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The 2014 National Drug Control Strategy: Baby Steps in the Right Direction [FEATURE]

Thu, 07/10/2014 - 13:57

The White House Office of National Drug Control Policy (ONDCP -- the drug czar's office) released its 2014 National Drug Control Strategy Wednesday. While in general, it is remarkable for its similarities to drug control strategies going back more than a decade, it does include some signals suggesting that the Obama administration is ready for a shift in emphasis in the drug war -- from a criminal justice approach to a more public health-oriented approach.

[image:1 align:left]But even that rhetorical positioning is somewhat undercut by the strategy's continuing commitment to the criminalization of drug users and the people who supply them, as well as particular policy prescriptions, such as its support for expansion of drug courts -- the use of the criminal justice system to enforce therapeutic health goals like abstinence from drug use, as opposed to measures that don't involve criminal justice intervention.

The 2014 strategy also continues the roughly 3:2 funding ratio between law enforcement and treatment and prevention spending that has marked federal anti-drug spending since at least the Clinton administration in the 1990s. And it does so somewhat deceptively.

"In support of this Strategy," ONDCP wrote in a press release, "the President has requested $25.5 billion in Fiscal Year 2015. Federal funding for public health programs that address substance use has increased every year, and the portion of the Nation's drug budget spent on drug treatment and prevention efforts -- 43% -- has grown to its highest level in over 12 years. The $10.9 billion request for treatment and prevention is now nearly 20% higher than the $9.2 billion requested for Federally-funded domestic drug law enforcement and incarceration."

What the press release doesn't mention when claiming that treatment and prevention spending now exceeds spending on law enforcement is that it did not include figures for drug interdiction and international spending on the law enforcement side of the ledger. The White House's proposed federal drug budget for 2015, however, shows that those drug prohibition-enforcement costs add up to another $5.4 billion, or $14.6 billion for enforcing drug prohibition versus $10.9 billion for treatment and prevention.

The strategy does, however, provide a sharper focus than in the past on reducing the harms associated with drug use, such as overdoses and the spread of HIV/AIDS, hepatitis C, and other blood-borne diseases. It calls for greater access to the opiate overdose reversal drug naloxone and supports needle exchange and state laws that provide limited immunity from prosecution for people suffering overdoses and the people who seek help for them -- the so-called 911 Good Samaritan laws. The strategy also sets a five-year goal for reducing overdose deaths, something drug reform advocates had been seeking.

The strategy also acknowledges the need to reduce mandatory minimum drug sentencing and recognizes that the US has the world's largest prison population, but in absolute terms and per capita. And, implicitly acknowledging that Americans increasingly see the war on drugs as a failed policy, the 2014 strategy has adjusted its rhetoric to emphasize public health over the drug war.

[image:2 align:right caption:true]But, despite polls now consistently showing majority support for marijuana legalization, and despite the reality of legal marijuana in two states, with two more and the District of Columbia likely to embrace it later this year, the 2014 strategy appears not only wedded to marijuana prohibition, but even disturbed that Americans now think pot is safer than booze.

That puts ONDCP at odds not only with the American public, but with the president. In an interview published in January by the New Yorker, Obama said marijuana is less dangerous than alcohol "in terms of its impact on the individual consumer."

Noting that about three-quarters of a million people are arrested on marijuana charges each year, and nearly nine out of ten of those for simple possession, the Marijuana Policy Project (MPP) pronounced itself unimpressed with the new national drug strategy.

The drug czar's office is still tone deaf when it comes to marijuana policy. It appears to be addicted to marijuana prohibition. Why stay the course when the current policy has utterly failed to accomplish its goals?" asked MPP communications director Mason Tvert.

"The strategy even goes so far as to lament the public's growing recognition that marijuana is not as harmful as we were once led to believe. President Obama finally acknowledged the fact that marijuana is less harmful than alcohol, yet his administration is going to maintain a policy of punishing adults who make the safer choice," Tvert continued. "Most Americans think marijuana should be made legal, and even the Justice Department has acknowledged that regulating marijuana could be a better approach than prohibition. Legalizing and regulating marijuana is not a panacea, but it is sound policy."

The Drug Policy Alliance (DPA), with a wider policy remit than MPP, had a nuanced response to the release of the drug strategy. It was critical of some aspects of the strategy, but had kind words for others.

"The administration says drug use is a health issue but then advocates for policies that put people in the criminal justice system," said Bill Piper, DPA national affairs director. "Until the drug czar says it is time to stop arresting people for drug use, he is not treating drug use as a health issue no matter what he says. I know of no other health issue in which people are thrown in jail if they don't get better."

Still, said Piper, the drug czar's office deserves some credit for addressing serious issues associated with drug use under prohibition.

"Director Botticelli should be applauded for taking strong steps to reduce drug overdose fatalities and the spread of HIV/AIDS, hepatitis C and other infectious diseases," he said. "His leadership on these issues, and his work overall to reduce the stigma associated with substance misuse, are encouraging."

But when it comes to marijuana policy, DPA found itself pretty much on the same page as MPP.

"The Administration continues to keep its head in the sand when it comes to marijuana law reform," said Piper. "Hundreds of thousands of Americans are being arrested each year for nothing more than possessing small amounts of marijuana for personal use. Once arrested they can be discriminated against in employment and housing for life. The administration can't ignore the destructive impact of mass arrests forever."

Categories: Treatment

Chronicle AM -- June 24, 2014

Tue, 06/24/2014 - 16:26

Your fearless reporter has been traveling, so the schedule is off, but the drug policy news continues. Paul Stanford calls it quits in Oregon, pot shops are coming within days in Washington, an Alabama drug task needs to reconsider its priorities (or maybe the people funding it need to reconsider theirs), and more. Let's get to it:

[image:1 align:right caption:true]Marijuana Policy

Paul Stanford Pulls Plug on Oregon CRRH Initiative. Paul Stanford, the man behind the Campaign for the Restoration and Regulation of Hemp legalization initiatives, announced Friday that had given up the effort to qualify for the November ballot. That leaves the New Approach Oregon initiative, which is well over 100,000 signatures. It needs some 87,000 valid voter signatures to qualify, and the campaign still has another week to get more signers.

Washington State Liquor Control Board Says First Marijuana Retail Stores Will Open July 8. The board, which is charge of legal marijuana commerce, said it will issue the first licenses July 7, but that the licensees would have to spend that first day getting their product into their store tracking programs.

Medical Marijuana

Rhode Island Legislature Amends Medical Marijuana Law. The legislature has amended the state's medical marijuana law to require national criminal background checks on all caregiver applicants and the mandatory revocation of the caregiver registry ID cards for those convicted of a felony. The bill, House Bill 7610, won final approval by the Senate last Friday. It also allows landlords not to lease to cardholders who want to grow and imposes weight, plant, and seedling limits on growing co-ops.

Collateral Consequences

Missouri Governor Signs Bill to End Food Stamp Ban for Drug Felons -- With Conditions. Gov. Jay Nixon signed into a law a bill that would allow people with drug felonies to obtain food stamps, but only if they submit to drug tests and an assessment to see if they need drug treatment, which they must enroll in and complete if they are determined to need it. The bill is Senate Bill 680. The 1996 federal welfare reform law banned drug felons from obtaining food stamps, but allowed states to opt out. By now, more than 30 have.

Opiates

Federal Bill Targeting Heroin, Prescription Opiates Filed. US Sens. Kelly Ayotte (R-NH) and Joe Donnelly (D-IN) have filed legislation that seeks to respond to rising levels of opiate use by creating a "Pain Management Best Practices Inter-Agency Task Force" to develop prescribing practices that aim to ensure "proper pain management for patients, while also preventing prescription opioid abuse." Along with federal agencies such as HHS, Defense, the VA, and the DEA, the task force would include treatment providers, people from pain advocacy groups and pain professional organization, and experts in pain research and addiction research. Pain advocates will be watching carefully. The bill, Senate Bill 2504, would also provide grants to expand prescription drug monitoring programs.

Law Enforcement

Texas to Spend $1.3 Million a Week on "Border Surge" Aimed at Immigrants, Drugs. Using the influx of underage immigrants across the US-Mexican border as a jumping off point, Texas authorities announced last week they plan to spend $30 million this year tightening border security, with a major emphasis on law enforcement and cutting drug flows. Gov. Rick Perry (R) has also asked President Obama to send a thousand National Guard troops, to be joined by hundreds of Texas troopers Perry is deploying to the border. What this will mean on the ground is more troopers patrolling the highways, more surveillance, more undercover operations -- in an area already sinking under the weight of the billions spent beefing up border security since 9/11.

