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Drug Policy

All articles with the "Drug Policy" tag.

Published: Thu, 25 May 2017 00:00:00 -0400

Last Build Date: Thu, 25 May 2017 23:46:59 -0400


California Senate Passes Bill Easing Up on Some Drug Sentencing

Tue, 16 May 2017 16:45:00 -0400

(image) With the news last week that Attorney General Jeff Sessions is telling federal prosecutors to ramp the war on drugs right back up, expect to see some resistant states publicizing efforts to do the opposite.

That's happening in California, where the state's Senate this week approved SB 180, 22-13. Nicknamed the Repeal Ineffective Sentencing (RISE) Act, the bill eliminates a particular drug-related sentencing enhancement under California law.

When a person is arrested for drug sale or possession for drug sale, the state requires their sentence be enhanced by three years for each previous felony conviction for violating similar laws, even if those previous convictions didn't result in jail time.

SB 180, sponsored by Sens. Holly Mitchell and Ricardo Lara, both Democrats, would eliminate the mandated sentence enhancements, except for one that applies when the felon gets minors involved in the trade.

Even though the legislation was obviously in the works for some time, supporters of the bill cited Sessions' recent call for tougher drug sentencing on the federal level as a concern, according to the Los Angeles Times.

And yes, apparently Republicans attempted crime fearmongering to try to stop it, pointing to the case of a cop in Whittier killed by a parolee with a lengthy history of crime. But that gentleman had a history of violent criminal behavior and parole violations. He was not a guy solely in jail over drug dealing. The assumption that the mandatory minimums and sentence enhancements are necessary to go after the violent criminals ignores the lengthy history and data showing these laws often swoop up non-violent, low-level criminals for long prison sentences.

The bill has many activist group co-sponsors, including the American Civil Liberties Union and the Drug Policy Alliance. Read the bill here. It is on its way to the Assembly now.

Iowa Expands Medical Marijuana Access; Looks to Strike Deal With Minnesota for Quicker Access

Tue, 16 May 2017 12:36:00 -0400

Iowa Gov. Terry Branstad on Monday signed a bill to expand access to medical marijuana in his state, but it might take as long as 18 months before patients with cancer and other diseases can get the drug in Iowa, as the state has to find growers and license distributors. In the meantime, Iowans might be able to travel to Minnesota to obtain medical marijuana, under a proposed agreement that would be the first of its kind in the country. "Iowa is trying to provide an innovative path to help patients obtain relief while the state gets its own system up and running," says Kate Bell, an attorney with Marijuana Policy Project, a national pro-legalization nonprofit. A component of the bill signed by Branstad directs state official in Iowa to contact Minnesota's Department of Health with the intention of opening a sharing agreement between the two states. Iowa Speaker of the House Linda Upmeyer (R-District 54) told the Associated Press last week that a deal between the two states could allow Iowans to have access to medical marijuana while the state is going through the process of setting up its own network of growers and distributors. "It's providing access to Iowans and doing it as quickly as we can," Upmeyer told the AP. "I just want to be sure if we have a tough time finding a grower, we have another source available." Minnesota would have to agree. A spokesman for the Minnesota Department of Health's medical cannabis program told Reason that the state legislature would have to change the rules to allow Iowans to access the drug in Minnesota. Minnesota Speaker of the House Kurt Daudt (R-District 31A) told the AP that he sees the potential for a sharing agreement with Iowa that would be "mutually beneficial thing" because it would allow manufacturers in Minnesota to find more customers. If Minnesota changes its rules along the lines of what has been floated by Upmeyer, the bilateral agreement between the two states would be unique, but it would not be the first time that a state has allowed out-of-state residents access to medical marijuana. According to the Marijuana Policy Project, 14 of the 29 states with legal medical marijuana allow some form of "reciprocity" to accept out-of-state marijuana prescriptions. The MPP says it's important for states to include reciprocity agreements in their medical marijuana laws so patients can safely obtain the drug while visiting a different state or, as is the case in Iowa, while waiting for dispensaries to be licensed and become operational in their home states. Despite the fact that medical marijuana is now legal in a majority of states, marijuana remains on the federal government's Schedule I list—a classification given to drugs with "no currently accepted medical use and a high potential for abuse," according to the Drug Enforcement Administration. There are concerns about a potential crackdown on state-level legalization efforts by the U.S. Department of Justice, particularly in the wake of Attorney General Jeff Sessions' comments last week encouraging prosecutors to seek harsher penalties for drug traffickers. But moving medical marijuana from Minnesota to Iowa is unlikely to get you in any more trouble than if you'd been transporting it within Minnesota. That's because of a 2005 Supreme Court ruling (Gonzalez v. Raich) that gave Congress the authority to regulate even intra-state non-commercial cannabis activity. "So the fact that it's interstate doesn't make it 'more illegal,'" Bell told Reason via email. Since patients can go directly from one state to the other—without having to pass through any states where medical marijuana is illegal—there should be limited law enforcement issues, she said. Since legalizing medical marijuana in 2015, Minnesota has seen steady growth in the number of patients accessing the drug. As of March 2017, there were more than 5,100 patients actively enrolled in the state's registry. The Minnesota Department of Health reports that 3,421 residents visited one of the state's four cannabis distribution centers in March, [...]

