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Rollin' With the Dragon: Opioids Are Gaining Popularity in the Club Scene

Fri, 04/06/2018 - 14:34
Click here for reuse options! The electronic dance music scene is most commonly associated with Molly, but there's a new kid in town.

The club kids have found a new high. According to a new study from electronic dance music (EDM) drug use watcher Joseph Palamar, opioids are becoming increasingly popular among people in the throbbing beat scene. Nearly 10 percent of them reported using opioids in the past year, a rate 2.5 times the national average, and 5 percent reported using them in the past month.

Oxycontin was the most commonly used opioid in the EDM scene, followed by Vicodin, Percocet, codeine, and Purple Drank (also known as Sizzurp or Leans), which also contains codeine.

In the study, researchers surveyed nearly 1,000 fans (ages 18-40) as they were about to enter EDM parties at nightclubs and festivals in New York City. Attendees were asked about their nonmedical use of 18 different opioids, from prescription pain pills to black market heroin and fentanyl.

The EDM scene has long been known for drug use, but the researchers warn that the turn to opioids is a dangerous trend that should not be ignored.

"We've always known that electronic dance music party attendees are at high risk for use of club drugs such as ecstasy or Molly, but we wanted to know the extent of opioid use in this population," said Palamar, the study's lead author and an associate professor of population health at NYU School of Medicine. 

The most popular prescription opioid reported in this scene was Oxycontin, which, like many prescription opioids, is used to relieve pain, but also produces euphoric effects, inducing relaxation and happiness. Following close behind were Vicodin, Percocet, codeine, and Purple Drank. About 15 percent of opioid users reported snorting them, while 11 percent reported injecting them, both forms of ingestion more likely to result in dependence.

People who had already used opioids reported a much higher propensity for using them again than did people who had never used them. Among previous users, nearly three-quarters (73.4 percent) said they would do them again, while only about 6 percent of non-users said they would try them if offered.

"This population of experienced drug users needs to be reached to prevent initiation and continued use, which can lead to riskier and more frequent use, dependence, and deleterious outcomes such as overdose—particularly if opioids are combined with other drugs," Palamar warned. "Many individuals in this population are experienced with drugs such as ecstasy, but due to their experience with various drugs, they may underestimate the addictive potential of opioids, which are typically not used as 'club drugs,'" Palamar added.

The study comes as the U.S. finds itself in the midst of an opioid crisis where nearly two million people are dependent and more than a hundred are dying of overdoses every day.

"The population in general needs better education about opioids," said Palamar. "Taking opioid pills is much different from taking ecstasy and it needs to be understood that opioids are not party drugs."

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Crusading Christian DA Indicted for Trading Light Sentences for Sexual Favors from Women Drug Dealers

Fri, 04/06/2018 - 10:30
Thou shalt not abuse thy post for perverted personal pleasure, hypocrite.

A Christian prosecutor who regularly boasted of waging culture wars against liberals resigned this week amid allegations that he gave women drug dealers lighter sentences in exchange for sexual favors.

The Pittsburgh Post-Gazette reports that Bedford County District Attorney William Higgins stepped down from his position after he was charged by a grand jury of offering female convicts leniency if they met his sexual demands.

Per the Post-Gazette, the Pennsylvania Attorney General’s Office charged Higgins with “obstructing administration of law or other governmental function, official oppression, recklessly endangering another person, intimidation of witnesses or victims and hindering apprehension or prosecution.”

“District Attorney Higgins traded his power and law enforcement authority for sexual favors and violated his oath to the people of Bedford County — compromising the security of his community and the safety of confidential informants,” state Attorney General Josh Shapiro said in a statement on the grand jury indictment.

As Patheos notes, Higgins in the past has not been shy about being a pro-Christian culture warrior, and has in the past boasted about being attacked by the American Civil Liberties Union.

“I guess I should take solace in the fact that the liberals are mad at me – again,” he said in 2014 regarding the case of a 14-year-old accused of desecrating a statue of Jesus. “If that tends to upset the ‘anti-Christian, ban-school-prayer, war-on-Christmas, oppose-display-of-Ten-Commandments’ crowd, I make no apologies.”


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MS 13 is a Street Gang, Not a Drug Cartel--And the Difference Matters

Fri, 04/06/2018 - 10:13
The U.S. could best fight MS 13 by better protecting vulnerable Latino kids who become its members, but instead Trump uses it as a political foil.

In October 2017, Attorney General Jeff Sessions announced that pursuing the Mara Salvatrucha, a Salvadoran gang also known as MS-13, was “a priority for our Organized Crime Drug Enforcement Task Forces.”

“Drugs are killing more Americans than ever before, in large part thanks to powerful cartels and international gangs and deadly new synthetic opioids like fentanyl,” Sessions told the International Association of Chiefs of Police on Oct. 23. He concluded that “perhaps the most brutal of these gangs is MS-13.”

President Donald Trump also cites MS-13 to justify his administration’s crackdown on illegal immigration from Latin America. In his 2018 State of the Union address, Trump threatened to “destroy” the group, which is responsible for a spate of brutal, high-profile murders in Boston, Long IslandVirginia and beyond.

There’s a problem here – and it’s not just MS-13’s violent ethos. It’s that the Trump administration is getting this gang all wrong.

I spent three years at American University’s Center for Latin American and Latino Studieschronicling the MS-13’s criminal exploits for the National Institute of Justice. Our studyproves that MS-13 is neither a drug cartel nor was it born of illegal immigration.

That misconception is fueling failed U.S. policies that, in my assessment, will do little to deter MS-13.

MS-13 is no Yakuza

The Trump administration is not the first administration to mischaracterize MS-13, which conducts vicious but rudimentary criminal activities like extortion, armed robbery and murder across Central America, Mexico and the U.S.

In 2012, the Obama-era Treasury Department put the group on a organized crime “kingpin” list with the Italian mafia Camorra, the Mexican criminal group the Zetas and the Japanese mob known as the Yakuza.

That designation gave the group a rarefied status in the underworld, which must have pleased its leadership.

But our research found that MS-13 is hardly a lucrative network of criminal masterminds. Instead, it is a loose coalition of young, often formerly incarcerated men operating hand to mouth across a vast geographic territory.

MS-13 was born in Los Angeles in the early 1980s, when scores of Salvadorans, many of them fleeing the country’s civil war, arrived to California. Like other Latino immigrant groups, the new arrivals formed a youth gang of the sort proliferating in L.A. at the time.

Then as now, MS-13 acted as a surrogate family for its members, though not a benign one. MS-13 created a collective identity that was constructed and reinforced by shared experiences, particularly expressions of violence and social control.

It has since spread to at least a half-dozen countries on two continents and has become a prime source of destabilizing violence, particularly extortion, in Central American countries like El Salvador and Honduras.

Inept at drug dealing

What MS-13 has not done is establish any real foothold in the international drug trafficking market.

It’s not for lack of trying. Our study found that MS-13 leaders have made several attempts to get into the business of running illicit drugs.

In the early 2000s, one MS-13 boss named Nelson Comandari tried to use the gang’s national criminal infrastructure to establish a drug distribution network. Comandari was well positioned to do it. He was powerful in L.A., had underworld family connections from El Salvador to Colombia and enjoyed strong ties to the feared Mexican Mafia, a U.S.-based prison gang with connections to Mexican cartels.

Yet within a few years Comandari was frustrated. MS-13 members turned out to be inept at drug smuggling and resistant to the whole idea. Our research found that the gang frowns upon those who put their personal business above the collective’s.

Comandari eventually went into the drug business on his own and was captured along the Texas-Mexico border in 2006.

A few years later, one of Comandari’s former lieutenants also tried to establish an international distribution pipeline between MS-13 and the Mexican drug cartel La Familia. The deal was thwarted by U.S. law enforcement in 2013.

Subsequent efforts have gotten nipped even sooner. In 2015, a midlevel MS-13 leader named Larry Naverete – spelled Navarrete in some federal documents – began smuggling small loads of methamphetamine into the U.S. via an MS-13 member operating from Tijuana.

