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"While We Wait, People Die:" Pastor and Ex-Addict Fight for Safe Drug Use Spaces

Thu, 12/07/2017 - 11:29
Needle exchange activist Shilo Jama has teamed with the Rev Pat Simpson to fight ODs in Washington state, but the pair face opposition from some corners

Shilo Jama, an activist and former drug addict, is used to being sworn at, spat at, and even threatened with death. As the head of what’s thought to be the US’s largest needle exchange, which has handed out 34 million syringes in the last 27 years, he has never shied away from controversy.

In the past, he has pushed legal boundaries by handing out crack and meth pipesand the opioid antidote naloxone. Now he’s embroiled in a bitter dispute over safe-use sites, where addicted people can take drugs openly with nurses on hand in case of overdose – and he has an unlikely ally: a Methodist pastor.

In response to the opioid abuse crisis, King County, which encompasses Seattle, has approved two such sites. Similar places operate in nine other countries, including Canada, Denmark and France. When they open, they will be the first legal facilities of their kind in the US.

But the decision has infuriated many in Seattle, who argue that they will encourage drug use and increase crime and public disorder, while not doing enough to get people into treatment. Nearly 70,000 people signed a petition calling for a public vote in an attempt to stop the sites. That move was overruled by a judge last month but an appeal is planned.

In the meantime, Jama, 42, who is a member of the county opioid addiction taskforce that recommended the sites, is fed up with waiting for them to open. Last year there were 332 deaths from drugs in King County, with two-thirds of those opioid-related overdoses.

Jama, executive director of the not-for-profit People’s Harm Reduction Alliance (PHRA) needle-swap programme, which operates out of a Methodist church in Seattle’s University District, said: “While we wait, people are going to die. I think every day of the folks who are dying needlessly while bigoted cowards yell and scream about hatred.”

Rumours have swirled that the organisation is planning an illegal site at the church, which also houses a childcare centre, a young adult shelter and meal programs.

Jama said he would only start one at the church if the county health department gave the green light.

“My opinion hasn’t changed. We want [safe-use sites] as part of the solution because people are dying. By any means necessary.”

Jama has the backing of the University Temple United Methodist church pastor, the Rev Pat Simpson, and the church’s board of trustees.

Simpson said: “We stand beside them. The PHRA has been with us in this building a long time. We’ve had time to learn that they are trustworthy, highly committed to their work and expanding services to meet unmet needs. For example, they started giving out Narcan [naloxone] before it was strictly officially permitted in order to equip people to reverse overdoses.”

Jama believes there should be several places for taking drugs safely across the city.

“A million-dollar facility is not a good idea. It’s too big, too much money. You just need a room in an existing facility where people can pop in and use. They need to be the price of a nurse and the paraphernalia. Super, super simple.”

Officials from Seattle-King County public health department said in a statement: “The independent safe consumption site proposed by the PHRA in Seattle’s University District is not part of our efforts. If the PHRA does establish a site, we will not have enforcement authority, except in the event that this particular facility becomes a threat to public health.”

Jama and Simpson’s stance is not popular in some quarters, and both have received some negative reaction.

But Simpson said the idea for a safe-consumption site had broad backing among her congregation. Their support of a harm reduction approach, focusing on safe use rather than abstinence, is a philosophical shift given that Methodism was a major organisation in the temperance movement that led to prohibition.

Simpson said: “When you look at the list of participants in the taskforce that recommended this and see the law enforcement representation there, the medical community, several layers of government, we’re part of a broad coalition that believes it’s the right thing to do.

“This is not some wildcat renegade effort. It’s well planned and it’s being done by knowledgeable people based on this long experience elsewhere. That’s why we have the confidence to do this and intend to brave the storm of whatever the opposition might be.”

She added: “We’re a congregation of people who appreciate science and are willing to look at the evidence and not just rely on gut reactions or public prejudice.”

Jama, who believes drugs should be legalised, says much of the opposition comes from fear and ignorance of nimbys (adherents to a “not in my backyard” view). “They have met a drug user or have had a drug user in their life that they have negative feelings about and they hypothesise that all drug users are like that. We are not a homogenised group of people.

“They have been very vile in their treatment of us. When I was on the streets, passersby called me disgusting and gross and spitted at me. I see them as no different to these people who are blinded by their own rage and hate.”

Seattle-born Jama, who spent time in foster care as a child, spoke of his own drug experiences. He tried magic mushrooms on a camping trip aged 13, began taking LSD in high school, and eventually ended up homeless with a heroin habit. He suffered a lot of trauma, he said, and felt a lot of anger.

The turning point came when his best friend died from an overdose in the mid-1990s. He volunteered at the needle exchange and found his vocation.

He also founded a drug users’ union, the Urban Survivors’ Union, which lobbies for alternative drug laws. He met his wife, a mental health worker whom he describes as “one of the best things in my life”, when she was helping out at the exchange.

Jama calls the 60 to 90 daily visitors to the exchange “my family”. They were all invited to his mermaid and unicorn-themed wedding reception, held in the alley next to Simpson’s church.

The PHRA now operates in eight locations, in Washington and Oregon. It has five employees and 250 volunteers, of which 51% have to be drug users.

“So many people come into the exchange with smiles – this is the only service that treats them with respect and dignity,” he said. “I say, ‘I love you just the way you are and I’m proud of you just the way you are,’ and some people look at me like I’m a crazy person, and other people give me big hugs.”

Jama still uses illegal drugs occasionally. Holding up his takeaway coffee cup, he points out that most people use some stimulant – whether caffeine, alcohol or illegal drugs.

He’s keen to stress that he is lobbying for the other proposals contained in the taskforce recommendations, as well as the safe consumption sites.

“We need to focus on mental health services and treatment on demand for folks who are in chaotic use. There is chaotic drug use and there is stable drug use. We want to keep people on stable drug use.”

Whether a safe-use room at the church will be part of that mission remains to be seen.

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Why It’s Getting Easier for Marijuana Companies to Open Bank Accounts

Thu, 12/07/2017 - 11:17
Almost 400 banks and financial institutions are now serving the industry.

Editor's Note: This story was updated 12/7 to correct the year when medical marijuana dispensaries opened in Hawaii (it was 2017), and 12/6 to clarify comments made by Brian Smith, who said that many marijuana businesses were reluctant to open bank accounts because they were hesitant to enter a highly regulated system.

State and local officials in places that recently legalized marijuana are bracing for the arrival of a sector that largely runs on cash. They’re anxiously envisioning burglars targeting dispensaries and business owners showing up at tax offices with duffel bags full of money.  

But the marijuana industry’s banking problems may be more manageable than many officials realize.

Just ask Washington state, which last year successfully pushed almost all legal marijuana businesses to open bank accounts and pay their taxes with a check or other non-cash method. Or Hawaii, which earlier this year announced a “cashless” system for buying medical marijuana, reliant on a technology analogous to PayPal.

“We’re definitely seeing more businesses in the industry getting banked every day,” said Aaron Smith, executive director of the National Cannabis Industry Association, a trade group. Despite the legal risk involved in serving the cannabis industry, almost 400 banks and credit unions now do, according to the U.S. Treasury — a number that has more than tripled since 2014.

That’s reassuring news for California, where sales of recreational pot start next month, as well as for Nevada, Maine and Massachusetts, where voters approved recreational marijuana sales last year, and Arkansas, Florida, Montana and North Dakota, where voters approved medicinal sales.

But the progress that has occurred in some legal markets remains fragile. The federal government still considers marijuana to be a dangerous, illegal drug. States can only permit marijuana sales — and financial institutions can only serve marijuana-related businesses — thanks to Obama-era guidelines that create wiggle room in federal law.

The Trump administration is rethinking those guidelines. “We’re looking at that very hard right now, we had a meeting yesterday and talked about it at some length,” Attorney General Jeff Sessions said at a press conference last week. “It’s my view that the use of marijuana is detrimental, and we should not give encouragement in any way to it, and it represents a federal violation, which is in the law and is subject to being enforced.”

Growing Access to Banking Services

Since the U.S. Treasury issued guidance on the issue in 2014, banks and credit unions have been able to do business with the marijuana industry without being prosecuted — so long as they monitor marijuana-related accounts closely to make sure they steer clear of Justice Department enforcement priorities, such as funding gang activity.

Local institutions that are chartered at the state level have been particularly willing to work with the industry.

In Oregon, where sales of recreational marijuana began in 2015, Salem-based Maps Credit Union decided to serve marijuana businesses after audits revealed some of its members were already in the industry. “It didn’t really square with our philosophy to kick members out,” said Shane Saunders, chief experience officer.  

Taking on the new line of business required investments in staff, anti-money laundering software, and extra security at bank branches, said Rachel Pross, the credit union’s chief risk officer. Under the current federal guidance, Maps has to send a report on each marijuana-related account to the U.S. Treasury every 90 days, plus a report each time an account experiences a cash transaction of over $10,000.

Maps staff run background checks on marijuana-related business owners who want to open an account. They conduct regular, in-person inspections of the businesses whose accounts they manage, and they require business owners to share their quarterly financial statements.

Dispensaries that bank with Maps make most of their sales in cash, because credit- and debit-card processors typically won’t touch marijuana money. As of October, the credit union had handled $140 million in cash deposits from 375 marijuana-related accounts in 2017, Pross said. Some companies hold multiple accounts.

In neighboring Washington, where recreational marijuana sales began in 2014, several financial institutions are openly working with the industry.

Washington has helped banks and credit unions monitor marijuana-related customers by collecting and publishing extensive data on monthly sales and legal violations to the liquor and cannabis control board’s website.   

State regulators last year nudged marijuana licensees to open desposit accounts, aware that banking services were available and worried that cash-based businesses threatened public safety.

“We gave them a deadline at some point in 2016,” said Brian Smith, communications director for the liquor and cannabis board: Either prove you can’t get a bank account, or the state won’t accept tax payments in cash.

Some marijuana businesses weren’t using banks not because services weren’t available, Smith said, but because they didn’t want the additional scrutiny. Today, most businesses have accounts and about 99 percent of taxes are paid in a form other than cash, he said. 

Some cash-reliant businesses complained about bank fees, which are typically higher for marijuana-related accounts than accounts that require less monitoring. Regulators were unsympathetic. “It’s a cost of doing business in this marketplace,” Smith said.

John Branch, a Seattle-based lawyer who owns a dispensary, says that fees are typically reasonable for small businesses like his. The fees he pays as a credit union member are in the hundreds of dollars, he said. “In the scheme of what it costs to run a marijuana business, it’s de minimis.”  

A National ‘Cashless’ Model?

In some states, such as Alaska and Hawaii, regulators say they’re not aware of any credit unions or banks that currently serve the industry. Recreational marijuana sales began in Alaska in 2015, and medical marijuana dispensaries opened in Hawaii in 2017.

But Hawaii is pioneering a workaround.  

Regulators have given a Colorado-based credit union permission to serve the state’s medical marijuana dispensaries. The credit union, in turn, has partnered with CanPay, an app that allows patients to transfer money from their bank accounts directly to the dispensary’s account.

This new cashless system enables the state to focus on patient, public and product safety while we allow commerce to take place. This solution makes sense,” Hawaii Gov. David Ige, a Democrat, said in a statement announcing the system in September.

Hawaii doesn’t require dispensaries to use CanPay or become members of the credit union, according to the state Department of Commerce and Consumer Affairs. Currently, three of the state’s four open dispensaries use the app, said Iris Ikeda, Hawaii’s state commissioner of financial institutions.   

“We are calling this a temporary solution,” Ikeda said. Policymakers hope that eventually a state-chartered bank or credit union will step in to serve the marijuana industry, she said.

State and local officials in other parts of the country are watching Washington and Hawaii closely and asking if their strategies might work elsewhere.

The California Treasurer’s office, facing the January 1 launch of what’s projected to be a $7 billion legal cannabis industry, has pointed to Washington’s data-sharing system as a possible model to emulate. But the Golden State can’t copy Washington’s centralized system exactly, because localities and several state agencies will share responsibility for supervising California’s marijuana businesses.

The California State Association of Counties is working on building a website that would publish locally collected information on licensees. Cara Martinson, the federal affairs manager for the nonprofit association, says the database would help cities and counties audit licensed businesses and keep track of their transactions, as well as giving more information to banks and credit unions.

Ikeda says that it may be easier to introduce electronic payment processing to new marijuana markets than long-established ones, and easier to get medical marijuana patients to sign up to use the app than recreational users, who might be leery of giving their names and financial information to a third-party payment processor.

Seattle dispensary owner Branch notes that stores with ATMs make money when they dispense cash, and store owners may not embrace an electronic payment system that instead will cost them 2 percent of each transaction, as CanPay’s service does.

