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What's Killing Us: The Ten Drugs Most Implicated in Overdose Deaths [FEATURE]

While there are signs that the country's drug overdose crisis may have plateaued, the number of people dying from drug overdoses continues to be unconscionably high. Shockingly, the number of overdose deaths has increased tenfold since 1980 when there were only 6,000 nationwide and nearly doubled just in the past decade to more than 72,000 last year.

The number of drug overdose deaths remains unconscionably high.
Now, in a new report, the Centers for Disease Control and Prevention (CDC) sheds some new light on precisely which drugs are most implicated in these deaths. While the report examines overdose deaths from 2011 to 2016, we're going to zero in on the 2016 data to get as close as possible to the present.

Three drug classes are involved: prescription and non-prescription opioids, benzodiazepines, and stimulants. Often, fatal overdoses involve more than one drug, whether it is drugs in the same class (heroin and fentanyl) or combinations of drug classes (heroin and benzos or fentanyl and cocaine.

Before we get into the number-crunching, it's worth taking a moment to consider that each single overdose death is a tragedy. A human life has been lost prematurely, the potential snuffed out, and friends and family members suffer greatly. It doesn't have to be that way. While we're going to look at deadly drugs, it behooves us to remember that many of these deaths are a function not just of the drugs themselves, but of drug prohibition.

People overdose on fentanyl, for example, because in a black market there is no packaging, no quality control, no dosage information to inform them of just how powerful is that powder they're snorting or injecting. Added to heroin or crafted into counterfeit prescription opioids by unscrupulous black market operators, fentanyl kills people who didn't even know they were taking it. Even more insidiously, fentanyl is turning up in black market cocaine and methamphetamine, whose users aren't even looking for an opioid high and haven't developed any tolerance to them (although some may be speedballing, that is, taking both an upper and a downer at the same time.

That said, here are the drugs making the greatest contributions to the 63,352 overdose deaths in 2016. (The numbers add up to more than that figure because in some overdoses, more than one drug is mentioned.)

1. Fentanyl -- 18,335

In 2016, fentanyl vaulted into first place in the deadly drug sweepstakes. As recently as 2011, the synthetic opioid was in 10th place, with some 1,660 overdose deaths attributed to it, but the death toll has increased more than tenfold in just five years. More than two-thirds of fentanyl overdose deaths also involved other drugs, and fentanyl is involved in more than a quarter (28.5 percent) of all overdose deaths, including 40 percent of cocaine overdose deaths and nearly a third (32 percent) of heroin deaths.

2. Heroin -- 15,961

At the tail end of the prescription opioid phase of the current overdose crisis in 2011, more people died from oxycodone than heroin, but between 2012 and 2015, heroin resumed its role as the leading opioid linked to fatal overdoses, only to be overtaken by fentanyl in 2016. The vast majority -- 70 percent -- of people who died from heroin were also using other drugs. More than a third were also using fentanyl, while nearly a quarter (23.8 percent) were also using cocaine. As prescription opioids became more difficult to obtain, the number of people dying from heroin skyrocketed, nearly tripling in the five years ending in 2016.

3. Cocaine -- 11,316

Cocaine deaths rose dramatically beginning in 2015 and by 2016 the annual death toll was double what it had been five years earlier. With bumper crops in Colombia in recent years, cocaine is cheap and plentiful. It is also increasingly being cut with fentanyl, which is implicated in 40 percent of cocaine deaths, and mixed with heroin, which is implicated in a third of them. Cocaine is named in 17.8 percent of all overdose deaths.

4. Methamphetamine -- 6,762

Meth-related overdose deaths tripled between 2011 and 2016, a dramatic increase in what has become America's forgotten drug problem. In 2016, slightly more than one out of ten drug overdose deaths involved meth. Of the top ten overdose drugs, meth is by far the one most likely to have been the sole drug implicated in the death, but even so, fentanyl was implicated in one out five meth deaths and heroin in one out of ten.

5. Alprazolam -- 6,209You know it as Xanax. This short-acting benzodiazepine is a favorite of stimulant users seeking to take the edge off, but also often forms part of a sedative cocktail with opioids or other benzos. About three-quarters of Xanax overdose deaths involve other drugs, with fentanyl, heroin, and oxycodone each involved in about one-quarter of Xanax deaths. Xanax deaths increased by about 50 percent over the five year period.

