold has increased ten-fold, from 5 kilograms (11 pounds) to 50 kilograms (110 pounds).

The death penalty can also be imposed for certain other drug offenses where quantity is not the issue, for example, the use of a minor in a drug trafficking operations, carrying or using firearms while committing drug-related crimes, having a prior death penalty or prison sentence longer than 15 years, or being the "leader" of a drug trafficking group.

The one man executed for drug offenses in Iran this year, identified as Kiomars Nosuhi, was convicted of being a "leader" of a drug trafficking group.

Bordering Afghanistan, the world's primary supplier of raw opium and heroin, Iran has for decades waged war on drug smugglers, with thousands of police and soldiers killed in the struggle. While opium smoking was a traditional Iranian pastime, the country now has one of the world's highest addiction rates, with heroin largely replacing opium. In recognition of that reality, in the past decade, Iranian officials have switched from harsh punishments of drug users to emphasizing drug treatment and harm reduction. The end of the reflexive resort to the death penalty for drugs marks another step in the country's march toward a more progressive policy response.

While human rights groups applaud the dramatic decline in drug executions, they continue to express concern over the way the Iranian judicial system responds to drugs.

"We welcome the significant reduction in the use of the death penalty and hope that this trend will continue towards complete abolition," said IHR spokesperson Mahmood Amiry-Moghaddam. "However, we have several serious concerns regarding the process of implementation of the new amendment, including bribery in the judicial system, insufficient capacity to handle a large number of cases, and lack of a monitoring organ overlooking the process."

And then there are the tens of thousands of drug offenders filling Iran's prisons. The country has more than 250,000 people behind bars, 50% to 70% for drug offenses. The Islamic Republic may not be running the gallows at full tilt anymore for drugs, but incarceration remains a key element of Iranian drug policy. Still, Iran has taken an important step forward.

Chronicle AM: NYC Marijuana Arrest Disparities Continue, Drug Protests Shake Tbilisi, More ... (5/14/18)

New York City has yet to escape from racially disproportionate marijuana arrests, the Mormon Church picks a fight with medical marijuana, nursing homes can't discriminate against people taking addiction medications, protests rock the capital of Georgia after a massive weekend drug bust, and more.

NYPD seems to think marijuana users only come in the colors black and brown. (IRIN)
Marijuana Policy

Oklahoma Legalization Initiative Campaign Getting Underway. A Tulsa-based group calling itself Green the Vote is now collecting signatures for a constitutional amendment to legalize marijuana. Campaigners will need nearly 124,000 valid voter signatures by September 8 to qualify for the November ballot. A medical marijuana initiative is already set to go before the voters next month.

New York City Pot Bust Racial Disparities Aren't Going Away. A major investigation by the New York Times has found continued racial disparities in marijuana enforcement and arrests in every neighborhood in the City. "Across the city, black people were arrested on low-level marijuana charges at eight times the rate of white, non-Hispanic people over the past three years. Hispanic people were arrested at five times the rate of white people. In Manhattan, the gap is even starker: Black people there were arrested at 15 times the rate of white people."

Medical Marijuana

Mormon Church Ups the Ante in Fight Against Utah Medical Marijuana Initiative. The church last Friday doubled down on its opposition to the medical marijuana initiative set for the November ballot. The church released a seven-page memorandum raising dozens of complaints it says "raises grave concerns about this initiative and the serious adverse consequences that could follow if it were adopted."

Drug Treatment

Justice Department: Nursing Facilities Can't Exclude Patients Using Addiction Medication. The Justice Department has reached a settlement with a skilled nursing facility in which the facility agreed to pay a fine for excluding a patient because the patient was being treated for opioid use disorder with suboxone and agreed not to discriminate in the future. "Our office is committed to protecting the rights of people with disabilities, which includes those in treatment for an Opioid Use Disorder," United States Attorney for Massachusetts Andrew Lelling said. "As Massachusetts faces this overdose epidemic, now more than ever, individuals in recovery must not face discriminatory barriers to treatment."

International

Taliban Kill Dozens of Afghan Police in Opium Trafficking Areas. In attacks late last week, Taliban fighters attacking Afghan police bases in Farah province, killing more than 30 police. The province, in the west of the country, contains vital opium smuggling routes into neighboring Iran. Opium from Afghanistan's primary opium province, Helmand, moves north into Farah before heading for the Iranian border.

