Methadone & Other Opiate Maintenance

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Crisis Looms for Addicts as Russia Bans Methadone in Crimea

Things are about to get harder for opiate users in Crimea, the former Ukrainian province now annexed by Russia. While Ukraine has embraced a harm reduction approach to hard drug use, Russia rejects such an approach and has some of the most repressive drug laws in the world.

Oberleitungsbusbahnhof in Simferopol (user Cmapm via Wikimedia)
Russia does not support efficient programs for preventing HIV and Hepatitis C among its drug using population, and harm reduction measures like needle exchanges and opiate substitution therapy (OST), of which methadone maintenance is a subset, are illegal.

Now, the concrete consequences of Crimea's reincorporation into the ample bosom of Mother Russia are coming home for drug users there. On Wednesday, Russian "drug czar" Viktor Ivanov -- one of 31 allies of Pres. Vladimir Putin sanctioned by the US government this month -- announced that Russia will ban the use of methadone in Crimea. That comes after vows a week before that he would move away from harm reduction practices in general in Crimea.

"Methadone is not a cure," Ivanov claimed. "Practically all methadone supplies in Ukraine were circulating on the secondary market and distributed as a narcotic drug in the absence of proper control. As a result, it spread to the shadow market and traded there at much higher prices. It became a source of criminal incomes," he said.

Whatever Ivanov says, cutting off methadone for an estimated 800 patients will be a disaster, the International HIV/AIDS Alliance warned. And the threat of a broader rejection of harm reduction measures puts an estimated 14,000 Crimean injection drug users at risk.

"When the supply of these medicines is interrupted or stopped, a medical emergency will ensue as hundreds of OST patients go into withdrawal, which will inevitably lead to a drastic increase in both acute illness as well as increases in injecting as people seek to self-medicate," said the alliance's Ukraine director, Andriy Klepikov.

"Any interruption to harm reduction programming is a disaster for health, human rights and the HIV epidemic in the region and we urge the authorities in Crimea to step in and ensure that critical supply chains are not disrupted and lives not put at risk as a result of territorial politicking," Klepikov added.

Ukraine has practiced methadone maintenance (or OST) therapy in Crimea since 2005. Patients in Simferopol, Sevastopol, Yalta, Eupatoria, Feodosia, Kerch and other cities receive daily treatment at local healthcare facilities.

The AIDS alliance is not the only group raising the alarm. The International Network of People who Use Drugs (INPUD) has issued an urgent appeal to UN rapporteurs on the Crimea "calling upon you all to issue a public statement making clear the imminent risk that this population faces of losing access to essential medicines, we are requesting that you raise the issue with the Russian government urging them not to close down the currently running opiate substitution programs; and we are calling upon you to raise the issue with utmost urgency with the Human Rights Council with a view to ensuring continued access to the programs."

When it comes to drug policy and harm reduction, Crimea would seem to be worse off as part of Russia than as part of Ukraine. As the AIDS alliance's Klepikov put it:

"The Russian Federation has extremely repressive drug laws and its punitive approach to people who use drugs means that it now experiences one of the highest rates of new HIV infections in the world. Injecting drug users represent nearly 80% of all HIV cases in the country."

Russia

Chronicle AM -- March 25, 2014

Richard Branson speaks out on California drug policy reforms, a leading anti-drug group gives up the ghost on fighting marijuana legalization, the Canadian government is under attack from a couple of directions, and more. Let's get to it:

Richard Branson speaks out again on drug policy reform (David Shankbone/wikimedia)
Marijuana Policy

Drugfree.org Gives Up on Anti-Marijuana Ad Campaign. The people who brought you "this is your brain on drugs" and similar anti-drug advertising campaigns have given up on fighting marijuana legalization. Formerly known as the Partnership for a Drug-Free America, the group and its CEO, Steve Pasierb, say they have rejected a request to launch a campaign against marijuana legalization because legalization "is happening in America." Here is the interview in Advertising Age where Pasierb speaks out.

Colorado Supreme Court Says Lawyers Can Work With Marijuana Businesses. The Colorado Supreme Court approved a rule change Monday that will eliminate the threat of ethics sanctions against attorneys who work with marijuana businesses. Lawyers "may assist a client in conduct that the lawyer reasonably believes is permitted by these constitutional provisions and the statutes, regulations, orders, and other state and local provisions implementing them," Chief Justice Nancy Rice wrote in the updated rule.

Delaware Poll Has Majority for Legalization, Two-Thirds for Decriminalization. A Public Policy Polling survey commissioned by the Marijuana Policy Project finds that a narrow majority (51%) support legalizing marijuana, while an overwhelming majority (68%) support decriminalization of the possession of small amounts.

Illinois Decriminalization Bill Has Hearing Today. A bill to decriminalize the possession of up to an ounce of marijuana gets a hearing today in the House Restorative Justice Committee. The measure, House Bill 5708, was introduced by Rep. Kelley Cassidy (D-Chicago).

Medical Marijuana

Florida CBD Medical Marijuana Bill Wins Senate Committee Vote. A bill to legalize a special strain of low-dose medical marijuana passed through the Senate Criminal Justice Subcommittee on Monday. Senate Bill 1030, sponsored by Sen. Rob Bradley (R-Fleming Island), Sen. Aaron Bean (R-Fernandina Beach), and Sen. Jeff Brandes (R-St. Petersburg) would only allow patients to use extracts containing at least 15% CBD and less than 0.5% THC. The House companion bill, House Bill 843, differs in several ways. The two measures would have to be reconciled if both pass their respective chambers.

Illinois Bill to Add Seizure Disorders Gets Hearing Today. A bill that would add seizure disorders to the list of diseases and conditions for which medical marijuana is approved gets a hearing today in the Senate Public Health Committee. Filed by Sen. Iris Martinez (D-Chicago), Senate Bill 2636 will be supported in committee by testimony from Kurt Florian, president of the Epilepsy Foundation of Chicago, as well as a family practitioner and parents of two children suffering from seizure disorders.

Drug Policy

Richard Branson Op-Ed Urges Support for California Drug Reforms. Virgin Airlines head and Global Drug Policy Commission member Richard Branson has penned an op-ed calling for support of an initiative campaign to decriminalize drug possession in California. Click on the title link to read the op-ed. Branson is also appearing this afternoon at an event in San Francisco, where Sundog Pictures will hold a special screening of its drug war documentary "Breaking the Taboo." That's at 5:30 pm at the New People Cinema on Post Street.

Law Enforcement

Pennsylvania Man Sues Philly Narcs for 13 Years of False Imprisonment. Philadelphia resident Kareem Torain has filed a lawsuit against a trio of current and former Philadephia narcotics officers, in which he claims they falsified evidence that led to him being convicted on drug charges and spending 13 years in prison. In addition to the individual narc, the lawsuit also targets the city of Philadelphia for "systemic deficiencies and deliberate indifference" that "have caused police officers, including defendant police Officers Monaghan and Reynolds, and former police Officer Walker in this case, to believe that they can violate the rights of citizens, with impunity, including the use of fraud and falsehood, without fear that their actions will be investigated." In recent years scores of drug cases have been dismissed by Philadelphia courts, and several lawsuits have been filed, claiming that narcotics officers routinely planted evidence and lied in court to secure convictions.

International

Russian Drug Czar Calls for New Plan to Combat Afghan Drug Threat. Viktor Ivanov, head of the Russian anti-drug agency, has called for the UN Security Council to address "planet scale" drug production in Afghanistan and for interested countries to create a global alliance for alternative development in Afghanistan through "forced industrialization." Ivanov is one of the Russian political leaders sanctioned as a result of the Crimea crisis, and last week, he suggested that the US was using the crisis to deliberately destroy the international anti-drug cooperation in order to hide its responsibility for the drug crisis in Afghanistan.

Canada Blocked Support for Harm Reduction at UN CND Meeting, Observers Say. Canadian diplomats in Vienna for the UN Commission on Narcotic Drugs (CND) meeting blocked harm reduction health approaches abroad that are widely practiced at home, said Canadian Drug Policy Coalition director Donald MacPherson, who attended the conference. "Historically, Canada had been a leader in this area," MacPherson noted. "A substantial amount of the scientific research validating harm reduction measures was done right here in Vancouver, and we've implemented quite robust harm reduction policies at the provincial level across Canada. It's hypocritical for us to oppose adoption of these strategies internationally, especially since this is a matter of life and death in many countries with high levels of injection drug use and HIV." Similarly, Richard Elliot, executive director of the Toronto-based Canadian HIV/AIDS Legal Network, described the position adopted by Canada in Vienna as "profoundly stupid."

Canada Court Hearing Request for Injunction to Allow Prescription Heroin This Week. The Vancouver-based Pivot Legal Society and Providence Health Care will be in court this week to argue that participants in the SALOME study (The Study to Assess Long-term Opioid Maintenance Effectiveness) should receive an exemption from recent amendments to federal drug laws that prohibit doctors from prescribing heroin to patients for whom other treatment options have been ineffective. Pivot is representing five patients whose condition improved while in the SALOME study, operated by Providence Health, and who can no longer access the treatment now that their time in the study is over. Click on the link for more details.