6. Oxycodone -- 6,199

It's most infamous formulation is OxyContin, but it is also sold as Roxicodone, Xtampza ER, and Oxaydo. It may have been the primary killer opioid a decade ago, but has chugged along at around 5,000 deaths a year before going over 6,000 in 2016. Four out of five people who overdose on oxycodone were also using another drug, most often Xanax (25.3 percent), followed by fentanyl (18.6 percent).

7. Morphine -- 5,014

The granddaddy of opioids. Morphine deaths increased slowly beginning in 2011, but have still increased by about 40 percent since then. More than eight out of 10 morphine deaths involve other drugs as well, particularly fentanyl, which is involved in one out three morphine deaths. Cocaine (16.9 percent) and heroin (13.7 percent) are also frequent contributors to morphine ODs.

8. Methadone -- 3,493

Prescribed as an opioid maintenance drug, methadone is one of the few drugs on this list to have seen the number of deaths decline between 2011 and 2016. They've dropped from more than 4,500 a year down to less than 3,500, a drop of roughly a quarter. Nearly three-fourths of all methadone deaths implicate other drugs, with Xanax being most common (21.5 percent), followed by fentanyl (15.1) and heroin (13.8).

9. Hydrocodone -- 3,199

This semi-synthetic opioid is sold under a variety of brand names, including Vicodin and Norco, and has proven remarkably stable in its overdose numbers. Between 2011 and 2016, it never killed fewer than 3,000 or more than 4,000, almost always (85 percent of the time) in concert with other drugs. Xanax was implicated in one-quarter of all hydrocodone overdoses, followed by oxycodone (17.2 percent) and fentanyl (14.9 percent).

10. Diazepam -- 2,022

The most well-known diazepam is Valium. Like Xanax, this anti-anxiety drug can be used to take the edge off a stimulant binge, but it's not coke heads and speed freaks who are dying from it. In more than nine out of 10 fatal Valium overdoses, other drugs are involved, most commonly the opioids oxycodone and fentanyl, each implicated in about a quarter of the deaths, and heroin, implicated in a fifth.

Using these drugs is dangerous. Using them under a prohibition regime is even more so. Users don't always know what they're getting, and that lack of knowledge can be fatal. If you're going to be messing with these substances, be extremely cautious. Try a test dose first. And don't do it alone. Stay safe out there.

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

Chronicle AM: Legal MJ Shortages, Mexico to Move Toward Legal MJ Market, More... (11/3/18)

The Granite State has a new guide to marijuana legalization, ONDCP releases coca cultivation and cocaine production figures for Peru and Bolivia, Canada suffers legal pot shortages, and more.

North America is becoming a very weed-friendly continent. (Creative Commons)
Marijuana Policy

New Hampshire Commission Issues Marijuana Legalization Report. The Commission to Study the Legalization, Regulation, and Taxation of Marijuana has released its report, complete with 54 separate recommendations on how legalization should be implemented. Among them are creating a state-level Cannabis Commission to regulate it, similar to the way the state regulates alcohol. The group estimated that legalization could bring in revenue of $36.6 million a year once the market stabilizes, and possibly reaching $47 million. The report is designed to help guide any legislative moves toward legalization.

Medical Marijuana

Iowa Regulators Reject Bid to Raise THC Cap on New Medications. The state's Medical Cannabinoid Board voted unanimously last Friday to rebuff an effort to raise the 3% THC cap on new medications. Proponents argued that more THC is more effective in treating some conditions, while critics worried that lifting the limit could encourage abuse. "I'd like to get another year or two under our belts and see how people respond with the current THC cap," said board member Lonny Miller, a family physician from Creston.

Foreign Policy

ONDCP Releases Data on Coca Cultivation and Cocaine Production in Peru and Bolivia. The White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) released the US government's annual estimates of coca cultivation and cocaine production for Bolivia and Peru last Friday. Although Peru produces more coca and cocaine than Bolivia, and although Peru's coca cultivation and potential cocaine production are trending up while Bolivia's are trending down, ONDCP was more critical of Bolivia. "The ongoing coca --cultivation in both Peru and Bolivia pose a threat for us as a nation, and aggravates our domestic drug addiction crisis," said ONDCP Deputy Director Jim Carroll. "It is important that our governments work together to take action against cultivation and production, and to save lives of those affected by drug trafficking. Peru continues to be a great partner and we have a shared responsibility to address this problem. In Bolivia, we would like to see real efforts against cultivation and production."

