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Debunking The Myths

Common sense in pain management -- read Chronic Pain & Opioids: Debunking the Myths, by Frank B. Fisher, MD -- also available in PDF. And check out this public service ad based on Debunking the Myths.


Physicians are under intense scrutiny because of concerns over prescription drug diversion and abuse. At the same time, they are also under pressure from patients and advocates to prescribe adequate pain medication. It is a difficult balancing act and sometimes, overzealous law enforcement can tip the scales. For more information click here.


The Cato Institute published this tremendous analysis of pain management policy by Professor Ronald T. Libby of the University of North Florida. Download a copy of the full report, and also check out this CSDP public service ad which excerpts the Libby report.

A Michigan study confirms what many patients already know: Pharmacies in minority and low-income areas are less likely to carry sufficient supplies of pain medications. Click here to read more about this study on access to pain medication which was published in the Journal of Pain in Oct. 2005.


Pain management: where healthcare and drug control policies intersect. Click here for more about pain management, diversion, and related items. Also check out this new CSDP public service ad on the federal war against physicians over pain management.


Florida Governor Charlie Crist and his cabinet voted unanimously to grant pain patient Richard Paey a full pardon for his 2004 conviction on drug trafficking and possession charges. For more information, click here.


The re-trial of Doctor William Hurwitz came to an end in July 2007. The doctor's sentence was reduced to less than five years. He was originally given 25 years. For more information, click here.


A federal judge is challenging the plea agreement entered into earlier in 2007 between prosecutors and Purdue Pharma, the manufacturer of OxyContin. For more information, click here.


The New York Times Magazine featured a cover story on pain management issues in their June 17, 2007 edition. Click here to read the story in full.


Purdue Pharma, manufacturer of OxyContin, and three current and former executives were allowed to plead guilty in federal court to misleading the public about Oxy's risks. For more information, click here.


Federal re-trial of pain specialist Dr. William Hurwitz ends – some charges dismissed, acquittal on some charges but guilty verdicts on others. For more information click here.


Commutation Urged After Appeal Fails

Chronic pain patient Richard Paey lost in the appeal of his sentence on drug charges and faces a mandatory minimum 25-year-sentence. For more information click here .


DEA Issues Policy Statement On Pain Management

The US Drug Enforcement Administration has issued a new policy statement on pain management and prescribing practices. For details, click here. Also, a full copy of the notice as published in the Federal Register is available by clicking here.


The 4th Federal Circuit Court of Appeals has granted a new trial to Dr. William Hurwitz of Virginia. Dr. Hurwitz had been accused of drug trafficking for prescribing large quantities of narcotics to patients. For more information click here.


Rightwing talkshow host Rush Limbaugh reached a plea deal with prosecutors – charges to be dropped in 18 months if he completes treatment, avoids re-arrest. For more info, click here.


One of the first physicians in the nation to be charged with the deaths of patients from narcotics abuse was found guilty of one count of manslaughter and five counts of narcotics trafficking in her retrial in Florida. Dr. Asuncion Luyao faces maximum 30 year prison term – an appeal is planned. Click here for more info.


First Annual Opioid Certification Program

Presented by the Opioid Management Society & the Journal of Opioid Management, the conference will be held April 22-23, 2006, at The Conference Center at Harvard Medical, Boston, MA. To register, contact the Opioid Management Society.


The cover story in Harvard Magazine's Nov-Dec 2005 issue is "The Science of Hurt," by Kathleen Koman. Download and read a PDF copy of this tremendous article.


FDA, doctors win versus DEA on question of final approval of new painkilling drugs. Click to read more.


Chronicle AM -- April 23, 2014

There's news on the marijuana legalization initiative front, decrim dies in New Hampshire, pot sentencing reform dies in Alabama, Illinois patients can keep their guns, drugged driving and reproductive rights make news, too. And more. Let's get to it:

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

Alaska Legalization Vote Pushed Back to November. A ballot initiative that could make Alaska the third US state to legalize recreational marijuana will go before voters in a general election in November rather than in August as previously scheduled, officials said on Monday. Alaska ballot initiatives typically go before voters in primary elections. But a lengthier-than-normal state legislative session this year forced the change because, under state rules, initiatives must go to voters no less than 120 days after the end of a session.

New Approach Oregon Legalization Initiative Gets Another Big Bucks Donation. The Drug Policy Action Network, the political arm of the Drug Policy Alliance, has given $100,000 to the New Approach Oregon legalization initiative campaign. That's the second $100,000 in a week for the initiative, which has just commenced its signature-gathering phase.

Total Marijuana Ban Initiative Proposed in Montana. A Billings businessman has proposed an initiative for the November 2014 ballot that effectively would ban the possession, use, cultivation, trafficking and transportation of marijuana in Montana. Steve Zabawa submitted the measure last week. If approved, it would change state law to say that any drug listed on Schedule 1 of the Federal Controlled Substances Act "may not be legally possessed, received, transferred, manufactured, cultivated, trafficked, transported or used in Montana."

