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The Good, the Bad, and the Ugly: The Top Ten US Drug Policy Stories of 2017 [FEATURE]

Thu, 12/28/2017 - 05:56

It was the best of times; it was the worst of times. Tens of thousands die of drug overdoses, hundreds of thousands get arrested for drugs, yet marijuana is seeing boom times. As we bid adieu to 2017, here are the year's drug policy highlights:

[image:1 align:right caption:true]1.The Opioid Crisis Deepens, With Overdose Deaths at an All-Time High

The country's opioid crisis showed no signs of abating in 2017, with the Centers for Disease Control estimating 66,000 overdose deaths this year, up from 63,000 in 2016. To be clear, only about two-thirds of fatal drug overdoses are linked to heroin and prescription opioids, but opioid overdoses surged in 2016 by 28%. It's too early for final data on 2017 overdoses, but there is little reason to doubt that opioids were driving the increase this year. The high levels of overdose deaths have led to a fall in US life expectancy for the past two years, only the third time that has happened in the past century. Policy efforts to curtail the problem have sometimes included regressive moves to up drug sentences, and have generally given only limited consideration to the needs many patients have to access these substances. But public health measures like naloxone distribution and "Good Samaritan" non-prosecution policies have also advanced.

2. Fentanyl is Killing More and More People

The powerful synthetic opioid fentanyl and its analogs are implicated in an increasingly large number of opioid overdose deaths. While deaths involving prescription opioids are decreasing, fentanyl-related deaths have increased by an average of 88% a year since 2013. Illicitly imported fentanyl from labs in China or Mexico is mixed with heroin with lethal results: Half of the increase in heroin-related overdose deaths is attributable to heroin cut with fentanyl, the CDC reported in September. There were nearly 20,000 deaths attributable to fentanyl and other illicit opioids in 2016; the 2017 numbers are likely to be even worse.

3. Key Federal Drug Policy Positions Remain Unfilled, and Kellyanne is In Charge

The Trump administration has not nominated anyone to head the DEA, and the agency is currently being led by Acting Administrator Robert Patterson after Chuck Rosenberg, the acting administrator when Trump took office, resigned in September, saying he didn't want to work with the administration any longer. Similarly, the White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) is without a permanent head after Trump's nominee, Pennsylvania GOP Rep. Tom Marino went down in flames in October in the wake of reports he steered a bill through Congress that impeded the DEA from going after pharmaceutical drug distributors. Neither the White House nor anyone else seems very interested in filling the position, in part, perhaps, because earlier in the year, Trump floated the notion of cutting ONDCP's budget by nearly 95%. But not to worry: Trump pollster, counselor, and apologist Kellyanne Conway is now leading the administration's fight against opioids -- even though she has no public health experience whatsoever.

[image:2 align:left caption:true]4. Attorney General Sessions Revives the Federal War on Drugs…

Under President Obama, Attorney General Eric Holder presided over a ratcheting down of harsh federal drug prosecutions and sentences, but current Attorney General Jeff Sessions is doing his best to undo those reforms. In May, Sessions announced that he had directed federal prosecutors to seek the most severe penalties possible in drug cases, including mandatory minimum sentences.

5. …But Fails to Implement a War on Weed, So Far

For all the wailing, gnashing of teeth, and dire predictions of a Sessions war on weed, it hasn't happened yet. The attorney general has made no secret of his dislike for the demon weed, but that has yet to translate into any firm policy positions or federal crackdowns on marijuana in states where it is legal, for either medical or recreational use. Congressional action continues to bar the use of Justice Department funds to go after medical marijuana, although the future of that law after January 22nd remains in doubt. But there was no bar on going after state-legal recreational marijuana, yet it didn't happen. Sessions told the House Judiciary Committee in November that the Obama-era Cole memo remains in effect. That memo directs prosecutors to pretty much leave state-legal marijuana alone except for specified concerns, such as the involvement of youth, violence, or diversion. Later in November, Sessions said the Justice Department was still examining the Cole memo, so all is not safe, but today legal marijuana is still standing.

6. Legal Marijuana's $10 Billion Dollar Year

In December, marijuana market watchers Arcview Market Research estimated that retail marijuana sales would hit $10 billion in 2017, up 33% over 2016. But that's just the beginning, Arcview said. With huge recreational markets such as California (pop. 39 million) and Canada (pop. 36 million) coming online next year, the group expects North American sales to top $24.5 billion by 2021. It's hard even for a pot-hating attorney general to get in front of that economic juggernaut.