Georgia Sees Mass Protests After Weekend Mass-Arrest Drug Raids. The capital, Tbilisi, was rocked by mass protests all weekend long after interior ministry police raided two popular nightclubs and arrested more than 60 people on drug charges. Protesters were demanding the freedom of those arrested and a liberalization of the country's drug policies, and were only persuaded to stop -- at least until next weekend -- after Interior Minister Giorgi Gakharia promised the government would start working on drug reforms today. The protests also saw the emergence of ultra-rightist thugs who came out to counter-demonstrate.

Chronicle AM: DOJ to Clamp Down on Pain Pills, Sanders Files Opioid Bill, More... (4/18/18)

Maine lawmakers pass another legal marijuana implementation bill, this time with veto-proof majorities; the Justice Department eyes a crackdown on pain pill production, Bernie Sanders takes aim at opioid makers and distributors, and more.

The Justice Department wants to crack down on pail pill production. And Congress is eyeing action, too. (Wikimedia)
Marijuana Policy

Maine Legislature Passes Legal Marijuana Implementation Bill, Governor Vows Veto. The state Senate on Tuesday approved the bill that would finally allow retail marijuana sales. The bill passed the House earlier and now goes to the desk of Gov. Paul LePage, who has threatened to veto it because it doesn't combine the state's adult use marijuana and medical marijuana regimes. LePage vetoed a similar bill last year. But this time around, the bill passed with enough support to overcome a veto. LePage has 10 days to sign, veto, or let the bill become law without his signature.

Medical Marijuana

Bipartisan Bill to Let VA Study Medical Marijuana Filed. A group of House Democrats and Republicans have filed HR 5520, the VA Medicinal Cannabis Research Act. The bill would clarify that the Veterans Administration has the authority to study medical marijuana and encourages the agency to do so. The bill would require the VA to report regularly to Congress about its progress on medical marijuana research. The bill is being championed by leaders in the House Veterans Affairs Committee and has 34 cosponsors.

Massachusetts High Court Urges Lawmakers to Clarify Law on Home Cultivation. In an opinion in a case of a medical marijuana patient arrested for growing 22 pot plants, the state's Supreme Judicial Court has urged lawmakers to revisit the law around home grows by patients. The law allows patients to grow enough marijuana to create a 60-day supply, defined in the state as 10 ounces. But the justices found the current law problematic and suggested a plant-based limit would be clearer. "Statutory and regulatory clarification would be most beneficial," wrote Justice Scott Kafker in the opinion in the case, Commonwealth vs. Richardson.

Hemp

Oklahoma Hemp Bill Heads to Governor's Desk. The Senate on Tuesday approved House Bill 2913, which would legalize industrial hemp production. The measure has already passed the House, so it now goes to the desk of Gov. Mary Fallin (R).

Heroin and Prescription Opioids

Justice Department Proposes New Regulations to Limit Prescription Opioid Production. Attorney General Jeff Sessions on Tuesday proposed new regulations for how the DEA sets opioid production quotas that could severely limit the amount of pain pills produced. "Under this proposed new rule, if DEA believes that a company's opioids are being diverted for misuse, then they will reduce the amount of opioids that company can make," Sessions said in prepared remarks. The proposed change must still go through the federal rule-making process before going into effect. It will be published in the Federal Register and opened to public comment in coming days.

Bernie Sanders Files Bill to Rein in Big Pharma on Opioids. Sen. Bernie Sanders (I-VT) on Tuesday filed Senate Bill 2961, which would ban drug companies from marketing opioids as non-addictive and fines them 25% of their profits if they violate the rule. The bill also seeks to stop pharmaceutical companies from distributing amounts of opioids "not medically reasonable," in a bid to stop distributors from flooding small towns with pills. "We know that pharmaceutical companies lied about the addictive impacts of opioids they manufactured," Sanders said in a statement. "They knew how dangerous these products were but refused to tell doctors and patients," he said. "Yet, while some of these companies have made billions each year in profits, not one of them has been held fully accountable for its role in an epidemic that is killing tens of thousands of Americans every year."

Harm Reduction

Maine Bill to End Age Restrictions on Naloxone Heads to Governor's Desk. Both houses of the legislature have approved Legislative Document 1892, which ends age restrictions on the opioid overdose reversal drug naloxone. Gov. Paul LePage (R) wants to limit naloxone access without a prescription to people 21 and over and has vetoed other naloxone access bills, but this bill has passed with a veto-proof majority. LePage has 10 days to act.