Alabama Drug Task Force Gets Busy With Chump Change Drug Round-Up. The West Alabama Narcotics Task Force based in Tuscaloosa arrested 24 people last Friday in a round-up that "stemmed from multiple ongoing investigations." But they were almost entirely charges like "unlawful sale of marijuana within three miles of a school" ($30,000 bond), "unlawful possession of drug paraphernalia" ($5,000 bond), and "unlawful possession of marijuana" ($15,000 bond). Only five of the charges didn't involve marijuana, and of those, three were for possession of a controlled substance, two were "unlawful sale of cocaine within three miles of a school," and one was for "interfering with government operations."

International

Vietnam Upholds Death Sentences for 29 Drug Smugglers. A Vietnamese appellate court last Thursday upheld the death sentences for 29 people convicted. The court reduced one other death sentence in the case to life in prison. The sentences came in what is Vietnam's largest heroin case ever, with 89 defendants and 1.5 tons of heroin involved.

Bolivia Coca Cultivation Drops to 11-Year Low. Coca cultivation declined 9% in Bolivia last, reaching the lowest level since 2002, according to the annual Bolivian coca survey conducted by the UN Office on Drugs and Crime (UNODC). This is the third straight decline, in line with the Bolivian government's commitment to reduce production to 50,000 acres by 2015. The 2013 crop was about 55,000 acres.

British Medical Association to Debate Legalizing Marijuana. Britain's largest doctors' organization will debate a motion calling on it to legalize marijuana as its Annual Representatives Meeting continues this week after a weekend hiatus. "The current law isn't working and only by adopting a different approach can we regulate, educate and exert a level of quality control," the motion says. "Cannabis use should be treated primarily as a health issue, not a criminal justice issue."

Categories: Treatment

Chronicle AM -- June 19, 2014

Thu, 06/19/2014 - 21:35

We can watch the marijuana policy landscape shift before our eyes, with legalization initiatives and decrim measures popping up around the country and even Oklahoma Republicans arguing over legalization. There is also action on the opiate front, the Senate will vote on defunding the DEA's war on medical marijuana in states where it is legal, and more. Let's get to it:

[image:1 align:right caption:true]Marijuana Policy

House Fails to Add Rider to Block DC Decriminalization Law. The House Financial Services and General Government Appropriations Subcommittee approved a familiar series of social policy riders on the District of Columbia budget, but did not include one that would seek to undo the city's recent adoption of marijuana decriminalization. It's not a done deal yet, however; such a rider could still be added during the legislative process. The subcommittee did approve riders barring the District from funding needle exchanges or medical marijuana programs.

Delaware Decriminalization Bill Heads for House Floor Vote. A bill that would decriminalize the possession of up to an ounce of marijuana and levy a maximum $250 fine passed the House Public Safety Committee today. House Bill 371 now heads for a House floor vote.

Marijuana Policy in the Oklahoma GOP Governor's Race. In next week's GOP primary, sitting Gov. Mary Fallin is up against two longshot opponents who both favor marijuana legalization. Both Chad Moody, also known as "The Drug Lawyer," and Dax Ewbank, a libertarian-leaning Republican, have come out in favor of freeing the weed. But Fallin says that's not on her to-do list: "I just don't see that it provides a substantial benefit to the people of Oklahoma," Fallin said.

Milwaukee Legalization Initiative Signature-Gathering Drive Underway. A coalition of Milwaukee groups have begun a petition drive to place a municipal legalization ordinance on the November ballot. The measure would legalize the possession of up to an ounce. The groups have until July 29 to come up with 30,000 valid voter signatures. People interested in helping out can get more information here.

Philadelphia City Council Votes to Decriminalize Marijuana. The city council today approved a decriminalization measure introduce last month by Councilman Jim Kenney. Up to 30 grams is decriminalized, with a maximum $25 fine. Four years ago this month, the city began treatment small-time possession as a summary offense, with a maximum $200 fine and three-hour class on drug abuse.

Activists Gather Twice the Signatures Needed for York, Maine, Legalization Initiative. Activists supported by the Marijuana Policy Project needed 100 valid voter signatures to present a marijuana legalization petition to the York Board of Selectmen. They handed in 200. Similar petition drives are going on in Lewiston and South Portland, and Portland voters approved a legalization referendum last year. The local efforts are laying the groundwork for a statewide legalization initiative in 2016.

Medical Marijuana

Sens. Rand Paul, Cory Booker Cosponsor DEA Defunding Amendment in Senate; Vote Could Come as Soon as Tonight. Sens. Rand Paul (R-KY) and Cory Booker (D-NJ) have cosponsored an amendment to the Justice Department funding bill that would shield medical marijuana patients and providers from the attention of the DEA in states where it is legal. The vote could come as soon as tonight or tomorrow. The House passed such an amendment at the end of last month.

New York Governor, Legislature in Tentative Deal as Session Draws to End. With the legislative ticking down its final hours, Gov. Andrew Cuomo (D) and legislative leaders today announced a deal that would allow passage of a medical marijuana pilot program, but would not allow patients to smoke their medicine.

North Carolina Limited CBD Medical Marijuana Bill Wins House Committee Votes. A bill that would allow some patients to use a high-CBD cannabis oil was approved by the House Health Committee Wednesday and the House Finance Committee today.

Drug Policy

Drug Policy in the Colorado GOP Senatorial Race. Former Colorado Congressman Tom Tancredo, who is running for the state's GOP senatorial nomination, is being attacked as a drug legalizer in a radio ad created by a committee supporting former Sen. Mike Copp. While Tancredo supports marijuana legalization and has in the past spoken of the need to consider drug legalization, he says he is not ready to legalize hard drugs and is demanding that the ads be pulled.

Opiates

Vermont Governor Signs Package of Bills Aimed at Opiate Use. Gov. Peter Shumlin (D) Tuesday signed into law a package of bills and executive orders that will ramp up treatment for opiate addiction, but also increase penalties for bringing more than one gram of heroin into the state. The centerpiece of the legislative package is Senate Bill 295, which will fund pretrial screening and drug treatment for suspects before they are arraigned.

New York Assembly Set to Approve Package of Heroin Bills. Gov. Andrew Cuomo (D) and key lawmakers announced Tuesday night that they had a deal on a package of heroin bills that would raise awareness of the issue and increase insurance coverage of heroin treatment. What isn't clear is whether they agreement also includes a series of Rockefeller drug law-style measure passed by the Republican-dominated Senate that would increase criminal penalties for some heroin offenses.

Harm Reduction

DC Police Chief Orders No Arrests for Overdose Victims. In a recent memorandum, Metropolitan Police Department Chief Cathy Lanier has instructed her police force to observe protections from arrest and charge granted under a DC law designed to encourage residents to seek immediate medical assistance for a person experiencing an overdose. The Good Samaritan Overdose Prevention Amendment Act of 2012 (#A19-564), which was passed by the D.C. Council in 2012 and took effect on March 19, 2013, provides limited legal protection from arrest, charge and prosecution for those who witness or experience a drug overdose and summon medical assistance.

Sentencing

Federal Fair Sentencing Act Picks Up Another Sponsor. And then there were 39. Rep. William Envart (D-IL) has signed on as a cosponsor to the Federal Fair Sentencing Act. That makes 25 Democrats, along with 14 Republicans. It would reduce the use of mandatory minimum sentences and impose retroactivity for crack cocaine sentences handed down before 2010.

International

Britain's Looming Khat Ban Could Create Black Market. A ban on khat is about to go into effect in England, and this report suggests that it could create political tensions in East Africa, as well as creating a black market for the substance in England itself.

Albanian Siege of Marijuana-Producing Village Continues. A police assault on the village of Lazarat that began Monday is still underway as clashes continued between police and armed villagers. Some 800 police are involved in the operation, and they say they have seized or destroyed more than 10 tons of marijuana so far. But that's only a fraction of the 900 tons the village is estimated to produce annually. The town's $6 billion pot crop is equivalent to about half Albania's GDP.