International

Canada Struggles to Meet Huge Demand for Legal Marijuana. Just two weeks after legal retail marijuana sales began, Canadian pot retailers -- both physical and online -- are having problems dealing with unexpectedly high demand. In much of the country, the legal supply has almost entirely dried up. "There is not enough legal marijuana to supply all of recreational demand in Canada," said Rosalie Wyonch, a policy analyst at the CD Howe Institute. "The shortages are happening faster than I would have expected, but our research suggested quite strongly that there would be shortages in the first year of legalization."

Colombia Announces New Strategy to Disrupt Drug Trade. Last Thursday, Colombian Attorney General Nestor Humberto Martinez announced a new "disruption policy" of going after the cocaine trade by cutting access to alkaloids and power sources in rural areas. He called for "petrochemical innovation" so that fuels stop yielding the factors needed to create cocaine hydrochloride, as well as restricting the sale of government-subsidized gasoline in cocaine and marijuana producing regions. But one analysis says the proposals "might sound innovative on paper but are unlikely to have a major impact on the drug trade and may end up hurting long-suffering residents."

Mexico's Ruling Party Plans Legislation To Legalize Marijuana Sales. Less than a week after the country's Supreme Court ruled that laws barring the personal use, possession, and cultivation of marijuana are unconstitutional, key figures in the ruling MORENA Party are already moving to craft legislation to create a legal marijuana market. First, they say, they will move to repeal the now null and void criminal laws against marijuana, and then, "We are going to take a step forward in the regulation that may already involve the production, marketing and distribution of marijuana," said Olga Sánchez Cordero, a senator who is expected to become interior secretary in the incoming government of President-elect Andrés Manuel López Obrador. "I say it from the heart: we celebrate it, the Court is setting a marvelous precedent for us to walk in that direction," Sánchez added.

Chronicle AM: MA Pot Shops to Open This Month, Coca Comes to Central America, More... (11/2/18)

A record number of gubernatorial candidates are endorsing marijuana legalization, Bay State pot shops will be open this month, cartels are experimenting with coca production in Central America, and more.

A cocaine lab discovered by Honduran authorities last year. (Honduran Prosecutor's Office)
Marijuana Policy

Record Number of Governor Candidates Call for Marijuana Legalization. A new analysis from Marijuana Moment finds that at least 21 major party gubernatorial candidates support legalizing marijuana, far more than any previous election cycle. But there are differences: Some candidates make legalization a centerpiece of their campaigns, while others embrace it only reluctantly or if pressed on the issue. For a list of those pro-legalization would-be governors, click on the link.

California Cities, Counties to Vote on Marijuana Taxes. More than two dozen cities and counties will have marijuana taxation proposals on their local ballots next week. Among the most controversial proposals is a San Francisco move to impose a 5% tax on gross sales receipts. That would come on top of the 15% state retail tax and the city's 8.75% sales tax, meaning pot sales would be taxed at a whopping 28.75%. The fear is the high levels of taxation will drive potential purchasers to the black market.

Massachusetts Legal Marijuana Sales to Begin This Month, State Says. The chairman of the state's Cannabis Control Commission said Thursday that legal marijuana sales would get underway "within the next week or two" after final inspections of pot shops are performed. "Everything is happening as quickly as we can," Chairman Steven Hoffman said. "There are no lags. We're working closely with the licensees so they understand the process. We're getting very close." It's been two years next week since Bay State voters approved marijuana legalization.

Medical Marijuana

First FDA-Approved Marijuana-Based Drug Now Available by Prescription. As of Thursday, the marijuana-based drug Epidiolex is now available by prescription in all 50 states. The FDA approved the drug in June, but manufacturer GW Pharmaceuticals had to wait for the DEA to reclassify its compounds out of Schedule I before it could begin selling it. That has now happened. Epidiolex is used for treating a rare form of epilepsy and a genetic btylerain dysfunction called Dravet syndrome, both of which can cause seizures.

