Prescription Opiates

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Chronicle AM: CA MJ Driving Bill Killed, Oh MedMJ Init Quits, More... (5/31/16)

An effort to create a per se marijuana DUID law in California ran into a brick wall of science, the Ohio effort to put a medical marijuana initiative on the ballot shuts down, a US senator seeks an investigation into Purdue Pharma over its claims on OxyContin's extended effectiveness, and more.

The California Assembly rejects a per se marijuana DUID bill after hearing there is no scientific basis for it. (Wikimedia.org)
Marijuana Policy

California Driving While High Bill Killed. A bill that sought to create a per se marijuana drugged driving level of 5 nanograms of THC per milliliter of blood has been killed in the Assembly Appropriations Committee. The committee killed it and a bill that would have let police use oral swabs to strengthen cases after cannabis industry officials said they were not supported by science.

Medical Marijuana

Illinois Medical Marijuana Program Gets Extension, Expansion. The House Friday voted to approve a plan to expand the state's medical marijuana program by adding PTSD and terminal illness to the program's list of qualifying conditions and by extending the program for an additional 2 ½ years. Gov. Bruce Rauner (R) has now come around and says he supports the bill, which still needs a final Senate vote. The measure is Senate Bill 10.

Ohio Medical Marijuana Initiative Backers Call It Quits. Faced with a medical marijuana bill approved by the legislature and awaiting the governor's signature, Ohioans for Medical Marijuana announced Saturday that they were ending their campaign to put an initiative on the November ballot. The Marijuana Policy Project-backed effort decided to call it quits because "the reality is that raising funds for medical marijuana policy changes is incredibly difficult, especially given the improvements made to the proposed program by the Ohio General Assembly and the fact that the Governor is expected to sign the bill." The bill passed by the legislature will allow people with about 20 different diseases and conditions to use marijuana, but not to smoke it.

Heroin and Prescription Opioids

US Senator Calls on Feds to Investigate Purdue Pharma Over OxyContin Time-Effectiveness Claims. A US senator has called for a federal investigation of Purdue Pharma, the manufacturer of OxyContin, in the wake of reports that the money-making pain reliever wears off early in many patients, leaving them exposed to pain and increased risk of addiction. Sen. Edward Markey (D-MA) Friday sent letters to the Justice Department, the Food and Drug Administration, and the Federal Trade Commission urging them to begin probes of the Connecticut-based drug maker.

New York Overdose Tracking Bill Goes to Governor. The Senate and the Assembly have both approved a bill that requires the state Health Department to track non-fatal drug overdoses in a bid to get a more complete picture of opioid drug use in the state. The bill is now on the desk of Gov. Andrew Cuomo (D).

US Senator Calls on Feds to Investigate Purdue Pharma Over OxyContin Time-Effectiveness Claims

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

A US senator has called for a federal investigation of Purdue Pharma, the manufacturer of OxyContin, in the wake of reports that the money-making pain reliever wears off early in many patients, leaving them exposed to pain and increased risk of addiction.

Sen. Edward Markey (D-MA) Friday sent letters to the Justice Department, the Food and Drug Administration, and the Federal Trade Commission urging them to begin probes of the Connecticut-based drug maker.

The move comes in the wake of a Los Angeles Times investigation into Purdue Pharma's claim that OxyContin relieves pain for 12 hours, which was one of the drug's main selling points. But the Times found that the effects often wear off before that, leaving patients cycling between relief and intense pain and suffering from opiate withdrawals before their next scheduled pill.

The Times also found that Purdue knew about the problem since OxyContin first appeared in 1996, but continued to claim that it worked for the full 12 hours in part to protect its revenues. The newspaper reported that when faced with the problem, Purdue instructed doctors to prescribe stronger doses, not more frequent ones. Stronger doses of opioid pain relievers are more likely to be implicated in overdose deaths.

"These are serious allegations," Markey wrote in his letter to Attorney General Loretta Lynch. "They raise questions about ongoing deception by Purdue, harm to the public, continued costs to the United States, and the availability of further judicial recourse against Purdue. If upon investigation these allegations are substantiated, the Department should take legal action" against the drug company.

Purdue has rejected the Times' findings, noting that the FDA had approved OxyContin as a 12-hour drug.

"We promote our medicines only within the parameters approved by FDA and, given FDA has not approved OxyContin for eight-hour use, we do not recommend that dosing to prescribers," the statement said.

That's not good enough for Markey, who represents a state hard-hit by problems with prescription opioids and heroin. More than 1,300 people died from opioid overdoses in the state last year, according to the state Department of Public Health.

In his letter to the FDA and FTC, Markey called Purdue "the leading culprit in the current opioid and heroin overdose epidemic" and accused it of making "false and misleading claims about the longevity of OxyContin's pain-relieving properties."

The FDA and FTC should "investigate these claims and take action to protect patients and consumers from the harm caused by Purdue Pharma's deceptive marketing materials."

Justice, FDA, and FTC all say they are studying Markey's letter.

Washington, DC
United States

Chronicle AM: Bratton Blames MJ for Prohibition Violence, Opioid Prescriptions Decline, More... (5/23/16)

Bill Bratton misses the point on prohibition and violence, Nebraskans will have to wait for medical marijuana, Fentanyl is displacing heroin in Vancouver, and more.

NYPD Commissioner Bill Bratton (Creative Commons)
Marijuana Policy

New York City's Top Cop Blames Marijuana Legalization -- Not Prohibition -- for Black Market Violence. NYPD Commissioner Bill Bratton Sunday criticized states that have legalized weed because there is violence around the black market in his city, which hasn't legalized weed. "Here in New York, the violence we see associated with drugs, the vast majority of it, is around the issue of marijuana, which is ironic considering the explosion in use of heroin now in the city," Bratton said. "Interestingly enough, here in New York City most of the violence we see -- violence around drug trafficking -- is involving marijuana and I have to scratch my head as we are seeing many states wanting to legalize marijuana, and more liberalization of policies."