Trump's Medical Marijuana Threat Contradicts the Law and His Own Position

Mon, 08 May 2017 08:00:00 -0400

The appropriations bill that President Trump signed on Friday renews a rider that bars the Justice Department from interfering with the implementation of state laws allowing medical use of marijuana. But Trump signaled in a signing statement that he may decide to ignore that restriction, known as the Rohrabacher-Farr amendment, notwithstanding his repeatedly expressed support for medical marijuana and for respecting state policy choices in this area. "Division B, section 537 provides that the Department of Justice may not use any funds to prevent implementation of medical marijuana laws by various States and territories," Trump says in the signing statement. "I will treat this provision consistently with my constitutional responsibility to take care that the laws be faithfully executed." The implication is that Trump's duty to enforce the federal ban on marijuana, which makes no exception for medical use, could compel him to disregard the bill's limits on the use of DOJ money. That position makes no sense, since Trump's duty to take care that the laws be faithfully executed includes this law, which explicitly tells the Justice Department to refrain from interfering with state medical marijuana programs. Last August the U.S. Court of Appeals for the 9th Circuit ruled that the Rohrabacher-Farr amendment prohibits the Justice Department from prosecuting medical marijuana suppliers who comply with state law, and the same analysis would also apply to civil forfeiture actions. As Steve Bell, a senior adviser at the Bipartisan Policy Center, told Bloomberg News, "It is the constitutional prerogative of the Congress to spend money and to put limitations on spending." Bell described Trump's signing statement as "an extremely broad assertion of executive branch power over the purse." Trump is not only trying to usurp the congressional power to decide how taxpayers' money will be spent; he is threatening to interfere with the autonomy that states are supposed to have under the 10th Amendment. He is also contradicting his own position both before and after his election. At the Conservative Political Action Conference in March 2015, Trump said he was leery of legalizing marijuana for recreational use, but "medical marijuana is another thing." He said he was "100 percent" in favor of medical use. He made similar statements while campaiging in Nevada that October, in New Hampshire the following January, and in Michigan two months later. White House Press Secretary Sean Spicer reiterated Trump's support for medical marijuana in February. "There's two distinct issues here: medical marijuana and recreational marijuana," Spicer said. "I think medical marijuana, I've said before that the president understands the pain and suffering that many people go through who are facing especially terminal diseases and the comfort that some of these drugs, including medical marijuana, can bring to them. And that's one that Congress, through a rider...put in an appropriations bill saying the Department of Justice wouldn't be funded to go after those folks. There is a big difference between that and recreational marijuana." The rider to which Spicer referred is the very one Trump has now signaled he may flout. Mind you, Trump has said states should be free even to legalize marijuana for recreational use, although he does not think that's a good idea. In the case of medical marijuana, he has taken the further step of saying he supports the policy, which makes this latest threat all the more puzzling. "Donald Trump continues to send mixed messages on marijuana," says Michael Collins, deputy director of the Drug Policy Alliance. "After stating during the campaign that he was '100 percent' in support of medical marijuana, he now issues a signing statement casting doubt on whether his administration will adhere to a congressional rider that stops DOJ from going after medical marijuana programs. The uncertainty is deeply disconcerting for patients and providers, and we urge the administration to clarify the[...]

Marijuana Policy in the Trump Era

Thu, 04 May 2017 12:00:00 -0400

Attorney General Jeff Sessions has called marijuana "only slightly less awful" than heroin. But with cannabis legal in 28 states and Washington, D.C., it's clear that federal and state drug policies are at odds. Does the Trump administration want to stop marijuana legalization? How is California dealing with the uncertainty that surrounds this legal industry? What can we expect in the next four years and beyond?

On April 20, 2017, Reason hosted a panel of experts interested in the state of marijuana legalization. Lynne Lyman, California State Director of the Drug Policy Alliance, Diane Goldstein of Law Enforcement Action Partnership, Kenny Morrison, president of the California Cannabis Manufacturer's Association and founder of the edibles manufacturer VCC Brands, and Jeff Chen, a researcher at the UCLA David Geffen School of Medicine, answered questions from Reason TV's Zach Weissmueller as well as viewers watching live on Facebook about the future of marijuana in America, what California's market might look like, how law enforcement is reacting to the changes, and the current state of marijuana science.

Hosted by Zach Weissmueller. Edited by Alex Manning. Camera by Manning and Paul Detrick.

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Injection Facilities a Bold Remedy for Overdose Deaths

