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All Reason.com articles with the "Drug Policy" tag.



Published: Tue, 21 Nov 2017 00:00:00 -0500

Last Build Date: Tue, 21 Nov 2017 07:53:20 -0500

 



Thomas Massie on Tax Reform, Shikha Dalmia on Deporting Americans

Thu, 16 Nov 2017 08:37:00 -0500

(image) Today, the House of Representatives is expected to pass its long-awaited, short-gestated version of tax reform. Among the many questions associated with the bill is whether it will indeed add $1.7 trillion of new red ink to the national debt over the next decade (as per Congressional Budget Office guesstimates), or whether "dynamic scoring" and supply-side magic will whittle that figure down to insignificance; whether your average family of four will indeed save $1,182 on their next tax bill or whether the elimination of the State and Local Tax (SALT) deduction will hammer tens of millions; and perhaps above all whether the Senate will pay even one bit of attention to the House's exertions (and conversely, whether the House will demand a conference committee if the Senate ever passes its version, or simply fold like it did when the upper chamber passed a 10-year budget resolution with a $1.5 trillion deficit hole).

All of which can mean only one thing: Time to get #SassyWithMassie! Today in the first hour of my 9-12 a.m. ET stint guest-hosting Stand UP! with Pete Dominick on SiriusXM Insight (channel 121), I will have on Kentucky's libertarian Republican congressman, Thomas Massie, to see whether and why he still stands by his recent comments to CNN that "I am going to vote for this. This is a new experience for me to be excited about a bill." Later in the program I'll also have on National Review staffer Kevin Williamson, who initially characterized the GOP plan as "An Anti-Growth Tax Cut."

Also on the program:

* Reason's own Shikha Dalmia, to talk about her marvelous new magazine piece, "How Immigration Crackdowns Screw Up Americans' Lives: The war on immigration has taken a great toll on unauthorized aliens, its targets. But it is also badly affecting Americans themselves, its intended beneficiaries."

* Daniel Miller, founder of the Psychedelic Society of Brooklyn, to talk about the 79th birthday of acid, and why dosing (or micro-dosing) may well be good for you.

* Bethany Mandel of The Federalist, to talk about her New York Times op-ed from yesterday, "Roy Moore Reminds Me of My Rabbi."

As ever, please call in any old time, at 1-877-974-7487.




The Federal Government Is Trying to Ban Kratom (Again)

Tue, 14 Nov 2017 11:28:00 -0500

A year after the Drug Enforcement Administration attempted to ban the plant-based drug kratom, only to back down when users claimed it helped them with opioid withdrawal symptoms, the Food and Drug Administration (FDA) announced on Monday that is has begun blocking the importation of kratom products. "To fulfill our public health obligations, we have identified kratom products on two import alerts and we are working to actively prevent shipments of kratom from entering the U.S.," FDA Commissioner Scott Gottlieb announced in a blog post today. His agency "has detained hundreds of shipments of kratom," Gottlieb adds. "We've used our authority to conduct seizures and to oversee the voluntary destruction of kratom products. We're also working with our federal partners to address the risks posed by these imports." Kratom is native to Southeast Asia and part of the coffee family. It works as a mild stimulant in low doses, and as a sedative in high doses. Users buy it as a nutritional or herbal supplement, and it has some rather well-known adherents in the internet community, including podcaster Joe Rogan and filmmaker Christopher Bell, who used kratom to ween himself off prescription painkillers after an injury. Gottlieb claims that the supplement is dangerous and has no demonstrated medical value: Calls to U.S. poison control centers regarding kratom have increased 10-fold from 2010 to 2015, with hundreds of calls made each year. The FDA is aware of reports of 36 deaths associated with the use of kratom-containing products. There have been reports of kratom being laced with other opioids like hydrocodone. The use of kratom is also associated with serious side effects like seizures, liver damage and withdrawal symptoms. But as Reason's Jacob Sullum reported last year, several hundred reports of adverse reactions to kratom are a miniscule number compared to other drugs: According to the U.S. Centers for Disease Control and Prevention, alcohol causes about 88,000 deaths a year in this country, while 28,000 deaths were attributed to heroin and opioid painkillers in 2014. Kratom looks pretty benign by comparison. Another point to keep in mind: "Deaths associated with kratom" are not necessarily caused by kratom. "Kratom is considered minimally toxic," noted a 2015 literature review in the International Journal of Legal Medicine. "Although death has been attributed to kratom use, there is no solid evidence that kratom was the sole contributor to an individual's death." As further proof of kratom's dangers, the DEA noted that "U.S. poison centers received 660 calls related to kratom exposure" from 2010 through 2015, an average of 110 a year. By comparison, exposures involving analgesics accounted for nearly 300,000 calls in 2014, while antidepressants and antihistamines each accounted for more than 100,000. In his announcement, Gottlieb revealed that the DEA asked the FDA to conduct a medical review of kratom, which is the first step in the traditional process of adding a subtance to the government's "schedule" of restricted drugs. While he encourages "those who believe in the proposed medicinal uses of kratom...to conduct the research that will help us better understand kratom's risk and benefit profile," his postion right now is that "there are currently no FDA-approved therapeutic uses of kratom." Based on Gottlieb's tone, I expect the FDA will work with the DEA to put kratom in Schedule I—the most tightly regulated category of drugs—until researchers provide evidence of its therapeutic utility. A full clinical trial of the drug would likely take a decade to complete and cost tens of millions of dollars. In the meantime, moving the drug to sSchedule I would criminalize its purchase, use, sale, production, and importation. For more on kratom, here's filmmaker Chris Bell talking to Reason.tv about how the plant changed his life: src="https://www.youtube.com/embed/cM4uO_0RAwQ" allowfullscreen="allowfullscreen" width="560" height="340" frameborder="0">[...]