Medical Marijuana

No Medical Marijuana Initiative for Nebraska This Year. Cornhusker medical marijuana advocates have decided to delay a petition drive to get the issue on the ballot until 2018. They cited the late start this year and the expense involved.

Rhode Island Senate Approves Adding PTSD to List of Qualifying Conditions. The Senate last Friday unanimously approved a bill that will add PTSD to the list of debilitating medical conditions that qualify a patient for medical marijuana. The bill now heads to the House.

Heroin and Prescription Opioids

Opioid Prescriptions are Falling for the First Time in 20 Years. Two reports from health information providers show that opioid prescriptions have declined in recent years. IMS Health reported a 12% decline in opioid prescriptions nationally since 2012, while Symphony Health Solutions reported an 18% drop during those years. IMS said prescriptions have fallen in 49 states, with only South Dakota showing an increase. The figures could have implications not only for overdose and addiction rates, but also for pain patients. "The climate has definitely shifted," said Dr. Daniel B. Carr, the director of Tufts Medical School's program on pain research education and policy. "It is now one of reluctance, fear of consequences and encumbrance with administrative hurdles. A lot of patients who are appropriate candidates for opioids have been caught up in that response."

International

In Vancouver, Heroin Has Been Displaced by Fentanyl. The synthetic opioid has been identified in half of all drug overdoses in the city this year, which is on track to exceed last year's drug overdose toll. Advocates for drug users in the city's Downtown East Side say there's no more heroin on the street after it has been pushed out by the cheaper and more potent Fentanyl. "Traditionally, heroin comes in about four different colors,"said the longtime drug advocate Hugh Lampkin of the Vancouver Area Network of Drug Users, describing a bland palette of beiges, browns and blacks. "Well now you're seeing multiple colors, like colors of the rainbow: green and pink and orange and white... Right away, when you see these colors that's a pretty good indicator that it's fentanyl that you're doing. The people who are controlling the supply, they're passing off what should be heroin as fentanyl because of the close proximity of the high."

Afghans Celebrate Bumper Opium Harvest. Hundreds of laborers from across the Pashtun heartland gathered in Naqil, Uruzgan province, to harvest a bumper crop of opium poppies and celebrate with after-work games in a festival-like atmosphere. "This is the only time of the year to make money," said Afzal Mohammad, who came all the way from Kandahar, standing amid chest-high poppy stalks nearby. "People work here for about 15 days and then are jobless for the rest of the year."

Chronicle AM: Shocking Forfeiture Poll, Oakland Racial Balance in MJ Industry Bill, More... (5/18/16)

Organized opposition is trying to emerge in California, legalization in Oregon is creating jobs and payrolls, Oakland attempts to redress racial imbalance in the legal marijuana business but catches some flak, and more.

The New York Senate is focused on addressing heroin and prescription pain pill use. (Wikimedia/Creative Commons)
Marijuana Policy

California Dems Tied to Law Enforcement Oppose Legalization Initiative. A pair of state Democratic lawmakers with "deep law enforcement ties" have come out in opposition to the Adult Use of Marijuana Act (AUMA) legalization initiative. Assemblyman Jim Cooper (D-Elk Grove), a former Sacramento County sheriff's official who regularly warns against drug liberalization, and Sen. Cathleen Gagliani (D-Stockton), "the Democratic senator most aligned with law enforcement," have joined with Republican colleagues to oppose the measure. The initiative is favored by many Democratic elected officials, including Lt. Gov. Gavin Newsom.

Oregon Legalization Creates Jobs, Payrolls. Retail cannabis employees will be paid nearly $46 million this year, and that number is set to increase in the future, according to a new report from local marijuana industry consulting firms. Legalization has also created at least 2,165 jobs, with more to come, the report said.

Medical Marijuana

Oakland Passes Marijuana Ordinance Designed to Encourage Minority Participation. The city council Tuesday unanimously approved a medical marijuana ordinance with an "equity program" that would reserve half of the city's new cannabis permits for people who live in a designated high-crime police beat in East Oakland or were imprisoned for marijuana-related crimes in Oakland in the past 10 years. But the plan is coming under fire from industry leaders who say it may actually be counterproductive to encouraging minority participation and could undercut a pot economy expected to boom if and when the state legalizes marijuana.

Heroin and Prescription Opioids

New York State Senate Releases Heroin Report. The GOP-dominated body has released a report on heroin and prescription pain pill use that recommends 48 changes to state law and policy, including increased penalties for the sale and possession of opioids. The report also calls for increased prevention, treatment, and harm reduction measures. The report includes a package of bills that were expected to be passed Tuesday night. Stay tuned.

Asset Forfeiture

Southern California Poll Finds 10% Report Having Cash or Property Seized Without a Conviction. The survey, conducted by Public Policy Polling, looked at Los Angeles, Riverside, and San Bernardino counties, and also found that 19%o of respondents said they knew someone who had experienced the same. The poll, sponsored by the Drug Policy Alliance, comes as a push is underway to get a civil asset forfeiture reform bill, Senate Bill 443, through the Assembly. The bill passed the Senate last year, but was blocked in the Assembly by law enforcement lobbying. It is still alive, though, and hopes are that it can get through the Assembly this year.

Chronicle AM: TN Pregnant Women Drug Law Fails, AR Welfare Drug Testing Starting, More... (3/24/16)

An asset forfeiture reform bill moves in New Hampshire, Arkansas and West Virginia advance welfare drug testing, a global commission on public health calls for drug decriminalization, and more.

Medical Marijuana

Louisiana House Committee Approves Bill to Set Up Medical Marijuana Shops. The House Health and Welfare Committee Wednesday approved House Bill 446, sponsored by Rep. H. Bernard LeBas (D-Ville Platte). The bill would create a licensing scheme for the distribution of medical marijuana products. The bill now heads for a House floor vote. It must still be approved by the Senate.