Thu, 27 Apr 2017 00:01:00 -0400

Addiction to opioids is hazardous to your health. To most people, this may sound like an obvious and inescapable reality. If your chief priority is staying cool, the thinking goes, you don't move to Phoenix. If you really want to stay alive, you don't use heroin. But humans have created innumerable places in Phoenix where it's possible to minimize personal contact with searing heat. Humans have also created places where it's possible to inject opioids at relatively low risk. Heroin users have long been susceptible to life-threatening diseases such as AIDS and hepatitis, which are spread through shared syringes. In recent years, those who use heroin or prescription opioids have also faced an increasingly common and more immediate peril: sudden death from overdose. In 2015, more than 33,000 Americans died of overdoses involving these drugs—nearly triple the number in 2002. That growing epidemic is one reason that life expectancy among whites actually declined last year. It's not hard to figure out why opioid dependence can lead to the morgue. Users may overdose because their heroin has been adulterated with other, more powerful drugs. They may combine opioids with alcohol or sedatives, aggravating the risk. They often shoot up alone or with other users, meaning they may have no one who can help them if things go wrong. The best way to reduce the toll is dissuading people from opioid use. But some people are drawn to intoxicating substances, and once they become dependent, they find it hard to abstain even if they would like to—which many don't. So the question becomes how to prevent inveterate users from dying. Not everyone thinks this objective is commendable. In the 1990s, drug users were contracting and dying of AIDS (and infecting their sexual partners) after shooting up with dirty syringes. But a lot of people, including President Bill Clinton, resisted efforts to expand access to clean needles. Like giving condoms to teens, this was seen as a false solution that would only encourage people to engage in risky behavior. Wrong. Making sterile needles available, it turned out, averted disease and saved lives without generating more addiction. Let drug users get the means to protect themselves, and many of them will take it. Self-destructiveness is not necessarily their goal. A comparable approach can avert overdose deaths. One tool is naloxone, a drug that quickly neutralizes the effects of opioids, reversing overdoses. Emergency rooms keep it on hand. Ambulances carry it. Some police departments equip officers with supplies. Another solution is coming to King County, Washington, which includes Seattle: safe injection facilities where people dependent on drugs can use them in clean conditions, without fear of arrest, under the supervision of health care workers. Those users who are ready to go straight will also get help finding treatment. Though it's never been done in the United States, it's a well-tested idea. The Drug Policy Alliance says these sites have been opened in some 100 cities around the world. They have spread because they work. Insite, which operates a venue in Vancouver, just over the Canadian border from Seattle, says 3 million injections have taken place there. Nearly 5,000 overdoses have been reversed, without a single overdose death. A review in the medical journal Drug and Alcohol Dependence found these facilities have been effective in fostering safer practices and reducing overdoses. Contrary to fears, they have not served to "increase drug injecting, drug trafficking or crime in the surrounding environments." Aside from the benefits to drug users, there are benefits to everyone else. The safe injection sites succeeded in curtailing public drug use and the presence of syringes left on the street. They save cities money for emergency medical care. But obstacles abound. Washington state Sen. Mark Miloscia, a Republican who opposes the Seattle initiative, told The Washington Post, "Saving [...]

Why LSD Trips Last Forever, What Happens When You Inject Psilocybin

Wed, 26 Apr 2017 17:25:00 -0400

The world's leading researchers of psychedelic drugs met in Oakland, Calif., this past weekend at Psychedelic Science 2017, sponsored by the Multidisciplinary Association of Psychedelic Science (MAPS). I attended for for a story I'm working on about MDMA-assisted therapy, and thought I'd share some items from my notebook. Why do LSD trips last so long? Psilocybin and MDMA are both active in the body for two to three hours when administered in tens of milligrams. LSD, meanwhile, is administered in micrograms (1 mcg is .001 mg) and yet the drug experience can exceed eight hours. UNC-Chapel Hill's Dave Nichols, a medicinal chemist who's been studying psychedelics for decades, shared some new research that explains why. Imagine a carnivorous pitcher plant. That's the 5-HT2B serotonin receptor. Lysergic acid diethylamide, LSD, is a fly. Instead of attaching to the top of the receptor, the LSD molecule gets pulled inside and the top of the receptor closes around it. Basically, LSD trips last forever because the drug gets trapped in a brain cage. (Nichols' team published their findings in January. You can read more about them here.) What happens when you inject psilocybin? The psilocybin-assisted therapy study conducted by Johns Hopkins University--which found that moderate and high doses of psilocybin, in conjunction with psychotherapy, reduced anxiety and depression in cancer patients--used gel caps as the method of administration. Most recreational users just eat the mushrooms or brew them into tea. Over in Europe, however, researchers have experimented with intravenous administration. Apparently, it's like "rocketing [someone] out of a cannon"; the come-up takes place over roughly a minute, rather than half an hour. Well, duh. Except, at a Q&A later in the day, Nichols revealed LSD doesn't work any quicker when administered via IV. It truly is the Good Friday mass of psychedelic drugs. Prohibition makes this kind of research stupidly expensive: The Imperial College of London pays 1,500 British Pounds per dose of UK Home Office-approved psilocybin, according to researcher Leor Roseman, who noted that street prices are a fraction of that. (The ICL is currently doing a ton of interesting psychedlelic research right now.) I'm not sure how easy it is to obtain isolated psilocybin on the black market, but the mushrooms themselves grow on cow shit and dead plant matter. Stateside, dried psilocybin shrooms go for about $5-$10 per gram, according to various mycophile message boards and my own independent research. The most common (and cheapest) strains contain about .6 mg of psilocybin per gram of dry weight, and more exotic (read: expensive) strains have as much as 1.6 mg per gram. The Home Office essentially charged the ICL a penalty for studying a drug that should never have been banned. This kind of oblique research penalty is not unique to psilocybin, or to the UK. Cannabis researchers in the U.S. have to buy their bud from NIDA's monopoly operation, and it is not quality stuff. Psychedelic researchers are cautiously optimistic about Scott Gottlieb at FDA: Gottlieb, Trump's nominee for head of the Food and Drug Administration, has said he'd like to speed up the drug approval process, perhaps using more flexible clinical trial designs. What does this mean for MAPS, currently sponsoring clinical trials for MDMA-assisted psychotherapy? MAPS clinical sites recently completed stage two trials, and the group is now negotiating stage three protocols with the FDA. All they really need is for the agency to treat them like it would any other sponsor of a new drug application. That may sound like a small ask, but the FDA's history with psychedelic researchers is replete with periods of capricious obstructionism. The agency environment changed in the mid 2000s, leading to the current research boon. MAPS Founder Rick Doblin expressed optimism that things will continue apace under Gottlieb. Placing a marker[...]