Jeff Sessions Used His Emergency Scheduling Powers Last Week. Here's What That Means.

Mon, 13 Nov 2017 11:55:00 -0500

We're about to see a sea change in how the feds plan to tackle overdose deaths, and it will likely have some very ugly unintended consequences. The Department of Justice (DOJ) announced last week that it has used its emergency scheduling powers to place all fentanyl analogs in schedule I. What does that mean? Glad you asked: What is emergency scheduling? The Controlled Substances Act allows the attorney general "to temporarily place a substance into Schedule I of the Controlled Substances Act for two years" without the consent of any other federal body "if he finds that such action is necessary to avoid an imminent hazard to the public safety." The Justice Department used emergency scheduling to place MDMA in schedule I in the 1980s. Physicians challenged that decision at the time, and lost. Absent emergency scheduling, getting a drug into or out of any scheduling category requires either legislation or a "scientific and medical evaluation" by the Department Health and Human Services. Why is the DOJ using its emergency powers? Under federal law, the Justice Department can prosecute a person for drug trafficking if the drug in question is a controlled substance, or if an unscheduled drug closely resembles a controlled substance and is intended to mimic it. Fentanyl, a highly potent analgesic used in surgeries and for pain management, is in schedule II, which is the legal and regulatory category for drugs with proven medical benefits that are also habit-forming, potentially dangerous, and prone to abuse. But many of fentanyl's analogs—drugs that are chemically different but work in a similar way—are not scheduled. And that makes prosecuting analog cases harder. Consider marijuana. Prosecuting a marijuana case requires proving only that the drug being sold was marijuana. But prosecuting a marijuana analog case, absent that specific compound having already been scheduled, requires proving that the drug in question is either chemically similar to marijuana or produces similar effects, and is intended for human consumption. This is why synthetic marijuana is frequently labeled as potpourri and why synthetic cathinones are marketed as bath salts. In short, prosecuting drug analog cases is a pain in the ass. Prosecutors have two particular reasons to dislike current federal analog laws. One is that chemists make new analogs faster than the feds can ban them. Between 2009 and 2014, the Drug Enforcement Administration (DEA) identified 233 new synthetic drugs in the American market that were designed to mimic the effects of controlled substances. But according to a 2014 presentation delivered by DEA agents at the National Conference on Pharmaceutical and Chemical Diversion, the process of adding analogs to the drug schedule lags far behind the development and importation of new compounds: To get a new compound on the schedule, the DEA has to analyze the compound, describe its chemical structure, and explain how it relates to an already scheduled drug. That's labor-intensive work, and the DOJ doesn't want to do it for every compound it comes across. There are a lot of analogs, and some of them may not be circulating in large enough volumes to justify the work that goes into identifying and then prohibiting them. The second reason prosecutors don't like the current laws is that drugs that haven't gone through scheduling process essentially have to be litigated. Courts have divided over the chemistry arguments made by prosecutors, and even when DOJ prevails, due process is still arduous. "The chemical composition of these drugs is ever evolving, and the current legal framework (both the statutes and the guidelines) is inadequate to ensure that the criminals who sell these deadly poisons face appropriate punishment," the Justice Department complained in a July letter to the United States Sentencing Commission. The current process for determining the sentencing range for analogs "is cumbersome, inefficient, and resource-intensive. It turns sentencing hearings into lengthy chemi[...]



Trump's Weak Response to Opioid Overdoses

Sun, 29 Oct 2017 00:01:00 -0400

You'd think it would be impossible to kill 100 people a day, every day, without inducing widespread shock and deafening demands for action. But that's what opioids have been doing for the past decade, and Americans have given it only passing attention. This year, the toll is expected to rise to 175 a day—64,000 in all. On Thursday, it looked as though President Donald Trump would address the problem with the urgency it demands. But his speech was blighted by his usual oratorical crimes: deep self-infatuation ("I've never had a drink"), bloated adjectives ("tremendous," "horrible"), cheap promises (changes "will come very, very fast"), and swipes at President Barack Obama ("not like in the past"). Trump went through a roster of fraudulent cures, such as building a border wall, demanding that China crack down on shipments of the powerful opioid fentanyl, and "really tough, really big, really great advertising" to discourage drug use. We know from experience that no amount of enforcement can stamp out the demand for or the supply of illicit substances. If fentanyl stopped arriving from China, which isn't likely, it would soon pour in from black-market labs in other countries, including this one. Anti-drug ads are irrelevant to those who develop a dependence on opioids prescribed for severe pain. And people in communities where opioid-laced corpses are piling up don't need to be informed that these drugs are dangerous. The public health offensive Trump declared is mostly a form of yoga: lots of posturing while staying in one place. More innovative remedies will be needed to actually turn back the relentless onslaught of overdose fatalities. Some people around the president are better connected to reality. On Wednesday, the commissioner of the Food and Drug Administration acknowledged to a House committee that the biggest need is a huge expansion of treatment for those dependent on opioids. Scott Gottlieb testified that therapies using methadone or buprenorphine have been proved safe and effective in combating addiction. Massachusetts, for example, found that they cut the risk of death by overdose by 50 percent among people who had survived previous overdoses. But the remedy works only for those who get it. "Unfortunately, far too few people who are addicted to opioids are offered an adequate chance for treatment that uses medications," Gottlieb said. He intends to encourage doctors to offer such remedies for anyone who is treated for an overdose. He hopes to banish the stigma of being on methadone or buprenorphine—and get people to recognize that a patient's medication-assisted treatment may last indefinitely, if not forever. We don't think diabetics should conquer their need for insulin. Why suppose that heroin addicts who are successfully treated with methadone should learn to live without it? The FDA can help by preaching the value of medication-assisted treatment and encouraging health insurance companies to cover it. The commissioner said this task is "part of our existing public health mandate to promote the appropriate use of medicine." Trump offered a couple of useful small ideas, including greater access to telemedicine services—so that people in remote areas can get medications needed for drug treatment or mental illness—and letting states use HIV/AIDS funds for treatment. But the humane, evidence-based solutions generally got short shrift. He would have done better to embrace the proposals of his Commission on Combating Drug Addiction and the Opioid Crisis, whose preliminary report stressed the need to "rapidly increase treatment capacity." Right now, it lamented, only 10 percent of drug treatment facilities offer medication-assisted treatment for opioid dependence. The commission, chaired by New Jersey Gov. Chris Christie, recommended making it easier for states to use federal Medicaid funds for treatment. It urged the federal government to expand access to methadone and other drug therapies through Medicare, the Department [...]



