The implementation of medical marijuana programs is associated with a decrease in the prevalence of opioids detected among fatally injured drivers, according to data published in the American Journal of Public Health.
Researchers at Columbia University in New York and the University of California at Davis performed a between-state comparison of opioid positivity rates in fatal car accidents in 18 states. Authors reported that drivers between the ages of 21 and 40 who resided in states that permitted medical marijuana use were approximately half as likely to test positive for opioids as were similar drivers in jurisdictions that did not such programs in place.
They concluded, “Operational MMLs (medical marijuana laws) are associated with reductions in opioid positivity among 21- to 40-year-old fatally injured drivers and may reduce opioid use and overdose.”
Prior comparisons have determined that medical cannabis access is associated with lower rates of opioid use, abuse, and mortality. Most recently, a 2016 study published in the journal Health Affairs reported a significant decrease in the use of prescription medications following the implementation of medical marijuana programs.
An abstract of the study, “State medical marijuana laws and the prevalence of opioids detected among fatally injured drivers,” appears online here.
In this week’s Legislative Round Up you’ll learn about a national call to action to renew federal legislation protecting hundreds of thousands of patients and providers. In other news, the marijuana movement received support from two leading national veterans groups and several important bills were signed into law at the state level. Keep reading for the latest news in marijuana law reform.
A federal provision limiting the Justice Department from prosecuting state-authorized medical marijuana patients and providers is set to expire at the end of this month. The provision, known as the Rohrabacher-Farr Amendment, maintains that federal funds can not be used to prevent states from “implementing their own state laws that authorize the use, distribution, possession or cultivation of medical marijuana.” Please visit our #TakeAction Center to contact your federally elected officials and urge them to move quickly to reauthorize the Rohrabacher-Farr Amendment and to keep these important patient protections in place.
In other news of national significance, members of the American Legion passed a resolution to promote research on marijuana’s potential use for treating post-traumatic stress disorder and traumatic brain injury. Additionally, the group called for marijuana to be removed from it’s current Schedule I classification within the Controlled Substances Act. A second veterans group, The American Veterans (AMVETS), also recently resolved that marijuana should be made available to veterans within the VA healthcare system in every state where it is legal.
Delaware: Governor Jack Markell has signed legislation, SB 181, into law permitting designated caregivers to possess and administer non-smoked medical marijuana formulations (e.g. oils/extracts) to qualifying patients “in a school bus and on the ground or property of the preschool, or primary, or secondary school in which a minor qualifying patient is enrolled.”
The measure takes immediate effect. To date, two other states — Colorado and New Jersey — impose similar legislation.
Florida: Another local municipality, New Port Richey, has approved marijuana decriminalization legislation. In a 3-2 vote, the council approved an ordinance providing police the discretion to issue a $155 civil citation in lieu of making a criminal arrest in cases involving less than 20 grams of marijuana. The New Port Richey vote mimics those of nearby municipalities Orlando and Tampa, which passed similar ordinances earlier this year and a wave of South Florida municipalities that passed similar ordinances last year. Under state law, simple marijuana possession is a criminal misdemeanor, punishable by up to one year in prison and a $1,000 fine.
Michigan: Lawmakers gave final approval this week to a package of bills, HB 4209/4210, HB 4827, SB 141, and SB 1014, to regulate the retail sale of medical cannabis and cannabis-infused products. The legislation licenses and regulates above-ground, safe access facilities where state-qualified patients may legally obtain medical marijuana, provides qualified patients for the first time with legal protections for their possession and use of non-smoked cannabis derived topicals and edibles, as well as cannabis-based extract products, and establishes regulations tracking the production and sale of medical marijuana products. The measures, which lawmakers had debated for the past two years, now await action by the Governor. #TakeAction
New Jersey: On September 14th, Governor Chris Christie signed legislation, A 457, into law that adds PTSD to the list of qualifying conditions eligible for medical marijuana therapy. More than a dozen states permit medical marijuana access for PTSD treatment. A retrospective review of PTSD patients’ symptoms published in 2014 in the Journal of Psychoactive Drugs reported a greater than 75 percent reduction CAPS (Clinician Administered Posttraumatic Scale) symptom scores following cannabis therapy.
The new law took immediate effect.
Tennessee: Last week the Nashville Metro Council advanced legislation providing police the option to cite rather than arrest minor marijuana offenders. Those cited would face only a $50 fine (or ten hours of community service.) Under state law, such offenses are punishable by up to one-year in prison. A final vote on the ordinance is scheduled for September 20. If you live in Nashville, consider contacting your member of the Metro Council and voicing your support for this common sense reform.
