Skip to Content

Top Stories (STDW)

Syndicate content
Updated: 20 hours 3 min ago

Chronicle AM: Groups Oppose New Fed Bill, Still no DEA Research Grow Licenses, More... (7/5/17)

Wed, 07/05/2017 - 20:28

Drug reformers and others are trying to stop a bill that would give Attorney General Sessions new powers to criminalize new drugs and craft new penalties, after a year the DEA still hasn't issued any new marijuana research grow licenses, and more.

[image:1 align:left caption:true]Marijuana Policy

DEA Still Hasn't Issued Any New Marijuana Grower Licenses. Almost a year after the DEA announced it would allow more organizations to produce marijuana for research purposes, it has yet to do so. Although DEA has received 25 applications for research grows, it says it is still processing them and has no estimate for when any applications may be granted. There is increasing demand for research marijuana, as well as for more potent, more diverse, and higher quality marijuana than is being produced by the University of Mississippi under a NIDA monopoly it has enjoyed since 1968.

Massachusetts Lawmakers Get Back to Work on Crafting Legalization Implementation. The legislature missed a self-imposed Friday deadline for reaching agreement on competing legalization implementation bills in the House and Senate and the marijuana conference committee was set to meet today to try to seek agreement. Two big issues of dispute are tax rates and whether localities can ban pot businesses without a popular vote.

Industrial Hemp

West Virginia Joins the Ranks of Legal Hemp States. As of Tuesday, state residents can apply to the agriculture commissioner for a license to grow hemp for commercial purposes. Some growers grew hemp crops last year, but those were licensed research grows. Now, those growers can be licensed as commercial growers, too.

Drug Policy

Dozens of Reform Groups Send Letter to Congress Opposing New Drug War Bill. More than 60 civil rights, human rights, faith, criminal justice, and drug policy reform organization have sent a letter to the House Judiciary Committee opposing House Resolution 2851, the Stop the Importation and Trafficking of Synthetic Analogues Act of 2017. The measure is part of Attorney General Sessions' effort to reenergize the war on drugs and would give him sweeping new powers to schedule new drugs and set corresponding penalties, including new mandatory minimums. Similar legislation by Sens. Grassley and Feinstein has been filed in the Senate.

Categories: Latest News

"Shocks the Conscience": South Dakota Forcibly Catheterizes Three-Year Old in Drug War [FEATURE]

Sun, 07/02/2017 - 22:32

The state of South Dakota is practicing a form of drug war excess tantamount to torture, according to a pair of federal lawsuits filed by the ACLU on June 28. One suit charges that law enforcement and medical personnel subject drug suspects to forcible catheterization if they refuse to submit to a drug test.

[image:1 align:left caption:true] The second suit charges even more outrageous conduct: State social workers and medical personnel subjecting a screaming toddler to the same treatment.

Let's be clear here: We are talking about a person having a plastic tube painfully inserted in his penis without his consent and with the use of whatever physical force is necessary by agents of the state. In the name of enforcing drug laws.

Law enforcement has an incentive to coerce people into consenting to warrantless drug tests -- with the realistic threat of forced catheterization -- because its state laws punish not just possession of drugs, but having used them. Under the state's "internal possession" or "unlawful ingestion" statutes, testing positive for illicit drugs is a criminal offense.

"Forcible catheterization is painful, physically and emotionally damaging, and deeply degrading," said ACLU of South Dakota executive director Heather Smith in a statement announcing the filings. "Catheterization isn't the best way to obtain evidence, but it is absolutely the most humiliating. The authorities ordered the catheterization of our clients to satisfy their own sadistic and authoritarian desires to punish. Subjecting anyone to forcible catheterization, especially a toddler, to collect evidence when there are less intrusive means available, is unconscionable."

In the case of the toddler, the ACLU is suing on behalf of Kirsten Hunter of Pierre and her thee-year-old son. According to the complaint, their ordeal began on February 23, when police arrived to arrest her live-in boyfriend for failing a probationary drug test. Accompanying the cops was Department of Social Services (DSS) caseworker Matt Opbroeck, who informed Hunter that she and her children would have to take drug tests, and that if she failed to agree, her two kids would be seized on the spot.

Under such coercion, Hunter agreed to take herself and her kids to St. Mary's Avera Hospital to be tested the next day. Here, in the dry language of the legal filing, is what happened next:

Ms. Hunter was met by [SMA medical staff] and told that she and her children needed to urinate in cups on orders of DSS.

At the time, A.Q., was not toilet-trained and could not produce a sample in a cup.

Even though other methods, such as placing a bag over his penis, would have yielded a urine sample, [SMA medical staff] immediately began to hold him down and to catheterize him.