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

Categories: Treatment

What To Do About the Drug Trade in West Africa? [FEATURE]

Thu, 06/19/2014 - 01:18

Over the past decade, West Africa has emerged as an increasingly important player in the global illicit drug trade. Although the region has historically not been a drug producing one -- with the important exception of marijuana -- it has become a platform for predominantly Latin American drug traffickers moving their illicit commodities toward lucrative European and Middle Eastern markets. The cocaine traffic alone is worth more than a billion dollars a year, according to a 2013 report from the UN Office on Drugs and Crime (UNODC).

[image:1 align:left caption:true]And the trade is becoming more complex. Now, it's not only cocaine flowing through the region, but heroin destined mainly for Western Europe and methamphetamines being manufactured there and exported to Asia and South Africa, that same UNODC report found.

The region -- stretching along the African coast from Nigeria to the east to Senegal on the west, and extending deep into the Sahara Desert in countries such as Mali and Niger -- is plagued by weak states and corrupt governments, making it attractive to criminals of all sorts, who thrive in lawless lands. And it's not just criminals. The region is also home to various bands of Islamist militants, some of whom are involved in the drug trade.

Now, a commission of prominent West Africans is calling for fundamental changes in drug policies in the region. Last week, the West Africa Commission on Drugs, issued a report, Not Just in Transit: Drugs, the State and Society in West Africa, calling for the decriminalization of drug use, treating drug use primarily as a public health issue, and for the region to avoid becoming the next front line in the failed war on drugs.

The commission is impressive. It was initiated by former UN Secretary-General Kofi Annan of Nigeria and headed by former Nigerian President Olusegun Obasanjo, and includes other former heads of state as well as a distinguished group of West Africans from the worlds of politics, civil society, health, security and the judiciary.

And so is its very existence. It marks the entrance of West African civil society into the international debate on drug policy in which calls for fundamental drug reform have gained increasing momentum in recent years. In 2008, former Latin American heads of state and other luminaries formed the Latin American Commission on Drugs and Democracy, and in 2011, Annan and other world luminaries and former heads of state came together to form the Global Commission on Drug Policy. Now, West Africa adds its voice to the chorus calling for change.

"We call on West African governments to reform drug laws and policies and decriminalize low-level and non-violent drug offenses," said Obasanjo upon the report's release last week. "West Africa is no longer just a transit zone for drugs arriving from South America and ending up in Europe but has become a significant zone of consumption and production. The glaring absence of treatment facilities for drug users fuels the spread of disease and exposes an entire generation, users and non-users alike, to growing public health risks."

"Most governments' reaction to simply criminalize drug use without thinking about prevention or access to treatment has not just led to overcrowded jails, but also worsened health and social problems," added Kofi Annan.

[image:2 align:right caption:true]"We need the active support and involvement of civil society and of the international community," said commission member Edem Kodjo. "South America, where most of the drugs smuggled to West Africa come from, and Europe, which is the main consumer market, must take the lead to deal with both production and consumption at home. We cannot solve this problem alone; governments and civil society have to come together in West Africa to help prevent the drug problem from getting completely out of hand."

The report won kudos from American drug reformer Ethan Nadelmann, head of the Drug Policy Alliance.

"First Europe, then the Americas, now Africa," he said. "Drug policy reform is truly becoming a global movement, with Kofi Annan and Olusegun Obasango providing the sort of bold leadership that we've also seen in Latin America. Maybe, just maybe, West Africa will be spared the fate of other parts of the world where prohibition-related crime, violence and corruption spiraled out of control."

But some analysts, while welcoming the report, suggested that it did not get at the heart of the problem in West Africa.

"The report focuses on public health, and that's great, but I'm not sure that's the issue," said Vanda Felbab-Brown, a senior fellow with the Center for 21st Century Security and Intelligence in the Foreign Policy program at the Brookings Institution who has published extensively on West Africa. "Nor are there generally large prison populations due to the arrests of low-level drug offenders. There is increasing drug use, and many addicts don't have access to public health. That, however is not because they were arrested, but because Africa in general doesn't have access to public health," she pointed out.

"In some senses, the commission report is preventative -- it warns of policies that would be counterproductive -- but it is not going to solve West Africa's problems," Felbab-Brown continued. "And the harm reduction approaches that dominate the discourse in Europe and the US are not really apropos for West African public health issues. The increasing focus of the international community is interdiction, but that accounts for only a small fraction of the total traffic, and the report doesn't deal with what kind of alternate law enforcement there should be, or who should be targeted."

But others thought the criminal justice and public health emphasis in the report were a step down the right path.

"The report's message about alternatives to criminalization for use and minor offenses is important in criminal justice terms -- to discourage the horrible over-representation of minor drug offenders in prisons in the region -- but also as a reminder that there are no such alternatives unless the health and social sectors develop those alternatives," said Joan Csete, deputy director of the Open Society Foundation's Global Drug Policy Program.

"Health ministries need to be as important around the drug policymaking table as the police, which is far from the case in most of Africa today," she added. "Services for treatment of drug dependence in the region are absent or of appalling quality. Improving health and social support for people with drug dependence is a key to drug policy reform in West Africa."

And Felbab-Brown agreed that while measures like drug prevention and treatment wouldn't solve the region's problems, they would still be helpful.

"We're already seeing quite a bit of heroin in the region, and we are seeing increasing use," she said. "These are cheap and prevalent commodities, the traffickers partake in kind, and user communities are being established. In a sense, developing strategies to prevent use, get treatment, and prevent the spread of HIV and Hepatitis C is useful because there are more and more users."

[image:3 align:left caption:true]But for Felbab-Brown, the key problem for West Africa is its weak and corrupt states.

"The big trafficking issues are around the intersection of very poor, very weak, very corrupt, and often very fragile states with state participation in various forms of criminality," she said. "Drugs are just another commodity to be exploited by elites for personal enrichment. Elites are already stealing money from oil, timber, and diamonds, and now there is another resource to exploit for personal enrichment and advancement," she argued.

"One narrative has it that drug trafficking has caused fragility and instability, but I think trafficking compounded the problems; it didn't create them," Felbab-Brown continued. "There is a systematic deficiency of good governance. Many of these states have functioned for decades like mafia bazaars, and the trafficking just augments other rents. There are rotten governments, miserable institutions, and poor leadership around all commodities, not just drugs."

"The states are not monolithic," Csete noted. "Some have high-level corruption, some are aggressive in trying to fight money-laundering and other elements of organized criminal networks, some rely heavily on traditional interdiction methods. Some of these countries have relatively strong democratic systems and relatively strong economic growth; some have governance institutions that are less strong."

The state of the states in West Africa influenced the commission and its recommendations, Csete said.

"Legalization of drugs -- production, sale, consumption -- was not judged to be politically feasible or necessarily desirable by the commission," she explained. "I think the commissioners generally perceive that generally these countries do not yet have a political climate favorable to debate on progressive changes in drug policy. The whole idea of the commission and its report is to open those debates -- high-profile people from the region saying things that sitting officials do not find it politically easy to say."

"These are newer post-colonial states," Felbab-Brown noted. "Are we having unreasonable expectations? Is this like Europe in the 13th Century, or is that some of these countries are doomed to exist in perpetual misgovernance?"

While there may be concern in Western capitals about the specter of West African drug trafficking, many West Africans have other, more pressing, drug policy concerns.

In its 2013 report, the UNODC noted that the importation of fake pharmaceutical drugs from South and Southeast Asia into the region was a problem. Joey Tranchina, a longtime drug policy observer who has recently spent time in Mali, agrees.

"Having traversed Mali from Bamako to Mopti, except for the usual oblique indigenous references to smoking weed, the only personal experience I have with drug crime is counterfeit pharmaceuticals from India, China, and Russia," he said. "They're sold cheap in the streets to people who can't afford regular meds and they take the place of real pharmaceuticals, especially malaria and HIV drugs. These drug scams are killing people in Mali," he said.

"Most people in West Africa don't see drug trafficking as that much of a problem," said Felbab-Brown. "If it's mostly going to Westerners, they say so what? For them it is a mechanism to make money, and those drug traffickers frequently become politicians. They are able to create and reconstitute patronage networks around drug trafficking, just as they were once able to get elected with money from blood diamonds."

It seems that, to the degree that drug use and drug trafficking are West African problems, they are problems inextricably interwoven with the broader issues of weak, fragile, and corrupt states that are unable or unwilling to deliver the goods for their citizens. The West Africa Commission on Drugs has pointed a way toward some solutions and avoiding some failed policies already discredited elsewhere, but it seems clear that that is just the beginning.