In this week’s Round Up we’ll update you regarding the status of a number of state and local ballot measures, and we’ll also highlight new legislation signed into law this week in Delaware. Plus we’ll give you the details on the latest Governor to endorse marijuana decriminalization. Keep reading below to get this week’s news in marijuana law reform!
Arizona: The Supreme Court this week rejected a lawsuit that sought to prohibit Proposition 205, the Arizona Regulation and Taxation of Marijuana Act, from going before voters this November. The Act allows adults twenty-one years of age and older to possess and grow specified amounts of marijuana (up to one ounce of marijuana flower, up to five grams of marijuana concentrate, and/or the harvest from up to six plants). It creates a system for licensed businesses to produce and sell marijuana and establishes a Department of Marijuana Licenses and Control to regulate the cultivation, manufacturing, testing, transportation, and sale of marijuana.
Voters in four additional states, California, Maine, Massachusetts, and Nevada, will also be deciding on similar adult use initiatives on Election Day.
Arkansas: The Secretary of State’s office this week certified that a competing medical marijuana initiative, the Arkansas Medical Marijuana Amendment, will also appear on the electoral ballot in November. Unlike Issue 7, The Arkansas Medical Cannabis Act, this second initiative does not include provisions allowing eligible patients to cultivate their own cannabis at home.
Statewide polling reports greater public support for the Medical Cannabis Act. Under state law, if voters approve both measures the one that receives the greatest number of votes will become law.
Voters in three additional states, Florida, North Dakota, and Montana, will decide on similar medical use measures in November. In Missouri, campaigners are litigating to ask the courts to review signature totals in the state’s second Congressional district.
Colorado: A municipal initiative effort that sought to permit for the adult use of marijuana in licensed establishments failed to qualify for the November ballot. The Responsible Use Denver initiative, backed by Denver NORML, needed 4,726 signatures to qualify for inclusion on November ballot. The campaign submitted more than 7,500 signatures, but just 2,987 were verified as eligible by the Denver Elections Division. The Campaign posted: “We are sad to report that our language did not make the November ballot. We plan to continue pushing the conversation with the city of Denver. Our opinion remains the same, that we have what we feel is the best solution for the city of Denver. Thank you to everyone that has supported us on this journey.” City officials did confirm that a separate municipal initiative seeking to establish a ‘Neighborhood-Supported Cannabis Consumption Pilot Program’ will appear on November’s ballot.
Delaware: Governor Jack Markell signed legislation into law this week permitting terminally ill patients to access medical cannabis. House Bill 400 (aka ‘Bob’s bill’) permits physicians to recommend cannabis therapy to terminally ill adults. It also permits those under 18 to access CBD products if they are suffering from “pain, anxiety, or depression” related to a terminal illness.
The new law takes effect at the end of November.
Oklahoma: State Question 788, a statewide initiative to establish a state-licensing system to permit eligible patients to possess and cultivate personal use quantities of cannabis for therapeutic purposes, is unlikely to appear on the 2016 electoral ballot. Although the Secretary of State has certified that initiative proponents collected sufficient signatures, proponents are now challenging the attorney general’s rewording of the ballot title. The legal challenge could force the issue to be decided in a special election. Updated information regarding this initiative campaign may be found on NORML’s 2016 initiatives page.
Pennsylvania: Governor Tom Wolf expressed support for marijuana decriminalization this week stating, “too many people are going to prison because of the use of very modest amounts or carrying modest amounts of marijuana, and that is clogging up our prisons, it’s destroying families, and it’s hurting our economy.”
Marijuana decriminalization legislation, House Bill 2076, is currently pending before members of the House Judiciary committee. The legislation would amend the state’s controlled substances act so that minor marijuana possession offenses are considered a non-criminal offense. Contact your state House members and urge them to support this common sense legislation. #TakeAction
Tennessee: Members of the Nashville Metro Council voted 32 to 4 to approve legislation to lessen local marijuana possession penalties. The proposal amends penalties for the possession of or exchanging of up to one-half ounce of marijuana to a $50 civil penalty or 10 hours of community service. The vote was the first of three the bill will receive; it is the first time a marijuana decriminalization measure was considered by the legislative body.
Under current state law, individuals convicted of possession of less than one ounce of marijuana face a misdemeanor charge that is punishable of up to one year in jail and a $2,500 fine. If you live in Nashville, consider contacting your Council member and urging them to support this common sense measure.
Justices determined that state-registered medical marijuana patients are forbidden from purchasing firearms because cannabis remains classified as a Schedule I substance under federal law. They further opined that the ban “furthers the Government’s interest in preventing gun violence” because marijuana users “are more likely to be involved in violent crimes.”