FDA Commissioner Scott Gottlieb Goes to Bat For Evidence-Based Opioid Policies

Fri, 27 Oct 2017 16:05:00 -0400

Food and Drug Administration Commissioner Scott Gottlieb is now the highest-ranking member of the Trump administration to say in plain language that America can't address the opioid crisis by relying on outdated prevention campaigns or forcing dependent and addicted users to quit cold turkey. "[G]iven the scale of the epidemic, with millions of Americans already affected, prevention is not enough," Gottlieb said in a statement to the House Committee on Energy and Commerce this week. He also pledged his agency would do everything in its power to "break the stigma associated with medications used for addiction treatment." A physician and former resident fellow at the American Enterprise Institute, Gottlieb's testimony provided a dramatic and welcome contrast to the blunt and shallow statements of other Trump administration officials. Whereas former Health and Human Services Secretary Tom Price said that methadone and buprenorphine therapy—which can reduce opioid-related mortality by 50 percent—amount to "just substituting one opioid for another," Gottlieb acknowledged this week that some people with opioid use disorders will need "a lifetime of treatment." His agency, he added, is "revising the labels of these medical products to reflect this fact." He has also instructed Food and Drug Administration staff to develop more extensive guidelines for "non-abstinence-based" products that "address a fuller range of the symptoms of addiction such as craving." Lastly, Gottlieb delivered a rousing rebuttal to the idea that addiction and dependence are no different: Because of the biology of the human body, everyone who uses opioids for any length of time develops a physical dependence—meaning there are withdrawal symptoms after the use stops. Even a cancer patient requiring long-term treatment for the adequate treatment of metastatic pain develops a physical dependence to the opioid medication. That's very different than being addicted. Addiction requires the continued use of opioids despite harmful consequences. Addiction involves a psychological craving above and beyond a physical dependence. Someone who neglects his family, has trouble holding a job, or commits crimes to obtain opioids has an addiction. But someone who is physically dependent on opioids as a result of the treatment of pain but who is not craving more or harming themselves or others is not addicted. The same principle applies to medications used to treat opioid addiction. Someone who requires long-term treatment for opioid addiction with medications—including those that cause a physical dependence—is not addicted to those medications. Here's the bottom line: We should not consider people who hold jobs, re-engage with their families, and regain control over their lives through treatment that uses medications to be addicted. Rather, we should consider them to be role models in the fight against the opioid epidemic. Others have drawn this distinction before, so I hesitate to applaud Gottlieb for acknowledging what his peers have said for years. But this is Washington, a place where drug policy experts are often drowned out by quacks, drug cops, and prosecutors. Gottlieb is not the most progressive reformer in this debate—he may end up calling for the removal of still more opioids from the market, which will hurt legitimate pain patients and likely drive non-medical users to the black market—but his perspective on using opioid therapy to treat opioid addiction puts him head and shoulders above the D.C. status quo.[...]



Massachusetts Mulls Whether to Classify Drug Dealers as Murderers

Fri, 27 Oct 2017 14:20:00 -0400

(image) Massachusetts state senators approved a massive criminal justice reform bill last night that would eliminate many drug-related mandatory minimum sentences (including those arbitrarily connected to "school zones"), restrict the use of solitary confinement, decriminalize sex between minors of similar ages, and set the age the criminal justice system considers you an adult at 19.

Unfortunately, it will also introduce a terrible new tool to the drug war.

To satisfy the urges of the state's Republican governor, Charlie Baker, the reform bill (S.2185) was amended yesterday to charge anybody who deals drugs with second-degree murder if someone they sold drugs to dies of an overdose.

Here's the amendment:

Any person while in the course of trafficking or unlawfully distributing a controlled substance as defined in Section 32E who knowingly or intentionally manufactures, distributes, dispenses, delivers, gives away, barters, administers or provides any amount of a controlled substance or counterfeit substance which results in death shall be punished as murder in the second degree as defined by section 1 of chapter 265. (b) Lack of knowledge of any previous health conditions shall not be a defense to any person who violates the provisions of this section.

According to WBUR, this amendment has itself been amended in order to make it clear that the law is intended to go after dealers, not people who share drugs. If that's the actual intent, Massachusetts Senate Minority Leader Bruce Tarr may have underestimated the creativity of prosecutors by including the words "barters," "administers," and "provides."