Categories: Treatment

Chronicle AM -- June 18, 2014

Wed, 06/18/2014 - 19:59

A pair of potential presidential contenders speak out on marijuana, five New England governors meet on the opiate issue, New York cops are starting to be trained to use the overdose reversal drug naloxone, New York's governor makes passage of medical marijuana there iffy, the Dutch high court rules cities can ban foreigners from cannabis coffee shops, and more. Let's get to it:

[image:1 align:left caption:true]Marijuana Policy

Hillary Clinton Evolves on Marijuana Policy. In an interview with CNN international correspondent Christiane Amanpour Tuesday, former First Lady and Secretary of State Hillary Clinton said she favors medical marijuana for people who are in "extreme medical conditions" and is willing to "wait and see" how recreational pot works in Colorado and Washington state. "On recreational, states are the laboratories of democracy," Clinton said. "We have at least two states that are experimenting with that right now. I want to wait and see what the evidence is." That's a step forward for Clinton, who in 2008 opposed marijuana decriminalization and who in 2012 said she doubted drug legalization would end black market violence in Central America.

Chris Christie Doesn't. New Jersey Gov. Chris Christie (R) said Monday night that medical marijuana is "a front for legalization" and suggested that -- unlike every other industry in the United States -- medical marijuana providers should not be concerned with making money. His remarks came in response to criticism of his management of the state's highly-regulated medical marijuana program. Christie has said repeatedly that he opposes legalization, and that it won't happen "on my watch."

No Legalization Initiative for Arizona This Year. A Safer Arizona campaign to get its legalization initiative on the November ballot is over after the campaign came up well short in its signature-gathering efforts. The group needed 250,000 signatures to qualify, but said it only had about a third of that number. They are vowing to be back in 2016.

Delaware Decriminalization Bill to Get Hearing Tomorrow. The House Public Safety and Homeland Security Committee will hold a hearing on a decriminalization bill tomorrow. House Bill 371, sponsored by Rep. Helene Keeley (D-Wilmington), would make possession of less than an ounce a civil infraction punishable by a fine. Under current law, possession of any amount is a misdemeanor punishable by up to six months in jail.

Medical Marijuana

New York Governor Rejects Medical Marijuana Bill, Demands No Smoking. Gov. Andrew Cuomo (D) has rejected the Compassionate Use Act just two days before the state's legislative session ends. Legislators are working to revise the bill in a manner acceptable to Cuomo, and he has signaled he was willing to waive legislative rules to allow a late bill to be introduced.

Opiates

New England Governors Meet to Address Opiates. The five governors of the New England states (except for Maine, whose Republican governor, Paul LePage didn't attend) met yesterday to address rising drug overdoses and agreed to cooperate on the cross-state monitoring of prescription drug monitoring and to expand drug treatment. They said they would try to make prescription monitoring mandatory and would try to curb "doctor shopping." The governors had nothing to say about ensuring that patients with legitimate needs for pain medications are able to get access to them.

Harm Reduction

New York Cops Get Training in Using Overdose Reversal Drug. By the end of this week, more than 600 New York state police officers and sheriff's deputies will have received the necessary training to carry and administer naloxone (Narcan), the opiate overdose reversal drug. The state has pledged to make the life-saving drug available to police officers across the state, and the program is just being rolled out now.

International

Myanmar's 15-Year Opium Eradication Effort a Failure, Government Minister Says. A Myanmar Home Affairs minister told parliament Monday that the country's 15-year effort to wipe out opium poppies had failed, and that the government would extend it for another five years. Brigadier General Kyaw Kyaw Tun said poppy crops had declined until 2006, but had been on the rise since then. It has been increasing at a rate of more than 10% a year in the past several years, he said. Myanmar is the world's second largest opium producer, although it trails far behind world leader Afghanistan in output.

Canada Prescription Opiate Overdoses on the Increase, New Report Says. Overdose deaths from prescription opiates have "risen sharply" and now account for about half of all drug-related deaths in the country, the Canadian Drug Policy Coalition said in a report released Monday. The report, Getting to Tomorrow: A Report on Canadian Drug Policy, calls for harm reduction measures and a public health approach to reduce overdose deaths.

Dutch High Court Decides Local Councils Can Ban Foreigners From Cannabis Coffee Shops. The Dutch Council of State, the country's highest court, has ruled that municipalities have the ability to bar people who are non-residents from the country's famous cannabis cafes. The aims of preventing drug tourism and combating organized crime are sufficient to allow discrimination based on nationality, the court ruled. The ruling comes in the case of coffee shop owners in the border towns of Maastrict and Limburg, where councilors had closed coffee shops for selling to tourists. Most other municipalities have not moved to ban foreigners. Read the advisory opinion here.

Categories: Treatment

Chronicle AM -- June 11, 2014

Wed, 06/11/2014 - 21:34

There's money in marijuana, as Colorado keeps finding out, MPP is eyeing Massachusetts in 2016, opponents of Florida's medical marijuana initiative got a big bucks contribution from a major Republican funder, Customs and Border Patrol fires its internal affairs head, the US Embassy in Kabul can't explain what impact $7 billion in anti-drug aid there has had, and more. Let's get to it:

[image:1 align:right caption:true]Marijuana Policy

Colorado Marijuana Revenues Keep Climbing. Recreational marijuana sales hit $22 million in April, with the state taking in more than $3.5 million in sales and excise taxes. With medical marijuana sales factored in, people bought more than $53 million worth of weed in Colorado in April.

MPP Opens Ballot Committee in Massachusetts, Eyes 2016. The Marijuana Policy Project (MPP) opened a ballot referendum committee in Massachusetts Tuesday, a preliminary step for a marijuana legalization campaign in 2016. The formation of the committee, the Campaign to Regulate Marijuana Like Alcohol in Massachusetts, allows MPP to begin raising and spending money in the state.

Medical Marijuana

Florida Polls Have Strong Support for Medical Marijuana Among Likely Voters. With medical marijuana on the ballot in November, a new poll shows 70% of likely voters support the constitutional amendment. Because it is a constitutional amendment, it needs 60% to pass. Another poll released this week has support at 66%. "Florida's medical marijuana amendment that will be on the ballot this fall continues to appear headed for easy passage," Public Policy Polling, which did the second poll, wrote in an analysis.

Conservative Billionaire Sheldon Adelson Kicks In $2.5 Million to Defeat Florida Medical Marijuana Initiative. Billionaire casino magnate and major Republican political donor Sheldon Adelson has donated $2.5 million to the campaign to defeat the Florida medical marijuana initiative. A newly-formed group backed by Adelson, the Drug Free Florida Committee, was started by longtime GOP fundraiser Mel Sembler and his wife Betty. It has raised $2.7 million so far and its top donors have been primarily Republicans.

Pennsylvania Medical Marijuana Bill Still Alive. Following a Tuesday hearing on Senate Bill 1182 Tuesday, committee members said they had been assured the bill would get a vote in the Senate Law and Justice Committee, but it will be then up to Senate leaders to decide if they will allow a floor vote. If it gets and wins a floor vote, the House would still have to pass it, or pass its own version.

Methamphetamine

Michigan Bill to Restrict Meth Precursor Purchases Passes House. A bill that would require people with prior methamphetamine convictions to obtain a prescription to buy cold medicines containing pseudoephedrine has passed the House. The bill also creates a statewide database for pseudoephedrine purchases and would require buyers to show the drivers' licenses.

Opiates

New York Governor Announces Doubling of State Police Drug Team to Fight Heroin, Prescription Pill Use. Gov. Andrew Cuomo (D) announced this morning that he will add 100 investigators to the State Police Community Narcotics Enforcement Team, nearly doubling the unit's size. He also announced that the state would make the overdose reversal drug naloxone to all first responders. And he announced an education and prevention campaign involving SUNY campuses.

New England Governors to Meet Next Week on Confronting Rising Opiate Use. The six New England governors are set to meet next week at Brandeis University in Waltham, Massachusetts, to forge a regional strategy in response to growing alarm over increased use of prescription opiates and heroin. Massachusetts has declared a public health emergency over opiates, and other states in the region are experiencing similar issues. [Ed: Whether any of the New England governors, or New York's governor and narcotics police, will bear in mind the needs of chronic pain patients, remains to be seen.]