Within two years, police on each side of the border had captured Navarete, who was operating from the California State Prison System, and his Mexican partner.

Why MS-13 fails at drug trafficking

One reason MS-13 has failed so roundly at becoming a drug cartel is that it is more of a social club than a lucrative criminal enterprise. Its members benefit from the camaraderie and support that comes with membership – not the heaping monetary rewards that never arrive.

Entrepreneurs who hope to leverage its network for their personal financial gain see the same strong resistance that scuttled Comandari’s plans.

Perhaps more critically, MS-13 is a decentralized organization with no clear hierarchy. The gang is broken into local cells called “cliques” – or “clicas” in Spanish – that are more loyal to each other than to the various leadership councils that operate around Central America and the U.S.

Put simply, it has no leader. So what looks on paper like a tremendous built-in infrastructure for moving illicit products across borders is actually a disparate, federalized organization of substructures with highly local, even competing, interests.

Finally, MS-13 is mostly about immediate gratification. It helps members eke out a living and get some perilous criminal thrills. That’s why extortion is a staple. Complex supply chains? Not so much.

Failed US policies

These findings suggest that the U.S. could fight MS-13 by better protecting the vulnerable young Latino kids who become its recruits – funding social and educational programs in immigrant neighborhoods, for example, or financing more early child intervention programs.

Instead, the Trump administration has used MS-13 as a foil to push its political agenda.

To justify imposing draconian immigration restrictions, Trump and Sessions link MS-13’s crimes to the issue of illegal immigration. Their rhetoric suggests that the group is staffed with undocumented migrants, thus proving that migrants are dangerous. In fact, statistics confirm that immigrants commit crimes at far lower rates than native-born U.S. citizens.

Conflating the gang with the sophisticated cartels currently waging a bloody war in Mexico likewise serves the administration’s goal of tightening border controls. It makes MS-13 seem like a foreign invader, not a homegrown threat. I suspect this rhetoric may also help Trump make the case that the U.S. should impose longer jail sentences for drug trafficking-related crimes.

What harsh law enforcement tactics aimed at ending immigration and breaking up drug cartels won’t do is address the real problems posed by MS-13 and other very violent, very American street gangs.


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New Momentum for Addiction Treatment Behind Bars

Thu, 04/05/2018 - 10:26
Can medication assisted treatment--otherwise known as opioid maintenance therapy--win broader acceptance from prison officials?

This story is part of an occasional series on the opioid crisis.

From the moment they are arrested, people with an addiction to heroin and prescription painkillers and those who are taking medications to beat their addictions face the prospect of painful opioid withdrawal.

At least a quarter of the people in U.S. prisons and jails are addicted to opioids. Those who are released rejoin their communities with dangerously reduced tolerance and nothing to blunt their drug cravings, making them highly susceptible to a deadly overdose.

But new scientific evidence and a recently announced federal investigation may soften prison officials’ long-held opposition to medication-assisted treatment.

Rhode Island is the only state that provides all three FDA-approved addiction medications, methadone, buprenorphine and a long-acting, injectable form of naltrexone known as Vivitrol, to all inmates. A recent study in the medical journal JAMA Psychiatry found that opioid overdose deaths dropped by nearly two-thirdsamong recently incarcerated people in the first year of a new program that screens and provides addiction medicines to all state inmates.

According to the study by Brown University researchers, the program not only reduces overdose deaths after the inmates are released, but also increases the likelihood they will stay in treatment and avoid getting arrested again.

Meanwhile in Massachusetts, which doesn’t provide methadone or buprenorphine to inmates, the U.S. Department of Justice is investigating whether corrections officials are violating the Americans with Disabilities Act by forcing inmates who were taking those addiction medicines when they entered prison to stop taking them while incarcerated.

Massachusetts lawmakers are considering a corrections bill that would require the state’s prisons and jails to offer all three FDA-approved medications.

A similar proposal is advancing in Connecticut, which has provided methadone to some inmates in some jails for six years. The bill there would expand the program to all medications for all inmates.  

And at the federal level, President Donald Trump promised last month to screen every federal inmate — roughly 180,000 people — for opioid addiction and provide Vivitrol in residential treatment centers prior to release. Trump also called for more federal support for state, local and tribal drug courts to help provide “evidence-based treatment as an alternative to or in conjunction with incarceration, or as a condition of supervised release.”

Opposition Within

Fewer than 1 percent of the more than 5,000 U.S. prisons and jails, housing more than 2 million inmates, allow access to the FDA-approved medication, even though medical societies, addiction experts and correctional health organizations support their use.

Finding the money to fund correctional drug treatment programs is a challenge in many states. But research shows that the cost of providing addiction medications in correctional facilities is outweighed over time by savings in both future health care and incarceration costs.

“In fact, not treating inmates with the community standard of care for addiction should be considered a violation of the U.S. Constitution’s Eighth Amendment prohibition on cruel and unusual punishment,” said Josiah Rich, a Brown University professor of medicine and epidemiology who coauthored the recent study of Rhode Island’s treatment program.

Standing in the way are sheriffs and other prison officials, who argue that allowing treatment inside prisons with methadone or buprenorphine — both narcotics that can be abused — will lead to the drugs being diverted within the prison and possibly to illicit street markets.

In Barnstable County, Massachusetts, for example, Sheriff James Cummings said he would not allow buprenorphine to be dispensed in his jail because it is considered contraband.

“We ruled out buprenorphine because it doesn’t work for the people we deal with,” Cummings said. “Inmates try to smuggle it into the facility every day. It’s a narcotic. They use it until they can get their next heroin fix so they don’t get sick and they sell it to get money to buy more heroin. It’s not a good fit.”

Instead, Barnstable in 2012 added Vivitrol to its re-entry program for opioid-addicted inmates who are scheduled to leave within the next two weeks. Cummings said the program has reduced overdose deaths and repeat offenses.

In general, Vivitrol is an easier sell in most prisons and jails, said Andrew Klein, who runs a Justice Department program aimed at getting more drug treatment into correctional facilities. But it’s not the best medication for everyone, he said.

In fact, nearly all corrections officials reject the use of either methadone or buprenorphine behind prison walls. That’s despite a history of research showing both medicines are highly effective at eliminating cravings, preventing overdoses and keeping people in recovery from opioid addiction.

Methadone has been used for addiction treatment almost exclusively in highly regulated clinics since its introduction in 1964. Buprenorphine has been available by prescription since 2002.

A Missed Opportunity

At least 1 in 5 incarcerated people are imprisoned because of drug charges, but in many states, even more inmates are addicted to heroin and other opioids.

In Connecticut, for example, at least 30 percent of the state’s 14,000 inmates are addicted to opioids, according to Kathleen Maurer, the medical director for the state’s corrections department.

Nationwide, a quarter of heroin addicts pass through the corrections system each year, according to a study in the Journal for Opioid Management.

This presents a huge opportunity to quell the opioid epidemic and prevent thousands of overdose deaths. Cut off from their drug supply, inmates are more likely to opt for addiction medications than people who haven’t been incarcerated, particularly when the medications can help them avoid painful withdrawal symptoms, according to Rich.

In addition, providing the medications and ensuring compliance should be much easier in the controlled environment of prisons and jails, said Dr. Kevin Fiscella, an addiction specialist who advises the National Commission on Correctional Health Care, which accredits prison health programs. “There is no better place to intervene in an individual’s addiction than in corrections.”

Yet very few correctional facilities offer it.

Methadone, the oldest and most researched addiction medication, is available in only 22 of the nation’s 3,300 local jails and even fewer of its prisons, according to Klein.

Five states — Hawaii, New Jersey, New York, Vermont and Washington — offer both methadone and buprenorphine to some inmates at one or more prisons or jails. Only Rhode Island offers all three medications to all inmates in all of its prisons and jails.

And in about 200 jails in about 40 states, naltrexone is offered to inmates who are close to being released, under programs primarily sponsored by its manufacturer, according to Klein.

