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More than 1.5 million people were arrested for drug offenses in the US last year, and more than 693,000 of those for marijuana offenses. The figures come from the FBI's 2013 Uniform Crime Report, which was released today.
[image:1 align:left caption:true]That's about one pot bust and slightly more than one other drug arrest every minute, 365 days a year. The vast majority of them are for simple possession. Over 87% of all marijuana arrests and 82% of all drug arrests were for possession only.
Marijuana arrests have declined from peaks early in this century. In 2008, there were a record 872,000 marijuana arrests, so pot busts have declined by slightly more than 20% since then. But arrests for other drug offenses continue apace, actually increasingly slightly last year. Still, because of the decline in marijuana arrests, the overall number of drug arrests dropped by about 50,000.
In 2008, marijuana arrests accounted for a majority (52%) of all drug arrests. Now, it is down to 40.6%.
Some of the decline in marijuana arrests can be attributed to the passage of decriminalization and legalization laws, particularly in the West, where pot arrests accounted for only 18% of all drug arrests. California decriminalized pot possession in 2011, and Colorado and Washington legalized it in the 2012 elections.
[image:2 align:right caption:true]In other parts of the country, marijuana arrests continued to roll along, even in the Northeast, where they accounted for 46% of all drug arrests. In the South, the figure was 49.8%, and in the Midwest, pot accounted for 51.7% of all drug arrests.
When it comes to race, blacks continue to be disproportionately represented among drug arrestees. African-Americans accounted for 30.7% of all drug arrests, but they only make up about 13% of the population. That means blacks are being arrested for drugs at 2 ½ times the rate their percentage of the population would predict.
Drug arrests were the single largest category of arrests made in the US and accounted for about 13% of all arrests. The 1.5 million drug arrests well exceeded second place larceny-theft (1.232 million) and third place driving under the influence (1.167 million). More than three times as many people were arrested for drug offenses than for all violent crimes combined (480,000).
The continued law enforcement emphasis on drug enforcement drew criticism from Law Enforcement Against Prohibition (LEAP).
[image:3 align:left caption:true]"Police made more drug arrests than for any other single category of crime. Meanwhile, only 64% of murders and 48% of violent crimes generally are being solved," said LEAP executive director Major Neill Franklin (Ret.), citing the FBI statistics. "We clearly have our priorities in the wrong place."
The Marijuana Policy Project (MPP), fresh from last week's successful "marijuana midterms," pronounced itself pleased with the decline in pot busts, but called for them to end, not just diminish.
"We're pleased to see the drop, but arresting even one adult for using a substance that is objectively less harmful than alcohol is inexcusable," said MPP communications director Mason Tvert. "Every year we see millions of violent crimes attributed to alcohol, and the evidence is clear that marijuana is not a significant contributing factor in such incidents. Yet our laws continue to steer adults toward drinking by threatening to punish them if they make the safer choice. These arrest numbers demonstrate that the threat is very real," he noted.
Tvert also echoed LEAP in criticizing law enforcement priorities.
"Law enforcement officials should be spending their time and resources addressing serious crimes, not arresting and prosecuting adults for using marijuana," he said. "Every year, these statistics show hundreds of thousands of marijuana-related arrests are taking place and countless violent crimes are going unsolved. We have to wonder how many of those crimes could be solved -- or prevented -- if police weren't wasting their time enforcing failed marijuana prohibition laws."
The laws must change, he said.
"A majority of Americans think marijuana should be legal for adults and treated similarly to alcohol. Voters in four states and the District of Columbia have now passed laws that reflect that, and we expect several more will do over the next few years. It's time for our laws to catch up with public opinion."
Federal drug sentencing reforms adopted earlier this year by the US Sentencing Commission went into effect today. They should result in tens of thousands of federal prisoners seeing their sentences cut and being released early, as well as ensuring that future offenders are not sentenced so harshly.
[image:1 align:left]The Sentencing Commission, an independent body in the judicial branch which is charged with setting federal sentencing guidelines, voted unanimously in April to reduce the guidelines for most drug sentences. Then, in July, it voted—again unanimously—to make those sentencing reductions retroactive, meaning they will be applied to current federal drug prisoners.
Congress had an opportunity to disapprove of the sentencing reductions, but failed to act, so the changes are now in effect.
As of today, current federal drug prisoners can begin petitioning courts for sentence cuts based on what the new guidelines call for. If the courts determine they are eligible for the sentence cuts and a reduction is appropriate, the sentences will be reduced. That will result in some federal prisoners getting out early, but none will be released until a year from today.
The sentence cuts will not, though, reduce mandatory minimum sentences, which are set by Congress. Prisoners serving sentences longer than the mandatory minimum may win sentencing reductions, but not below the mandatory minimum.
For the past two decades, the Sentencing Commission has attempted to rein in the harshly punitive impulses in Congress that led it to impose lengthy prison sentences for even low-level drug offenses in the 1980s. The federal prison population has increased more than three-fold since 1980, driven largely by the war on drugs. According to the Bureau of Prisons, the 98,482 federal drug prisoners make up 48.8% of all federal prisoners.