A change in federal law would solve the cannabis industry’s banking problem and wipe away the need for services tailored to the industry, such as CanPay. But Congress has so far failed to pass — or even seriously consider — a law that would reclassify marijuana as a less dangerous substance or allow banks and credit unions to work with businesses without risking their charters.

U.S. Rep. Ed Perlmutter, a Colorado Democrat who proposed a bill on the issue this year, says no action is expected anytime soon.

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Wisconsin Governor Walker’s Plan to Drug Test Food Stamp Applicants Would Be Wasteful, Ineffective and Perhaps Unconstitutional

Thu, 12/07/2017 - 10:03
Click here for reuse options! It's yet another attempt to stigmatize and criminalize people living in poverty.

Wisconsin Governor Scott Walker announced plans this week to move forward with making Wisconsin the first U.S. state to drug test people applying for food stamps.

We’ve been down this road before. Several states have attempted to drug test people applying for public assistance, yet in each case it has proven to be costly, ineffective, and often unconstitutional.

Disproportionately impacting the poor and communities of color, Walker’s proposal stigmatizes people who seek public assistance and perpetuates the dangerous, baseless notion that low-income people and communities of color are somehow less deserving and more likely to use drugs.

If Governor Walker really wants to help people struggling with problematic drug use, he could start by investing in accessible and evidence-based rehabilitation and treatment programs in Wisconsin. According to a report from Wisconsin’s Department of Health Services, less than 23% of people who need addiction treatment in Wisconsin receive it.

And Walker’s clearly neither interested in saving his state money – drug testing public assistance recipients costs the government more money than it saves -- nor investing in treatment.

And there’s a big catch: The Fourth Amendment of the U.S. Constitution prohibits unreasonable search and seizure. Police or other state authorities must have probable cause before they can search an individual person. And they must establish that probable cause before a judge who then issues a warrant.

Governor Scott Walker appears to believe that applying for food stamps is probable cause to assume that all able-bodied adult applicants have committed a crime and therefore should be subjected to drug tests and then be given the choice to go into rehab or go hungry should they test positive.

But this assumes three things. First, that anyone who tests positive for drugs is engaged in problematic drug use and unable to hold a job. Second, that a drug test can distinguish between therapeutic use of a drug under the supervision the health care system versus personal use for some other reasons outside the supervision of the health care system. Third, anyone who tests positive for drugs should be pressured into rehabilitation or treatment.

None of these assumptions stand up to science.  Some people use drugs and alcohol on an occasional basis and are totally functional and able to hold down and even excel at work. Studies have consistently shown over decades that problematic use is limited to a small fraction of people who use drugs. Second, drug tests identify drug usage, not addiction, and most positive tests simply identify marijuana use. Third, even if a drug test could identify only those people whose use of drugs is problematic, coerced treatment is much less effective than voluntary treatment, not to mention a violation of individual autonomy and human rights.

So let’s call this policy out for what it is: yet another attempt to stigmatize and criminalize people living in poverty and, in particular, poor communities of color.

This piece first appeared on the Drug Policy Alliance Blog.

 

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Will Cannabis Replace Opioids as Painkillers?

Wed, 12/06/2017 - 11:15
The debate continues over whether cannabis is a viable alternative.

With America caught in the throes of the opioid epidemic, researchers and drugmakers alike continue to suggest that the answer lies in marijuana-based painkillers. In fact, a number of studies also hint that medical cannabis might be the magic bullet everyone is looking for.

Not so fast, some key experts said at the Forbes Healthcare Summit. Dr. Tom Frieden, the former head of the Centers for Disease Control and Prevention (CDC) under President Obama, leveled sharp criticism at the idea of marijuana replacing opioids as viable painkillers. Frieden, who now spearheads the non-profit Resolve to Save Lives—a $225 million, five-year global health campaign—was quick to say medical marijuana won’t end the crisis.

“The huge problem with legalization is that in the current legal context of the U.S., if you legalize a product you cannot restrict its market, and what we’re looking at is the prospect of having Big Tobacco paralleled by Big Marijuana actively promoting marijuana use,” Frieden said. “It could be very harmful for some people and some communities. That said, there may be a role for some individuals, and obviously this is a tough issue.”

Currently legal in 29 states and the District of Columbia, medical marijuana continues to grow and expand in the U.S. As such, drug companies like GW Pharmaceuticals and Cara Therapeutics are actively looking to exploit marijuana as a less harmful alternative to opioids, Forbes piece said.

Yet there aren’t enough research studies to prove that it’s a sustainable solution. At the summit, the National Institute on Drug Abuse’s deputy director Wilson Compton observed that the studies that do exist tend to be too few and far between. “While it looks like there’s a general signal, we don’t know who the marijuana, or the cannabinoids within the plant, might be useful for,” Compton said. “And that’s where I think research needs to move.”

Compton echoes the stance of the Drug Enforcement Administration (DEA), which still considers marijuana to be a Schedule I drug, defined as having no accepted medical uses and a high potential for abuse.

“Could marijuana be a life raft out of this sea of painkillers?” AC Shilton asked in Vice storyfrom earlier this year. Using Tennessee as an example, the writer examined how the state maintains that marijuana is illegal in every application while lawmakers vote against limiting opioid prescriptions even while record numbers of overdoses happen under their watch.

“It's a life raft with a slow leak at best,” Shilton considered, though “a leaky raft starts to look pretty appealing” when it comes to the opioid epidemic. Still, it’s not so much the research that’s confounding as it is all the legalities around marijuana, which are “confusing, especially for medical professionals.”

All that red tape means that continuing marijuana research is, at best, a nightmare to secure federal research money. (Interestingly, the Vice piece notes that “it’s easier to score research grants if your hypothesis is one testing the negative impacts of [marijuana].”)

We shouldn’t let red tape tangle up marijuana’s potential as a painkiller, Andrew Kolodny told attendees at the healthcare summit. Kolodny, the co-director of Brandeis University’s Opioid Policy Research Collaborative, thinks medical pot isn’t a perfect solution—but it’s something.

“If I had a patient who was suffering from severe intractable pain and had tried everything, I would sooner try marijuana on a patient than heroin,” he said. “When you are prescribing opioids, you are essentially giving them heroin.”

And given that 60,000 Americans died from drug-related overdoses last year alone, it seems irresponsible to not try everything possible to save lives.

 

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Medical Marijuana Patients Are Being Told to Give Up Their Guns

Tue, 12/05/2017 - 11:12
Authorities in Pennsylvania and Hawaii are cracking down on medical marijuana users who own firearms.

Twenty-nine states and Washington D.C. now allow patients to have access to medical marijuana, but some of these patients are bumping up against a federal law that prohibits the sale of guns to people who use marijuana. 

Authorities in Pennsylvania and Hawaii have spoken out last week, declaring that people who have medical marijuana licenses in those states will need to give up access to firearms. 

The decisions are tied to a 50-year-old law, which was upheld in a Supreme Court ruling last year. 

“The Gun Control Act of 1968 prohibits anyone from possessing guns if they use or are addicted to cannabis,” Christopher Morales, a California criminal defense attorney, told Leafly. The law forbids people who use federally restricted substances from owning firearms, even if the substances they use are legal in the state that they reside in. 

A Nevada medical marijuana patient challenged the law after she was denied the right to buy a firearm because of her medical marijuana card. Last September the Supreme Court ruled that it is not a violation of the Second Amendment for states to deny gun ownership to people who use medical marijuana. 

"It is beyond dispute that illegal drug users, including marijuana users, are likely as a consequence of that use to experience altered or impaired mental states that affect their judgment and that can lead to irrational or unpredictable behavior,” justices wrote in the ruling. 

Last week the Honolulu Police Department sent letters to medical marijuana users saying that they will need to turn in their weapons within 30 days of receipt. 

“Your medical marijuana use disqualifies you from ownership of firearms and ammunition,” the letter said, according to a copy obtained by Leafly. The letter went on to say that the medical marijuana patients would need a doctor’s clearance to get their firearms back. 

[Editor's Note: Faced with a wave of criticism, the Honolulu Police are now reviewing that policy.]

In Pennsylvania, authorities made a similar proclamation. 

"So in fact an individual who is issued a medical marijuana card in Pennsylvania who is a user of medical marijuana, that individual would be prohibited from purchasing or technically possession of a firearm under federal law," Major Scott C. Price, Pennsylvania state police director of the Bureau of Records and Identification, said Tuesday, according to Lehigh Valley Live

Federal authorities agreed. 

"There are no exceptions in federal law for marijuana used for medicinal or recreational purposes," said Special Agent Joshua E. Jackson, spokesman for the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives in Washington, D.C.

Medical marijuana licenses come up on background checks, but 22% of gun sales take place between unlicensed sellers who are not required to conduct background checks, according to Leafly

 

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Portugal's Radical Drug Policy Is Working. Why Hasn't The World Copied It?

Tue, 12/05/2017 - 00:00
Since it decriminalized all drugs in 2001, the Iberian nation has seen dramatic drops in overdoses, HIV infection and drug-related crime.

When the drugs came, they hit all at once. It was the 80s, and by the time one in 10 people had slipped into the depths of heroin use – bankers, university students, carpenters, socialites, miners – Portugal was in a state of panic.

Álvaro Pereira was working as a family doctor in Olhão in southern Portugal. “People were injecting themselves in the street, in public squares, in gardens,” he told me. “At that time, not a day passed when there wasn’t a robbery at a local business, or a mugging.”

The crisis began in the south. The 80s were a prosperous time in Olhão, a fishing town 31 miles west of the Spanish border. Coastal waters filled fishermen’s nets from the Gulf of Cádiz to Morocco, tourism was growing, and currency flowed throughout the southern Algarve region. But by the end of the decade, heroin began washing up on Olhão’s shores. Overnight, Pereira’s beloved slice of the Algarve coast became one of the drug capitals of Europe: one in every 100 Portuguese was battling a problematic heroin addiction at that time, but the number was even higher in the south. Headlines in the local press raised the alarm about overdose deaths and rising crime. The rate of HIV infection in Portugal became the highest in the European Union. Pereira recalled desperate patients and families beating a path to his door, terrified, bewildered, begging for help. “I got involved,” he said, “only because I was ignorant.”

In truth, there was a lot of ignorance back then. Forty years of authoritarian ruleunder the regime established by António Salazar in 1933 had suppressed education, weakened institutions and lowered the school-leaving age, in a strategy intended to keep the population docile. The country was closed to the outside world; people missed out on the experimentation and mind-expanding culture of the 1960s. When the regime ended abruptly in a military coup in 1974, Portugal was suddenly opened to new markets and influences. Under the old regime, Coca-Cola was banned and owning a cigarette lighter required a licence. When marijuana and then heroin began flooding in, the country was utterly unprepared.

Pereira tackled the growing wave of addiction the only way he knew how: one patient at a time. A student in her 20s who still lived with her parents might have her family involved in her recovery; a middle-aged man, estranged from his wife and living on the street, faced different risks and needed a different kind of support. Pereira improvised, calling on institutions and individuals in the community to lend a hand.

In 2001, nearly two decades into Pereira’s accidental specialisation in addiction, Portugal became the first country to decriminalise the possession and consumption of all illicit substances. Rather than being arrested, those caught with a personal supply might be given a warning, a small fine, or told to appear before a local commission – a doctor, a lawyer and a social worker – about treatment, harm reduction, and the support services that were available to them.

The opioid crisis soon stabilised, and the ensuing years saw dramatic drops in problematic drug use, HIV and hepatitis infection rates, overdose deaths, drug-related crime and incarceration rates. HIV infection plummeted from an all-time high in 2000 of 104.2 new cases per million to 4.2 cases per million in 2015. The data behind these changes has been studied and cited as evidence by harm-reduction movements around the globe. It’s misleading, however, to credit these positive results entirely to a change in law.

Portugal’s remarkable recovery, and the fact that it has held steady through several changes in government – including conservative leaders who would have preferred to return to the US-style war on drugs – could not have happened without an enormous cultural shift, and a change in how the country viewed drugs, addiction – and itself. In many ways, the law was merely a reflection of transformations that were already happening in clinics, in pharmacies and around kitchen tables across the country. The official policy of decriminalisation made it far easier for a broad range of services (health, psychiatry, employment, housing etc) that had been struggling to pool their resources and expertise, to work together more effectively to serve their communities.

The language began to shift, too. Those who had been referred to sneeringly as drogados (junkies) – became known more broadly, more sympathetically, and more accurately, as “people who use drugs” or “people with addiction disorders”. This, too, was crucial.

