Cocaine

The Year in Drugs II: Good, Bad, and Ugly Global Drug Policy in 2018 [FEATURE]

Cocaine (STDW) - Fri, 12/28/2018 - 19:31

(See our Top Domestic Drug Stories of 2018 piece here.)

It's been a year we couldn't wait to put behind us, but as 2018 comes to an end, we can look back on some advances on the international drug policy front, as well as continued brutal and regressive responses from some quarters. Here are 10 of the global drug policy stories that shaped the year, for better or worse:

[image:1 align:left caption:true]1. Drug Death Penalty Reforms Cause Massive Drop in Executions

Early this year, it became official: Iran had reformed its death penalty statutes to radically reduce the number of people facing execution for drug offenses, and it had done so retroactively, saving the lives of thousands already on death row. By mid-year, it was clear that the move was having an impact, as human rights observers reported a 99% reduction in drug executions, with only one person being executed for drugs as of June, compared to more than a hundred during the same period in 2017.

2. Canada Becomes the First G8 Country to Legalize Marijuana

Justin Trudeau pledged that he was elected prime minister, his government would legalize marijuana. It didn't happen as fast as he would have liked, but the Liberals' legalization bill passed parliament in June and went into effect on October 17. So far, the sky has not fallen.

3. Medical Marijuana Earns Growing Acceptance

The year began with Thailand announcing a plan to allow medical marijuana and ended with Thailand approving it and becoming the first Southeast Asian country to do so. But in the meantime, Israeli pharmacies began selling medical marijuana in April, Zimbabwe legalized it in May, and Portugal and Luxembourg followed suit in June. In November, Great Britain joined the club, and Greece issued its first medical marijuana production licenses. Late in the year, in South Korea, the National Assembly approved an amendment to the country's drug laws that will pave the way for the use of medical marijuana by prescription, and New Zealand also approved it in December Not a bad year for medical marijuana.

[image:2 align:right caption:true]4. The Philippines Drug War Continues, But Pressures Mount…

The bloody drug war of Philippines President Rodrigo Duterte continued apace in 2018, with a death toll now put at 12, 000 (20,000 by some estimates), but Duterte has come under increasing pressure both domestically and internationally. In February, both Amnesty International and Human Rights Watch aimed broadsides at the Philippines even as the International Criminal Court began "preliminary examinations" of whether there is sufficient evidence to bring a case before the court. In March, activists called out drug war human rights abuses at the embassy in Washington, DC. By July, an unbowed Duterte was vowing to continue a "relentless and chilling" drug war even as national human rights groups said he was using it as a cover for assassinating political opponents. In September, he unleashed an attack on a second drug war critic, Senator Antonio Trillanes, after last year imprisoning critic Senator Leila de Lima on trumped up drug charges. She is still imprisoned.

5.. ...and the Rot Spreads in the Region

Following the lead of the Philippines, other countries in the region have also embraced drug war thuggery and human rights abuses. In May, the Bangladeshi opposition warned of a wave of police killings of drug suspects, and within weeks, more than a hundred were killed and 20,000 arrested, even as evidence emerged that the crackdown was being used to hide political assassinations. The situation was fraught enough that the UN human rights head and even the US State Department expressed concern. Drug war killings were also reported in Indonesia, although there were mixed signals about moves toward reforms there, and Sri Lanka vowed to begin hanging drug dealers. Paradoxically though, a Malaysian court's imposition of a death sentence on a man for providing cannabis oil to patients now appears to have resulted in a moratorium on the death sentence and could end the death penalty in its entirety in the county.

6. The US President Aligns Himself With Global Drug War Authoritarians

President Donald Trump was a baleful presence on the global drug policy stage this past year, sympathizing with drug war authoritarians such as Philippines President Rodrigo Duterte and Turkish Prime Minister Erdogan, as well as drug death penalty countries such as China and Singapore. He said early in the year he wants to execute all drug dealers and admires the Singapore approach (mandatory death penalty for drug trafficking), a statement that moved more than 150 organizations to condemn his call. At year's end, he was singing a similar tune with a ghoulish call for more Chinese drug executions. In between, he went to the United Nations to try to gin up a reinvigorated global drug war.