Just look at Florida to see how this legislation goes astray. The state has had a law on the books that allows prosecutors to charge drug dealers with first-degree murder when somebody dies of an overdose. The law's application has absolutely not been limited to trying to lock away drug dealers. A woman was recently charged with murder when her friend died of a drug overdose. The woman had taken money from her friend and introduced her to the dealer, but she was not a drug dealer herself.

It's a frustrating and chronic problem. Even as they recognize that heavy mandatory minimum sentences have not been successful in stopping drug use, politicians—and, honestly, a significant part of the population—cannot set aside the idea that this crisis can be stopped by harshly punishing the right people.




Jeff Sessions Says MS-13 Is a Major Player in the Narcotics Trade. The DEA Disagrees.

Wed, 25 Oct 2017 17:25:00 -0400

Attorney General Jeff Sessions announced Monday that a gang called La Mara Salvatrucha, or MS-13, will now be "a priority" for the Justice Department's Organized Crime Drug Enforcement Task Forces. These inter-agency task forces "all have one mission," Sessions said this week at a gathering of the International Association of Chiefs of Police this week. "To go after drug criminals and traffickers at the highest levels." Historically, MS-13 has not trafficked drugs at the "highest levels." Founded in the 1980s by El Salvadoran immigrants in Los Angeles, the group's original purpose was to protect other El Salvadoran refugees of the country's 1980s civil war (in which the U.S. played an ugly role) from Southern California street gangs. It has since evolved into a more sinister and violent organization. But according to the Drug Enforcement Administration and other groups, MS-13 is still a small fry in the drug trafficking business. In a post pushing back against Sessions' remarks, Sarah Kinosian of the human rights group Washington Office on Latin America writes that MS-13 focuses mostly on extortion, street-level drug sales, and inter-gang violence in El Salvador and in the U.S. Federal indictments of MS-13 members reflect that claim. The State Department's 2017 International Narcotics Control Strategy report, released in March of this year, says that "[c]riminal street gangs such as Mara Salvatrucha (MS-13) and 18th Street [another El Salvadoran gang with an American presence, and the sworn enemies of MS-13] do not yet appear to be a formal part of the transnational drug logistics chain, except as facilitators of trafficking through Honduras." The DEA, meanwhile, says in its 2017 Threat Assessment—which the agency released on the same day that Sessions announced MS-13 was now drug enemy number one—that Mexico's Transnational Criminal Organizations (TCOs) "remain the greatest criminal drug threat to the United States; no other group is currently positioned to challenge them." (If that sounds familiar, recall that a DEA spokesperson said this to the Post in August: "Mexican cartels, Mexican transnational organizations are the greatest criminal threat to the United States. There's no other group currently positioned to challenge them. Whenever drug investigations that we do involve MS-13, we respond, but right now the No. 1 drug threat in the U.S. is the Mexican cartels.'') MS-13 not harmless, in other words, but they also aren't driving the heroin and fentanyl crises. We've known for several months now that the DEA and Sessions are at odds about which transnational drug groups to prioritize. In August, the Washington Post reported that acting DEA Administrator Chuck Rosenberg and Sessions went head to head over the focus on MS-13 "despite warnings from Rosenberg and others at the DEA that the gang, which draws Central American teenagers for most of its recruits, is not one of the biggest players when it comes to distributing and selling narcotics." (Though Rosenberg left the DEA earlier this month, he wrote the 2017 Threat Assessment introduction.) Why does any of this matter? Because Mexican CTOs are somehow stronger now than ever before. After two decades of splitting the U.S. heroin market with Colombia—Mexico used trucks to get black tar heroin to the west coast, Colombia used planes and boats to get white powder heroin to the eastern seaboard—the DEA says Mexico is now the dominant supplier to the eastern U.S.: Mexico also sends us a substantial amount of fentanyl, which it obtains from China. It also matters because more than 80,000 people have died in Mexico since 2006, when then-newly elected Mexico President Felipe Calderon kicked off a U.S.-funded offensive against his country's drug lords. In the decade since then, the U.S. has spent tens of billions of dollars on the Merida Initiative while also doubling the number of U.S. Customs and Border[...]



Why Are Local Officials Shutting Down Needle Exchange Programs During a Crisis?