No Decriminalization for New Hampshire This Year. Criminal penalties for possessing small amounts of marijuana will not change, after the Senate refused to consider a House-passed bill. Under House Bill 1625, the penalty for having an ounce or less of marijuana or hashish would have been the same as a traffic ticket, and it would have lowered the penalties for growing less than six marijuana plants. The bill passed the House by a better than two-to-one margin, but the Senate refused to accept the bill. It had killed a nearly identical bill last session.

Louisiana to Retain Harsh Marijuana Penalties. The Senate Judiciary Committee voted Tuesday to kill a bill that would reduce the state's marijuana penalties, some of the harshest in the country. Senate Bill 323 would have made simple possession a misdemeanor punishable by no more than six months in jail. Under current law, repeat pot possession offenders can be jailed for up to 20 years. The measure failed on a 4-3 vote.

Medical Marijuana

Florida Limited CBD Medical Marijuana Bill Wins House Committee Vote. A bill to allow patients suffering from seizures or severe pain to use high CBD cannabis oil has passed the House Judiciary Committee. House Bill 843 passed the committee 15-3 and now heads for a House floor vote.

Wisconsin Governor Signs Limited CBD Medical Marijuana Bill. Gov. Scott Walker (R) last week signed into law Assembly Bill 726, which allows the use of CBD cannabis oil to treat severe seizures in children.

Illinois Medical Marijuana Patients Can Keep Their Guns. Illinois regulators finalizing the state's conditions for medical marijuana have removed a proposed rule that would have barred legal gun owners from becoming cannabis-using patients. Some patients had said they would rather continue to use marijuana illegally rather than give up their firearms owners ID cards. The wording drew numerous complaints in public comments from gun owners who hoped to apply for medical cannabis cards. Many said their rights were being trampled.

Drugged Driving

Arizona Supreme Court Rules Presence of Marijuana Metabolite Not Sufficient to Prove Impaired Driving. The state's high court ruled Tuesday that motorists with a secondary marijuana metabolite in their system cannot be charged with a DUI on that basis alone, indicating the court was unconvinced the mere presence of the metabolite proves impairment. The state had argued that even the presence of metabolites in the urine of users was sufficient for a conviction, but the high court said "this interpretation would criminalize otherwise legal conduct" and "leads to absurd results." The case is Arizona v. Shilgevorkyan.

Michigan Bill Would Allow Police to Saliva Test for Drugs During Traffic Stops. The House Judiciary Committee is considering a package of bills related to drugged driving, including one, House Bill 5385, that would allow police to include saliva testing through a mouth swab. The measure is opposed by medical marijuana advocates, who raised concerns about the accuracy of the tests. The committee will continue taking testimony on the bills, which would also allow for police officers to confiscate driving licenses and issue temporary permits for drugged drivers as they do for suspected drunk drivers now.

Reproductive Rights

Tennessee Legislature Passes Bill Criminalizing Pregnant Women for Drug-Related Harm to Fetuses. A bill that holds women criminally accountable for illegal drug use during pregnancy, with punishments of up to 15 years in prison, passed the legislature last week. Senate Bill 1391 punished drug-using women if their babies are stillborn or born addicted or otherwise harmed. Gov. Bill Haslam (R) has 10 days to decide whether to sign it into law.

Alabama Supreme Court Rules That Women Can Be Charged With Chemical Endangerment if They Become Pregnant and Use a Controlled Substance. The state Supreme Court last Friday upheld the conviction of a woman who gave birth to a baby that tested positive for cocaine, even though the infant was healthy. In so doing, the court upheld the state's 2006 chemical endangerment law and held that the word "child" in the law includes fertilized eggs. The case is Ex Parte Sara Jane Hicks. Alabama and South Carolina are the only states that authorize the prosecution of pregnant women for drug use, although as we see above, Tennessee could soon join them.

Prescription Drugs

Oklahoma Senate Approves Bill Adding Prescription Drugs to Drug Trafficking Law. The Senate Monday approved a bill adding four additional drugs to the state's Trafficking in Illegal Drugs Act. The measure, House Bill 2589, adds morphine, oxycodone, hydrocodone and benzodiazepine to the list of controlled substances in the act. Individuals convicted under the act would receive a minimum of 10 years, which is twice the prison term for possession of these substances. The bill is supported by the Oklahoma Bureau of Narcotics. It has been amended and will return to the House of Representatives for reconsideration.

Opiate Pain Relievers

FDA Panel Recommends Against Approving Dual Opioid Medication. An advisory panel of the Food and Drug Administration (FDA) voted Tuesday against approving a combination morphine-oxycodone painkiller. The drug, Moxduo, would be the first medication to combine both opioids in one capsule. Moxduo's manufacturer, QRxPharma, says the drug is intended to provide faster relief from moderate to severe pain, with fewer side effects than currently available opioids. The panel voted unanimously against approving it, concluding that QRxPharma had not proved the drug is less likely to cause potentially life-threatening respiratory suppression, compared with taking oxycodone or morphine alone.

Search and Seizure

US Supreme Court Upholds Vehicle Stops Based on Anonymous Tip. An unusually divided Supreme Court ruled Tuesday that an anonymous 911 phone call reporting a reckless driver justified a traffic stop that led to a marijuana. The 5-4 decision saw Justice Antonin Scalia side with the court's liberal minority, but Justice Stephen Breyer's vote gave the conservative majority the win. The case is Navarette v. California. The ruling means police need not corroborate anonymous reckless driving tips before stopping a vehicle.