[image:3 align:left caption:true]7. South Africa Legalizes Marijuana

In a case brought by three marijuana users, the country's Constitutional Court ruled that the private possession, cultivation, and consumption of marijuana is legal. "It will not be a criminal offense for an adult person to use or be in possession of cannabis in private for his or her personal consumption," Deputy Chief Justice Raymond Zondo wrote in his ruling. It will, however, remain illegal to use cannabis in public and to sell and supply it. The ruling did not set allowable quantities, with the court saying parliament had two years to come up with a new law that reflected the ruling.

8. Glimmers of Hope in Mexico

then-President Felipe Calderon unleashed the latest chapter of the country's drug wars, bringing violence to levels not seen before in the country, Mexico is showing signs it is ready for change. The death toll from prohibition-related violence is higher than ever, and that is impelling a psh for change, most notably with the election of Andres Manuel Lopez Obrador, who is very open to finding exits from the drug war, whether it's legalized opium production in Guerrero, granting amnesty for non-violent drug trafficking offenders, or legalizing marijuana. And speaking of legalizing marijuana, the Mexican Supreme Court in November struck down the ban on marijuana possession, cultivation, and use. Now, Lopez Obrador's governing MORENA Party has filed a bill to legalize marijuana sales. Tackling the violence, may be a bit more difficult.

9. Colombia Sees a Record Coca Crop as US Cocaine Deaths Rise

Efforts to reduce coca cultivation and cocaine production in the country after the peace agreement with the FARC rebels have not gone well, and that's causing rising worry in Washington. In June, the UN Office on Drugs and Crime reported that 2017 production was at an all-time high, prompting expressions of concern from the drug czar's office and support from President Trump for new rightist Colombian President Ivan Duque's "head-on fight against drug trafficking." That could include a renewed resort to aerial fumigation, even drones, as well as forced eradication of coca crops, leading to renewed conflict in cultivation zones. Meanwhile, cocaine is now the third leading cause of drug overdose deaths, trailing only fentanyl and heroin.

[image:4 align:right caption:true]10. Historic UN Cannabis Review Hits Last-Minute Procedural Delay

In June and again in November, the Expert Committee on Drug Dependence (ECDD) of the World Health Organization (WHO) met to consider the evidence on cannabis (marijuana) and its placement in the UN drug scheduling system, which determines whether or what level of control the UN drug conventions mandate that countries maintain for the substance. The conventions specify that substances should receive such an evaluation before being scheduled, but that never happened for marijuana. Observers believe the process should lead to marijuana being moved to a less restrictive schedule than it is in currently -- if the Commission on Narcotic Drugs (CND) votes to adopt such a recommendation from ECDD.

That didn't happen when, earlier this month, WHO voted to delay release of ECDD's recommendations until January, for unexplained reasons. That may mean they get taken up at the main annual CND meeting in Vienna in March, rather than December's intersessional. The delay seems unusual, and probably political, but its intent is unclear.

The next few months may tell. In the meanwhile, ECDD says that CBD shouldn't be scheduled at all. But that didn't stop the US FDA from saying that treaties require it be scheduled, even though they also think it shouldn't be.

Categories: Cocaine

The Year in Drugs I: The Top Domestic Drug Policy Stories of 2018 [FEATURE]

Cocaine (STDW) - Thu, 12/20/2018 - 05:22

This is a year that just about everybody is eager to see come to an end, but when it comes to drug policy, 2018 hasn't been half-bad, at least in the US. (Check back next week for our Top International Drug Policy Stories.)

We've seen marijuana legalization spread further, we're on the verge of seeing Congress pass major sentencing reform legislation, and the ban on domestic hemp cultivation is coming to an end, among other things.