West Virginia Becomes the 29th State to Allow Medical Marijuana Use

Thu, 20 Apr 2017 09:45:00 -0400

Yesterday West Virginia Gov. Jim Justice signed a bill that makes his state the 29th to allow medical use of marijuana. West Virginia is the sixth state to legalize medical marijuana in the last year and the third (along with Ohio and Pennsylvania) to do so through the legislature. In the other three states—Arkansas, Florida, and North Dakota—voters approved ballot initiatives authorizing medical marijuana last November. West Virginia's new law recognizes marijuana as a treatment for patients with terminal illnesses or any of 14 specified conditions, including cancer, HIV/AIDS, epilepsy, multiple sclerosis, Crohn's disease, post-traumatic stress disorder, and intractable pain. Patients whose doctors recommend marijuana will be able to obtain it in the form of pills, oils, gels, creams, ointments, tinctures, liquids, and vaporizable extracts from state-regulated dispensaries. The dispensaries will not sell buds for smoking or marijuana edibles, although patients can prepare their own at home. The law does not allow home cultivation, and patients can legally possess no more than a month's supply at a time. "This legislation is going to benefit countless West Virginia patients and families for years to come," says Matt Simon of the Marijuana Policy Project (MPP), a West Virginia native. "Medical marijuana can be effective in treating a variety of debilitating conditions and symptoms. It is a proven pain reliever, and it is far less toxic and less addictive than a lot of prescription drugs. Providing patients with a safer alternative to opioids could turn out to be a godsend for this state." One downside to West Virginia's law is a new standard for driving under the influence of marijuana that erroneously equates impairment with a blood THC level of three nanograms per milliliter. That's even lower than the unfair and unscientific five-nanogram cutoff that Colorado and Washington adopted when they legalized marijuana for recreational use. As MPP notes, West Virginia's DUID standard "could make it illegal for some patients to ever drive, since many patients have THC levels at this amount or greater many hours or days after last administering cannabis." West Virginia's rules put it on the less liberal end of a medical marijuana spectrum that ranges from highly permissive (e.g., California) to highly restrictive (e.g., New York). Eight of the 29 medical marijuana states also allow recreational use. Medical use was approved by ballot initiative in 14 of those states, beginning with California in 1996. In the rest, as in West Virginia, medical marijuana laws originated in the state legislature. Another 18 states have approved medical marijuana laws that MPP deems "ineffective because they are either unworkable or exceptionally restrictive." These laws allow use of specific cannabis products—typically low-THC, high-CBD extracts—and often do not provide a way to legally obtain them. But if you count those 18 states, MPP says, "only three states—Idaho, Indiana, and Kansas—have not approved any form of medical marijuana law." Although the federal government still does not recognize any legitimate use for marijuana, surveys find strong popular support for letting patients have access to it. A Quinnipiac University Poll conducted in February and a Marist Poll conducted last month put support for medical marijuana at 93 percent and 83 percent, respectively. In both surveys, large majorities of both Republicans and Democrats favored medical access, as does President Trump. Even his attorney general, arch-prohibitionist Jeff Sessions, concedes that "dosages can be constructed in a way that might be beneficial."[...]