At the time, [they] did not inform Ms. Hunter of altemative methods of getting a urine sample or explain the risks associated with catheterizing a child.

Ms. Hunter did not know that she could object nor was she given any opportunity to object. Ms. Hunter did not speak with or see a doctor.

A.Q. was catheterized and screamed during the entire procedure.

On information and belief, A.Q. was catheterized with an adult-sized catheter.

Ms. Hunter was humiliated and upset about A.Q.'s catheterization.

A.Q. was injured physically and emotionally.

In the aftermath of the state-sanctioned assault, three days later, A.Q. had to be taken to a hospital emergency room 100 miles away in Huron for constipation and pain and discomfort in his penis, and he had to return again to ASM two days after that, where he was diagnosed with a staph infection in his penis.

Hunter and the ACLU are suing DSS caseworker Opbroeck, Opbroeck's bosses, Department of Social Services Secretary Lynn Valenti and DSS Division of Child Protective Services Director Virginia Wieseler, and St. Mary's Avera, Registered Nurse Katie Rochelle, Nurse Practitioner Teresa Cass, and four unnamed SMA medical employees.

The ACLU argues that forcible catheterization of A.Q. violates the Fourth Amendment's proscription against warrantless searches, the Fifth Amendment's right not to be forced to testify against oneself, and the 14th Amendment's due process clause because "it shocks the conscience, it was not medically necessary, and it was not reviewed by a judge." The lawsuit seeks monetary relief as well as declaration that the procedure is unconstitutional.

"The Fourth Amendment guarantees people the right to be free from unreasonable government searches," said Courtney Bowie, ACLU of South Dakota Legal Director. "There is nothing reasonable about forcibly catheterizing a child. The Constitution's purpose is to protect people from government intrusions exactly like this."

There is nothing reasonable about forcibly catheterizing drug defendants, either -- especially when the only drug use suspected is of marijuana -- but the second lawsuit filed by the ACLU alleges the practice is widespread among law enforcement agencies in the state, including repeated allegations of forced catheterizations after the victims have agreed to provide urine samples, the sole reason being that police involved could "gratify their sadistic desires," the complaint says.

"State agents, including law enforcement officers, in multiple cities and counties in South Dakota have conspired to attempt to rationalize, justify, and illegally forcibly catheterize drug suspects, and illegally coerce drug suspects to provide urine samples by threatening them with illegal forcible catheterization if they will not voluntarily provide a urine sample," the complaint says.

The conspiracy violates the civil rights not only of those subjected to forced catheterization, but those threatened with, the ACLU argues.

The lawsuit has five plaintiffs, all of whom were subjected to the procedure, and lists 20 unnamed police officers from Pierre, Sisseton, and the Highway Patrol, as well as one named Pierre officer, and the cities of Pierre and Sisseton. The lawsuit seeks injunctive relief to stop the practice, as well as "compensatory and punitive damages."

Categories: Latest News

Customs Seizes Childproof Marijuana Lock Boxes, Calls Them "Drug Paraphernalia" [FEATURE]

Wed, 06/21/2017 - 21:03

In a prime illustration of the perversities of the war on drugs, US Customs has seized a shipment of a thousand lock boxes aimed at allowing marijuana, tobacco, and pharmaceutical users to keep their stashes safe from kids. Customs has officially designated the boxes as drug paraphernalia, even though everyone involved concedes the boxes are aimed at preventing drug use by kids.

[image:1 align:left]The stash cases were designed by and destined for Stashlogix, a Boulder, Colorado, firm established in the wake of marijuana legalization in the state in 2012 to address a mini-panic over news reports about the dangers of marijuana for kids. Those reports were generally overstated, but the need for secure stashes for pot and other potentially dangerous goodies remained.

"People didn't have ways to safely store these items out of reach of kids, other than up on shelves or in sock drawers," Stashlogix cofounder Skip Stone told the Washington Post. So he and a partner founded the company to market cases and containers "for the storage and transport of medicine, tobacco, and other stuff."

The company's small, lockable cases, with tiny jars and odor-neutralizing inserts included, were a hit with customers. "People love the product," Stone said. "They use it for all sorts of things, but cannabis is definitely one of them. They keep it locked, they feel safer, they feel more responsible."

So the company geared up production, placing orders with a Chinese factory, but things came to a crashing halt on April 28, when Customs seized 1,000 of the storage cases.

"This is to officially notify you that Customs and Border Protection seized the property described below at Los Angeles International Airport on April 28, 2017," read a letter received by Stashlogix. The agency had seized the bags, valued at $12,000, because "it is unlawful for any person to import drug paraphernalia."