A lot went on in drug policy in 2018. Here are eight stories that helped define the year:

1. Overdose Deaths Remain Unconscionably High But Appear to Have Leveled Off

[image:1 align:left caption:true]The nation's fatal drug overdose crisis is far from over, but it now looks like it at least didn't get any worse this year. Driven in large part by the rise of fentanyl, overdose deaths reached a stunning 72,000 in 2017, a figure ten times the number in 1980 and double that of only a decade ago.

But preliminary reports on the 2018 overdose numbers suggest that this may be the year the crisis began to ease. In June, the Centers for Disease Control and Prevention released provisional data showing that overdose deaths had declined for six straight months, dropping 2.8 percent from their 2017 peak. That report also found that opioid overdose deaths had declined by 2.3 percent.

With both heroin and prescription opioid deaths declining, fentanyl has emerged as the most common drug involved in overdoses, being implicated in about a quarter of all drug overdose deaths. While the apparent decline in opioid overdose deaths this year is good news, the recent increases in cocaine and methamphetamine overdose deaths is not. And while any break in a years-long climb in overdose deaths is certainly welcome, another 70,000 or so Americans will still have died from them this year. We have a long, long way to go.

2. Safe Injection Sites Draw Nearer, But Feds Fire Warning Shots

Safe injection sites -- also known as supervised consumption sites, among other names -- where drug users can consume their doses under medical supervision and with an opportunity to engage with social services are a proven harm reduction intervention. More than a hundred cities around the world, mainly in Europe, Canada, and Australia have resorted to such facilities as a means of providing better outcomes, not only for drug users but also for the communities in which they live.

There are no legally permitted safe injection sites in the United States (although some underground ones are reportedly operating in Seattle, and there may be more in hiding), but this year saw mounting pressure and serious efforts to get them up and running in a number of American states and cities. It also saw mounting resistance from federal officials.

At the state level, California, Colorado, Missouri, and New York all saw safe injection site bills filed. Only the bill in California made it out of the legislature, but to the great frustration of reformers, it was vetoed by Gov. Jerry Brown (D), who cited long outdated beliefs about substance use in his veto message. Still, the fact that bills are being filed shows the issue is gaining momentum.

The momentum is even stronger among a handful of major cities. Denver, New York City, Philadelphia, and Seattle have all taken steps to clear the way for safe injection sites this year, although none are yet in place.

While like California's Gov. Brown, some state and local level political figures are hesitant to embrace them, a major reason none is yet in place is federal hostility. As the clamor for the facilities grows louder, so does opposition from the Trump administration. As Denver publicly pondered opening one, the local DEA and the US Attorney loudly warned they would be illegal, and the Philadelphia US Attorney did the same thing. Early in the year, the DEA in Washington issued a warning against safe injection sites, and in August, Deputy Attorney General Rod Rosenstein authored an op-ed in the New York Times issuing similar dire threats.

3. A Major Federal Sentencing Reform Bill Is Set to Pass

[image:2 align:right caption:true]The first major federal sentencing reform bill in eight years is now one vote away from passing Congress. The bill, known as the First Step Act (S.3649), is the culmination of years of work by the likes of Senate Judiciary Committee Chairman Charles Grassley (R-IA) and Sen. Dick Durbin (D-IL), and includes prison reform language as well as provisions that would reduce sentences for certain drug offenses. It very nearly died earlier this month when Senate Majority Leader Mitch McConnell (R-KY) announced he would not bring it to a Senate floor vote, but under broad pressure, including from President Trump, McConnell relented, and the bill passed the Senate Tuesday

The sentencing reforms include retroactivity for the Fair Sentencing Act (the 2010 law that reduced the crack/powder cocaine sentencing disparity), allowing the potential release of around 2,600 people; expansion of the "safety valve" allowing judges more discretion to sentence beneath mandatory minimum sentences; reform of the "three strikes" law, reducing the "second strike" mandatory minimum of 20 years to 15 years, and reducing the "third strike" mandatory minimum of life-in-prison to 25 years.

The late word is that the bill will pass the House easily, but that hasn't happened as of this writing. If and when it does, the country will have taken a significant step toward a more just and humane federal criminal justice system. The passage has also drawn major media attention as a rare example of bipartisanship in Washington today.

