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Could Kratom Be a Better Choice for Heroin and Pain Pill Users? [FEATURE]

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

The Southeast Asian herb is now available powdered...
A Southeast Asian herb is gaining popularity among addicted heroin and prescription opiate users, pain sufferers, and hipsters looking for a nice buzz, and it's legal -- at least for now. It's usually consumed as a tea, and is now available at non-alcohol kratom bars in several states, as well as in powdered from in specialty shops and on the Internet.

It is regulated as an herbal supplement, not a controlled substance, but it is coming under some scrutiny by lawmakers and regulators. The FDA banned its import in 2014, and the DEA has it listed as a drug of concern, but has not moved to criminalize it. It is illegal in four states, though -- Indiana, Tennessee, Vermont and Wyoming -- and similar laws are now being proposed in Florida and New Jersey.

The stuff is called kratom, and was traditionally used in Thailand and Malaysia to help endure physical labor, relieve pain, and stop diarrhea. It was also good for relieving the symptoms of opium withdrawal.

That's because its active ingredients activate the same opioid receptors heroin and prescription pain pills do. And it behaves like an opiate -- with a couple of exceptions, one interesting and one quite important.

...or it can be brewed into a tea. (wikimedia.org)
Like other opiates, it relieves pain, slows bowel activity, produces euphoric feelings, and creates physical addiction and a whithdrawal syndrome. But unlike other opiates, it causes a pleasant, caffeine-type buzz in small doses. More significantly, it is apparently very difficult -- if not impossible -- to overdose on. The few deaths where kratom is implicated include poly-drug use, or as in a case reported by the New York Times, suicide by a young kratom user who was also being treated for depression.

"Direct kratom overdoses from the life-threatening respiratory depression that usually occurs with opioid overdoses have not been reported," says Oliver Grundmann, clinical associate professor of medicinal chemistry at the University of Florida, told journalist Maia Szalavitz at Vice. Grundmann should know; he just reviewed the research on kratom for the International Journal of Legal Medicine.

"It's a fascinating drug, but we need to know a lot more about it, Dr. Edward W. Boyer, a professor of emergency medicine at the University of Massachusetts Medical School and a co-author of several scientific articles on kratom, told the Times. "Recreationally or to self-treat opioid dependence, beware -- potentially you're at just as much risk" as with an opiate.

Well, except for that whole fatal overdose thing. And like the kratom high, the physical dependence appears much milder.

Szalavitz consulted Mark Swogger, an assistant professor of psychiatry at the University of Rochester Medical Center, who with his colleagues analyzed 161 "experience reports" posted by kratom users on the drug information site Erowid.org for a recent study in the Journal of Psychoactive Drugs.

"I think it's pretty safe to say that kratom has at least some addiction potential. The data is fairly strong on that and our study also found that people are reporting addiction," but "overall, we found that it's really mild compared to opioid addiction and it didn't seem to last as long."

About one in six of the users reported nausea or stomach pain and 6% actually vomited. There have been a handful of other handful of reports of liver problems.

All this makes kratom something like opium's mild-mannered little sister. And that is apparently something a lot of people are looking for.

One of them was Susan Ash, 46, who told the Times she began taking kratom while being treated for dependence on prescription pain relievers and now takes a small dose daily to ease chronic pain and depression.

She was so impressed with the results that last year, she founded the American Kratom Association to represent consumers. The group now has more than 2,000 members and lobbies against bills to ban the herb.

"We know from all our experiences that kratom has the potential to be a wonderful medicine," she said. "We're all experiencing that it's changing our lives. We do agree that more science is needed to actually prove this potential that we know it has."

Yes, more science is needed, and kratom does have its disaffected users, as the Times was quick to dig up, but so far, it looks like we have a drug like opium, but with attenuated effects. If people are taking kratom to get off heroin or prescription pills or to treat pain or just to get a nice buzz, and they're not overdosing by the tens of thousands, as they are with the opiates, that would seem like an overall good thing. If we want to reduce harm from heroin and prescription opiates, kratom should be studied and, perhaps, embraced, not proscribed.

Chronicle AM: Fed Bill Would Allow MJ Ad Mailings, Far-Reaching MD Bills Filed, More... (2/5/16)

Oregon's federal representatives fight to protect marijuana advertising, medical marijuana and CBD bills are moving in the states, a Maryland delegates files bills for drug treatment on demand, supervised injection sites, opiate maintenance (including heroin), and drug decriminalization -- quite a package! -- and more.