International

Cocaine Production Beginning to Pop Up in Central America. Cocaine production is starting to pop up in Central America, a development that could bring the supply of the drug closer to the US. Officials in Guatemala and Honduras have found at least four separate coca plantings this year and last year. Although the total acreage involved -- about 125 acres -- is a tiny fraction of total coca planting, local officials said the fields constituted pilot projects by drug cartels exploring whether they can reduce transportation costs and risk by moving their product from major cocaine-producing countries to Central America.

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

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

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

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

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

Medical Marijuana

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

Cocaine

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

Heroin and Prescription Opioids

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

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

Harm Reduction

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

Chronicle AM: Colombia Moves Backwards on Drug Policy, NYPD Pot Arrests Now Halted, More... (9/4/18)

Colombia's new president moves resolutely backward on drug policy, New York City's era of mass marijuana possession arrests is over, the California legislature has been busy, and more.

The era of New York City as the world's marijuana arrest capital has come to an end. (Creative Commons)
Marijuana Policy

California Lawmakers Pass Bill that Will Support Local Cannabis Equity Programs to Increase Representation in the Industry by Persons from Communities Most Harmed by Cannabis Prohibition. The legislature has approved Senate Bill 1294, which helps create equity in the cannabis industry through the distribution of grants to localities offering assistance to persons most harmed by cannabis prohibition and generational poverty. SB 1294 will offer grants to localities with existing equity programs -- such as Los Angeles, Oakland, Sacramento, and San Francisco -- to support them as they offer equity-qualifying applicants and licensees business loans and grants, regulatory compliance and technical assistance, and licensing fee waivers. SB 1294 reflects a nationwide movement to ensure that this growing industry is representative and accessible to all persons, no matter their financial or criminal history background. Advocates, entrepreneurs, and local governments now call on Gov. Jerry Brown (D) to sign this important measure.

Delaware Governor Signs Marijuana Expungement Bill Into Law. Gov. John Carney (D) last Friday signed into law Senate Bill 197, which "provides mandatory expungement eligibility to individuals who were convicted of the possession [of one ounce or less], use or consumption of marijuana prior to Delaware's decriminalization of these offenses." The provision only applies to people who have no other criminal convictions on their records.

New York City Change in Marijuana Arrest Policy Now in Effect. As of Saturday, the NYPD is no longer arresting people for small-time marijuana use or possession in most cases. The city arrested more than 10,000 people on such charges last year. Officials said the change came because the arrests had nothing to do with public safety and were racially disproportionate. "Our new policy, we're going to see a humongous drop in people in communities of color being arrested for marijuana," NYPD Chief Rodney Harrison said. "And that was one of the whole goals of this whole new policy."

New Psychoactive Substances

DEA Makes Synthetic Cathinone Schedule I Substance. The DEA last Friday announced it was placing the synthetic cathinone N-Ethylpentylone into Schedule I of the Controlled Substances Act. This is a temporary scheduling action good for up to 24 months, during which time research will be conducted to see if the drug should be permanently scheduled. DEA said the drug was linked to 151 deaths in the US since 2015.

Sentencing Policy

California Lawmakers Pass Bill Giving Judges the Power to Set Aside Ineffective and Punitive Five-year Sentence Enhancement. The legislature last Friday gave final approval to Senate Bill 1393, which would restore judicial discretion to the application of a five-year sentence enhancement for each prior serious felony on a person's criminal record. Current law requires judges to add an additional five-years to cases, even when the judge believes that the punishment is unjust and unwarranted. If signed into law, judges would have maximum flexibility during the penalty phase of a trail to impose, or not impose, the additional five-years. A coalition of people who are directly impacted, their families, service providers, and advocates now call on Gov. Jerry Brown (D) to sign this important measure.

International

Colombian President Moves to Recriminalize Drug Possession. President Ivan Duque announced on Sunday measures to give police the power to seize personal use quantities of drugs that had previously been legalized. "This week will sign the decree through which, in development of the police code 02 of the 2009 legislative act, we will give the authorities tools to confiscate any dose of drugs or hallucinogens in the streets of Colombia, and thus face the root of micro-trafficking problems," said Duque. The measures would appear to contradict rulings by the country's Constitutional Court, which in 2012 approved the decriminalization of small amounts of cocaine and marijuana for personal use.