4. Marijuana Legalization Advances in the States

At the beginning of the year, marijuana for adult recreational use was legal in eight states, all in the West or New England and all thanks to the initiative process. As 2018 comes to a close, that number has jumped to ten, with Vermont in January becoming the first state to legalize it through the legislature and Michigan in November becoming the first Midwest state to legalize it.

The initiative process is available in only half the states, and when it comes to legalizing weed, the low-hanging fruit has already been picked. A legalization initiative in conservative Nebraska went down to defeat this year, and remaining initiative states like the Dakotas, Nebraska, Oklahoma, and Arkansas are among the most socially conservative and least likely to free the weed. But prospects are rosier in initiative states Arizona, Missouri, and Ohio. We are likely to see pot on the ballot in all three in 2020.

Vermont remains the sole state to legalize it legislatively, but a handful of states edged ever closer close this year. New Jersey Gov. Phil Murphy (D) wanted pot legalized in his first 100 days. That didn't happen, and legalization hasn't gotten through the legislature yet, but there is a small chance it could still happen this year and a very good chance it will be a done deal by early next year. Legislatures throughout the Mid-Atlantic states and Northeast grappled with the issue, laying the groundwork for next year and the year beyond, and just this week, New York Gov. Andrew Cuomo (D) called for legalization next year. The long march continues.

5. Marijuana Is Still Federally Illegal, But the Crackdown Never Came

As the year comes to end, legal weed is still here and Jeff Sessions isn't. President Trump's first attorney general was an avowed foe of marijuana (as well as drug and criminal justice reform in general), but despite rescinding the Obama-era Cole memo, which basically told federal prosecutors to leave state law-abiding pot businesses alone, the much-feared crackdown on the industry never came.

Federal prosecutors, for the most part, continue to view legal marijuana businesses as a low priority, especially when faced with much more serious drug problems, such as the opioid overdose epidemic. But Sessions was also undercut by his own boss, who in April arranged a deal with Colorado Republican Sen. Cory Gardner in which he agreed to support a bill protecting states that have broken with federal pot prohibition in return for Gardner's allowing Justice department appointments to move forward.

This year saw a plethora of federal marijuana reform bills, but with Republican leadership in both houses firmly opposed, the Capitol was where marijuana reform went to die. With Democrats in control of the House next year, things promise to be different next year, although the GOP-led Senate will remain an obstacle. But with pot consistently polling in the 60s, those Republican senators may grudgingly start coming on board.

6. Marijuana Legalization is Nice, But We Need Social Justice, Too

This year saw social justice concerns around marijuana legalization move front and center in two distinct ways: demands for the expungement of marijuana arrest records for people whose offenses are no longer crimes and demands for restorative racial justice from communities that have suffered the brunt of the war on drugs.

The year started with two major West Coast cities, San Francisco and Seattle, leading the way on expungement. The, in September, California became the first state to put state-level automatic expungement into effect. Delaware and Rhode Island, which have both decriminalized but not legalized pot, also passed expungement bills this year. Expungement is also a contentious issue in the ongoing battle to get legalization passed in New Jersey.

After a half-dozen years of legalization and well-heeled white guys making bank off legal weed, the call for racial justice, whether in terms of set-asides to guarantee minority participation in the industry or for funding streams aimed at restoring drug war-ravaged communities, is growing too loud to be ignored. This is an ongoing struggle now being played out not only in pot-legal states, but especially in states on the cusp of legalization. Moving forward, it's likely that every successful state legalization bill is going to have to address issues of social and racial justice. As they should.

7. Industrial Hemp Becomes Federally Legal

[image:3 align:left caption:true]Finally, the absolutely most ridiculous aspect of federal marijuana prohibition is dead. Recreational marijuana's country cousin, hemp can't get anyone high, but is extremely useful in a broad range of industries, from foods to textiles and beyond. Thanks to a lawsuit from hemp interests more than a decade ago, hemp could be imported for American firms to use in their products, but because the DEA refused to recognize any distinction between hemp and recreational marijuana, American farmers were forced to stand on the sidelines as their competitors in China, Canada, and other countries raked in the rewards.