More Michigan Protests Over Dispensary Raids. Dozens of patients, advocates, and supporters took to the steps of the state capitol in Lansing Tuesday to protest a new wave of raids by the Michigan State Police and local narcotics teams. Both state Sen. Coleman Young (D-Detroit) and Rep. Jeff Irwin (D-Ann Arbor) addressed the crowd.

Heroin and Prescription Opioids

Kentucky Senate Restores Funding for Heroin Fight. The Senate Wednesday agreed to restore $12 million in funding for anti-heroin efforts that had been proposed by Gov. Matt Bevin (R), but cut by the House last week. House Democrats had slashed the $32 million over two years proposed by the governor to $20 million. Now, the House and Senate will have to thrash out the difference in conference committee.

Asset Forfeiture

New Hampshire House Approves Bill to End Civil Asset Forfeiture. The House Wednesday approved House Bill 636, which would require a criminal conviction before assets could be seized and which would move seized goods from the drug forfeiture fund to the state's general fund. Gov. Maggie Hassan (D) is threatening to veto the bill, saying that because of the state's opioid crisis, this isn't the time to eliminate law enforcement resources.

Drug Policy

Hawaii Lawmakers Take Up Resolution Urging Study on Drug Decriminalization. The House Judiciary Committee today is hearing a resolution, HCR 127, that calls on the state's Legislative Research Bureau to "conduct a study on the feasibility and advisability of decriminalizing the illegal possession of drugs for personal use in Hawaii" so that it "would constitute an administrative or civil violation rather than a criminal offense." If the resolution passes both chambers, the study would be due before year's end to be ready for next year's legislative session. The study would examine Portugal's experience with decriminalization as a possible model for the state.

Drug Testing

Arkansas Welfare Drug Testing to Begin Within Days. The head of the Department of Workforce Services, Daryl Bassett, said Wednesday that the state's welfare drug testing program would get underway within "seven to 10 days." Under the program, all applicants for government aid would be screened for possible drug use and those deemed likely to have been using drugs would have to undergo drug testing. Refusal to take the drug test will result in being denied benefits for six months. Someone who tests positive can continue to receive aid if he follows treatment and recovery plans set by state officials.

West Virginia Governor Signs Welfare Drug Test Bill. Gov. Early Ray Tomblin (D) today signed into law a bill that mandates screening of all welfare applicants for drug use and drug testing those for whom case workers have "reasonable suspicion" of drug use. Applicants who fail drug tests can continue to receive benefits as long as they enroll in drug treatment and job training programs, but a second failed test could mean loss of benefits for up to a year, and a third would earn a lifetime ban.

Harm Reduction

King County Sheriff Says He Would Not Arrest Drug Users Going to Seattle Safe Injection Site. King County Sheriff John Urquhart edged ever closer Tuesday to outright support of a safe injection site in Seattle. "I guarantee you," said Urquhart, "that if you're going into a safe injection site, you will not be arrested by any of my deputies, period." But he was careful to add that while he was "intrigued" by the success of Vancouver's InSite supervised injection facility, he is not yet ready to endorse them for Seattle.

Pregnancy

Tennessee Law That Allows Assault Charges for Pregnant Drug Users Not Renewed. The state's two-year experiment with arresting pregnant drug users is about to come to an end after the legislature failed to re-authorize the law this week. At least a hundred women have been prosecuted under the program, which has been condemned by human rights, civil rights, and pregnant women's rights advocates.

International

Leading Global Health Commission Calls for Reform of Drug Policies Worldwide. A leading global public health commission is calling for new policies that would transform our approach to drug use, addiction and control worldwide, including the decriminalization of minor and non-violent drug offenses. According to a report released this morning by the Johns Hopkins Bloomberg School of Public Health and The Lancet, the war on drugs and zero-tolerance policies have undercut public health across the globe and have directly contributed to many of today's most urgent public health crises, while doing little to affect drug markets or drug use. The Johns Hopkins University -- Lancet Commission on Public Health and International Drug Policy calls for worldwide reform of drug policies, including: the decriminalization of minor and non-violent drug use, possession and petty sale; enactment of policies that reduce violence and discrimination in drug policing; increased access to controlled medicines that could reduce the risk of overdose deaths; and greater investments in health and social services for drug users. The report is based on an extensive review by the Commissioners of the published evidence, and on original analyses and modeling on violence, incarceration and infectious diseases associated with drug policies.

Chronicle AM: Pain Pills to Get "Black Box" Warning, FL to Get Syringe Exchanges, More... (3/23/16)

The Vermont marijuana legalization bill gets a first House hearing, it's do or die tomorrow for Georgia CBD legislation, the FDA orders "black box" warnings for quick-acting prescription opioids, Florida's governor has signed a syringe exchange bill into law,and more.

The FDA is mandating a "black box" warning for opioid pain pills. (wikimedia.org)
Marijuana Policy

Arizona Legalization Campaign Has Raised Ten Times More Funds Than the Opposition. According to a new report from the Arizona Center for Investigative Reporting, the Campaign to Regulate Marijuana Like Alcohol has raised $1.1 million for its legalization effort, while the leading group opposing legalization, Arizonans for Responsible Drug Policy, has raised only $90,000. The legalization campaign needs 150,642 valid voter signatures to qualify for the November ballot. It already has 180,000 raw signatures and says it aims to collect 225,000 to have a nice cushion.

Vermont Legalization Bill Gets House Panel Hearing. The House Judiciary Committee Tuesday heard testimony on the legalization bill, Senate Bill 241, from representatives of state police, prosecutors, and sheriffs. The witnesses said legalization would not end the black market, worried about out-of-state pot tourists driving under the influence, and called for a marijuana DUID law. More hearings are coming.