Voting Rights

Virginia Governor to Restore Voting Rights for Drug Offenders. Virginia Gov. Terry McAuliffe (D) announced Friday that he will immediately restore voting rights to anyone who has completed their sentence for a drug offense, and reduce the waiting period for other violent felonies from five years to three. Virginia is one of four states that ban all ex-felons from voting for life unless they receive clemency from the governor. But governors in these states can take executive action to alter the policies on these felons.

International

Sinaloa Cartel Losing Ground in Ciudad Juarez, Stratfor Analyst Says. The Carrillo Fuentes drug-trafficking organization, with its enforcement arm La Línea, is moving to regain the El Paso-Juárez corridor from the Sinaloa cartel, whose power in Juarez is eroding quickly, according to a terrorism and security analyst from the Texas-based private intelligence firm Stratfor. Click on the link for more details.



Chronicle AM -- April 4, 2014

Cops like to say they don't make the laws; they merely enforce them, but that wasn't exactly the case today in Louisiana, Oregon, and Washington, DC. Plus, decrim has a last hurrah in Maryland, an Alabama welfare drug testing bill passes, Vermont moves against the new pain reliever Zohydro, and more. Let's get to it:

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

Maryland Legislators Try to Revive Decriminalization Bill Today. An effort was underway in Annapolis Friday to revive a decriminalization bill just days after it was scuttled in committee. The effort to revive House Bill 879 is being led by members of the Legislative Black Caucus, who will try to amend the bill on the House floor. It was turned from a decriminalization bill to a study bill earlier this week in the House Criminal Justice Committee, chaired by reform foe Rep. Joe Vallario (D-Prince Georges).

Louisiana Marijuana Sentencing Reform Bill Derailed. Rep. Austin Badon (D-New Orleans) has pulled his measure to soften marijuana penalties from consideration in the House Criminal Justice Committee after testimony by the head of the Louisiana Sheriffs Association. Association executive director Michael Ranatza said sheriffs fear the bill, House Bill 14, could lead to decriminalization of marijuana. Louisiana has some of the harshest marijuana laws in the country.

Oregon State Police Withdraw from Anti-Marijuana Summit. The Oregon State Police have withdrawn from an anti-marijuana conference scheduled for later this month after the police superintendent learned the event is closed to the public. OSP was listed as a cosponsor of the summit, which includes sheriffs from Malheur and Yamhill counties, a Medford police official and law enforcement officials from Colorado, Washington and Arizona, as well as anti-drug reform groups such as Drug Watch International, Save Our Society from Drugs, and the Drug Free America Foundation.

Medical Marijuana

Ammiano Reintroduces California Medical Marijuana Regulation Bill. San Francisco Assemblyman Tom Ammiano (D) has reintroduced his medical marijuana regulation bill. The new bill is Assembly Bill 1894. The previous version, Assembly Bill 604 had been pending in the Senate. The major change is the addition of language authorizing limited local transaction and use taxes.

Connecticut Picks Locations for Six Dispensaries. Locations for Connecticut's six medical marijuana dispensaries have been selected, the state Consumer Protection Commissioner said Thursday. The facilities in Branford, Bridgeport, Bristol, Hartford, South Windsor and Uncasville were authorized by the state's medical marijuana program to dispense Connecticut-produced marijuana products.

Drug Testing

Labor Department Says Texas Can't Make Drug Tests a Condition for Receiving Unemployment Benefits. The US Labor Department has ruled that Texas cannot enforce a law passed by the Legislature in 2013 which makes passing a drug test a requirement for some workers to get and keep unemployment compensation benefits. The law was watered down by the legislature to cover only people who are in professions where drug testing is a requirement, like truck driving and nursing. The feds say the law as it is written is too vague and it is unclear exactly what workers will qualify.

Alabama Legislature Approves Welfare Drug Testing Bill. The legislature has approved a bill that would require welfare applicants who have a drug conviction in the last five years to undergo drug testing before receiving benefits. People could keep their benefits after one positive drug test. After a second positive, the person would be ineligible for one year. The recipient would be permanently ineligible after a third positive drug test. Senate Bill 63 now goes to the desk of Gov. Robert Bentley (R).

Harm Reduction

FDA Approves Innovative New Device to Reverse Opiate Overdose. The Food and Drug Administration has approved Evzio, a handheld device containing naloxone, designed for lay people to use outside of hospital settings. When activated, the device will give verbal instructions about how to use Evzio to deliver the medication.

Prescription Opiates

Vermont Issues Emergency Rules to Restrict Access to Zohydro. Gov. Peter Shumlin (D) and state officials announced Thursday that Vermont is moving to restrict access to the new opiate pain reliever Zohydro, the first single-ingredient hydrocodone drug approved for patients in the US. New emergency rules require that prescribers of Zohydro conduct a thorough medical evaluation and risk assessment. This is only the latest move against Zohydro, which was approved by the FDA last fall -- Massachusetts Gov. Deval Patrick (D) banned it outright earlier this week and a handful of congressmen have called for the FDA to reverse its decision. But Zohydro's maker, Zogenix, said the drug is no more potent than other hydrocodone medications. The company also says it has set up a board of experts to guard against abuse of the drug and that its sales representatives are not being paid based on the volume of sales, but rather on their efforts to ensure prescribers, pharmacists and patients are educated to understand the risks and benefits of extended-release opioids Politicians have been quick to raise the alarm about possible increases in addiction and overdose deaths with Zohydro, but they haven't been nearly as quick to talk about its usefulness in addressing the needs of legitimate pain patients.