[image:3 align:right caption:true]7. Pot is More Popular than Ever

Just ask Gallup. The venerable polling firm has been tracking support for marijuana legalization since 1969, when it was at just 12%. In its latest poll, from October, Gallup now has support for marijuana legalization at 64%. What is really impressive is the rapid increase in support in the past 20 years: In 1996, support was at 25%; by 2012, it had doubled to 50%; and it's gained another 14 points in the five years since. Other pollsters are reporting similar current levels of support for marijuana legalization. And this could be another reason the attorney general hesitates to crack down on weed.

8. No State Legalized Weed, But 2018 Should Be Different

After 2016 saw marijuana legalization initiatives win in California, Maine, Massachusetts, and Nevada -- losing only in Arizona, closely -- anticipation was high that 2017 would see more states come aboard. It didn't happen. There are two explanations for this: First, it was an off-off election year and no initiatives were on the ballot, and second, it's hard to move controversial legislation though the state house. Still, the Vermont legislature actually passed a legalization bill, only to see it vetoed by a Republican governor, and that governor now says he is ready to sign a legalization bill. That could happen as early as next month. Likewise, a number of other states saw legalization bills make serious progress, and we could see those efforts come to fruition in places like Connecticut, Delaware, New Jersey, and Rhode Island. And 2018 will most likely see at least one legalization initiative. Activists in Michigan have already handed in signatures and should have enough of a cushion to qualify for the ballot.

9. Safe Injection Sites in the US Draw Ever Nearer

The harm reduction intervention has been proven to save lives, increase public health and public safety, and get hardcore drug users in touch with medical and social service help, and the message is finally on the verge of getting though in the US. At least two major West Coast cities, San Francisco and Seattle, are advancing plans to open such facilities -- although not without staunch opposition -- and, under the progressive leadership of young Mayor Svante Myrick, Ithaca, New York, is making similar plans.

10. The War on Drugs Rolls On

Despite the legalization of medical and/or recreational marijuana in various states, despite various sentencing reforms at the state and federal level, despite the growing recognition that "we can't arrest our way out of this problem," the drug war just keeps on going. The FBI released its annual Uniform Crime Report in November, and while the numbers are from 2016, this year's numbers are unlikely to be any better. More than 600,000 people got arrested for marijuana offenses in 2016, down from a peak of nearly 800,000 in 2007, but still up by 75,000 or 12% over 2015. It's the same story with overall drug arrests: While total drug arrest numbers peaked at just under 1.9 million a year in 2006 and 2007 -- just ahead of the peak in prison population -- and had been trending downward ever since, they bumped up again last year to 1.57 million, a 5.6% increase over 2015.

Categories: Mandatory Minimums

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

Thu, 12/07/2017 - 03:14

As Drug War Chronicle marks the publication of its 1,000th issue (with yours truly having authored 863 of them going back to 2000), we reflect on what has changed and what hasn't in the past couple of decades. This piece recounts our domestic drug policy evolution in the US; a companion piece looks at the international picture.

[image:1 align:left]A lot has happened. We've broken the back of marijuana prohibition, even if we haven't killed it dead yet; we've seen medical marijuana gain near universal public acceptance, we've seen harm reduction begin to take hold, we've fought long and hard battles for sentencing reform -- and even won some of them.

But it hasn't all been good. Since the Chronicle began life as The Week Online With DRCNet back in 1997, more than 30 million people have been arrested for drugs, with all the deleterious consequences a drug bust can bring, and despite all the advances, the drug war keeps on rolling. There's been serious progress made, but there's plenty of work left to do. 

Here are the biggest big picture drug stories and trends of the past 20 years:

1. Medical Marijuana

It was November, 1996, when California became the first state to legalize medical marijuana, five years after San Francisco became the first city in the country to pass a medical marijuana measure, thanks in large part to the efforts of activists who mobilized to make its use possible for AIDS patients. Two years later, Alaska, Oregon, and Washington came on board, and three years after that, Hawaii became the first state to allow it though the legislative process. Now, 29 states, the District of Columbia, Guam, and Puerto Rico allow for the use of medical marijuana, and public support for medical marijuana reaches stratospheric levels in polls.

But the battle isn't over. The federal government still refuses to officially recognize medical marijuana, potentially endangering the progress made so far, especially under the current administration, efforts to reschedule marijuana to reflect its medical uses remain thwarted, some of the more recent states to legalize medical marijuana have become perversely more restrictive, and in some of the more conservative states, lawmakers attempt to appease demands for medical marijuana legalization by passing extremely limited CBD-only laws.