Dallas City Council Rejects Ticketing Instead of Arresting Pot Possessors. The city council has backed away from a plan to ticket small-time pot possessors after realizing that state law prevents the city from imposing the policy outside of Dallas County. Tiny portion of the city of Dallas extend into neighboring Collin, Denton, Kaufman, and Rockwell counties. The idea had been supported by the police chief and several council members.

Medical Marijuana

Last Chance for Georgia CBD Expansion Tomorrow. The legislative session ends at midnight tomorrow, and lawmakers will have a chance to take up a bill that would expand qualifying conditions for the state's CBD medical marijuana registry. The measure, House Bill 722, was defeated earlier in the session, but lead sponsor Rep. Allen Peake (R-Macon) has added it as an amendment to another bill to try to get it through tomorrow.

Iowa Patients, Supporters Rally in Des Moines. Hundreds of people gathered on the steps of the state capitol Tuesday to urge lawmakers to approve a comprehensive medical marijuana program. "This is not a partisan issue. This is something for the health and safety of our citizens," said Windsor Heights Mayor Diana Willits. "It truly is heartbreaking that legislators are not paying attention to their citizens and their constituents. It's time for everybody to put their political obstacles aside and do what's right in a nonpartisan way." The state passed a 2014 law allowing patients with epilepsy to use CBC cannabis oil, but that law did not provide for manufacturing or distributing the medicine in the state. A bill this year, House File 2384, would establish two grow facilities in the state and allow use of CBDs by patients who suffer from epilepsy, multiple sclerosis or terminal cancer. It is still being debated at the committee level. A recent poll had support for medical marijuana at 78%.

Ohio Medical Marijuana Bill Coming. Sen. Kenny Yuko (D-Richmond Heights) said Tuesday he plans to introduce a medical marijuana bill shortly. Yuko said the legislature needs to act on medical marijuana this spring or see the decision possibly taken out of its hands by the voters. There are at least three medical marijuana initiative campaigns brewing.

Asset Forfeiture

Mississippi Asset Forfeiture Reform Bill Survives Legislative Deadline. Tuesday was the day bills approved by one chamber had to see committee action in the other chamber or die, and House Bill 1410, the Asset Forfeiture Transparency Act, survived. It was approved by the Senate Accountability, Efficiency, Transparency Committee Tuesday afternoon and is now headed for a Senate floor vote. The bill would not end civil asset forfeiture, but require state officials to maintain a searchable database of all cash and property seized by law enforcement.

Heroin and Prescription Opioids

FDA Says Opioid Pain Relievers Will Have to carry "Black Box" Warnings. The Food and Drug Administration (FDA) announced Tuesday it will require immediate-release opioids to carry a "black box" warning label alerting users to the risks of misuse, addiction, overdose, and death. The warnings will refer users to the manufacturer's website for details. "Opioid addiction and overdose have reached epidemic levels over the past decade, and the FDA remains steadfast in our commitment to do our part to help reverse the devastating impact of the misuse and abuse of prescription opioids," FDA Commissioner Robert Califf, MD said in a news release. "Today's actions are one of the largest undertakings for informing prescribers of risks across opioid products, and one of many steps the FDA intends to take this year as part of our comprehensive action plan to reverse this epidemic."

Democratic Rep. Tears Into Pharma Company for Price-Gouging on Overdose Reversal Drug. Rep. Elijah Cummings (D-MD) used his opening remarks at a House Committee on Oversight and Government Reform hearing on heroin use to rip into Amphastar Pharmaceutical, the manufacturer of the overdose reversal drug naloxone (Narcan), for trying to profit off the crisis. "We can no longer allow drug companies to keep ripping off the taxpayers for life-saving medications," Cummings said. "Cities all around the country have recognized the need to equip their first responders, police officers and public health officials with naloxone -- a drug that can reverse opioid overdoses in a matter of minutes."

Harm Reduction

Florida Governor Signs Syringe Access Bill. Gov. Rick Scott (R) today signed into law the Miami-Dade Infectious Disease Elimination Act (IDEA Act), which will allow for the creation of needle exchanges.

International

Commission on Narcotics Drugs Meeting Ends, Now on to the UNGASS on Drugs. The 59th session of the Commission on Narcotic Drugs (CND) ended Tuesday in Vienna. The meeting and its outcome document are laying the groundwork for the UN General Assembly Special Session (UNGASS) on drugs at UN headquarters in New York next month.

Latin America's Largest Medical Marijuana Crop Now Being Harvested. Workers near the city of Colbun in central Chile have begun harvesting some 6,000 marijuana plants destined for 4,000 Chilean medical marijuana patients. The operation is being overseen by the Daya Foundation, which has hired 60 local temporary workers for the job. "It is an important day. We want it to be the first harvest of many more to come in Latin American countries," Ana Maria Gazmuri, president of the Daya Foundation.

Chronicle AM: CA Lt. Gov. Endorses Legalization Init, Latin America Marijuana Progress, More... (3/22/16)

California's lieutenant governor endorses the pot legalization initiative, Maryland moves to recriminalize public pot smoking, Indiana's governor signs some anti-meth bills, several Latin American countries advance on marijuana policy, and more.

California Lt. Gov. Gavin Newsom endorses the AUMA. (wikipedia.org)
Marijuana Policy

California Lieutenant Governor Endorses AUMU Legalization Initiative. This is not exactly a shocker since Lt. Gov. Gavin Newsom (D) has been deeply involved in laying the groundwork, but in a Sacramento Bee op-ed Tuesday, he made it official. Citing the goals of protecting youth and public safety, reducing the black market, offering legal protection to "good actors," and raising revenues, Newsom wrote:  "I believe the California Adult Use of Marijuana Act – which has been endorsed by groups as diverse as the NAACP, the California Medical Association and the California Council of Land Trusts – achieves all of these objectives and I will be urging voters to support it this November."