Mon, 23 Oct 2017 13:20:00 -0400

Back when he was governor of Indiana, Mike Pence, after much praying and pressure, relented and signed legislation that permitted counties to establish needle exchange programs if they could show they were having an HIV or hepatitis C epidemic. Rural Indiana was indeed having such an epidemic at the time, and even the sheriff of Scott County, where the number of new HIV cases had seen a dramatic increase, determined that a needle exchange program was needed. He told Pence as much. After the needle exchange program began, Scott County saw a notable drop in new HIV cases. It has been a small but important success as America figures out how to deal with an increase in heroin use. But those efforts are potentially at risk now. Two counties in Indiana have shut down their relatively new needle exchange programs, expert advice and actual outcomes be damned. Lawrence County, Indiana, saw its Hepatitis C infection rate more than double in the early part of the decade, thanks to intravenous drug use; it's tough to determine trends on the basis of just two years of data, but numbers from the state indicate that there will be fewer infections in 2017 than in 2016. But the county council voted last week not to continue the program. One council member, Rodney Fish, told NBC that he voted against it for "moral reasons": I did not approach this decision lightly. I gave it a great deal of thought and prayer. My conclusion was that I could not support this program and be true to my principles and my beliefs. He claims that he spoke to several health professionals before his vote, and he said he would possibly support a hospital-based program. In August, the council for Madison County, in northern Indiana, also voted to end its needle exchange program over the objections of local health officials. In both counties, opponents of the program argued that operationally it was less about needle "exchange" than needle "distribution." Critics were concerned that they were facilitating drug abuse rather than decreasing the health risks of drug abuse. Indiana's not the only place where local leaders are turning their backs on a needle-exchange-based solution to reduce the spread of HIV and Hepatitis C. In Camden, New Jersey, bureaucratic maneuvers appear to have shut down a needle exchange van that was serving hundreds of drug-users a week. Journalist April Saul reports that property development in Camden forced the van off a vacant lot last year. The program organizers worked with the city to come up with a new location, and in April they identified one. But the mayor of Camden has not signed off on the new agreement, so the program has had to return tens of thousands of dollars in state funding and lay off an employee. So to summarize the state of affairs: Government officials at various levels (including the Department of Justice) want to make it harder for doctors to prescribe opioids as a long-term pain-fighting solution. The result is that people are turning to heroin on the black market. This heroin is often adulterated with other drugs like fentanyl and opioids, causing an increased risk of overdoses and an increased risk of transmitting HIV and Hepatitis C. And government officials are standing in the way of medical solutions to those problems because of moral judgment about people with addictions and a public distaste for funding a solution that makes it seem like we're subsidizing self-harm. If government officials don't like handing out needles to heroin users, they could let nonprofits take the whole thing over, including the funding. Or maybe they could think a little more carefully about how they approach opioid addiction in the first place.[...]



Former NFL Players Say League Should Allow Players to Use Marijuana to Treat Pain, Injuries

Sun, 22 Oct 2017 12:30:00 -0400

Medical marijuana has been legalized in 29 states, but it remains illegal for professional football players to use as a treatment for injuries and chronic pain. That doesn't mean players in the National Football League aren't using the drug. Quite the opposite. Eben Britton, who retired in 2014 after seven years in the NFL and who has admitted to playing games while high on marijuana and painkillers, estimates that more than half of the players in NFL locker rooms are using marijuana recreationally, or to treat injuries and control pain. During a discussion hosted by Herb.co, a marijuana culture website, Britton talked about his experience using marijuana versus using opioids and other pain-killers. "I would take these pills and I would feel insane," Britton says. The opioids made him feel "more depressed, more helpless, more pissed off." Britton's assessment of widespread marijuana use in the NFL is supported by other players' experience. In a survey conducted earlier this year by BudTrader.com, an online medical marijuana marketplace, 68 percent of the current and former players polled said they had used marijuana (either for recreational or medical purposes) during their career, while 87 percent said they would use it if the league allowed it (and 89 percent said they believed it would be an effective treatment for pain and other ailments). That tracks pretty closely with how the rest of the country feels about medical marijuana. A Quinnipiac University Poll conducted in February found support for medical marijuana at 93 percent nationwide, with large majorities cutting across all demographics. According to Gallup's latest polling, support for legalizing recreational marijuana is at 60 percent, the highest percentage recorded in the polling firm's 47 years of tracking that question. As Steve Chapman wrote earlier today here at Reason, legal marijuana is becoming the norm. The NFL has never allowed players to use marijuana for any reason—though league officials and the head of the NFL's players' union have begun discussing the possibility of allowing players to use the drug for medical purposes. But there is a well-documented history of teams handing out pharmaceutical pain-killers by the handful. Several former players are suing the NFL, alleging that official team doctors ignored federal laws for prescription drugs and disregarding medical guidance by handing out piles of opioids and other painkillers before, during, and after games. "I've seen plenty of guys leave the game addicted to pain pills. I've never seen anyone leave the game addicted to marijuana," says Marvin Washington, who played 11 seasons in the league and participated in the Herb.co discussion. src="https://www.youtube.com/embed/zMFEpkoZo-o" allowfullscreen="allowfullscreen" width="560" height="315" frameborder="0"> The NFL's position on marijuana could soon change. Jerry Jones, the Dallas Cowboys' owner and possibly the most powerful billionaire in the NFL's inner circle of powerful billionaires, has floated the idea of loosening the NFL's ban on marijuana. And Allen Sills, the league's new chief medical officer, is interested in researching how marijuana could be used to help players manage their pain. "Certainly the research about marijuana and really more particularly cannabinoid compounds as they may relate to the treatment of both acute and chronic pain, that is an area of research that we need a lot more information on and we need to further develop," Sills, a Vanderbilt University neurosurgeon, said in an interview with The Washington Post. Despite overwhelming public support, and evidence the NFL's ban is no preventative, NFL Commissioner Roger Goodell has remained unmoved. Goodell suspended Buffalo Bills offensive tackle Seantrel Henderson last year for using medical marijuana to treat Crohn's disease, even though Henderson[...]