Sentencing

Who Wants to Kill Sentencing Reform? No Surprises Here. The Huffington Post reports that law enforcement groups including the National Sheriffs' Association, the International Association of Chiefs of Police, the National Narcotic Officers' Associations' Coalition, the National Association of Police Organizations and the Major County Sheriffs' Association are quietly trying to kill a bipartisan bill that would roll back tough mandatory sentences for people convicted of federal drug offenses under legislation passed during the height of America's drug war three decades ago. The bill is the Smarter Sentencing Act (Senate Bill 1410), which passed the Senate Judiciary Committee in January. Click the title link for the full story.

New Report Shows Failure of Connecticut's Sentencing Enhancement Drug Free Zones. A new report from the Prison Policy Initiative finds that Connecticut's 1,500-foot sentencing enhancement zones are so pervasive that they blanket almost all urban areas, creating an "urban penalty" that increases the sentence imposed for a given offense simply because it was committed in a city rather than in a town. The report recommends the sentencing enhancement zones be shrunk to 100 feet. This would allow the law to actually create the specially protected places as intended. Connecticut Senate Bill 259, which just passed out of the Judiciary Committee, takes a similar approach and would decrease that size to 200 feet. The report is Reaching too far: How Connecticut's large sentencing enhancement zones miss the mark." You can read it by clicking on the title link.



Chronicle AM -- March 13, 2014

Attorney General Holder endorses federal drug sentencing reductions, CBD medical marijuana bills move in the South, a New Hampshire decriminalization bill advances, Zohydro may get some competition, and the UN is generating plenty of news, and more. Let's get to it:

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

Marylanders Rally for Legalization. Nearly 100 supporters of sweeping changes in Maryland's marijuana laws rallied in Annapolis Thursday before planned legislative hearings on bills to legalize -- or at least decriminalize -- possession of the drug. The House Judiciary Committee is hearing a series of marijuana reform bills this afternoon, including a legalization bill (House Bill 880) from Rep. Curt Anderson (D-Baltimore).

Maryland Poll Has Slim Majority for Legalization. As the legislature considers marijuana reform bills, a new Goucher Poll has support for legalization at 50.1%, with 39.4% opposed. The poll also had a whopping 89.6% in favor of medical marijuana.

New Hampshire Decriminalization Bill Passes House. The House approved a decriminalization bill by a veto-proof margin Wednesday. House Bill 1625, sponsored by Rep. Adam Schroadter (R-Newmarket) and a bipartisan group of seven cosponsors including Sen. Jeff Woodburn (D-Dalton), would make possession of up to one ounce of marijuana punishable by a civil fine of up to $100. It would also make cultivation of up to six plants a Class A misdemeanor instead of a felony. Currently, possession of any amount of marijuana is a misdemeanor punishable by up to one year in prison and a fine of up to $2,000. Now, it's on to the state Senate.

Medical Marijuana

Kentucky Senate Approves CBD Medical Marijuana Bill. The Senate passed a bill allowing doctors to prescribe and patients to use CBD cannabis oil for medical reasons Wednesday. The bill passed with no opposition. Senate Bill 124 now goes to the House.

Georgia Senate Committee Approves CBD Medical Marijuana Bill. The Senate Health and Human Services Committee unanimously approved House Bill 885, which would allow patients to use CBD-based cannabis oils. It also amended the bill to allow parents to bring the oil into the state without facing penalties. The bill has already passed the House and now awaits a Senate floor vote.

South Carolina Senate Panel Approves CBD Medical Marijuana Bill. A subcommittee of the Senate Committee on Medical Affairs approved a bill allowing people suffering from epilepsy to use CBD cannabis oil Wednesday. Senate Bill 1035 still needs to pass the full committee. Similar legislation is moving in the House.

Hemp

Tennessee Hemp Bill Wins House Committee Vote. A bill that would allow the cultivation of hemp for research purposes passed the House Agriculture and Natural Resources Committee Wednesday. House Bill 2445 now heads for the House Finance Ways and Means Committee.

Drug Testing

Mississippi Food Stamp Drug Testing Bill Heads to Governor. A bill that would require applicants for Temporary Assistance for Needy Families (TANF) to undergo drug testing if there is a suspicion they are using drugs passed the Senate Wednesday and now goes to the desk of Gov. Phil Bryant (R), who has made it a keystone of his legislative agenda. House Bill 49 passed the Senate after debate in which supporters couched the program as an additional benefit that could help somebody struggling with addiction, while opponents said it was unfairly singling out the poor.