Major League Baseball's War on PEDs Is Still Petty and Pointless

Wed, 19 Apr 2017 17:15:00 -0400

Pittsburgh Pirates outfielder Starling Marte was suspended Tuesday after testing positive for the testosterone derivative Nandrolone, an androgenic compound that increases lean body mass and strength, decreases fat mass, and expedites soft tissue repair. Prolonged use also causes left ventricular hypertrophy and high blood pressure, but it's the first set of effects that'll cause Marte to miss 80 games and render him ineligible for postseason play in the event the Pirates make it that far without him. Over at Yahoo!, MLB columnist Jeff Passan argues that Marte's suspension means we should revisit, for the millionth time, the MLB's policy on performance enhancing drugs. "The line between so-called PEDs and other drugs isn't thin. It just doesn't exist," Passan writes, citing the MLB's broad use of anti-inflammatories and other painkillers, which players can gobble without fear of getting their pay docked and being dragged through the mud. "The only reason PEDs are considered cheating is because federal drug policies stigmatized certain substances, and those now come with a scarlet S. Never mind that most players who take drugs today do so in order to deal with the rigors of a full season – of the grind, the travel, the responsibility to maintain playing shape in an environment that grows less conducive to it as the demands to do more increase." Baseball is America's most vengeful sport, governed by an esoteric code that allows victims of bat-flips and joyful baserunning to retaliate with violence, so it makes (some) sense that the reactions to Marte's rule-breaking have been Jeff Sessions-like, with one fellow MLBer suggesting that Marte's wages should be permanently depressed for the rest of his career: Historically, fans have been no more forgiving, at least when it comes to juice. Shortly after Pete Rose admitted to betting on games while managing the Reds, Gallup asked sports fans which offense was more serious. They chose PEDs by a mile: But I thought baseball was about rules! The MLB's drug policy is not uniquely stupid. Former players are suing the NFL for pumping them full of painkillers and NSAIDs to keep them on the field, a vicious cycle that former NFL wide receiver Nate Jackson gruesomely documents in his memoir Slow Getting Up. Are fans outraged about guys playing hurt? Maybe, but I suspect they care far more about players being better than they should be, like that time people could not shut the hell up about allegations Peyton Manning used HGH after neck surgery. Meanwhile, the Buffalo Bills suspended a player last year for using medical marijuana, under a doctor's supervision, to treat Crohn's disease. Not even the NBA--arguably America's most socially liberal league (David Stern's racist dress code notwithstanding)--is above this nonsense. Last month, it suspended Knicks center Joakim Noah for 20 games after he used a research chemical to heal faster from an injury. There is no drug in existence that could make Noah worth the concrete boots of a contract he signed with the Knicks last summer, because there is nothing you can inject into a surgically repaired 32-year-old seven-footer that will make him less old, less tall, or less busted. (And besides, is suspending him really worse than making him play in front of the mouth breathers at Madison Square Garden, recently seen booing the best Knicks pick since Patrick Ewing?) Like Passan, I think it's time to revisit the PED standards for most sporting bodies, if only to bask in the dysfunction that's sweeping the globe. I speak of the Therapeutic Use Exemption (TUE), in which the MLB has been a two-faced pioneer. Back in 2005, when the MLB announced it was going to crack down on amphetamine use--as deeply ingrained a baseball tradition as beaning guys for enjoying the game--it did so by allowing players to medicalize said use. Now, when the the MLB Players Associat[...]

Marijuana Is Bad, DHS Chief Says, Although It's 'Not a Factor in the Drug War'

Wed, 19 Apr 2017 07:30:00 -0400

In a Meet the Press interview on Sunday, Homeland Security Secretary John Kelly said "marijuana is not a factor in the drug war," which is instead focused on methamphetamine, heroin, and cocaine. Apparently that dismissive comment got Kelly into trouble, because two days later, in a speech at George Washington University, he gave marijuana top billing in his description of the drug threat posed by "transnational criminal organizations." And lest anyone think Kelly does not take marijuana seriously, he added three paragraphs emphasizing that he does: Let me be clear about marijuana. It is a potentially dangerous gateway drug that frequently leads to the use of harder drugs. Additionally, science tells us that it is not only psychologically addictive but can also have profound negative impact on the still developing brains of teens and up through the early 20s. Beyond that, however, its use and possession is against federal law and until the law is changed by the U.S. Congress we in DHS are sworn to uphold all the laws on the books. DHS personnel will continue to investigate marijuana's illegal pathways along the network into the U.S., its distribution within the homeland, and will arrest those involved in the drug trade according to federal law. CBP will continue to search for marijuana at sea, air and land ports of entry and when found take similar appropriate action. When marijuana is found at aviation checkpoints and baggage screening TSA personnel will also take appropriate action. Finally, ICE will continue to use marijuana possession, distribution and convictions as essential elements as they build their deportation / removal apprehension packages for targeted operations against illegal aliens. They have done this in the past, are doing it today, and will do it in the future. No doubt Kelly's marijuana comment on Meet the Press annoyed Attorney General Jeff Sessions, an old-fashioned drug warrior who believes "good people don't smoke marijuana" and has hinted that he plans to ratchet up enforcement of the federal ban in states that have legalized pot. Before yesterday's conspicuous correction, Washington Post reporter Derek Hawkins claimed Kelly and Ashcroft had staked out "two vastly different positions on marijuana" and "could hardly be further apart." But it's not as if Kelly has ever expressed any doubt about the wisdom or fairness of pot prohibition. As head of the U.S. Southern Command in 2014, Kelly complained that marijuana legalization in Colorado and Washington had made foreign officials less keen to help him stop Americans from getting the drugs they want. He reiterated that complaint in a Military Times interview last November, during which he said he was, like Donald Trump, open to medical use of marijuana but against broader legalization. "It is a gateway," Kelly said. "There's no doubt." Sessions sounds only somewhat more skeptical about marijuana's medical potential, saying, it "has been hyped, maybe too much," although "dosages can be constructed in a way that might be beneficial." Even Kelly's statement about marijuana to Meet the Press host Chuck Todd seemed to be aimed at deflating the idea that anything good could come from legalization: Todd: Marijuana legalization, does that help your problem or hurt your problem? Kelly: Yeah, marijuana is not a factor in the drug war. Kelly's concern about marijuana's role as a "gateway" to "harder drugs," of course, implicitly concedes that marijuana is less dangerous than other illegal intoxicants. But such talk has been a staple of anti-pot propaganda since Harry Anslinger was running the Federal Bureau of Narcotics, and even Sessions concedes that marijuana is "slightly less awful" than heroin. In short, notwithstanding The Washington Post's hyperbolic take, there is not much daylight between Kelly and Sessons on this issue.[...]