Legal Marijuana Is Becoming the Norm

Sun, 22 Oct 2017 00:00:00 -0400

The war on drugs has been going on since 1971, and we have a winner: marijuana. Back then, possession of pot carried heavy penalties in many states—even life imprisonment. Today, 29 states sanction medical use of cannabis, and eight allow recreational use. Legal weed has become about as controversial as Powerball. One sign of the shift came in Wednesday's debate among the Democrats running for governor of Illinois. The state didn't get its first medical marijuana dispensary until 2015, and it decriminalized possession of small amounts of pot only last year. But most of the candidates endorsed legalization of recreational weed, and one supported "full decriminalization." Those positions are not politically risky, in Illinois or in most places. They're mainstream. In 2016, Gallup Poll found that 60 percent of Americans supported full legalization—up from 36 percent in 2005. Given the choice, voters generally favor it. Nine states had cannabis initiatives on the ballot last year. Medical marijuana won in four states, and recreational pot won in another four. Only Arizona's recreational pot measure failed. Next year should further erode pot prohibition. "Campaigns are underway in at least five states to legalize either medical or recreational cannabis," reports Marijuana Business Daily. It also notes that New Jersey, Rhode Island and Vermont could get recreational cannabis through legislative action. All this progress has occurred even though federal law bars possession and use—impeding normal commerce in states that permit dispensaries. Under President Barack Obama, the Justice Department chose to defer to states that allowed cannabis. But banks generally are leery of doing business with pot dispensaries, forcing many to operate on cash alone. As a candidate, Donald Trump indicated he would follow more or less the same course as Obama. Attorney General Jeff Sessions, however, has been an implacable opponent of liberalization. He once joked—well, I assume he was joking—that he had no problem with the Ku Klux Klan until he "found out they smoked pot." He appointed a task force on crime, hoping it would confirm his preposterous claim that Obama's laissez-faire policy was to blame for rising violence. But the panel report, which has not been made public, recommended sticking with that approach. The case for full legalization becomes stronger all the time. One reason is that the disproportionate impact on African-Americans has gained more attention. Blacks are nearly four times likelier to be arrested for pot possession than whites even though there is no racial difference in usage. Drug enforcement has been a major motive for stop-and-frisk tactics that have fostered resentment of cops among black men. Treating cannabis like beer or cigarettes would greatly curtail such encounters. For years, opponents said legalization would lead to disaster. But as Supreme Court Justice Oliver Wendell Holmes Jr. noted, "A page of history is worth a volume of logic." We no longer have to rely on ominous forecasts. We now have actual experience in states that have taken the leap, and the results refute the fears. Studies show that after Colorado permitted recreational pot, there was no increase in adolescent use or traffic fatalities. In Washington, which voted for legalization in 2012, crime rates proceeded to decline. California found that when medical dispensaries closed, neighborhood crime didn't fall; it rose. This year, the National Academies of Sciences, Engineering and Medicine found "substantial evidence that cannabis is an effective treatment for chronic pain in adults." That helps explains why states that allow cannabis have far lower rates of opioid overdoses. The simple reality is that marijuana eases suffering and saves lives. States with fiscal problems—Illinois being a promin[...]



Florida Woman Introduced a Friend to Her Dealer. Now She Faces Murder Charges.

Wed, 18 Oct 2017 15:00:00 -0400

(image) A Central Florida woman has been charged with first-degree murder in the fentanyl-related overdose death of a friend simply for helping the friend connect with a drug dealer.

Florida's drug war is particularly vicious. Prosecutors there can charge people who provide drugs with murder if their customers die from drug overdoses. Earlier this year, the state added fentanyl and other opioids to the list of drugs that can trigger murder charges (and some new mandatory minimum sentences as well).

But Jamie Nelson, 34, was not the dealer who provided the fentanyl and heroin that killed Tracy Skornika in June. According to police, Skornika gave Nelson $50 to help her to find a heroin connection. Nelson took her to a dealer she apparently knew. Skornika overdosed and was found on her bathroom floor. She was pronounced dead three hours later at a hospital.

There's nothing is this story that even suggests that Nelson wanted her friend dead. The Orlando Sentinel report on the case notes that Nelson cried when she found out Skornika had died.

It's an absurd upending of justice to think someone should be indicted for first-degree murder without intending to kill anybody. But Florida's drug war is so focused on punishment that prosecutors and lawmakers don't even care about intent. Nelson could face the death penalty if she's convicted.

This story needs attention, because these laws are sold as mechanisms to punish sinister drug dealers. But that's obviously not what's happening here, and this isn't an anomaly. A Reason investigation by C.J. Ciaramella and Lauren Krisai showed that Florida's prisons are full of people like Nelson: fellow addicts, not high-level drug dealers. Read what their data show here.




Feds Admit Their Prosecution of Medical Marijuana Users in Washington Was Illegal

Wed, 18 Oct 2017 14:05:00 -0400

Since 2012 federal prosecutors have been trying to imprison three medical marijuana users in Washington, arguing that they grew cannabis for profit rather than relief of their symptoms. In a startling shift this week, the U.S. Attorney's Office in Spokane finally conceded what the defendants—Rhonda Firestack-Harvey; her son, Rolland Gregg; and his wife, Michelle Gregg—have been saying all along: that they grew marijuana in compliance with Washington's law allowing medical use of the plant. The government also admitted in a brief filed on Monday night that its pursuit of the case has therefore been illegal since December 2014, when Congress first passed a spending rider that prohibits the Justice Department from prosecuting people for conduct permitted by state medical marijuana laws. "This filing is a victory for the family and lawful medical marijuana users all across the country," says Phil Telfeyan, the defendants' attorney. "Our government should not use federal money to prosecute people abiding by state laws. This filing will have far-reaching effects that should help end the federal prosecution of marijuana users in states where it's legal." The Greggs and Firestack-Harvey, who received sentences ranging from one year to 33 months in October 2015, are the remaining defendants in what was dubbed the Kettle Falls Five case. The other two defendants were Jason Zucker, a family friend who pleaded guilty in exchange for a 16-month sentence just before the trial started in February 2015, and Firestack-Harvey's husband, Larry Harvey, who died of pancreatic cancer in August 2015. The Justice Department is now admitting that whole ordeal was illegal, because "the United States was not authorized to spend money on the prosecution of the defendants after December of 2014." The Greggs and Firestack-Harvey plan to seek dismissal of the case on that basis. Beginning in 2012, federal prosectors argued that the Kettle Falls Five, whose combined plant total was less than the limit set by Washington's medical marijuana law, were growing too much cannabis for their own use and must have been selling it. But there was never much evidence to support that theory, and the weakness of the government's case was reflected in the March 2015 verdict. The jury convicted the Greggs and Firestack-Harvey of growing marijuana but acquitted them of distribution and a related conspiracy charge. It also rejected the government's attempt to count plants grown in previous years, which would have triggered a five-year mandatory minimum sentence, and the allegation that the defendants possessed firearms "in furtherance of" a drug trafficking crime, a charge that carries an additional five-year mandatory minimum. The jury was not allowed to hear testimony about the medical use of marijuana, which the prosecution argued was irrelevant under federal law. But that was not actually true, since Congress had by the time of the trial barred the Justice Department from interfering with the implementation of state medical marijuana laws. In 2016 the U.S. Court of Appeals for the 9th Circuit, which includes Washington, ruled that the restriction made it illegal to prosecute people for actions that comply with such laws. Last June the 9th Circuit made it clear that the Justice Department was also barred from continuing to pursue cases initiated prior to the ban on interference. Before the Kettle Falls Five trial, Telfeyan argued that the case should be dismissed in light of the spending rider. U.S. District Judge Thomas Rice disagreed, noting that the prosecution was arguing that the defendants had not complied with state law. What has changed since then is not just the 9th Circuit's rulings, which prosecutors cited in this week's brief, but the government's abandonm[...]