[image:2 align:right caption:true]"The reduction in drug guidelines that becomes effective tomorrow represents a significant step toward the goal the Commission has prioritized of reducing federal prison costs and overcrowding without endangering public safety," Judge Patti Saris, chair of the Commission, said in a statement. "Commissioners worked together to develop an approach that advances the causes of fairness, justice, fiscal responsibility, and public safety, and I am very pleased that we were able to agree unanimously on this reasonable solution. I am also gratified that Congress permitted this important reform to go forward."
According to the Commission, more than 46,000 current drug prisoners will be eligible for sentence reductions through retroactive application of the revised sentencing guidelines. The Commission estimates that the sentence cuts will reduce the federal prison population by 6,500 within five years and more significantly as time goes on.
The Drug Policy Alliance (DPA) applauded the sentencing reductions, and especially the Commission's move to apply them to current prisoners.
"It makes little sense, of course, to reform harsh sentencing laws proactively but not retroactively," said Ethan Nadelmann, DPA executive director. "But that’s what politicians do when they’re scared of allowing people out of prison early. The Sentencing Commission really had no choice but to rectify the moral absurdity of keeping people locked up based on sentences that are no longer the law. What they did was right and just."
"This is an important step toward undoing some of the worst harms of the drug war by allowing people to be reunited with their families," added DPA media relations manager Tony Papa, who served 12 years in prison for a nonviolent drug offense.
[image:3 align:left caption:true]While the Sentencing Commission has been working for years to address prison overcrowding and unduly harsh sentencing, recent years have also seen some advances in Congress. In 2010 Congress unanimously passed legislation reducing the crack-powder cocaine sentencing disparity. Bipartisan legislation reforming mandatory minimum sentencing, the Smarter Sentencing Act (S 1410), has already passed out of committee this year and is awaiting a floor vote in the Senate. Attorney General Eric Holder has made numerous changes this year, including directing U.S. Attorneys to charge certain drug offenders in a way that ensures they won’t be subject to punitive mandatory minimum sentencing.
Sentencing Commission Chair Judge Parris said Congress still needs to get around to passing comprehensive reforms.
"Only Congress can act to fully solve the crisis in federal prison budgets and populations and address the many systemic problems the Commission has found resulting from mandatory minimum penalties," she said. "I hope that Congress will act promptly to pass comprehensive sentencing reform legislation."
Maybe then we can actually reverse the decades-long trend of sustained growth in the federal prison population. Actually, thanks to reforms already passed by Congress, we may see the first decrease in the federal prison population announced next month, when the Bureau of Justice Statistics issues its annual prison population report. The preliminary numbers suggest that the population may have peaked in 2012.
This move by the Sentencing Commission will only accelerate that (presumed) trend, but will only result in sentence reductions for about half of incarcerated federal drug offenders. There is still more work to be done.
Election Day is less than a week away, and it's not just statewide marijuana, medical marijuana, sentencing reform, and drug testing initiatives that we're watching. In five states, voters in some cities or counties will have opportunities to cast ballots for local marijuana reform measures.
[image:1 align:left]In four out of the five states—California being the exception—the local initiatives, some binding, some not, are chances to vote for decriminalizing or legalizing pot. In all of those states, these city- or county-level measures are just the latest steps in sometimes years-long campaigns laying the groundwork for state-level legalization, either through the ballot box or through the legislature.
California is a special case this year. With pot possession already decriminalized, its unique medical marijuana laws providing broad, if uneven, access, and the near certainty that statewide legalization is going to be on the ballot in 2016, nobody is bothering with local legalization measures in 2014 (although they had successful ones in a number of cities in the past).
In California, all the action is about medical marijuana. Let's start there.
With the state legislature unable or unwilling to pass statewide medical marijuana regulations, battles on the topic regularly devolve to the local level. This year is no exception. There are three broad areas of contention this year: cultivation, dispensaries, and taxes.
Four counties are dealing with cultivation issues. In Butte County, Measure B is a less restrictive ordinance than Measure A, which was passed by the board of supervisors. Both are on the ballot. In Lake County, Measure O and Measure P, both seek to overturn the restrictive Measure N, which was narrowly approved by voters last year. Measure O would allow more plants to be grown, while Measure P declares that personal—not commercial—grows are a fundamental right and that people growing for their own use are exempt from county cultivation ordinances.
In Nevada County, Measure S would liberalize the county's restrictive cultivation ordinance by allowing indoor cultivation anywhere, eliminating some minimum distance and other restrictions, and allowing up to 60 plants to be grown on plots over 30 acres. In Shasta County, Measure A is a referendum on an ordinance banning outdoor grows and home cultivation. A "no" vote on Measure A would repeal the ordinance.
[image:2 align:right caption:true]Dispensaries are on the ballot in a number of cities and counties. In Orange County's Santa Ana, two competing measures are on the ballot. Measure CC would allow for a minimum of 22 dispensaries, while the more restrictive, city council-sponsored Measure BB has no minimum number of dispensaries, a higher tax rate, and more restrictions than Measure CC.
In San Diego County, two cities have dispensary measures on the ballot. In Encinitas, Measure F would allow dispensaries and tax them at a 2.5% rate, while in La Mesa, Measure J would do the same thing. In Riverside County, Blythe's Measure Z would authorize and regulate dispensaries, with a 15% business tax.