A Maryland bill could lead to the first supervised injection facility in the US. (vch.ca)
Marijuana Policy

Oregon Federal Reps File Bill to Allow Published Marijuana Ads. Responding to warnings from the US Postal Service that mailing newspapers or magazines with marijuana advertising is prohibited even in states where it is legal, Oregon's two Democratic senators, Ron Wyden and Jeff Merkley, have joined with two Democratic House members, Earl Blumenauer and Suzanne Bonamici, to file the Marijuana Advertising in Legal States (MAILS) Act (HR 4467). The bill would reverse the USPS policy. "Federal agencies must respect the decisions made by law-abiding Oregonians and small business owners in the state," Wyden said. "Our bill updates the federal approach to marijuana, ending the threat to news publications that choose to accept advertising from legal marijuana businesses in Oregon and other states where voters also have freely decided to legalize marijuana."

Michigan Legalization Campaign Getting Close to Signature Goal. The MILegalize campaign says it has already collected some 240,000 raw signatures and is seeking another 100,000 to ensure a comfortable cushion for invalidated signatures. The state requires 252,000 valid voter signatures to qualify for the November ballot.

Medical Marijuana

Alabama Bill Would Expand Access to CBD Cannabis Oil. Rep. Mike Ball (R-Madison County) has introduced House Bill 61, which would expand access to CBD beyond a limited study program at the University of Alabama-Birmingham. The new bill would allow parents with a valid recommendation for CBD cannabis oil to possess it in the state.

Delaware Bill Would Allow CBD Cannabis Oil for Kids in Schools. Sen. Ernie Lopez (R-Lewes) has filed Senate Bill 181, which would allow authorized caregivers to possess and administer CBD cannabis oil to pupils in school as needed.

Utah Medical Marijuana, CBD Cannabis Oil Bills Move. Two medical marijuana-related bills are headed for the Senate floor after winning committee votes. Senate Bill 73, filed by Rep. Mark Madsen (R-Saratoga Springs), would allow whole plant medical marijuana, while Senate Bill 89, sponsored by Sen. Evan Vickers (R-Cedar City), would expand on CBD cannabis legislation passed last year.

Kratom

Florida Bill to Ban Kratom Advances. A bill that would ban the increasing popular Southeast Asian herb, which some are using as an alternative to opiates or as a means to withdraw from them, has passed the House Criminal Justice Subcommittee. The bill, House Bill 73, would make possession of kratom a misdemeanor. A similar measure seeking to make possession a felony failed last year.

New Synthetic Drugs

Kentucky Bill to Toughen Penalties for New Synthetic Drugs Advances. A bill that would increase penalties for possessing or selling new synthetic drugs has passed the House Judiciary Committee. The bill is House Bill 66.

Drug Policy

Maryland Bill Package Attempts Comprehensive Drug Decriminalization, Harm Reduction Approach. A set of four bills being filed today would upend the way the state deals with drug use and related problems. One bill would provide for drug treatment on demand in emergency rooms and hospital settings, a second bill would allow for safe injection facilities (there are currently none in the US), a third bill would allow for opiate maintenance therapy, including with heroin, and a fourth bill would decriminalize the use and possession of personal use quantities of illicit drugs. The package is being sponsored by Delegate Dan Morhaim (D-Baltimore County).

Drug Testing

Utah Bill Would Repeal Welfare Drug Testing Law. Since Utah approved a welfare drug testing law, only 47 applicants out of nearly 14,000 have tested positive for drugs. That's enough for Rep. Angela Romero (D-Salt Lake City) to call for an end to the program. Her House Bill 172 would do just that. It is currently before the House Economic Development and Workforce Services Committee.

Chronicle AM: Obama Wants $1 Billion to Fight Opioids, Legal Pot Sales Hit $5.4 Billion, More... (2/2/16)

A new report finds marijuana is a booming market, California doctors get on board with the AUMA legalization initiative, the White House wants nearly a billion bucks to fight opioid addiction -- with most of it going for "medication-assisted treatment" -- and more.

People line up to buy heroin in Chicago. The White House wants nearly $1 billion to fight opioid addiction. (Chicago PD)
Marijuana Policy

Legal Pot Sales Hit $5.4 Billion Last Year, Report Says. Legal marijuana sales increased 17.4% last year to $5.4 billion, according to data released this week by the ArcView Group. Nearly 80% of the sales were for medical marijuana, but $998 million was for legal adult use, up dramatically from $351 billion in 2014. Overall sales should grow to $6.7 billion this year, the group predicted.