The online news site Vox recently published original research showing that a smaller number of states offer naltrexone in their prisons.

Under an executive order issued by Democratic Gov. Gina Raimondo in 2016, the state not only continues medications for those who enter incarceration on an addiction drug, but also offers medication to prisoners who, after a substance abuse screening at intake, are deemed to need it. Rhode Island is spending $2 million annually on the program.

According to Traci Green, the lead author of the Rhode Island study and an adjunct professor of epidemiology at Brown University, “The great hope is that we can take what we’ve learned in prisons and jails and transplant it to other places in the community such as hospital emergency departments, where we’re also touching the lives of people who use drugs.”

“The good news for other states,” she said, “is that what we’ve done here is entirely replicable.”

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A Beginner's Guide To Reading Marijuana Labels

Thu, 04/05/2018 - 10:13
The plant has never been more accessible, so read up.

Marijuana is now legal in a manner similar to beer in a number of states. Because of this, millions of residents and tourists, alike, now have the luxury of walking into a dispensary and buying pot products never before seen in circles of black market commerce.


But legal marijuana, while a serious mega-industry that stands to change the world, is still a bit of a novelty for the moment. People often rush to dispensaries with bright eyes and purchase a variety of items without properly understanding how to use them.

Unfortunately, this lack of knowledge has caused some folks to get a little too stoned for their own good and, in a state of high anxiety, even seek out the counsel of police and emergency room staff. And let’s face it – any situation involving cops and doctors is never a good time.

Yet, bad trips can be avoided relatively easily. The secret is in labeling comprehension. Here are a few tips, according to Green State.

Flower Potency

Not all marijuana is created equal. Some of the hundreds of strains available on the market have a higher THC content than others. Think of it like walking into a liquor store. It is common knowledge by now that whiskey has a higher alcohol content than beer. These two products must be enjoyed in very different ways, or else the effects can be severe. Weed, while much safer than alcohol, is not much different. Most strains have anywhere between 5-25 percent THC. The lower the number, the less stoned effects can be expected. Most customers reach for the strain with the highest THC level that they can get. But without the proper tolerance, they have the potential to drive people over the edge of comfortability. For beginers, starting slow is recommended.

Cannabidiol (CBD) Shouldn’t Be Ignored

Marijuana rich in CBD is often bypassed because the cannabinoid does not produce stoned effects. But this all-important ingredient has a way of taming the effects of THC. Its therapeutic benefits can alleviate the anxiety often brought about from too much THC. First time marijuana users can achieve a more pleasurable experiencing from strains high in CBD.


Some pot products display THC:CBD ratio. This aspect of pot labeling is easier to translate than it sounds. Here’s the rub: The higher the THC content, the stronger the buzz.

Sativa Vs. Indica

Sativa and Indica strains are like Jekyll and Hyde. Sativa’s produce a more uplifting buzz, while Indica’s are soothing and mellow. For the marijuana consumer looking to spawn creativity, productivity or a steady stream of laughter, Sativa is the way to go. People interested in a relaxing night at home might enjoy Indica-dominant strains the best.

Edibles Are No Joke

Cannabis edibles are one of the most popular products sold in dispensaries. But they are also the leading reason why some inexperienced pot consumers end up freaking out and calling 911. Although marijuana cannot cause a fatal overdose, it can sometimes be difficult to convince a person of this once they start to feel the intense effects of 100-milligrams of THC. But most of these products are not intended to be consumed all at once. Anything with 100 milligrams of THC should be broken up. Newcomers to the edible scene should start with no more than 10 milligrams at a time. Also, the effects from edibles take longer to kick in than smoking marijuana. So give it 45 minutes or so before eating another 10-milligram dose.

Warning Labels

Pay attention to the warning labels. Although a lot of fun, these products should be respected.


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Maybe White People Shouldn't Take Drugs From Indigenous Cultures

Wed, 04/04/2018 - 13:18
Click here for reuse options! Ayahuasca and peyote are more popular than ever, but think twice before trying them.

White people love to try drugs from other cultures. Just think of the scene in Zoolander when Hansel recounts a story to Derek about hallucinating that he’s falling off a mountain, and suddenly remembers he’s been “smoking peyote for six straight days.” Other iconic white guys in cinema have famously partaken: Tony Soprano, the stars of “Young Guns.” Ben Stiller experiments with ayahuasca in While We’re Young in an attempt to spice up his love life with his wife. There are enough examples of these scenes to say there is a trope in television and film of sending a reserved character on a spiritual awakening by having them experiment with psychedelic drugs. In other cases, it is a way to solidify a character’s New Age kookiness, as in the case of Hansel or Lily Tomlin’s character in Netflix’s “Grace and Frankie.” But while these scenes can be humorous, they also normalize and publicize the use of drugs that white people arguably don’t have a right to. 

Ayahuasca is one such drug that’s been particularly in vogue among white people lately; so much so that the New Yorker dubbed it the "drug of choice for the age of kale.” The hallucinogenic tea is traditionally brewed by the native groups of the Amazon rainforest for medicinal and shamanic purposes. Tribes in several Brazilian religions drink it as a spiritual rite. While some hipsters cook it up in their Bushwick kitchenettes, traditionalists insist that the drug only be tested in its native South America. Often when white characters in movies and television shows take ayahuasca or peyote, the medicinal and spiritual context is left out, perpetuating false beliefs about why indigenous communities use them to begin with.

Drug use can certainly fit into contemporary definitions of cultural appropriation, which is legally defined as "taking intellectual property, traditional knowledge, cultural expressions, or artifacts from someone else's culture without permission," Susan Scafidi, the author of Who Owns Culture? Appropriation and Authenticity in American Law, told Jezebel, "This can include unauthorized use of another culture's dance, dress, music, language, folklore, cuisine, traditional medicine, religious symbols, etc. It's most likely to be harmful when the source community is a minority group that has been oppressed or exploited in other ways or when the object of appropriation is particularly sensitive, e.g. sacred objects."

Note Scafidi’s definition includes “traditional medicine." Of course, not all non-native people who take ayahuasca take the drug purely for recreational purposes; some want to pay homage to indigenous wisdom. But really, how many could that be, compared to those who simply want to follow in Jennifer Aniston’s footsteps?

Whatever their intent, the appropriation of ayahuasca has negatively impacted the economies of the communities they come from, particularly when tourists travel to pursue psychedelic drugs. In 2016, Vice reported on the impact of the ayahuasca craze in the Amazon, where community experts say it has commodified the practice in a way that cheapens the actual spiritual practice of ayahuasca. “As ayahuasca has become more and more popular with foreign tourists….we have found that pseudo shamans have sprung up everywhere to cater for the demand," Valerie Meikle, a Reiki master and holistic healer, told Vice. "This means that the ayahuasca rituals have obviously lost some of their original power and very often the ceremony is adapted to suit foreigners who are ready to pay high prices on low-quality rituals." The overall impact cheapens the very practice these tourists seek.

Peyote has also been appropriated by white drug enthusiasts in regions of Mexico. Vice writes: “Under Mexican law only the Wixárika can consume peyote, but New Age enthusiasts are eagerly simulating this experience by partaking in an illicit peyote-based tourist trap booming in nearby Real de Catorce. The dusty former ghost town is brimming with non-indigenous fixers offering tourists peyote and a place to trip. For the Wixárika, the trend adds insult to injury. ‘We’re upset that people come here and steal peyote because for us it’s a deity, not a drug,' [local representative Aukwe] Mijarez told Vice. 'It’s part of our identity and we respect it.'”

As more white tourists flock to these regions to take from local cultural practices, progressive organizations are increasingly vocal about protecting them. “We advise people to be very cautious about non-Indigenous controlled establishments that have anything to do with Indigenous peoples, their lands, cultures, and resources, period,” Agnes Portalewska, communications manager of Cultural Survival, a nonprofit that seeks to advance indigenous peoples’ rights worldwide, told AlterNet. “Ayahuasca, peyote, etc. are spiritual and cultural practices that are rooted in specific cultures and should not be commercialized and exploited, but protected as private community sacred practices."