ASAM White Paper Calls for Vastly Expanded Drug Testing. The American Society for Addiction Medicine (ASAM) has published a white paper by former NIDA director and present day drug testing consultant Robert Dupont calling drug testing "underutilized" and arguing it should be expanded to be include people of all ages in virtually all aspects of daily life. The totalitarian vision is ably critiqued by NORML drug testing expert Paul Armentano (click the title link), as well as by progressive talk radio host Thom Hartman, who countered Dupont with an op-ed entitled "It's Time to End All Drug Testing." Both Armentano's and Hartman's critiques are worth the read.

Prescription Opioids

Oxycontin Maker Offers Alternative to Zohydro. Purdue Pharma, the manufacturer of Oxycontin, says it has completed testing of an abuse-resistant version of the painkiller hydrocodone, a surprise development that could derail sales of the recently launched Zohydro, a similar medication that has been criticized for lacking such safeguards. Purdue Pharma says it plans to submit its extended-release hydrocodone drug to the Food and Drug Administration later this year. Shares of rival Zogenix Inc. plunged more than 20% after the announcement, which appears to jeopardize sales of the company's just-launched drug Zohydro. Zogenix began shipping Zohydro to pharmacies last week.

Sentencing

Attorney General Holder Endorses Proposal to Cut Federal Sentences. US Attorney General Eric Holder today endorsed a proposal from the US Sentencing Commission to reduce the sentences of people convicted of federal drug trafficking offenses by about a year, from an average of 62 to months to an average of 51 months. "This overreliance on incarceration is not just financially unsustainable," Holder said. "It comes with human and moral costs that are impossible to calculate."

International

Listen to the UN Commission on Narcotic Drugs Sessions. You can do it by clicking on the UNODC's webcast page at the link above. Also, Oregon activist Doug McVay has uploaded audio of the second part of today's plenary session here. There will be more updates on McVay's weekly Drug War Facts podcast.

UNODC Panel Says Criminalizing Drug Use "Not Beneficial". Today, a key working group of the United Nations Office on Drugs and Crime (UNODC) announced the release of groundbreaking recommendations discouraging criminal sanctions for drug use. The Scientific Consultation Working Group on Drug Policy, Health and Human Rights of the UNODC -- which includes Nora Volkow, head of the US National Institute on Drug Abuse (NIDA) -- is releasing the recommendations at the High-Level Segment of the 57th UN Commission on Narcotic Drugs. The working group recommendations say "criminal sanctions are not beneficial" in addressing the spectrum of drug use and misuse.

UNODC Sees "Serious Setbacks" in Fight Against Drugs. Addressing the opening session of the Commission on Narcotic Drugs (CND), UN Office on Drugs and Crime (UNOC) head Yury Fedotov said the global fight against drugs had suffered "serious setbacks," including record opium crops in Afghanistan, violence linked to drug trafficking in Central America, and weak West African states succumbing to the blandishments of traffickers. While he said legalization was no solution, he did add that: "A public health response to the drug use problem should consider alternatives to penalization and incarceration of people with use disorders."

Caricom Creates Commission to Study Marijuana Legalization. The leaders of the Caricom Caribbean trade bloc announced today that they are creating a commission to study the impact of legalizing marijuana. The move came at the end of a two-day summit where members discussed a preliminary report on decriminalization. The commission is charged with presenting its report in early July for a Caricom summit in Antigua.

Iran Executed More Than 300 People for Drugs Last Year, Report Says. A report from the nonprofit group International Campaign for Human Rights in Iran released Wednesday says Iran executed 331 people on drug-related charges last year. The drug executions accounted for almost half of all executions in the Islamic Republic, the report found. The UN Office on Drugs and Crime sponsors anti-drug programs in Iran, and is under increasing pressure from European donor countries to put in place measures to stop its support from contributing to the death penalty.

Dire Prospects for Afghanistan Drug War, Analysis Finds. A new analysis from Alex Pollard-Lipkis of Foreign Policy in Focus finds that "if costly drug war strategies in Afghanistan have been unsuccessful even with a strong US military presence, they won't stand a chance after the US withdraws." The analysis critiques contemporary US approaches and peeks into the post-US future. Click on the title link to read the whole thing.



Chronicle AM -- March 11, 2014

The District of Columbia could legalize marijuana at the ballot box this year, Dr. Sanjay Gupta doubles down on his support for medical marijuana with a new CNN special tonight, the UN Commission on Narcotic Drugs meeting this week in Vienna is attracting a lot of attention, and more. Let's get to it:

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

DC Legalization Initiative Cleared for Signature-Gathering. The District of Columbia Board of Elections announced this morning that it had approved a marijuana legalization initiative for signature-gathering. That means voters in the nation's capital could vote to free the weed in November. Now, the DC Cannabis Campaign must gather some 25,000 signatures to qualify for the November ballot. But first, the Board of Elections must finalize the language for the measure. It has 20 days to do so.

Colorado Takes in $2 Million in Marijuana Taxes in First Month of Legalization. The state of Colorado collected $2.01 million in retail marijuana sales and excise taxes in January, the first month of legal sales, the Department of Revenue reported Monday.

Missouri Legalization Bill Gets Committee Hearing. A bill to legalize marijuana in the Show-Me State got a hearing in the House Crime Prevention and Public Safety Committee Monday. House Bill 1659, sponsored by Rep. Chris Kelly (D-Columbia), got a mixed reception in the hearing, with GOP lawmakers expressing skepticism. The committee took no vote and offered no timetable for further action.