California Medical Association Endorses AUMA Legalization Initiative. The CMA, the largest doctors' group in the state, announced Monday that is will support the Adult Use of Marijuana Act legalization initiative. The initiative, funded by tech billionaire Sean Parker and supported by Lt. Gov. Gavin Newsom (D), has as one of its proponents Dr. Donald Lyman, who authored the CMA's 2011 policy called for decriminalization. "The California Medical Association believes the Adult Use of Marijuana Act is a comprehensive and thoughtfully constructed measure that will allow state officials to better protect public health by clarifying the role of physicians, controlling and regulating marijuana use by responsible adults and keeping it out of the hands of children," Dr. Steven Larson, CMA's president, said in prepared remarks.

Medical Marijuana

New Hampshire Patient Who Sued Over Medical Marijuana Access Dies. Linda Horan, who sued the state in November to issue her a medical marijuana card so she could get her medicine in Maine because New Hampshire dispensaries hadn't opened, died Monday at age 64. The ailing labor leader won her lawsuit and was able to procure medical marijuana out of state, but succumbed to cancer. The court ruling applied only to Horan, but days after the ruling, the states began sending out ID cards to patients.

Wyoming Medical Marijuana Initiative Won't Qualify for Ballot. A spokesman for Wyoming NORML, which organized the campaign, said Monday that the group had only managed to gather some 7,000 raw signatures ahead of next week's deadline and will fall far short of the more than 25,000 valid voter signatures required to make the ballot. The group will try again in 2018, it said.

Hemp

Twenty States Have Hemp Bills This Year, Vote Hemp Says. The industry group has issued its annual report and says 20 states are working to legalize or expand hemp production. There's much more in the report, too.

Drug Policy

White House Seeks $1 Billion to Fight Heroin and Prescription Opiate Abuse. The Obama administration Tuesday proposed a billion dollars in new funds over the next two years to combat widespread opioid use. More than $900 million of the newly sought funding would go for medication-assisted treatment (opioid maintenance), which also includes therapy. The administration said that 2.2 million people have been identified as needing treatment for opioid addiction, but only one million are receiving it.

Drug Testing

West Virginia Lawmaker Proposes Drug Testing Legislators. State lawmakers have once again introduced a bill to drug test welfare applicants, and in response, Delegate Shawn Fluharty (D-Wheeling) has introduced House Bill 2925, which would subject legislators to the same sort of testing. "There's no reason why state legislators should get a pass, simply because we wear suits," he said.

Chronicle AM: AK to Allow Some Social Pot Smoking, Sentencing Reform Moves in Congress, More (11/23/15)

Marijuana Policy

You'll be able to toke up with this at some Alaska pot shops. (wikimedia.org)
Alaska Will Allow Marijuana Use at Some Stores. The state's Marijuana Control Board voted 3-2 last Friday to allow consumption at some pot shops, making it the first state to do so. Board Chairman Bruce Schulte said there seemed to be public demand for such an option.

New Jersey Marijuana Arrests Going Up, Not Down. Even as state legislators discuss marijuana legalization, New Jersey cops are busily arresting pot smokers at a record pace. Marijuana arrests jumped 10% in 2012 and 10% again in 2013, according to New Jersey State Police Uniform Crime Reports. The 24,765 marijuana arrests is the highest number in 20 years, and nearly double the amount in 1993.

Vermont Legalization Supporters Release Report. The Vermont Cannabis Collaborative has released a report outlining a legalization framework for state lawmakers. The report calls for home grows of up to nine plants, craft growers who could grow up to 99 plants, and large-scale operators, who could have a grow space of up to 30,000 feet. There's much more at the report link.

Medical Marijuana

Arizona Supreme Court Mixed Ruling on Medical Marijuana DUID. The state's high court ruled last Friday that medical marijuana cardholders don't have immunity from prosecution under the state's DUID law, but also held that cardholders can try to mount a defense showing that they did not have enough marijuana or pot metabolites in their system to actually be impaired.

Pennsylvania Medical Marijuana Bill Wins Committee Vote. The House Rules Committee voted 25-8 last Wednesday to advance a medical marijuana bill. The bill has already passed the Senate, but still needs a House floor vote. Gov. Tom Wolf (D) has said he will sign the bill.

Heroin and Prescription

Maryland Legislator Proposes Heroin Maintenance Program. Delegate Dan Morhaim (D) said last Thursday he plans to offer legislation next year to provide free heroin to addicts in a bid to reduce crime.

Asset Forfeiture

New Mexico Senators Sue Albuquerque Over Asset Forfeiture. A bipartisan pair of state senators have filed a lawsuit against the city of Albuquerque over its vehicle seizure program, which they say violates the state's recently passed asset forfeiture reforms. Sens. Lisa Torraco (R-Albuquerque) and Daniel Ivey-Soto (D-Albuquerque) are seeking an injunction to stop the city from seizing vehicles without the owner first being convicted of a crime.