“Cultural appropriation is a huge problem when it comes to Indigenous cultures, and especially spirituality," she added. "A huge part of this spiritual tourism is that the practice is taken out of context, exploited and commercialized.”

Some drugs have been so appropriated into white circles, we’ve forgotten we took them from other cultures in the first place. Psychedelic mushrooms grow across all continents, but became popular after Valentina and R. Gordon Wasson, a J.P. Morgan banker and his wife, wrote in Life Magazine in 1957 about their experience participating in an indigenous mushroom ceremony in Oaxaca, Mexico. Inspired by their account, Timothy Leary, the father of the psychedelic drug movement, traveled to Mexico to experience psilocybin mushrooms for himself, inspiring generations of hippies and drug enthusiasts to seek the far-out experience as well. Now you can find shrooms in the fanny pack of nearly any festival-goer at Coachella.

White people’s drug usage in general is filled with hypocrisies beyond the realm of cultural appropriation. Just look to the current irony of marijuana in the U.S.: while white men dominate the burgeoning legal industry, making millions in profits, black and brown people are still disproportionately punished for possessing and selling it.

Our increasingly globalized world means white people will continue to seek out things that do not belong to them, so to suggest we shouldn't appropriate drugs from other cultures is pretty futile. The only possible solution is the same one that’s been proposed for repairing acts of cultural appropriation in music, fashion and food: we need to pay proper tribute to the culture the practice comes from, honor its history and do everything possible to financially compensate the community from which it came.  

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The Science Can No Longer Be Ignored: Legal Cannabis Access Reduces Opioid Abuse and Mortality

Wed, 04/04/2018 - 12:51
Click here for reuse options! For many patients, cannabis offers a viable alternative to opioids.

Scientific data is growing exponentially in support of the notion that legalized cannabis access can significantly mitigate opioid use and abuse.

On Monday, the esteemed Journal of the American Medical Association, Internal Medicine published a pair of persuasive new studies reinforcing this opinion.

In the first study, investigators from the University of Kentucky and Emory University assessed the relationship between medical and adult-use marijuana laws and opioid prescribing patterns among Medicaid enrollees nationwide. Enrollees included all Medicaid fee-for-service and managed care enrollees—a high-risk population for chronic pain, opioid use disorder, and opioid overdose.

Researchers reported that the enactment of both medicalization and adult-use laws were both associated with reductions in opioid prescribing rates, with broader legalization policies associated with the greatest rates of decline.

“State implementation of medical marijuana laws was associated with a 5.88 percent lower rate of opioid prescribing. Moreover, the implementation of adult-use marijuana laws, which all occurred in states with existing medical marijuana laws, was associated with a 6.38 percent lower rate of opioid prescribing,” they concluded. “[T]he further reductions in opioid prescribing associated with the newly implemented adult-use marijuana laws suggest that there were individuals beyond the reach of medical marijuana laws who may also benefit from using marijuana in lieu of opioids. Our finding that the lower opioid prescribing rates associated with adult-use marijuana laws were pronounced in Schedule II opioids further suggest that reaching these individuals may have greater potential to reduce the adverse consequences, such as opioid use disorder and overdose.”

In the second study, University of Georgia researchers evaluated the association between the enactment of medical cannabis access laws and opioid prescribing trends among those eligible for Medicare Part D prescription drug coverage. Researchers reported that medicalization, and specifically the establishment of brick-and-mortar cannabis dispensing facilities, correlated with significantly reduced opioid prescription drug use.

“This longitudinal analysis of Medicare Part D found that prescriptions filled for all opioids decreased by 2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law. Prescriptions for all opioids decreased by 3.742 million daily doses per year when medical cannabis dispensaries opened,” they concluded. “Combined with previously published studies suggesting cannabis laws are associated with lower opioid mortality, these findings further strengthen arguments in favor of considering medical applications of cannabis as one tool in the policy arsenal that can be used to diminish the harm of prescription opioids.”

The new findings should come as little surprise to those paying attention. State-specific data from cannabis-access jurisdictions have consistently established that in regions where medical cannabis access is permitted, patients routinely decrease their opioid intake. For instance, according to data published last month by the Minnesota Department of Health, among patients known to be taking opiate painkillers upon their enrollment into the program, 63 percent “were able to reduce or eliminate opioid usage after six months.”

Minnesota’s findings are hardly unique. 2016 data gathered from patients enrolled in Michigan’s cannabis access program reported that marijuana treatment “was associated with a 64 percent decrease in opioid use, decreased number and side effects of medications, and an improved quality of life.” A review of state-registered patients from various northeastern states yielded similar results, finding 77 percent of respondents acknowledged having reduced their use of opioids following cannabis therapy. A significant percentage of respondents also reported decreasing their consumption of anti-anxiety medications (72 percent), migraine-related medications (67 percent), sleep aids (65 percent), and antidepressants (38 percent).

A 2017 assessment of medical cannabis patients in Illinois revealed that participants in the state-run program frequently reported using marijuana "as an alternative to other medications—most commonly opioids, but also anticonvulsants, anti-inflammatories, and over-the-counter analgesics." New Mexico patient data reports: compared to non-users, medical cannabis enrollees "were more likely either to reduce daily opioid prescription dosages between the beginning and end of the sample period (83.8 percent versus 44.8 percent) or to cease filling opioid prescriptions altogether (40.5 percent versus 3.4 percent)."

Two just-published clinical trials from Israel (where medical cannabis use is legally permitted) further affirm this phenomenon. In the first study, which assessed cannabis use among the elderly, investigators reported that over 18 percent of the study's participants "stopped using opioid analgesics or reduced their dose.” They concluded, "Cannabis can decrease the use of other prescription medicines, including opioids." In the second trial, which assessed the safety and efficacy of cannabis in a cohort of over 1,200 cancer patients over a six-month period, scientists reported that nearly half of respondents reported either decreasing or eliminating their use of opioids during treatment.

Another recently published clinical trial provides insight into explaining the physiology behind this relationship. Investigators from Columbia University assessed the efficacy of low doses of inhaled cannabis and sub-therapeutic doses of oxycodone on experimentally-induced pain in a double-blind, placebo-controlled model. Researchers assessed subjects’ pain tolerance after receiving both substances separately or in concert with one another. While neither the administration of cannabis nor oxycodone alone significantly mitigated subjects’ pain, the combined administration of both drugs did so effectively.

Authors determined, “Both active cannabis and a low dose of oxycodone (2.5 mg) were sub-therapeutic, failing to elicit analgesia on their own; however, when administered together, pain responses … were significantly reduced, pointing to the opioid-sparing effects of cannabis.” They concluded, “Smoked cannabis combined with an ineffective analgesic dose of oxycodone produced analgesia comparable to an effective opioid analgesic dose without significantly increasing cannabis’s abuse liability.”

Growing evidence also indicates that patients’ alternative use of cannabis is associated with declining percentages of opioid-induced mortality among adults residing in legal access states. Data published in 2017 in the American Journal of Public Health reported that adult use marijuana sales in Colorado were linked with a 6.5 percent decrease in monthly opioid deaths. A 2014 study published by a team of investigators from the University of Pennsylvania and the Johns Hopkins Bloomberg School of Public Health in Baltimore reported an even stronger correlation. They determined, “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.” A 2015 examination by investigators at the RAND Corporation similarly determined, “[S]tates permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.” A follow-up paper published by these same researchers in February further acknowledged, “[M]edical marijuana laws reduce the misuse of prescription opioids, as reflected in treatment admissions and overdose deaths, primarily through the allowance and opening of dispensaries.”

Despite claims to the contrary from the Trump administration, the available data is consistent and clear. For many patients, cannabis offers a viable alternative to opioids. It is time for the administration to stop placing political ideology above the health and safety of the American public, and to acknowledge the well-established efficacy of medical marijuana in the treatment of chronic pain.