Straight taxation questions are also on the ballot in Santa Cruz County (Measure K), the city of Santa Cruz (Measure L), Shasta Lake City (Measure C), and two Riverside County communities, Cathedral City (Measure N) and Desert Hot Springs, which has both a cultivation tax measure (Measure HH) and a dispensary tax measure (Measure II) on the ballot.
[Thanks to the Drug Policy Forum of California and its November 2014 Election Guide for the information on California local initiatives.]
In Maine, the Marijuana Policy Project (MPP) and local allies are sponsoring possession legalization initiatives in two towns, Lewiston and South Portland. A similar effort in York was blocked by recalcitrant town leaders. This year's effort builds on last year's success in Portland, Maine's largest city, where a similar initiative was approved with 67% of the vote.
Lewiston is the state's second largest city, while South Portland is its fourth largest. Victories in those two cities next week, along with last year's victory in Portland, will lay the groundwork for a statewide legalization push in 2016, which MPP says is coming.
For the last six election cycles, activists with the Drug Policy Forum of Massachusetts and MassCann/NORML have been laying the groundwork for marijuana law reform through the use of non-binding Public Policy Questions (PPQs), by which voters signal their reform desires to their elected representatives. The questions have been on medical marijuana, decriminalization, and legalization—and they have never lost.
[image:3 align:left caption:true]Public opinion in the form of successful public policy questions helped decriminalize marijuana in 2008 and legalize marijuana in 2012. This year, the questions are all about legalization, and the aim is clear: making Massachusetts a legal marijuana state within the next couple of years.
This year, the question asks: "Shall the State Representative from this district be instructed to vote in favor of legislation that would allow the state to regulate and tax marijuana in the same manner as alcohol?"
Voters will be answering that question in the following districts: 4th Barnstable, 4th Berkshire, 1st Essex, 2nd Franklin, 14th Middlesex, 15th Middlesex, 24th Middlesex, and 8th Norfolk.
But wait--there's more. Meanwhile, Bay State Repeal has an even less restrictive question on the ballot in five districts. That question asks whether voters would like to tell their representatives to "replace the state's restrictions on marijuana with a law that regulates the cultivation and commerce in marijuana by persons over the age of 21, in the same manner as laws that apply to the cultivation and sale of fruits, vegetables, and herbs."
That question will be asked the following districts: 4th Essex, 7th Essex, 8th Essex, 3rd Middlesex, and 6th Middlesex. A slightly different form of the question will be asked in the 2nd Hampshire district.
In an fight led by the Safer Michigan Coalition, marijuana decriminalization is on the ballot in 11 Michigan towns and cities this year. Like the efforts in Maine and Massachusetts, the effort in Michigan this year is part of an ongoing process whose ultimate end is legalization. Eleven other Michigan cities, including Detroit, Flint, Grand Rapids, Kalamazoo, and Lansing—the state's largest cities—have already passed similar measures. No city has ever defeated one.
This year, voters will have the chance to do the same in Berkley, Clare, Frankfort, Harrison, Huntington Woods, Lapeer, Mt. Pleasant, Onaway, Port Huron, Pleasant Ridge and Saginaw.
All will be voting on questions similar to this one, from Port Huron: "Shall the Charter of the City of Port Huron, Michigan be amended such that nothing in the Code of Ordinances shall apply to the use, possession or transfer of less than 1 ounce of marijuana, on private property, or transportation of 1 ounce or less of marijuana, by a person who has attained the age of 21 years?"
The state's most populous county, Bernalillo County, and its third most populous, Santa Fe County, will vote on advisory, non-binding questions designed to measure popular support for marijuana decriminalization.
In both counties, the question asks: "Are you in favor of the [...] County Commission supporting County, City, and Statewide efforts to decriminalize possession of one ounce or less of marijuana?"
There should also have been a pair of municipal decriminalization initiatives in Albuquerque and Santa Fe, but it didn't work out that way. The Drug Policy Alliance and Progress New Mexico worked through the summer and into the fall to put the initiatives before the voters in Albuquerque and Santa Fe, but neither actually happened.
In Santa Fe, the city council, when presented with the qualified initiative, just voted to accept it instead of putting it to a popular vote. In Albuquerque, the reason no vote is occurring is not so happy. Although the city council voted to put the initiative on the November ballot, Mayor Richard Berry (R) vetoed it.
If the past is any indication, these building-block local initiatives should all fare very well at the polls and continue to build the number of American political jurisdictions that have gone on record for ending pot prohibition. Come back next week to see if we can confirm that.
It's now less than two weeks until Election Day, and statewide marijuana initiatives are on the ballot in four states. All have a shot at winning, and as the clock ticks down, all of them are seeking last minute help to get them over the top.
[image:1 align:right]The Chronicle talked this week to people in the various campaigns, and all of them have concrete ideas on what people can do to help -- whether in-state or not -- in the final days. But before we get to what can be done, let's first review the initiatives, three that would legalize marijuana and one that would legalize medical marijuana:
Alaska Measure 2
The Measure 2 initiative allows adults 21 and over to possess up to an ounce and up to six plants (three flowering). It also allows individual growers to possess the fruits of their harvest even in excess of one ounce, provided the marijuana stays on the premises where it was grown. The initiative also legalizes paraphernalia.