Chronicle AM: Colombia's New President Vows Drug Crackdown, ND Pot Init Lives, More... (8/8/18)

The Northern Mariana Islands could be the first US territory to legalize weed, a North Dakota legalization initiative looks like it will probably make the ballot, Colombia's new president vows to resort to old prohibitionist drug war policies, and more.

Newly installed Colombian President Ivan Duque vows a drug crackdown. (Flickr)
Marijuana Policy

Marijuana Legalization Bill Passes Northern Mariana Islands House. The Northern Marianas Islands House of Representatives on Wednesday approved a marijuana legalization bill, House Bill 20-178, on an 18-1-1 vote. The bill legalizes the use of marijuana for medicinal purposes, but also for adult use. People can possess up to an ounce and grow a limited number of plants, and the bill creates a regime for legal, regulated, and taxed production and sales. It now goes before the territory's Senate. If it passes, the Northern Marianas would be the first US territory to legalize marijuana.

North Dakota Legalization Initiative Likely to Make Ballot, State Officials Say. State election officials have told Marijuana Moment that the organizers of a marijuana legalization initiative have very likely come up with enough valid voter signatures to qualify for the November ballot. The group, LegalizeND, submitted about 18,700 raw signatures; it needs 13,452 valid voter signatures to qualify. The elections office is currently finishing the signature verification process and will announce on August 13 whether the measure qualified.

Congressional Bar on DC Regulated Sales Leading to Distribution Arrest Surge, Report Finds. More than 900 people were arrested for marijuana offenses in the nation's capital last year, a jump of 37% over 2016 figures, according to new data from the DC Metro Police. Pot arrests bottomed out at 323 in 2015, the first full year of legalization. Prior to legalization, the vast majority of arrests were for possession, but since then, distribution and possession with intent to distribute account for the majority of pot arrests. Analysts pointed to the congressional bar against the District allowing legal, regulated sales as being behind both the overall jump in arrests and the increasing percentage of sales and possession with intent arrests.

International

Colombia's New President Takes Office, Vows Drug Crackdown. Ivan Duque, a conservative ally of former President Alvaro Uribe, was installed as president Tuesday. He immediately pointed to the expansion of coca production, corruption, and the violence of drug trafficking groups as problems he will address. "The time has come for us to unite to confront all illegalities," including drug trafficking and production, he said. "We will be effective in the eradication and substitution of illegal crops, accompanied by productive opportunities" for farmers and a crackdown on drug traffickers, Duque promised. "Building peace, Colombians, means to defeat the drug cartels," he said.

Chronicle AM: OK Legalizes MedMJ, Colombia Drug War Could Be Gearing Up, More... (6/27/18)

Oklahoma voters pass a very progressive medical marijuana initiative, legalizers win the Democratic gubernatorial nominations in Colorado and Maryland, Maine passes a major medical marijuana overhaul, and, with rightists now in power in Washington and Bogota, it looks like a new drug war is looming in Colombia.

Cocaine supply is at record levels and Colombia's newly elected president wants to do something about it. (CBP)
Marijuana Policy

Marijuana Legalizers Win Democratic Gubernatorial Nominations in Two States. Colorado US Rep. Jared Polis, a leading congressional proponent of marijuana legalization, won the nomination in his state, while former NAACP head Ben Jealous, who has also called for marijuana legalization, won the nomination in Maryland.

Florida Medical Marijuana Proponent Now Wants 2020 Legalization Initiative. Orlando attorney John Morgan, the man behind the state's successful 2016 medical marijuana initiative, now says he wants to put a legalization initiative on the 2020 ballot. It would "pass overwhelmingly," Morgan said. The longtime Democratic fundraiser pointed to President Trump's recent comments on marijuana: "And I believe in light of President Trump's position, America is ready and willing."

Texas Poll Has Narrow Majority for Legalization. More than half of Texas registered voters polled in the newest University of Texas/Texas Tribune poll support legalizing marijuana. Some 53% said they favored legalizing either small amounts (30%) or any amount (23%). Another 31% would support legalizing medical marijuana, leaving only 16% against legalizing marijuana in any form. A much larger majority -- 69% -- supported reduced penalties for the possession of small amounts.

Medical Marijuana

Maine Legislature Passes Medical Marijuana Overhaul. The legislature has passed a sweeping overhaul of the state's medical marijuana program. The bill removes current qualifying conditions and allows doctors to recommend medical marijuana for any ailment and allows caregivers to expand their operations in exchange for tighter regulations. The bill now goes to the desk of Gov. Paul LePage.