It is important to note that Portugal stabilised its opioid crisis, but it didn’t make it disappear. While drug-related death, incarceration and infection rates plummeted, the country still had to deal with the health complications of long-term problematic drug use. Diseases including hepatitis C, cirrhosis and liver cancer are a burden on a health system that is still struggling to recover from recession and cutbacks. In this way, Portugal’s story serves as a warning of challenges yet to come.

Despite enthusiastic international reactions to Portugal’s success, local harm-reduction advocates have been frustrated by what they see as stagnation and inaction since decriminalisation came into effect. They criticise the state for dragging its feet on establishing supervised injection sites and drug consumption facilities; for failing to make the anti-overdose medication naloxone more readily available; for not implementing needle-exchange programmes in prisons. Where, they ask, is the courageous spirit and bold leadership that pushed the country to decriminalise drugs in the first place?

In the early days of Portugal’s panic, when Pereira’s beloved Olhão began falling apart in front of him, the state’s first instinct was to attack. Drugs were denounced as evil, drug users were demonised, and proximity to either was criminally and spiritually punishable. The Portuguese government launched a series of national anti-drug campaigns that were less “Just Say No” and more “Drugs Are Satan”.

Informal treatment approaches and experiments were rushed into use throughout the country, as doctors, psychiatrists, and pharmacists worked independently to deal with the flood of drug-dependency disorders at their doors, sometimes risking ostracism or arrest to do what they believed was best for their patients.

In 1977, in the north of the country, psychiatrist Eduíno Lopes pioneered a methadone programme at the Centro da Boavista in Porto. Lopes was the first doctor in continental Europe to experiment with substitution therapy, flying in methadone powder from Boston, under the auspices of the Ministry of Justice, rather than the Ministry of Health. His efforts met with a vicious public backlash and the disapproval of his peers, who considered methadone therapy nothing more than state-sponsored drug addiction.

In Lisbon, Odette Ferreira, an experienced pharmacist and pioneering HIV researcher, started an unofficial needle-exchange programme to address the growing Aids crisis. She received death threats from drug dealers, and legal threats from politicians. Ferreira – who is now in her 90s, and still has enough swagger to carry off long fake eyelashes and red leather at a midday meeting – started giving away clean syringes in the middle of Europe’s biggest open-air drug market, in the Casal Ventoso neighbourhood of Lisbon. She collected donations of clothing, soap, razors, condoms, fruit and sandwiches, and distributed them to users. When dealers reacted with hostility, she snapped back: “Don’t mess with me. You do your job, and I’ll do mine.” She then bullied the Portuguese Association of Pharmacies into running the country’s – and indeed the world’s – first national needle-exchange programme.

A flurry of expensive private clinics and free, faith-based facilities emerged, promising detoxes and miracle cures, but the first public drug-treatment centre run by the Ministry of Health – the Centro das Taipas in Lisbon – did not begin operating until 1987. Strapped for resources in Olhão, Pereira sent a few patients for treatment, although he did not agree with the abstinence-based approach used at Taipas. “First you take away the drug, and then, with psychotherapy, you plug up the crack,” said Pereira. There was no scientific evidence to show that this would work – and it didn’t.

He also sent patients to Lopes’s methadone programme in Porto, and found that some responded well. But Porto was at the other end of the country. He wanted to try methadone for his patients, but the Ministry of Health hadn’t yet approved it for use. To get around that, Pereira sometimes asked a nurse to sneak methadone to him in the boot of his car.

Pereira’s work treating patients for addiction eventually caught the attention of the Ministry of Health. “They heard there was a crazy man in the Algarve who was working on his own,” he said, with a slow smile. Now 68, he is sprightly and charming, with an athletic build, thick and wavy white hair that bounces when he walks, a gravelly drawl and a bottomless reserve of warmth. “They came down to find me at the clinic and proposed that I open a treatment centre,” he said. He invited a colleague from at a family practice in the next town over to join him – a young local doctor named João Goulão.

Goulão was a 20-year-old medical student when he was offered his first hit of heroin. He declined because he didn’t know what it was. By the time he finished school, got his licence and began practising medicine at a health centre in the southern city of Faro, it was everywhere. Like Pereira, he accidentally ended up specialising in treating drug addiction.

 A nurse hands out methadone to addicts in Lisbon. Photograph: Horacio Villalobos/Corbis via Getty Images

The two young colleagues joined forces to open southern Portugal’s first CAT in 1988. (These kinds of centres have used different names and acronyms over the years, but are still commonly referred to as Centros de Atendimento a Toxicodependentes, or CATs.) Local residents were vehemently opposed, and the doctors were improvising treatments as they went along. The following month, Pereira and Goulão opened a second CAT in Olhão, and other family doctors opened more in the north and central regions, forming a loose network. It had become clear to a growing number of practitioners that the most effective response to addiction had to be personal, and rooted in communities. Treatment was still small-scale, local and largely ad hoc.

The first official call to change Portugal’s drug laws came from Rui Pereira, a former constitutional court judge who undertook an overhaul of the penal code in 1996. He found the practice of jailing people for taking drugs to be counterproductive and unethical. “My thought right off the bat was that it wasn’t legitimate for the state to punish users,” he told me in his office at the University of Lisbon’s school of law. At that time, about half of the people in prison were there for drug-related reasons, and the epidemic, he said, was thought to be “an irresolvable problem”. He recommended that drug use be discouraged without imposing penalties, or further alienating users. His proposals weren’t immediately adopted, but they did not go unnoticed.

In 1997, after 10 years of running the CAT in Faro, Goulão was invited to help design and lead a national drug strategy. He assembled a team of experts to study potential solutions to Portugal’s drug problem. The resulting recommendations, including the full decriminalisation of drug use, were presented in 1999, approved by the council of ministers in 2000, and a new national plan of action came into effect in 2001.

Today, Goulão is Portugal’s drug czar. He has been the lodestar throughout eight alternating conservative and progressive administrations; through heated standoffs with lawmakers and lobbyists; through shifts in scientific understanding of addiction and in cultural tolerance for drug use; through austerity cuts, and through a global policy climate that only very recently became slightly less hostile. Goulão is also decriminalisation’s busiest global ambassador. He travels almost non-stop, invited again and again to present the successes of Portugal’s harm-reduction experiment to authorities around the world, from Norway to Brazil, which are dealing with desperate situations in their own countries.

“These social movements take time,” Goulão told me. “The fact that this happened across the board in a conservative society such as ours had some impact.” If the heroin epidemic had affected only Portugal’s lower classes or racialised minorities, and not the middle or upper classes, he doubts the conversation around drugs, addiction and harm reduction would have taken shape in the same way. “There was a point whenyou could not find a single Portuguese family that wasn’t affected. Every family had their addict, or addicts. This was universal in a way that the society felt: ‘We have to do something.’”

Portugal’s policy rests on three pillars: one, that there’s no such thing as a soft or hard drug, only healthy and unhealthy relationships with drugs; two, that an individual’s unhealthy relationship with drugs often conceals frayed relationships with loved ones, with the world around them, and with themselves; and three, that the eradication of all drugs is an impossible goal.

“The national policy is to treat each individual differently,” Goulão told me. “The secret is for us to be present.”

Adrop-in centre called IN-Mouraria sits unobtrusively in a lively, rapidly gentrifying neighbourhood of Lisbon, a longtime enclave of marginalised communities. From 2pm to 4pm, the centre provides services to undocumented migrants and refugees; from 5pm to 8pm, they open their doors to drug users. A staff of psychologists, doctors and peer support workers (themselves former drug users) offer clean needles, pre-cut squares of foil, crack kits, sandwiches, coffee, clean clothing, toiletries, rapid HIV testing, and consultations – all free and anonymous.

On the day I visited, young people stood around waiting for HIV test results while others played cards, complained about police harassment, tried on outfits, traded advice on living situations, watched movies and gave pep talks to one another. They varied in age, religion, ethnicity and gender identity, and came from all over the country and all over the world. When a slender, older man emerged from the bathroom, unrecognisable after having shaved his beard off, an energetic young man who had been flipping through magazines threw up his arms and cheered. He then turned to a quiet man sitting on my other side, his beard lush and dark hair curling from under his cap, and said: “What about you? Why don’t you go shave off that beard? You can’t give up on yourself, man. That’s when it’s all over.” The bearded man cracked a smile.

During my visits over the course of a month, I got to know some of the peer support workers, including João, a compact man with blue eyes who was rigorous in going over the details and nuances of what I was learning. João wanted to be sure I understood their role at the drop-in centre was not to force anyone to stop using, but to help minimise the risks users were exposed to.

“Our objective is not to steer people to treatment – they have to want it,” he told me. But even when they do want to stop using, he continued, having support workers accompany them to appointments and treatment facilities can feel like a burden on the user – and if the treatment doesn’t go well, there is the risk that that person will feel too ashamed to return to the drop-in centre. “Then we lose them, and that’s not what we want to do,” João said. “I want them to come back when they relapse.” Failure was part of the treatment process, he told me. And he would know.

João is a marijuana-legalisation activist, open about being HIV-positive, and after being absent for part of his son’s youth, he is delighting in his new role as a grandfather. He had stopped doing speedballs (mixtures of cocaine and opiates) after several painful, failed treatment attempts, each more destructive than the last. He long used cannabis as a form of therapy – methadone did not work for him, nor did any of the inpatient treatment programmes he tried – but the cruel hypocrisy of decriminalisation meant that although smoking weed was not a criminal offence, purchasing it was. His last and worst relapse came when he went to buy marijuana from his usual dealer and was told: “I don’t have that right now, but I do have some good cocaine.” João said no thanks and drove away, but soon found himself heading to a cash machine, and then back to the dealer. After this relapse, he embarked on a new relationship, and started his own business. At one point he had more than 30 employees. Then the financial crisis hit. “Clients weren’t paying, and creditors started knocking on my door,” he told me. “Within six months I had burned through everything I had built up over four or five years.”

In the mornings, I followed the centre’s street teams out to the fringes of Lisbon. I met Raquel and Sareia – their slim forms swimming in the large hi-vis vests they wear on their shifts – who worked with Crescer na Maior, a harm-reduction NGO. Six times a week, they loaded up a large white van with drinking water, wet wipes, gloves, boxes of tinfoil and piles of state-issued drug kits: green plastic pouches with single-use servings of filtered water, citric acid, a small metal tray for cooking, gauze, filter and a clean syringe. Portugal does not yet have any supervised injection sites (although there is legislation to allow them, several attempts to open one have come to nothing), so, Raquel and Sareia told me, they go out to the open-air sites where they know people go to buy and use. Both are trained psychologists, but out in the streets they are known simply as the “needle girls”.

“Good afternoon!” Raquel called out cheerily, as we walked across a seemingly abandoned lot in an area called Cruz Vermelha. “Street team!” People materialised from their hiding places like some strange version of whack-a-mole, poking their heads out from the holes in the wall where they had gone to smoke or shoot up. “My needle girls,” one woman cooed to them tenderly. “How are you, my loves?” Most made polite conversation, updating the workers on their health struggles, love lives, immigration woes or housing needs. One woman told them she would be going back to Angola to deal with her mother’s estate, that she was looking forward to the change of scenery. Another man told them he had managed to get his online girlfriend’s visa approved for a visit. “Does she know you’re still using?” Sareia asked. The man looked sheepish.

“I start methadone tomorrow,” another man said proudly. He was accompanied by his beaming girlfriend, and waved a warm goodbye to the girls as they handed him a square of foil.

In the foggy northern city of Porto, peer support workers from Caso – an association run by and for drug users and former users, the only one of its kind in Portugal – meet every week at a noisy cafe. They come here every Tuesday morning to down espressos, fresh pastries and toasted sandwiches, and to talk out the challenges, debate drug policy (which, a decade and a half after the law came into effect, was still confusing for many) and argue, with the warm rowdiness that is characteristic of people in the northern region. When I asked them what they thought of Portugal’s move to treat drug users as sick people in need of help, rather than as criminals, they scoffed. “Sick? We don’t say ‘sick’ up here. We’re not sick.”

I was told this again and again in the north: thinking of drug addiction simply in terms of health and disease was too reductive. Some people are able to use drugs for years without any major disruption to their personal or professional relationships. It only became a problem, they told me, when it became a problem.

Caso was supported by Apdes, a development NGO with a focus on harm reduction and empowerment, including programmes geared toward recreational users. Their award-winning Check!n project has for years set up shop at festivals, bars and parties to test substances for dangers. I was told more than once that if drugs were legalised, not just decriminalised, then these substances would be held to the same rigorous quality and safety standards as food, drink and medication.