Mexican Lawmakers Hit DC, NYC to Discuss Their Marijuana Reform Proposals. Legislators from the Mexican Congress and the Mexico City Assembly will be in Washington, DC, and New York City to discuss the bills they introduced to decriminalize the consumption and purchase of marijuana for personal use in Mexico City and to legalize medical marijuana countrywide. Mexico City Senator Mario Delgado and Mexico City Assembly member Vidal Llerenas, both from the Democratic Revolution Party (PRD), will be in DC on March 24 and 25 and in NY on March 26 to discuss the aims of the marijuana reform proposals in Mexico. Click on the link for more details.

Chronicle AM -- March 12, 2014

Medical marijuana is keeping state legislators busy, Maine's governor has a 20th Century approach to drug problems, New Mexico's governor cuts funds to a diversion program, Indonesia shifts its stance on drug users, and more. Let's get to it:

Responding to new synthetic drugs by banning them is still a favored response in state legislatures. (wikimedia.org)
Medical Marijuana

DEA, LAPD Raid Dispensaries. DEA agents assisted by LAPD officers raided and closed several Los Angeles dispensaries Tuesday. They hit the Black Rose dispensary in Fairfax, Downtown Medical Caregivers off Main Street, Washington and Western Medical Group in Harvard Heights, Herbman in Exposition Park and two homes in Beverly Hills. The same person allegedly owns all four dispensaries.

Vermont Senate Passes Medical Marijuana Expansion Bill. A bill that lifts the 1,000-patient cap on the state's dispensaries and authorizes two more dispensaries passed the Senate with little debate Tuesday. Senate Bill 247 now heads to the House.

Revised Alabama CBD Medical Marijuana Bill Passes Senate. A CBD medical marijuana bill revised by its sponsors so that the University of Alabama-Birmingham would conduct a research study passed the Senate on a unanimous vote Tuesday night. Senate Bill 174 now moves to the House.

Utah CBD Medical Marijuana Bill Passes Senate. A bill that would allow compassionate use of non-intoxicating cannabis oil by Utahns with untreatable epilepsy passed the Senate Tuesday by a wide margin, despite reservations some senators have about the oil's safety and long term benefits. House Bill 105 now goes back to the House, which had already passed it, but now must sign off on changes in the Senate version.

Michigan Medical Marijuana Bills Get Hearing. Two bills that would legalize the manufacture and sale of medical marijuana-infused products such as brownies and oils and permit communities to allow and regulate marijuana dispensaries got a hearing in the Senate Government Operations Committee hearing Tuesday, but no vote. Committee chair and Senate Majority Leader Randy Richardville (R-Monroe) is not expected to schedule another hearing for at least a couple of weeks. The bills are House Bill 5104 and House Bill 4271.

California Bill to Tighten Location Restrictions on Dispensaries Killed in Committee. A bill that would have widened "dispensary free" zone around schools from 600 feet to 1,000 feet has been blocked in the Assembly Public Safety Committee, Assembly Minority Leader Connie Conway (R-Tulare) said Tuesday. Conway is the author of the bill in question, Assembly Bill 1588.

American Herbal Pharmacopoeia Releases Study on Marijuana and Epilepsy. The medical research group American Herbal Pharmacopoeia (AHP) issued a new scientific review Tuesday, Cannabis in the Treatment of Epilepsy, which compiles much of the leading and historical research on epilepsy and cannabis (medical marijuana) for use by scientists, physicians, patients, and parents, as well as those producing and manufacturing it for treatment. Patient advocacy group Americans for Safe Access (ASA) will host a Google Hangout today, March 12th at 8:00pm EDT, featuring AHP director Roy Upton, ASA scientific advisory board member Dr. Sunil Aggarwal and others.

Law Enforcement

Maine Governor Wants More Drug War. Confronted by increasing levels of opiate drug use, Maine Gov. Paul LePage (R) responded Tuesday by proposing to beef up drug war spending. The conservative governor wants to add 22 new state positions including 14 new Maine Drug Enforcement agents, four new prosecutors for the Office of the Maine Attorney General as well as four new district court judges to bolster the state's four drug courts in Lewiston, Presque Isle, Bangor and Portland. He also criticized methadone, saying the drug should be provided in a clinical setting only. He said he intended to focus equally on the addiction side of the drug equation but did not offer any details.

New Mexico Governor Vetoes Funding for Drug Diversion Pilot Program. Gov. Susana Martinez (R) vetoed spending $140,000 for a Santa Fe program to divert some drug offenders to treatment Tuesday. The city's pre-booking diversion program, otherwise known as Law Enforcement Assisted Diversion (LEAD), will begin late this month. If successful, this model could become a model for other New Mexico communities, saving both the criminal justice and health systems tens of millions of dollars each year.

Salvia Divinorum

Rhode Island Bill to Ban Salvia, Jimson Weed Has Hearing Today. A bill that would ban the use of salvia divinorum and Jimson weed was scheduled for committee action today. House Bill 7191, sponsored by Rep. Arthur Corvese (D-North Providence), gets a vote before the House Judiciary Committee. It's not clear what prompted the bill.

New Synthetic Drugs

Minnesota Synthetic Drug Ban Bill Wins House Committee Vote. A bill that would give the state pharmacy board the authority to use its emergency powers to classify new synthetic drugs as banned substances is advancing in the House. House File 2446, introduced by Rep. Erik Simonson (D-Duluth) passed the House Health and Human Services Policy Committee Tuesday with few questions and a unanimous vote.

International

LEAHN Releases Frankfurt Principles on Drug Law Enforcement. The Law Enforcement and HIV Network (LEAHN) has released the Frankfurt Principles on Drug Law Enforcement, developed at the International Conference on Drug Policy and Policing last November in Frankfurt. The principles are designed to make law enforcement an effective partner in a harm reduction approach to drug use and related illness.

TDPF Releases Report on Dutch Coffee Shop Policy. Prompted by "misreports and misunderstandings that have led many to believe the Netherlands is retreating from its pragmatic policy of allowing cannabis to be sold via 'coffee shop,'" the British Transform Drug Policy Foundation has released a new report to set things straight. The report is Cannabis policy in the Netherlands: Moving forward, not backwards.

Ghana Anti-Drug Head Calls for Marijuana Legalization Debate. The executive secretary of the Narcotics Control Board (NACOB), Akrasi Sarpong, has called for a national debate on legalization of marijuana in the country. "Ordinary people can say don't legalize it but that will be vocalizing the ostrich hiding its head in the sand, because there is a virtual legalization on the ground," Sarpong said. Many people believe "what you are fighting is not crime," he added. "Reports say cannabis is the number one problem in Africa so what are we therefore saying. People laugh at these things, because, they are growing them in their homes," he said.

Peru Ponders Restarting Drug Plane Shootdown Program.Peru suspended its law allowing its Air Force to shoot down suspected drug planes in April 2001, when the Peruvian Air Force, accompanied by a CIA support plane, mistakenly shot down an aircraft carrying American missionaries, killing Veronica Bowers and her infant daughter. Now, Congressman Carlos Turbino, a retired general, has filed a bill to reinstate the program. It is currently before the congressional defense committee, even though it is opposed as unnecessary by the government of President Ollanta Humala.

New Indonesian Drug Law Emphasizes Rehabilitation Instead of Punishment of Drug Users. Indonesian ministers this week signed a memorandum of understanding that they say will declare drug users "victims" instead of criminals, to be treated at rehabilitation centers instead of sentencing to prison. President Susilo Bambang Yudhoyono has gone on the record supporting a softer touch for addicts, but early efforts to push for more rehabilitation centers have met with resistance from judges who are loathe to appear weak on drugs and lawmakers who often use the early release of traffickers as opportunities to grandstand against the president. Drug user make up 42% of all Indonesian prisoners.

Marijuana Reform Rally Set for Glasgow Next Month. A mass marijuana rally called by the Glasgow Cannabis Social Club is set for the city center next month, and it's already causing grumbling. "People will be extremely annoyed at the high-profile celebration of something that's illegal," grumped Conservative MSP John Lamont. "It is disappointing that such a carnival in homage to an illegal substance is being facilitated in this way," he added. The old fogies want the police to shut it down, but the police have said they will stop it only if lawbreaking takes place. The celebration is due to take place at Glasgow Green on Sunday April 20. So far, more than 200 people have signed up via Facebook to attend.

Chronicle AM -- February 26, 2014

A Maryland police chief embarrasses himself with bogus marijuana death claims, welfare drug testing bills face challenges in the Deep South, a hemp bill advances in Indiana, Russia's drug czar says "nyet" to legalization, and more. Let's get to it:

Marijuana Policy

Maryland Decriminalization, Legalization Bills Get Hearing; Police Chief Cites Hoax Story About Pot Overdose Deaths. Sen. Robert Zirkin's (D-Baltimore) Senate Bill 364, which would decriminalize marijuana possession, and Sen. Jamie Raskin's (D-Montgomery County) Senate Bill 658, which would legalize marijuana, got hearings in the Senate Judiciary Committee Tuesday. Law enforcement opposed the bills, while leaders of the ACLU and NORML members supported it. The lowlight of the hearing was Annapolis Police Chief Michael Pristoop's testimony mentioning an article about 37 overdose deaths the day marijuana became legal in Colorado. After being called out for repeating the hoax story by Sen. Raskin, Pristoop quickly backtracked.