Louisiana Marijuana Reform Advocates Rally on Capitol Steps in Baton Rouge. Although there is no legalization bill filed in Louisiana, legalization advocates rallied at the state capitol Monday to get their voices heard. The event was organized by Legalize Louisiana, which seeks to "decriminalize, legalize, and regulate marijuana" in the Bayou State. Although there is no legalization bill this year, there are bills to decriminalize and to allow for medical marijuana.

Legalization Would Be a "Terrible Mistake," Says NYPD Commissioner. NYPD Commissioner Bill Bratton said Tuesday it would be a 'terrible mistake' to legalize marijuana and predicted problems for states that go that course. But he did say he supported medical marijuana.

Medical Marijuana

Dr. Sanjay Gupta Doubles Down for Medical Marijuana; Special Airs Tonight. CNN's Dr. Sanjay Gupta, who first saw the light on medical marijuana a few months ago, has reiterated his support for the herb's medicinal uses and will air a new special on the topic, Weed 2: Cannabis Madness: Dr. Sanjay Gupta Reports," at 10 p.m. ET on tonight.

In New Crackdown, Los Angeles Shutters A Hundred Dispensaries. More than 100 dispensaries have shut down since Los Angeles started enforcing new rules restricting them, City Atty. Mike Feuer announced Monday. In addition to the rules prompting scores of closures, Feuer said city lawyers had successfully fended off a host of legal challenges. In one closely watched case, they prevented a dispensary from opening in Mar Vista, securing a permanent injunction before it could set up shop.

Minnesota Medical Marijuana Bill Stalled By Cops. A key lawmaker said Tuesday she doesn't see a path forward for legalizing medical marijuana after talks with law enforcement hit a standstill. Rep. Carly Melin (DFL-Hibbing) said she had conceded to virtually all demands from law enforcement over the weekend but was still unable to get their support for her bill, House File 1818. Melin said she had no choice but to postpone a House committee hearing that would have been lawmakers' second look at the issue. "Law enforcement won't support any bill that would result in helping any patients," Melin said in an interview with The Associated Press. "The governor has to get involved."

Drug Testing

Georgia Food Stamp Drug Test Bill Passes Senate Committee. A bill that would require food stamp recipients suspected of drug use to pass a drug test to receive benefits narrowly passed out of the Senate Health and Human Services Committee Monday. House Bill 772, sponsored by Rep. Greg Morris (R-Vidalia) has already passed the House. It's not clear if it now goes to another committee or to a Senate floor vote.

Prescription Opioids

West Virginia Senator Manchin Joins Call to Overturn FDA Approval of Zohydro. US Sen. Joe Manchin (D-WV) has joined the call for the FDA to overturn its recent approval of Zohydro, a single-ingredient hydrocodone drug approved for people suffering from chronic pain. It is the first ever single-ingredient drug to be approved by the FDA. Manchion joins Sen. Charles Schumer (D-NY) and a number of legislators, prosecutors, and medical groups seeking to reverse the decision. But the FDA and the drug's manufacturer say the drug is needed to treat chronic pain.

Drug Use

RAND Corporation Report Reviews Past Decade's Drug Use. A new report from the RAND Corporation, What America's Drug Users Spend on Illegal Drugs: 2000-2010, pegs spending on illicit drugs at $100 billion a year. It also notes that from 2000 to 2010, the amount people spent on cocaine dropped by half from $55 billion to $28 billion, reflecting dramatic decreases in the availability of cocaine after 2006: from approximately 300 pure metric tons in 2000 to about 150 pure metric tons in 2010.

International

UN Drugs Meeting Opens after Historic Reforms Shatter Consensus on Drug Control System. The UN Commission on Narcotic Drugs (CND) opens its annual meeting this week after a year of historic reforms. This year’s meeting—which is taking place Vienna from March 13-21—is expected to be unusually contentious after a monumental 2013-2014. Unprecedented reforms have shaken the foundations of global drugs policy and set the stage for an explosive international debate. For live updates, check out the CND Blog.

Report Finds UN Stuck in Denial Over Marijuana Regulation. A new report from the Transnational Institute and the Global Drug Policy Observatory has been released in the run-up to the UN Commission on Narcotic Drugs meeting this week. The report, The Rise and Decline of Cannabis Prohibition: the History of Cannabis in the UN drug control system and options for reform, unveils the long and little-known history of cannabis regulation from the late 19th century when it was widely used for medical, ceremonial and social purposes to the post-WWII period when US pressure and a potent mix of moralistic rhetoric and unreliable scientific data succeeded in categorising cannabis as a drug with 'particularly dangerous properties' on a par with heroin in the 1961 Single Convention on Narcotic Drugs. It also brings the history up-to-date with more recent developments as an increasing number of countries have shown discomfort with the treaty regime's strictures through 'soft defections', such as turning a blind eye, decriminalization, coffee shops, cannabis social clubs and generous medical marijuana schemes. These have stretched the legal flexibility of the conventions to sometimes questionable limits. The report outlines specific options for reform and assesses their potential for success. These options include: WHO review and modification of cannabis scheduling; state parties amending the treaties; modifying the conventions 'inter se', e.g. between specific states only; or denunciation of the treaty and re-accession with a reservation (carried out recently by Bolivia in order to defend indigenous rights and the use of coca leaf in its natural form).