But having a hemp-friendly senator from a hemp-friendly state allowed hemp legalization to move this year. Senate Majority Leader Mitch McConnell (R-KY) actually fought for the hemp bill, shepherding it into the must-pass farm appropriations bill and keeping it in there through negotiations with the House. President Trump has signed the farm bill, including the hemp provision, into law.

8. Here Come the 'Shrooms

Initiative campaigns to legalize or decriminalize the use and possession of psilocybin-containing magic mushrooms began popping up in 2018. Actually, the first state-level initiative came last year in California, but this past summer it failed to qualify for the fall ballot.

Right now, there are two psilocybin initiatives in the signature-gathering phase, a municipal initiative in Denver that would decriminalize the use, possession, and cultivation of psilocybin-containing mushrooms, and the statewide Oregon Psilocybin Service Initiative, which would decriminalize possession of psilocybin, allow magic mushrooms to be grown with a license, and would allow for therapeutic use of psilocybin. The Denver initiative would go before voters in May 2019, while the Oregon initiative aims at the 2020 election.

If psilocybin initiatives follow the pattern set by marijuana legalization initiatives, the first time may not be the charm. But more will follow.

Categories: Cocaine

What's Killing Us: The Ten Drugs Most Implicated in Overdose Deaths [FEATURE]

Cocaine (STDW) - Wed, 12/19/2018 - 23:25

While there are signs that the country's drug overdose crisis may have plateaued, the number of people dying from drug overdoses continues to be unconscionably high. Shockingly, the number of overdose deaths has increased tenfold since 1980 when there were only 6,000 nationwide and nearly doubled just in the past decade to more than 72,000 last year.

[image:1 align:right caption:true]Now, in a new report, the Centers for Disease Control and Prevention (CDC) sheds some new light on precisely which drugs are most implicated in these deaths. While the report examines overdose deaths from 2011 to 2016, we're going to zero in on the 2016 data to get as close as possible to the present.

Three drug classes are involved: prescription and non-prescription opioids, benzodiazepines, and stimulants. Often, fatal overdoses involve more than one drug, whether it is drugs in the same class (heroin and fentanyl) or combinations of drug classes (heroin and benzos or fentanyl and cocaine.

Before we get into the number-crunching, it's worth taking a moment to consider that each single overdose death is a tragedy. A human life has been lost prematurely, the potential snuffed out, and friends and family members suffer greatly. It doesn't have to be that way. While we're going to look at deadly drugs, it behooves us to remember that many of these deaths are a function not just of the drugs themselves, but of drug prohibition.

People overdose on fentanyl, for example, because in a black market there is no packaging, no quality control, no dosage information to inform them of just how powerful is that powder they're snorting or injecting. Added to heroin or crafted into counterfeit prescription opioids by unscrupulous black market operators, fentanyl kills people who didn't even know they were taking it. Even more insidiously, fentanyl is turning up in black market cocaine and methamphetamine, whose users aren't even looking for an opioid high and haven't developed any tolerance to them (although some may be speedballing, that is, taking both an upper and a downer at the same time.

That said, here are the drugs making the greatest contributions to the 63,352 overdose deaths in 2016. (The numbers add up to more than that figure because in some overdoses, more than one drug is mentioned.)

1. Fentanyl -- 18,335

In 2016, fentanyl vaulted into first place in the deadly drug sweepstakes. As recently as 2011, the synthetic opioid was in 10th place, with some 1,660 overdose deaths attributed to it, but the death toll has increased more than tenfold in just five years. More than two-thirds of fentanyl overdose deaths also involved other drugs, and fentanyl is involved in more than a quarter (28.5 percent) of all overdose deaths, including 40 percent of cocaine overdose deaths and nearly a third (32 percent) of heroin deaths.