2. Marijuana Legalization: In the War on Weed, Weed is Winning

Twenty years ago, pot wasn't legal anywhere, and Gallup had public support for legalization at a measly 25%. A lot has changed since then. It took repeated tries, but beginning in 2012, states started voting to free the weed, with Colorado and Washington leading the way, Alaska and DC coming on board in 2014, and California, Maine, Massachusetts, and Nevada joining the ranks last year. Now, about a fifth of the country has legalized weed, with more states lining up to do so next year, including most likely contenders Delaware, Michigan, New Jersey, and Vermont.

Now, Gallup has support for legalization at 64% nationwide, with even a slight majority (51%) of Republicans on board. The only demographic group still opposed to pot legalization is seniors, and they will be leaving the scene soon enough. Again, the battle is by no means over. Marijuana remains illegal under federal law, and congressional efforts to change that have gone nowhere so far. But it seems like marijuana has won the cultural war, and the rest is just cleaning up what's left of the pot prohibition mess.

3. Marijuana, Inc.: The Rise of an Industry

State-legal marijuana is already a $10 billion dollar a year industry, and that's before California goes on line next month. It's gone from outlaws and hippie farmers in the redwoods to sharp-eyed business hustlers, circling venture capitalists, would-be monopolists, and assorted hangers on, from accountants, lawyers, and publicists to security and systems mavens, market analysts, and the ever-expanding industry press.

These people all have direct pecuniary interests in legal marijuana, and, thanks to profits from the golden weed, the means to protect them. Marijuana money is starting to flow into political campaigns and marijuana business interests organize to make sure they will continue to be able to profit from pot.

Having a legal industry with the wherewithal to throw its weight around a bit is generally -- but not entirely -- a good thing. To the degree that the marijuana industry is able to act like a normal industry, it will act like a normal industry, and that means sometimes the interests of industry sectors may diverge from the interests of marijuana consumers. The industry or some parts of it may complain, for instance, of the regulatory burden of contaminant testing, while consumers have an interest in knowing the pot they smoke isn't poisoned.

And getting rich off weed is a long way from the justice-based demand that people not be harassed, arrested, and imprisoned for using it. Cannabis as capitalist commodity loses some of that outlaw cachet, some ineffable sense of hipster cool. But, hey, you're not going to jail for it anymore (at least in those legal states).

4. The Power of the People: The Key Role of the Initiative Process

The initiative and referendum process, which lets activists bypass state legislatures and put issues to a direct popular vote, has been criticized as anti-democratic because it allows special interests to use an apathetic public to advance their interests, as both car insurers and tobacco companies have attempted in California. It also gets criticized for writing laws without legislative input.

But like any political tool, it can be used for good or ill, and when it comes to drug reform, it has been absolutely critical. When legislatures refuse to lead -- or even follow -- as has been the case with many aspects of drug policy, the initiative process becomes the only effective recourse for making the political change we want. It was through the initiative process that California and other early states approved medical marijuana; it was five years later that Hawaii became the first state where the legislature acted. Similarly with recreational marijuana legalization, every state that has legalized it so far has done it through the initiative process; in no state has it yet made its way through the legislature, although we're hoping that will change next year.

And it's not just marijuana. The initiative process has also been used successfully to pass sentencing reforms in California, and now activists are opening the next frontier, with initiatives being bruited in California and Oregon that would legalize psychedelic mushrooms.

The bad news: Only 24 states have the initiative process. The good news: The ones that do lead the way, setting an example for the others.

[image:2 align:right caption:true]5. The Glaring Centrality of Race

It took Michelle Alexander's 2010 publication of The New Jim Crow: Mass Incarceration in the Age of Colorblindness to put a fine point on it, but the centrality of race in the prosecution of the war on drugs has been painfully evident since at least the crack hysteria of the 1980s, if not going back even further to the Nixonian law-and-order demagoguery of the late 1960s and early 1970s.

We've heard the numbers often enough: Blacks make up about 13% of the population and about 13% of drug users, but 29% of all drug arrests and 35% of those doing state prison time for drugs. And this racial disparity in drug law enforcement doesn't seem to be going away.

Neither is the horrendous impact racially-biased drug law enforcement has on communities of color. Each father or mother behind bars leaves a family exploded and usually impoverished, and each heavy-handed police action leaves a bitter aftertaste.