[image:2 align:right caption:true]When challenged by Stashlogix, Customs conceded that "standing alone, the Stashlogix storage case can be viewed as a multi-purpose storage case with no association with or to controlled substances," but it pointed out that the odor-absorbing carbon inset could be used to hide the smell of weed, and it cited favorable reviews of the product in the marijuana press, concluding "that there exists one consistent and primary use for the Stashlogix storage cases; namely, the storage and concealment of marijuana."

The federal government doesn't officially recognize the legality of medical or recreational marijuana, and Customs is following decades-old drug war paraphernalia laws to achieve a perverse result: Making marijuana potentially riskier in places where it is legal. After all, half of current pot smokers are parents, and this application of federal policy is making it more difficult for them to keep their kids out of their stashes.

Stone is appealing the ruling, but in the meantime, he's had to write off an additional $18,000 worth of goods still outside the country and lay off his three employees. He's looking for a domestic manufacturer for his cases, since Customs can't mess with domestic goods and the DEA hasn't made paraphernalia a high priority, but the ultimate solution lies in Washington.

"It's going to take an act of Congress to clear up some of these contradictions between state and federal law," he told the Post. "These paraphernalia laws are outdated. Keeping kids safe should be more important than outdated regulations."

Categories: Latest News

America, We Can Fix This: 24 Ways to Reduce Opioid Overdoses and Addiction [FEATURE]

Tue, 06/13/2017 - 07:06

Drugs, mainly opioids, are killing Americans at a record rate. The number of drug overdose deaths in the country quadrupled between 1999 and 2010 -- and compared to the numbers we're seeing now, those were the good old days.

[image:1 align:left]Some 30,000 people died of drug overdoses in 2010. According to a new estimate from the New York Times, double that number died last year. And the rate of increase in overdose deaths was growing, up a stunning 19% over 2015.

The Times' estimate of between 59,000 and 65,000 drug overdose deaths last year is greater than the number of American soldiers killed during the entire Vietnam War, greater than that number of people killed in the peak year for car crash deaths, greater than the number of people who died in the year the AIDS epidemic peaked, and higher than the peak year for gun deaths.

In the first decade of the century, overdoses and addiction rose in conjunction with a dramatic increase in prescription opioid prescribing; since then, as government agents and medical professionals alike sought to tamp down prescribing of opioids, the overdose wave has continued, now with most opioid OD fatalities linked to illicit heroin and powerful black market synthetic opioids, such as fentanyl and carfentanil.

The Centers for Disease Control and Prevention says we are in the midst of "the worst drug overdose epidemic in history," and it's hard to argue with that.

So, what do we do about it? Despite decades of failure and unintended consequences, the prohibitionist reflex is still strong. Calls for more punitive laws, tougher prosecutorial stances, and harsher sentences ring out from state houses across the land to the White House. But tough drug war policies haven't worked. The fact that the overdose and addiction epidemic is taking place under a prohibition regime should make that self-evident.

More enlightened -- and effective -- approaches are now being tried, in part, no doubt, because today's opioid epidemic is disproportionately affecting white, middle class people and not the inner city black people identified with heroin epidemics of the past. But they are also being tried because for the past quarter-century an ever-growing drug reform movement has articulated the failures of prohibition and illuminated more effective alternatives.

The drug reform movement's most powerful organization, the Drug Policy Alliance, this spring published A Public Health and Safety Approach to Problematic Opioid Use and Overdose, which lays out more than two dozen specific policy prescriptions in the realms of addiction treatment, harm reduction, prevention, and criminal justice that have been proven to save lives and reduce dependency on opioids. These policy prescriptions are doable now -- and some are being implemented in some fashion in some places -- but require that political decisions be made, or that forces be mobilized to get those decisions made. Some would require a radical divergence from the orthodoxies of drug prohibition, but that's a small price to pay given the mounting death toll.

Here are 24 concrete policy proposals that can save lives and reduce addiction right now. All the facts and figures are fully documented in the heavily-annotated original. Consult it if you want to get down to the nitty-gritty. In the meantime:

Addiction Treatment

1. Create Expert Panel on Treatment Needs: States should establish an expert panel to address effective treatment needs and opportunities. The expert panel should evaluate barriers to existing treatment options and make recommendations to the state legislature on removing unnecessary impediments to accessing effective treatment on demand. Moreover, the panel should determine where gaps in treatment exist and make recommendations to provide additional types of effective treatment and increased access points to treatment (such as hospital-based on demand addiction treatment). The expert panel must also set evidence-based standards of care and identify the essential components of effective treatment and recovery services to be included in licensed facilities, especially with regards to medication-assisted treatment, admission requirements, discharge, continuity of care and/or after-care, pain management, treatment programming, integration of medical and mental health services, and provision of or referrals to harm reduction services. The expert panel should identify how to improve or create referral mechanisms and treatment linkages across various healthcare and other providers. The panel should establish clear outcome measures and a system for evaluating how well providers meet the scientific requirements the panel sets. And, finally, the expert panel should evaluate opportunities under the ACA to expand coverage for treatment.