The initiative grants regulatory oversight to the state Alcoholic Beverage Control Board, but gives the legislature the authority to create a new entity, the Marijuana Control Board. In either case, the regulatory authority will have nine months to create regulations, with applications for marijuana businesses to open one year after the initiative becomes effective.
A $50 an ounce excise tax on sales or transfers from growers to retailers or processors would be imposed.
The initiative does not alter either existing DUI laws or the ability of employers to penalize employees for testing positive for marijuana.
The initiative would not interfere with existing medical marijuana laws.
[image:2 align:left]DC Measure 71
The Measure 71 initiative would allow adults 21 and over to possess up to two ounces of marijuana and six plants, three of which can be mature. Households could grow up to 12 plants, six of which can be mature. Growers can possess the fruits of their harvests. Plants could only be grown indoors.
Adults could transfer up to an ounce to other adults without remuneration. There are no provisions for taxing and regulating marijuana sales because District law forbids initiatives from taking up tax and revenue matters. A bill is pending before the DC city council that would do precisely that.
The initiative also legalizes the sale and possession of paraphernalia used for marijuana consumption. It does not change existing DUI law, nor does it "make unlawful" any conduct covered by the District's medical marijuana law.
Oregon Measure 91
The Measure 91 initiative allows adults 21 and over to possess up to eight ounces and four plants per household. Individuals can also possess up to 16 ounces of marijuana products or 72 ounces of liquid marijuana products. And individuals can also transfer up to an ounce of marijuana, 16 ounces of marijuana products, or 72 ounces of liquid marijuana products to other adults for "non-commercial" purposes.
[image:3 align:right]The initiative would designate the Oregon Liquor Control Commission to regulate marijuana commerce. The commission would license, audit, and inspect growers, suppliers, and retailers. The commission could set purchase amount limits, which are not specified in the initiative. The commission would have until January 4, 2016 to begin licensing growers, producers, and retailers.
Marijuana sales from producers to processors or retailers would be taxed at a rate of $35 per ounce, $10 per ounce of leaves, and $5 per immature plant. The commission can recommend to the legislature any changes in the tax structure, which would then have to act to enact them.
The initiative does not alter either existing DUI laws or the ability of employers to penalize employees for testing positive for marijuana.
The initiative would not interfere with existing medical marijuana laws.
Florida Amendment 2
The Amendment 2 medical marijuana initiative makes legal the use of marijuana by a qualifying patient or caregiver. It would also make it legal for doctors to recommend medical marijuana and for "marijuana treatment centers" to distribute it.
[image:4 align:left]Patients qualify by having a "debilitating medical condition" including, but not limited to, cancer, multiple sclerosis, hepatitis C, HIV, and Crohn's Disease. Doctors could also recommend marijuana for "other conditions for which a physician believes that the medical use of marijuana would likely outweigh the potential health risks for a patient."
The Florida Department of Health would regulate medical marijuana and would issue patient and caregiver ID cards, develop rules and regulations for dispensaries, and define reasonable amounts of marijuana for medical use.
The initiative specifically does not allow use of medical marijuana by non-qualifying patients or the use of motor vehicle by patients under the influence. Nor does it require any accommodation for medical marijuana in schools or on the job or that health insurance companies cover medical marijuana expenses.
Because the initiative is a constitutional amendment, it needs 60% of the votes to pass.
What Can You Do?
Even with less than two weeks left in the campaigns, people can still help. There are slightly different tasks and needs in the different states, but all the campaigns are eager for help.
"On that page, there are tabs that let people send messages to friends and family -- basically a pre-written email -- as well as phone banking tool," said Chris Rempert, Alaska political director for the Marijuana Policy Project, which is backing the campaign. "We have a limited phone bank list targeted toward people likely to support us, but less likely to get out and vote. People can go there, sign up, and start calling."
The campaign could also use some cash. Donations can be made online here.
"We've spent so much money on advertising, we're running low on funds for the final push," said Rempert. "We need money for yard signs, campaign literature, and the like."
And volunteers on the ground could help, too.
"Especially in Anchorage, we need help with getting signs up and phone banking," Rempert said. "We'll be doing door-to-door canvassing and volunteers would be welcome."
Don't forget engaging with local media.
"People who are in Alaska should be writing letters to the editor," he said. "The opposition has formed a grass-roots Facebook and letter-writing effort, so anyone who can write a letter will be appreciated."
In the nation's capital, the DC Cannabis Campaign is already in the early voting phase of the election. It is using social media, including a #YesOn71 Twitter hashtag, to get the word out.
It could, though, still use volunteers to go to the precincts and hand out information, as well as for phone banking. And it could use more money. To volunteer, go here; to donate, go here. You can even pay in bit coins, if you have them.
In Oregon, the Vote Yes on 91 campaign is urging people to contact their in-state friends and family members, do phone banking, and more.
"If you know any Oregonians, write them a short personal email about why passing Measure 91 is so important," said campaign spokesman Peter Zuckerman. "Reach out to your friends and family members and tell them to vote yes."
Volunteers can still help, too.
"Whether you're an Oregonian or not, you can volunteer," Zuckerman said. "We're working very hard to get out the vote, and we need help. Go to our web site, where we have mobile GOTV groups. If you can get at least six people to phone together at a house, we will send you materials to do it."