Maryland House Approves Bill Making Public Pot Smoking a Misdemeanor. The House of Delegates Monday approved House Bill 777, sponsored by Del. Brett Wilson (R-Washington). The bill rolls back last year's decriminalization of marijuana possession by making it a misdemeanor to smoke it in a public place. Some House Democrats supported the bill, saying that unwanted exposure to pot smoke is a public health issue.

Heroin and Prescription Opioids

Connecticut Seeks to Limit Opioid Prescriptions for First-Time Patients. The legislature's Public Health Committee Monday unanimously passed a bill that would require doctors to only prescribe seven days' worth of opioid drugs to first-time patients. But some doctors are uncomfortable with the measure, with one MD who is a member of the state's Alcohol and Drug Policy Council calling it a "feel good" idea that will be unworkable and ineffective. "I think you wind up hamstringing well-educated, good doctors and not weeding out the ones with poor prescribing practices," said Dr. J. Craig Allen, medical director of Rushford treatment center with the Hartford HealthCare Behavioral Health Network, which includes the Hospital of Central Connecticut. "A global law that limits prescriptions won’t result in better medical care."

Methamphetamine

Indiana Governor Signs Anti-Meth Bills. Gov. Mike Pence (R) Monday signed into law a package of bills aimed at shutting down meth labs in the state. One requires pharmacies to limit the number of cold pills sold to unfamiliar customers without a prescription, while a second bars people with meth offenses from buying pseudoephedrine without a prescription.

International

Argentine Deputy Files Medical Marijuana Bill. Deputy Diana Conti has introduced a bill that would amend Argentina's drug laws to allow the use, possession, and cultivation of medical marijuana. "The science has advanced, and it appears to me that the prohibition and punishment for the possession of marijuana must end," she said.

Brazil Public Health Agency Authorized Import of CBD Cannabis Oils. Brazil's public health agency, ANVISA, has authorized the prescription and importation of low-THC, high-CBD cannabis oils for the treatment of epileptic seizures. The news was published in the official gazette.

Uruguay Reaches Agreement on Pharmacy Marijuana Sales. The government and the pharmacy industry have reached an accord to get pharmacy pot sales up and running nearly three years after the country legalized marijuana. The new accord paves the way toward actually getting sales going, but it's still not clear when that will actually happen. 

A Maryland Lawmaker's Paradigm-Shifting Approach to the Heroin and Pain Pill Crisis [FEATURE]

With nearly 47,000 Americans dying of drug overdoses in 2014 -- more than from gunshots or car crashes -- the problem of heroin and prescription opioid (pain pill) addiction is getting well-deserved attention. From community town halls to state capitals, as well as in Congress and on the rival presidential campaigns, the crisis is spawning demands for solutions.

http://stopthedrugwar.org/files/dan-morhaim-180px.jpg
Dan Morhaim
The response, in general, has been more sympathetic than to earlier waves of hard drug use, such as heroin in the 1960s or crack cocaine in the 1980s, which brought down the harsh drug war policies of Nixon and Reagan. Now, there are more calls for drug treatment than for further law enforcement crackdowns, police departments are carrying overdose reversal drugs, and public health agencies are taking on a more prominent role.

But addicts continue to be arrested, with all the deleterious consequences that entails, and, when it comes to policy, the problem of addiction remains largely in the realm of criminal justice. Harm reduction practices proven in other parts of the world improve both the lives of drug users and those of the communities they live in continue to be shunted aside in the US.

That could change in at least one state. Veteran Maryland Delegate Dan Morhaim (D-Baltimore County) has just introduced a paradigm-shifting package of bills that would begin to move the state's posture toward drug use from prohibition to public health and harm reduction. Morhaim, a practicing physician with three decades of frontline hospital ERs, brings to his approach a vision formed by that experience.

If enacted, Morhaim's package would mark a radical, but commonsensical, humane, and scientifically-supported shift in Maryland's drug policies. Here's what it includes:

  • Emergency Room Treatment on Demand. House Bill 908 provides treatment on demand in emergency rooms and hospital settings. The bill requires acute care hospitals to have a counselor available or on-call at all times and specified arrangements for transferring patients to appropriate treatment settings. Addicted patients make up a large percentage of uninsured visits to ERs, making them an ideal place for initial therapeutic contact.
  • Safe Consumption Sites. House Bill 1212 allows individuals to use drugs in approved facilities while supervised by trained staff who also provide sterile equipment, monitor the person for overdose and offer treatment referrals. Similar on-going programs in Australia, Canada, and several European countries have eliminated overdose deaths, reduced the spread of disease, and provided points of accessto the most hard-to-reach drug users.
  • Drug Decriminalization. House Bill 1219 decriminalizes the possession and use of small quantities of drugs: one gram of meth or heroin, two grams of cocaine, 10 hits of MDMA, 150 micrograms of LSD. The object is to keep otherwise non-criminal drug users out of the criminal justice system, saving resources and avoiding saddling more residents with criminal records.
  • Heroin Maintenance. House Bill 1267 allows a four-year pilot study of "poly-morphone assisted treatment" with pharmaceutical grade opioids, including heroin, to treat under medical supervision a small number of hardcore users who have proven resistant to other forms of treatment. Ongoing heroin maintenance programs in several European countries have been shown to reduce illegal drug use, decrease crime, reduce the black market for heroin, and lead to less chaotic lives for their participants.

The package didn't exactly come out of nowhere. Morhaim's experiences in the ER, where he dealt not only with direct consequences of drug use -- overdoses, infections -- but also direct consequences of drug prohibition -- old women injured in muggings for black market drug money, the toll of dead and wounded in black market drug turf battles -- colored his approach.