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Watch: New Jersey Cops Grab Man's Genitals in Search of Marijuana

Wed, 04/04/2018 - 11:28
They didn't find any weed, so they gave him a ticket for tailgating. Now he's suing.



Police Grab Man's Genitals in Search of Marijuana

A newly released bodycam video shows New Jersey State Police officers sticking their hands down a driver’s pants during a traffic stop after claiming they smelled marijuana on his person. Jack Levine ...

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Pizza, Pad Thai and Pot: Home Delivery of Marijuana Is Legal in These States

Tue, 04/03/2018 - 10:23
Colorado isn't one of them. Sorry, Denver.

This story is part of an occasional series on marijuana laws in the states.

It’s been legal to buy small amounts of marijuana in Colorado for over four years. But consumers can’t order buds, edibles or the marijuana concentrate called “shatter” through the mail — that’s illegal under federal law. And they can’t have weed delivered to their doorstep, like a pizza or an order of pad thai.

Lawmakers in Colorado and other states that pioneered recreational marijuana legalization have been reluctant to allow home delivery, even in an era when consumers are used to getting everything from diamond rings to toilet paper delivered.

Supporters say delivery makes it easier for medical marijuana patients to get their medicine, helps licensed marijuana businesses compete with the black market, and could reduce drugged driving. Opponents say delivery could make it easier for kids to buy drugs and could turn delivery cars into targets for thieves.

Skeptics also say launching a risky service could attract unwanted federal attention. Denver is concerned that marijuana delivery could cause additional safety issues and draw federal scrutiny, according to a statement from Eric Escudero, communications director for the city’s Department of Excises and Licenses. Earlier this year, U.S. Attorney General Jeff Sessions rescinded Obama-era guidance that had told federal prosecutors not to target marijuana businesses that are licensed and regulated.

Colorado legislators last year rejected language in a bill that would have legalized marijuana delivery. Now they’re considering a pilot program instead. Democratic state Rep. Jonathan Singer, a sponsor of both bills, said the earlier proposal failed because it went too far, too fast, for some of his colleagues. The current bill is “a slow step in the right direction,” he said.

Colorado, Washington state, Alaska and Washington, D.C., don’t allow home delivery of marijuana. Oregon, California and Nevada do, but services are not universal. In Oregon, state data shows that close to two-thirds of counties have a dispensary licensed to make recreational marijuana deliveries. In California, marijuana industry advocates say that less than a third of cities and counties in the state allow retail marijuana sales, which could include home delivery.  

But illegal and quasi-legal delivery businesses are widespread regardless of the law.

Washington, D.C., for instance, allows cannabis possession but not sales. So businesses, including delivery companies, are selling overpriced stickers, cookies, and cold-pressed juice with a gift of cannabis thrown in. “At Juiced, we make sure that all our products make an impact that will enhance your spirit and your mood:),” says one such company’s website, with a coy smiley face emoji.

Safety, Diversion Concerns

In Colorado, opponents of legalizing home delivery include law enforcement, county officials, the city of Denver and Democratic Gov. John Hickenlooper.

“That notion of having a delivery person go around house to house and dropping off potentially significant amounts of marijuana — any amount of marijuana — I think we look at that as just a hazard,” Hickenlooper told the Cannabist, a website of the Denver Post, last spring when the Legislature was considering legalizing home delivery statewide.

“And if we’re really serious about keeping marijuana out of the hands of teenagers,” he said, “delivery service offers more opportunity for that marijuana to get into the hands of kids.”

Home delivery could also bring marijuana sales into counties that don’t allow such sales, said Eric Bergman, policy director at Colorado Counties Inc., a membership association for county officials. More than half of the state’s counties prohibit marijuana businesses within their jurisdiction, according to state data. Some cities within those counties’ borders do allow marijuana businesses to operate.

Marijuana businesses, meanwhile, are lobbying for a change in the law. Advocates for a San Francisco-based marijuana delivery startup called Eaze, which some have called “Uber for weed,” have told Colorado lawmakers that technology can help allay some of their concerns.

For instance, the Eaze app blocks orders to places where delivery isn’t allowed. “Eaze has a whole team of people that monitors, is it legal in that city? Is it legal in that ZIP code?” said Elizabeth Conway, principal at Gide LLC, a firm that lobbies for cannabis and tech companies.

Not all cities oppose permitting marijuana delivery. Seattle Mayor Ed Murray, a Democrat, argued that allowing delivery would help licensed businesses compete with the black market, potentially driving out illegal businesses. A supplemental budget bill currently on Democratic Washington state Gov. Jay Inslee’s desk would require regulators to study home delivery of medical marijuana.

Local Control

States that do allow marijuana home delivery don’t allow just anyone to drive around with weed for sale. Oregon’s rules address when pot can be delivered (8 a.m. to 9 p.m.), where (only houses and apartments in the locality where the retailer is licensed), how often (one delivery per person per day), and to whom (adults over 21), for instance. Drivers can’t take more than $3,000 worth of weed products “out for delivery” at one time.

California’s long list of rules includes a requirement that delivery vehicles be outfitted with a GPS tracking system and prohibits “unmanned vehicles” such as autonomous cars from delivering weed.

Cities and counties in both states can opt out of allowing delivery or set more stringent rules, adding further complication.

For instance, just 12 of the 88 cities in Los Angeles County are planning to regulate cannabis, said Joe Nicchitta, the countywide coordinator for the Los Angeles County Office of Cannabis Management. Some areas want to allow retail storefronts but not delivery services, some want to allow delivery but not storefronts, and some want both.

“The concern is that there will be a race to the bottom,” he said, where delivery businesses will “locate in the area with the most lax regulations and then deliver all over the county.”

For businesses, the biggest concern isn’t what they need to do to get licensed but whether localities will allow them to operate at all, said Max Mikalonis, legislative advocate for the California Cannabis Delivery Association. “There are huge swaths of the state that cannot legally be delivered to.”

Mikalonis is among the lobbyists pushing for a state Senate bill that would stop localities from banning marijuana delivery services. Right now, it can take hours for business owners to figure out, city by city, what addresses they’re allowed to serve, he said, adding that allowing delivery would help medical marijuana patients and bolster the legal market.

In recent years several California marijuana delivery drivers have been robbed, some at gunpoint. Such incidents have been cited by Colorado law enforcement groups in their arguments against allowing delivery services there.   

Sgt. David Woolsey, who works for the division of marijuana control at the San Jose Police Department, said that since the city began allowing marijuana home delivery last year, there’s only been one such incident, a burglary of a delivery driver’s car (the driver was not hurt). Robberies and homicides that involve black market delivery businesses are probably more common, he said, but it’s hard to say for sure because the black market is hard to track.

Nine businesses in the San Jose area are currently licensed and offering delivery, he said. “The problem is there are 35 or 40 illegal delivery services active in our area.” Some unlicensed businesses have their own websites, others post to Craigslist, Facebook and other social media sites, he said.

It’s difficult for law enforcement to track down illegal businesses that advertise online, Woolsey said, because they often don’t have an obvious location.

He said city officials decided to allow home delivery because they wanted to push consumers to buy their weed legally. The legal market is governed by rules and regulations that keep consumers, employees and businesses safe, he said. 

Consumers can be blissfully unaware that “legal marijuana” doesn’t mean all methods of purchase, anywhere, are allowed, officials and industry insiders say. Both Nicchitta and Woolsey said their teams want to help consumers better identify which cannabis businesses are legal. 

In Nevada, Ben Sillitoe, CEO of Oasis Cannabis, a licensed dispensary close to the Las Vegas Strip, said his employees have been making regular deliveries of cannabis since 2016 with few hiccups. Fifteen percent of the store’s cannabis sales come from deliveries, he said.

“We’ve had issues where children have tried to order delivery — we’ve been able to catch that,” he said. Oasis staff members review the purchasers’ identification to make sure they are over 21 before handing over the pot.

He said that he needs to be able to offer delivery to stay competitive.

“The black market has been delivering for as long as the black market has existed,” he said. “It’s something customers are accustomed to.”