Harm Reduction an Alternative to Incoherent Opioid Addiction Policies

Wed, 19 Apr 2017 00:05:00 -0400

You can't pick up a newspaper, turn on the TV or radio, or access any online news source without encountering headlines screaming "opioid epidemic." There is the alarming rise in the number of chronic pain patients who have become addicted to opioids. And the explosion, in recent years, of opioid prescriptions by health care providers now under government pressure to curtail their prescribing. This pressure has driven many opioid addicts to the illicit drug market to avoid the pains of withdrawal. There, according to the Centers for Disease Control and Prevention (CDC), they often find opioid heroin cheaper and sometimes more readily available despite a 50-year "War on Drugs." Thus they become heroin addicts. Media hysteria begets calls to action. Politicians and the administrative state devise new laws to control this "evil plague." As a surgeon who regularly prescribes painkillers for patients suffering from postoperative pain or painful conditions, I see a painful cognitive dissonance. Begin with US policy towards heroin. Originally developed in the 1870s, diacetyl-morphine was marketed under the brand name Heroin, by the Bayer pharmaceutical company. Despite pleas by the Surgeon General and the American Medical Association to keep it legal, Heroin was banned in the US in 1924 because political leaders believed it the drug corrupted an individual's moral character. Meanwhile, dilaudid, 3 to 4 times more potent than morphine, is legal and is routinely administered for pain both as an oral and an injectable agent. Fentanyl, or Duragesic, is legal, too, although it is more than 50 times the potency of morphine. There is even greater cognitive dissonance with methadone, the powerful opioid approved for use in the US in 1947 and commonly used in this country to treat addiction to heroin and other opioids. Chronic users of opioids develop a tolerance, requiring ever-increasing doses to achieve the desired effect. A low, oral dose of methadone binds with enough of a person's opioid receptors to prevent withdrawal symptoms yet not produce the euphoric effects. The idea behind "methadone maintenance" programs is to transfer the addiction from heroin or another opioid. Because they do not experience the euphoria and "escape" of their chosen opioid, methadone addicts can resume a normal, productive—even conventional—life. Some can be tapered off from methadone and "detoxified." But many remain on methadone, sometimes for their entire lives. To put things in proper perspective, chronic alcohol use is much more dangerous. Chronic use can cause cirrhosis of the liver, cardiomyopathy (heart failure from damaged heart muscle), encephalopathy and dementia, chronic pancreatic inflammation, and has been linked to cancer of the stomach and the esophagus. In addition, one can overdose on alcohol as well—which may cause a person to stop breathing, become hypoxic, and die. And here's where the cognitive dissonance comes in: it is perfectly acceptable and permissible—even public policy—to allow people to be chronically addicted to the opioid methadone. The side-effects of prolonged use are considered serious yet tolerable. But it is unacceptable and counter to public policy for a person to be chronically addicted to any other opioid, even if that person self-doses to prevent withdrawal while avoiding the "high" in order to lead a peaceful and productive life. The concept of "harm reduction" as an approach to substance abuse has gained increased acceptance by health care practitioners as well public health and government authorities. Harm reduction approaches chemical dependency in a non-judgmental and realistic way, leaving drug prohibition in place. The strategy seeks to ameliorate the most destructive effects of prohibition on the individual drug user and addict. The health care practitio[...]

Trump Expected to Nominate Former Prosecutor Tom Marino For Drug Czar

Tue, 11 Apr 2017 15:15:00 -0400

(image) Pennsylvania's Tom Marino, a three-term member of the House of Representatives and a former prosecutor, will likely be Trump's nominee to head the Office of National Drug Control Policy, CBS reports. More:

A source familiar with personnel moves in the White House says that Marino is in the final stages of completing his paperwork and an official announcement is forthcoming. When asked for comment, the White House said it had no personnel announcements at this time. Marino's office had no comment.

Marino, who is serving his third term representing Pennsylvania's rural 10th congressional district, was appointed to serve on the House's bipartisan committee combating the opioid epidemic in 2016 after the enactment of two bills he introduced on drug control.

Marino spent 10 years as District Attorney of Lycoming County before President George W. Bush nominated him in 2002 as the U.S. Attorney for the Middle District of Pennsylvania, where Marino says he prosecuted "a wide range of federal offenders, from violent criminals and drug dealers to white collar businessmen who cooked the books."

As a member of the House, he's also voted against pretty much every piece of marijuana reform legislation:

While the Trump White House declined to comment, marijuana prohibitionist Kevin Sabet told CBS News, "My understanding is that Tom has a deep understanding of the issue and is excited to get started."

Tom Angell, the most dogged reporter of marijuana policy news I know, is currently combing through Marino's record of drug policy statements. Here's a taste:

"One treatment option I have advocated for years would be placing nondealer, nonviolent drug abusers in a secured hospital-type setting under the constant care of health professionals," he wrote. "Once the person agrees to plead guilty to possession, he or she will be placed in an intensive treatment program until experts determine that they should be released under intense supervision. If this is accomplished, then the charges are dropped against that person. The charges are only filed to have an incentive for that person to enter the hospital-slash-prison, if you want to call it."

More from Angell here.

California's Governor Rejects Anti-Competitive Marijuana Rules

Thu, 06 Apr 2017 07:00:00 -0400

(image) On Tuesday night California Gov. Jerry Brown unveiled proposed legislation aimed at reconciling Proposition 64, the 2016 ballot initiative that legalized cannabis for recreational use in that state, with the medical marijuana regulations that state legislators approved in 2015. The bill generally favors the more liberal rules of Proposition 64, a.k.a. the Adult Use of Marijuana Act (AUMA), over the more restrictive provisions of the Medical Cannabis Regulation and Safety Act (MCRSA), which is good news for entrepreneurs and consumers.