Harm Reduction

FDA Approves Narcan Nasal Spray. The Food and Drug Administration last Thursday approved a naloxone nasal spray to stop or reverse opiate overdoses. The FDA said it was as effective as the injectable form of the drug.

Sentencing

Historic Sentencing Reform Bill Passes House Judiciary Committee. Last Thursday, the House Judiciary Committee voted unanimously to advance the Sentencing Reform Act. The bill, introduced by Chairman Bob Goodlatte (R-VA) and Ranking Member John Conyers (D-MI), and sponsored by thirty other Representatives, would reduce mandatory minimum sentences for drug offenses, expand the federal "safety valve" (which allows judges to use their discretion to sentence people below statutory mandatory minimums), and make many of the sentencing reductions retroactive. The bill is also moving in the Senate, where the Senate Judiciary Committee advanced its version last month.

International

China Bans More Than a Hundred New Psychoactive Substances. China last month banned more than a hundred new psychoactive substances, including alpha-PVP, more widely known as "flakka." It is now illegal to distribute flakka, synthetic opiates, and a score of other chemicals.

Chronicle AM: Canada Starts to Move on Legalizing Pot, Irish Cops Support Heroin Decriminalization, More (11/16/15)

Nick Scutari tries to get the marijuana legalization ball rolling in New Jersey, a petition calling for the DEA head to be fired is going strong, Democratic candidates talk drug and crime policy at the debate, Canada moves toward pot legalization, Irish cops support heroin decrim, and more. 

Ireland's drugs minister wants to decriminalize heroin, and the cops are on board with it. (wikimedia.org)
Marijuana Policy

New Jersey Legislative Hearing on Pot Legalization Today. Sen. Nicholas Scutari (D), who filed a marijuana legalization bill, S 1896, earlier this session, is holding a hearing on the topic today. Today's witnesses will include supporters of marijuana law reform; opponents will get a chance to opine at a later hearing. No vote is expected today. "A journey of a thousand steps starts with the first," said Scutari, who as chairman of the Senate Judiciary Committee, called the hearing. "The first step was introducing the bill and this is the natural next step — to talk about the benefits of legalization and the negative impact prohibition has had."

Medical Marijuana

Petition To Fire DEA Head Over Medical Marijuana "Joke" Comment Has 80,000 Signatures. Uh, make that 83,044 signatures as of mid-afternoon today. DEA Administrator Chuck Rosenberg is still getting heat over his statement that medical marijuana is "a joke." It's just his latest comment suggesting the nation's top drug cop is not that well-informed in his subject area.

Florida Supreme Court Cancels Medical Marijuana Initiative Hearing. Backers of a 2016 medical marijuana initiative have just seen one obstacle removed from their path. After Attorney General Pam Bondi (R) announced she would ask the high court to block the initiative, the state Supreme Court has canceled a hearing on it set for December 8. The initiative from United for Care is already well-advanced in the signature gathering process. A similar initiative failed last year with 58% of the vote—60% was needed because it was a constitutional amendment.

Illinois Sees More Than $200,000 in Medical Marijuana Sales in First Week. Only a handful of dispensaries are open in the state, but they took in $211,000 in sales after opening last Monday. The medi-weed was selling for around $450 an ounce, or $16 a gram.

Heroin and Prescription Opiates

EEOC Sues Employer Who Refused to Hire Methadone User. In its latest lawsuit against employers taking actions against prescription medication users, the Equal Employment Opportunity Commission is going after a company that allegedly refused to hire a woman who is prescribed methadone to deal with her heroin addiction. EEOC alleges that the company is violating the Americans With Disabilities Act because the woman is a recovering substance abuser, has a history of disability, and was "regarded" as disabled based on her methadone use. EEOC has also sued other employers over discrimination against methadone patients, as well as other prescription drug users.

Drug Policy

Democratic Candidates Talk Drug, Crime Policy in Last Saturday's Debate. Bernie Sanders reiterated his support for ending federal marijuana prohibition, while Martin O'Malley and Hillary Clinton joined Sanders in calling for criminal justice reforms and addressing racial inequalities in the criminal justice system. Click on the link for more details.

International

Canada's Prime Minister Begins the Process of Legalizing Marijuana. Freshly-elected Liberal Prime Minister Justin Trudeau has instructed Justice Minister Jody Wilson-Raybould to begin the process of legalizing and regulating marijuana. Trudeau told Wilson-Raybould he expected her to "deliver on your top priorities," which includes "Working with the Ministers of Public Safety and Emergency Preparedness and Health, create a federal-provincial-territorial process that will lead to the legalization and regulation of marijuana."