Law Enforcement

Myles Ambrose, Nixon's First Drug Czar, Dies. Myles Ambrose has died at age 87. He was President Richard Nixon's first "drug czar," serving as head of the White House Office of Drug Abuse Law Enforcement (ODALE), the precursor to the DEA, which was formed in 1973. He had come to Nixon's attention when, as head of Customs, he initiated Operation Intercept, which shut down the US-Mexico border in 1969. Ambrose appeared set to take over DEA, but was pushed aside, in part due to bureaucratic infighting and in part because of hints of scandal related to his visits to the home of a Texas banker investigated in a drug trafficking conspiracy.

Customs and Border Protection Fires Its Own Head of Internal Affairs. The US Customs and Border Patrol (CBP) has let go James Tomsheck, head of internal affairs for the agency, after claims he failed to investigate hundreds of allegations of abuse. More than 800 complaints of abuse by agents had been made during his tenure since 2006, but only 13 resulted in disciplinary actions. Tomsheck's firing by CBP head Gil Kerlikowske is part of an attempt by Kerlikowske to address widespread allegations of abuse by American border agencies. Last week, Kerlikowske set out new rules for the use of deadly force, only to be followed hours later by a Border Patrol agent shooting and killing a fleeing drug trafficker. At least 22 people have been killed by Border Patrol agents since January 2010 and many more injured.

Sentencing

New Jersey Bail Reform Bill Gets Committee Vote Today. The Assembly Judiciary is set to consider Assembly Bill 1910, which would implement widely supported reforms to the state's bail system. Under the proposed legislation, arrestees would be assessed for risk and pretrial release decisions would be based on their measured risk, not their ability to pay money bail. Companion legislation in the state Senate, Senate Bill 946, was approved by the Budget and Appropriations Committee last week.

International

Rising Afghan Opium Production Threatens Reconstruction, US Official Says. Afghanistan's record-level opium production is stoking corruption, spilling into the financial sector, and aiding the Taliban and criminal networks, all of which threaten national reconstruction, John Sopko, the special inspector general for Afghan reconstruction, told a House subcommittee Tuesday. The US has spent $7 billion on anti-opium efforts since it invaded Afghanistan in late 2001, but "On my trips to Afghanistan in 2013 and earlier this year, no one at the Embassy could convincingly explain to me how the US government counter-narcotics efforts are making a meaningful impact on the narcotics trade or how they will have a significant impact after" the US-led combat mission ends in December," Sopko said.

Finland Greens Call for Marijuana Legalization, Drug Policy Shift From Punishment to Harm Reduction. The Finnish Green League has adopted a new manifesto on drugs that says "the focus of drug policy should be shifted from punishments to reducing adverse effects" and that "the criminal sanctions for the use of cannabis as well as the possession and cultivation of cannabis for personal use should be abolished." The Greens hold 10 seats in Finland's 198-seat parliament and are part of the ruling six-party "rainbow coalition" government.

Categories: Treatment

Chronicle AM -- June 10, 2014

Tue, 06/10/2014 - 22:02

New York City residents are still getting arrested for marijuana at the rate of 80 a day, New York state residents face another year without medical marijuana passing, Philly heads for decriminalization of a sort, the Justice Department supports retroactivity for recent sentencing reforms, the Sinaloa cartel has apparently lost another key leader, and more. Let's get to it:

[image:1 align:right caption:true]Marijuana Policy

Colorado Lawsuit Claims Marijuana Taxes Violate Fifth Amendment. Denver attorney Robert Corry Jr. has filed a lawsuit on behalf of an unnamed marijuana retailer arguing that paying pot taxes violates a citizen's Fifth Amendment right against self-incrimination since marijuana remains illegal under federal law. The lawsuit seeks a permanent injunction to stop the state from collecting taxes and the return of all taxes collected. A similar lawsuit has been filed in Washington state by attorney Douglas Hiatt.

New York City Marijuana Arrests So Far This Year at Same Pace as Last Year. New Yorkers are still being arrested for small-time pot possession in high numbers under new Mayor Bill DeBlasio (D). According to the Marijuana Arrest Project, so far this year, NYPD is arresting an average of 80 people a day for pot possession, compared to 78 a day throughout 2013 under then-Mayor Michael Bloomberg (R). Another constant is that blacks and Latinos continue to make up the vast majority of marijuana possession busts. They accounted for 87% of pot arrests last year and 86% so far this year. Click on the title link for more details.

Philadelphia City Council Committee Approves Decriminalization Measure. A city council committee yesterday approved a bill that would make possession of up to 30 grams of marijuana a code violation punishable by a $25 fine -- but would still give police officers the discretion to arrest. But Mayor Michael Nutter opposes the bill. His Public Safety Director, Mike Resnick, said the opposition stems the discretional arrest provision, which he said could create unfair situations. A final vote is likely next week.

Medical Marijuana

North Carolina "March Against Fear" Aims to Generate Support for Medical Marijuana. North Carolinian Todd Stimson is leading a 259-mile "March Against Fear" from Asheville to Raleigh to help bring attention to a pending medical marijuana bill, House Bill 1161. The bill was filed last month and is now languishing in the House Judiciary Committee. Click on the title link to join up or get more info.

Key New York GOP Legislator Says He Will Not Allow Vote on Medical Marijuana. Senate Finance Committee Chairman John DeFrancisco (R) said today he would not allow a vote on the Compassionate Care Act, sponsored by Sen. Diane Savino (D). "The Savino bill will not come out of my committee, the Finance Committee," he said. "You don't have any kind of reasonable research on the effects. You have people coming in here every day trying to ban e-cigarettes and use of tobacco in other ways." He said he and other Senate Republicans may be open to legislation that would not allow marijuana to be smoked. The session ends next Thursday.

Clark County, Nevada, Commissioners Approve 18 Dispensary Licenses. There will soon be 18 medical marijuana dispensaries operating in unincorporated parts of Clark County, the home of Las Vegas. County commissioners approved the licenses yesterday. Nevada approved medical marijuana in 2000, but only approved dispensaries last year.

Drug Testing

Repeated School Drug Tests of Pennsylvania 10-Year-Old Provoke Scorching Editorial. The editorial board at the Pennsylvania news website PennLive has penned a strong editorial condemning the drug testing policy at the Susquenita Middle School, which has resulted in a 10-year-old girl be tested three times so far. The editorial notes that state law requires that school districts actually show there is problem and show that drug testing helps, but that Susquenita has failed to do either. "Repeatedly drug testing a trouble-free 10-year-old student like Natalie Cassell shows how ridiculous this kind of random snooping is. Innocent students are treated like criminals, while drug-using students can dodge the tests simply by deciding not to join after-school activities," PennLive noted. "At a time when school districts across the state are pleading for more state funding, surely Susquenita schools can find a better uses of money than an unproven, highly invasive program that randomly tests innocent 10-year olds.

Sentencing

Justice Department Supports Making Drug Sentence Cuts Retroactive. Attorney General Eric Holder announced Tuesday that the Justice Department is formally supporting a US Sentencing Commission proposal to allow some nonviolent drug offenders currently doing time in federal prisons to seek sentence reductions. The proposal would extend sentencing reforms already approved by the commission by making them retroactive.

Smarter Sentencing Act Gains Four More Sponsors. The Smarter Sentencing Act of 2013 picked up four more cosponsors Monday, three Democrats and one Republican. They are Del. Eleanor Holmes Norton (D-DC), Rep. Kathy Castor (D-FL), Rep. Tony Cardenas (D), and Rep. Paul Ryan (R-WI). The measure now has 37 cosponsors, 24 Democrats and 13 Republicans. It has been sitting in the House Judiciary Committee's Subcommittee on Crime, Terrorism, Homeland Security and Investigations since January.

Prescription Opiates

Massachusetts Governor Unveils Plan to Fight Opiate Use. Gov. Deval Patrick (D) today released a $20 package of proposals to deal with "the opioid addiction epidemic" in his state. He is calling for a summit of regional governors, as well as streamlined access to treatment, better prevention measures, and "strengthening safe prescribing and dispensing practices" to "minimize diversion and misuse." That last bit is likely to raise concerns among people worried about adequate access to prescription opiates. But unlike some other state-level responses to rising levels of opiate use, Patrick's did not contain a law enforcement component. The link leads to the full press release.

