White House holds summit on reducing overdose toll, Nevada psychedelic study bill goes to governor, and more.

Marijuana Policy

New Coalition of Major Marijuana Groups Launches Push for Scheduling Reform. A new coalition of marijuana companies and advocacy groups calling itself the Coalition for Cannabis Scheduling Reform announced Tuesday that it is launching a campaign to reschedule marijuana even as it pushes for full-on legalization. The group will work with advocates, stakeholders, lawmakers and administration officials to promote education about the need to remove marijuana from Schedule I of the Controlled Substances Act (CSA).

That is a less bold position than that held by advocacy groups calling for outright legalization, but the coalition says that moving marijuana to Schedules III, IV or V of the CSA would still represent "historic progress." that shouldn’t be discounted.

The coalition includes Acreage Holdings, American Trade Association for Cannabis & Hemp (ATACH), Columbia Care, Cresco Labs, Curaleaf, Dutchie, Green Thumb Industries, Marijuana Policy Project, National Cannabis Roundtable, Scotts Miracle-Gro, US Cannabis Council, Weldon Project, and Vicente LLP.

Advocates of full-on legalization warn that placing marijuana in another, less restrictive schedule (as opposed to completely descheduling it) could wreak havoc in existing legal marijuana markets and lead the way to further big business consolidation within the industry.

Psychedelics

Nevada Assembly Approves Psychedelic Task Force Bill. A bill to create a working group to study psychedelics and develop plans to allow for regulated access for therapeutic purposes that has already passed the Senate, Senate Bill 242, passed  the Assembly on Sunday. When introduced, the bill had language legalizing psilocybin and promoting research into the psychedelic, but it was amended in the Senate to now have only the working group, which would examine the use of psychedelics "in medicinal, therapeutic, and improved wellness." The bill now goes to the desk of Gov. Joe Lombardo (R).

Drug Policy

At White House Summit, Biden Administration Vows Renewed Effort to Fight Drug Overdoses. At a White House summit held jointly with public health officials from Canada and Mexico, the Biden administration vowed to improve its fight to combat drug overdoses, which took 109,000 lives last year. Administration officials pledged a multifaceted approach to tackling illicit drugs, especially fentanyl.

"Today's summit is needed because the global and regional drug environment has changed dramatically from just even a few years ago," Rahul Gupta, director of the White House Office of National Drug Control Policy (ONDCP, the drug czar's office), told the summit. "Synthetic drugs have truly become a global threat," he added. "Today, we're here to ... look at how our collective response can be improved, and the role data collection has on saving lives," Gupta said.

International

Taliban Opium Ban Is Taking Hold. An April 2022 prohibition on opium-growing from Taliban leader Hibatullah Akhundzada did not result in significant reductions in cultivation last year, but this year is different. The BBC traveled the country, consulted with farmers, government ministers, and experts, and used satellite analysis to report the following:

"The Taliban leaders appear to have been more successful cracking down on cultivation than anyone ever has. We found a huge fall in poppy growth in major opium-growing provinces, with one expert saying annual cultivation could be 80% down on last year. Less-profitable wheat crops have supplanted poppies in fields - and many farmers saying they are suffering financially."

"It is likely that cultivation will be less than 20% of what it was in 2022," said Afghanistan drug trade expert David Mansfield. "The scale of the reduction will be unprecedented. The high resolution imagery of Helmand province shows that poppy cultivation is down to less than 1,000 hectares when it was 129,000 hectares the previous year," said Mansfield, noting that would be a 99 percent reduction in the crop in that formerly key opium-producing province.

Farmers aren't happy, though: "You're destroying my field, God destroy your home," one woman shouted angrily at a Taliban eradication unit as they razed her poppy field.

How to deal with substance abuse during pregnancy is a fraught issue, generating harsh sanctions against pregnant women who use drugs or who lose their fetuses before birth and are drug users. According to data compiled by Pregnancy Justice, the advocacy group formerly known as National Advocates for Pregnant Women, prosecutors filed more than 1,300 criminal cases against pregnant women between 2006 and 2020, a rate of more than a hundred a year. They are almost always poor women of color.

Hardnosed prosecutors and child protection agencies enabled by state and federal laws use a number of techniques and statutes to go after pregnant women who use drugs. As compiled by the Guttmacher Institute, a research and policy group committed to advancing sexual and reproductive health and rights, they include:

• Making drug use during pregnancy a crime. Such laws have been upheld by state Supreme Courts in Alabama and South Carolina.
• Several states have expanded their civil child-welfare requirements to include prenatal substance use, so that prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect.
• Some states, under the rubric of protecting the fetus, authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant people who use drugs; these policies sometimes also apply to alcohol use or other behaviors.
• A number of states require health care professionals to report or test for prenatal drug exposure, which can be used as evidence in child-welfare proceedings.
• To receive federal child abuse prevention funds, states must require health care providers to notify child protective services when the provider cares for an infant affected by illegal substance use.