The drug war conveyor belt, feeding an endless number of black men and women into the half-life of prison, is clearly a key part of a system of racially oppressive policing that has led to eruptions from Ferguson to Baltimore. If we are going to begin to try to fix race relations in this country, the war on drugs is one of the key battlefronts. Thanks in part to Alexander's bestseller, civil rights organizations from the traditional to newer movements like Black Lives Matter have devoted increasing focus to criminal justice, including drug policy reform.

6. Harm Reduction Takes Hold

We don't think teenagers should be having sex, but we know they're going to, anyway, so we make condoms available to them so they won't get pregnant or STDs. That's harm reduction. So is providing clean needles to injection drug users to avoid the spread of disease, making opioid overdose drugs like naloxone widely available so a dosing error doesn't turn fatal, passing 911 Good Samaritan laws to encourage and OD victims' friends to call for help instead of run away, and providing a clean, well-lit place where drug users can shoot or smoke or snort their drugs under medical supervision and with access to social service referrals.

Two decades ago, the only harm reduction work going on was a handful of pioneering needle exchanges, thanks to folks like Dave Purchase at the North American Syringe Exchange Network (founded in 1988), and early activists faced harassment and persecution from local authorities. But it was the creation of the Harm Reduction Coalition in 1993 that really began to put the movement on the map.

In this century, harm reduction practices have gained ground steadily. Now, 33 states and DC allow needle exchange programs to operate, 40 states and DC have some form of 911 Good Samaritan laws, and every state in the county has now modified its laws to allow greater access to naloxone.

The next frontier for American drug war harm reduction is safe injection sites, and on the far horizon, opiate-assisted maintenance. There is not yet a single officially sanctioned operating safe injection in the country, but we are coming close in cities such as Seattle and San Francisco. And let's not forget drug decriminalization as a form of harm reduction. It should be the first step, but that's not the world we live in -- yet.

7. Sentencing Fever Breaks

Beginning in the Reagan years and continuing for decades, the number of prisoners in America rose sharply and steadily, driven in large part by the war on drugs. The phenomenon gained America infamy as the world's biggest jailer, whether in raw numbers or per capita.

But by early in the century, the fever had broken. After gradually slowing rates of increases for several years, the number of state and federal prisoners peaked around 2007 and 2008 at just over 1.6 million. At the end of 2015, the last year for which data is available, the number of prisoners was 1.527 million, down 2% from the previous year. And even the federal prison system, which had continued to increase in size, saw a 14% decline in population that year.

But most drug war prisoners are state prisoners, and that's where sentencing reform have really begun to make a difference. States from California to Minnesota to Texas, among others, enacted a variety of measures to cut the prison population, in some cases because of more enlightened attitudes, but in other cases because it just cost too damned much money for fiscal conservatives.

Current US Attorney General Jeff Sessions would like very much to reverse this trend and is in a position to do some damage, for instance, by instructing federal prosecutors to pursue tough sentences and mandatory minimums in drug cases. But he is hampered by federal sentencing reforms passed in the Obama era. Sessions may be able to bump up the number of people behind bars only slightly; the greater danger is that his policies serve as an inspiration for similarly inclined conservatives in the states to try to roll back reforms there.

8. The Rise (and Fall) of the Opioids

In 1996, Purdue Pharma introduced Oxycontin to the market. The powerful new pain reliever was pitched to doctors as not highly addictive by a high pressure company sales force and became a tremendous market success, generating billions for the Sackler family, the owners of the company. Opioid prescriptions became more common.

For many patients, that was a good thing. Purdue Pharma's marketing push coincided with a push by chronic pain advocates -- patients, doctors and others -- to ease prescribing restrictions that had kept many patients in feasibly treatable pain. And which in many cases still do: A 2011 report by the Institute of Medicine found that while "opioid prescriptions for chronic noncancer pain [in the US] have increased sharply . . . [tlwenty-nine percent of primary care physicians and 16 percent of pain specialists report they prescribe opioids less often than they think appropriate because of concerns about regulatory repercussions." As the report noted, having more opioid prescriptions doesn't necessarily mean that "patients who really need opioids [are] able to get them."