2. Increase Insurance Coverage for Medication-Assited Treatment (MAT): Seventeen state medical plans under the Patient Protection and Affordable Care Act (ACA) do not provide coverage for methadone or buprenorphine for opioid dependence. Moreover, the Veterans Administration's (VA's) insurance system has explicitly prohibited coverage of methadone and buprenorphine treatment for active duty personnel or for veterans in the process of transitioning from Department of Defense care. As a result, veterans obtaining care through the VA are denied effective treatment for opioid dependence. Insurance coverage for these critical medications should be standard practice.

3. Establish and Implement Office-Based Opioid Treatment for Methadone: Currently, with a few exceptions, methadone for the treatment of opioid dependence is only available through a highly regulated and widely stigmatized system of Opioid Treatment Programs (OTPs). Moreover, several states have imposed moratoriums on establishing new OTPs that facilitate methadone treatment despite large, unmet treatment needs for a growing opioid-dependent population. Patients enrolled in methadone treatment in many communities are often limited to visiting a single OTP and face other inconveniences that make adherence to treatment more difficult. Initial trials have suggested that methadone can be effectively delivered in office-based settings and that, with training, physicians would be willing to prescribe methadone to their patients to treat their opioid dependence. Office-based methadone may help reduce the stigma associated with methadone delivered in OTPs as well as provide a critical window of intervention to address medical and psychiatric conditions. Office-based opioid treatment programs offering methadone have been implemented in California, Connecticut, and Vermont.

4. Provide MAT in Criminal Justice Settings, Including Jails/Prisons and Drug Courts: Individuals recently released from correctional settings are up to 130 times more likely to die of an overdose than the general population, particularly in the immediate two weeks after release. Given that approximately one quarter of people incarcerated in jails and prisons are opioid-dependent, initiating MAT behind bars should be a widespread, standard practice as a part of a comprehensive plan to reduce risk of opioid fatality. Jails should be mandated to continue MAT for those who received it in the community and to assess and initiate new patients in treatment. Prisons should initiate methadone or buprenorphine prior to release, with a referral to a community-based clinic or provider upon release. In addition, drug courts should be mandated to offer participants the option to participate in MAT if they are not already enrolled, make arrangements for their treatment, and should not be permitted to make discontinuation of MAT a criterion for successful completion of drug court programs. The Substance Abuse and Mental Health Services Administration will no longer provide federal funding to drug courts that deny the use of MAT when made available to the client under the care of a physician and pursuant to a valid prescription. The National Association of Drug Court Professionals agrees: "No drug court should prohibit the use of MAT for participants deemed appropriate and in need of an addiction medication."

[image:2 align:right caption:true]5. Offer Hospital-Based MAT: Emergency departments should be mandated to inform patients about MAT and offer buprenorphine to those patients that visit emergency rooms and have an underlying opioid use disorder, with an appointment for continued treatment with physicians in the community. Hospitals should also offer MAT within the inpatient setting, and start MAT prior to discharge with community referrals for ongoing MAT.

6. Assess Barriers to Accessing MAT to Increase Access to Methadone and Buprenorphine: A number of known barriers prevent MAT from being as widely accessible as it should be. The federal government needs to reevaluate the need for and effectiveness of the OTP model and make necessary modifications to ensure improved and increased access to methadone. And, while federal law allows physicians to become eligible to prescribe buprenorphine for the treatment of opioid dependence, it arbitrarily caps the number of opioid patients a physician can treat with buprenorphine at any one time to 30 through the first year following certification, expandable to up to potentially 200 patients thereafter. Moreover, states need to evaluate additional barriers created by state law, including, among others, training and continuing education requirements, restrictions on nurse practitioners, insurance enrollment and reimbursement, and lack of provider incentives.

7. Establish and Implement a Heroin-Assisted Treatment Pilot Program: Heroin-assisted treatment (HAT) refers to the administering or dispensing of pharmaceutical-grade heroin to a small and previously unresponsive group of chronic heroin users under the supervision of a doctor in a specialized clinic. The heroin is required to be consumed on-site, under the watchful eye of trained professionals. This enables providers to ensure that the drug is not diverted, and allows staff to intervene in the event of overdose or other adverse reaction. Permanent HAT programs have been established in the United Kingdom, Switzerland, the Netherlands, Germany and Denmark, with additional trial programs having been completed or currently taking place in Spain, Belgium and Canada. Findings from randomized controlled studies in these countries have yielded unanimously positive results, including: 1) HAT reduces drug use; 2) retention rates in HAT surpass those of conventional treatment; 3) HAT can be a stepping stone to other treatments and even abstinence; 4) HAT improves health, social functioning, and quality of life; 5) HAT does not pose nuisance or other neighborhood concerns; 6) HAT reduces crime; 7) HAT can reduce the black market for heroin; and, 8) HAT is cost-effective (cost-savings from the benefits attributable to the program far outweigh the cost of program operation over the long-run). States should consider permitting the establishment and implementation of a HAT pilot program. Nevada and Maryland have introduced legislation of this nature and the New Mexico Legislature recently convened a joint committee hearing to query experts about this strategy.