California officials plan to start distributing marijuana licenses by next January, but first legislators have to decide how that will work. The MCRSA requires independent marijuana distributors, similar to the state-appointed middlemen who have the exclusive right to distribute alcoholic beverages in most states, and restricts other licensees (growers, manufacturers, transporters, and retailers) to no more than two categories. The AUMA does not require independent distributors and imposes no restrictions on vertical integration, except that testing companies cannot hold other licenses.

Brown thinks the latter approach makes more sense. "Overly restrictive vertical integration stifles new business models and does not enhance public and consumer safety," he says. "Allowing for a business to hold multiple licenses including a distribution license will make it easier for businesses to enter the market, encourage innovation, and strengthen compliance with state law."

Brown also favors the AUMA's narrower definition of cannabusiness "owners" who are required to undergo background checks. The AUMA sets the threshold at a 20 percent ownership stake, compared to 5 percent under the MCRSA.

Brown's bill preserves the MCRSA's limit on the number of midsized growers "in furtherance of the intent of Proposition 64 to prevent illegal production and avoid illegal diversion to other states." It also prohibits medical and recreational retailers, who will collect different taxes and enforce different age restrictions, from operating under the same roof. That separation might help the Trump administration, which according to White House Press Secretary Sean Spicer supports medical marijuana but frowns on recreational use, target some cannabusinesses while leaving others alone.

The Drug Policy Alliance (which backed the AUMA), the California Cannabis Industry Association, the United Food and Commercial Workers Western States Council, and the California Cannabis Manufacturers Association are pleased with Brown's proposal. The Teamsters, who represent the employees of state-mandated alcohol distributors and hoped to represent the employees of state-mandated cannabis distributors, are not. "We're going to fight that part of it really hard," Teamsters lobbyist Barry Broad told The Sacramento Bee. "It raises really significant anti-trust issues that we don't think are accounted for....It's quite conceivable that the entire market can be owned by someone who also controls distribution and access to the market. It's a big problem."

For the Teamsters, yes. For the rest of us, not so much.

Massachusetts Doctors Want a Safe Place for People to Use Illegal Drugs

Wed, 05 Apr 2017 17:41:00 -0400

The United States is currently home to zero facilities where users of illicit intravenous drugs can get high under a doctor's supervision. Seattle and King County, Washington recently announced plans to open two such facilities, called supervised injection sites. Later this month, the Massachusetts Medical Society will vote to ask their state to do likewise. "It's about trying to get individuals into an environment, where they have a much better chance of surviving their substance use disorder, to a point in time where they actually are able to make progress in recovery," Dr. Dennis Dimitri tells Boston's WBUR. "We felt that the ethics of doing this were justifiable, that putting a program such as this in place would do more benefit than any harm." The trustees will ask their members to vote in favor of a supervised injection site pilot later this month. Vancouver's Insite, a supervised injection site opened in 2003, has had 3.5 million visits, 5,000 overdoses, and zero deaths. (Seattle Mayor Ed Murray visited Insite, and it cemented his decision to bring the model to his city.) The Sydney Medically Supervised Injecting Centre in Sydney, Australia, opened in 2001. In the intervening decade and a half, it's received 860,000 visits during which 4,397 people have overdosed and zero have died. Supervised injection sites, in other words, are really good at keeping heroin and opioid users alive. They're staffed by medical professionals and stocked with clean needles and the overdose reversal drug Naloxone. People who want to quit can talk to addiction experts about their options, like medication-assisted therapy. People who don't want to quit can use without dying, or contracting and spreading diseases like HIV and hepatitis. These facilities work so well that even Iran uses them. And yet the U.S., which consumes more prescription opioids than any nation on Earth, has zero. "I just don't think that that's the direction we ought to be going in," Norwood Police Chief William Brooks told WBUR, of the Massachusetts Medical Society statement. "It does feel like we're giving up, we're throwing our hands up, and I don't think we should do that." Brooks is not a bad guy. He applauded Massachusetts Attorney General Maura Healey's deal with Amphastar Pharmaceuticals to subsidize the purchase of Naloxone for Massachusetts first responders, saying it was in "keeping with our core mission to protect human life." But there are echoes of Maine Gov. Paul LePage in his reluctance to get on board with a safe injection site. This time last year, LePage vetoed a bill that would allow pharmacies to sell Naloxone without a prescription, saying access to the drug "serves only to perpetuate the cycle of addiction." In a way, LePage was right: Keeping an overdose victim alive increases the odds that person will get high again, because their odds of ever using again are zero if they're dead. In a similar way, Brooks is right: Giving users a safe place and clean equipment is a concession to the reality of drug addiction. More policymakers should make that concession, because the relevant policy questions are these: 1.) What keeps users alive? 2.) What curtails the spread of communicable diseases associated with illicit drug use? 3.) What brings problem users into contact with people who can help them? 4.) What treatments work for people who want to quit? Right now, people are dying from drug overdoses because policymakers have allowed their distaste for aberrant behavior to supersede globally recognized best practices. Brooks, and others like him, can continue to hate heroin and Oxy and fentanyl, to despise the toll of addiction, to mourn the design flaws of the human brain. But it is unacceptable for harm reduction skeptics to blo[...]