Mexico to Consider Cutting Jail Sentences, Raising Possession Limits for Marijuana. Jumpstarted by a Supreme Court decision earlier this month allowing four Mexicans to use marijuana, the forthcoming national debate on marijuana policy will consider easing jail sentences and raising limits for personal possession of pot, Deputy Interior Minister Roberto Campa said. The national consultation is set for January through March.

Irish Police Back Decriminalizing Heroin Possession. The Garda Representative Association, which represents some 11,000 Irish police officers, is backing the government drug minister's call to decriminalize heroin possession. "I think anything that can deal with the curse of drugs and some innovating thinking on this is to be welcomed," the GRA’s general secretary, PJ Stone, said, adding that the proposal would be seen as a brave move. "We don’t even have enough cells to lock up drug users who get arrested for possessing drugs," a GRA member from Dublin added.

(This article was prepared by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also pays 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.)

Chronicle AM: Federal Sentencing Reform Advances, OH Legalization Init in Dead Heat, More (10/22/15)

It's nail-biting time for marijuana legalizers in Ohio -- and for different reasons in California -- the Obama administration rolls out new measures to deal with heroin and prescription opiates, a federal sentencing reform bill advances, and more.

The Senate Judiciary Committee has approved a sentencing reform bill. (nadcp.org)
Marijuana Policy

Billionaire Philanthropist Sean Parker Circulating California Legalization Initiative Draft. Napster cofounder and early Facebook president Sean Parker has a team of lobbyists and political consultants circulating a draft legalization initiative this week. The move comes as the state's legalization effort is in turmoil, with state activists organized as ReformCA having drafted their own initiative, only to see national reform groups, such as the Drug Policy Alliance and Marijuana Policy Project, drift away. Click on the link for all the juicy details.

Another Ohio Poll Has Legalization Initiative in Dead Heat. A second poll this week has found the ResponsibleOhio legalization initiative race "too close to call." A new Bowling Green State University poll has the initiative supported by 44.4% of "likely voters," with 42.9% opposed. Among "definite voters," the measure does a bit better, getting 46% support, with 45% opposed and 9% undecided. Earlier this week, a University of Akron Buckeye poll had voters evenly split at 46%.

Heroin and Prescription Opiates

Obama Announces New Steps to Combat Heroin and Prescription Drug Abuse. The administration announced Wednesday that it is moving to increase access to drug treatment and to expand the training of doctors who prescribe opiates in a bid to fight high levels of heroin and prescription opiate use. The plan includes doubling the number of doctors who can prescribe the maintenance drug buprenorphine. The administration has a "sense of urgency that we at the federal level can do more to address this issue," said ONDCP head Michael Botticelli. Click on the link for much more.

Sentencing

Senate Judiciary Committee Approves Sentencing Reform and Corrections Act. The committee today voted 15-5 to advance the bill, S. 2123, which would reduce mandatory minimum drug sentences, expand the federal "safety valve," expand early release and reentry programming, and make other sentencing reforms retroactive.

International

Capture of Gulf Cartel Leader Sparks Weekend of Violence in Matamoros. The mayor of the Mexican border city just across the Rio Grande River from Brownsville, Texas, has warned residents to exercise caution and stay indoors after the arrest last Friday of a Gulf Cartel leader sparked a weekend of clashes between security forces and cartel gunmen. Prado "El Ciclon 7" Rodriguez, the cartel's Matamoros boss, was captured Friday morning, with traffic blockades and gunfights breaking out that same day and continuing through the weekend.

Chronicle AM: UN Decriminalization Drama, Global Undertreatment of Pain Report, More (10/19/15)

A thousand march for marijuana in Dallas, a few dozen in Montgomery; a UNODC document calling for drug decriminalization gets leaked, then yanked; the Global Commission on Drug Policy issues a report on pain, and more.

A Halloween/Reefer Madness-themed billboard rolled out today by Arizona legalization activists.
Marijuana Policy

Dallas March for Marijuana Brings Nearly a Thousand to the Streets. Around a thousand people joined a march calling for marijuana law reform in Texas Saturday. The march was organized by Dallas-Fort Worth NORML. Click on the link for more.

Dozens Turn Out for Alabama Rally for Marijuana Law Reforms. Several dozen people took to the foot of the state capitol last Friday to call for marijuana decriminalization and access to medical marijuana. Efforts to pass a medical marijuana bill have stalled in the legislature.

Medical Marijuana

Seneca Nation Moving Toward Medical Marijuana. The Seneca Nation of Indians is preparing to vote early next month on whether to authorize the National Council to start drafting laws and regulations to govern medical marijuana. The vote would be only a first step toward the tribe getting in the medical marijuana business. The Justice Department opened the door for tribes to get involved in pot operations with a memo last fall.

