Seattle and surrounding King County are on a path to establish the country's first supervised drug consumption sites as part of a broader campaign to address heroin and prescription opioid misuse. A 99-page report released last week by the Heroin and Prescription Opiate Addiction Task Force calls for setting up at least two of the sites, one in the city and one in the suburbs, as part of a pilot project.
[image:1 align:left]The facilities, modeled on the Canadian government-funded InSite supervised injection site in Vancouver, just 140 miles to the north, would be places where users could legally inject their drugs while under medical supervision and be put in contact with treatment and other social services. There have been no fatal overdoses in the 13-year history of InSite.
Although such facilities, which also operate in various European countries and Australia, have been proven to reduce overdose deaths and drug use-related disease, improve local quality of life, and improve the lives of drug users, they remain controversial, with foes accusing them of "enabling" drug use. Thus, the report refers to them not as "safe injection sites," or even "supervised consumption sites," but as the anodyne "Community Health Engagement Locations" (CHELs).
"If it's a strategy that saves lives then regardless of the political discomfort, I think it is something we have to move forward," said County Executive Dow Constantine, discussing the plan at a news conference last week.
The safe sites will address the region's high levels of opioid and heroin use, or what the task force called "the region's growing and increasingly lethal heroin and opioid epidemic." As the task force noted, the number of fatal overdoses in the county has tripled in recent years, with the rate of death rising from roughly one a week (49) in 2009 to one very other day (156) in 2014. The current wave of opioid use appears centered on young people, with the number of people under 30 seeking treatment doubling between 2006 and 2014, and now, more young people are entering detox for heroin than for alcohol.
[image:2 align:left caption:true]Overdose deaths actually dropped last year to 132, thanks to Good Samaritan laws that shield people who aid overdose victims from prosecution and to the wider use of the opioid overdose reversal drug naloxone. But that's still 132 King County residents who needn't have died. Task force members said the CHELs would help reduce that number even further.
"The heroin epidemic has had a profound effect not just on our region, but across our country as a whole," said Seattle Mayor Ed Murray. "It is critical that we not only move forward with meaningful solutions that support prevention and treatment, but that we remove the stigma surrounding addiction that often creates barriers to those seeking help.
Not only are key local elected officials on board, so is King County Sheriff John Urquhart. He said the safe site plan was workable.
"As long as there was strong, very strong, emphasis on education, services, and recovery, I would say that yes, the benefits outweigh the drawbacks," he said. "We will never make any headway in the war on drugs until we turn the war into a health issue."
The region may willing to embrace this ground-breaking harm reduction measure, but it is going to require some sort of federal dispensation to get around the Controlled Substances Act and the DEA. How that is going to happen remains to be seen, but Seattle is ready.
The task force wasn't just about CHELs. In fact, the safe sites are just a small, if key, component of a broad-based, far-ranging strategy to attack the problem. The task force report's recommendations come in three categories:
[image:3 align:right caption:true]Primary Prevention
- Increase public awareness of effects of opioid use, including overdose and opioid-use disorder.
- Promote safe storage and disposal of medications.
- Work with schools and health-care providers to improve the screening practices and better identify opioid use.
Treatment Expansion and Enhancement
- Make buprenorphine more accessible for people who have opiate-use disorders.
- Develop treatment on demand for all types of substance-use disorders.Increase treatment capacity so that it’s accessible when and where someone is ready to receive help.
Health and Harm Reduction
- Continue to distribute more naloxone kits and making training available to homeless service providers, emergency responders and law enforcement officers.
- Create a three-year pilot project that will include at least two locations where adults with substance-use disorders will have access to on-site services while safely consuming opioids or other substances under the supervision of trained healthcare providers.
Will Seattle and King County be able to actual implement the CHELs? Will the federal government act as obstacle or facilitator? That remains to be seen, but harm reductionists, policymakers, and drug users in cities such as Portland, San Francisco, and New York will be watching closely. There have been murmurs about getting such sites up and running there, too.
Chronicle AM: Seattle Call for Injection Sites, Duterte Wants More Lethal Drug War, More... (9/20/16)
A Seattle/King County heroin task force has recommended two safe injection sites be established, a California bill to let landlords ban medical marijuana smoking dies, Nevada legalization foes get organized, and more.
[image:1 align:right caption:true]Marijuana Policy
Nevada Legalization Foes Get Organized. Opponents of the Question 2 legalization initiative have organized as Protecting Nevada's Children, complete with a slick website that warns that "legalizing marijuana… like giving candy to a baby." Officials with the no campaign are also worrying about "a well-prepared workforce" if Las Vegas becomes "the Amsterdam of the West." The group refuses to divulge its funding, saying it would be revealed in mid-October, when campaign finance reports are due.
California Bill to Let Landlords Ban Medical Marijuana Smoking Dies. Assemblyman Jim Wood (D-North Coast) has dropped his bill that would let landlords ban smoking medical marijuana after he conceded he was unable to figure out how to meet the needs of medical marijuana patients.