International

Key Sinaloa Cartel Figure Reported Dead. Reports are emerging from Mexico that Juan Jose "El Azul" Esparragoza, a key figure in the Sinaloa cartel, has died of natural causes. After the capture of cartel head Joaquin "El Chapo" Guzman by Mexican authorities earlier this year, Esparragoza and Ismael "El Mayo" Zambada were viewed as the effective leaders of the cartel.

Spanish Authorities Close Down Barcelona Cannabis Club for Selling… Cannabis. A Barcelona cannabis club has been closed after police spotted a man approaching tourists and taking them to the club to score. Under Spanish law, one can grow marijuana for personal use, but not sell it. The cannabis clubs have sprung up as a way for consumers to pool their growing resources. Members pay an annual membership fee for a chance to share in the proceeds of the collectively cultivated cannabis, but they're not supposed to sell it.

Categories: Treatment

Chronicle AM -- June 5, 2014

Thu, 06/05/2014 - 20:53

An Arkansas marijuana legalization initiative can start signature-gathering, DC's medical marijuana program now includes more eligible conditions, Tennessee's governor unveils his prescription drug plan, Canada's mandatory minimum sentencing law is being challenged, and more. Let's get to it:

[image:1 align:right caption:true]Marijuana Policy

Arkansas Legalization Initiative Approved for Signature-Gathering. State Attorney General Dustin McDaniel yesterday approved the popular name and ballot title for a constitutional amendment initiative that would legalize marijuana. Supporters of the Arkansas Hemp and Cannabis Amendment now have just over one month -- until July 7 -- to submit more than 78,000 valid voter signatures in order to qualify for the November ballot. A medical marijuana initiative sponsored by Arkansans for Compassionate Care is already in the signature-gathering phase.

Medical Marijuana

Group Targets DNC Chair Debbie Wasserman Schultz for Not Voting to End DEA Interference in Medical Marijuana States. The medical marijuana advocacy group Americans for Safe Access is now running TV ads criticizing Rep. Debbie Wasserman Schultz (D-FL), chairwoman of the Democratic National Committee as "out of touch" for voting against a measure to bar the DEA from interfering in medical marijuana states. Wasserman Schultz was one of only 18 Democrats who voted against it while 170 Democrats voted for it. The ads are running on MSNBC in South Florida, where her district is.

DC Medical Marijuana Program Adds New Qualifying Conditions. The DC Department of Health has approved new conditions for which patients will be able to use marijuana. They are seizure disorders, Lou Gehrig's Disease, decompensated cirrhosis, cachexia or wasting syndrome, and Alzheimer's. Hospice patients will also be allowed to use marijuana. Previously, the DC program had been restricted to people suffering from HIV/AIDS, cancer, glaucoma, and muscle spasticity.

Heroin

Ohio Democratic Candidates Call for Tougher Action Against Heroin. Democratic gubernatorial candidate Ed FitzGerald and Democratic attorney general candidate David Pepper are calling for tougher action against heroin. FitzGerald said he wants tougher enforcement on dealers and that rising heroin use should be treated as a public health emergency. And Pepper called for heroin overdose deaths to be treated like murder. FitzGerald added that not enough dealers are going to prison, especially after a sentencing reform bill passed. The Ohio Republican Party responded calling the Democrats "tone deaf" and "ghoulish," saying that Gov. John Kasich (R) has been a strong advocate on the issue, and besides, Attorney General Mike DeWine's (R) office had just indicted two heroin dealers last week.

Prescription Drugs

Tennessee Governor Rolls Out Prescription Drug Plan. Gov. Bill Haslam (R) Tuesday unveiled his seven-point program to battle problems associated with prescription drug use. "Prescription for Success: Statewide Strategies to Prevent and Treat the Prescription Drug Abuse Epidemic in Tennessee" calls for reducing the prescribing of prescription opiates, reducing overdose deaths (including through enactment of a 911 Good Samaritan law), increasing prevention, early intervention, and treatment, and increased cooperation among state agencies and between the state and other entities. While it has a law enforcement component, that doesn't seem to be emphasized. [Ed: There are some good provisions in this document, but reducing the prescribing of pain medications needs to be handled with great care. Although more people are getting opiates now, not all of the people who need them are, and it could easily get even worse for pain patients.]

Drug Testing

California Initiative to Drug Test Doctors Qualifies for Ballot. An initiative that requires random, suspicionless drug and alcohol testing of doctors has qualified for the November 2014 ballot, according to the Secretary of State's office. It also requires doctors to report any other doctor they suspect of being impaired by drugs or alcohol. It also increases the cap on pain and suffering damages in medical malpractice lawsuits, which may the initiative's main goal. Legislative analysts estimate it could cost the state "at least in the low tens of millions of dollars annually" in higher malpractice costs and up to "hundreds of millions of dollars annually" because of changes in the amount and type of health care services provided.

Law Enforcement

In Massive Heroin Sweep, New Jersey Police Arrest Seven Users for Every Dealer. New Jersey cops arrested 325 people during an eight-week heroin sting, but only 40 of them are accused of selling heroin. The rest are alleged heroin users. Authorities said all were arrested on relatively low-level charges and all would have a chance to go through treatment programs, but the head of the state's drug court program said she wasn't sure the system could accommodate all of them.

International

New Zealand Workers Win Drug Testing Case. Workers at a mill who were subjected to mandatory drug tests after two marijuana plants were found growing on the site were treated unfairly and must be compensated, the Employment Relations Authority has ruled. The mill owner had argued that the discovery of pot plants was "reasonable cause" to drug test everybody, but the authority disagreed. "This is a victory for our members, and a victory for common decency and respect," says Ron Angel, a union organizer for timber workers. "Drug testing has to be about proving actual impairment at work - not treating workers as guilty until proven innocent."

Canada Battle over Mandatory Minimum Sentences Heads to BC Appeals Court. A case that could eventually overturn the Conservative government's mandatory minimum sentence scheme for drug offenses is being heard in the BC Court of Appeals today. Earlier this year, a BC provincial court judge ruled unconstitutional an automatic one-year prison term for a person repeatedly convicted of drugs. Lawyers for the government appealed; thus today's hearing. The case is that of Vancouver Downtown Eastside resident Joseph Lloyd, a long-time drug user with 21 previous convictions who was convicted last fall of trafficking small amounts of heroin, cocaine, and meth. The provincial court judge held that mandatory minimum sentences amounted to cruel and unusual punishment.

Bolivian Village to Bake Coca Birthday Cake for UN Head Ban Ki-Moon. UN Secretary General Ban Ki-Moon will be in Bolivia when his birthday rolls around on June 15, and the mayor of Cobija, Ana Lucia Reis, says they are going to bake him a coca birthday cake. "The idea is that Ban tries the coca and realizes that coca is part of our culture and is not cocaine," she said.

Categories: Treatment

Chronicle AM -- June 2, 2014

Mon, 06/02/2014 - 20:53

A Nevada marijuana legalization initiative picks up a key endorsement, Iowa joins the ranks of the CBD medical marijuana states, Tennessee's governor gets ready to roll out a new plan to address prescription drug use, thousands march for legalization in Santiago, Chile, the Peruvian president backs away from forced coca eradication, and more. Let's get to it:

[image:1 align:left caption:true]Marijuana Policy

Nevada's Largest Newspaper Endorses Legalization Initiative. The Las Vegas Review-Journal, by far the largest circulation newspaper in the state, has endorsed the state's fledgling legalization initiative, which has set its sights on 2016. Click on the title link to read the Sunday editorial.

California Sen. Feinstein Opposes Cutting Federal Funds for Medical Marijuana Raids. Just hours after the US House approved an amendment that would block the Justice Department and the DEA from using taxpayer funds to go after medical marijuana providers in states where it is legal, Sen. Dianne Feinstein (D-CA) said that "if a similar amendment were offered in the Senate, I would strongly oppose it." She said that while she sympathizes with patient needs, "rogue medical marijuana dispensaries, which require little or no medical bona fides and are prevalent throughout California, present major challenges for communities across the country." The 80-year-old politician credited the feds with closing more than 400 "rogue dispensaries" and worried that "the House amendment would prevent these critical enforcement activities from continuing."

Medical Marijuana

Iowa Governor Signs Limited CBD Medical Marijuana Bill. Gov. Terry Branstad (R) last Friday signed into law Senate File 2360, which will allow people suffering seizure disorders to use high-CBD cannabis oil with a neurologist's recommendation.