Iowa Semi-Decriminalization Bill Introduced. A bill that would remove the possibility of jail time for possession of less than an ounce and a half of marijuana has been introduced by Rep. Bruce Hunter (D-Des Moines). It's not a true decriminalization bill because it would keep simple possession as a misdemeanor offense. House File 2313 has been referred to the House Judiciary Committee. Click on the link to read the bill.

Texas Poll Finds Near Majority for Legalization. Almost half -- 49% -- of Texans surveyed in a University of Texas/Texas Tribune poll support legalizing weed in either small quantities (32%) or any quantity (17%). Another 28% supported legalization only for medical purposes, while only 23% opposed any form of legalization.

New York Poll Finds Majority Oppose Legalization. A new Siena poll has support for legalization at only 43%, with 53% opposed. That contrasts with a recent Q Poll that had New Yorkers supporting legalization 57% to 39%. Differences in the questions asked and the margin of error in the polls may account for the difference. Or New Yorkers are conflicted.

Medical Marijuana

Kentucky CBD Medical Marijuana Bill Advances. A bill that would allow for the trial use of high CBD cannabis oil to treat childhood epileptic seizures was approved by the Senate Health and Welfare Committee Wednesday. Senate Bill 124 now heads for the Senate floor.

Hemp

Hemp Bill Advances in Indiana. A bill to legalize the production of industrial hemp passed the House Agriculture Committee Tuesday and now heads for the House floor. The bill is Senate Bill 357. It has already passed the Senate.

Drug Testing

Welfare Drug Testing Bill Advances in Georgia. A bill that would require food stamp and welfare recipients to undergo drug testing upon "reasonable suspicion" passed the House Judiciary Committee Monday. House Bill 772 now moves to the House floor.

Welfare Drug Testing Bill Stalls in Alabama Senate. A bill requiring drug testing of some welfare applicants hit a roadblock in the Senate Tuesday when Senate President Pro Tem Del Marsh (R-Anniston) adjourned the body after Democrats began fighting the bill. Senate Bill 63 would require drug testing of any applicant with a drug conviction in the last five years. It is just one of five bills in the Republican agenda to tighten regulations for public assistance.

Sentencing

West Virginia Senate Approves Draconian Drug Sentencing Bill. A bill that would increase the penalty for bringing drugs into West Virginia from one year to up to 15 years passed the Senate Monday. It now goes to the House.

International

Russian Drug Czar Rules Out Marijuana Legalization, Methadone Maintenance. The head of Russia's Federal Drug Control Service has called marijuana a dangerous gateway drug and said the authorities did not plan to legalize it, or to allow methadone treatment for heroin addicts. "Marijuana users have a 50 or 60 times higher risk of switching to heroin. There is one step from dope to heroin," Viktor Ivanov said in an interview with the Interfax news agency. He completely ruled out legalization, saying it was too risky in an advanced society. "Today we live in the age of high technology, a lot of things are managed with the help of computer systems. Someone who works at a nuclear power plant can wreak real havoc after smoking marijuana," he said. Ivanov also scoffed at needle exchange and methadone maintenance, saying there was little reliable evidence methadone maintenance worked. [Ed: Ivanov must have missed the entirety large body of research done on both needle exchange and methadone maintenance, which has found them to be effective and of paramount importance.]

Colombia's FARC Calls for Dismantling Drug-Paramilitary Nexus. Colombia's FARC guerrilla army called Tuesday for the dismantling of drug and paramilitary organizations it said were embedded within the Colombian state. The call was part of the FARC's six-point program to deal with the drug issue in the country, which is the fourth item on the agenda of peace talks between the FARC and the Colombian government.

British Chief Constable Says Give Heroin to Addicts. Mike Barton, Chief Constable for Dunham Constabulary, is calling for heroin maintenance for addicts. Such a move would "take money out of drug dealers' pockets," he said, adding that it "isn't practical" to simply arrest addicts. His comments come in a BBC documentary in which he went to Copenhagen to visit drug consumption rooms there.

Hoffman, Heroin, and What Is To Be Done [FEATURE]

The news last Sunday that acclaimed actor Phillip Seymour Hoffman had died of an apparent heroin overdose has turned a glaring media spotlight on the phenomenon, but heroin overdose deaths had been on the rise for several years before his premature demise. And while there has been much wailing and gnashing of teeth -- and quick arrests of low-level dealers and users -- too little has been said, either before or after his passing, about what could have been done to save him and what could be done to save others.

cooking heroin (wikimedia.org)
There are proven measures that can be taken to reduce overdose deaths -- and to enable heroin addicts to live safe and normal lives, whether they cease using heroin or not. All of the above face social and political obstacles and have only been implemented unevenly, if at all. If there is any good to come of Hoffmann's death it will be to the degree that it inspires broader discussion of what can be done to prevent the same thing happening to others in a similar position.

Hoffman, devoted family man and great actor that he was, died a criminal. And perhaps he died because his use of heroin was criminalized. Criminalized heroin -- heroin under drug prohibition -- is of uncertain provenance, of unknown strength and purity, adulterated with unknown substances. While we don't know what was in the heroin that Hoffman injected, we do know that he maintained his addiction and went to meet his maker with black market dope. That's what was found beside his lifeless body.

In a commentary published by The Guardian, actor Russell Brand, a recovered heroin addict, laid the blame for Hoffman's demise on the drug laws. "Addiction is a mental illness around which there is a great deal of confusion, which is hugely exacerbated by the laws that criminalise drug addicts," Brand wrote, calling prohibitionists' methods "so gallingly ineffective that it is difficult not to deduce that they are deliberately creating the worst imaginable circumstances to maximise the harm caused by substance misuse." As a result, "drug users, their families and society at large are all exposed to the worst conceivable version of this regrettably unavoidable problem."

We didn't always treat our addicts this way. Even after the passage of the Harrison Act in 1914, doctors continued for years to prescribe maintenance doses of opiates to addicts -- and hundreds of them went to jail for it as the medical profession fought, and ultimately lost, a battle with the nascent drug prohibition bureaucracy over whether giving addicts their medicine was part of the legitimate practice of medicine.

The idea of treating heroin addicts as patients instead of criminals was largely vanquished in the United States, but it never went away -- it lingers with methadone substitution, for example. But other countries have for decades been experimenting with providing maintenance doses of opioids to addicts, and to good result. It goes by various names -- opiate substitution therapy, heroin-assisted theatment, heroin maintenance -- and studies from Britain and other European countries, such as Germany, the Netherlands, and Switzerland, as well as the North American Opiate Medications Initiative (NAOMI) and the follow-up Study to Assess Long-Term Opiate Maintenance in Canada have touted its successes.

Those studies have found that providing pharmaceutical grade heroin to addicts in a clinical setting works. It reduces the likelihood of death or disease among clients, as well as allowing them to bring some stability and predictability to sometimes chaotic lives made even more chaotic by the demands of addiction under prohibition. Such treatment has also been found to have beneficial effects for society, with lowered criminality among participants and increased likelihood of their integration as productive members of society.

The dry, scientific language of the studies obscures the human realities around heroin addiction and opioid maintenance therapy. One NAOMI participant helps put a human face on it.

"I want to tell you what being a participant in this study did for me," one participant told researchers. "Initially it meant 'free heroin.' But over time it became more, much more. NAOMI took much of the stress out of my life and allowed me to think more clearly about my life and future. It exposed me to new ideas, people (staff and clients) that in my street life (read: stressful existence) there was no time for."

"After NAOMI, I was offered oral methadone, which I refused. After going quickly downhill, I ended up hopeless and homeless. I went into detox in April 2007, abstained from using for two months, then relapsed. In July 2008 I again went to detox and I am presently in a treatment center... I am definitely not "out of the woods" yet, but I feel I am on the right path. And this path started for me at the corner of Abbott and Hastings in Vancouver... Thank you and all who were involved in making NAOMI happen. Without NAOMI, I wouldn't be where I am today. I am sure I would be in a much worse place."

Arnold Trebach, one of the fathers of the drug reform in late 20th Century America, has been studying heroin since 1972, and is still at it. He examined the British system in the early 1970s, when doctors still prescribed heroin to thousands of addicts, and authored a book, The Heroin Solution, that compared and contrasted the US and UK approaches. Later this month, the octogenarian law professor will be appearing on a panel at the Vermont Law School to address what Gov. Peter Shumlin (D) has described as the heroin crisis there.