The Justice Department Is Now Going After Chinese Fentanyl Manufacturers

Tue, 17 Oct 2017 17:30:00 -0400

The Drug Enforcement Administration announced today that U.S. Attorneys in North Dakota and Mississippi have, for the first time ever, indicted two Chinese nationals for illegally exporting fentanyl and other research chemicals to the U.S. Unsealed yesterday, the DOJ's indictments accuse Xiaobing Yan and Jian Zhang of running two separate international conspiracies intended to circumvent federal bans on various schedule I drugs and their analogs. In addition to Yan and Zhang, the DOJ indicted several American citizens and two Canadian prisoners who participated in the conspiracy from behind bars. Here's the relevant information from the unsealed Zhang indictment: Two suspects, Jason Berry and Daniel Ceron, worked with Zhang to arrange shipments from China to the U.S. while they were incarcerated in a medium security prison facility in Drummondville, Quebec. (Prisoners running things from the inside is not new, but participating in a global drug trafficking operation seems pretty novel to me.) Zhang allegedly began exporting fentanyl and fentanyl analogs to the U.S. in 2013, and the DOJ says he was able to send thousands of shipments during a three-year period. Drugs shipped by Zhang allegedly ended up in "North Dakota, Oregon, Florida, Georgia, North Carolina, New Jersey, California, South Carolina, Ohio, and elsewhere." From the DOJ press release: "Zhang ran an organization that manufactured fentanyl in at least four known labs in China and advertised and sold fentanyl to U.S. customers over the Internet. Zhang's organization would send orders of fentanyl or other illicit drugs, or pill presses, stamps, or dies used to shape fentanyl into pills, to customers in the United States through the mail or international parcel delivery services." (For more than a year now, American journalists have been pointing to Chinese websites that sold fentanyl to the U.S. with horrified shock. Looks like DOJ wasn't blind, just investigating quietly.) Yan's case is even more interesting, as the DOJ alleges he shipped not just fentanyl, but a spectrum of synthetic drugs that are analogous to substances banned in the U.S.: In addition to fentanyl and fentanyl analogs, Yan's chemical manufacturing company is accused of shipping "research chemicals" such as synthetic cannabinoids (which mimic marijuana), cathinones (which mimic amphetamines), and synthetic empathogens (which mimic MDMA) to the U.S. None of the non-fentanyl synthetics Yan allegedly shipped have received nearly as much human testing as the drugs they're based on. Some of them are probably carcinogenic. As with fentanyl, the market for these research chemicals is entirely dependent on the prohibition of drugs that have existed for decades longer and are demonstrably safer. Yan started shipping to the U.S. in 2010, which is the same year pharmaceutical companies rolled out their tamper-proof opioid formulations. I don't know if the two events are related, but the process by which international actors recognize and exploit opportunities in the American drug market is hugely under-researched. From the press release: "Yan monitored legislation and law enforcement activities in the United States and China, modifying the chemical structure of the fentanyl analogues he produced to evade prosecution in the United States." Also from the press release: "Over the course of the investigation, federal agents identified more than 100 distributors of synthetic opioids involved with Yan's manufacturing and distribution networks. " I doubt this stops illicit fentanyl exports to the U.S., though it's likely to put pressure on the Chinese government, which is either incapable or uninterested in regulating its own chemical manufacturing industry.[...]