There's still more to come, too, Zuckerman said.
"We will be rolling out other ways to help soon, so stay tuned," he advised. "Voter turnout is going to be really important in this election. This is a tough campaign, and we have to fight for every vote. We know your readers are really committed to this issue. Please do everything you can to encourage your readers to help us out."
In Florida, the United For Care campaign is engaged in an uphill battle to hit that difficult 60% mark. As the election season enters its final days, the campaign is still looking for volunteers and still accepting donations. Florida would be the first state in the South to pass a full-blown medical marijuana initiative, and it could still use your help.
It's not too late to make a difference. Act now.
In many ways, ours is harsh, moralistic, and punitive society. One need only look at our world-leading incarceration rate to see the evidence. We like to punish wrongdoers, and our conception of wrongdoers often includes those who are doing no direct wrong to others, but who are doing things of which we don't approve.
[image:1 align:left]We label those people of whom we don't approve. When it comes to drugs and drug use, the labels are all too familiar: Heroin users are "fucking junkies;" alcohol abusers are "worthless drunks;" cocaine smokers are "crack heads;" stimulant users are "tweakers;" people with prescription drug habits are "pill poppers." The disdain and the labeling even extends to the use of drugs on the cusp of mainstream acceptance. Marijuana users are "stoners" or "pot heads" or "couch potatoes."
Such labeling -- or stigmatizing -- defines those people as different, not like us, capital-O Other. It dehumanizes the targeted population. And that makes it more socially and politically feasible to define them as threats to the rest of us and take harsh actions against them. It's a pattern that we've seen repeatedly in the drug panics that sweep the nation on a regular basis. Drug users are likened to disease vectors or dangerous vermin that must be repressed, eradicated, wiped out to protect the rest of us.
(It is interesting in this regard to ponder the response to the most recent wave of opiate addiction, where, for the first time, users are being seen as "our sons and daughters," not debauched decadents or scary people of color who live in inner cities. Yes, the impulse to punish still exists, but it is now attenuated, if not superseded, by calls for access to treatment.)
Never mind that such attitudes can be counterproductive. Criminalizing and punishing injection drug use has not, for example, slowed the spread of blood-borne infectious diseases such as HIV and hepatitis C. To the contrary, it has only contributed to the spread of those diseases. Likewise, criminalizing drug possession does not prevent drug overdoses, but it may well prevent an overdose victim's friends or acquaintances from seeking life-saving medical attention for him.
A recent survey from the National Council on Alcoholism and Drug Dependence reinforces the view that we tend to stigmatize drug users as morally decrepit. That survey found that Americans are significantly more likely to have negative attitudes about drug addiction and addicts than about mental illness.
Only one out of five said they would be willing to work closely on the job with a person addicted to drugs (as compared to 62% for mental illness), and nearly two-thirds said employers should be able to deny a job to someone with an addiction issue (as compared to 25% for mental illness). And 43% said drug addicts should be denied health insurance benefits available to the public at large.
"While drug addiction and mental illness are both chronic, treatable health conditions, the American public is more likely to think of addiction as a moral failing than a medical condition," said study leader Colleen L. Barry, Ph.D. of the Johns Hopkins Bloomberg School of Public Health. "In recent years, it has become more socially acceptable to talk publicly about one's struggles with mental illness. But with addiction, the feeling is that the addict is a bad or weak person, especially because much drug use is illegal."
"The more shame associated with drug addiction, the less likely we as a community will be in a position to change attitudes and get people the help they need," study coauthor Beth McGinty, Ph.D. said in a news release. "If you can educate the public that these are treatable conditions, we will see higher levels of support for policy changes that benefit people with mental illness and drug addiction."
As the survey suggests, the process of stigmatization is an impediment to smart, evidence-based approaches to dealing with problematic drug use. Now, the Denver-based Harm Reduction Action Center is trying to do something about it.
[image:2 align:right]In the last few days, it has rolled out a new anti-stigmatization campaign featuring the faces of injection drug users, the locations where they overdosed or suffered other bad consequences, and their individual stories in brief.
"My name is Alan," says a middle-aged man with a brushy mustache. "I overdosed on heroin. Right there in that parking lot in that picture. I know the risks of doing heroin, but drug dependency is strong."
The second part of Alan's message is repeated with each drug user pictured: "There are 11,500 injection drug users like me in Metro Denver. 73% of us carry Hepatitis C. 14% of us have HIV. The transmission of bloodborne diseases and drug overdoses are nearly 100% preventable. Support the Harm Reduction Action Center. Learn more about how our public health strategies keep you, and the people you know, safe."
"My name is Andrew," says a dreadlocked and pierced young man whose image is coupled with a photo of an empty apartment. "After a decade living as a homeless youth, the most traumatic thing that happened to me didn't happen to me at all. It happened to my best friend Val. She died of a heroin overdose. Right here in this picture. She was my friend. She was someone's daughter. Sobriety has taught me a lot about the thin line that separates us all. Val was someone you knew. She probably served you coffee. She probably even greeted you with a friendly smile."
"My name is Joanna," says a woman whose image is paired with a photo of a car parked beneath a highway overpass. "When I was diagnosed with lymphoma, I was prescribed a heavy dose of pain killers. Cancer hurts, but with treatment, it went away. My dependency on opioids did not. Two years later, this is where I live; in a car, under the interstate. I did not choose to get cancer. I did not choose to get dependent on opioids."