Sad Legislation or SADDEST Legislation?: The Protecting Kids from Candy-Flavored Drugs Act of 2017

Thu, 30 Mar 2017 17:53:00 -0400

(image) The best part of moral panics is that the people succumbing to them don't realize it. Those Salem Witch Trial perpetrators? They knew that witches abounded (read this excellent biography of Samuel Sewall, a judge who literally wore sackcloth and ashes in penance for his role in executing people). Same thing with the folks behind scares over ritual satanic child abuse in the 1980s (hello, Janet Reno) and so many other bizarro scares.

The latest chapter in this comes courtesy of Sens. Dianne Feinstein (D-Calif.) and Chuck Grassley (R-Iowa), who have introduced "The Protecting Kids from Candy-Flavored Drugs Act of 2017" because...

The legislation would:

  • Provide an enhanced penalty when a person manufactures, creates, distributes, dispenses, or possesses with intent to distribute a controlled substance listed in Schedule I or Schedule II that is:
  • Combined with a beverage or candy product,
  • Marketed or packaged to appear similar to a beverage or candy product, or
  • Modified by flavoring or coloring to appear similar to a candy or beverage product.

(image) Which is to say that it would take aim not so much at coke or meth—we await still the introduction of Sour Kids Meth and Nerds (Now With Even More Cocaine)!—but at various marijuana-laced edibles for sale in states that legalized recreational and medical marijuana. Indeed, despite claiming "many instances" of the pusher man wooing innocent boys and girls to the pleasures of coke and meth, Feinstein and Grassley provide no examples in their press releases or legislation. And while it's true that some (legal) pot peddlers have marketed candy-bar-looking products for adults, legalization in Colorado has not increased marijuana use by adolescents.

But why ruin a bad piece of bipartisan legislation being pushed by two senators whose collective age is 166 years old by insisting that they prove their case? If this bill protects just one kid from a candy-flavored drug, it will be worth it. Especially to Feinstein and Grassley.

Related: Buzz Bowl I: Four Loko vs. Joose!

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Johns Hopkins University Dropped Out of a Clinical Trial for Smoked Cannabis, and Veterans With PTSD Want to Know Why

Tue, 28 Mar 2017 09:30:00 -0400

Some U.S. military veterans received unpleasant news last week when they tried enrolling in a clinical trial conducted by the Department of Psychiatry and Behavioral Science at Johns Hopkins University. Upon calling a widely circulated hotline number intended to connect former servicemembers to researchers conducting a study on the efficacy of smoked cannabis as a treatment for post-traumatic stress disorder, they learned the study wasn't happening. Not at Hopkins, anyway. "If you are calling about the PTSD study, please know we are no longer participating in that study," the voicemail greeting said as of Monday morning. While the message has been playing since at least last week, neither Johns Hopkins University nor the psychiatry department had formally announced withdrawing from the study as of yesterday. That's why Sean Kiernan, president of the Warriors for Weed Project, sent a letter to Johns Hopkins University Ron President on Monday demanding that the university publicly explain why it was no longer participating in the study, which is sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). "We're upset with Hopkins," Kiernan told me by phone today. "Something is going on there." A clinical trial measuring the efficacy of smoked marijuana as a treatment for PTSD has been in the works since 2014, when the Department of Health and Human Services approved MAPS' request to purchase research cannabis from the National Institutes on Drug Abuse. NIDA holds a monopoly on legally growing and providing marijuana for research purposes, and a clinical trial is the first step in having whole-plant marijuana moved from Schedule I of the Controlled Substances Act to Schedule II, where it can be legally prescribed for therapeutic purposes. (Currently, doctors may recommend marijuana under state laws, but they may not prescribe it under federal law.) The trial was slated to take place at both the University of Arizona and Johns Hopkins, but was briefly delayed when the University of Arizona fired researcher Sue Sisley, allegedly to avoid the wrath of Arizona lawmakers who opposed her work on medical marijuana. In 2016, Sisley announced she would continue her portion of the trial at the Scottsdale Research Institute. Sisley, along with Johns Hopkins professor Ryan Vandrey, would study whether various doses of smoked marijuana could help reduce the symptoms of treatment-resistant PTSD, using a $2 million grant MAPS received from the Colorado Department of Public Health and Environment. While Sisley's work will continue, Vandrey, of the Johns Hopkins Behavioral Pharmacology Research Unit, confirmed to me in an email on Monday that his team "has withdrawn its participation in the MAPS study." He referred me to a university spokesperson for additional information. On Tuesday, a university spokesperson released the following statement: "It is Johns Hopkins' mission to conduct high quality scientific research and save lives. Johns Hopkins elected to withdraw from the MAPS study of cannabis in veterans with PTSD prior to any participant enrollment because our goals for this study weren't in alignment. Johns Hopkins remains dedicated to helping military veterans, finding improved treatments for PTSD, and conducting innovative research to enhance our understanding of both the risks and benefits of cannabis/cannabinoids." "Johns Hopkins wanted to remain focused on clinical research, and MAPS wanted to focus on the science as well as on the policy issues surrounding the science related to the NIDA monopoly on marijuana for research," Brad Burge, communications director for MAPS, wrote in an email. "We still have an exceptionally strong researc[...]