Phillip Seymour Hoffman (wikimedia.org)
"The death of Phillip Seymour Hoffman is a tragedy all the way around," Trebach told the Chronicle. "It's a bad idea to use heroin off the street, and he shouldn't have been doing that."

That said, Trebach continued, it didn't have to be that way.

"If we had had a sensible system of dealing with this, he would have been in treatment under medical care," he said. "If he was going to inject heroin, he should have been using pharmaceutically pure heroin in a medical setting where he could also have been exposed to efforts to straighten out his personal life, and he could have access to vitamins, weight control advice, and the whole spectrum of medical care. And if he had had access to opioid antagonists, he could still be alive," he added.

While Hoffman may have made bad personal choices, Trebach said, we as a society have made policy choices seemingly designed to amplify the prospects for disaster.

"This is a sad thing. He is just another one of the many victims of our barbaric drug policy," he said. "This was a totally unnecessary death at every level. He shouldn't have been using, but we should have been taking care of him."

The stuff ought to be legalized, Trebach said.

"I'm an advocate of full legalization, but if we can't go that far, we need to at least provide social and psychological support for these people," he said. "And even if we were to decriminalize or legalize, I would still want to figure out ways to provide support and love and kindness to people using the stuff. I advise you not to do it, but if you're going to use it, I want to keep you alive. I remember talking to people from Liverpool [a famous heroin maintenance clinic covered in the '90s by Sixty Minutes, linked above] about harm reduction around heroin use back in the 1970s. One of the ladies said it is very hard to rehabilitate a dead addict."

"There are plenty of things we can be doing," said Hilary McQuie, Western director for the Harm Reduction Network, reeling off a list of harm reduction interventions that are by now well-known but inadequately implemented.

"We can make naloxone (Narcan) more available. We need better access to it. It should be offered to people like Hoffman when they are leaving treatment programs, especially if they've been using opiates, just as a safeguard," she said. "Having treatment programs as well as harm reduction programs distribute it is important. We can cut the overdose rate in half with naloxone, but there will still be people using alone and people using multiple substances."

There are other proven interventions that could be ramped up as well, McQuie said.

"Safe injection sites would be very helpful, so would more Good Samaritan overdose emergency laws, and more education, not to mention more access to methadone and buprenorphine and other opioid substitution therapies (OST)," she said, reeling off possible interventions.

Dr. Martin Schechter, director of the School of Population and Public Health at the University of British Columbia in Vancouver, knows a thing or two about OST. The principal study investigator for the NAOMI and the follow-up SALOME study, Schechter has overseen research into the effectiveness of treating intractable addicts with pharmaceutical heroin, as well as methadone. The results have been promising.

"What we're using is medically prescribed pharmaceutical diacetylmorphine, the active ingredient in heroin," he explained. "It's what you have when you strip away all the street additives. This is a stable, sterile medication from a pharmaceutical manufacturer. We know the precise dose tailored for each person. With street heroin, not only is it adulterated and injected in unsterile situations, but people really don't know how strong it is. That's probably what happened to Mr. Hoffman."

Naloxone (Narcan) can reverse opiate overdoses (wikimedia.org)
In NAOMI, 90,000 injections were administered to study participants, and only 11 people suffered overdoses requiring medical attention.

"Never did we have a fatal overdose," Schechter said. "Because it was in a clinic, nurses and doctors are right there. We administer Narcan (naloxone), and they wake up."

Heroin maintenance had even proven more effective than methadone in numerous studies, Schechter said.

"There have been seven randomized control trials across Europe and in Canada that have shown for people who have already tried treatments like methadone, that medically prescribed heroin is more effective and cost effective treatment than simply trying methadone one more time."

Those studies carry a lesson, he said.

"We have to start looking at heroin from a medicinal point of view and treat it like a medicine," he argued. "The more we drive its use underground, the more overdoses we get. We need to expand treatment programs, not only with methadone, but with medically prescribed heroin for people who don't respond to other treatments."

Safe injection sites are also a worthwhile intervention, Schechter said, although he also noted their limitations.

"Injecting under supervision is much safer; if there is an overdose, there is prompt attention, and they provide sterile equipment, reducing the risk of HIV and Hep C," he said. "But they are still injecting street heroin."

He would favor decriminalizing heroin possession, too, he said.

Harm reduction measures, opioid maintenance treatments, and the like are absolutely necessary interventions, said McQuie, but there is a larger issue at hand, as well.

"We still need to look at the overall issue of the stigmatization of drug users," she said. "People aren't open about their use, and that puts them in a more dangerous situation. It's really hard in a criminalized environment."

Stigmatization means to mark or brand someone or something as disgraceful and subject to strong disapproval. Defining an activity, such as heroin possession, as a crime is stigmatization crystallized into the legal structures of society itself.

"The ultimate harm reduction solution," McQuie argued, "is a regulated, decriminalized environment where it is available by prescription, so people know what they're getting, they know how much to use, and it's not cut with fentanyl or other deadly adulterants. People wouldn't have to deal with all the collateral damage that comes from being defined as criminals as well as dealing with the consequences of their drug use. They could deal with their addictions without having to worry about losing their homes, their families, and their freedoms."

While such approaches have a long way to go before winning wide popular acceptance, policymakers should at least be held to account for the consequences of their decision-making, McQuie said, suggesting that the turn to heroin in recent years was a foreseeable result of the crackdown on prescription opioid pain medication beginning in the middle of the last decade.

"They started shutting down all those 'pill mills' and people should have anticipated what would happen and been ready for it," she said. "What we have seen is more and more people turning to injecting heroin, but nobody stopped to do an impact statement on what would be the likely result of restricting access to pain pills."

The impact can be seen in the numbers on heroin use, addiction, and overdoses. While talk of a "heroin epidemic" is overblown rhetoric, the number of heroin users has increased dramatically in the past decade. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the number of past year users grew by about 50% between 2002 and 2011, from roughly 400,000 to more than 600,000. At the same time, the number of addicted users increased from just under 200,000 to about 370,000, a slightly lesser increase.

If there is any good news, it is that, according to the latest (2012) National Household Survey of Drug Use and Health, the number of new heroin users has remained fairly steady at around 150,000 each year for the past decade. That suggests, however, that more first-time users are graduating to occasional and sometimes, dependent user status.

And some of them are dying of heroin overdoses, although not near the number dying from overdoses from prescription opioids. Between 1999 and 2007, heroin deaths hovered just under 2,000, even as prescription drug deaths skyrocketed, from around 2,500 in 1999 to more than 12,000 just eight years later. But, according to the Centers for Disease Control, by 2010, the latest year for which data are available, heroin overdose deaths had surpassed 3,000, a 50% increase in just three years.

While the number of heroin overdose deaths is still but a fraction of those attributed to prescription opioid overdoses and the numbers since 2010 are spotty, the increase that showed up in 2010 shows no signs of having gone away. Phillip Seymour Hoffman may be the most prominent recent victim, but in the week since his death, another 50 or 60 people have probably followed him to the morgue due to heroin overdoses.

There are ways to reduce the heroin overdose death toll. It's not a making of figuring out what they are. It's a matter of finding the political and social will to implement them, and that requires leaving the drug war paradigm behind.

New York City, NY
United States

Could Different Drug Policies Have Saved Philip Seymour Hoffman?

The tragic death of actor Philip Seymour Hoffman yesterday has prompted expressions of grief and of praise for his talent. It also, naturally, has prompted discussions of addiction, the impact of pain pill prescriptions on the addicted, even of pain pill restrictions causing more people to turn to heroin.

Philip Seymour Hoffman at the 81st Academy Awards (courtesy Chrisa Hickey, flickr.com/photos/chrisahickey/, via wikimedia.org)
While the latter raises the question about whether different drug policies could make things safer or less damaging or risky for heroin addicts, I haven't heard that question directly raised in the media. Although we don't know how Hoffman would have fared under a different system -- a system that had more options available, we do have information from places that do offer more options, and they are worth examining.

One of those options is heroin maintenance programs (also known now as heroin assisted treatment, or HAT). The most famous such program operated in Liverpool, England, before the conservative Thatcher government, encouraged by the Reagan administration (so we heard), shut it down. But HAT programs current operate in Switzerland, The Netherlands, Germany, Denmark, and the Canadian cities of Vancouver and Montreal. Patients in such programs receive a supply of pharmaceutically-produced heroin from a clinic (for free, though one can infer similar benefits if the heroin were merely cheap). They regularly access health services as a part of their participation. Those who need to inject the drug to relieve their cravings receive instruction on how to do so without damaging their veins, and heroin is made available in other forms as well.

A 2009 paper by leading drug policy researcher Peter Reuter, written for The Abell Foundation in Baltimore, reviewed research done in three of those countries. According to Reuter, Switzerland found a decrease in criminal involvement from 70% of the patients down to 10% after 18 months; and an increase in employment, from 14% to 32%. The health safety results were particularly impressive, including decreased contact with the street drug scene, and with very few adverse events or safety issues.