8. Evaluate the Use of Cannabis to Decrease Reliance on Prescription Opioids and Reduce Opioid Overdose Deaths: Medical use of marijuana can be an effective adjunct to or substitute for opioids in the treatment of chronic pain. Research published last year found 80 percent of medical cannabis users reported substituting cannabis for prescribed medications, particularly among patients with pain-related conditions. Another important recent study reported that cannabis treatment "may allow for opioid treatment at lower doses with fewer [patient] side effects." The result of substituting marijuana, a drug with less side effects and potential for abuse, has had profound harm reduction impacts. The Journal of the American Medical Association, for instance, documents a relationship between medical marijuana laws and a significant reduction in opioid overdose fatalities: "[s]tates with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws."Another working paper from the RAND BING Center for Health Economics notes that "states permitting medical cannabis dispensaries experienced a 15 to 35 percent decrease in substance abuse admissions and opiate overdose deaths." There is also some emerging evidence that marijuana has the potential to treat opioid addiction, but additional research is needed.

Harm Reduction

9. Establish and Implement Safe Drug Consumption Services: States and/or municipalities should permit the establishment and implementation of safe drug consumption services through local health departments and/or community-based organizations. California and Maryland have introduced legislation to establish safe drug consumption services, and the City of Ithaca, New York has included a proposal for a supervised injection site in their widely-publicized municipal drug strategy. In Washington State, the King County Heroin an Prescription Opiate Addiction Task Force has recommended the establishment of at least two pilot supervised consumption sites as part of a community health engagement program designed to reduce stigma and "decrease risks associated with substance use disorder and promote improved health outcomes" in the region that includes the cities of Seattle, Renton and Auburn.

10. Maximize Naloxone Access Points, Including Lay Distribution and Pharmacy Access, As Well As Immunities for Prescription, Distribution and Administration:Naloxone should be available directly from a physician to either a patient or to a family member, friend, or other person in a position to assist in an overdose, from community-based organizations through lay distribution or standing order laws, and from pharmacies behind-the-counter without a prescription through standing order, collaborative agreement, or standardized protocol laws or regulations. Though some states, including California, New York, Colorado and Vermont, among others, have access to naloxone at each of these critical intervention points, many others only provide naloxone through a standard prescription. Civil and criminal immunities should be provided to prescribers, dispensers and lay administrators at every access point. In addition, all first responders, firefighters and law enforcement should be trained on how to recognize an overdose and be permitted to carry and use naloxone. Naloxone should also be reclassified as an over-the-counter (OTC) medication. Having naloxone available over-the-counter would greatly increase the ability of parents, caregivers, and other bystanders to intervene and provide first aid to a person experiencing an opioid overdose. FDA approval of OTC naloxone is predicated on research that satisfies efficacy and safety data requirements. Pharmaceutical companies, however, have not sought to develop an over-the-counter product.88 Federal funding may be needed to meet FDA approval requirements.

11. Provide Dedicated Funding for Community-Based Naloxone Distribution and Overdose Prevention and Response Education: Few states provide dedicated budget lines to support the cost of naloxone or staffing for community-based opioid overdose prevention programs. The CDC, however, reports that, between 1996 and 2014, these programs trained and equipped more than 152,280 laypeople with naloxone, who have successfully reversed 26,463 opioid overdoses.89 Without additional and dedicated funding, community-based opioid overdose prevention programs will not be able to continue to provide naloxone to all those who need it, and the likelihood of new programs being implemented is slim. A major barrier to naloxone access is its affordability and chronic shortages in market supply, 90 which overdose prevention programs, operating on shoestring budgets, can have a difficult time navigating.

12. Improve Insurance Coverage for Naloxone: Individuals who use heroin and other opioids are often both uninsured and marginalized by the healthcare system.91 States should insure optimal reimbursement rates for naloxone to increase access to those who need it most – users themselves.