While it's popular to blame doctors and Big Pharma for getting a bunch of pain patients addicted to opioids, that explanation is a bit too facile. Many of the people strung out today were never patients, but instead obtained their pain pills on the black market. Through a perverse system of incentives, people on Medicaid could obtain the pills by prescription for next to nothing, then resell them for $40 or $60 apiece to people who wanted them. Some pain management practices were on the cutting edge of relieving pain for patients who needed the help. But others were little more than shady pill mills, popping up in places like Ohio, Kentucky, and Florida -- places that would become the epicenter of an opioid epidemic within a few years.

When the inevitable crackdowns on pain pill prescribing came, legitimate prescribers of course got caught in the crossfire sometimes, especially those who served the poor or the patients who in the worst chronic pain. Their being targeted, or others reining in their prescribing practices, left many patients in the lurch again. And the closure of pill mills left addicted people in the lurch. But there was plenty of heroin to make up for the missing pills the addicted used to take. Mexican farmers have been happy to grow opium poppies for the American market for decades, and Mexican drug trafficking organizations know how to get it to market.

The whole thing has been worsened by the arrival of fentanyl, a synthetic opioid dozens of times stronger than pure heroin, which seems to be coming mostly from rogue Chinese pharmaceutical labs (although the Mexicans appear to be getting in on the act now, too).

And now we have a drug overdose crisis like the country has never seen before, with around 60,000 people estimated to die from overdoses this year, most of them from opioids (by themselves or in combination with alcohol and/or other drugs). The crisis is inspiring both admirable harm reduction efforts and an execrable turn to harsher punishments, while making things harder again for many pain patients. While many argue that the gentle side of the response to this epidemic is because the victims are mainly white, I would suggest that argument pays short shrift to all the years of hard work advocates and activists of all ethnicities have put in to creating more enlightened drug policies.

9. Policing for Profit: The Never Ending Fight to Rein in Asset Forfeiture

Twenty years ago, pressure was mounting in Washington over abuses of the federal civil asset forfeiture program, just as it is now. Back then, passage of the Civil Asset Forfeiture Reform Act (CAFRA) of 2000 marked an important early victory in the fight to rein in what has tartly described as "policing for profit." It was shepherded though the house by then Judiciary Committee Chairman Rep. Henry Hyde, an Illinois Republican.

How times have changed. Now, with federal agents seizing billions of dollars each year though civil forfeiture proceedings and scandalous abuse after scandalous abuse pumping up the pressure for federal reform, the Republican attorney general is calling for more asset forfeiture. And Jeff Sessions isn't just calling for it; he has undone late Obama administration reforms aimed at reining in one of the sleaziest aspects of federal forfeiture, the Equitable Sharing program, although he is having problems getting Congress to go along.

In the years since CAFRA, a number of states have passed similar laws restricting civil asset forfeiture and directing that seized funds go into the general fund or other designated funds, such as education, but state and local police have been able to evade those laws via Equitable Sharing. Under that program, instead of seizing money under state law, they instead turn it over to the federal government, which then returns 80% of it to the law enforcement agency -- not the general fund and not the schools.

This current setup, with its perverse incentives for police to evade state laws and pursue cash over crime, makes asset forfeiture reform a continuing battlefield at both the state and the federal levels. A number of reform bills are alive in the Congress, and year by year, more and more states pass laws limiting civil asset forfeiture or, even better, eliminating it and requiring a criminal conviction before forfeiture can proceed. Fourteen states have now done that, with the most recent being Connecticut, New Mexico and Nebraska. That leaves 36 to go.

10. Despite Everything, the Drug War Grinds On

We have seen tremendous progress in drug policy in the past 20 years, from the advent of the age of legal marijuana to the breaking of sentencing fever to the spread of harm reduction and the kinder, gentler treatment of the current wave of opioid users, but still, the drug war grinds on.

Pot may be legal in eight states, but that means it isn't in 42 others, and more than 600,000 people got arrested for it last year -- down from a peak of nearly 800,000 in 2007, but still up by 75,000 or 12% over 2015.

It's the same story with overall drug arrests: While total drug arrest numbers peaked at just under 1.9 million a year in 2006 and 2007 -- just ahead of the peak in prison population -- and had been trending downward ever since, they bumped up again last year to 1.57 million, a 5.6% increase over 2015.

There are more options for treatment or diversion out of jail or prison, but people are still getting arrested. Sentencing reforms mean some people won't do as much time as they did in the past, but people are still getting arrested. And the drug war industrial complex, with all its institutional inertia and self-interest, rolls on. If we want to actually end the drug war, we're going to have to stop arresting people for drugs. That would be a real paradigm shift.

Categories: Mandatory Minimums