Many of those findings relate more to indigent addicts than they would to a famous actor. But the final point seems key, very few "adverse events" (e.g. overdoses and so forth) or safety issues, in any of the programs. Again, we don't know how Hoffman would have fared if he had entered a heroin maintenance program instead of buying it on the street. For that matter, we don't know if under legalization, broad or just for the addicted, whether Hoffman would have accessed such services in time, or chose to access them at all. But we know that many people do access these services in the countries that offer them, and that very few of the patients enrolled suffer overdose.

More generally, by prohibiting heroin, even for people who are already addicted to it, we prevent a whole class of possible approaches from every being taken to try to help people -- a whole set of options that people with substance abuse problems might be able to use to manage their problems -- to literally save their lives.

In the meanwhile, there are things to do that are legal even now, at least in a few states that have moved forward with them, with no federal laws standing in the way. These are Good Samaritan policies, that protect people from criminal liability when they seek help in an overdose situation; and use of the antidote medication for heroin overdoses, Naloxone. Meghan Ralston wrote about these in an oped yesterday.

We can also improve the debate. It's not enough to talk about the challenges of addiction and the risk of relapse people can face their entire lives, important as that is. It's a good start that people are starting to recognize the unintended consequences of the pain pill crackdown. But that isn't enough either. It's also important to take the next logical step in the argument, and rethink prohibition.

Chronicle AM -- January 16, 2014

Florida's medical marijuana initiative appears poised to qualify for the ballot (if it survives a challenge in the state Supreme Court), a new poll finds the country evenly split on marijuana legalization, Afghanistan was on the agenda in the Senate yesterday, and more. Let's get to it:

harvesting opium poppies in Afghanistan (unodc.org)
Marijuana Policy

ABC News/Washington Post Poll Has Americans Split on Marijuana. A new ABC News/Washington Post poll has support for marijuana legalization nationwide at 49%, with 48% opposed. The poll is in the same ballpark as other polls since the November 2012 elections, where support for legalization has ranged between 45% and 58%. Click on the link to see full poll results.

DEA Operations Chief Bemoans Marijuana Legalization Trend. DEA operations chief James Capra told a Senate committee Wednesday that marijuana legalization at the state level was "reckless and irresponsible" and could lead to dire consequences. "It scares us," Capra said, responding to a question. "Every part of the world where this has been tried, it has failed time and time again." [Editor's Note: No country had legalized marijuana until Uruguay did late last year, and that hasn't gone into effect yet. If Capra is referring to Amsterdam, where sales are tolerated, if not technically legal, cannabis coffee shops are now in their fourth decade of existence, and the problems associated with them are relatively trivial.] "There are more dispensaries in Denver than there are Starbucks," he continued. "The idea somehow people in our country have that this is somehow good for us as a nation is wrong. It's a bad thing. This is a bad experiment. It's going to cost us in terms of social costs."

Missouri Marijuana Legalization Petitions Approved for Circulation. Secretary of State Jason Kander announced Wednesday that 13 marijuana legalization initiatives had been approved for signature-gathering. The bakers' dozen initiatives are all variations on a theme: legalize and regulate marijuana in Missouri. They were submitted by Columbia defense attorney Dan Viets, the chairman of the activist group Show-Me Cannabis. To make the November 2014 ballot, organizers must gather 157,778 valid voter signatures for at least one of them by May 4.

Maryland Coalition to Legalize Marijuana Launched. Maryland legislators Thursday launched an effort to get a marijuana legalization bill, the Marijuana Control Act of 2014, passed this year. They were joined at a press conference by members of the newly formed Marijuana Policy Coalition of Maryland, which includes the ACLU of Maryland, Law Enforcement Against Prohibition, the Maryland League of Women Voters, the Marijuana Policy Project, and the Maryland NAACP.

Medical Marijuana

Florida Initiative Campaign Has Gathered 1.1 Million Signatures. The folks behind the Florida medical marijuana initiative, United For Care/Patients United for Freedom, announced Wednesday night that they had gathered 1.1 million signatures, nearly half a million more than needed to qualify for the ballot. While all the signatures haven't been validated yet, organizers are now confident they will pass that hurdle. Now, they have to wait and see if the state Supreme Court is going to allow the effort to move ahead.

Washington Patients, Advocates Speak Out Against Bill That Would Gut Medical Marijuana System. The House Health Committee got an earful from medical marijuana advocates at a hearing Wednesday on House Bill 2149, which would eliminate cultivation cooperatives (and thus, dispensaries) by 2020 and reduce the amount of marijuana patients could possess and the number of plants they could grow. The bill mirrors many of the recommendations of the state Liquor Control Board, which is charged with implementing I-502 marijuana legalization.

Hemp

Indiana Hemp Bill Introduced. State Sen. Richard Young (D-Milltown) has introduced Senate Bill 357, which would allow the Department of Agriculture to license industrial hemp growing and production. The bill requires the department to get necessary approvals from the federal government, which has yet to approve any such production anywhere in the US.

Illinois Hemp Bill Seeks New Life in 2014. State Rep. Kenneth Dunkin (D-Chicago) introduced a hemp bill, House Bill 2668, last year, but it has languished in committee despite picking up some bipartisan support. He said Wednesday that he was cautiously optimistic that opposition may be softening, and the bill could move this year.

Heroin

Maine Heroin Deaths Up Fourfold from 2011 to 2012. The number of heroin overdose deaths in Maine quadrupled between 2011 and 2012, according to numbers released by state officials Wednesday. Officials said the increase was due to tightening restrictions on the use of prescription opiates, a cheap heroin supply, and, possibly, cuts in MaineCare. But while the increase was dramatic, the 28 heroin overdose deaths reported in 2012 is well below the 2005 peak of 43. In the years between 2005 and 2011, heroin deaths declined steadily.

Heroin Prevention Bill Package Passes Wisconsin Assembly. The State Assembly Wednesday passed the HOPE (Heroin Opiate Prevention and Education) package of four bills designed to reduce the number of overdose deaths in the state. Sponsored by Rep. John Nygren (R-Marinette), one bill would allow anyone to use naloxone to reverse overdoses, another would grant legal immunity to drug users who call for help in an overdose emergency, a third would allow communities to establish prescription drug drop-off points, and the fourth would require people to show ID when picking up prescription drugs. The naloxone and legal immunity bills are Assembly Bill 446 and Assembly Bill 447. The package now moves to the Senate.

Kratom

Oklahoma Wants to Ban Kratom, But Meets Resistance. The Oklahoma Bureau of Narcotics wants to ban the Southeast Asian herb kratom, which it calls "the legal form of heroin," but kratom fans are responding with dismay and disputing the narcs' assessment. Kratom is not a controlled substance under federal law, but narc Mark Woodward said he planned to ban it until it is federally proven to have medical benefits. Kratom users have started a petition to challenge efforts to ban Kratom.

Drug Courts

Study Finds Drug Courts Ignore Science When it Comes to Opiate Substitution Therapies. A small study of drug courts in New York state finds that their skeptical approach to opiate substitution therapies (OST), such as methadone and buprenorphine, can be a barrier to successful treatment. "Many courts do not respect medical consensus on scientifically sound treatment standards. Some courts included OST as part of court-mandated treatment options, while others allowed OST for a court-defined period of time as a bridge to abstinence. Still others showed intolerance and even disdain for anything having to do with methadone and buprenorphine, or -- as with the drug court in Albany County -- refused outright to admit people on methadone or buprenorphine treatment," the authors wrote. "Ordering people who are dependent on opioids to get off their prescribed methadone or buprenorphine medicines can force patients to seek out and become dependent on other opioids like prescription analgesics. Addiction to prescription opioids has been recognized as a priority problem by U.S. policy-makers, but drug courts may be exacerbating it."

Search and Seizure

ACLU Sues Border Patrol Over Interior Border Check Point Searches. The American Civil Liberties Union (ACLU) has filed suit against the Border Patrol, claiming its agent routinely violate the constitutional rights of local residents by stopping and searching them at interior checkpoints on highways near the border. In a 1976 ruling, the US Supreme Court ruled that immigration checkpoints were permissible if the stops were brief, involved "a limited enquiry into residence status," and a visual inspection of the exterior of the vehicle. "But that's not what's happening here," said ACLU attorney James Duff Lyall in Tucson. He said the cases mentioned in the lawsuit provide strong indications that the Border Patrol is using the checkpoints for general crime control, "which the courts have said is not acceptable for a checkpoint. The same thing is happening over and over again to many border residents," Lyall said. "They're going on fishing expeditions where there's no reasonable suspicion."

International

Afghan Drug Situation "Dire," Federal Auditor Tells Senators."The situation in Afghanistan is dire with little prospect for improvement in 2014 or beyond," Special Inspector General for Afghanistan Reconstruction John Sopko told the Senate Caucus on International Narcotics Control Wednesday. Poppy cultivation is at record levels and the drug trade now accounts for 15% of Afghan GDP, Sopko said.