The images and the messages are strong and direct. That's the idea, explained HRAC executive director Lisa Raville.
[image:3 align:left]"This campaign is about bringing awareness of our work in the community, focusing on the common sense approach championed by harm reduction," she said. "Stigma, of course, is one of the biggest stumbling blocks, preventing otherwise reasonable conversation on the matter of communicable diseases and accidental overdoses. This campaign sets the scene that harm reduction is a valid and evidence-based approach to public health. Access to clean syringes, proper syringe disposal, and naloxone are key components to a comprehensive public health strategy that curbs the spread of HIV, HVC, and reduces the rate of otherwise fatal overdoses."
It's a message directed at the general public even more than drug users themselves, Raville said.
"One of the fundamental problems faced by health care advocates working with injection drug users is a generalized, public perception that the issue is isolated to people and places outside of the normal social sphere. Generally speaking, our tendency is to dissociate our ordinary experiences -- the people we know and the places we go -- from things that we consider dangerous, dark, or forbidden," she said.
"In the arena of injection drug use, the consequence of this mode of thinking has been historically devastating," she continued. "Instead of crafting public policy that works to minimize the harm caused by addiction, our trajectory tends towards amplifying consequences for anyone that wanders outside of the wire and into these foreign spaces. Rather than treating addiction as a disease, we treat it as something that is volitional and deserving of its consequences. Accordingly, our policies view the contraction of blood-borne pathogens and the risk of overdose as deterrents to the act of injecting drugs."
That cold-blooded attitude may make some people feel better about themselves and their policy prescriptions, but it hasn't proven useful in reducing deaths, disease, or other harms resulting from injection drug use. Instead, it tends to increase them.
"These 'consequences,' of course, have little impact on rates of addiction," Raville argued. "They do, however, all but ensure the continued spread of HIV and hepatitis C. Moreover, possession and distribution of naloxone, a drug that counters the effects of otherwise fatal opiate overdoses, remains criminal in many areas throughout the world."
At bottom, the campaign is not just about drug users but about better public health.
"As our campaign points out, when we drive things underground, we make them truly dangerous," Raville said. "Harm reduction is predicated on the fact that people use drugs. Those who inject drugs are among the most insular and at-risk for contracting HIV, HCV or dying of an overdose. Like a stone that falls in the water, these acute health-related events have ripples which touch all of us, regardless of whether or not we use drugs. HIV infects those who inject the same as those who do not; the best way to prevent its spread is to prevent its spread across all populations of people, not just those deemed more socially 'worthy.' By facing stigma head-on and by humanizing the people in our community who we serve, the Harm Reduction Action Center hopes to normalize the issue and bring the conversation about drug use and healthcare to a more practical level. As a public health agency that serves people who inject, we could get so much more done in our community without stigma."
In California, an initiative designed to increase the caps on medical malpractice awards is catching the attention not only of powerful legal and medical interests, but also drug reformers. That's because, in what opponents call a cynical ploy, the malpractice initiative leads with a provision to impose drug testing on doctors.
[image:1 align:left caption:true]Proposition 46, whose controversial ballot title is "Drug and Alcohol Testing of Doctors, Medical Negligence Lawsuits. Initiative Statute," would, if passed, make California the first state in the nation to impose drug testing on doctors. According to a Ballotpedia summary, it would:
- Increase the state's cap on non-economic damages that can be assessed in medical negligence lawsuits to over $1 million, from the current cap of $250,000.
- Require drug and alcohol testing of doctors and reporting of positive tests to the California Medical Board.
- Require the California Medical Board to suspend doctors pending investigation of positive tests and take disciplinary action if the doctor was found impaired while on duty.
- Require health care practitioners to report any doctor suspected of drug or alcohol impairment or medical negligence.
- Require health care practitioners to consult the state prescription drug history database before prescribing certain controlled substances.
The fight over Prop 46 is shaping up to be the most expensive initiative campaign ever, with rival groups having already raised nearly $70 million. The vast majority of that funding is coming from opponents of the initiative, primarily the very well-heeled state medical community. The No on 46 campaign committee alone has raised nearly $57 million to kill it.
The stakes are huge. Portrayed by supporters -- mainly trial lawyers -- as a boon to patients harmed by medical misconduct and hamstrung by state laws limiting malpractice awards, state analysts estimate that it could cost state health care programs "tens of millions to several hundred million dollars annually," while a legion of hospitals, health clinics, medical practices, and other health care professionals warn that Prop 46 would drive up health care costs across the board while primarily benefiting the bottom line of malpractice lawyers.
Law firms and attorneys' groups are the biggest backers of Prop 46, but they aren't the only ones. The advocacy group Consumer Watchdog is also backing it to the tune of more than $2 million, and has laid out some arguments in favor of it.
"According to a study published in the Journal of Patient Safety, medical negligence is the third leading cause of death in the country behind only heart disease and cancer. As many as 440,000 people die each year from preventable medical negligence. That's like a 747 crashing every 10 hours," the group said in a March flyer. "The California Medical Board estimates that almost one-in-five doctors (18%) suffer from drug and/or alcohol abuse at some point during their careers -- and leading medical safety experts have called for random drug testing to curb substance abuse and ensure patient safety."