In spite of Portugal’s tangible results, other countries have been reluctant to follow. The Portuguese began seriously considering decriminalisation in 1998, immediately following the first UN General Assembly Special Session on the Global Drug Problem (UNgass). High-level UNgass meetings are convened every 10 years to set drug policy for all member states, addressing trends in addiction, infection, money laundering, trafficking and cartel violence. At the first session – for which the slogan was “A drug-free world: we can do it” – Latin American member states pressed for a radical rethinking of the war on drugs, but every effort to examine alternative models (such as decriminalisation) was blocked. By the time of the next session, in 2008, worldwide drug use and violence related to the drug trade had vastly increased. An extraordinary session was held last year, but it was largely a disappointment – the outcome document didn’t mention “harm reduction” once.

Despite that letdown, 2016 produced a number of promising other developments: Chile and Australia opened their first medical cannabis clubs; following the lead of several others, four more US states introduced medical cannabis, and four more legalised recreational cannabis; Denmark opened the world’s largest drug consumption facility, and France opened its first; South Africa proposed legalising medical cannabis; Canada outlined a plan to legalise recreational cannabis nationally and to open more supervised injection sites; and Ghana announced it would decriminalise all personal drug use.

The biggest change in global attitudes and policy has been the momentum behind cannabis legalisation. Local activists have pressed Goulão to take a stance on regulating cannabis and legalising its sale in Portugal; for years, he has responded that the time wasn’t right. Legalising a single substance would call into question the foundation of Portugal’s drug and harm-reduction philosophy. If the drugs aren’t the problem, if the problem is the relationship with drugs, if there’s no such thing as a hard or a soft drug, and if all illicit substances are to be treated equally, he argued, then shouldn’t all drugs be legalised and regulated?

Massive international cultural shifts in thinking about drugs and addiction are needed to make way for decriminalisation and legalisation globally. In the US, the White House has remained reluctant to address what drug policy reform advocates have termed an “addiction to punishment”. But if conservative, isolationist, Catholic Portugal could transform into a country where same-sex marriage and abortion are legal, and where drug use is decriminalised, a broader shift in attitudes seems possible elsewhere. But, as the harm-reduction adage goes: one has to want the change in order to make it.

When Pereira first opened the CAT in Olhão, he faced vociferous opposition from residents; they worried that with more drogados would come more crime. But the opposite happened. Months later, one neighbour came to ask Pereira’s forgiveness. She hadn’t realised it at the time, but there had been three drug dealers on her street; when their local clientele stopped buying, they packed up and left.

The CAT building itself is a drab, brown two-storey block, with offices upstairs and an open waiting area, bathrooms, storage and clinics down below. The doors open at 8.30am, seven days a week, 365 days a year. Patients wander in throughout the day for appointments, to chat, to kill time, to wash, or to pick up their weekly supply of methadone doses. They tried to close the CAT for Christmas Day one year, but patients asked that it stay open. For some, estranged from loved ones and adrift from any version of home, this is the closest thing they’ve got to community and normality.

“It’s not just about administering methadone,” Pereira told me. “You have to maintain a relationship.”

In a back room, rows of little canisters with banana-flavoured methadone doses were lined up, each labelled with a patient’s name and information. The Olhão CAT regularly services about 400 people, but that number can double during the summer months, when seasonal workers and tourists come to town. Anyone receiving treatment elsewhere in the country, or even outside Portugal, can have their prescription sent over to the CAT, making the Algarve an ideal harm-reduction holiday destination.

After lunch at a restaurant owned by a former CAT employee, the doctor took me to visit another of his projects – a particular favourite. His decades of working with addiction disorders had taught him some lessons, and he poured his accumulated knowledge into designing a special treatment facility on the outskirts of Olhão: the Unidade de Desabituação, or Dishabituation Centre. Several such UDs, as they are known, have opened in other regions of the country, but this centre was developed to cater to the particular circumstances and needs of the south.

Pereira stepped down as director some years ago, but his replacement asked him to stay on to help with day-to-day operations. Pereira should be retired by now – indeed, he tried to – but Portugal is suffering from an overall shortage of health professionals in the public system, and not enough young doctors are stepping into this specialisation. As his colleagues elsewhere in the country grow closer to their own retirements, there’s a growing sense of dread that there is no one to replace them.

“Those of us from the Algarve always had a bit of a different attitude from our colleagues up north,” Pereira told me. “I don’t treat patients. They treat themselves. My function is to help them to make the changes they need to make.”

And thank goodness there is only one change to make, he deadpanned as we pulled into the centre’s parking lot: “You need to change almost everything.” He cackled at his own joke and stepped out of his car.

The glass doors at the entrance slid open to a facility that was bright and clean without feeling overwhelmingly institutional. Doctors’ and administrators’ offices were up a sweeping staircase ahead. Women at the front desk nodded their hellos, and Pereira greeted them warmly: “Good afternoon, my darlings.”

The Olhão centre was built for just under €3m (£2.6m), publicly funded, and opened to its first patients nine years ago. This facility, like the others, is connected to a web of health and social rehabilitation services. It can house up to 14 people at once: treatments are free, available on referral from a doctor or therapist, and normally last between eight and 14 days. When people first arrive, they put all of their personal belongings – photos, mobile phones, everything – into storage, retrievable on departure.

“We believe in the old maxim: ‘No news is good news,’” explained Pereira. “We don’t do this to punish them but to protect them.” Memories can be triggering, and sometimes families, friends and toxic relationships can be enabling.

To the left there were intake rooms and a padded isolation room, with clunky security cameras propped up in every corner. Patients each had their own suites – simple, comfortable and private. To the right, there was a “colour” room, with a pottery wheel, recycled plastic bottles, paints, egg cartons, glitter and other craft supplies. In another room, coloured pencils and easels for drawing. A kiln, and next to it a collection of excellent handmade ashtrays. Many patients remained heavy smokers.

Patients were always occupied, always using their hands or their bodies or their senses, doing exercise or making art, always filling their time with something. “We’d often hear our patients use the expression ‘me and my body’,” Pereira said. “As though there was a dissociation between the ‘me’ and ‘my flesh’.”

To help bring the body back, there was a small gym, exercise classes, physiotherapy and a jacuzzi. And after so much destructive behaviour – messing up their bodies, their relationships, their lives and communities – learning that they could create good and beautiful things was sometimes transformational.

My uncle and heroin: ‘What surprises me most – you have no teeth’ | Sarah Resnick Read more

“You know those lines on a running track?” Pereira asked me. He believed that everyone – however imperfect – was capable of finding their own way, given the right support. “Our love is like those lines.”

He was firm, he said, but never punished or judged his patients for their relapses or failures. Patients were free to leave at any time, and they were welcome to return if they needed, even if it was more than a dozen times.

He offered no magic wand or one-size-fits-all solution, just this daily search for balance: getting up, having breakfast, making art, taking meds, doing exercise, going to work, going to school, going into the world, going forward. Being alive, he said to me more than once, can be very complicated.

“My darling,” he told me, “it’s like I always say: I may be a doctor, but nobody’s perfect.”

A longer version of this piece appears on thecommononline.org. Research and travel for this piece were made possible by the Matthew Power Literary Reporting Award

• Follow the Long Read on Twitter at @gdnlongread, or sign up to the long read weekly email here.

 

 

 

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The Assassination of Fred Hampton, Surveillance of Civil Rights Leaders, and Harassment of Black Lives Matter Just Business as Usual for Law Enforcement

Mon, 12/04/2017 - 15:34
Click here for reuse options! The criminalization of drug use is an easy excuse to surveil and control populations.

On this day 49 years ago, Fred Hampton, Black Panther Party of Self-Defense State chairman, was drugged and assassinated by the Chicago Police Department (with the assistance of the FBI). Just another day of law enforcement doing its job.  

In the United States, the role of law enforcement is to maintain “law and order” first and foremost. Moreover, law enforcement, especially the FBI, has historically played a major role in stifling social movements that seek to disrupt or dramatically alter the social order of the US.

From the violent strike-breaking and union-busting of the late 19th and early 20th century, to the surveillance of anti-war and civil rights leaders during the Vietnam era, to the imprisonment of Black Panther Party members and other political prisoners that continues to this day, US law enforcement does an especially good job of quelling the dissidence of oppressed peoples, no matter how peaceful the leader.  

Take Dr. Martin Luther King, Jr. Lauded today as the shining example of peace, equality and the “proper” way to protest, MLK was targeted and jailed by local police and surveilled by the FBI from December 1955 until his assassination in 1968.

The US government doesn’t take well to unrest, and the creation of laws and their ultimate enforcement are the prime means of subduing any agitation. The war on drugs is a prime example of this, as described in this infamous quote by Nixon aide John Ehrlichman:

“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.” 

The criminalization of drug use is an easy excuse to surveil and control populations. In the effort to restore and maintain law and order, blacks and Latinos are policed, arrested, incarcerated and criminalized at disproportionate rates for drug use and sales, despite the fact that white people sell and use drugs at the same, if not slightly higher, rate.  

The collateral consequences of this mass criminalization include the destruction of families, disenfranchisement rates that mirror those of the Jim Crow-era, school-to-prison pipelines, the creation and perpetuation of an economic and social caste system, and modern day slavery. Targeted traffic stops, violent SWAT raids and incessant racialized searches, known as stop-and-frisk, in search of drugs are daily reminders that the drug war is the justification to create a police state of black and Latino communities in order to maintain and control these populations.

The mass policing and criminalization does not stop at local law enforcement. Just as the FBI labeled the Black Panther Party and other civil rights organizations and leaders “black extremist groups” and surveilled and infiltrated their ranks, the FBI’s creation of the category “black identity extremist” (following the emergence of groups like Black Lives Matter and celebrities like Colin Kaepernick who speak out and protest against police brutality and mass criminalization), is just history repeating itself.  

Moreover, the Trump administration is doing all in its power to be harsher on enforcing our racist drug laws. Attorney General Jeff Sessions' announcement of $12 million grant funding for state and local law enforcement in an effort to combat the opioid crisis, money that could be better used to increase access to evidence-based treatment, illustrates the longstanding truth: maintaining law and order comes before saving lives.

Today, as we remember the life of an electrifying liberator, let us not forget the truth of his death. Fred Hampton was murdered by the Chicago Police Department as he lay in bed drugged and unconscious next to the pregnant mother of his child. The FBI, with use of an informant, coordinated this attack. His death was an act of police brutality. His death was government-sanctioned murder. His death was an assassination. Most of all, his death was law enforcement doing its job.

This piece first appeared on the Drug Policy Alliance Blog.

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As Kratom Use Surges, Some States Enact Bans

Mon, 12/04/2017 - 11:48
An estimated 3 million to 5 million people are using kratom and reporting positive results, but some states are bringing down the ban hammer.

CARRBORO, N.C. — On a sunny November afternoon in this quiet college community, a steady stream of customers walks through the doors of a local cafe called Oasis for a cup of an increasingly popular herbal beverage. The menu offers coffee, black tea, beer, wine and pastries, but nearly everyone opts for a $5 mug of kratom (pronounced KRAY-dum).

A powder ground from the leaves of an indigenous Southeast Asian tree related to the coffee plant, kratom (Mitragyna speciosa) offers pain relief and mood enhancement, similar to prescription painkillers.

Advocates say the substance, which does not depress the respiratory system and therefore presents little to no overdose risk, could help reduce the nation’s reliance on highly addictive and often deadly prescription painkillers. Some addiction experts also argue the plant could be used as an alternative to methadone, buprenorphine and Vivitrol in medication-assisted therapy for opioid addiction.

Used for centuries to fight fatigue, pain and anxiety in Indonesia, Malaysia, Myanmar, Papua New Guinea and Thailand, kratom was rarely taken in the United States until recently.

Now, with growing concerns about the dangers of prescription painkillers, an estimated 3 million to 5 million people are using kratom and reporting positive results, based on information from retailers. But worries that the unregulated plant product could be abused for its mild euphoric qualities and users could become addicted are spurring federal officials to issue public health warnings — and a handful of states and cities to impose bans.

Alabama, Arkansas, Indiana, Tennessee, Vermont, Wisconsin and the District of Columbia have banned kratom, along with at least three cities — Denver, San Diego and Sarasota, Florida. Legislation was considered last year in at least six other states — Florida, Kentucky, New Hampshire, New Jersey, New York and North Carolina.

Animal studies have shown that kratom use may lead to addiction. But user surveys indicate that although the herb can be habit-forming, withdrawal symptoms are no worse than those encountered when quitting coffee, sugar or certain herbal supplements. Withdrawal symptoms, which typically last three to four days, include muscle aches, cravings, a runny nose, restlessness and mood swings.

The Drug Enforcement Administration last year said it intended to classify the herbal supplement as an illegal Schedule 1 drug, along with heroin, LSD and marijuana. But after public demonstrations, letters from Congress and a petition with more than 142,000 signatures, the agency put the proposal on hold.