Kansas Silver Haired Legislature to Renew Push for Medical Marijuana. The Silver Haired Legislature, which advocates for senior citizens, is again calling on the legislature to pass medical marijuana. At a meeting earlier this month in Topeka, the group adopted three proposed bills it will push to see passed in the next term. Click on the link for more details.

International

UN Bid to Urge Drug Decriminalization Foiled. The UN Office on Drugs and Crime (UNODC) has withdrawn a document calling on governments to consider "decriminalizing drug use and possession for personal consumption" after at least one country objected. The document was leaked by Sir Richard Branson over the weekend, and when a journalist violated the UNODC's embargo on release of the document, UNODC walked back the report.

Global Commission on Drug Policy Releases Report on Undertreatment of Pain. The Global Commission on Drug Policy (GCDP) today released its third thematic report, The Global Crisis of Avoidable Pain: The Negative Impact of Drug Control on Public Health. The report was launched by Commissioners, former Swiss President Ruth Dreifuss, UN Secretary General Special Envoy on HIV/AIDS in Eastern Europe and Central Asia, Michel Kazatchkine and former United Nations Special Rapporteur on the right to health, Anand Grover. The report finds that three-quarters of the world's population has no access to pain-relieving drugs and that "the reasons for this have little to do with issues of cost or scarcity of supplies- and everything to do with the prohibition and repressive stand the world has taken on drugs. States are obsessed by the fear that people will use controlled medicines, such as morphine as drugs, thereby neglecting the important medical uses." Click on the title link to read the report.

WOLA Discussion on Impact of Drug Policy on Human Rights in the Americas Wednesday. The Washington Office on Latin America (WOLA) is hosting the discussion in Washington, DC, at lunch time Wednesday. Click on the link for speakers, more information, and to RSVP.

State Department Cuts Some Mexico Drug War Funding Over Human Rights Concerns. The State Department has concluded that Mexico failed to reach some human rights goals in its drug war, triggering the cutoff of millions of dollars of drug war assistance. The move only affects a small portion of overall US drug war aid to Mexico, but does signal growing frustration with alleged abuses by Mexican security forces. Some 15% of aid provided to Mexican security forces is subject to human rights provisions, meaning that Mexico lost $5 million of a total of $148 million in US drug war funding this year. That $5 million was instead diverted to Peru to help finance coca eradication.

Mexico Supreme Court to Take Up Marijuana Legalization Next Week. The high court is set to discuss a legal challenge that could effectively legalize the use and production of marijuana. The challenge comes from a non-profit that filed an injunction against the Mexican health regulatory body COFEPRIS over a 2013 ruling by that body. The hearing is set for October 28.

Norway's Two Largest Cities to Move Toward Giving Free Heroin to Addicts. The cities of Oslo and Bergen are set to begin heroin-assisted treatment pilot programs after the Labor Party won local elections there, but they will have to win approval from the national parliament first. Parliament rejected a 2012 effort to start the programs. Norway has the world's second highest drug overdose rate, after Estonia.

Chronicle AM: OR Marijuana Sales Begin This Week, FDA Defends Oxycontin for Youth, More (9/29/15)

Half of Oregon's dispensaries will start selling marijuana to any adult beginning this week, the FDA fires back at critics of its pediatric prescribing rules for Oxycontin, a prominent UN official lists the ways the drug "problem" impacts human rights, and more.

The FDA counters critics who say its rules for pediatric prescribing will increase availability. (wikipedia.org)
Marijuana Policy

Florida Legalization Bill Filed. Rep. Michelle Rehwinke Vasilinda (D-Tallahassee) has introduced a bill to legalize marijuana. The measure is House Bill 4021. This is the second time she has filed the bill.

Oregon Dispensaries to Start Selling to Recreational Users This Week. More than half of the state's 345 medical marijuana dispensaries have told the Health Authority they plan to sell recreational marijuana starting Thursday, October 1. Recreational marijuana has been legal in the state since July 1, but recreational pot shops won't be open until next year, so the state is allowing dispensaries to fill the void.

Medical Marijuana

Maryland Now Taking Applications for Medical Marijuana Businesses. As of Monday, the Maryland Medical Cannabis Commission is accepting applications for state licenses for growers, processors, and dispensaries. The commission will issue 15 licenses for growers, up to 92 for dispensaries, and an unlimited number for processors. The deadline for applications is November 6, and dispensaries could be stocked and open by next fall. Click on the commission link for more details.