In that same flyer, Consumer Watchdog also warned that "doctors are the biggest suppliers for chronic prescription drug abusers" and that "drug prescribed by doctors caused or contributed to nearly half of recent prescription drug overdose deaths in California." But such scary claims beg the question of who else would be expected to supply prescription drugs.
[image:2 align:right]While lawyers and some consumer advocates are lining up to support Prop 46, it is also generating a huge and powerful group of opponents, including hundreds of medical groups, health care providers, hospitals, insurance companies, and clinics and private practices worried about rising malpractice insurance costs. It is also opposed by dozens of county medical associations, the state Chamber of Commerce and many local affiliates, along with more than a dozen labor unions.
The strange bedfellow opposition extends even further, with the state Republican Party, the state American Civil Liberties Union (and its local affiliates), and the California NAACP all among groups coming out against Prop 46. Also among its foes are most of the major newspapers in the state, which have thoroughly condemned it.
"If doctors are drug-addled, other doctors and nurses have a duty to report them," the Sacramento Bee editorialized. "If doctors make horrible mistakes during surgery, there might be cause for testing. But Proposition 46 would impose the insulting requirement of random testing on all doctors who have hospital privileges, and require that the Medical Board of California discipline any doctors whose tests are dirty. In its propaganda, Consumer Watchdog jokes about privacy concerns in a lowest-common-denominator video showing that other professionals must provide urine samples. Simply because laws allow for testing of some workers doesn't mean physicians' privacy should be trampled."
The conservative San Diego Tribune was similarly irked by the use of doctor drug testing as a come-on designed to induce voters to favor the initiative, calling it "a pathetic scam" in the title of its editorial.
"Plainly, the doctor drug-testing provision is 'the ultimate sweetener' designed to make this foul brew go down better. It wasn't a critic who used that term," the newspaper noted. "It was Jamie Court, president of Consumer Watchdog, in an interview with The Los Angeles Times. Such an openly cynical attempt to manipulate voters shouldn't be rewarded. Vote no on Proposition 46."
The drug testing provision has also provoked opposition from the state's largest marijuana consumer organization, CA NORML, and the Drug Policy Forum of California, which urged supporters to vote no on Prop 46 in its 2014 Election Guide.
[image:3 align:left caption:true]"Drug testing is about marijuana," explained CA NORML head Dale Gieringer. "More than half the drug test positives out there are marijuana. This initiative deceitfully claims to be about alcohol and prescription drug abuse by doctors, but drug testing is almost useless with alcohol -- unless you're actually drunk at the time, I suppose -- and if you closely read the text of the initiative, you see that prescription drugs are perfectly excusable as long as the doctor has a prescription. So, there's a medical excuse for the prescription drugs mentioned in the ads, but not for medical marijuana, since the initiative only allows exemptions for prescribed controlled substances."
The drug testing regime proposed by the initiative is antiquated, too, Gieringer said.
"This thing is using urinalysis drug testing standards promulgated by the feds a generation ago," he pointed out. "The list of illegal drugs includes PCP -- yeah, that's a major problem, all those docs on PCP -- but doesn't include the new synthetics. And the list specifically includes marijuana metabolites, but not THC. That's because they're relying on urinalysis, which can't detect active THC, so only the inactive metabolite is being considered under this insidious proposition."
In other words, the drug tests wouldn't catch doctors with alcohol problems unless they were literally drinking on the job, would excuse the presence of prescription drugs if the doctor had a prescription, and wouldn't find doctors who were actually high on pot, but would find those who had used the substance days or weeks earlier. But it sounded good in focus groups.
"As we know, the drug testing provision was an afterthought," Gieringer said. "This is being done by trial lawyers, and the basic purpose is to heighten the limits on malpractice liability. But those focus groups showed everybody liked the idea of drug testing doctors."
The drug testing provision may indeed have been a sweetener designed to improve Prop 46's chances at the polls next month. But the well-funded and broad-based opposition campaign is taking its toll.
Although it polled well in a June Field poll, coming in with 58% support, support has declined since then. An August Field poll saw support plummet, with only 34% in favor, 37% opposed, and 29% undecided. But it isn't over until it's over. The number of undecideds less than a month out is big enough to swing the results either way.
The airwaves across California are already filled with Prop 46 campaign ads. We can only expect them to increase in the next few weeks as the deep-pocketed contenders throw everything they've got at the voters in the final days of campaigning.
As Oregon voters consider Measure 91, an initiative on the November ballot that would regulate, legalize and tax marijuana for adults 21 and older, many are looking to how similar laws are affecting Colorado and Washington. Measure 91 supporters Tuesday brought together a panel of experts from those two pioneering states to make the case that marijuana legalization is a winner, with more positives than negatives for states that have taken the step.
[image:1 align:left caption:true]Admittedly, we have not had a lot of time to judge -- Colorado began allowing legal, regulated sales only this January and the first marijuana stores in Washington didn't open until July -- but early results have been promising.
In Colorado, the state has already taken in more than $27 million in taxes and fees, with more than $5 million already allocated to building schools. At the same time, violent crime in Denver has declined by 5.2%, even as the state is set to save somewhere between $12 million and $40 million in annual criminal justice system costs, according to the Colorado Center on Law and Policy.