Seattle Heroin and Opioid Task Force Issues Report, Calls for Two Safe Injection Sites. The King County Heroin and Opiate Addiction Task Force has issued a final report calling on increased prevention and access to treatment for addicted users. Among other recommendations, the report calls for authorities to "Create a three-year pilot project that will include at least two locations where adults with substance-use disorders will have access to on-site services while safely consuming opioids or other substances under the supervision of trained healthcare providers." Look for a detailed article on the task force recommendations tomorrow.
North Dakota Legislature Squabbles Over Drug Sentences. Legislators are working off-session on a pair of criminal justice reform bills aimed at curbing a growing prison population, but some are reluctant to embrace reductions in drug sentences that experts said were necessary to actually achieve prison population cuts. There was support for reducing some sentences for drug possessors, but not for drug sellers. A proposal from the Department of Corrections and Rehabilitation to eliminate mandatory minimums for people dealing drugs was rejected. But a proposal from the Council of State Governments to make probation the presumptive sentence for first-time, low-level felonies was accepted. The bills will be introduced at the beginning of the next session.
Philippines President Wants Six More Months of Drug War Because He "Cannot Kill Them All" Fast Enough. Even as the death toll from President Rodrigo Duterte's slow motion massacre of drug suspects tops 3,000, the hardline leader is saying he wants to extend his crusade another six months. "I did not realize how severe and how serious the drug menace was in this republic until I became president," Duterte said. "Even if I wanted to I cannot kill them all because the last report would be this thick," he said, referring to a new police list of people including top officials suspected of being involved in the drugs trade.
Chronicle AM: CA&MA Polls, Kratom Proponents Mobilize, Canada OKs Prescription Heroin; More... (9/14/16)
The polling is looking good in Massachusetts and better in California, there will be no initiative for Michigan this year, kratom proponents fight a proposed DEA ban, Canada gives the go-ahead for expanded heroin prescribing, and more.
[image:1 align:left caption:true]Marijuana Policy
Marijuana Could Be a $50 Billion a Year Industry Within a Decade. A new report from financial analysts Cowen & Company says the legal weed industry could grow to a $50 billion a year business by 2026. The report notes that legalizing pot in California alone could triple the size of the industry, currently around $6 billion a year.
California: LA Times Poll Has Prop 64 at 58%. The Prop 64 legalization initiative is supported by 58% of voters, according to a new USC Dornsife/Los Angeles Times poll. Only 34% said they would vote against the measure, with 8% undecided. "It's very clear that Californians' attitudes have changed dramatically on this issue over the last several years," said Dan Schnur, director of the poll and of the Jesse M. Unruh Institute of Politics at USC. "The opposition is going to have to identify a fairly sizable source of campaign funding if this initiative is to be close," he added.
California: Eyewitness News/Southern California Newsgroup Poll Has Prop 64 at 52%. The Prop 64 legalization initiative has 52% in a new poll from Eyewitness News/Southern California Newsgroup. Some 40% said they would vote no, with 8% undecided.
Massachusetts Poll Has Legalization Initiative Up By Five Points. A new poll from WBUR TV has support for the Question 4 legalization initiative at 50%, with 45% opposed. "There's some big demographic splits, particularly along age lines," pollster Steve Koczela said. "Younger people are very much in favor of legalization, and it declines steadily as you move up the age brackets to where you get to voters who are 60-plus, and they're opposed to it by a 17-point margin."
Federal Judge Puts Final Nail in Coffin of Michigan Legalization Initiative. A federal court judge rejected a last chance effort by MI Legalize to get its legalization initiative on the November ballot. Judge Linda Parker Tuesday denied a motion from the group to stop the printing of election ballots, saying there was not enough time to stop the election process. MI Legalize gathered enough signatures to qualify for the ballot, but some of them came outside a 180-day mandated by state law. MI Legalize challenged rulings by state officials that knocked those signatures off the tally, but lost in the state courts -- and now, in federal court.
Kratom Supporters Fight Proposed DEA Ban. Proponents of the Southeast Asian plant with mild opium-like qualities have mobilized to block the DEA proposed emergency move to place the substance on Schedule I of the Controlled Substances Act. Hundreds marched in front of the White House Tuesday and more than 120,000 have signed a Change.org petition opposing the ban, meaning the White House will have to publicly address the issue.
Canada Has Approved Prescription Heroin. The Canadian government last week quietly approved new regulations that will allow doctors to prescribe diacetylmorphine (heroin) to long-term users who have not responded to more conventional approaches to weaning them from the drug. The Crosstown clinic in Vancouver is currently the only place in the country with a heroin maintenance program, but that should now not be the case for long.
British MPs Call for Medical Marijuana. The All Party Parliamentary Group on Drug Policy Reform has called for medical marijuana to be legalized in the United Kingdom. The call comes on the heels of a report by neurologist Dr. Mike Barnes urging that marijuana be moved from Schedule I to Schedule IV on the British drugs classification scheme. "Many hundreds of thousands of people in the UK are already taking cannabis for primarily medical reasons," said MP Caroline Lucas, who co-chairs the group. "It is totally unacceptable that they should face the added stress of having to break the law to access their medicine."