US to Help Afghanistan With Drug Problem, State Department Official Tells Senators. At the same hearing mentioned in the story above, Assistant Secretary of State for the Bureau of International Narcotics and Law Enforcement Affairs ("drugs and thugs") William Brownfield vowed the US would remain committed to helping Afghanistan fight drug production and trafficking even after US and NATO troops pull out at the end of this year. "We will continue to ensure our counternarcotics programs are well integrated with broader US efforts, including assistance programs aimed at supporting a vibrant legal economy," he testified Wednesday. "The expanding cultivation and trafficking of drugs is one of the most significant factors putting the entire US and international donor investment in the reconstruction of Afghanistan at risk," he said.

Chronicle AM -- January 9, 2014

Alaska appears poised to vote on marijuana legalization, New York's governor announces a half-step toward medical marijuana, the ACLU fights for our rights on a couple of fronts, and trouble could be coming to the coca fields of Peru. And more. Let's get to it:

Bolivian President Evo Morales has a new bully pulpit from which to crusade for coca. (wikimedia.org)
Alaska Marijuana Legalization Initiative Campaign Hands in Signatures. Supporters of an initiative to legalize marijuana in Alaska handed in 46,000 signatures Wednesday. The campaign only needs 30,000 valid signatures to qualify for the August ballot. State election officials have 60 days to verify the signatures.

Marijuana Decriminalization Bill Filed in Alabama. Rep. Patricia Todd (D-Birmingham) has filed a bill that would decriminalize the possession of up to an ounce of marijuana. An as yet unspecified fine would apply to offenders. The bill has been assigned to the House Judiciary Committee and will be scheduled for a hearing when the session gets underway next week.

Alabama Governor Rejects Legal and Medical Marijuana. Gov. Robert Bentley (R) said Wednesday he opposes legalizing marijuana for either recreational or medical purposes, although he suggested he would be open to FDA-approved medical marijuana products. "I do believe there are medications out there that will do the same thing," Bentley said. "Now if someone wants to use the medicine that is in marijuana, go through the testing when you do that through the FDA, go through all of that -- that's fine. I have no problem with that."

Medical Marijuana

New York Governor Announces Limited Medical Marijuana Program. Gov. Andrew Cuomo (D) used his State of the State address Wednesday to announce he will initiate a limited medical marijuana program through executive action. Advocates said the measure was not enough and that the state legislature needs to pass pending medical marijuana legislation.

Asset Forfeiture

Utah Moving to Undo Asset Forfeiture Reforms. The Utah legislature moved late last year to roll back asset forfeiture reforms approved by state voters in a 2000 referendum. In unanimous votes, legislators approved a bill that will kill the provision requiring reimbursement for property owners who win in court and to require prosecutors to file such cases in a timely manner. Read Radley Balko's lengthy report by clicking on the link.

Drugs and Pregnancy

Experts File Brief Challenging Use of Child Abuse Law against Pregnant Women Using Methadone. Some 76 groups and experts in maternal, fetal, and child health, addiction treatment, and health advocacy filed an amicus curiae (friend of the court) brief before the New Jersey Supreme Court, urging it to overturn a lower court ruling making the state's civil child abuse law applicable to women who received medically prescribed methadone treatment while pregnant.

Search and Seizure

Indiana ACLU Challenges Pain Medication Drug Test Rules. The ACLU of Indiana filed a lawsuit Wednesday in federal court challenging a new state rule that requires patients prescribed a certain level of pain medications to undergo annual drug tests. The rule concocted by the state Medical Licensing Board last month requires such patients to sign a treatment agreement that includes agreement to undergo the annual tests. The ACLU argues that the rule violates Fourth Amendment proscriptions against unreasonable searches and seizures.

Massachusetts ACLU Sues to Block Drug Dog Sniffs of Prison Visitors. The ACLU of Massachusetts and a prisoners' rights group have filed a lawsuit in Suffolk County Superior Court seeking to block the state Department of Corrections from using drug dogs to search prison visitors. The suit seeks a preliminary injunction to immediately stop the practice and allow for public comment on the policy, which the department instituted in November. A hearing is set for January 24.

International

Peru Coca Eradication to Target VRAEM for First Time, DEVIDA Head Says. The Peruvian government for the first time will attempt to eradicate large amounts of coca crops in the Apurimac, Ene, and Mantaro river valleys (VRAEM), the head of the Peruvian anti-drug agency DEVIDA said Wednesday. The area is the most densely planted coca growing region in the world, accounting for more than half of all Peruvian production, and is the home of Shining Path guerilla remnants who got involved in the drug trade as their rebellion fizzled 20 years ago. DEVIDA wants to eradicate 37,000 acres of coca crops there, about 75% of total plantings in the region. Look for trouble when eradication efforts actually get underway, probably in August.

Bolivia to Use G-77 Post to Push for Legal Coca Leaf Internationally. Bolivian President Evo Morales has assumed chairmanship of the Group of 77 nations, and he said Wednesday that he would use his position to push for removing coca leaf from the 1961 UN Single Convention's list of internationally banned drugs. Bolivia briefly left the treaty in 2012 before returning last year with a reservation that it did not recognize the ban on coca leaf chewing. "Last year, we achieved recognition of traditional consumption of the coca leaf," he said. "Our next task will be to remove the coca leaf from the list of prohibited substances."

Germans Not Ready for Marijuana Legalization, Poll Finds. Only 29% of Germans said they favored legalizing marijuana in a new poll, while 65% were opposed. The only political party with a majority favoring legalization was the Greens, and just barely, with 51%. A Green politician, Monika Herrmann, is trying to open a Dutch-style cannabis coffee shop in Berlin's Friedrichshain-Kreuzberg district, but would need federal government approval. This poll isn't going to help.

France Approves Marijuana-Based Medicine for Multiple Sclerosis. France's health ministry announced Thursday it had approved the use of Sativex, a cannabinoid mouth spray, to treat patients suffering from multiple sclerosis (MS). The drug is the first marijuana-based medicine to be made available in the country. Sativex is already approved in more than 20 countries.

Chronicle AM -- November 14, 2013

Years in prison for growing weed in Missouri, life in prison for drug smuggling in Singapore -- we still have a long way to go. There's more drug policy-related news as well today. Let's get to it:

Canadian addicts are suing Ottawa over its moves to block prescription heroin.
Marijuana Policy

Missouri Brother and Sister Get 20+ Years for Growing 12 Pot Plants. If anyone still wonders why marijuana law reform is needed, here's why: An eastern Missouri brother and sister, ages 24 and 36, have been sentenced to 22 years and 15 years in prison, respectively, for growing 12 pot plants and eight seedlings. Prosecutors sought the harsh sentences, saying it was a "large-scale" grow and that guns and bullet-proof vests were present in the home. But neither guns nor vests are illegal, and the couple wasn't charged with a weapons enhancement; they got a combined 37 years in prison for growing a few plants.

NORML Endorses Pennsylvania Governor Candidate. The National Organization for the Reform of Marijuana Laws (NORML) has endorsed John Hanger for governor. Hanger is running for the Democratic Party nomination and won NORML's endorsement in part because of his three-point plan to legalize marijuana in the Keystone State by 2017. "NORML PAC is pleased to endorse John Hanger in his campaign to become Pennsylvania's next governor," said NORML Communications Director Erik Altieri. "Mr. Hanger is the only candidate who isn't afraid to openly discuss and campaign on a platform that calls for widespread reform of Pennsylvania's marijuana laws."

Medical Marijuana

I-502 Leader Calls for Medical Marijuana Home Grows to Remain. Alison Holcomb, architect of Washington state's successful marijuana legalization campaign, has called on state regulators to continue allow medical marijuana patients to grow their own. I-502, the legalization initiative, does not allow home cultivation for non-patients, and regulators have proposed ending home cultivation for patients as well, but have run into considerable flak for that and other proposals that impinge on the existing medical marijuana system. Holcomb's statement came Wednesday, the last day for public input on the issue.

Criminal Justice

Virginia's Criminal Justice System Cruel, Ineffective, and Crisis-Bound, Report Says. The Justice Policy Institute released a report Wednesday bemoaning the state of criminal justice in the Old Dominion. The report's title pretty much says it all: Virginia's Justice System: Expensive, Ineffective, and Unfair. While the state has made some recent progress, it "continues to suffer under misguided policies and practices of the past," the report concluded. The report made a number of reform recommendations, including reintroducing parole and reducing the focus on drug offenses.

International

Canadian Addicts Sue for Prescription Heroin. Five Vancouver heroin addicts and Providence Health Care have launched a constitutional challenge to the federal government's ban on prescribing the drug. Health Canada's special access program (SAP) had recently approved applications from BC doctors to give diacetylmorphine (heroin) treatment to about 20 patients who were completing their participation in a Vancouver-based clinical trial -- the first time it had ever done so, but the federal health ministry denounced the decision and immediately changed policies to ensure it was never allowed again.