"I'm a physician, not a prosecuting attorney," Morhaim told the Chronicle. "I come at this from a public health perspective. We talk about 'surges' to fight this and that, but what we haven't had in this country is a surge in the public health approach, real, substantive public health. This is different, and some will see it as controversial, but I'm comfortable with that. This is something that's really corroding the heart and soul of our society."

He wasn't alone.

"I've had a lot of conversations, and my district has generally been very supportive of these kind of innovative things. No negative feedback. There's a broad consensus that the war on drugs is a failure," Morhaim said. "People are really cognizant of that. And I'm an Emergency Room physician at a Level II trauma center, I've also done healthcare for the homeless. I've been on the front lines, seen the carnage, the death, the violence, and the way this affects the families, and I'm speaking from true experience, and people respect that."

Not only did Morhaim have support in his community, he had support from a strong group of advocates and experts.

"As things were coming to a head, Delegate Morhaim reached out to us at the Drug Policy Alliance (DPA)," said DPA staff attorney Lindsay LaSalle, who was involved in developing the proposals. "He said he felt like he could offer progressive solutions to the crisis and he wanted our subject matter expertise to help develop those proposals."

DPA, Law Enforcement Against Prohibition (LEAP), whose executive director, Neill Franklin, is a former Baltimore police officer, and the Open Society Foundations joined with academics, lawyers, doctors, and harm reductionists to develop and refine the policy proposals that became the bill package. Local institutions of higher learning, including the University of Maryland, the University of Baltimore, and Johns Hopkins University, had academics involved in the effort as well.

Passing the bills won't be easy, and it's not likely to happen this year, but Morhaim and his supporters are playing to win in the not-too-distant future.

"Dan is currently on the second year of a four year term," LaSalle said. "These bills were introduced strategically this term with the understanding that it would be a year of educating colleagues and generating positive media coverage. This is always a long game; we don't expect passage this year, but we hope to gain traction on one or more of these in the next two or three years."

"I've been in the legislature a long time, and I've learned you just have to be persistent, you listen and address concerns, maybe you accept an amendment to a bill," Morhaim said.

He pointed to the successful effort to get medical marijuana through the legislature.

"On that, people had suggestions, and we said let's fix it in the bill," he recalled. "Law enforcement didn't oppose it because I sat down and worked with them."

He also recalled legislative battles he had fought -- and won -- around smoking in restaurants and the use of safety seats for children.

"Banning smoking in restaurants seemed impossible in 1995, but now it's commonplace," he said. "The same with kids safety seats. Both of those were hard-fought on the political level, but when we talk to people, we can convince them. These things take time, but when you recognize what's not working, then you can explore what is. People are looking for answers."

Although Morhaim's package of bills is the most comprehensive, explicit harm reduction interventions are being considered in other places, too. California will see a safe consumption site bill introduced next week, and activists and officials in a number of cities, including New York City, San Francisco, and Seattle are laying the groundwork for such facilities at the local level.

"We're getting traction on these issues," said LaSalle. "Nevada was the first state with a heroin-assisted treatment bill, and while it didn't get out of committee, we had robust hearings, with international experts. And that California bill will be moving forward this session. Drug treatment and harm reduction don't always go hand in hand, but in this case the treatment community is cosponsoring or officially supporting safe consumption sites."

Meanwhile, some states are moving in the opposite direction. In Maine, the administration of Tea Party Gov. Paul Le Page (R) is seeking to reverse a law passed last year that defelonized drug possession. (The rambunctious Republican has also called for guillotining drug dealers, blamed black drug dealers for impregnating white Maine girls, and called for vigilantes to shoot drug dealers.) And next door in New Hampshire, the attorney general wants to start charging heroin suppliers with murder in the event of fatal overdoses. Prosecutors in other states have also dusted off long-unused statutes to bring murder or manslaughter charges.

"We need to ask those people why they're doubling down on a failed policy," said LaSalle. "Why would this work now when it's just more of the same that's been in place for four decades, and now we have use and overdoses and Hep C increasing."

"I understand the impulse to 'Do Something!' in response, and because criminalization has been our go-to response, it seems logical that increasing penalties or prosecutions is a way to solve the problem, but we know, we have shown, that it is not. It's frustrating."

It can be worse than frustrating, too, LaSalle noted.

"Using murder charges as a whipping stick in the case of overdoses is really counterproductive," she said. "If the goal is to reduce overdoses, this is going to reduce the likelihood of anyone calling 911. Maybe they shared their stash, and if they could face murder charges, they now have a serious disincentive to call."

Clearly, the war on drugs is not over. But after half a century of relying predominantly on the forces of repression to deal with drug use, a new vision, both smarter and more humane, is emerging. Now comes the political fight to enact it.

Annapolis, MD
United States

Chronicle AM: FL MedMJ Init Qualifies for Ballot, VT Gov Endorses Pot Legalization Bill, More... (1/28/16)

Busy, busy. State legislatures are in full swing, and the bills just keep coming. Meanwhile, Florida's medical marijuana initiative has qualified for the ballot, Vermont's governor endorses legalization, and more.

Heroin is on the agenda at statehouses this week. (wikimedia.org)
Marijuana Policy

Federal Judge Throws Out Lawsuit Against Colorado's Legalization. A Colorado US District Court judge has rejected a lawsuit challenging the legality of marijuana legalization in the state. The lawsuit was filed by a Washington, DC-based anti-marijuana group, the Safe Streets Alliance, and asked the court to find the state and Pueblo County guilty of violating the Racketeer Influenced and Corrupt Organizations (RICO) Act. The judge in the case rejected the claims, concluding that private parties have no standing to seek recourse for alleged violations of the Supremacy Clause, which makes federal law the supreme law of the land. Another lawsuit, filed by the states of Nebraska and Oklahoma, is still being decided.