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5 Common Misunderstandings about Ayahuasca Demystified

Tue, 04/03/2018 - 10:10
What do you think you know about this powerful mind-altering concoction?

Ayahuasca is one of the most powerful mind-altering potions on the planet. When ingested, the brew brings people into an enchanted cosmos of spirit allies and tricksters or what scientists might consider as archetypes of the mind. Whatever labels you throw on the experience of ayahuasca, it is difficult to not finish a ceremony feeling enchanted and otherworldly – like you have just come from a space where ancient embodied knowledge and deep wisdom reside.

This article does not cover the risks and benefits of ayahuasca. Here, I am going to share with you some of the popular misconceptions about ayahuasca and why they are incorrect or misleading. Some of the myths are relatively innocent and partially true, one of them is actually dangerous. The following five misconceptions are currently traveling the ayahuasca world at the speed of satellite and modem transmissions. If you know of any other common or dangerous ayahuasca myths, please share them with us in the comments below.

Ayahuasca has Been Used for Thousands of Years


It’s very common to hear people say, “Ayahuasca has been used by indigenous Amazonian cultures for 5000 or even 8000 years.” This is certainly possible. Ayahuasca use might, in fact, be this old, but scientists have found no conclusive evidence of ayahuasca being consumed beyond a few hundred years ago.

Anthropologists have suggested that ayahuasca was probably first used among Tukanoan speaking groups of the Upper Western Amazon. Considering archeological and anthropological studies, Bernd Brabec de Mori suggests it is unlikely that ayahuasca drinking is thousands of years old. He noted that archeologists have recorded vast ancient trade networks connecting tribes of the Tukano region to other parts of the Amazon, and there is no evidence of ancient ayahuasca trade or use there.

It may be difficult to find records of ancient ayahuasca drinking because the jungle climate does a good job of destroying or devouring things. We may never know how old ayahuasca drinking truly is, but there is evidence of DMT-containing snuff preparations being used back in 200BC, and DMT is an important chemical element in most ayahuasca brews.

Various anthropologists have argued that ayahuasca drinking probably spread among indigenous people over the last 200 hundred years or so. Bernd Brabec de Mori mapped the language of ayahuasca magical songs, or icaros, across parts of the Amazon. He found many of the lyrics and words about ayahuasca could be linked to indigenous migrations of the last few hundred years.

But, a few hundred years of indigenous ayahuasca drinking a long time if we consider how young the psychedelic movement is in modern Western societies. Also, it’s important to recognize that other psychedelic plants were used among ancient cultures in the Amazon jungle, just as they were used in ancient civilizations across the whole globe.

Ayahuasca is Legal in the United States


This is both true and false. Over the last year there have been a few ayahuasca groups in the Unites States claiming, loud and proud, to be operating legally when in fact they were dangerously illegal.

One of the groups, called Ayahuasca Healings, claimed to be offering the “first ever legal ayahuasca church in the United States.” The news went viral online, celebrated in articles published by VICE, Daily Beast and other outlets. Ironically, not only was Ayahuasca Healings operating illegally in the United States, there have been two other Ayahuasca groups (União do Vegetal and Santo Daime) operating legally in the U.S. since 2006 and 2008. The Brazilian ayahuasca religions Santo Daime and União do Vegetal have churches operating legally in various parts of the globe, including South America, Europe and North America. But this was not always the case.

There have been cases of police raiding ayahuasca ceremonies in Europe. Yes, that is correct. Police in both Germany and Italy stormed into ceremonies armed with guns to arrest the so-called “drug takers.” I cannot imagine anything more terrifying than being in the middle of an ayahuasca experience, traveling the depths and heights of my soul, and being confronted with adrenaline-pumped authorities shouting at me with guns in their hands.

In comparison to the legal hoaxes, ayahuasca is being used secretly and illegally in vast underground medicine and spirituality networks that span from Russia to South Africa, Australia, Japan, Indonesia, India and the United States. This cultural space is obviously not regulated by governments. It is organically self-regulated by people taking risks to share the sacred medicine with their communities.

Vomiting is a Side Effect of Drinking Ayahuasca


Often mainstream media articles about ayahuasca  state that one of the “side effects” of ayahuasca is vomiting. They make ayahuasca sound like a pharmaceutical drug that has the undesirable “side effects” of vomiting, sweating, and diarrhea. Ayahuasca can, and often does invoke unpleasant bodily processes, like vomiting, sweating or even in some cases diarrhea. But this is far from being a “side effect” of the brew; people who drink ayahuasca understand ayahuasca vomiting as a powerful way of attaining holistic healing. To borrow medical terminology, purging is not a “side-effect” but a “central-effect,” or perhaps, a “sub-central-effect” of ayahuasca.

Some people express disappointment if they didn’t purge during a ceremony. The purge can cleanse the body and it is often followed immediately by strong visions. Purging can also bring psychological insight. In its most basic sense, ayahuasca purging requires a psychological commitment to surrender, trust and let-go, which is not always easy when you are in a visionary world of strong emotions. The purge is something many people initially struggle with.

There are different healing philosophies about the ayahuasca purge. They include scientific, spiritual and shamanic versions, and some philosophies incorporate elements from each of these different perspectives. But something they all share is the idea that the purge is a cleansing process that can bring more peace and vitality to the person’s life. A friend once told me, “pharmaceuticals make you feel great in the beginning, then bad later. Ayahuasca makes you feel bad in the beginning, then great later”. This metaphor has limitations. But it has some truth; alluding to how ayahuasca is a different types of medicine to most medicines people consume in Western societies.

Some people never purge and rarely have unpleasant bodily experiences when drinking ayahuasca. They still report attaining different types of healing and spiritual insight. But the purge should certainly not be treated as an unwanted side effect of the brew.

Science shows DMT Flooding the Brain at Birth and Death


Another common myth getting around the Internet is that DMT, the potent psychedelic molecule in ayahuasca, is released by the pineal gland of the brain when we are born and when we die. This is a super cool idea, and hopefully it’s true. It would make me feel more comfortable with the idea that the universe is inherently ethical. But there has been no scientific proof that the brain produces increased amounts of DMT when we are born or when we die.

An experiment on the process of death would be pretty easy to do, right? Get a group of terminally ill people to agree to being inspected upon death to measure the DMT levels in their system. For the time being, the idea is a hypothesis that can be traced to psychopharmacologists Jace Callaway and then Dr. Rick Strassman. Dr Strassman conducted incredibly pioneering research into DMT experiences in the 1990s. Given the types of mystical experiences people were having when they took DMT, he suggested that DMT plays a central role in near death experiences (NDE). He also believes the pineal gland in the center of the brain marks the point at which the life-force or spirit enters the foetus in the first trimester of pregnancy and then exits upon death.

The pineal gland is the seat of the soul, according to the seventeenth century French philosopher Rene Descartes, and philosophers have had a good time laughing at Descartes for this belief for centuries. But in 2013, scientists discovered DMT in the pineal glands of rodents and human lung tissue. Interestingly, the pineal gland corresponds biologically with the “third eye” or “inner eye” of mystical traditions of the East and West. Science has not yet proven or disproven the link between DMT, birth and death, but there certainly are solid facts pointing to DMT being darn significant to what it means to be human.

Ayahuasca is a Female Spirit Being for Indigenous Cultures


Mother Ayahuasca, La Madre, The Grandmother, and The Divine Feminine are all commonly evoked or summoned in the visions of Western ayahuasca drinkers. The effects of ayahuasca appear to resonate with maternal or feminine qualities for many people. But is Ayahuasca considered a female spirit being for everyone?

It is a less than interesting endeavor when science tries to prove or disprove spiritual beliefs. This is not my intention here. My intention is to share with you some of the cultural diversity of ayahuasca drinking in the Amazon rainforest. This, I hope, can help us build a more holistic vision of ayahuasca.