Mexican Cartel Pays $25 Million a Year in Bribes, Newspaper Says. The Knights Templar (Los Caballeros Templarios) drug trafficking organization in Michoacan is paying nearly $25 million a year to different officials in the state, the Mexico City newspaper El Milenio reported. The group also spends about $5 million a year in bribes in other states where it has a smaller footprint. In Michoacan, federal police commanders are getting more than $25,000 a month, state police commanders are getting more than $18,000 a month, and so are some officials in prosecutors' offices. Journalists are also on the cartel's payroll, with print reporters getting $3,000 a month and radio reporters getting nearly $2,000 a month. The numbers come from an intelligence report made available to reporters.

Colombia's FARC Ready to Deal with Coca Issue. As the leftist guerrillas of the FARC and the Colombian government enter the next phase of their negotiations to end the nearly half-century-old armed struggle there, the FARC's top leader, Timoleon Jiminez, said the issue of illicit drug cultivation, which is next on the agenda, could be addressed, but only in the context of social justice for the peasantry. "We understand that if rural communities are satisfied in their basic aspirations as a result of agreements in dialogs and many negotiation tables taking place in the country, the problem of illegal crops would have disappeared forever in Colombia," he said. "Our satisfaction for a Colombia without coca will be enormous, much more, if the way leads to a Colombia without poverty that can make use of its political rights without any threats and violence." Peace talks resume next week in Havana.

First Singapore Drugs Death Row Inmate Re-Sentenced. The first person to benefit from Singapore's reform of its draconian death-penalty-for-drugs law was re-sentenced Thursday. Yong Vui Kong had been sentenced to death for bringing less than two ounces of heroin into the country, but under the sentencing reform, he was re-sentenced to life in prison and 15 lashes of the cane. The changes allow judges the discretion to sentence a courier to life imprisonment and caning if he is found to have substantively assisted the authorities in the fight against drug-trafficking.

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

New Daily Roundups from Drug War Chronicle

If you've been following Drug War Chronicle on our web site the past week, you have probably noticed a new, daily feature, "Chronicle AM." The AM is a roundup of stories that have hit the news wires. As Phil noted in his award speech two weeks ago, there is too much happening now to be able to give it all even medium-level coverage, much less to do so quickly. Chronicle AM is a way to survey a lot of the important stories each day, and we continue to publish our usual features and newsbriefs on a daily basis too. The following are the stories we noted in Chronicle AM installments during the past week.

Marijuana Policy

New Hampshire Marijuana Legalization Bill Dies in Committee. House Bill 492, which would have taxed and regulated marijuana like alcohol was defeated in the House Criminal Justice and Public Safety Committee Wednesday on an 11-7 vote. The action came just a week after a state poll showed 60% supported the bill.

Federal Judge Cuts Marijuana Sentences. Maryland US District Court Judge James Bredar Monday handed down sentences lighter than called for in federal guidelines in a major marijuana smuggling case, saying such offenses are "not regarded with the same seriousness" as they were just a few decades ago. Bredar also noted that the federal government's decision to largely leave marijuana sales in legalization states raised "equal justice" concerns.

Amendments Filed to California Marijuana Legalization Initiative. Americans for Policy Reform, the people behind the 2014 Marijuana Control, Legalization and Revenue Act initiative, Wednesday filed amendments to the proposed law. They include strengthening some penalties and clarifying medical marijuana patient ID card requirements. This is one of two initiatives aiming at 2014 in California, neither of which have big donor support.

Portland, Maine, Marijuana Legalization Initiative Draws Late Opposition. Small signs urging Portlanders to "Vote No on Question 1, NO to POTland" have begun popping up just days before the city votes on legalization next week. Who put them up is a mystery; no group has filed paperwork at city hall opposing the initiative. The initiative would not legalize marijuana per se, but would allow people 21 and over to "engage in activities for the purposes of ascertaining the possession of marijuana and paraphernalia."

Arkansas Attorney General Rejects Marijuana Legalization Initiative. Attorney General Dustin McDaniel Tuesday rejected the ballot title for a proposed legalization initiative, saying the language was ambiguous. This is the second time he has rejected the measure, which can still be rewritten and resubmitted.

Colorado to Vote Tuesday on Marijuana Tax. Colorado voters will decide Tuesday whether to impose a 15% excise tax on marijuana sales to pay for school construction and a 10% sales tax to pay for marijuana regulation. The tax vote wasn't included in Amendment 64 because state law requires any new taxes to be approved by the voters. The measure is expected to pass despite opposition from some marijuana activists.

No Pot in Washington Bars, State Regulators Say. The Washington State Liquor Control Board Wednesday filed a draft rule banning any business with a liquor license from allowing on-site marijuana use. The state's pot law already bars public use, including in bars, clubs, and restaurants, but some businesses have tried to find loopholes allowing customers to use on premise, such as by having "private clubs" within the establishment.

DC Marijuana Reform Moves Could Spur Congress to Ponder Legalization. The DC city council appears set to approve decriminalization, and DC marijuana activists are pondering a 2014 ballot initiative to legalize marijuana. That could set the stage for Congress to finally turn its sights on federal marijuana legalization, Bloomberg News suggested in this think piece.

One-Fourth of Americans Would Buy Legal Weed, Poll Finds. At least one out of four Americans (26%) said they would buy marijuana at least on "rare occasions" if it were legal, according to a Huffington Post/YouGov poll released Thursday. Only 9% said they buy it on rare occasions now. One out of six (16%) of respondents said they never buy it now, but might if it were legal.

Dispensaries like this one could become marijuana retail stores in Colorado.
Let A Hundred Pot Shops Bloom… in Colorado. The Colorado Marijuana Enforcement Division reported late last week that it has received applications from 136 people seeking to open adult use marijuana retail stores. By law, only people currently operating medical marijuana businesses could apply. Those who applied by the end of October will have decisions on their applications before year's end, meaning they could open on January 1, the earliest date adult marijuana sales will be allowed in the state.

NYC Subway Vigilante Bernie Goetz Busted in Penny Ante Marijuana Sting. The New York City man who became a national figure after shooting four teens who asked him for money on the subway back in 1984 was arrested last Friday over a $30 marijuana sale. Bernie Goetz is accused of selling the miniscule amount of marijuana to an undercover officer.

Colorado Voters Approve Marijuana Taxes. Colorado voters approved a taxation scheme that will add 25% in wholesale and retail taxes to the price of legally sold marijuana in the state. Proposition AA was winning with 64% of the vote at last report.

Three Michigan Cities Approve Marijuana Measures. Voters in the Michigan cities of Lansing, Jackson, and Ferndale handily approved local measures to legalize the possession of small amounts of marijuana by adults 21 and over. The measures passed with 69% of the vote in Ferndale, 63% in Lansing, and 61% in Jackson. The trio of towns now join other Michigan cities, including Grand Rapids and Detroit, that have municipally decriminalized pot possession.

Medical Marijuana

Florida Lawmakers Oppose Medical Marijuana Initiative. Florida House and Senate leaders said late last week that they will join Attorney General Pam Bondi (R) in asking the state Supreme Court to block a medical marijuana initiative from going to the ballot. "We certainly don't want a situation like they've got in Colorado," explained state Rep. Doug Holder (R-Venice). Petitioners have gathered only about 200,000 of the more than 600,000 signatures they need to make the ballot. They have until February, unless the state Supreme Court puts the kibosh on the effort.

Florida Governor Candidate Supports Medical Marijuana Initiative. Candidate for the Democratic gubernatorial nomination Nan Rich said last Friday she supports a proposed medical marijuana ballot initiative. "I've seen the research, I've studied the issue, and I've met with patients who clearly benefit and desperately need medically prescribed cannabis," Rich said in a statement. "That's why I'm signing the petition to get this important measure on the ballot in 2014 and I'm calling on all of my friends and supporters to do the same. There is simply no reason patients should suffer when an effective, safe, and organic remedy is readily available."

Washington State Regulators to Hold Hearing on Controversial Medical Marijuana Plans. The Washington state Liquor Control Board announced last Friday it will hold a hearing November 13 in Lacey to take public testimony on proposed changes to the state's medical marijuana system. Regulators have issued draft recommendations that would reduce the amount of medical marijuana patients could possess and end their ability to grow their own, among other things.

Search and Seizure

Federal Appeals Court Blocks Judge's Ruling on NYPD Stop-and-Frisk. The 2nd US Court of Appeals in New York City blocked an order by District Court Judge Shira Scheindlin requiring changes in the NYPD's much criticized stop-and-frisk program. In an unusual move, the appeals court also removed Judge Scheindlin from the case, saying she had violated the code of conduct for federal judges by giving media interviews and publicly responding to criticism of her court. Scheindlin had found that NYPD violated the civil rights of tens of thousands of people by subjecting them to stop-and-frisk searches based on their race.

New Mexico Man Sues over Forced Anal Drug Search. A Deming, New Mexico, man detained for running a stop sign allegedly had his buttocks clenched when ordered out of his vehicle by police, leading them to suspect he had drugs secreted in his rectum. Police obtained a search warrant from a compliant judge, then had medical personnel forcibly subject the man to repeated anal probes, enemas, and a colonoscopy in a futile attempt to find any drugs. In addition to the unreasonableness of the invasive searches, they also took place outside of the jurisdiction where the warrant was issued and after the timeline specified in the warrant. The victim, David Eckert, ought to be picking up a nice check one of these years.