New Mexico Poll Finds Strong Support for Legalization. Three out five (61%) adult New Mexicans support legalizing and regulating marijuana, according to a new poll from Research & Polling. The poll comes as the legislature ponders two bills, one that would amend the state constitution to let voters decide the issue, and one that is a straightforward legalization bill. The bills are Senate Joint Resolution 5 and House Bill 75, respectively.

Vermont Governor Endorses Legalization Bill. Gov. Peter Shumlin has endorsed the Senate Judiciary Committee's legalization bill, Senate Bill 137. "The War on Drugs has failed when it comes to marijuana prohibition," Gov. Shumlin said. "Under the status quo, marijuana use is widespread, Vermonters have little difficulty procuring it for personal use, and the shadows of prohibition make it nearly impossible to address key issues like prevention, keeping marijuana out of the hands of minors, and dealing with those driving under the influence who are already on Vermont's roads. The system has failed. The question for us is how do we deal with that failure. Vermont can take a smarter approach that regulates marijuana in a thoughtful way, and this bill provides a framework for us to do that."

DC Poll Finds Residents Want District to Move Ahead With Regulation -- Despite Congress. A substantial majority of District residents believe Mayor Bowser should move forward with taxation and regulation of marijuana despite Congressional prohibition, according to a survey conducted over the weekend by Public Policy Polling (PPP) for the Drug Policy Alliance, DC Vote, DC Working Families and the Washington City Paper. Two-thirds (66%) of respondents believe the mayor should pursue a legal method (such as use of reserve funds) to implement taxation and regulation of marijuana in the District. In light of congressional interference attempting to prevent such regulation, 63% of residents view marijuana legalization as a statehood issue for the District.

Medical Marijuana

Americans for Safe Access Releases Report on State Medical Marijuana Programs. The patient advocacy group graded each state and graded harshly. No state earned an "A" and only 12 earned a "B." Read the report here.

California Bill to Halt Medical Marijuana Bans Heads to Governor's Desk. After passing the Senate earlier this week, Assembly Bill 21, has now passed the Assembly and awaits a signature from Gov. Jerry Brown (D). The bill lifts a March 1 deadline for localities to regulate medical marijuana or lose control to the state. The deadline has prompted more than a hundred localtities to enact bans on various sorts in a bid to retain local control.

Florida Medical Marijuana Initiative Qualifies for the November Ballot. The group behind the effort, United for Care, said Wednesday the Division of Elections has recorded 692,981 verified voter signatures, nearly 10,000 more than needed to qualify. A similar effort won 58% of the vote in 2014, but failed to pass because constitutional amendments require 60% of the vote to pass in Florida.

Heroin and Prescription Opiates

Injection Drug Use Driving Appalachian Hepatitis B Infections. The Centers for Disease Control and Prevention report that acute Hepatitis B was up 114% in Kentucky, Tennessee, and West Virginia between 2009 and 2013. The report found that injection drug was tied to 75% of the new cases. Unlike Hep C, Hep B can be prevented with a vaccine, but vaccine coverage is low among adults nationwide.

Maine Governor Wants Gunowners to Shoot Drug Dealers. Just days after saying Maine should revive the guillotine to execute drug dealers, Gov. Paul LePage suggested just shooting them instead. "I tell ya, everybody in Maine, we have constitutional carry," LePage said in an on-camera interview in Lewiston. "Load up and get rid of the drug dealers. Because, folks, they're killing our kids," the governor said. He then denied that he was encouraging vigilantism.

New York Assembly Minority Task Force Releases Report on Heroin Addiction. The task force has come out with suggestions for combating heroin and opiate addiction. The recommendations include earlier drug education, involuntary "emergency medical" detention of addicts, and a felony "death by dealer" statute. Now, the task force must work with Assembly Democrats to create legislation.

Drug Testing

South Dakota Welfare Drug Testing Bill Killed in Committee. The Health and Human Services voted to kill a bill that would have required welfare applicants to undergo mandatory, suspicionless drug testing. Even the Republican governor had opposed the bill.

International

Producers of Prohibited Plants Issue Declaration Ahead of UNGASS. The Global Forum of Producers of Prohibited Plants (coca, opium, marijuana) is demanding that growers be heard at the UN General Assembly Special Session on Drugs in April. In a joint declaration from producers in 14 countries, the group urged an end to forced eradication of drug crops, the removal of the three plants from international drug control treaties, and sustainable rural economic development. Click the title link for a full list of participants and recommendations.

The Top 10 Domestic Drug Policy Stories of 2015 [FEATURE]

As the year winds down, we look back on the big stories in drug policy, from marijuana reform to climbing fatal overdose levels to sentencing reforms and beyond.

Marijuana remained a major story this year. (wikimedia.org)
The Sky Hasn't Fallen on Legal Marijuana States. The great social experiment with marijuana legalization appears to be going off without a serious hitch, and that's great news for people in states where it will likely be an issue next year. No outbreaks of reefer-induced mass criminality have taken place, no hordes of zombie school kids have appeared. In fact, very little at all seems to have happened, except that in Washington state, marijuana arrests are way down, tax revenues are flowing in, and, and ditto for Colorado, where legal pot has created 16,000 jobs (not to mention thousands more in weed-related industries) and, in Denver at least, a real estate boom is going on. Evaluating the impacts of a policy shift like ending state-level marijuana prohibition is a complicated and long-term affair, but so far it we're not seeing any signs of major social policy disaster.

The Marijuana Majority Solidifies. Marijuana legalization is now consistently winning majority support in national polls. An April CBS News poll (released on 4/20) reported support at "an all-time high" at 53%, while a Pew Research poll that some month also came in at 53%. An October Gallup poll had support at 58%, a November Morning Consult poll had it at 55%. This is really quite remarkable: Less than a decade ago, fewer than a third of people were ready to legalize it. Beginning in 2012 or 2013, public opinion reached the tipping point, and now we've clearly tipped.