Last month, Food and Drug Administration chief Scott Gottlieb issued a public health warning, citing 36 deaths in which kratom was present, but not necessarily the cause. About 50,000 Americans die of drug overdoses each year. In addition, the FDA, which has been seizing imports of kratom at U.S. ports since 2013, stepped up import enforcement.

The agency also cited a 10-fold increase in kratom-related calls to poison centers between 2010 and 2015 — from 26 calls to 263, out of roughly 2.2 million calls a year. And Gottlieb warned about the unknown risks of using kratom to treat opioid addiction, saying he fears some kratom may have been laced with opioids, and that the FDA needs to conduct more study on the plant’s potential benefits.

In response, the American Kratom Association, a Colorado-based advocacy and lobbying organization, issued its own analysis of FDA data on adverse drug events, calling the kratom numbers “incredibly insignificant in the broader context” of drug-related deaths and adverse reactions.

All Kinds

At Oasis, no one seems concerned about the hubbub in Washington. Owner Robert Roskind says the controversy has only improved business by focusing attention on what he says is still a little-known plant with huge benefits and few drawbacks. “Except for the rare upset stomach or lightheadedness, it has helped nearly everyone,” he said. “And it’s cheap. I have about 300 customers and most come here several times a week. Some buy take-home packages.”

With subdued lighting, soft music and mystical artwork, Oasis has a peaceful vibe. Customers are happy to talk about their reasons for taking kratom, and they vary widely.

A group of University of North Carolina students from nearby Chapel Hill sit on floor pillows in a corner, reading and working on laptops. Kratom sharpens their focus when they need to study for an exam, one student said. “It’s like coffee without the jitters.”

A 27-year-old tattooed chef from Brooklyn said he started drinking kratom to relieve withdrawal symptoms after he decided to quit heroin on his own three months ago. A conservatively dressed 22-year-old fraternity brother said kratom has helped him stop binge drinking.

A woman in her 40s, recovering from brain cancer therapy, says it relieves her anxiety and improves her sense of well-being. Two women who work with preschoolers say it lowers their stress level. And a 29-year-old construction worker says it keeps his fibromyalgia symptoms, including pain and fatigue, at bay so he can get up and work every day.

Even among the diverse crowd here at Oasis, Bob Whyte, a well-dressed 80-year-old businessman from Chapel Hill stands out. A self-described straight-laced “boy scout,” he said he’s been drinking kratom three times a day to relieve severe back pain from failed surgery.

“I’d been taking tramadol and hydrocodone consistently for two years when I found out about kratom,” he said. Whyte said his doctors didn’t want him to keep taking the highly addictive prescription painkillers, and they had no objections when he told them he was switching to kratom.

At first, Whyte said he was a little fearful about trying the plant-based medicine. Roskind gave him a kratom brownie and suggested he eat half of it at home.

“I picked a day when I wouldn’t be driving and sat on the front porch and had half a brownie. I waited a half-hour and felt fine, so I had the other half. That’s when I had a little happy moment there on the porch,” he said sheepishly.

Since that July morning, Whyte said he’s figured out what dose is best for him — enough to bring his pain down to a tolerable level without feeling drowsy. Now he says he’s telling everyone he knows about kratom.

Research Needed

Despite rave reviews from kratom users, most physicians and researchers argue that research using human clinical trials is needed to accurately determine the leaf powder’s potential harms and benefits. They also insist that oversight of commercial sales of the plant is needed to ensure consumers are getting high-quality, uncontaminated products.

But scientists and other stakeholders differ about whether sales of the plant should be curtailed in the meantime.

The American Society of Addiction Medicine argued in comments to the DEA last year that the whole botanical product, like the powder sold at Oasis, should be made illegal to prevent people with addictions from trying to use it to recover. Since three FDA-approved medications exist that have proven safe and effective, using kratom to treat opioid addiction presents an unnecessary risk for people with addictions, the group said.

At the same time, they recommended that what appears to be the plant’s primary active ingredients, mitragynine and 7-hydroxymitragynine, should remain legal so they can be researched for their pain relief and addiction treatment potential.

Oliver Grundmann, an associate professor of medicinal chemistry at the University of Florida College of Pharmacy, has surveyed kratom users and found that very few report becoming addicted and most use it to treat chronic pain, mental health conditions and drug addiction.

“I’m questioning whether we are doing any good by banning kratom,” Grundmann said. If states and the federal government make kratom illegal, he said, it would not only slow the progress of research, but it would also leave many kratom users no choice but to switch back to painkillers or heroin. 

 

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How to Save Lives in the 'Overdose Capital of America'

Mon, 12/04/2017 - 11:31
A new documentary streaming on Netflix is a window into what it’s like to be on the front lines of the opioid crisis.

Heroin(e) is a powerful film that follows the stories of three women in Huntington, West Virginia, who are battling the opioid crisis on its front lines. Drug addiction is so common in Huntington, the “overdose capital of America,” that it’s weaved into the fabric of everyday life. In one scene, paramedics work to revive an overdose victim at a convenience store while people step around the commotion and move along the checkout line as if nothing is happening.

Fire Chief Jan Rader is the first responder who carries not only the film, but also the weight of the crisis in her community as she works to save as many people as possible and get addicts into long-term recovery. Judge Patricia Keller is part mother-hen, part school principal, doling out encouragement and discipline with equal compassion. Necia Freeman, a volunteer with a local church group, drives around at night providing food, shelter and help to those teetering on the edge.

Opioid overdoses are now the leading cause of death for Americans under 50, having killed 64,000 Americans in 2016, a 17 percent increase from the previous year. President Trump had promised to designate the crisis a “national emergency,” which would have prompted more federal dollars to help. Instead, he recently declared it a “public health emergency,” to the consternation of his critics.

I spoke with filmmaker Elaine McMillon Sheldon, who co-produced Heroin(e) with the Center for Investigative Reporting, and Chief Jan Rader about the growing epidemic, treatment options and making the film.

Titi Yu: Chief Rader, what did you think about the president’s announcement and how do you think it will affect your work as a first responder?

Jan Rader: Well, I guess we will see. In my mind it’s a good first step and I hope it’s backed up with more to come. Certainly opening up telemedicine in the rural communities is a help, because we do have a lack of providers. Bringing in [federal grant funds to target those with opioid addictions, part of Trump’s declaration] is going to help that, but it’s going to take further steps to deal with this epidemic.

TY: From your perspective, what does that look like? Is it more money?

JR: It’s such a complex issue. We’ll just take probably anything. But in our area, the No. 1 issue is that we have a bottleneck at detox. In Cabell County, with a population of 96,000 people, we only have eight detox beds. That’s important, because people have to go into detox before they go into recovery.

The other problem is that the eight detox beds we do have are not medically assisted, and we desperately need them to be. It’s almost inhumane because if they don’t die from detoxing off of opiates, they wish they were dead. So if we had medically assisted detox we’d have a lot more people willing to detox and get into long-term care.

Elaine McMillon Sheldon: And also Naloxone right, Jan?

JR: Oh yes, we use any and all Naloxone donations that we get. That’s where I would hope that Big Pharma would step up to the plate. You have to be alive in order to get into long-term care. Naloxone’s key to keeping people alive.

TY: So tell me more about Naloxone; what does it do?

JR: Opioids latch onto receptors in the brain that actually suppress the respiratory system. And if you stop breathing, or you’re not breathing sufficiently for five to six minutes, then you’re brain dead. Then the heart stops working. It’s critical to get to people as quickly as possible when they overdose. What Naloxone does is it knocks the opiate off those receptors so they start breathing again. That is key, and sometimes [people] wake up instantaneously.

TY: How expensive is Naloxone?

JR: You know, my department is quite poor. So for me to carry Narcan [the brand name for Naloxone], I have to accept donations. If we don’t have Narcan, we provide rescue breathing until Cabell County EMS arrives. For a nasal dose, you’re talking about $50 a dose. We had Evzio [a naloxone auto-injector], and those are [as much as $4,500] a box and there are two doses in the box.

The good thing about our area is that not only did our health department start applying [for] grants so first responders can carry Naloxone, but they were also handing out free Naloxone to friends and families of those suffering from substance use disorder. Over 1,100 lives have been saved without intervention from first responders. For parents with an adult child that’s suffering from substance abuse disorder, they at least can sleep a little better at night knowing that they have a reversal drug to give to their own child if they overdose. So I think we need to continue to supply as much Naloxone to the general public as we possibly can.

TY: So Elaine, what prompted you to want to make this film?

EMS: You can’t live in West Virginia and not know that this problem has been impacting us for many years. Today, because of the headlines, everybody knows what’s going on here. But we’ve been experiencing this crisis since the ’90s, with the pill mill and then with heroin. I grew up in Logan, West Virginia, where right down the street a so-called doctor from another state set up shop in a cinder block building with no furniture, and had a woman just sitting there with a full bag of prescriptions, handing them out, day after day.

So this is part of growing up here. You knew it was happening. Once I got to high school and then college, it started taking classmates from me. We started seeing more people either dying or imprisoned for felonies such as robberies, to get drugs. Some of my friends have had their children taken away from them and put in the foster-care system. I didn’t want to speak about this subject for a long time because the majority of the media focuses on the bleak and dire circumstances of an addict. I don’t have it in me to put that kind of suffering on screen. I wanted to produce something that would hopefully guide us forward.

When I met Jan, Patricia and Necia, I found them very inspiring. They make Huntington a part of the West Virginia that we should be proud of, a leader in the state. The film was a chance to not only highlight the women doing this work but also what the average citizen can do to help save a person’s life or to help make change. I think we need more stories like these today.

TY: There was a scene where Jan says she’s worried about how the younger medics are dealing with the increase in the number of deaths they see every day. I imagine there are moments that must have had a profound impact on you as well.

EMS: I was really conflicted about that. I talked to Jan quite a bit about all the ethical choices around filming someone hitting rock bottom. That is not something we took lightly, and honestly it was quite difficult for me. And if it wasn’t for us focusing our efforts on the first responders including Jan, I don’t know that I could have done that. But I was filming people who were helping save a life and that gave me the motivation to keep on filming. What I’ve seen is nothing compared to what first responders have to deal with day in and day out.

TY: Can you tell us a bit more about the court-appointed drug rehab program?

JR: Judge Keller, who by trade is a family court judge, is an amazing person. She doesn’t get paid to do drug court; she just does it on her own, pro bono. She really cares about individuals and she’s not willing to give up on people when they screw up. I can’t speak for her, but we have had many conversations on her goals. I look for Judge Keller to do wonderful things as a family-court judge, because if we treat one person, the triggers are still there in the family. But if you treat the whole family, then you really tackle it from a holistic point of view — you’re doing away with the triggers. A lot of people are unsuccessful in long-term treatment because they get better and then they go right back into the same household with the same family members nagging them or not understanding. There’s so much collateral damage and family members need counseling and treatment also, whether they’re using or not. I looked at some models in New England where they do a home health-care model with addiction counseling. They treat people in their homes with their family units and it’s quite successful.

EMS: When we talk about addiction, I think one of things for me is the tremendous brain drain from the state. Young people leave every day and our death rate is higher than our birth rate. But what scares me is that we have such a high population of young people who are addicted. Once they do get clean, it’s really hard for them to return home. I’ve been making a film about four guys going through recovery and the ones that return to the same environment they left didn’t do well.

TY: Jan, in a very emotional scene, you thanked Mickey, an addict, for teaching you more than he would ever know. What did you mean by that and how has doing this work changed your life?

JR: I was very blessed; I grew up in with a family who loved me and provided for me. I never had to want for anything. We weren’t rich, but we always had food in our bellies and clothing and things like that. I was never beaten or mistreated and my parents always gave back to their community. So starting out as a first responder — and I’m an old medic and I went to nursing school — I was never taught anything about what addiction truly is. And there was a lot of ignorance surrounding substance use disorder.

But Mickey in particular — he’s such a nice guy. My education has come through dealing with the Mickeys of the world and dealing with those with substance use disorder. It’s like there has to be a better way. Why are we treating people poorly? Why are we not embracing them and trying to lift them up? And Mickey, I had him as an overdose case multiple times and he was a very belligerent user. He would get very angry when we would catch him using. And that’s how I knew him. I’d get an overdose call, and when I see Mickey’s address, I would think, “Oh this is gonna be a doozy.”

[Phone rings in the background] We have an overdose right now, just so you know.