There certainly are many reports of ayahuasca being a female spirit in different indigenous cultures. And there certainly are reports of ayahuasca being a male spirit in Amazonian cultures. For instance, during her fieldwork in Iquitos, Peru, anthropologist Evgenia Fotiou described meeting male shamans and apprentices who claim that ayahuasca is a male spirit.  In parallel, in the Brazilian ayahuasca religion Santo Daime, the ayahuasca vine has been considered male.

For the famous shaman Maestro Juan Flores of the Asháninka, ayahuasca is a male spirit. Maestro Juan Flores has gained international recognition for his shamanic work. He was featured on the front cover of the French edition of National Geographic in 2013. In an interview available on YouTube, the shaman explains that the ayahuasca vine is male, and the chacruna plant, that is usually prepared with ayahuasca, is female. He says:

There is no Mother Ayahuasca. Ayahuasca is always a male spirit. That’s who we are. Dedicated shamans, male warriors, working for the benefit and healing of the people.

Finally, I would like to share with you some short excerpts from an indigenous ayahuasca initiation in the 1970s. The initiate, Alberto Prohano of the Yagau, describes a vision of encountering a “man” who is the “mother ayahuasca spirit”. Unlike most Western depictions of Mother Ayahuasca, here she is ambiguous and has powers to heal and to harm. Alberto Prohano described his visionary ayahuasca initiation:

I open my eyes. It’s a man. Then he says, ‘I am the mother of ayahuasca. Do you want to reach the world above, the second floor? … Here, change into this, taita (vocative of father), before you get sick and the virotes [magic darts] penetrate your body.’ I put on a kind of clothing and then we go down to the earth again… The mothers of ayahuasca visit each other frequently, even beyond the middle of the sky. Each time you cure, they are present… The mothers call you father. They come and go. But they can also do harm. – Ayahuasca Reader: Encounters with the Amazon’s Sacred Vine. 


If you want to go deep into your learning about ayahuasca, I suggest you check out the online ayahuasca courses at Kahpi. You’ll find over 100 short video lessons on everything you need to know to gain confidence, trustworthy knowledge and practical wisdom about the Amazonian brew.


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What It's Like for an American Drug Reformer to Go to a Country with a Compassionate System

Mon, 04/02/2018 - 13:27
Click here for reuse options! Who knew governments could actually do good things in the realm of drug policy?

The American activists couldn't wrap their heads around it. Sitting in a dingy office in a nondescript building in central Lisbon, they were being provided a fine-grained explanation of what happens to people caught with small amounts of drugs in Portugal, which decriminalized the possession of personal use amounts of drugs 17 years ago.

The activists, having lived the American experience, wanted desperately to know when and how the coercive power of the state kicked in, how the drug users were to be punished for their transgressions, even if they had only been hit with an administrative citation, which is what happens to people caught with small quantities of drugs there.

Nuno Capaz was trying to explain. He is vice chairman of the Lisbon Dissuasion Commission, the three-member tribunal set up to handle people caught with drugs. He had to struggle mightily to convince the Americans that it wasn't about punishment, but about personal and public health.

"The first question," he explained, "is whether this person is a recreational user or an addict."

If the person is deemed only a recreational user, he may face a fine or a call to community service. If he is deemed an addict, treatment is recommended—but not required.

"But what if they don't comply?" one of the activists demanded. "Don't they go to jail then?"

No, they do not. Instead, Capaz patiently explained, they may face sanctions for non-compliance, but those sanctions may be little more than a demand that they regularly present themselves to a hospital or health center for monitoring.

In a later hallway conversation, I asked Capaz about drug users who simply refused to go along or to participate at all. What happens then? I wanted to know.

Capaz shrugged his shoulders. "Nothing," he said. "I tell them to try not to get caught again."

Welcome to Portugal. The country's low-key, non-headline-generating drug policy, based on compassion, public health, and public safety, is a stark contrast with the U.S., as the mind-boggled response of the activists suggests.

Organized by the Drug Policy Alliance and consisting of members of local and national groups working with the drug reform organization, as well as a handful of journalists, the group spent three days in the country last month seeing what an enlightened drug policy looks like. They met with high government officials directly involved in creating and implementing drug decriminalization, toured drug treatment, harm reduction, and mobile methadone maintenance facilities, and heard from Portuguese drug users and harm reduction workers as well.

The Portuguese Model and Its Accomplishments

They had good reason to go to Portugal. After nearly two decades of drug decriminalization, there is ample evidence that the Portuguese model is working well. Treating drug users like citizens who could possibly use some help instead of like criminals to be locked up is paying off by all the standard metrics—as well as by not replicating the thuggish and brutal American-style war on drugs, with all the deleterious and corrosive impacts that has on the communities particularly targeted for American drug law enforcement.

Here, according to independent academic researchers, as well as the UN Office on Drugs and Crime and the European Monitoring Center of Drugs and Drug Abuse, is what the Portuguese have accomplished:

  • Drug use has not dramatically increased. Rates of past year and past month drug use have not changed significantly or have actually declined since 2001. And Portugal's drug use rates remain among the lowest in Europe, and well below those in the United States.
  • Both teen drug use and problematic drug use (people who are dependent or who inject drugs) have declined.
  • Drug arrests and incarceration are way down. Drug arrests have dropped by 60 percent (selling drugs remains illegal), and the percentage of prisoners doing time for drug offenses has dropped from 44 percent to 24 percent. Meanwhile, the number of people referred to the Dissuasion Commission has remained steady, indicating that no "net-widening" has taken place. And the vast majority of cases that go before the commission are found to be non-problematic drug users and are dismissed without sanction.
  • More people are receiving drug treatment—and on demand, not by court order. The number of people receiving drug treatment increased by 60 percent by 2011, with most of them receiving opiate-substitution therapy (methadone). Treatment is voluntary and largely paid for by the national health system.
  • Drug overdose deaths are greatly reduced. Some 80 people died of drug overdoses in 2001; that number shrunk to just 16 by 2012. That's an 80 percent reduction in drug overdose deaths.
  • Drug injection-related HIV/AIDS infections are greatly reduced. Between 2000 and 2013, the number of new HIV cases shrank from nearly 1,600 to only 78. The number of new AIDS cases declined from 626 to 74.

"We came to the conclusion that the criminal system was not the best suited to deal with this situation," explained Capaz. "The best option should be referring them to treatment, but we do not force or coerce anyone. If they are willing to go, it's because they actually want to, so the success rate is really high. We can surely say that decriminalization does not increase drug usage, and that it does not mean legalizing drugs. It's still illegal to use drugs in Portugal, it's just not considered a crime. It's possible to deal with these users outside the criminal system."

Dr. Joao Goulao, who largely authored the decriminalization law and who is still general director for intervention on addictive behaviors—the Portuguese "drug czar"—pointed to unquantifiable positives resulting from the move: "The biggest effect," he said, "has been to allow the stigma of drug addiction to fall, to let people speak clearly and to pursue professional help without fear."

They Take the Kids!

The American activists know all about fear and stigma. And the cultural disconnect—between a country that treats drug users with compassion and one that seeks to punish them—was on display again when a smaller group of the activists met with Dr. Miguel Vasconcelos, the head psychologist at the Centro Taipa, a former mental hospital that now serves as the country's largest drug treatment center.

As Dr. Vasconcelos explained the history and practice of drug treatment in Portugal, one of his listeners asked what happened to drug users who were pregnant or had children.

"They take the kids," Vasconcelos said, smiling. But his smile turned to puzzlement as he saw his listeners reacted with disappointment and dismay.

For the Americans, "they take the kids" meant child protective services swooping in to seize custody of the children of drug-using parents while the parents go to jail.

But that's not what Vasconcelos meant. After some back and forth, came clarity: "No, I mean they take the kids with them to treatment."

Once again, the Americans, caught firmly in the mind-set of their own punishing society, expected only the worst of the state. But once again, light bulbs came on as they realized it doesn't have to be like that.