[image:3 align:left caption:true]13. Provide Naloxone to Additional At-Risk Communities: People exiting detox and other treatment programs as well as periods of incarceration are at particularly high risk for overdose because their tolerance has been substantially decreased. After their period of abstinence, if they relapse and use the same amount, the result is often a deadly overdose. States should require overdose education and offer naloxone to people upon discharge from detox and other drug treatment programs and jails/prisons. The Substance Abuse and Mental Health Services Administration has declared that prescribing or dispensing naloxone is an essential complement to both detoxification services as well as medically supervised withdrawal. Vermont passed legislation making naloxone available to eligible pilot project participants who are transitioning from incarceration back to the community. In addition, there are other programs/studies that provide naloxone to recently released individuals on a limited basis, including in San Francisco, California, King County, Washington and Rhode Island.

14. Encourage Distribution of Naloxone to Patients Receiving Opioids: Physicians should be encouraged to prescribe naloxone to their patients and opioid treatment programs should inform their clients about naloxone, if prescribing or dispensing an opioid to them. Pharmacists should similarly be encouraged to offer naloxone along with all Schedule II opioid prescriptions being filled, for syringe purchases (without concurrent injectable medication), and for all co-prescriptions (within 30 days) of a benzodiazepine (such as Valium™, Xanax™ or Klonopin™) and any opioid medication. The Rhode Island Governor's Overdose Prevention and Intervention Task Force found that offering naloxone to those prescribed a Schedule II opioid or when co-prescribed a benzodiazepine and any opioid would have reached 86% of overdose victims who received a prescription from a pharmacy prior to their death, and could have prevented 58% of all overdose deaths from 2014 to 2015.

15. Expand Good Samaritan Protections: "Good Samaritan" laws provide limited immunity from prosecution for specified drug law violations for people who summon help at the scene of an overdose. But, protection from prosecution is not enough to ensure that people are not too frightened to seek medical help. Other consequences, like arrest, parole or probation violations, and immigration consequences, can be equal barriers to calling 911. States with Good Samaritan laws already on the books should evaluate the protections provided and determine whether expansion of those protections would increase the likelihood that people seek medical assistance.

16. End the Criminalization of Syringe Possession: Syringes should be exempt from state paraphernalia laws in order to provide optimal access to people who inject drugs. Twenty-two states criminalize syringe possession. Thus, even if there is a legal access point, such as pharmacy sales, paraphernalia laws still permit law enforcement to arrest and prosecute individuals in possession of a syringe. Public health and law enforcement authorities should not be working at cross-purposes.

17. Reduce Barriers to Over-The-Counter Syringe Sales and Permit Direct Prescriptions of Syringes: While the non-prescription, over-the-counter sale of syringes is now permitted in all but one U.S. state, access is still unduly restricted.States should evaluate the potential barriers to accessing syringes over-thecounter and implement measures to improve access. Moreover, doctors should be permitted to prescribe syringes directly to their patients, a practice few states currently permit.

18. Authorize and Fund Sterile Syringe Access and Exchange Programs; Increase Programs: States should explicitly authorize and fund sterile syringe access and exchange programs, and states that have already authorized them should evaluate how to increase the number or capacity of programs to ensure all state residents – whether in urban centers or rural communities -- have access to clean syringes, as well as evaluate any possible barriers to access such as unnecessary age restrictions.

19. Provide Free Public, Community-Level Access to Drug Checking Services: Technology exists to test heroin and opioid products for adulterants via GC/MS analysis, but it has so far been unavailable at a public level in the US (aside from a mail-in service run by Ecstasydata.org). Making these services available in the context of a community outreach service or academic study would lower the number of deaths and hospitalizations and also allow for real-time tracking of local drug trends.

Prevention

20. Establish Expert Panel on Opioid Prescribing: Though the CDC has issued guidelines for prescribing opioids for chronic pain, the guidelines are voluntary and are likely to exacerbate disparities in treatment that already exist. Research has shown, for example, that African Americans are less likely than whites to receive opioids for pain even when being treated for the same conditions. Moreover, the CDC guidelines only address prescribing practices for chronic pain, not prescribing practices more broadly. States should accordingly establish an expert panel to undertake an assessment as to whether prescribing practices, such as co-prescriptions for benzodiazepines and opioids or overprescribing of opioids, have contributed to increased rates of opioid dependence, and, if so, the expert panel should develop a plan to address any such linkages as well as any treatment disparities. The plan must account for the potential negative effects of curtailing prescribing practices or swiftly reducing prescription opioid prescribing volume. A task force in Rhode Island found that while changes in opioid supply can have the intended effect of reducing availability of abuse-able medications, they have also been linked to an increase in transition to illicit drug use and in more risky drug use behaviors (e.g., snorting and injecting pain medications). The plan must also account for chronic pain patients, particularly those already underserviced, and not unduly limit their access to necessary medications. Finally, to the extent prescribing guidelines are issued as part of the plan, they should be mandatory and applied across the board.