Heroin and Prescription Opiates

FDA Rejects Critics on Oxycontin for Youth. In response to critics including US senators, the Food and Drug Administration (FDA) has defended its decision last month to allow the prescribing of the powerful opioid to pediatric patients. Critics accused the agency of expanding access to the drug, but the FDA said doctors could already prescribe Oxycontin to pediatric patients and the agency was merely setting prescribing standards. "It's important to stress that this approval was not intended to expand or otherwise change the pattern of use of extended-release opioids in pediatric patients," said FDA spokesman Eric Pahon said in a statement. "Doctors were already prescribing it to children, without the safety and efficacy data in hand with regard to the pediatric population."

Drug Policy

UN Official Says Drug "Problem" Violates Human Rights in Five Areas. UN Deputy Commissioner for Human Rights Flavia Pansieri said Monday that the global drug "problem" violates human rights in the areas of the right to health, rights relating to criminal justice and discrimination, the rights of the child, and the rights of indigenous peoples. "It is clear that the world's drug problem impacts the enjoyment of a wide range of human rights, often resulting in serious violations," said Pansieri, "It is, nevertheless, a positive development that human rights are increasingly being taken into account in the preparations for the General Assembly's Special Session on the world drug problem to be held in April 2016." The remarks came during her report to the High Commissioner on Human Rights.

Harm Reduction

New York Governor Signs Bill to Expand Opiate Maintenance in Drug Courts. Gov. Andrew Cuomo (D) last Friday signed into law Senate Bill 4239, which prohibits drug court judges from forcing defendants to withdraw from opiate maintenance treatments as a condition of avoiding prison. Click on the title link for more details.

International

New Zealand Activists Call for Party Pill Drug Testing. The New Zealand Drug Foundation is calling on the government to legalize pill testing services. Foundation Executive Director Ross Bell said it was only a matter of time until someone died taking pills of unknown provenance. He added that the government routinely tests drugs for criminal justice purposes, and that those results should be made available as a public health measure. The government said it hadn't considered pill testing, but was open to the possibility in the future.

Chronicle AM: Needle Exchanges Spread in WVA, Obama Admin Eases Buprenorphine Restrictions, More (9/18/15)

It's looking like Arizona will vote on marijuana legalization next year, the Obama administration eases restrictions on the opiate maintenance drug buprenorphine, needle exchanges expand in West Virginia, and more.

Marijuana Policy

Arizona Legalization Initiative on Track With Signature Gathering. The Marijuana Policy Project-backed Campaign to Regulate Marijuana Like Alcohol said Thursday that it has already gathered 75,000 signatures, putting the group about one-third of the way to its goal of gathering 230,000 by July 2016. The group needs more than 150,000 valid voter signatures to qualify for the November 2016 ballot. A second group, Arizonans for Mindful Regulation wants to put its own initiative on the ballot, but has gathered only about 6,000 signatures so far.

Heroin and Prescription Opiates

Obama Administration Makes Big Announcement Addressing Heroin Epidemic. Health and Human Services Secretary Sylvia Burrell said Thursday that her agency would rewrite regulations to make it easier for doctors to treat opiate addiction with buprenorphine in a bid to get a handle on opiate abuse and addiction. "We need to lift people out of opioid-use disorder through medication-assisted treatment," Burwell said. "This epidemic is multifaceted, and we need to respond with the best solutions that medicine and behavioral therapy can provide together, so we need to increase the use of buprenorphine, which can help us treat opioid use disorder when combined with psycho-social support."

Ohio Bill Would Require Insurers to Cover Tamper-Resistant Drugs. A bipartisan pair of legislators have introduced a bill that would require insurance companies to provide coverage for tamper-resistant drugs that are more difficult to abuse. Reps. Robert Schrager (R-Findlay) and Nickie Antonion (D-Cleveland) said the measure is necessary because the long-term cost of opiate abuse in the state will cost the state millions of dollars. The bill has not yet appeared on the state legislative website.

Harm Reduction

West Virginia County to Begin Needle Exchange Program. Harrison County plans to move forward with a needle exchange/harm reduction program after hearing of the success of a similar program in Morgantown. The Morgantown exchange began in 2013, when 34 local residents tested positive for Hepatitis C. There have been 118 Hep C infections in Harrison County this year. It is a regional problem -- West Virginia and Kentucky have the highest Hep C infection rates in the country, many of them tied to intravenous drug use.

Illinois Governor Vetoes Heroin Bill Over Medicaid Treatment Funding [FEATURE]

Faced with a public health crisis related to heroin and prescription opioid use, the Illinois state government created a bipartisan Heroin Task Force in a comprehensive effort to address the problem from all angles. The task force created a set of policy recommendations that were embodied in House Bill 1, the Heroin Crisis Act.