But now, a growing number of experts, including maternal/fetal specialists, federal health officials and people who treat addiction, are saying that such responses are counterproductive. Women who feel subject to prosecution may avoid health care entirely or may shy away from interventions such as a medication-assisted treatment (MAT) with opioids such as methadone or buprenorphine, increasing their likelihood of fatal overdoses. Overdoses are a eading cause of preventable death among pregnant women.

A study published this week in the Maternal and Child Health Journal of 26 pregnant Massachusetts women found that the decision whether or not to use MAT "was entirely wrapped up in what happened with respect to mandated reporting to Child Protective Services at the time of delivery," according to Dr. Davida Schiff, the study author and an addiction medicine specialist at Massachusetts General Hospital in Boston. The women underwent "intense anxiety and stress" about the threat they would be reported to child protective services.

"This has led to many women either deciding to not start life-saving medication during pregnancy or to wean off of that life-saving medication during pregnancy and really risk poor outcomes for themselves and their babies," Schiff said.

That someone is using drugs while pregnant "does not diagnose anyone's ability to parent," said Dr. Hendrée Jones, executive director of the University of North Carolina's Horizons Program, a drug treatment program. "I have a woman getting ready to deliver, and she is terrified that somehow they're going to find drugs in her system and Child Protective Services is going to be called and her baby's going to be snatched away," Jones said.

"Across the entire country, we're seeing a general trend toward more punitive policies, and those are kind of the policies that consider substance use during pregnancy to be child abuse or neglect," said Laura Faherty, a policy researcher at the RAND Corporation.

The head of the National Institute on Drug Abuse (NIDA), Dr. Nora Volkow, also thinks things have gone too far.

"We should remove criminalization of women who are pregnant and taking drugs," she said. "That needs to stop. We know that mortality from overdoses is greater in women that are pregnant than counterparts of the same age that are not pregnant. This is extraordinarily important because it's telling us that there's something that is making these pregnant women more vulnerable."

The need for change from punitive prohibitionist policies is urgent. A 2019 study found that the rate of opioid-related diagnoses among pregnant women more than doubled between 2010 and 2017, with ongoing research suggesting another big increase after 2017. And a 2022 study found that the number of pregnant women and new mothers dying of drug overdoses reached a record high in 2020, nearly doubling to11.85 per 100,000 from 6.56 per 100,000 in 2017.

Punitive prohibitionist policies are not working. It is time for another approach.

Pot isn't the only thing you can buy in some Los Angeles-area pot shops, overdose deaths appear to have plateaued last year, and more.

Psychedelics

Los Angeles Pot Shops Are Openly Selling Magic Mushrooms. Some Los Angeles-area marijuana retailers are openly selling psilocybin mushrooms even though they remain prohibited under state and federal law. (A measure that would decriminalize them, Senate Bill 58, is currently before the legislature.) The sellers are responding to high demand for the popular psychedelics.

In one Los Angeles County shop visited by the Los Angeles Times, customers must hand over their drivers' licenses to a receptionist and put away their cell phones before being buzzed into a secured room to check out the psychoactive wares. A large glass jar is "filled to the brim with stubby mushrooms, which have brown caps and psilocybin's characteristic bluish tint," while other jars filled with "mushroom-infused" liquids are also on offer. As are chocolate bars with magic mushrooms and magic mushroom gummies.

The flouting of the drug laws is not without risk. The LA County Sheriff's Department says it has served search warrants at about 50 pot shops selling magic mushrooms in the last six months alone In April 2022, the department reported making 227 arrests at "illegal marijuana dispensaries" and seizing thousands of pounds of marijuana, as well as "29 pounds of mushrooms."

"They won't typically openly sell them," said Lt. Jay Moss of the Sheriff's Department's narcotics bureau. "They'll usually have a small amount -- two to 10 pounds, I'd say -- of mushrooms, and you have to ask for it because they don't have it on display. They might be somewhere out of view, like in the back. We investigate and serve search warrants at these illegal dispensaries in attempts to shut them down," he said. "The analogy is kind of like whack-a-mole: you shut them down and they reopen in another location."

Harm Reduction

White House Seeks to Prod Naloxone Makers. The Biden administration is seeking to prod manufacturers of the opioid overdose reversal drug naloxone to increase access to the drug and lower its cost. Dr. Rahul Gupta, head of the Office of National Drug Control Policy (ONDCP -- the drug czar's office) "plans to have conversations with manufacturers to share his key principle moving forward: the easier it is for people to access naloxone, the more lives we can save," an ONDCP spokesperson said. The planned meeting is part of Biden administration efforts "to ensure naloxone is both accessible and affordable to everyone who may need it," the spokesperson added.