Illinois Senate Approves Medical Marijuana for Minors, People With Epilepsy. The state Senate last Friday approved a bill that would allow minors and people of all ages suffering from epilepsy to use medical marijuana. The legislation is Senate Bill 2636. It has already passed the House and now goes to the desk of Gov. Pat Flynn (D).

Prescription Opiates

Tennessee Governor to Unveil Plan to Address Pain Pills Tomorrow. Gov. Bill Haslam (R) will announce tomorrow a seven-point plan to address rising levels of prescription opiate use. One official said drug treatment will be a key component. In recent years, Tennessee has enacted prescription monitoring legislation and cracked down on doctors accused of over-prescribing opiates. Just last month, a committee of physicians appointed by the health commissioner agreed on new prescribing guidelines that set limits on daily doses doctors can prescribe. The program to be announced tomorrow is supposed to have seven points. Stay tuned.

Law Enforcement

Homicide Charges for Heroin Overdoses Rise in Wisconsin, But…. In a fine example of investigative journalism, the Gannet Wisconsin Investigative Media Team has released an analysis of the increasing use of homicide charges in heroin overdose cases in the state. Under Wisconsin law, anyone who makes, sells, or delivers a controlled substance that leads to an overdose death can by charged with first-degree reckless homicide by drug delivery. The report finds the number of such prosecutions spiking, but that sentences all over the place and the likelihood of being prosecuted depends largely on which county you are in. A good read.

In Warren County, Kentucky, the Drug War Dominates the Court Docket. The latest batch of indictments is out from the Warren County grand jury in Bowling Green, and more than half of them are for drug offenses. Nineteen people were indicted, 11 of them for drug offenses. There were four for possession of meth precursors, three for drug trafficking, two for marijuana trafficking, and one each for meth manufacture and drug possession. There was also one assault, one grand theft, and some drunk driving and "flagrant nonsupport" charges. Drug charges accounted for 58% of all the indictments.

International

Peru President Backs Off on Forced Coca Eradication in the VRAE. In a televised speech Sunday night, Peruvian President Ollanta Humala said he is indefinitely postponing plans to forcibly eradicate coca crops in the valleys of the Apurimac, Ene, and Mantaro Rivers (VRAE). The announcement came just days after Humala fired Carmen Macias as head of the anti-drug agency DEVIDA. Macias had been a strong advocate of a militarized eradication in the region, which produces more than half the country's coca crop and is also home to remnants of the Shining Path. Critics had warned that an aggressive eradication campaign would only help such rebels.

Uruguayan Presidential Candidate Who Vowed to Undo Marijuana Legalization Loses in Primary. "We are going to overturn this law that legalized marijuana growing. Nobody plant anything! Don't plant anything because we're going to knock it down!" National Party presidential nomination favorite Sen. Jorge Larranaga said ahead of Sunday's primary election to see who would get a chance to succeed outgoing President Jose Mujica. But instead, Larranaga lost in a surprise outcome.

Thousands March for Marijuana Legalization in Chile. Thousands of people marched through the streets of Santiago, the Chilean capital, Sunday in support of marijuana legalization. "Don't drive and drive, smoke and fly!" read one sign. Much open marijuana use was reported. Demonstrators demanded decriminalization and legalization, specifically including the right to grow their own.

New Bermuda Premier Says No to Marijuana Legalization, But Leaves Door Open for Decriminalization. Incoming Bermuda Premier Michael Dunkley said last Friday his administration has no plans to legalize marijuana, but could get behind a decriminalization scheme. Dunkley's comments came during a debate on the findings of the Cannabis Reform Collaborative, whose report earlier this month called for medical marijuana, decriminalization, and eventual legalization. "I think it is important to reiterate that the government's public undertaking has related to decriminalization and any potential wider use of cannabis," Dunkerly said. "Let me indicate early in this debate that at this time, the government is not prepared to consider personal cultivation, licenses for commercial cultivation and sale or blanket legalization of cannabis. In so far as this report recommends those things, they do not represent this government's current intentions."

Categories: Treatment

The Ibogaine Frontier: A Report from Durban [FEATURE]

Fri, 05/30/2014 - 21:30

special to Drug War Chronicle by Douglas Greene

Three dozen ibogaine providers, researchers and advocates gathered from May 7-10 in Durban, South Africa for the 4th International Ibogaine Provider's Conference, sponsored by the Global Ibogaine Therapist Alliance (GITA).

[image:1 align:left caption:true]The cover of the conference program guide and report features Esu, a deity in several religions with a multitude of responsibilities, including protecting travelers, roads (particularly crossroads), power over fortune and misfortune, and the personification of death. The illustration was highly apropos -- 52 years after the discovery of ibogaine's interrupting effects on opioid use disorders by Howard Lotsof, the father of the modern ibogaine movement, ibogaine advocates and providers are at an existential crossroads, with serious concerns about sustainability, safety and efficacy.

The last GITA conference was held in October 2012 in the harm reduction heaven of Vancouver, Canada. For this conference, GITA wanted to get back to the medicine's root -- iboga, a rainforest shrub native to West Central Africa that is sacred to practitioners of the Bwiti religion. After years of ibogaine's increasing popularity to treat Westerners with substance use disorders, iboga is under intense ecological pressure, and could be extinct in its native habitat of Gabon by late 2016, according to Yann Guignon, who wrote a report on the status of iboga for the Gabonese government in 2011-2012.

Guignon comes from an unusual background. He was born in France, but has been in Gabon since 2006, when he was initiated in the Dissumba branch of Bwiti. In 2007, France banned iboga after a death that had only an incidental connection to iboga.

Guignon gave the attendees a full report on the parlous state of the plant. "Over 90% of the iboga has disappeared from the country," Guignon said, and what it left is unaffordable -- the price of iboga has risen tenfold in less than decade. A bottle of 300 grams of medium quality root bark costs 100 euros (about $136), in a country where the 30% of the population that is employed has a minimum salary of 120 euros (about $163) per month.

There are also many factors endangering the supply of iboga: increasing land development and urbanization, the growing political and social power of evangelical Christians and climate change. As a result, "fake iboga" is now being marketed as iboga root bark and causing fatalities due to its cardiotoxic effects. And some Bwiti have started using alcohol instead of iboga in their ngenza (practice).

In response to these formidable threats to iboga's future, GITA and Guignon are taking action. GITA has proposed undertaking a collaborative effort with the Ethnobotanical Stewardship Council to launch the Iboga Dialogues, a multi-stakeholder engagement process to develop fair trade and safety standards for global use of iboga and ibogaine. Meanwhile, Guignon and his associate Jean-Nicolas Dénarié have started a few plantations on private land, and are in discussions with the Gabonese government to develop a plantation in one of Gabon's national parks, with the eventual goal of having a plantation in each of Gabon's 13 national parks.

Concerns about safety have been part and parcel of ibogaine's history as a drug detox. It's not just potent psychologically (about 75% of people treated experience intense personal and transpersonal visions -- not hallucinations, as often described in erroneous media reports). On a physiological level, it can produce bradycardia (a slow heartbeat) and/or arrhythmias (irregular heart rhythms). Last year alone, four of the 12 citations for ibogaine on the medical database PubMed were about deaths and toxicity. And rumors of deaths at clinics (as well as sexual assaults and thefts of intellectual property) have served to undermine the disorganized and reputationally disadvantaged ibogaine subculture.

[image:2 align:right caption:true]However, some pioneering providers are attempting to improve ibogaine's safety profile, not just by taking what should be common sense precautions (using medicine that has been tested for purity, extensive medical screening and monitoring of treatments by qualified medical professionals), but by using cumulative, low dose psycholytic protocols that include iboga root bark, TA (an extract that includes all twelve alkaloids found in the plant) and ibogaine hydrochloride.

According to Clare Wilkins, Director of Pangea Biomedics, this approach has several advantages over the standard practice of using a flood dose of ibogaine hydrochloride: it uses scarce iboga more efficiently, and allows for treatment of high-risk individuals who are normally excluded from ibogaine treatment. Most importantly, it allows clients to be conscious and gradually integrate the insights they glean about their substance use disorders into their awareness and daily practices.

Safety practices were also discussed by Kenneth Alper, MD, an associate professor of psychiatry at the NYU Langone Medical Center and Jeffrey Kamlet, M.D., FASAM, a Miami Beach-based specialist in addiction medicine, both during the conference and in a post-conference seminar devoted to provider discussion of treatment protocols and practices. Topics included patient electrolyte levels (the "number one problem in treatment" according to Kamlet), treatment of bradycardia and withdrawal from Suboxone, methadone and alcohol prior to treatment.