In Washington state, the reviews are fewer since retail stores just began operating in July (although Brookings has issued a report), but customers bought $3.2 million worth of legal weed that first month, with sales doubling to more than $6.9 million in August. More than another $6 million worth had been sold in the first three weeks of September. Tax revenues from legal marijuana sales are estimated to reach $636 million over the next five years.
But while Washington retail sales have just gotten underway, the legalization of personal possession has been the law since the beginning of 2013, and the results on that front are remarkable. According to official state court data, the number of misdemeanor marijuana charges against adults dropped dramatically, from more than 5,500 in 2012 to only 120 last year.
The experiences of Colorado and Washington show that -- if done correctly -- marijuana legalization can be a big winner for other states as well, experts and officials from the two pioneer states said Tuesday.
"People call this an experiment, but it's time to treat marijuana like the drug it is, not the drug we fear it to be," said Colorado state Rep. Jonathan Singer, who was one of only two state representatives to endorse Amendment 64. "We have to thank the people for leading; the legislature has been following," he said.
Issues remain, Singer said, but the state is dealing with them.
"Lawmakers have to ensure that we responsibly regulate edibles and concentrates, so consumers are well aware of what they're putting in their bodies. We want consumers educated," he said. The legislature has passed a bill dealing with edibles.
"The biggest issue is banking, and a bill I sponsored created first-of-a-kind cannabis credit co-ops," Singer said. "We will soon be petitioning the Federal Reserve for services with members of the industry who have formed their own co-ops. When dispensaries get robbed, it's for the cash, not the marijuana."
[image:2 align:right caption:true]"When voters decided to support Amendment 64, they did so to bring marijuana above ground in the hope that it wouldn't detrimentally impact public health and safety, and so far, it hasn't," said Art Way, Colorado state director for the Drug Policy Alliance. "The most important impact we've seen is that thousands of people are no longer being arrested for simple possession of marijuana in our state," he said.
"All marijuana offenses have declined by about 50%, and law enforcement resources have been freed up to fight violent crime," Way continued. "The state is saving millions of dollars a year in criminal justice system expenses."
For retired Denver police officer Tony Ryan, marijuana law enforcement was a distraction from more serious business.
"Chasing marijuana smokers was not at the top of my list because I needed my officers to handle calls for service," Ryan said. "We didn't have enough officers to cover calls, in part because of the distraction of doing narcotics enforcement, and when you're enforcing narcotics laws, you're mostly enforcing marijuana laws. This frees up police officers to do what they're supposed to do -- answer calls for service and work on solving crimes."
Lewis Koski is director of Marijuana Enforcement for the state of Colorado, and he said officials are keeping on top of the situation.
"We've recently been focused on how to comprehensively and effectively regulate the edibles manufacturing process," he said. "We also do licensing and monitoring of the businesses that cultivate, manufacture, transport, and sell marijuana, and our licensing process is pretty robust."
The department also runs stings to check for age compliance, he said. Increased youth access to marijuana is one of the most often heard fears of legalization foes.
"We put undercover underage individuals into the retail stores to see if they could buy anything, but what we've seen is a 100% compliance rate," he said.
While Washington hasn't had as lengthy an experience with legalized, taxed, and regulated sales as Colorado, experts and officials from the Evergreen State also said legalization was working for them.
[image:3 align:left]"We've enjoyed a successful, albeit slow, launch," said Seattle City Attorney Pete Holmes. "We did see the virtual elimination of marijuana possession arrests, which has resulted in a restoration of justice. We're no longer hounding people for the possession of marijuana in the state of Washington."
There are issues remaining, but they are soluble, Holmes said.
"One impediment is that our medical marijuana laws were in disarray after the former governor vetoed a regulation bill, and as a result, I-502 didn't touch medical at all," he noted. "The biggest unfinished business for us is how the legislature will address medical. Perhaps it will be folded into the I-502 system."
Holmes also pointed to the issue of revenue sharing, the problem of some localities opting out, and the lack -- so far -- of a legal supply adequate to put a sizeable dent in the black market.
Like his Colorado law enforcement colleague, former Seattle Police Chief Norm Stamper saw legalization as a smart move.
"It's no secret that relations between police officers and the communities they are required to serve are strained, especially with young and poor people, and marijuana enforcement is a big factor in this," Stamper argued. "A vast number of poor young people of color have been arrested over the years. With I-502, there is a major shift in law enforcement priorities. Now, police can focus on burglaries and robberies and the like, and by freeing up resources, we can also deal a serious if not fatal blow to major drug dealers. This is making a huge and positive difference."
I-502 chief proponent Alison Holcomb was brief and to the point.
"I-502 has preserved public safety, reduced the burden on police and prosecutors, and generated significant new tax resources," she said.
"We've learned a lot from Colorado and Washington, and we purposefully set up a very deliberative process," said Oregon Measure 91 campaign spokesman Anthony Johnson. "The state will have a full year to analyze what's going on there and implement what's best for Oregon. We will regulate marijuana very much like we regulate beer and wine."
But first, they have to win. Measure 91 is leading in the polls, but by no means comfortably. Getting the message out about how things have gone in Colorado and Washington should only help.