Oklahoma Legalizes Medical Marijuana. One of the reddest of red states went green on Tuesday. Voters in Oklahoma approved a remarkably progressive medical marijuana initiative by a healthy margin of 56% to 43%. The initiative, State Question 778, allows registered patients to possess up to three ounces of marijuana anywhere and up to eight ounces at home. Patients also have the right to grow up to six mature and six immature plants or have designated caregivers do it for them. It also creates a system of licensed dispensaries, cultivation, and processing facilities and sets taxes at a relatively low 7%. The initiative also bars localities from using zoning laws to block dispensaries (although they wouldn't be allowed within 1,000 feet of a school). But what is most striking about Question 778 is that it does not restrict access to medical marijuana to a list of qualifying conditions. In fact, the initiative language explicitly states that "[T]here are no qualifying conditions" and that the only limitation on a doctor's recommending medical marijuana is that it must be done "according to the accepted standards a reasonable and prudent physician would follow when recommending or approving any medication."

Harm Reduction

Ohio Officials Dragging Feet on Federal Needle Exchange Funds, Advocates Charge. The advocacy group Harm Reduction Ohio is accusing the state Health Department of using a bureaucratic delaying tactic to prevent needle exchange programs from accessing any of the funds the state is expected to receive for HIV prevention. Group head Dennis Cauchon said the department is failing to submit a necessary form to the federal Centers for Disease Control and Prevention. "Preventing HIV, hepatitis and drug overdoses are crucial health measures and save massive amounts of money and treatment," Cauchon wrote. Surrounding states submitted the necessary paperwork in 2016, he noted. "The Ohio Department of Health's refusal to support this would be nothing short of reckless, irresponsible and ignorant."

International

UNODC Says Cocaine, Opium Supplies at Record Levels. In its 2018 World Drug Report released Tuesday, the UN Office on Drugs and Crime (UNODC) reported that both cocaine and opium supplies were at their highest ever recorded levels last year. UNODC also described the non-medical use of prescription opioids, such as fentanyl, as a major threat to public health. "Drug markets are expanding, with cocaine and opium production hitting absolute record highs, presenting multiple challenges on multiple fronts," said UNODC Executive Director Yury Fedotov in a statement. "The real problematic issues for us have been the increase in opium production in Afghanistan and the massive increase in cocaine production, particularly because of Colombia," added Thomas Pietschmann, a drug research expert at the UNODC, and one of the lead authors of the report.

Colombia's New Rightist President-Elect Welcomes Trump's Support in New War on Drugs. President-elect Ivan Duque said Monday he welcomed Donald Trump's support for his agenda of a "head-on fight against drug trafficking" during a congratulatory phone call from the US leader. "Today I received a call from the US president where he congratulated us for the results achieved in the last elections and also his commitment to support our security, justice agenda, our agenda of a head-on fight against drug trafficking," Duque told reporters. The US wants Duque to clamp down hard on coca cultivation, which is at record levels. During the campaign, Duque vowed to reinstate the forced eradication of coca crops and the aerial spraying of herbicides over coca farms.

Colombia's Outgoing President Authorizes Use of Drones for Aerial Coca Eradication. Outgoing President Juan Manuel Santos on Tuesday authorized the use of drones to spray herbicides on coca crops. The move comes a day after the US said Colombian coca cultivation had increased 11% last year and cocaine production jumped 19%. Santos' government suspended aerial eradication of coca crops with glyphosate in 2015 after the World Health Organization linked it to cancer. Using low-flying drones would limit the dangers associated with glyphosate, he said.

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

Chronicle AM: RI Senate OKs Life Sentence for ODs Bill, Guatemala's First Coca Crop, More... (5/30/18)

A bill that would mandate life sentences for selling drugs involved in fatal overdoses is moving in Rhode Island, a California US attorney says he's too busy with the black market to go after legal marijuana, another Utah poll has a medical marijuana initiative winning, Guatemala gets its first coca crop and more.

Cocaine traffickers are beginning to move coca production from South America to Central America. (Pixabay)
Marijuana Policy

California US Attorney Says Too Much Black Market Work to Focus on Legal Market. Sacramento-based McGregor Scott, US Attorney for the Northeastern District of California, said Tuesday there is so much marijuana being grown illegally on federal lands and trafficked to other states that he doesn't have the resources to go after state-legal marijuana operations. Scott said he would focus on interstate trafficking, organized crime, and damage to public lands.