The Simpleminded Opioid Narrative That Doomed Tom Marino

Tue, 17 Oct 2017 16:40:00 -0400

Today Tom Marino, the Pennsylvania congressman whom Donald Trump nominated to head the Office of National Drug Control Policy, withdrew his name because of a bill he was publicly bragging about just a year and a half ago. That bill, the Ensuring Patient Access and Effective Drug Enforcement Act of 2016, was uncontroversial when it was enacted. Not a single member of Congress opposed it. Neither did the Justice Department, the Drug Enforcement Administration (DEA), or President Obama, who signed it into law on April 19, 2016. Yet Marino's sponsorship of the bill killed his nomination because of the way the law was framed in reports by 60 Minutes and The Washington Post. According to those reports, which were the product of a joint investigation, Marino was doing the bidding of the pharmaceutical industry, and everyone else involved in enacting his bill was either bought off, duped, or steamrollered. But that portrayal is persuasive only if you follow the lead of 60 Minutes and the Post by uncritically adopting the perspective of a hardline DEA faction that was unhappy with the bill. "In April 2016, at the height of the deadliest drug epidemic in U.S. history, Congress effectively stripped the Drug Enforcement Administration of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation's streets," the Post reports. "In the midst of the worst drug epidemic in American history," says 60 Minutes, "the U.S. Drug Enforcement Administration's ability to keep addictive opioids off U.S. streets was derailed." The provision highlighted by both reports limited the DEA's power to immediately suspend the registrations of manufacturers, distributors, pharmacists, and doctors based on an "imminent danger to the public health or safety." Marino's bill defined that phrase to mean "a substantial likelihood of an immediate threat that death, serious bodily harm, or abuse of a controlled substance will occur in the absence of an immediate suspension of the registration." It thereby constrained the DEA's ability to summarily stop people from prescribing or supplying controlled substances, requiring some evidence of a genuine emergency. To my mind, any limit on the DEA's power is welcome. The DEA, not surprisingly, tends to take a different view. But the DEA's leadership, which at the time was trying to promote a less antagonistic relationship with the pharmaceutical industry, signed off on the new language, as did the Justice Department. Legislators read the DEA's approval to mean there were no law enforcement objections to the bill, which explains why it passed Congress with no resistance. Even ardent prohibitionists thought the clarification of the "imminent danger" standard was fair and reasonable. "We worked collaboratively with DEA and DOJ...and they contributed significantly to the language of the bill," a spokesman for Sen. Orrin Hatch (R-Utah) told the Post. "DEA had plenty of opportunities to stop the bill, and they did not do so." A spokesman for Sen. Sheldon Whitehouse (D-R.I.) likewise said the DEA never expressed any reservations, adding, "The fact that it passed the entire Senate without hearing any sort of communication that would have triggered concern of at least one senator doesn't really pass the smell test." By contrast, the disgruntled drug warriors who were the main sources for the Post and 60 Minutes stories—most conspicuously, Joe Rannazzisi, who used to run the DEA's Office of Diversion Control—see the bill as a shameful surrender to the evil pharmaceutical companies that profit from opioid addiction. That is the view that the Post and 60 Minutes adopted, almost without qualification. The reports give short shrif[...]



The Pros and Cons of a Heroin Shortage

Fri, 13 Oct 2017 16:15:00 -0400

"Interdiction is critically important to increase the cost and reduce accessibility of opioids," write former Centers for Disease Control chief Thomas R. Frieden and Brandeis University's Andrew Kolodny in a new paper for the Journal of the American Medical Association. "As with tobacco and alcohol, if heroin and illicitly produced synthetic opioids such as fentanyl are more expensive and more difficult to obtain, use should decrease." But we don't need to extrapolate from alcohol and tobacco policies to figure out what a heroin shortage would do to consumption. The United Kingdom and Australia both experienced heroin droughts in the last decade and a half. It would be wise to look at what happened in those countries before ramping up interdiction efforts in the U.S. How Heroin Users in the U.K. Responded to the 2010–2011 Heroin Shortage From October 2010 to January 2011, heroin purity dropped and prices increased across most of Europe, due to a constellation of factors that ranged from fungal infections in Afghanistan's poppy fields to interdiction efforts in Europe. As a result of the reduced supply, heroin prices in the U.K. more than doubled, from £17,000 per kilogram in early 2010 to £40,000 per kilo a year later. At the street level, heroin purity plummeted from around 35 percent pre-drought to 13 percent at the end of the shortage. Basically, wholesale heroin buyers were diluting their product with cutting agents—some of them inert, some of them toxic—in an attempt to maintain their profit margins. What happened to users? Mandatory drug testing revealed a large drop in positive heroin tests, from 45 percent before the drought to 21 percent in January 2011. While less heroin meant less heroin use, it didn't mean less risky drug consumption. According to surveys conducted by researchers at the London School of Hygiene and Tropical Medicine, many users continued to inject drugs sold as heroin. Several users reported an increase in tissue damage caused by cutting agents, leading to infections and loss of limbs. Others reported severe memory loss lasting several days. Some users realized they weren't buying heroin and adopted "indigenous harm reduction strategies," such as alternating injections with smoking in hopes of reducing the odds of infection. Other users simply switched to crack cocaine, often in conjunction with depressants, such as benzodiazepines and alcohol. The researchers write that one heroin user "drank 20-30 cans of high strength alcohol beer a day for the duration of the shortage—a practice which he was unable to cease post-drought and subsequently describe[s] as more problematic than his heroin use." The transition to alcohol is particularly noteworthy, considering that intravenous drug users are at higher risk for hepatitis c, which is in turn exacerbated by excessive alcohol consumption. Many of the heroin users surveyed by the London School researchers were also participating in methadone treatment. As in the U.S., it was not uncommon pre-draught for users to sell their methadone in order to buy heroin. Illicit methadone selling all but disappeared during the drought as users needed the drug to stave off withdrawal symptoms. The U.K.'s experience suggests that reducing heroin and fentanyl importation to the U.S. (a longshot, considering the resources Washington currently expends on such efforts) without an accompanying increase in access to medication-assisted therapy would lead to disastrous unintended consequences. (Frieden and Kolodny, to their credit, call for dramatically expanding access to methadone and buprenorphine for people with opioid use disorders.) How Heroin Users Reacted to the Australian Heroin[...]