2. Heroin -- 15,961

At the tail end of the prescription opioid phase of the current overdose crisis in 2011, more people died from oxycodone than heroin, but between 2012 and 2015, heroin resumed its role as the leading opioid linked to fatal overdoses, only to be overtaken by fentanyl in 2016. The vast majority -- 70 percent -- of people who died from heroin were also using other drugs. More than a third were also using fentanyl, while nearly a quarter (23.8 percent) were also using cocaine. As prescription opioids became more difficult to obtain, the number of people dying from heroin skyrocketed, nearly tripling in the five years ending in 2016.

3. Cocaine -- 11,316

Cocaine deaths rose dramatically beginning in 2015 and by 2016 the annual death toll was double what it had been five years earlier. With bumper crops in Colombia in recent years, cocaine is cheap and plentiful. It is also increasingly being cut with fentanyl, which is implicated in 40 percent of cocaine deaths, and mixed with heroin, which is implicated in a third of them. Cocaine is named in 17.8 percent of all overdose deaths.

4. Methamphetamine -- 6,762

Meth-related overdose deaths tripled between 2011 and 2016, a dramatic increase in what has become America's forgotten drug problem. In 2016, slightly more than one out of ten drug overdose deaths involved meth. Of the top ten overdose drugs, meth is by far the one most likely to have been the sole drug implicated in the death, but even so, fentanyl was implicated in one out five meth deaths and heroin in one out of ten.

5. Alprazolam -- 6,209You know it as Xanax. This short-acting benzodiazepine is a favorite of stimulant users seeking to take the edge off, but also often forms part of a sedative cocktail with opioids or other benzos. About three-quarters of Xanax overdose deaths involve other drugs, with fentanyl, heroin, and oxycodone each involved in about one-quarter of Xanax deaths. Xanax deaths increased by about 50 percent over the five year period.

6. Oxycodone -- 6,199

It's most infamous formulation is OxyContin, but it is also sold as Roxicodone, Xtampza ER, and Oxaydo. It may have been the primary killer opioid a decade ago, but has chugged along at around 5,000 deaths a year before going over 6,000 in 2016. Four out of five people who overdose on oxycodone were also using another drug, most often Xanax (25.3 percent), followed by fentanyl (18.6 percent).

7. Morphine -- 5,014

The granddaddy of opioids. Morphine deaths increased slowly beginning in 2011, but have still increased by about 40 percent since then. More than eight out of 10 morphine deaths involve other drugs as well, particularly fentanyl, which is involved in one out three morphine deaths. Cocaine (16.9 percent) and heroin (13.7 percent) are also frequent contributors to morphine ODs.

8. Methadone -- 3,493

Prescribed as an opioid maintenance drug, methadone is one of the few drugs on this list to have seen the number of deaths decline between 2011 and 2016. They've dropped from more than 4,500 a year down to less than 3,500, a drop of roughly a quarter. Nearly three-fourths of all methadone deaths implicate other drugs, with Xanax being most common (21.5 percent), followed by fentanyl (15.1) and heroin (13.8).

9. Hydrocodone -- 3,199

This semi-synthetic opioid is sold under a variety of brand names, including Vicodin and Norco, and has proven remarkably stable in its overdose numbers. Between 2011 and 2016, it never killed fewer than 3,000 or more than 4,000, almost always (85 percent of the time) in concert with other drugs. Xanax was implicated in one-quarter of all hydrocodone overdoses, followed by oxycodone (17.2 percent) and fentanyl (14.9 percent).

10. Diazepam -- 2,022

The most well-known diazepam is Valium. Like Xanax, this anti-anxiety drug can be used to take the edge off a stimulant binge, but it's not coke heads and speed freaks who are dying from it. In more than nine out of 10 fatal Valium overdoses, other drugs are involved, most commonly the opioids oxycodone and fentanyl, each implicated in about a quarter of the deaths, and heroin, implicated in a fifth.

Using these drugs is dangerous. Using them under a prohibition regime is even more so. Users don't always know what they're getting, and that lack of knowledge can be fatal. If you're going to be messing with these substances, be extremely cautious. Try a test dose first. And don't do it alone. Stay safe out there.

This article was produced by Drug Reporter, a project of the Independent Media Institute.

Categories: Cocaine
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