ENCOD Calls for UN to End the Drug War. The European Coalition for Just and Effective Drug Policies (ENCOD) will use the UN Commission on Narcotic Drugs this week to call on the UN to end the war on drugs. A delegation of five Encod members will join the debate inside the UN: Urki Goñi, chairman of Cannabis Social Club Urjogaberdea in the Basque Country, Spain, Doug Fine, author of 'Hemp Bound' and 'Too High To Fail: Cannabis & the New Green Economic Revolution', Dionisio Nuñez, Bolivian ex-minister of coca affairs, Janko Belin, Encod chairman and Joep Oomen, Encod coordinator. On Friday March 14 one of them will deliver a speech to the plenary meeting. ENCOD will also be reporting nightly from the sessions later this week on the ENCOD web site.

Legalization Won't Solve World's Drug Problem, UN Drug Chief Says.Yuri Fedotov, head of the UN Office on Drugs and Crime, told reporters Monday that while it is up to member states to decide "what needs to be done," legalization ain't it. "As the head of UNODC, I have to say that legalization is not a solution to the (world's) drug problem," Fedotov said. "It is very hard to say that this law (adopted by Uruguay's parliament) is fully in line with legal provisions of the drug control conventions," he added.

UN Drug Chief Praises Iran Drug Fight Despite Executions. Yuri Fedotov, head of the UN Office on Drugs and Crime, said Monday that Iran's anti-drug efforts were "very impressive" and that Iran "takes a very active role to fight against illicit drugs" even though human rights and harm reduction groups have criticized its frequent resort to the death penalty for drug offenders. Still, he added that UNODC opposes the death penalty and that he planned to raise the issue with Iranian leaders during the UN Commission on Narcotic Drugs meeting in Vienna this week.



Responding to Holder on Heroin, Reformers Call for a Health Direction [FEATURE]

US Attorney General Eric Holder had heroin on his mind Monday, using his weekly video message and an accompanying press release to draw attention to rising heroin overdose deaths and vowing to combat the problem with a combination of law enforcement, treatment, prevention, and harm reduction measures. Drug reformers generally responded positively, but called on the Obama administration to seek comprehensive, science- and health-based solutions instead of engaging in more drug war.

[image:1 align:left caption:true]"Addiction to heroin and other opiates -- including certain prescription pain-killers -- is impacting the lives of Americans in every state, in every region, and from every background and walk of life -- and all too often, with deadly results. Between 2006 and 2010, heroin overdose deaths increased by 45%," Holder said. "Scientific studies, federal, state and local investigations, addiction treatment providers, and victims reveal that the cycle of heroin abuse commonly begins with prescription opiate abuse. The transition to -- and increase in -- heroin abuse is a sad but not unpredictable symptom of the significant increase in prescription drug abuse we've seen over the past decade."

What Holder didn't mention is that the rise in prescription pain pill misuse is tied to a massive increase in prescribing opioids for pain in the past decade. A study published last fall found that between 2000 and 2010, the amount of opioids prescribed for non-cancer pain had nearly doubled, and that during the same period, the percentage of people complaining of pain who received prescriptions for opioids jumped from 11% to nearly 20%. But reining in prescriptions generally isn't the answer either.

But at the same time, a 2011 Institute of Medicine report found that while "opioid prescriptions for chronic non-cancer pain [in the US] have increased sharply… 29% of primary care physicians and 16% of pain specialists report they prescribe opioids less often than they think appropriate because of concerns about regulatory repercussions."

As the IOM report noted, having more opioid prescriptions doesn't necessarily mean that "patients who really need opioids [are] able to get them." Opioid misuse and under-use of opioids for pain treatment when they are needed are problems that coexist in society. Pain pill crackdowns have also been found to result in increased use of street heroin, as a Washington Post article last week reports -- two additional reasons advocates prefer public health approaches to heroin more than law enforcement -- and why great care should be taken with the law enforcement measures.

"It's clear that opiate addiction is an urgent -- and growing -- public health crisis. And that's why Justice Department officials, including the DEA, and other key federal, state, and local leaders, are fighting back aggressively," Holder continued. "Confronting this crisis will require a combination of enforcement and treatment. The Justice Department is committed to both."

Holder pointed to DEA efforts to prevent diversion of pharmaceutical pain-relievers to non-medical users, mentioning investigations of doctors, pharmacists, and distributors.

"With DEA as our lead agency, we have adopted a strategy to attack all levels of the supply chain to prevent pharmaceutical controlled substances from getting into the hands of non-medical users," Holder said.

[image:2 align:right caption:true]Holder also pointed out that DEA had opened some 4,500 heroin investigations since 2011 and promising more to come.

But, as Holder noted, "enforcement alone won't solve the problem," so the administration is working with civil society and law enforcement "to increase our support for education, prevention, and treatment."