Groundwork Well Laid for Marijuana Legalization Efforts Next Year. Efforts are well-advanced in a half-dozen states states to put legalization initiatives on the ballot next year. A Nevada initiative has already qualified for the November ballot and a Massachusetts initiative has also met its initial signature gathering hurdle (but must let the legislature have a chance to act before gathering a token amount of additional signatures to qualify for November). Initiative signature gathering campaigns are also well-advanced in Arizona, Maine, and Michigan, and while the California effort lags behind, an initiative backed by some deep-pocketed funders should qualify for November as well. State polls in those states show majorities for legalization, but support numbers only in the 50s suggests that victories are by no means inevitable. Those numbers tend to get pushed down in the course of an actual campaign, especially if there's well-funded opposition. And serious efforts are underway in two states, Rhode Island and Vermont, to pass legalization at the state house next year.

Monopoly Marijuana Gets Rejected in the Heartland. In a clear signal that marijuana legalization is not inevitable, a well-funded, but equally well-loathed legalization initiative went down in flames in November. The ResponsibleOhio initiative would have enshrined within the state constitution a "monopoly" under which pot would be legalized, but only 10 growers could produce commercial pot crops. The effort was opposed by the state's Republican political establishment, as well as the usual suspects in law enforcement, but also by most of the state's marijuana legalization activists. Concerns about the role of industry money in the movement are on the rise, but ResponsibleOhio wasn't even industry money -- it was just a set of wealth investors hoping to cash in with their privileged positions in a newly legal and high lucrative industry.

Black Lives Matter's Policing Critique Implicates the Drug War. The most energetic mass movement since 2011's Occupy Wall Street (and beyond) is taking direct aim at policing abuses that have festered for a generation -- and the war on drugs is deeply implicated in them. BLM's Campaign Zero manifesto to end police violence includes numerous drug war-related reform targets. From the militarization of policing to mass incarceration, from stop-and-frisk to "policing for profit," the objects of BLM's ire are key components of the drug war, and the movement is raising the racial justice imperative in the loudest fashion possible.

Heroin overdoses are still on the increase. (New Jersey State Police)
Overdoses Kill Tens of Thousands, Harm Reduction Responses Emerge. Drug overdoses are now the leading cause of accidental death in the US, claiming some 44,000 lives a year. Heroin is involved in more than 8,000 of those deaths, but prescription opiates are involved in twice that number. Deaths related to prescription opiates are actually leveling off in line with a decrease in prescribing beginning in 2012, but heroin deaths, which quadrupled between 2002 and 2013, are not, especially as people who once had access to pain pills resort to the black market. With the rising death toll -- and the changing demographics of users; younger, whiter, less "urban" -- has come a new openness toward harm reduction measures that can actually save lives, especially the wider availability of the opiate overdose reversal drug naloxone (Narcan). Access to the drug is being increased around the country, thousands of lives are being saved, even the drug czar is for it. It's not like having supervised injection facilities, where users can inject under medical supervision, and which are proven to practically eliminate overdoses (Vancouver's InSite points to exactly zero fatal overdoses in nearly 16,000 injections), but it's a start.

Asset Forfeiture Reform Picks Up Steam. The use of asset forfeiture has been a favorite drug war tactic of police and prosecutors for years, and has grown to the point where federal law enforcement seized more from citizens than burglars did last year. It's been 15 years since the last round of federal asset forfeiture reform, and the pressure is building in Washington. The year started off with then Attorney General Holder abruptly limiting federal seizure sharing with state and local cops, which cut off a main conduit for local cops to get around state asset forfeiture laws (the federal equitable sharing program allowed seizing law enforcement agencies to keep 80% of seizures, while state laws often required seizures to go into general funds). That was followed by the filing of a Rand Paul bill to end federal civil asset forfeiture with a House panel signaling support. The practice is also under fire in the states, where more than a dozen took up bills this year. In two states, Maryland and Wyoming, bills passed the legislature, only to be vetoed by Republican governors, but new asset forfeiture reform laws went into effect July 1 in Montana and New Mexico and passed in Michigan in the fall. Look for more asset forfeiture reform battles next year, both in Congress and at the statehouse.

Some 6,000 drug war prisoners got out in one fell swoop at the beginning of November. (nadcp.org)
6,000 Federal Drug War Prisoners Come Home. At the end of October, the largest prisoner release in recent US history took place, with some 6,000 prisoners set free after their drug sentences were cut thanks to policy changes by the US Sentencing Commission. Another 8,000 are set to be released the same time next year. Along with other sentencing reforms enacted in the past few years, the move has resulted in the federal prison population declining for the first time since Ronald Reagan unleashed the modern drug war in the early 1980s.

Obama Commutes Drug Sentences. President Obama commuted the sentences of 68 drug offenders earlier this year, and just last week he commuted the sentences of nearly a hundred more. Obama has now issued more commutations (which actually free people still behind bars, as opposed to pardons, which are granted after the fact) than the last five presidents combined, and with some 35,000 having petitioned for commutations at the invitation of the Justice Department, we could well see another big batch next year before he leaves office.

Drug Policy Becomes a Presidential Election Issue. In a good way. On the issue of marijuana policy, Bernie Sanders has become the first serious mainstream presidential candidate to endorse marijuana legalization, and, as this Marijuana Policy Project report card on the presidential candidates shows, many of the others -- from both parties -- support medical marijuana, decriminalization, and/or a states' rights approach to legalization. Not all of them do, of course, but supporting marijuana reform is now a thoroughly mainstream position in presidential politics. Similarly, the candidates have been addressing high rates of prescription opiate and heroin use, with even some GOP candidates talking about treating addiction as a health and public health issue, not a criminal justice one. Democratic contenders have also been addressing the problem as a public health issue, most recently in the New Hampshire Democratic debate. We've come a long way from competing to see who can be the "toughest" on drugs.

(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.)

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