21. Mandate Medical Provider Education: States should mandate that all health professional degree-granting institutions include curricula on opioid dependence, overdose prevention, medication-assisted treatment, and harm reduction interventions, and that continuing education on these topics be readily available.

22. Develop Comprehensive, Evidence-Based Health, Wellness, and Harm Reduction Curriculum for Youth: State education departments, in conjunction with an expert panel consisting of various stakeholders that ascribe to scientific principles of treatment for youth, should develop a comprehensive, evidence-based health, wellness, and harm reduction curriculum for use in schools that incorporates scientific education on drugs, continuum of use, and contributors to problematic drug use (e.g., coping and resiliency, mental health issues, adverse childhood experiences, traumatic events and crisis), as well as how reduce harm (e.g., not mixing opioids with benzodiazepines). Education departments should also establish protocols and resources for early intervention, counseling, linkage to care, harm reduction resources, and other supports for students.

CRIMINAL JUSTICE

23. Establish Diversion Programs, Including Law Enforcement Assisted Diversion (LEAD): LEAD is a pre-booking diversion program that establishes protocols by which police divert people away from the typical criminal justice route of arrest, charge and conviction into a health-based, harm-reduction focused intensive case management process wherein the individual receives support services ranging from housing and healthcare to drug treatment and mental health services. Municipalities should create and implement LEAD programs and states and the federal government should provide dedicated funding for such programs. Various other forms of diversion programs exist and can be implemented should LEAD prove unsuitable to a particular population or municipality.

24. Decriminalize Drug Possession: Decriminalization is commonly defined as the elimination of criminal penalties for drug possession for personal use. In other words, it means that people who merely use or possess small amounts of drugs are no longer arrested, jailed, prosecuted, imprisoned, put on probation or parole, or saddled with a criminal record. Nearly two dozen countries have taken steps toward decriminalization. Empirical evidence from the international experiences demonstrate that decriminalization does not result in increased use or crime, reduces incidences of HIV/AIDs and overdose, increases the number of people in treatment, and reduces social costs of drug misuse. All criminal penalties for possession of small amounts of controlled substances for personal use should be removed.

Categories: Latest News

How Many States Will Legalize Marijuana This Year? [FEATURE]

Tue, 05/30/2017 - 17:43

This article was produced in collaboration with AlterNet and first appeared here.

In the euphoric aftermath of marijuana legalization victories in California, Maine, Massachusetts, and Nevada last November, the marijuana blogosphere was alive with predictions about which states would be next to free the weed. Extract listed 10 states, MerryJane went big with 14 states, the Joint Blog listed five states, Leafly homed in on six states, and Weed News went with seven states. AlterNet got into the act, too, with "The Next 5 States to Legalize Marijuana."

[image:1 align:left]But unlike the first eight states, which all legalized it via the initiative and referendum process, for legalization to win this year, it would have to be via a state legislature. Yet here we are, nearing the halfway point of 2017, and we're not seeing it. And we're unlikely to see it for the rest of this year. The states that had the best shots are seeing their legislative sessions end without bills being passed, and while bills are alive in a couple of states -- Delaware and New Jersey -- they're not likely to pass this year either.

To be fair, we have seen significant progress in state legislatures. More legalization bills have been filed than ever before, and in some states, they are advancing like never before. In Vermont, a bill actually got through the legislature, only to fall victim to the veto pen. But actually getting a legalization bill past both houses of a legislature and a governor has yet to happen.

And while there is rising popular clamor -- buoyed by favorable opinion polls -- for state legislatures to end pot prohibition, the advocacy group most deeply involved in state-level legalization efforts, the Marijuana Policy Project (MPP), understands the difficulties and intricacies of working at the state house. While it has worked hard, it made no promises for victory this year, instead saying it is committed to "ending prohibition in eight more states by 2019."

That MPP list doesn't include initiative states, of which we could see a handful next year. MPP is already involved in Michigan, where legalization is polling above 50%, and first-stage initiative campaigns are already underway in Arizona, Arkansas, Missouri, and the Dakotas. It would be disappointing for reform advocates if they have to wait until November 2018 and the popular vote to win another legalization victory, and given the progress made in state houses this year, they hope they won't have to. Still, legalization at the state house is proving a tough row to hoe.

Drug War Chroniclethought the best prospects were in Connecticut, Maryland, New Mexico, Rhode Island, and Vermont. Here's what's happened so far:

Connecticut. Legalization isn't quite dead yet this year, but it is on life support. A legalization bill died in the General Assembly after getting several hearings this year, but failing to even get a vote in the judiciary and public safety committees. In a last-ditch move, Assembly Democrats this month included marijuana legalization in their budget recommendations as a means of addressing budget problems, but they conceded they don't have enough votes in their caucus to pass it and said they added legalization merely "to spur conversation." The dour figure of Gov. Dannel Malloy (D) and his hints of a veto didn't help.