Mickey’s a man who started using at age 8. His mom was getting drunk and high and he had no life. All he knew was getting high until he was 34 years old, when he got clean. He’s super intelligent and funny. He let go of all that anger that he had. They always say that drugs kill your brain cells. Well, I can’t imagine how smart he would be or what he would have been able to accomplish had he not suffered like that as a young boy. He was physically and sexually abused when he was growing up. And it’s just like, “How in the world can he be that resilient?” I can’t imagine that I would have survived that. What an amazing person to go through that. And now he’s healthy, he’s happy and he’s involved in his children’s life, which he had never been before. And Mickey teaches us so much about humanity. I mean, who am I to judge? I didn’t take an oath to judge; I took an oath to save lives. I just saw him the other day, happy as he can be. His wife was just diagnosed with cancer for the second time. They were in recovery together and now they are clean together. It’s just a humbling experience to know people like Mickey.

TY: So I guess the question is, and I think you’ve already answered it in a way, but: How do you stay hopeful?

JB: How dare I say that I’ve had a bad day because I’ve seen three overdoses when somebody lost their child or their sister or their wife or husband. How dare I think I had a bad day, you know what I mean? Now if I have a bad day, somebody else always had a worse day. I know not all first responders look at it that way, but maybe someday they’ll connect the dots and realize, “You know what, I don’t have it so bad,” because I really, truly believe that every one of us is just one bad time of our lives away from addiction.

TY: Elaine, do you have thoughts on that as well? About being hopeful, because despite the bleakness of the topic, you made a very hopeful film.

EMS: I think one of the reasons I was drawn to Jan, and the other women too, is trying to understand how they stay hopeful. And I think we give up on people too easily. What I love about what they’re doing here in Huntington is the belief in a second chance and a third chance. It’s really remarkable to see Jan even on a bad day find purpose in what she’s doing. It’s a lesson on being a good person and a good people within humanity take care of each another.

One of the reasons why I think addiction has taken over so many communities is that we’ve lost each other. We live isolated from each other, and our society is at a point where we feel like we don’t need another. I think seeing a crisis like this shows us how much we really do need one another.

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State Courts Slap Down Cops on Outrageous Over-the-Top Pot Raids

Fri, 12/01/2017 - 12:39
Click here for reuse options! There's this thing called the Fourth Amendment...

With the federal judiciary increasingly the domain of conservative jurists, state courts may not be the first but the last resort for people seeking redress of grievances against the state. And they are stepping up: In two recent rulings, state courts in Florida and Michigan have thrown out marijuana cases because of dangerous, overly aggressive SWAT-style raids.

In the Florida case, a heavily armed SWAT team of Collier County Sheriff's deputies hoping to seize two dozen pot plants growing in the back yard of Juan Falcon's home arrived at his front door at 7am, yelled that they were police, and broke down his door with a battering ram, throwing two flashbang grenades into the home for good measure.

As the state's Second District Court of Appeal noted in its ruling that the search was illegal, police knew they were hitting a family residence with two children in the home, that Falcon had no criminal record, and that he posed no threat of violence.

Florida law allows "knock and announce" searches, where police can forcibly enter a residence when homeowners fail to respond in a timely fashion to their demands to open up. But in a unanimous decision authored by Judge Susan Rothstein-Youakim, the appeals court held that police in this case went too far:

At just past 6:45 a.m. on April 9, 2014, a SWAT unit of at least six heavily armed deputies appeared on the front doorstep of Falcon’s residence to execute a search warrant. Less than an hour earlier, the deputies had all been briefed on the fact that Falcon lived in the residence with his family, which included an adolescent son and a teenage daughter. Notwithstanding the nature of the suspected offense, the deputies had no reason to believe that there were any weapons in the residence or that Falcon was armed and dangerous; his criminal history consisted of one arrest for driving under the influence. The deputies also had no reason to believe that Falcon knew that they were coming, that anyone inside the residence was at risk of harm, or that Falcon or his family might try to escape or destroy evidence.

Not only were the cops overly aggressive given the totality of the circumstances, Rothstein-Youakim concluded, they violated the "knock and announce" law by announcing their presence, but then breaking down the door "with such haste that the occupant does not have a reasonable opportunity to respond."

The court reversed Falcon's conviction for maintaining a marijuana grow house.

In the Michigan case, the state Supreme Court reached a similar conclusion, throwing out the convictions of two Kent County jail guards for possessing marijuana-infused butter after Kent County narcotics agents conducted predawn raids without warrants on their homes. One raid came at 4am and the other at 5:30am.

The Kent County narcs insisted the warrantless raids were proper because they were only doing "knock and talk" interactions with the suspects. Under the state's "knock and talk" law, police can go to someone's home without a warrant and engage them in hopes of turning up suspicious behavior. In these cases, heavily armed police appeared in the middle of the night, demanded entrance to the homes, and the intimidated homeowners and their families consented to the search.

The jail guards later challenged the legality of those searches, and in a unanimous decision, the state Supreme Court agreed the searches were unlawful:

In these cases, the police officers exceeded the scope of the implied license to knock and talk because the officers approached defendants’ respective homes without warrants during the predawn hours; therefore, the officers trespassed on Fourth-Amendment-protected property. And because the officers trespassed while seeking information about defendants’ alleged possession of marijuana butter, they performed searches in violation of the Fourth Amendment.

In the wake of that ruling, the trial judge in the case ruled last month that the marijuana-infused butter seized in the raids could not be used as evidence because police had violated the Fourth Amendment's proscription against unwarranted searches and seizures.

Police conduct thousands of these SWAT-style drug raids each year. In rare cases, the resort to paramilitarized SWAT teams to go after drug suspects in middle of the night raids resembling combat operations may be justified, but in all too many cases, they amount to dangerous overkill. It's a shame that elected officials fail to rein them in, but at least some state courts still uphold the Constitution. 

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Will Citizens Be Able To Grow Their Own Marijuana In New Jersey?

Fri, 12/01/2017 - 11:50
If there's no home cultivation, it's not really legalization.

Since Phil Murphy became governor elect, replacing the nation’s least popular governor in history, Chris Christie, New Jerseyites have been waiting with bated breath to see cannabis become legal. Some out of worry, but most out of pure excitement.

Murphy promised to legalize recreational cannabis within his first 100 days in office. While there was already a bill introduced in January, it has stayed in committee and in Assembly respectively, with Christie’s foot firm on the brakes.

Legislators and advocates are working on drafting a new bill now, as they acknowledge that the older bill needed some tweaking to pass the Legislature.

To answer the above question on home cultivation, the answer is a strong maybe. In the current bill the answer is no, no growing your own, however, that could change with the new bill. Kate Bell from the Marijuana Policy Project says that they are advocating strongly for home grow inclusion and they seem to be making progress with their case, according to NJ.com.

As to the rest of what we know about the existing bill, adults 21 and over will be able to possess up to one ounce of dried cannabis. Only towns that allow recreational sales will stand to benefit from the tax revenue. Best of all, those whose criminal records consist of nonviolent cannabis “crimes” will be eligible to have their records expunged.

Criminal justice is one of Murphy’s main reasons for wanting to dispel of prohibition. He knows the numbers and that black and brown people are arrested and incarcerated at much higher levels than whites, while data shows that people of all races use cannabis at around the same rate.

A new, diverse market is about to open in New Jersey, and diversity is one of the original bill’s points. It calls for women and minorities to be given the chance at licenses to grow or distribute. It’s not all about the weed, it’s about jobs, justice, diversification, infrastructure and the tax revenue that will help in all areas.

And though the original bill doesn’t allow for public usage, there’s a great possibility that legislators have been doing their homework and know that places to consume are a must. Plus, MPP is already on it. New Jersey may have a new kind of social club sooner than later…

 

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Another 6,000 Tainted Massachusetts Drug Cases Get Overturned

Fri, 12/01/2017 - 11:29
That's in addition to another 21,000 earlier this year. Something is rotten in the Bay State.

BOSTON (CN) – Closing out a banner year for overturned drug convictions, the American Civil Liberties Union announced a 25 percent boost Thursday to the number of cases being dismissed by prosecutors over tainted evidence.

“Today we announce that multiple Massachusetts district attorneys are now poised to dismiss thousands of wrongful convictions due to evidence tainted by Sonja Farak,” said Carol Rose, executive director of the ACLU of Massachusetts, addressing reporters from the group’s offices in Boston. “This shameful history of misconduct keeps repeating itself.”

The Thursday morning press conference marks the second blast this year at drug convictions in the commonwealth tainted by laboratory misconduct.

More than 21,000 drug convictions were overturned in April based on their connection to Annie Dookhan, the disgraced Hinton State Laboratory chemist who went to prison after she admitted to having doctored the results about one in six of the criminal drug cases tried in Massachusetts between 2003 and 2012.

While Dookhan’s efforts served to goose her lab work, Farak at the Amherst drug lab pleaded guilty in 2014 to stealing cocaine she was supposed to be testing.

The ACLU noted in a petition to the Massachusetts Supreme Judicial Court this fall that Farak was abusing a pharmacy’s worth of drugs on an almost daily basis from August 2004 until Jan. 18, 2013. During this time she “was under the influence of methamphetamine, amphetamine, phentermine, ketamine, MDMA, MDEA, LSD, cocaine, or other narcotics (or suffering withdrawal from those substances),” the petition said.

Attorneys at the ACLU want the evidence that crossed paths with Farak to meet the same fate as the Dookhan cases. They say the state attempted to conceal the extent of the damage.

“Upon finding out about Ms. Farak’s malfeasance, prosecutors mislead the public about the scope of the scandal,” said Rose. “Our primary purpose today is to seek justice for thousands of people who have been needlessly suffering.”

The ACLU’s Farak petition led the Supreme Judicial Court to demand that Massachusetts district attorneys produce a list of affected cases as well as a list of cases that they intended to dismiss.

They had until the end of the day Thursday to comply.

Five district attorneys announced ahead of the ACLU’s morning press conference that they were dismissing a total of 6,057 cases.

“Given the nature and extent of her misconduct, retesting the substances at issue is unlikely to yield a reliable result,” Suffolk District Attorney Dan Conley said. “The most appropriate step is to notify the court that we will not pursue any further litigation in any of the identified cases.”

Suffolk, which is home to Boston, is dismissing 135 cases. Hampden County accounts for the bulk of dismissed cases (3,940), while the Northwestern District DA, who handles Franklin and Hampshire counties, is dismissing the next highest number of cases (1,497). Middlesex and Worcester counties are dismissing 245 and 241 cases, respectively.

The remaining district attorneys released their numbers later Thursday, announcing the dismissal of roughly 1,000 more cases. Essex is dismissing about 500 cases, Bristol reported 203, Plymouth gave an estimate of about 100, and Norfolk reported 76. The DA of the three counties making up the Cape & Islands did not find any cases. Berkshire County was reportedly reviewing 600 cases but has not revealed how many it will dismiss.

Jillian Fennimore, a spokeswoman for the state Attorney General’s Office, said that her office did not submit any dismissals because they were not away of any cases from their office that were affected by Farak.

“It’s unfortunate that the ACLU chose to stage a press conference without reading the AG’s brief filed in this case, which calls for speedy relief for these defendants,” Fennimore said in an email. “Sonja Farak’s crimes were egregious and, as our filings today make clear, this office has been working hard to resolve these cases as quickly as possible. Staff in the AG’s Office have been working hard for months to review databases, identify the Farak defendants, and secure their speedy relief. For the ACLU to suggest otherwise is false and irresponsible.”

The ACLU brought its Farak petition with the Committee for Public Counsel Services, and the firm Fick & Marx.

“This case is a reflection of how a misguided war on drugs turned into a war on poor people and a war on people of color,” Randy Gioia, deputy chief counsel at the Committee for Public Counsel Services, said Thursday. “It turns out that for thousands of people the system that sent them to jail or put them on probation was rotten to the core.

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Bugs, Mold, and Excrement: Welcome to the Brave New World of California Cannabis

Thu, 11/30/2017 - 12:21
Project CBD critiques the new regulations for America’s largest marijuana market--and it isn't pretty.

On November 16, 2017, California officials released a new set of regulations for cannabis manufacturing, testing, and growing. In many respects, these updates are a significant improvement to the initial draft regulations, however, some major problems remain. 

Two important issues pertain to regulations on mold and foreign filth, which are absurdly loose. And unlike the initial proposal, no statement as to the rationale behind the new regulations has been released.

Safety requirements

Allowable limits for contaminants including pesticides, solvents, and microbes are described in sections 5718-5723 of the new regulations. These regulations have fixed a major issue in the initial draft where two different units were confused – parts per million by weight (µg/g) and parts per million by volume. Now solvent and pesticide limits are given in µg/g.