International

The Bangladeshi Department of Narcotics Control has proposed new drug legislation for the country which includes the use of the death penalty for people caught selling more than 200 grams of methamphetamine. Under current law, the maximum punishment is 15 years in prison. Bangladeshi law already allows the death penalty for some other drug offenses, including heroin trafficking, but its use is actually very rare in the country. The last execution for a drug offense was in 2009.

Culture Shock: American Activists Confront Compassionate Portuguese Drug Policy [FEATURE]

The American activists couldn't wrap their heads around it. Sitting in a dingy office in a nondescript building in central Lisbon, they were being provided a fine-grained explanation of what happens to people caught with small amounts of drugs in Portugal, which decriminalized the possession of personal use amounts of drugs 17 years ago.

partial view of Lisbon, looking toward the Tagus River (Wikimedia)
The activists, having lived the American experience, wanted desperately to know when and how the coercive power of the state kicked in, how the drug users were to be punished for their transgressions, even if they had only been hit with an administrative citation, which is what happens to people caught with small quantities of drugs there.

Nuno Capaz was trying to explain. He is Vice Chairman of the Lisbon Dissuasion Commission, the three-member tribunal set up to handle people caught with drugs. He had to struggle mightily to convince the Americans that it wasn't about punishment, but about personal and public health.

"The first question," he explained, "is whether this person is a recreational user or an addict."

If the person is deemed only a recreational user, he may face a fine or a call to community service. If he is deemed an addict, treatment is recommended -- but not required.

"But what if they don't comply?" one of the activists demanded. "Don't they go to jail then?"

No, they do not. Instead, Capaz patiently explained, they may face sanctions for non-compliance, but those sanctions may be little more than a demand that they regularly present themselves to a hospital or health center for monitoring.

In a later hallway conversation, I asked Capaz about drug users who simply refused to go along or to participate at all. What happens then? I wanted to know.

Capaz shrugged his shoulders. "Nothing," he said. "I tell them to try not to get caught again."

Welcome to Portugal. The country's low-key, non-headline-generating drug policy, based on compassion, public health, and public safety, is a stark contrast with the US, as the mind-boggled response of the activists suggests.

Organized by the Drug Policy Alliance and consisting of members of local and national groups that work with the organization, as well as a handful of journalists, the group spent three days in-country last month seeing what an enlightened drug policy looks like. They met with high government officials directly involved in creating and implementing drug decriminalization, toured drug treatment, harm reduction, and mobile methadone maintenance facilities, and heard from Portuguese drug users and harm reduction workers as well.

The Portuguese Model and Its Accomplishments

They had good reason to go to Portugal. After nearly two decades of drug decriminalization, there is ample evidence that the Portuguese model is working well. Treating drug users like citizens who could possibly use some help instead of like criminals to be locked up is paying off by all the standard metrics -- as well as by not replicating the thuggish and brutal American-style war on drugs, with all the deleterious and corrosive impacts that has on the communities particularly targeted for American drug law enforcement.

Here, according to independent academic researchers, as well as the UN Office on Drugs and Crime and the European Monitoring Center of Drugs and Drug Abuse, is what the Portuguese have accomplished:

Drug use has not dramatically increased. Rates of past year and past month drug use have not changed significantly or have actually declined since 2001. And Portugal's drug use rates remain among the lowest in Europe, and well below those in the United States.

Both teen drug use and "problematic" drug use (people who are dependent or who inject drugs) have declined.

Drug arrests and incarceration are way down. Drug arrests have dropped by 60% (selling drugs remains illegal) and the percentage of prisoners doing time for drug offenses has dropped from 44% to 24%. Meanwhile, the number of people referred to the Dissuasion Commission has remained steady, indicating that no "net-widening" has taken place. And the vast majority of cases that go before the commission are found to be non-problematic drug users and are dismissed without sanction.

More people are receiving drug treatment -- and on demand, not by court order. The number of people receiving drug treatment increased by 60% by 2011, with most of them receiving opiate-substitution therapy (methadone). Treatment is voluntary and largely paid for by the national health system.

Drug overdose deaths are greatly reduced. Some 80 people died of drug overdoses in 2001; that number shrunk to just 16 by 2012. That's an 80% reduction in drug overdose deaths.

Drug injection-related HIV/AIDS infections are greatly reduced. Between 2000 and 2013, the number of new HIV cases shrank from nearly 1,600 to only 78. The number of new AIDS cases declined from 626 to 74.