Maryland. A Senate legalization measure, Senate Bill 927, and its House companion, House Bill 1186, both got committee hearings, but neither could get a vote out of disinterested committee chairs. A bill that would have amended the state constitution to legalize personal possession and cultivation, Senate Bill 891, suffered the same fate. The General Assembly is now adjourned until January 2018.

New Mexico. Hopes for legalization this year in the Land of Enchantment crashed and burned back in February, when a measure to do just that, House Bill 89, died an ignominious death in the House Business and Industry Committee. Four out of five committee Democrats joined all five committee Republicans to bury it on a 9-1 vote. And the legislature killed a decriminalization bill, too, before the session ended. Again, a veto threat-wielding governor in the background, Susana Martinez (R), didn't help.

Rhode Island. Although a full third of House members cosponsored the legalization measure, House Bill 5555, the House Judiciary Committee this month failed to vote on it, instead passing House Bill 5551, which punts on the issue by instead creating a commission to study marijuana legalization and report back in March 2018. That bill now awaits a House floor vote.

Vermont. The Green Mountain State became the first to see a marijuana legalization bill, Senate Bill 22, approved by the legislature, only to see it vetoed last week by Republican Gov. Phil Scott, who cited concerns about drugged driving and youth access. Scott did leave the door open for a modified bill to win his approval this year, but that would require legislators to agree on new language and get it passed during a two-day "veto session" next month, which in turn would require Republican House members to suspend some rules. That's looks unlikely, as does the prospect of a successful veto override. But it's not dead yet.

[image:2 align:right caption:true]For reform advocates, it's a case of the glass half full.

"This is still a historic time," said Justin Strekal, political director for the National Organization for the Reform of Marijuana Laws (NORML). "For the first time, we saw a state legislature pass a bill removing all penalties for the possession and consumption of marijuana by its citizens. We've had great victories in the past 10 years, but they've all been through the initiative process. Now, with the polls continuing to show majorities favoring outright legalization, legislators are feeling more emboldened to represent their constituents, but it won't happen overnight."

"We've seen bigger gains than any other year in history," said MPP Communication Director Mason Tvert. "There's never been a legislature in all our history that passed a law making marijuana legal for adults, and now one did. That's pretty substantial."

But Tvert conceded that legalization via the state house is a course filled with obstacles.

"In Rhode Island, the leadership is still holding it up, although it looks like it will pass a legalization study commission," he said. "In Delaware, a bill passed easily in committee, but it needs two-thirds to pass the House, and that's tough to do in the first year. In Vermont, last year, we had the governor, but not both houses of the legislature; this year we had the legislature, but not the governor," he elaborated.

"That's the nature of representative democracy and the structure of government in the US," Tvert said. "It requires a lot of pieces to fall into place."

"One of the biggest obstacles we face is the demographics of those chair those legislative committees," said NORML's Strekal. "They tend to skew toward older, more prohibitionist age brackets, but as these turn over to a new generation of legislators and elected officials, we should be able to get more of those bills out of committee, like we just saw in Delaware."

Tvert pointed to an example of the committee chair bottleneck in the Lone Star State.

"It's one thing to lose on a floor vote in the House," he said. "It's another thing to have a whip count showing you could win a floor vote, and you can't get a vote. That was the case in Texas with both medical marijuana and decriminalization. They had immense support and couldn't get votes."

[image:3 align:left]Despite the vicissitudes of politics at state capitals, marijuana reformers remain confident that history is on their side.

"This is a situation where times are changing and people are becoming increasingly impatient," said Tvert. "When you have people's lives negatively affected by prohibition and obvious solutions staring you in the face, it's understandable that some people get antsy, but we've seen some pretty significant developments this year, and there will be more to come."

Tvert compared the legalization situation now with medical marijuana a few years back.

"With medical marijuana, we won in five initiative states between 1996 and 2000 before Hawaii became the first legislative medical marijuana state," he noted. "Since then, there've been nine more initiative states and 14 more legislative states. Now, we've seen eight states legalize in through initiatives in 2012 and 2016, Once this gets through one state legislature, the floodgates will open."

NORML's Strekal was taking the long view.

"In the grand scheme of things, this movement is chugging along much faster than other issues have advanced historically," he said. "It's important to keep in mind how far we've come."

But marijuana legalization is still a work in progress, and we've still yet to see that first legislative state fall. Maybe next year.

Categories: Latest News