Now that cadre of activists is back home, and they are going to begin to try to apply the lessons they learned in their own states and communities. And although they had some abstract understanding of Portuguese drug decriminalization before they came, their experiences with the concrete reality of it should only serve to strengthen their desire to make our own country a little less like a punitive authoritarian one and bit more like Portugal.



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Gun Violence Debate Needs to Include Police Militarization and Drug Prohibition Violence

Mon, 04/02/2018 - 12:05
We won't stop the killings until we address all of the causes.

On March 14, thousands of students walked out of school to protest gun violence, demanding legislators enact more stringent gun control in the U.S.  Later that night in Rio de Janeiro, Marielle Franco, a Brazilian city council member and a vocal critic of Brazil’s militarized law enforcement, was assassinated.

Four days later, 22-year-old Stephon Clark was shot and killed by the Sacramento police. While news outlets and social media made note of these murders, the national conversation instead largely focused on the March for Our Lives protest that took place the following weekend. As the media continued to cover the responses to the March for Our Lives, news broke that the two officers responsible for the murder of Alton Sterling would not be facing charges for their use of lethal force that left yet another black father dead. In the span of two weeks, the country was engrossed in the discussion of gun control and gun violence, yet there was very little discussion of the main victims of gun violence: people of color.

Communities of color (primarily black and Latinx communities) face increased gun violence at the hands of both community members and the police ostensibly charged with protecting them. While these communities were addressed by some of the courageous students at March for Our Lives, the solutions presented—stricter background checks and weapons bans—are ultimately ineffective for these vulnerable communities, as they only address a small percentage of the victims of gun violence. A more complete attempt at a solution must address the war on drugs, its role in militarizing the police and the effect it has had on communities of color.

Consider historical precedent. During Prohibition, the supply of alcohol was illegal, yet demand remained, causing the rise of an illicit market. Given the illegality of that market, ensuring some sense of justice fell to individuals rather than police and rule of law. As a result, the country witnessed an increase in organized crime, violence and murder—all directly stemming from the prohibition of alcohol, which effectively decreased with the 21st Amendment. The war on drugs has had the same path, with the exact same results, but more dire consequences. We have seen decades of remarkable gun violence, in Miami, LA, Chicago and even internationally, all in the name of the illicit drug market. The current response by the powers that be to this violence, faced largely by black and brown people, benefits neither from learning from history or understanding community need. Instead of calling for an end to this failed drug war, the main driver of gun violence, or reevaluating the legal status of drugs in our society, our government has responded through the militarization of law enforcement.

First, the Anti-Drug Abuse Act of 1988 authorized the Edward Byrne Memorial Justice Assistance Grant (JAG) program, providing a monetary incentive for anti-drug policing. Then, the National Defense Authorization Act of 1990 authorized the Department of Defense to transfer military equipment to law enforcement agencies, for use in so-called “counterdrug activities.” This was further catalyzed by Bill Clinton’s creation of the Department of Defense Excess Property Program (1033 Program), which further armed law enforcement with surplus military equipment. For decades, law enforcement has been affected by this feedback loop, making drug policing both the rationale for and result of more militarization of our local police departments.

Providing local police departments with military grade weapons and equipment in order to fight the drug war has resulted in police who look like soldiers patrolling communities that feel like combat zones. Furthermore, in spite of the reality of nearly uniform rates of drug use and sales across racial lines, black and Latino communities are policed for drug activity at a disproportionately higher rate compared to their degree of engagement in drug activities. It then comes as no surprise that black and Latino individuals suffer higher rates of gun violence at the hands of the police without any justice. In this drug war, the propaganda motivating the police soldiers features enemies painted as black and brown.

During wartime, propaganda is an effective, arguably essential, tool, particularly wielded by the media. In the case of the war on drugs, the media’s stigmatization and dehumanization of black and brown people have had the strongest effect on the war. For decades, the media has focused on black and Latino communities when warning of the horrors of drugs. Drug use became a racial issue, with people of color being labeled crackheads, thugs and drug dealers. This has not changed, even in the wake of the “gentler” drug war.

Thanks to centuries of racism and slavery, in conjunction with decades of racist drug war rhetoric, people of color are deemed criminals first, people second. The same cannot be said for white offenders. On February 14, a former student went to his former high school in Parkland, Florida and carried out one of the deadliest school shootings, killing 17 people, most of them students. Little over a month later, Stephon Clark fit the description (young black male) of a suspect accused of breaking car windows and was pursued on foot by two Sacramento police officers.

Today, the Parkland shooter, having confessed to the shooting, is sitting in jail awaiting his day in court. He was safely apprehended and arrested by the police without the use of any force, while Stephon Clark is dead, a victim of immediate lethal force. We can hope for some justice in this case, but if history is of any indication, neither officer will see their own days in court. For black and Latino people, every day is a struggle to prove their own humanity, as victims of community gun violence and as victims of state-sanctioned murder, both of which are permitted and committed by the war on drugs.

This piece first appeared on the Drug Policy Alliance Blog.

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Where Marijuana is Legal, Opioid Prescriptions Fall, Studies Find

Mon, 04/02/2018 - 11:20
It's not the first time the correlation has been evident.




As more states legalize medical and recreational marijuana, doctors may be replacing opioid prescriptions with suggestions to visit a local marijuana dispensary. Two papers published Monday in JAMA ...

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Marijuana 101: A Simple Guide to Marijuana Tasting

Mon, 04/02/2018 - 11:13
And how to know which strain is which.

Marijuana has been made legal in a growing number of states for recreational use. This means the days of buying weed in the shadows is on borrowed time. With the newfound freedom of legal cannabis, the industry has managed to cultivate a wide variety of interesting strains. Some are designed to help the user stay focused throughout the day, while others do everything from calm anxiety to keep the user dry when its raining outside. Okay, maybe the concept of ganja galoshes is a bit of a stretch. But you get the picture.

Since marijuana is being treated more like alcohol these days, it stands to reason that the scene could soon see an uprising in cannabis tastings. Similar to the swish and spit rituals taking place at wineries and other liquor-slinging establishments, the reach of marijuana will one day be given center stage for customers to hit samples before making a purchase.

When this happens, it will be crucial for the average pot smoker to elevate his or her palate, as to not come off like a complete imbecile when blowing smoke in front of that class of people who refuses to call cannabis “pot” anymore. You know the ones. It is for this reason we have assembled a marijuana-testing guide to help the seemingly one-dimensional stoner cheat his or her way into the kingdom of connoisseurs.


The first thing a true cannabis snob looks for is the overall appearance of the bud. These folks get excited when they see the herb is covered in crystals. That excitement spirals into a spastic fit the second they realize the color of the crystals is more yellow than white. Typically, the more yellow, the more THC. But no matter how yellow the crystals, always ask the weed steward when they plan to roll out the really strong stuff.


Now that you’ve identified a good-looking bud, the next step is to examine its aroma. Don’t worry. You do not have to be well versed in the art of cannabis selection to represent like a marijuana master. Similar to how it is done in beer and wine tastings, just wave the herb under the nose and take shallow sniffs. The goal is to try and get a feel for its components. You might catch a whiff of citrus, pine or even the business end of a skunk. But, as a rule, if the aroma is pleasing, chances are you will be happy with the next step.


In order to truly taste a cannabis selection, pot snobs swear by a variety of methods in which to capture a rush of optimal flavor. Some say a French inhale is the best method for tasting bud. But the most important aspect of this process to remember is the first hit is when the magic happens. Unless a person has been assigned to pen an elaborate tasting profile on a particular strain, the best advice here is to just take in the smoke, hold it in, and search for the flavors that turned you while testing the aroma. Chances are you will stumble onto something new to tickle the senses. Just make sure the device you are using to sample the bud is clean.


This is the fun part – the test drive. Just kick back and see how the herb hits you. Does it make you chatty, sleepy, or does it turn you into a cartoon character? It is important to understand how a strain works on you personally. But remember, there are more strains to sample. A good weed testing will consist of around 5-6 strains. You’ll need to try all of them. But be sure to cleanse your palate after every sample. Fruit juice or plain crackers are good for this.


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