American health regulators approved an over-the-counter version of Narcan earlier this year. The Food and Drug Administration approved the first generic version of the drug in 2021.

Public Health

Fatal Drug Overdoses Hit Record High Last Year but Appear to Be Plateauing. Drug overdose deaths increased slightly last year after jumping mightily during the coronavirus pandemic, according to new data from the Centers for Disease Control and Prevention (CDC) suggesting that the increase in overdoses is leveling off. The CDC estimates the overdose death toll last year at 109,680, up two percent over the 107,622 deaths in 2021. But the increase is far lower than the 30 percent increase in 2020 and the 15 percent increase in 2021.

"The fact that it does seem to be flattening out, at least at a national level, is encouraging," said Katherine Keyes, a Columbia University epidemiology professor whose research focuses on drug use. "But these numbers are still extraordinarily high. We shouldn't suggest the crisis is in any way over."

A New York bill increasing civil penalties for illicit pot shops is signed into law, Oregon regulators approve the nation's first licensee for therapeutic psilocybin services, and more.

Marijuana Policy

New York Governor Signs Bill to Increase Civil Penalties for Illicit Pot Shops. Gov. Kathy Hochul (D) last Wednesday signed into law Assembly Bill 3281, which increases civil and tax penalties for unlicensed marijuana retailers, including fines of up to $20,000 a day. The move is aimed at reigning in an illicit marijuana market in the state that exploded in the months-long gap between marijuana being legalized and licensed retail sales that only recently began. At this point, there are only a handful of licensed marijuana outlets in the state compared to more than a thousand unlicensed outlets in New York City alone.

"As New York State continues to roll out a nation-leading model to establish its cannabis industry, these critical enforcement measures will protect New Yorkers from illicit, unregulated" Hochul said. "Unlicensed dispensaries violate our laws put public health at risk and undermine the legal cannabis market. With these enforcement tools, we're paving the way for safer products, reinvestment in communities that endured years of disproportionate enforcement, and greater opportunities for New Yorkers."

Medical Marijuana

Florida Lawmakers Approve Bill to Allow Telehealth Renewals for Medical Marijuana, Help Black Farmers Get Grow Licenses. With a final vote in the Senate last Wednesday, the legislature approved House Bill 387. The measure allows doctors to renew approvals for medical marijuana patients via telehealth. New patients will still require an in-patient exam. The measure could also help Black farmers get medical marijuana grow licenses after years of delays. Only one license has been issued to a Black farmer, and this bill could lead to the Department of Health issuing additional licenses to Black farmers.

Psychedelics

Oregon Regulators Approve Nation's First Psilocybin Service Center. The Oregon Health Authority has awarded a license to EPIC Healing in Eugene to provide therapeutic psilocybin services, where people can use the psychedelic in a supervised and facilitated environment. This is a national first and comes after state voters approved therapeutic psilocybin services in 2020. Now, the state has issued at least one license in all four licensing categories -- facilitators, testing labs, psilocybin manufacturing, and therapeutic services.

"This is such a historic moment as psilocybin services will soon become available in Oregon, and we appreciate the strong commitment to client safety and access as service center doors prepare to open," Oregon Psilocybin Services (OPS) Section Manager Angie Allbee said in a press release.

Harm Reduction

Federal Government Provides Grant to Study Safe Injection Sites. New York University and Brown University announced Monday that they had received a four-year, $5 million grant to study whether safe injection sites can prevent drug overdoses, estimate their costs, and weigh potential savings for health care and criminal justice systems. This marks the first time the federal government has paid for such a study. The study will focus on two safe injection sites already operating in New York City and one set to open next year in Rhode Island and hopes to enroll a thousand adult drug users. The grant comes from the National Institute on Drug Abuse (NIDA). Studies from the 14 countries that currently allow safe injection sites have found they radically reduce drug overdose deaths.

"There is a lot of discussion about overdose prevention centers, but ultimately, we need data to see if they are working or not, and what impact they may have on the community," said NIDA director Dr. Nora Volkow.

Florida Lawmakers Pass Bill to Decriminalize Fentanyl Test Strips. The House last Wednesday gave final, unanimous approval to a bill that decriminalizes fentanyl test strips by removing them from the state's list of drug paraphernalia, Senate Bill 164. More than 6,000 Floridians died in drug overdoses implicating fentanyl in 2020. A similar bill failed last year after some critics claimed that legalizing the test strips would incentive drug use.

International

Honduran Police Seize a Million Coca Plants, Rustic Labs. The Honduran National Police announced that a raid last Friday in a protected forest reserve in the eastern part of the country resulted in the seizure of more than one million coca plants, two million seedlings, and "four rustic structures" used to extract alkaloids from the coca leaf and store chemicals used in the process. While coca has traditionally been grown almost exclusively in its native Andean region of South America, Honduran authorities have been encountering small coca plantations on their soil since 2017, but never one approaching this size.