And although he didn't use the words "harm reduction," Holder is also calling for some harm reduction measures. He urged law enforcement and medical first responders to carry the overdose reversal drug naloxone (Narcan) and signaled support for "911 Good Samaritan" laws, which grant immunity from criminal prosecution to those seeking medical help for someone experiencing an overdose.

Holder got restrained plaudits from drug reformers for his small steps toward harm reduction measures, but they called for a more comprehensive approach.

"Preventing fatal overdose requires a comprehensive solution," said Meghan Ralston, harm reduction manager for the Drug Policy Alliance. "While naloxone is an absolutely critical component, we need a scientific, health-based approach to truly address the roots of the problem. This includes improving access to effective, non-coercive drug treatment for everyone who wants it, as well as improving access to medication-assisted treatments such as methadone and buprenorphine."

[image:3 align:left caption:true]Ralston also added that just making naloxone available to cops and EMTs wasn't good enough. Friends and family members, not "first responders," are most often the people who encounter others in the throes of life-threatening overdoses.

"While we applaud Attorney General Holder's clear support for expanding access to naloxone, particularly among law enforcement and 'first responders,' we urge him to clarify that he supports naloxone access for anyone who may be the first person to discover an opiate overdose in progress," she said.

But Law Enforcement Against Prohibition (LEAP), a group of law enforcement officials opposed to the war on drugs, applauded the move, which could help soften reflexive law enforcement opposition to carrying the overdose antidote, an attitude reflected in the the International Association of Chiefs of Police's opposition to all harm reduction measures.

"Police may not be the first to embrace change, but we are slowly evolving," said Lieutenant Commander Diane Goldstein (Ret.). "We cannot arrest our way out of a public health problem, and it's clear that the Attorney General is beginning to understand that and to embrace the role of harm reduction in reducing death, disease and addiction in our communities. We still have a long way to go, but this is a good sign."

The idea is "a no-brainer," according to executive director Major Neill Franklin (Ret.). "It is simply immoral not to support something proven to save lives for political reasons," Franklin added. "Yes, police send a message when they choose not to carry naloxone. But that message is not 'don't do drugs,' it's 'if you make the wrong decisions in your life, we don't care about you.' That offends me both as a former cop and as a human being."

The nuanced pushback to Holder's law enforcement/prevention/treatment/hint of harm reduction approach is good as far as it goes, but it doesn't go far enough. Decriminalizing and destigmatizing now illicit drug use, as has been the case in Portugal, is an obvious next step, and removing the question of drugs from the purview of the criminal justice system altogether would be even better. Still, that a sitting attorney general is calling for treatment and harm reduction as well as law enforcement is a good thing, and for reformers to be calling him on not going far enough is a good thing, too.



The Drug Enforcement Administration worked with pain management specialists to develop pain prescription guidelines so that law enforcement could do its job and physicians could do theirs. A month later, DEA pulled the guidelines.


In a letter, 30 state attorneys general take DEA to task over withdrawal of pain management prescription guidelines. Check out this public service ad on the letter.


OxyContin has been the center of controversy as pain management has moved to the front of the public consciousness. Much of what's been reported is exaggerated. Click here for more news and information about Oxy and pain management issues.


Excerpts from Cato Institute Analysis*:

"The government is waging an aggressive, intemperate, unjustified war on pain doctors."

"By demonizing physicians as drug dealers and exaggerating the health risk of pain management, the federal government has made physicians scapegoats for the failed drug war. Even worse, the Drug Enforcement Administration's renewed war on pain doctors has frightened many physicians out of pain management altogether, exacerbating an already serious health crisis - the widespread undertreatment of intractable pain."

"Experts agree that tens of millions of Americans suffer from undertreated or untreated pain ... According to one 1999 survey, just one in four pain patients received treatment adequate to alleviate suffering."

"The medical evidence overwhelmingly indicates that when administered properly, opioid therapy rarely, if ever, results in 'accidental addiction' or opioid abuse."

"Pain specialists make an important distinction between patients who depend on opiates to function normally - to get out of bed, tend to household chores, and hold down jobs - and

addicts who take drugs for euphoria, and whose lifestyles deteriorate as a result of taking opiates, instead of improving. The DEA makes no such distinction."

"The relationship between a doctor and his patient is crucial to the proper assessment and treatment of the patient's condition. The DEA's aggressive investigative procedure poisons the doctor-patient relationship from both sides."

"The DEA continues to lower its evidentiary standards, making it nearly impossible for many doctors to determine what is and isnt permitted."

"Large quantities of narcotics routinely go missing en route from manufacturers to wholesalers and from wholesalers to retailers. The DEA itself acknowledges this problem. Given the poor job the DEA is doing of monitoring the narcotics it's charged with overseeing ... DEA's attempt to blame physicians for the drugs' street availability seems arbitrary, unjustified, and capricious."

Common Sense for Drug Policy
www.CommonSenseDrugPolicy.org, www.DrugWarFacts.org

H. Michael Gray, Chair; Robert E. Field, Co-Chair
info@csdp.org

* "Treating Doctors as Drug Dealers: The DEA's War on Prescription Painkillers" by Professor Ronald T. Libby, June 16, 2005.
http://www.cato.org/pubs/pas/pa545.pdf

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