Other significant changes:

  • Solvent limits are largely improved. Certain class 2 solvents have been banned, as Project CBD had previously suggested.
  • Pesticide limits have swung from being very strict to being overly lax. The environmental concerns related to pesticide overuse appear more problematic than the health effects for consumers.
  • Many pesticide safety limits are still based on regulations for tobacco, which is entirely inappropriate.
  • Required tests for microbial contamination are minimal.
  • Limits on mold – one of the most common contaminants of cannabis – are nearly nonexistent. A product is deemed to pass regulations if less than 1/4th of it is covered in mold.

Solvents - §5718

Solvents are broken into two categories for the purpose of regulations. Category 1 solvents are banned and are not permissible at any detectable levels in cannabis products. Category 2 solvents are allowed up to set action limits that depend on the solvent in question and whether the product is inhaled or not. Action limits for non-inhaled products were appropriate in the initial draft proposal and have not changed.

The initial proposed regulations allowed for the use of highly dangerous solvents, including benzene, which Project CBD suggested be banned from use in cannabis manufacturing. We also suggested that regulators consider banning “class 2” solvents such as chloroform, since they are unnecessary for producing most kinds of cannabis extracts.1 The new regulations now ban the use of benzene and some class 2 solvents like chloroform, but allow other class 2 solvents, including hexane. (Hexane is rarely used to extract oil from cannabis, but is sometimes used to clean the oil of pesticides or other adulterants.) Although Project CBD hopes that cannabis manufacturers avoid using hexane to extract or clean oil, we believe these regulations are appropriate.

Each permissible solvent has a maximum allowable concentration in inhaled cannabis products (e.g. vape cartridges). In the initial draft proposal, these limits were based on safety data from California’s Occupational Health and Safety Administration (OSHA), although the limits were improperly calculated due to confusion with units. (“Parts per million” can have multiple meanings, as mentioned above. See the previous Project CBD statement for more detail.) The new limits are particularly stringent for some class 2 solvents and are overly lenient for ethanol residues.2   On the whole, the new limits are sensible.

Pesticides - §5719

Similar to solvents, pesticides are broken into banned pesticides, which are not allowed at any detectable concentration, and allowed pesticides. The action limits for permitted pesticides depend on whether the product is inhaled or not.

The regulations were released with only 5 days for public comments – including the weekend – and were not accompanied by any statement of reasons explaining how new safety limits were determined. As such, Project CBD’s comments on the new pesticide regulations point out potential problems without necessarily suggesting how these issues could be fixed or their extent.

In the new regulations, the list of banned pesticides has shrunk dramatically, from 42 to 21. One of these now-allowed pesticides is a neonicotinoid (acetamiprid) and four others have “high acute toxicity” to humans, according to the initial statement of reasons (bifenthrin, cyfluthrin, naled, and abamectin). Most of the rest of the now-allowed pesticides were banned in the original proposal due to environmental concerns, including myclobutanil (often sold Eagle-20).

The initial set of draft regulations on pesticides were very strict in some regards. The limit of detection (LOD) – which is the lowest concentration of a compound that can be detected reliably – was arbitrarily set at 0.01 – 0.02 µg/g. This is lower than the actual LOD of pesticides in cannabis for most labs. This has changed – now labs will determine their LODs scientifically and list these LODs on lab reports.3 This is an important fix.

To reiterate: because no statement of reasons has been released, we do not know the rationale behind the limits for pesticides on non-inhaled products. But we can say with some certainty that it is not based on the relative safety of these pesticides.

Safe limits for pesticide ingestion are given as the acceptable daily intake (ADI) or acute reference dose (ARfD), and are reported by the World Health Organization. The ADI indicates a level of pesticide ingestion that is considered safe for chronic daily use, which makes sense for food or medicine. Converting the ADIinto a limit for a pesticide in cannabis products depends on the amount of product that is consumed. If the limits were based on safe ingestion limits, the ratio of the ADI to the action limit would be constant. In the current proposal, this ratio varies from 2.5 to 750, a 300-fold difference. Pesticides like trifloxystrobin, bifenazate, and permethrin have very high action limits compared to their toxicity when ingested.

It appears that the limits were not based on environmental concerns either: Of the seven least regulated pesticides (i.e. those with the highest allowable limits), five were originally banned due to potential ground water contamination.

For inhaled products, the limits still appear to be based on tobacco, as described in the initial statement of reasons. This may be because very little is known about the effects of heating or burning pesticides (an information vacuum attributable to lobbying from the tobacco industry). Some pesticides will, in fact, become safer when burned, while many others will break down to much more toxic compounds.

The EPA has previously stated that it need not study the health effects of burning pesticides at concentrations below 0.1 µg/g in cigarettes because those individuals are already smoking tobacco. After all, nicotine is the insecticide upon which neonicotinoids are based.

It may be true that inhaling less than 0.1 µg/g of most pesticides is safe. But regulations need to be based on scientific data. If safety data on burning and inhaling pesticides is not available, then the law should include provisions to be updated as new data emerges.

The outcomes of the tobacco industry’s war against science should never be used as the basis of safety regulations for another industry. Tobacco is the leading cause of preventable deaths in the United States, killing roughly half a million people every year. This is precisely because the tobacco industry lobbied to ensure that scientific data on health and safety was not used to inform laws or regulations. That should not be the starting point for any aspect of the emerging cannabis industry.

Foreign material - §5722

The foreign material testing, described in §5722, is beyond the pale. §5722(e) states that:

A sample shall be deemed to have passed the foreign material testing if the presence of foreign material does not exceed:
(1) 1/4 of the total sample area covered by sand, soil, cinders, or dirt;
(2) 1/4 of the total sample area covered by mold;
(3) 1 insect fragment, 1 rodent hair, or 1 count mammalian excreta per 3.0 grams; or
(4) 1/4 of the total sample area covered by an 
imbeddedforeign material.

A small piece of chocolate weighs about 3.5 grams. 

Under the new regulations, a 16-piece chocolate bar would be considered acceptable if four pieces were covered in dirt, four more were covered in mold, and each of the 16 pieces had an insect part or rat poop on it.

Microbes - §5720

There is an unprecedented change in regulations on microbial contamination. Cannabis is not required to be free of mold nor are labs required to test for mold. The only limit on mold is given in (2) of the foreign filth section quoted above, which states that up to 1/4th of a product can be covered in mold.

Under the new proposal, products only need to be screened for three microbes: pathogenic E. coli, salmonella, and in the case of inhaled products, aspergillus. Since no statement of reasons were released with the regulations, it is not clear why 

California is so loose with microbes. Giving regulators the benefit of the doubt, it may be that they are trying not to restrict the use of beneficial microbes, an organic growing practice that uses non-harmful microbes as an alternative to pesticides. But mold is one of the most common contaminants on cannabis. It is absolutely essential to test for mold on cannabis, particularly when grown indoors.

Phase in of safety testing - §5715

The regulations have been released with just over a month before they will be implemented. To ease the burden on labs, testing will be phased in over the course of a year. This gives labs time to develop and validate methods for each kind of product and each kind of test.

On January 1, 2018, all legal products must be tested for cannabinoids, allowed solvents, banned pesticides, microbes, and product homogeneity.  On July 1, 2018, three additional tests will be required: banned solvents, allowed pesticides, and foreign material. On January 1, 2019, heavy metals, mycotoxins, and possibly terpenes will also be tested before sales.

Project CBD hopes that terpene testing will become more commonplace, as this will help to illuminate the therapeutic properties of these important plant components.

Other regulations

There are many important aspects of the new regulations that address issues beyond consumer safety. Here are some key points:

  • There is effectively no longer a limit on the size of grows. Each license allows a group or individual to grow up to one acre of cannabis, but there is no limit on the number of licenses a group can get. Project CBD shares the concerns of farmers who are worried that this will allow large-scale agriculture to push out smaller, more sustainable gardens. Privileging wealthy out-of-state investors and big players at the expense of family farmers is bad policy with unhealthy long-term implications for California’s economy and environment.
  • Law enforcement are allowed to copy the materials, records, and books of any employee of any licensed cannabis business. See §5800(a)(4).
  • Recreational products can’t be given away for free. Medical patients can be given free products through a compassionate care program, but this program must be run by a local jurisdiction, not a cannabis business. Moreover, only licensed retailers (e.g. a legal dispensary), not product manufacturers, can provide free products to patients. See §5411.
  • Medical patients under the age of 18 cannot be served at a dispensary. Their caregiver must buy product for them. See §5400(b).
  • Edibles are required to contain no more than 10 mg THC per serving and 100 mg THC per package. Other products must contain less than 1000 mg or 2000 mg THC per package, depending if the product is recreational or medical. See §40306.
  • Edibles cannot contain any other addictive substances, including caffeine, alcohol, and nicotine. Exceptions are made for cannabis chocolate, tea, and coffee. See §40300(b).
  • Labs are required to be certified by one of two groups (the International Standard Oganization or International Electrotechnical Commission). This will help ensure the accuracy and consistency of lab tests, which has been problematic in the past.
  • It is now much easier to get a license to do ethanol extraction, since it is considered a “nonvolatile solvent.” See the definition of “nonvolatile solvent” in §40100.

Copyright, Project CBD. May not be reprinted without permission.

1 Solvents are classified into one of three groups by the FDA. Class 1 solvents like benzene are either very toxic or environmental hazards and should be avoided in manufacturing if at all possible. Class 3 solvents like ethanol and butane are fairly safe at low concentrations. Class 2 solvents like chloroform and dichloromethane are less dangerous than class 1 solvents, but should be avoided if the use of a class 3 solvent is possible.
2 This is not to say that the allowable limits are wrong. But compared to safety data from OSHA, limits are disproportionately lax for ethanol and strict for class 2 solvents.
3 A second number to be listed on lab reports is the limit of quantification (LOQ), which is at least as large as the LOD. The LOQ is the limit at which the concentration of a chemical can be accurately discerned. The range between the LOD and the LOQ is the range of concentrations where a test can show that a chemical is present, but cannot determine its exact concentration.
4 Products with multiple servings (e.g. a chocolate bar) will be tested every 6 months to ensure that every piece has roughly the same amount of cannabinoids in it. Specifically, the relative standard deviation must be less than 10% of the mean amount of each cannabinoid.

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Google Should Follow Apple's Lead and Remove Video Games Glorifying the Drug War in the Philippines

Thu, 11/30/2017 - 11:12
It's time for corporations to stop profiting off of Duterte's atrocities.

The President of the Philippines is responsible for a brutal drug war that has killed thousands of people in his country. He is also the protagonist in a series of online video games that glorify these murders. In these games, players act as Duterte and score points by eliminating “criminals”, “zombies”, and “people infected by drugs”, echoing the stigmatizing language used by Duterte himself in reference to people who use drugs. Up until yesterday, these games were widely available on Apple’s app store, as well as on Android’s Google Play store. Yesterday, Apple quietly removed the games from its store.

The removal of the games from Apple’s store comes after the Asian Network of People Who Use Drugs (ANPUD) released an open letter in October to Apple CEO Tim Cook calling on Apple “to immediately remove apps (games) that are promoting murder, extrajudicial killings, violence, and the war on drugs in the Philippines.” The letter was signed by 131 organizations, including human rights and drug policy reform groups.

Meanwhile, the Google Play store continues to host the offensive and gruesome games (some rated “E” for “Everyone”) glorifying President Duterte’s drug war. In September, we called on Google to take down these games.

Sign this petition: Tell Google Play to Remove Games That Glorify Duterte’s Horrific Drug War in the Philippines

President Duterte has championed a campaign that is responsible for the extrajudicial killing of more than 12,000 people, showing his complete disregard for due process or human rights. It seems pretty clear that these games violate Google Play's policy, which says, “We don’t allow apps that lack reasonable sensitivity towards or capitalize on a natural disaster, atrocity, conflict, death, or other tragic event.” Google should follow Apple’s lead and remove the video games that capitalize on the real tragedy that is unfolding in the Philippines.

This piece first appeared on the Drug Policy Alliance Blog.

 

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Can Psychedelics Help Cancer Survivors Shake Death Anxiety?

Wed, 11/29/2017 - 21:57
Ask Eddie Marritz.

When Eddie Marritz was diagnosed with small cell carcinoma, which is the type of cancer typically found in lungs, he thought it was a death sentence.

He was with his wife Hannah when he got the news. “We were on the six train,” Marritz recalls. “I was holding onto a pole and not feeling too steady emotionally. I said to her, ‘This is the day I've been waiting for all my life. This is the day where the delusion that I'm going to live forever meets the reality of I'm going to get something and die.’”

Eddie eventually beat cancer. “In the spring of 2013, I had done four rounds of chemotherapy and in late June I was operated on and it was a bit to recover from,” says Marritz. “I mean, it was a four-hour operation. I have a new bladder. They took out my prostate.”