New Jersey Legalization Advocate Wants to Tie Legalization, Medical Marijuana. State Sen. Nicholas Scutari (D-Union) is working on a plan to combine a marijuana legalization push with a bid to expand medical marijuana, but some lawmakers are warning the effort could blow up chances for either to pass this year. The medical marijuana expansion plan has broad support; the move to legalize marijuana is much more contentious.

Northern Marianas Legalization Bill Advances. The Commonwealth of the Northern Marianas Islands (CNMI) has taken another step toward legalizing marijuana. The House Committee on Judiciary and Government Operations has unanimously approved a bill that would allow adults to grow, possess, and consume marijuana and set up a system of taxed and regulated sales and production. The bill has already passed the Senate and now awaits a House floor vote.

Medical Marijuana

Yet Another Utah Poll Has Medical Marijuana Initiative Winning. A new poll from Dan Jones & Associates finds that nearly three out of four Utah residents support the Utah Patients Coalition medical marijuana initiative. The poll had 72% either "strongly" or "somewhat" in support, with 25% opposed, and only 2% undecided. While the LDS Church has come out against the measure, even 59% of self-described very active Mormons say they are for it.

Sentencing

Rhode Island Senate Approves Bill Allowing Life Sentences in Overdose Deaths. The state Senate on Tuesday approved Senate Bill 2279A, which allows prison sentences of up to life for those convicted of selling, delivering, or distributing an illegal drug that results in a fatal overdose. The bill passed 22-11 over the objections of treatment professionals, mental health advocates, and civil liberties organizations, which argued that tougher sentences will only make it harder to fight drug overdoses. "We know, based on decades of criminal justice based drug policy, that harsher penalties do not decrease drug using activity. So, this bill's disturbing message will not decrease drug use, nor drug trafficking -- the economics ensure this -- but it will further marginalize people who use drugs and increase their fears," a joint letter to the Senate said. "Use of a public health approach, not lengthy criminal sentences for users and small-time dealers, is essential for our state's ability to continue to make headway in this crisis." The bill now goes to the House.

International

Guatemalan Authorities Bust First Coca Farm. The National Civil Police announced over the weekend that they had found and destroyed a 2 ½ plot of coca plants sown between coffee plants, the first discovery of coca cultivation in the country. The crops were found in a remote area of Alta Verapaz department. Honduras recently saw its first and second discovery of coca plantings, too, suggesting that traffickers are attempting to cut risk and transport costs by planting the cocaine-producing crop nearer to US markets.

Chronicle AM: NM Marijuana Poll, House Passes Limited Prison Reform Bill, More... (5/23/18)

A solid majority of New Mexicans support marijuana legalization, the House passes a limited prison -- but not sentencing -- reform bill, an Open Society Foundations report calls for increased opportunities for legal coca sales in Colombia, and more.

Colombian coca grower. A new report says more legal markets for the crop could reduce violence. (dea.gov)
Marijuana Policy

New Mexico Poll Has Strong Support for Legalization. A poll from Research & Polling Inc. conducted in March but not released until yesterday has support for marijuana legalization at 63%. Respondents were asked if they would support a bill to legalize, tax, and regulate marijuana. Support was up 2% over a similar poll in 2016.

Medical Marijuana

West Virginia Bid for Special Session to Address Marijuana Banking Issues Fizzles. The legislature concluded its may interim meetings Tuesday without securing enough signatures in the House of Delegates to force a special session to address marijuana banking issues. The legislature needed three-fifths of members in both the Senate and the House to force a special session. Enough senators signed on to meet that bar, but not enough delegates did.

Prison Reform

House Passes Prison Reform Bill Backed By Trump. The House easily passed a bipartisan prison reform bill Tuesday, but it faces a murky future in the Senate. House Resolution 5682 aims to reduce recidivism by providing training programs for prisoners. Powerful senators, including Sen. Chuck Grassley (R-IA), however, are holding out for a more substantive bill that includes not just prison reforms, but also sentencing reforms. "For that deal to pass the Senate, it must include sentencing reform. At least as of now, that's something Sen. Durbin and I still are sticking together on," Grassley said at a Tuesday event on criminal justice reform.