Although there's been an enormous amount of anecdotal evidence for ibogaine's efficacy, there has been a lot more popular media than medical articles about ibogaine (including a few stories after the death of actor Philip Seymour Hoffman and a major Al Jazeera piece that aired shortly after the conference). Consequently, most major drug policy reform organizations have remained silent on ibogaine. Even the Drug Policy Alliance, which honored Lotsof in 2009 just before his death with its Robert C. Randall Award for Achievement in the Field of Citizen Action, offers only a tepid endorsement of ibogaine research. ("Our take on ibogaine is that is shows interesting potential to assist some people in recovering from substance dependence. It should be more widely researched," says DPA harm reduction manager Meghan Ralston.)

[image:3 align:left caption:true]Despite ibogaine being an oneirogenic (a substance that produces dream states) rather than a psychedelic, MAPS (the Multidisciplinary Association for Psychedelic Studies) has emerged as a major institutional supporter of ibogaine research. MAPS Founder and Executive Director Rick Doblin has spoken enthusiastically about his experience with ibogaine, and MAPS is currently collecting data for two observational studies of ibogaine's long-term efficacy in treating opioid dependence at clinics in Mexico and New Zealand. The lead researchers for these studies presented the assembled iboganauts with the latest updates.

Thomas Kinsgley Brown, PhD of the University of California, San Diego, reported on the preliminary results of the Mexico study. Data entry for the study was completed in April. According to Dr. Brown, "[i]n the first month, 11 of the [30] participants relapsed, another seven in the second month, one person in the third month, another four in months for through six, one person in the seven month and as many as five went all 12 months without relapsing."

These numbers may not be too impressive -- but as GITA's Development Director Jonathan Dickinson has pointed out, most ibogaine providers are using the drug as a detox, not as an ingredient in a comprehensive treatment plan. Dr. Brown also emphasized that six of the 30 participants had some continuing care in the first few months after ibogaine treatment, and suggested that it might be valuable to compare the ASI (Addiction Severity Index) subscores and/or months to relapse of the participants who received continuing care and those who did not. Factors that Dr. Brown suggested might be determinative of successful ibogaine treatment are a patient's drug use history, age, outlook and expectations of treatment, as well as the integration, type and suitability of fit of any continuing care they receive.

Although in an earlier stage of the study, the results in New Zealand tentatively appear to be promising, according to lead researcher Geoff Noller, PhD and Tanea Paterson, a substance use practitioner/ibogaine provider at Ibogaine Te Wai Pounamu (New Zealand's only current ibogaine treatment provider). The study enrolled its 14th and final subject in April. Seven of the participants were tracked for all 12 months of follow-up (as well as one who was lost to contact at 11 months), and of the six participants still being monitored, three (50%) remain opioid free. Noller and Paterson hypothesized that the differences between the results of the Mexico and the New Zealand studies could be attributed to (among other factors) ibogaine's status as a non-approved prescription medicine in New Zealand, which allows for an integrated system of care between physicians, pharmacists, ibogaine treatment providers and continuing care providers.

"In Durban we saw some important steps on a long road towards uniting the therapeutic and sacramental communities that use ibogaine and iboga. The important factor was outlining a sustainability dialogue that will affect both communities deeply, and I think beyond the practical function of planting trees this dialogue will have an evolutionary impact for everyone involved. What we have seen is that the situation we're facing with iboga's sustainability is grim, but that contained within it is a massive opportunity for cultural dialogue and healing. I believe that here we have been successful in initiating that," said Dickinson.

A conference report is available here. Ibogaine has a long way to go to achieve mainstream acceptance, and potentially safer ibogaine metabolites and analogs, such as noribogaine and 18-MC, are being aggressively developed. But as this conference demonstrated, there is a passionate, committed group of providers and researchers who are working globally to advance the states of the art and science of ibogaine practice.

Categories: Treatment

Chronicle AM--May 30, 2014

Fri, 05/30/2014 - 20:34

Yesterday was a bad day for the DEA as the House thrice voted to slap its hands, an anti-marijuana initiative in Montana gets okayed for signature-gathering, the New York Senate releases a report on heroin and opiate addiction and calls for more drug war, marijuana legalization supporters rally in Tel Aviv, and more. Let's get to it:

[image:1 align:right caption:true]Marijuana Policy

Montana Anti-Marijuana Initiative Approved for Signature-Gathering. An initiative that would repeal Montana's already severely scaled-back medical marijuana law and ban anything listed as a Schedule I controlled substance under the federal Controlled Substances Act, including marijuana, has been approved for signature-gathering. But Billings car dealer and initiative sponsor Steve Zabawa has only three weeks to get the 24,175 signatures necessary to get the measure on the November ballot.

Medical Marijuana

In Historic Vote, House Bars Justice Department, DEA from Using Taxpayer Funds to Interfere with Medical Marijuana in States Where It Is Legal. The US House of Representatives voted 219-189 last night to approve an amendment to 2015 Commerce, Justice, and Science appropriations bill to cut off funds for the Justice Department and its agencies, including the DEA, to interfere in state-sanctioned medical marijuana programs. If the Senate doesn't come up with similar language, the provision will have to be fought for in conference committee.

Hemp

In Historic Vote, House Bars Justice Department, DEA from Using Taxpayer Funds to Interfere with Hemp Production in States Where It Is Legal. The US House of Representatives voted last night to bar the Justice Department and its agencies, including the DEA, from using taxpayer dollars to interfere with industrial hemp production in states where it is legal. Hemp production for research purposes in states that have laws allowing it was approved by the Congress as part of the omnibus farm bill earlier this year. A dozen states have such laws.

Law Enforcement

In Historic Vote, House Takes Funds from DEA, Shifts Them to Addressing Rape Kit Backlog. In addition to barring the DEA from going after hemp and medical marijuana in states where they are legal, the House also approved an amendment from Rep. Steven Cohen (D-TN) to take $5 million from the DEA's appropriation and shift the money into grants for state and local law enforcement to address backlogs of untested rape kits. The House voted down another Cohen amendment that would have taken $15 million from the DEA and allocated it instead to the Legal Services Corporation. The House also approved an amendment that would block additional staffing for the Pardon Attorney's Office in a bid to thwart President Obama's call for drug war prisoners to seek clemency.

Heroin and Opiates

New York Senate Task Force Proposes Massive Package of Prevention, Treatment, Law Enforcement Bills to Fight Increased Heroin, Prescription Pill Use. The state Joint Senate Task Force on Heroin and Opioid Addiction issued its final report Wednesday. The report, Solutions to New York's Heroin Epidemic, calls for prevention, treatment, and harm reduction measures, but the 25-bill package it includes is heavy on law enforcement. Thirteen of the 25 proposed bills would ratchet up the drug war. There is a complete list of the bills in the package in the report.

International

Colombian Government Releases Outline of Drug Accords With FARC. The Colombian government has released a document laying out the points agreed to with the FARC guerrillas on dealing with drug cultivation and the illicit drug trade. The two sides, meeting at peace talks in Havana a couple of weeks ago, reached the agreement a couple of weeks ago. Colombia Reports has the details at the title link.

Despite Drug Decriminalization, Colombia Continues to Arrest, Hassle Drug Users, Researcher Finds. In a report from the Research Consortium on Drugs and the Law, researcher Diane Guzman found that Colombia continues to rely excessively on punishing drug users, even though drug use is decriminalized there. Guzman blames police enforcement strategies and their focus on arrest, and reports that drug users detained by police are often let go after they pay bribes. She also found that Colombia's goal of reducing drug addiction suffers because the country doesn't devote sufficient resources to improving health care and rehabilitation for drug users. The report, En Busca De Los Derechos: Usuarios De Drogas Y Las Respuestas Estatales En América Latina, also examines drug policies in seven other Latin American countries. Guzman wrote the Colombia chapter.

Thousands March for Marijuana in Tel Aviv. An estimated 2,000 people marched and rallied for marijuana legalization in Tel Aviv Thursday night. The march comes as the Knesset prepares to debate a bill easing restrictions on medical marijuana next week and a bill from MK Tamar Zandberg to legalize marijuana a few weeks from now.

Categories: Treatment