"We came to the conclusion that the criminal system was not the best suited to deal with this situation," explained Capaz. "The best option should be referring them to treatment, but we do not force or coerce anyone. If they are willing to go, it's because they actually want to, so the success rate is really high. We can surely say that decriminalization does not increase drug usage, and that it does not mean legalizing drugs. It's still illegal to use drugs in Portugal, it's just not considered a crime. It's possible to deal with these users outside the criminal system."

Dr. Joao Goulao, who largely authored the decriminalization law and who is still General Director for Intervention on Addictive Behaviors -- the Portuguese "drug czar" -- pointed to unquantifiable positives resulting from the move: "The biggest effect," he said, "has been to allow the stigma of drug addiction to fall, to let people speak clearly and to pursue professional help without fear."

They Take the Kids! (with them to treatment)

The American activists know all about fear and stigma. And the cultural disconnect -- between a country that treats drug users with compassion and one that seeks to punish them -- was on display again when a smaller group of the activists met with Dr. Miguel Vasconcelos, the head psychologist at the Centro Taipa, a former mental hospital that now serves as the country's largest drug treatment center.

As Dr.Vasconcelos explained the history and practice of drug treatment in Portugal, one of his listeners asked what happened to drug users who were pregnant or had children.

"They take the kids," Vasconcelos said, smiling. But his smile turned to puzzlement as he saw his listeners react with resignation and dismay.

For the Americans, "they take the kids" meant child protective services swooping in to seize custody of the children of drug-using parents while the parents go to jail.

But that's not what Vasconcelos meant. After some back and forth, came clarity: "No, I mean they take the kids with them to treatment."

Once again, the Americans, caught firmly in the mind set of their own punishing society, expected only the worst of the state. But once again, light bulbs came on as they realized it doesn't have to be like that.

Now that cadre of activists is back home, and they are going to begin to try to apply the lessons they learned in their own states and communities. And although they had some abstract understanding of Portuguese drug decriminalization before they came, their experiences with the concrete reality of it should only serve to strengthen their desire to make our own country a little less like a punitive authoritarian state and bit more like Portugal.

Chronicle AM: NJ Opioid Fight Plan, WI Forfeiture Bill Signed, NJ Pot Poll, More... (4/4/18)

Alaska regulators return to the issue of social use, a Tennessee medical marijuana bill dies, New Jersey's governor outlines a plan to fight opioid abuse, and more.

New Jersey Gov. Phil Murphy (D) outlines a plan to take on the opioid crisis. (Wikimedia)
Marijuana Policy

Alaska Regulators Take Up Social Clubs Again. The state's Marijuana Control Board will be meeting the rest of this week to discuss whether to allow on-site marijuana use at authorized retail stores. The board adopted rules in 2015 to allow for such use, but never finalized them. Under the current proposal, use could only take place in a designated area of the store, and people could only use marijuana purchased at the store.

New Jersey Poll Shows Residents Evenly Split on Legalization. A new poll from the Stockton Polling Institute of the William J. Hughes Center for Public Policy has Garden Staters split nearly down the middle on pot legalization. The poll had 49% in favor, with 44% opposed. The poll also found that one out of four respondents would try the herb if it were legal, or continue to use it if they currently do.

Medical Marijuana

Tennessee Medical Marijuana Bill Dies. The sponsor of a medical marijuana bill has pulled it, saying he didn't have the support to move it in the Senate. Senate Bill 1710 sponsor Sen. Steve Dickerson (R-Nashville) was blunt: "Unfortunately, I do not have the votes." A companion measure is still alive in the House, but there will be no medical marijuana in the Volunteer State this year.

Heroin and Prescription Opioids

New Jersey Governor Outlines Plan to Fight Opioids. Gov. Phil Murphy (D) announced a plan to spend $100 million on a range of anti-addiction programs, including new funding for community-based treatment providers, as well as more housing and job training for residents with -- or without -- drug dependency problems. In terms of dollars, the proposal includes $56 million for front-line prevention, treatment and recovery programs; $31 million for job training and to address social risk factors like homelessness; and $13 million to improve data collection and other state infrastructure.

Asset Forfeiture

Wisconsin Governor Signs Asset Forfeiture Reform Bill into Law. Gov. Scott Walker on Wednesday signed into law Senate Bill 61, which does not end civil asset forfeiture, but puts limits on how long police can hold property before someone is charged and reduce the amount of money police can keep when they sell seized property.

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