The chemo and operation were successful for Eddie, but he couldn't shake the anxiety of having come so close to dying. So he entered New York University's psilocybin cancer anxiety study, where he met Dr. Jeffrey Gus, a co-principal investigator in the study and Eddie's guide through the psychedelic experience.

During the Summer of Love in 1967, Dr. Jeffrey Gus was a teenager. “Life Magazine came into our home,” he says, “and when I read about LSD on college campuses I said, 'that is for me.' I wasn't able to actually become involved with it. So we passed each other. And it wasn't until the late '90s that I saw the return of psychedelics in psychiatry.”

In early 2007, Gus and his colleagues at NYU received an investigational drug license from the FDA and the DEA, as well as approval from the university to start the study. As part of the research they administered to cancer survivors the drug psilocybin, which is the technical term for the active ingredient found in what's commonly known as magic mushrooms.

“When people came to our study and they took psilocybin,” said Gus, “it was such a vastly different experience than a 22 year old who took mushrooms to go to a rave. The sense of being assaulted by noise and loudness and people versus being quiet and the expectation of reviewing your life to find meaning. Same medicine, right? Same molecule. But a very, very different meaning, context and intention.”

“When you're diagnosed with cancer, or anything that you know pretty much spells the potential for life to be finite, you can get pretty wrapped up in yourself," said Marritz. "I certainly did.”

“Some of the people in our study were cured of cancer, but they still had tremendous existential distress around having had cancer, the fear of relapsing with their cancer, and it still haunted them," said Gus. "So even though it was somehow gone from their body, it was still part of their psychic landscape. We saw people who had existential distress in reaction to cancer as having, in some ways, lost meaning in life. When you lose meaning in life, life is meaningless. It’s a kind of death and it leads to a quicker death. To find meaning is to be alive.”

To hear how Dr. Jeffrey Gus guided Eddie through the psychedelic experience to help treat his anxiety, listen to “The Bigger Picture.”

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A Tennessee Judge's Outrageous Abuse of the Drug Court System

Wed, 11/29/2017 - 13:09
Click here for reuse options! He's throwing people who tested positive for nicotine in the clink.

A Tennessee judge has taken the questionable logic of drug courts to a ridiculous and punitive extreme by jailing drug court participants for having smoked cigarettes.

That's right, Hamilton County Drug Court Judge Tom Greenholtz has taken it upon himself to punish people under his supervision for using a legal substance because he thinks doing so will give them a "better chance at life."

Earlier this month, he jailed a handful of drug court participants who came up positive for nicotine in court-mandated drug tests.

"We routinely test for nicotine as we do for other controlled substances," Greenholtz told Chattanooga TV station Newschannel 9, blithely ignoring the fact that nicotine is not a controlled substance under state or federal law and that cigarette smoking is not a crime.

As for throwing hapless drug court victims in jail for violating his arbitrary edict: "It shows how serious we are about combatting this," he said.

Drug courts first appeared in the 1990s as a response to the overflowing jails and prisons generated by the war on drugs and were designed to keep drug users out of prison by subjecting them to intense judicial oversight replete with jail cell punishments for people who relapsed while under supervision.

But from the beginning, while prosecutors and drug court judges give lip service to the widely accepted idea that drug addiction is a chronic, relapsing medical condition, the drug court model punishes people for suffering that medical condition. And now, Judge Greenholtz has taken that paradox to a whole new level.

He is punishing people who may indeed be physically addicted to nicotine even though using or possessing nicotine is not a crime. That's what can happen when you let judges act like doctors.

As a means of dealing with drug-addicted people, drug courts are humane only in comparison with imprisonment. The vast majority of drug court participants are there solely because they got caught using or possessing drugs. In an enlightened society, we would either offer them assistance if they desire it or just leave them alone (not arrest them in the first place) absent harm to themselves or others. Instead, with drug courts, we subject them to intense judicial scrutiny and punish them for relapsing.

As the Drug Policy Alliance noted in a damning 2014 report on drug courts:

Drug courts have spread across the country, yet available research does not support their continued expansion. Most drug courts do not reduce imprisonment, do not save money or improve public safety, and fail to help those struggling with drug problems. The drug court model must be corrected to play a more effective role in improving the well-being of people involved in the criminal justice system who suffer substance misuse problems – while preserving scarce public safety resources.

Throwing people in jail for smoking does not appear to be "improving the well-being of people involved in the criminal justice system" or "preserving scarce public safety resources."

There is some scientific research suggesting that people who quit smoking cigarettes do better in recovering from drug dependency, but that research finds only small differences. That study found a mere 3% difference in recovery rates between people who had quit smoking and those who hadn't. And the people in the study who had quit smoking had done so voluntarily—not under threat of imprisonment.

People who had actually participated in the Hamilton County Drug Court had a different take.

Paula Brazzell told Newschannel 9 she had been addicted to pain pills for years, it took her several attempts to get clean, and that cigarettes helped.

"I think so, yeah," she said. "It calmed me down."

One of Brazzell's friends was part of the group Judge Greenholtz jailed for smoking this month. Brazzell couldn't believe it.

"You're taking up those cells, paid for by taxpayer dollars to put somebody in jail for failing a nicotine test? I mean come on," she said.

Drug courts are a very blunt tool with which to address drug dependency. They become even more questionable when used as social engineering to punish people who aren't committing any crime other than a social faux pas by smoking.  

 

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New Yorkers Say It's Time to Legalize Marijuana

Wed, 11/29/2017 - 12:05
Will Albany ever get around to heeding the will of the people?

 

 

New Yorkers Say It's Time to Legalize Marijuana

Legalize it, New Yorkers are telling their legislators. The majority of the Empire State said it’s time for lawmakers to pass a bill legalizing marijuana, with 62 percent of residents surveyed voting ...

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Science: Regular Consumption Of Marijuana Keeps You Fit And Active

Wed, 11/29/2017 - 11:53
Study confirms that cannabis consumers are more fit, remain more active.

An apple a day keeps the doctor away. Here’s a new health-related adage to consider: Regular consumption of marijuana keeps you thin and active.

According to researchers at Oregon Health and Science University, people who use marijuana more than five times per month have a lower body mass index (BMI) than people who do not marijuana.

The researchers concluded:

“Heavy users of cannabis had a lower mean BMI compared to that of never users, with a mean BMI being 26.7 kg/m in heavy users and 28.4 kg/m in never users.”

The study also suggested that people who consume marijuana on a regular basis are more physically activity than those that use it sporadically or not at all.

Of course, this is not the first time scientific studies have reached this conclusion:

  • A study published last year in the Journal of Mental Health Policy and Economics suggests that regular consumers of cannabis have a lower BMI than those who do not use the drug.
  • A 2013 study published in the American Journal of Medicine found that cannabis consumers have 16 percent lower levels of fasting insulin and 17 percent lower insulin resistance levels than non-users. The research found “significant associations between marijuana use and smaller waist circumferences.”
  • And data published in British Medical Journal in 2012 reported that cannabis consumers had a lower prevalence of type 2 diabetes and a lower risk of contracting the disease than did those with no history of cannabis consumption.

In the 2016 study, lead author Isabelle C. Beulaygue from the University of Miami concluded:

“There is a popular belief that people who consume marijuana have the munchies, and so [they] are going to eat a lot and gain weight, and we found that it is not necessarily the case.”

Researchers have not identified the reason behind the findings. But some suggest that those who consume cannabis regularly may be able to more easily break down blood sugar, which may help prevent weight gain.

If you’re interested in exploring the benefits described above, check out our directory for stores near you.

 

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Opioid Users Are Building a Movement for Public Health Solutions to the Epidemic

Tue, 11/28/2017 - 14:14
Click here for reuse options! Addicts need less incompetent advice from Trump cronies and more funding for treatment.

The opioid drug epidemic is the largest public health crisis facing our country right now, taking the lives of 64,000 people in the U.S. last year. Each day, 90 Americans overdose on painkillers like Oxycontin and Percocet, heroin, and synthetic opioids like fentanyl. Overdose is now the leading cause of death for Americans under 50.

Although President Trump declared the opioid drug epidemic a public health emergency last month, the government needs to invest tens of billions of dollars to address a national crisis of this scale. Perhaps predictably, Trump’s toothless declaration was not accompanied by any additional funds.

Trump’s plans to gut defund Medicaid and the Affordable Care Act stand at odds with a serious attempt to fight the epidemic, which has devastated states in the Northeast and Midwest. As the largest provider of opioid addiction treatment and overdose prevention, Medicaid plays a critical role that has grown even larger since passage of the ACA. In the 31 states that expanded Medicaid coverage, 1.2 million people with opioid addiction gained access to health care.

In addition to not allocating any new funding to the public health emergency and attempting to gut affordable healthcare, Trump has appointed cronies like Chris Christie to head his opioid commission and Newt Gingrich as a paid advocate. When he first took office, Trump tasked his son-in-law, Jared Kushner, with solving the opioid crisis as part of an absurdly broad portfolio. In recent months, however, the scope of Kushner's responsibilities appear to have narrowed.

With these antics, Trump risks minimizing the grave national impact of the epidemic while aggrandizing the role of law enforcement in fighting the problem. Over the summer, he told reporters, “Strong law enforcement is absolutely vital to having a drug-free society. I’m confident that by working with our health care and law enforcement efforts we will fight this deadly epidemic and the United States will win.”

It is entirely reasonable to fear that Trump, instead of relying on medical providers and public health experts to offer evidence-based solutions, will listen to partisan advisers offering strongman solutions like increased policing, a ramped-up war against drug cartels, or so-called mandatory treatment, which in some cases is unpaid hard labor.

Already, the U.S. spends $100 billion a year on policing and another $80 billion on incarceration. Attorney General Jeff Sessions has signaled his intention to restart the war on drugs and double down on incarceration.

Even deadlier than the AIDS epidemic at its peak, the opioid crisis costs the U.S. nearly $80 billion a year, which includes costs from health care, lost productivity, addiction treatment, and criminal justice involvement. The opioid emergency needs real solutions and the funding for them, not half-measures and showboating.

This is why opioid users and their allies have launched the Opioid Network, a diverse, multiracial coalition of health care providers, drug users, community organizing groups and families from around the country. Many members are first-time activists, like Don LoGuidice from Ohio who lost a son to an overdose, or longtime drug user Brian Jablonski from Indiana.

We are taking our message to Washington and calling on Congress to release $45 billion in funding for opioid treatment, to protect Medicaid and pass the Alexander-Murray bill to stabilize the health care system so that addiction treatment is safe, affordable and accessible.

Convened and supported by the Center for Popular Democracy, the coalition includes affiliates in Indiana, Maryland, Ohio, Delaware, New Hampshire, and Vermont, along with Doctors Allied for Indian Health and VOCAL-NY, which emerged from the AIDS crisis and fought for funding for HIV and AIDS.

Over the summer, many of us put our bodies on the line to defend the Affordable Care Act. Now we plan to use the same tactics to pressure Congress to fund real solutions to the opioid crisis. We will flood the streets, hold town halls and make our voices heard.

Federal funding is crucial for bringing safe injection facilities, currently underground, above ground and staffing them with trained medical professionals, decriminalizing syringes and expanding syringe exchange programs, and making overdose antidotes like naloxone widely available without a doctor’s prescription.

Some observers have asked where the opioid epidemic’s ACT UP is. Formed in the late 1980s in response to government inaction on AIDS, ACT UP staged direct actions calling for funding for treatment and research and proactive policies and legislation to address the epidemic that killed 43,000 at its peak in 1995. One successful protest shut down the Federal Drug Administration for a day.

Setting the gold standard for what a direct action campaign can achieve, ACT UP won an entire new stream of funding for people with HIV/AIDS totaling over $3 billion, eventually turning AIDS into a manageable chronic condition, instead of a fatal one.

This is what we aim to do with the Opioid Network. We will turn up the heat on Congress and the Trump administration to ensure there is a steady stream of funding to address this crisis and that medical experts and drug users have a direct voice in the solution.

The opioid epidemic is a public health crisis. To help opioid users, Congress must provide the necessary funding for safe and accessible treatment, and invest in knowledgeable, trained medical experts rather than the incompetent advice of Trump’s Beltway buddies and a revved-up criminal justice system. Anything less would be ineffective and a waste of time and resources.

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Under Trump, Drugs Are Pouring Across America's Border Like Never Before

Mon, 11/27/2017 - 11:51
Despite the chest thumping, the dope just keeps coming.

 

 

Drug Seizures by Immigration Agents See Six-Year High

Drug traffickers are sending a deluge of illicit and prescription drugs across the border, a sign traffickers aren’t intimidated by President Donald Trump’s beefed-up border security. Custom ...

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