Second New Mexico Anal Drug Search Victim Emerges. Yesterday, the Chronicle AM noted the case of Deming, New Mexico, resident David Eckert, who was subjected to anal probes, enemas, x-rays, and colonoscopies without his consent after being pulled over for running a stop sign. The cops suspected he had drugs. He didn't and is now suing the police, the county, and the medical personnel who participated. Now, a second victim has emerged. Timothy Young was stopped for failure to use a turn signal. As was the case with Eckert, a drug dog -- Leo the K-9 -- alerted, but as was the case with Eckert, no drugs were found, despite the extensive invasive searches. Turns out the drug dog has not been certified for more than two years and has a history of false alerts, and the hospital where the searches were conducted was not within the jurisdiction of the search warrant. It looks like another New Mexico resident will get a big check at the taxpayers' expense one of these days.

Drug Testing

Truckers Object to Federal Bill to Allow Hair Drug Tests. A bill pending in Congress, House Resolution 3403, the "Drug Free Commercial Driver Act of 2013," is drawing opposition from an independent trucker group, the association's organ Landline Magazine reports. The bill would allow trucking companies to use hair testing for pre-employment and random drug tests. Currently, federal regulations mandate urine testing and allow hair testing only in conjunction with urine tests, not as a replacement. Hair-based testing can reveal drug use weeks or months prior to the testing date. The independent truckers accuse bill sponsors of carrying water for larger trucking firms that want to undercut their competition.

Michigan Governor Signs Unemployment Drug Testing Law. Gov. Rick Snyder (R) Tuesday signed a bill that denies unemployment benefits to job seekers who fail employer drug tests. The law is in effect for one year as a pilot program.

Drug Testing Provision Stripped from New Hampshire Hep C Bill. A bill written in the wake of an outbreak of Hep C infections linked to an Exeter Hospital employee will not include random drug testing for health care employees. The bill, House Bill 597, originally contained such language, but it was stripped out in the House Health, Human Services, and Elderly Affairs Committee. Federal courts have held that drug tests constitute a search under the meaning of the Fourth Amendment and thus require probable cause, except in limited circumstances.

Psychedelics

New Group Formed to Assure Sustainability of Psychedelic Plants. The Ethnobotanical Stewardship Council was launched at the International Drug Policy Reform Conference in Denver last weekend. It will concentrate on "assuring the sustainability and safe use of traditional plants," and prominently mentioned ayahuasca in its formation announcement.

Sentencing Reform

Bipartisan Mandatory Minimum Reform Bill Introduced in US House. On Wednesday, Reps. Raul Labrador (R-ID) and Bobby Scott (D-VA) introduced the Smarter Sentencing Act, which would significantly reform mandatory minimum drug sentencing policies. Companion legislation in the Senate, Senate Bill 1410, was introduced in July. The bills would halve mandatory minimum sentence lengths and expand safety valve access, as well as extend retroactivity under the Fair Sentencing Act of 2010.

Study Shows Way to Louisiana Sentencing Reform. A study released Tuesday by the Reason Foundation, the Pelican Institute for Public Policy, and the Texas Public Policy Foundation details how Louisiana can reduce its prison population and corrections spending without lessening public safety by eliminating mandatory minimum sentences for nonviolent offenders and reforming its habitual offender law. The study, "Smart on Sentencing, Smart on Crime: Reforming Louisiana's Determinate Sentencing Laws," is available online here.

International

At Least Five Dead in Mexico Vigilante vs. Cartel Clashes. Attacks in the Western Mexican state of Michoacan, home of the Knights Templar cartel, between anti-cartel vigilantes and cartel members left at least five dead and thousands without electric power last weekend. The fighting erupted after anti-cartel "self defense forces" marched Friday in the Knights Templar stronghold of Apatzingan and accelerated over the weekend. Vigilantes said they saw the bodies of at least 12 cartel members.

UNODC Head Says Afghan Opium Crop is Thriving, Spreading. In remarks in advance of the release of the UN Office on Drugs and Crime's annual Afghan opium survey early in November, UNODC head Yury Fedotov warned that the poppy crop will increase for the third straight year and that cultivation had spread into formerly poppy-free areas under central government control. Afghanistan accounts for about 90% of the global illicit opium supply.

New Zealand to Host International Conference on Drug Reform Laws. The country has drawn international attention for its innovative approach to new synthetic drugs -- regulating instead of prohibiting them -- and will be the site of a March 20, 2014 "Pathway to Reform" conference explaining how the domestic synthetic drug industry began, how the regulatory approach was chosen and how it works. International attendees will include Drug Policy Alliance head Ethan Nadelmann and Amanda Fielding, of Britain's Beckley Foundation.

Canada SSDP to Hold National Conference in Vancouver. Canadian Students for Sensible Drug Policy (CSSDP) will hold its sixth annual conference on November 22-24 in Vancouver, BC. Featured speakers will include Donald McPherson, head of the Canadian Drug Policy Coalition; Dana Larsen, director of Sensible BC and the Vancouver Dispensary Society; and Missi Woolrdige, director of DanceSafe, among others.

Hong Kong Docs Criticize Government Drug Testing Plan. The Hong Kong Medical Association said Monday that a government plan to allow police to test anyone for drug use based on "reasonable suspicion" is flawed and violates basic human rights. The local government began a four-month consultation on the plan in September, and now the doctors have weighed in. The association said that drug testing was an unproven method of reducing drug use and resources should instead be devoted to prevention and education campaigns and cooperation with mainland police against drug trafficking.

India to Greatly Expand Opiate Maintenence Centers. Responding to an increase in the number of injection drug users, the Indian government is moving to expand the number of its Opiate Substitution Therapy (OST) centers six-fold, from a current 52 to 300 by the end of the year. Drug user groups, including the Indian Drug Users Forum, and harm reduction groups, such as Project Orchid have been involved in planning the expansion. It's not clear what drug the Indians are using in OST.

Ireland Parliament to Debate Marijuana Legalization This Week. A private motion by independent Dail, or Irish parliament, member Luke "Ming" Flanagan will be debated on Tuesday and Wednesday. Flanagan's bill would make it legal to possess, grow, and sell marijuana products.

Cartel Violence Flares in Mexican Border Town. Sunday shootouts between rival drug trafficking organizations and between traffickers and soldiers left at least 13 people dead in the Mexican border town of Matamoros, just across the Rio Grande River from Brownville, Texas. Four men and a woman were killed in clashes between rival gangs, and eight more died in fighting with Mexican Marines. Somewhere north of 75,000 people have been killed in violence since former President Felipe Calderon called out the armed forces to wage war on the cartels six and a half years ago. Meanwhile, the drugs continue to flow north and the guns and cash flow south.

Toronto Mayor Rob Ford (wikipedia.org)
Toronto Mayor Admits He Smoked Crack, But Says He's Not an Addict. Months after rumors of a video showing Toronto Mayor Rob Ford smoking crack cocaine emerged, but only days after Toronto police said they had a copy of that video, Ford told reporters Tuesday that he had indeed smoked crack, but that he did so "in a drunken stupor" and that he wasn't an addict. Time will tell if his political career survives the revelation.

Marijuana Legalization Debate Looms in Morocco. Moroccan activists and politicians are close to firming up a date later this month for the parliament to hear a seminar on the economic implications of legalization hosted by the powerful Party of Authenticity and Modernity. Morocco is one of the world's largest marijuana producers, with output estimated at 40,000 tons a year, most of which is transformed into hashish and destined for European markets.

Czech Police in Mass Raid on Grow Shops. Although the Czech Republic has a reputation as a pot-friendly destination, recreational marijuana use remains illegal. Czech police served up a reminder of that reality Tuesday, raiding dozens of stores that sell growers' supplies. Police seized fertilizer, grow lights, and marijuana growing guidebooks and said they suspected store owners of violating drug laws by providing people with all the equipment they needed to grow their own. There was no mention made of any arrests.

New Zealand Court Says Employer Can't Force Workers to Undergo Drug Tests. New Zealand's Employment Court has ruled that companies cannot impose random drug tests on workers, nor discipline them for refusing such a test. Mighty River Power Company had a collective bargaining agreement with workers, which allowed testing only under specified circumstances, but initiated random drug tests later. If the company wants random drug test, the court said, it would need to negotiate a new provision in the collective bargaining agreement.

Mexican Military Takes over Key Pacific Seaport in Bid to Fight Cartels. The Mexican military has moved into the major port of Lazaro Cardenas and the adjoining town of the same name in the violence-plagued state of Michoacan. Soldiers are now responsible for policing duties, and all 113 police officers in Lazaro Cardenas have been sidelined until they undergo drug testing and police training. The port of Lazaro Cardenas is the main entrepot for precursor chemicals used in the manufacture of methamphetamine, which is produced in the state by the Knights Templar cartel. The Knights are also engaged in ongoing fighting with vigilante "self-defense" forces in the state.

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

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