Heroin is taking a toll not only in Chicago, but in its suburbs. (kirk.senate.gov)
The bill passed the House and Senate in May, and was sent to Gov. Bruce Rauner (R) in June, where it sat on his desk until this week. On Monday, Rauner finally acted -- not by signing the bill, but by vetoing critical sections of it that he says the state cannot afford. He has now sent the bill back to the legislature and asked it to remove the offending sections.

But saying, "People are dying," the measure's House sponsor, Rep. Lou Lang (D-Skokie), has vowed an effort to override the veto. An override could be within reach -- the bill passed by veto-proof majorities in both houses -- but for members of a governor's own party, a veto override is a hard vote to take.

Here's what the bill does:

  • It increases the availability of opiate overdose reversal drugs and requires private insurance to cover at least one of them, as well as acute treatment and stabilization services. It allows licensed pharmacists to dispense overdose reversal drugs, allows school nurses to administer them to students suffering from overdoses, and provides protection from civil liability for people who administer them in good faith.
  • It requires the Department of Human Services and the State Board of Education to develop a three-year pilot heroin prevention program for all schools in the state, requires the Department of Human Services to develop materials to educate prescription opiate users on the dangers of those drugs, and it requires the Department of Insurance to convene working groups on drug treatment and mental illness and on parity between state and federal mental health laws.
  • It intensifies the state's prescription monitoring program by tightening reporting requirements and it requires doctors to now document the medical necessity of any three sequential 30-day prescriptions for Schedule II opioids.
  • On the criminal justice front, it permits multiple chances at drug court and prevents prosecutors from unilaterally blocking entry to drug court, and it requires prosecutors and public defenders to undergo mandatory education on addiction and addiction treatment. It also increases criminal penalties for "doctor shopping" if fraud is involved.
  • It requires Medicaid coverage of all heroin treatment, including methadone and other opiate maintenance treatment, as well as all anti-overdose medications.

People lining up to buy heroin in Chicago. (Chicago PD)
It's the latter provision to which Rauner objects.

"I support all of the above measures and applaud the multifaceted approach to combating this epidemic in Illinois. Unfortunately, the bill also includes provisions that will impose a very costly mandate on the State's Medicaid providers. I am returning the bill with a recommendation to address that concern," he said in a veto statement.

"House Bill 1 mandates that fee-for-service and medical assistance Medicaid programs cover all forms of medication assisted treatment of alcohol or opioid dependence, and it removes utilization controls and prior authorization requirements," Rauner continued. "These changes would limit our ability to contain rising costs at a time when the State is facing unprecedented fiscal difficulties. Importantly, the State's Medicaid programs already cover multiple forms of medication necessary to treat alcohol and opioid dependence. But without adequate funding to support mandated coverage for all forms of treatment, regardless of cost, this change would add to the State's deficit."

His recommendation is simply to delete the language requiring Medicaid coverage.

Rep. Lang and other bill supporters aren't going for that.

"There's a human cost to not doing it," Lang said. "People are addicted, people are sick, people are dying. You want to talk about the costs of providing methadone and Narcan to addicts, but you forget totally that if you cure them or they get off the stuff, there's a savings to the Medicaid system on a different line item, because they're no longer in emergency rooms, they're no longer a burden to law enforcement."

Heroin and opiate addiction is a serious problem in Illinois. The rate of drug overdose deaths has nearly doubled since 1999, and in the Chicago suburbs, people have been dying of drug overdoses at a rate of three per day since 2012. In the state as a whole, 633 people died of heroin overdoses last year, with nearly half (283) in Chicago.

At the same time as the problem with heroin and prescription opioids has been deepening, the state's ability to provide treatment has been decreasing. According to a report this month from the Illinois Consortium on Drug Policy, the state's ranking for drug treatment capacity has fallen from 28th in the nation in 2009 to 47th this year. This as demand for heroin and opiate treatment statewide is increasing dramatically. In Chicago and the surrounding suburbs, 35% of drug treatment admissions are for heroin, more than twice the national average.

The consortium's director and the study's lead author, Kathleen Kane-Willis, noted that Illinois is one of only a few states nationwide that doesn't allow Medicaid coverage of opiate maintenance treatment.

"We're going to pay for not paying," she said.

But bill supporters could also find the votes to override the veto. Rep. Lang says that is what's he going to try to do, and with a 114-0 vote in the House and a 46-6 vote in the Senate the first time around, he has plenty of supporters to ask. If that happens, Illinois will get the drug treatment it needs, and Rauner will still be able to maintain his fiscally conservative credentials.

Springfield, IL
United States

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