International

Open Society Report Calls for Boosting Colombia's Legal Coca Market to Reduce Violence. A new report from Open Society Foundations calls on Colombia to move away from traditional drug eradication measures that have not proven successful and instead create policies that encourage coca farmers to stay out of the black market. The report says both international and Colombian law allow coca to be grown for legal purposes, and Colombia should move to increase that prospect.

Europe's Top Five Cities for Cocaine, Ecstasy, and Speed Use

Do you want to know Europe's true party capitals? The European Monitoring Commission on Drugs and Drug Abuse (EMCDDA) is here to help. Last month it released its latest annual report on drug use levels in 56 European cities in 19 countries.

Raving in Vienna (Wikimedia)
The report relied not on survey results or extrapolations from drug seizures, but a much more direct method: an analysis of daily wastewater samples in the catchment areas of wastewater treatment plants over a one-week period. Researchers analyzed the wastewater from approximately 43 million people, looking for traces of four illicit drugs: amphetamine, methamphetamine, cocaine, and MDMA (ecstasy).

The epidemiological analysis of wastewater is "a rapidly developing scientific discipline with the potential for monitoring close to real-time, population-driven trends in illicit drug use," the EMCDDA points out. Their researchers can now use it to estimate levels of drug use by measuring the levels of drugs and their metabolites excreted into the sewers by urine.

So, which cities are doing the most drugs? We'll give you the top five for each drug, as well as a bit of discussion below:

Amphetamines (milligrams/1,000 people/day)

Eindhoven (Netherlands)     271.7

Antwerp Zuid (Belgium)      268.8

Saarbrucken (Germany)        242.0

Oostende (Belgium)               236.4

Mainz (Germany)                    226.9

The loads of amphetamine detected varied considerably across study locations, with cities in the north and east of Europe reporting much higher levels than in the south. Amphetamine, a working man's drug, was also found more evenly throughout the week than the party drugs, which tend to show up more in weekend samples. Of the top 15 cities, nine were in Germany, three each in Belgium and the Netherlands, and one in Iceland. Berlin came in 10th, Amsterdam 11th.

Cocaine (milligrams/1,000 people/day)

Barcelona (Spain)                  965.2

Zurich (Switzerland)             934.4

Antwerp Zuid (Belgium)      822.9

St. Gallen Hofen (Switzerland)      821.7

Geneva (Switzerland)           794.8

Cocaine use is highest in western and southern European cities, particularly in Belgium, the Netherlands, Spain, and the UK, but Switzerland, with three of the top five and five of the top 10 cokiest cities, certainly deserves mention. Year-to-year figures show that an upward trend first reported in 2016 continues.

MDMA (Ecstasy)(milligrams/1,000 people/day)

Amsterdam (Netherlands)    230.3

Eindhoven (Netherlands)     165.1

Antwerp Zuid (Belgium)      95.3

Zurich (Switzerland)             85.2

Utretcht (Netherlands)          59.8

The Dutch really love their E, taking three of the top five spots, and nearby Antwerp is really starting to look like an unsung drug hotspot, appearing in all three top fives so far. Berlin, Barcelona, Geneva, and Paris are all in the top 10, but at use levels only about one-fifth of Amsterdam.

Methamphetamine (milligrams/1,000 people/day)

Chemnitz (Germany)            240.6

Erfurt (Germany)                 211.2

Budweis (Czech Republic)      200.2

Brno (Czech Republic)            105.7

Dresden (Germany)              180.2

Like plain old amphetamine, meth use generally concentrated in northwest Europe, although the Czech Republic is certainly cranking, too, as it traditionally has. It is most popular in eastern Germany, Finland, and Norway.

One city worth mentioning is notable for its absence from these top fives: Lisbon. Portugal is the only country in Europe to have decriminalized the use and possession of all drugs, but its capital and largest city consistently ranked low-to-middling in drug use levels: The wastewater in Lisbon contained zero methamphetamine, came in 11th for Ecstasy use, 45th for amphetamine use, and 28th for cocaine use.

Those figures from Lisbon strongly suggest that other countries can decriminalize drug use and possession without seeing their populations turned into deranged party animals. In the meantime, the real party animals might want to head to Antwerp.

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