Chronicle AM: MT MedMJ Patients Out of Luck, Christie Signs Needle Exchange Funding, More... (9/1/16)
It the end of easy access for Montana medical marijuana patients, the Arizona Supreme Court rejects the last challenge to that state's legalization initiative, the second Arkansas medical marijuana initiative is now officially on the ballot, Chris Christie signs a needle exchange funding bill, and more.
[image:1 align:right caption:true]Marijuana Policy
More Smoke Pot, Fewer Find it Risky, Survey Reports. Survey data shows more adults are using marijuana, they are using it more often, and they're less inclined to think it's risky than in the past, research results reported in The Lancet found. The number of adults using marijuana in the past year has jumped to 32 million -- going from one in ten in 2002 to one in eight in 2014. Only one-third of adults thought weekly marijuana use was risky, down from half in 2002.
Alaska Attorney General Says Pot Social Clubs Are Illegal. State Attorney General Jahna Lindemuth said in a legal opinion Wednesday that marijuana social clubs are illegal. "Under Alaska law, a business cannot sell or provide marijuana or allow marijuana to be consumed on the premises unless it is licensed as a retail marijuana store by the Marijuana Control Board," Lindemuth wrote. The ruling does not apply to retail pot shops, for which state regulators are considering rules that would allow on-site cannabis consumption.
Arizona Supreme Court Rejects Challenges to Pot Legalization Initiative. Arizonans will be voting on Proposition 205 on November 8. The state Supreme Court has thrown out the last challenges to the measure, which accused it of misleading voters with its language, but the high court upheld a lower court ruling that Prop 205 substantially complies with legal requirements for initiatives.
It's Official: Second Arkansas Initiatives Qualifies for the Ballot. Secretary of State Mark Martin's office said Wednesday that the Arkansas Medical Marijuana Amendment had submitted sufficient valid voter signatures to qualify for the November ballot. That means Arkansas voters will have two medical marijuana initiatives to vote on. The Arkansas Medical Cannabis Act was approved for the ballot in July. If both pass, the one with the most votes goes into effect.
Delaware Governor Signs Bill Allowing Medical Marijuana for Terminally Ill. Gov. Jack Markell (D) Wednesday signed into law "Bob's Bill," named for lung cancer patient Robert Jester, who died in 2014 without being able to legally use marijuana to ease his suffering. The bill allows for medical marijuana for terminally ill patients, including those under 18 who are suffering pain, anxiety, or depression.
Montana Medical Marijuana Patients Now Out of Luck. In the biggest medical marijuana rollback ever, as of September 1, medical marijuana dispensaries are now illegal, and up to 12,000 patients have lost legal access to marijuana. Medical marijuana providers are now limited to three patients, and thousands of patients have no provider. This is the end result of the GOP-led legislature's 2011 move to gut the state's voter-approved medical marijuana law. An initiative that would restore the state's medical marijuana system, I-182, has been approved for the November ballot.
New Jersey Governor Signs Needle Exchange Funding Bill. Gov. Christ Christie (R) Wednesday signed into law Assembly Bill 415, which creates permanent funding for five locally run needle exchange programs. Three of them, in Atlantic City, Camden, and Paterson, had already run out of funds and were close to closing their doors. "These programs not only distribute clean syringes to intravenous drug users, but also deliver lifesaving education, treatment, and testing to their participants," according to Christie's bill-signing statement.
New Psychoactive Substances
California Bill Would Make Possession of Synthetic Cannabinoids, Stimulants a Crime. The legislature has approved a bill requested by the California Narcotics Officers Association that would make first-time possession of specified synthetic cannabinoids or stimulants an infraction, with subsequent offenses treated as misdemeanors. Under current state law, selling the drugs is a crime, but possessing them isn't. The measure, Senate Bill 139, now goes to the desk of Gov. Jerry Brown (D). It is opposed by the ACLU and the Drug Policy Alliance.
EU Wants to Ban New, Powerful Synthetic Cannabinoid. The European Commission announced Wednesday that it wants to ban MDMB-CHMICA, also known as "Black Mamba," a synthetic cannabinoid reportedly 10 times stronger than already banned synthetic cannabinoids. The European Monitoring Center on Drugs and Drug Abuse reported that it has been linked to at least 42 "acute intoxications" and 29 deaths.
Philippines President Snubs UN Effort to Meet Over Drug Killings. President Rodrigo Duterte has turned down a meeting with UN Secretary-General Ban Ki-moon after threatening last month to quit the UN over its criticism of the mass killings of drug users and dealers since he came to office three months ago. Officials from Duterte's office said he was too busy to meet with the head of the global body. One UN official said it was "basically unheard of" for a national leader to be "too busy" to meet the secretary-general.