They concluded, “[The plaintiff in this case] does not have a constitutionally protected liberty interest in simultaneously holding a [medical cannabis] registry card and purchasing a firearm.”
In 2011, the Bureau of Alcohol, Tobacco and Firearms issued a memorandum to all gun dealers in the United States specifying, “Any person who uses … marijuana, regardless of whether his or her state has passed legislation authorizing marijuana for medicinal purposes, is an unlawful user of or addicted to a controlled substance, and is prohibited by federal law from possessing firearms or ammunition.”
In response to today’s court ruling, NORML Deputy Director Paul Armentano said: “There is no credible justification for a ‘marijuana exception’ to the US Constitution. Responsible adults who use cannabis in a manner that is compliant with the laws of their states ought to receive the same legal rights and protections as do other citizens. It is incumbent that members of Congress act swiftly to amend cannabis’ criminal status in a way that comports with both public and scientific opinion, as well as its rapidly changing legal status under state laws.”
The Ninth Circuit decision, Wilson v Lynch et al., is available online here.
Since 1996, when California voters approved the medical use of marijuana, most of the high-profile political progress that has been made towards legalizing marijuana has been made in the United States. And starting with Colorado and Washington, all of the full legalization experiments have been homegrown.
But that does not mean we should not be looking to other countries for successful experiments and policies. Drug use and abuse is worldwide, so the solution to the destructive war on drug users must also be worldwide.
The Portugal Experiment
In 2001, the Portugal legislature bravely enacted a comprehensive form of drug decriminalization, in which all criminal penalties were removed for personal drug possession and use offenses — reclassifying them as administrative violations. Instead of arresting individuals in possession of personal-use amounts of any drug, defined as less than a ten-day supply of any drug — a gram of heroin, ecstasy, or amphetamine; two-grams of cocaine; or 25 grams of marijuana — they are now given a violation and ordered to appear before a rather ominous sounding “dissuasion commission.”
The possession of larger amounts of drugs and drug sales continue to be criminal matters for which an offender is subject to arrest and prosecution.
The “dissuasion commission,” which is comprised of one local legal official and two health and social service professionals, first determines whether the individual is addicted, and if so to what degree. It then determines whether the individual is referred to a voluntary treatment program, given a fine, or receives other administrative sanctions. The majority of cases are simply suspended, and the violator receives no sanction. According to Nuno Capaz, a sociologist who serves on the Lisbon “dissuasion panel,” between 80 and 85 percent of the people who are referred to the panels today are caught with hashish or cannabis.
For persistent offenders, or those identified as addicts, these panels can order sanctions or treatment, and recreational users may face fines or community service. If an addict refuses treatment, they are required to check in regularly with their family doctor (Portugal has a free national healthcare program), and if they fail, the local police remind them of their obligation. And those running the Portuguese system attribute this close working relationship between the police and the public health officials as crucial to their success. “This small change actually makes a huge change in terms of police officers’ work,” says Capaz. “Of course, every policy officer knows where people hang out to smoke joints. If they wanted to they would just go there and pick up the same guy over and over. That doesn’t happen.”
Flying in the face of the more prevalent “lock-em-up and throw-away-the-key” anti-drug policies popular at the time in most countries, especially the United States, there were initially fears that Portugal would become overrun with heroin addicts from all over Europe, and the government received a lot of criticism for their experimental policy from such staid groups as the International Narcotics Control Board – part of the UN drug convention system.
What Decriminalization Really Means
Decriminalization was a half-way measure originally recommended for marijuana policy in the U.S. by the National Commission on Marijuana and Drug Abuse in 1972. It says consumers, who generally comprise up to 90 percent of the marijuana arrests, should be removed from the criminal justice system, but that commercial sales of marijuana should remain illegal. While that is obviously an improvement over total prohibition, where users are also subject to arrest and jail, it generally is thought to lead to an increase in demand without any legal supply — a boon to the illegal black market and those willing to take the risk to sell to the newly legal consumers.
Seventeen states in the U.S. have enacted a version of marijuana decriminalization (some have eliminated all penalties for minor possession offenses; others have reduced the penalty to a fine-only). But more recently states that wish to end prohibition have looked toward full legalization, where the commercial market is regulated and taxed. Nonetheless, decriminalization remains an option for those states that no longer wish to treat smokers as criminals, but do not yet feel politically comfortable with full legalization.
Not The Results In Portugal That Were Expected
But the results from Portugal seem to dispel those initial fears that decriminalizing drugs would result in an increase in dangerous drug use, especially among addicts.
First, and most importantly, decriminalization in Portugal for a decade and a half has not led to any major increases in the rate of drug use. There were minor increases in drug use during the initial year (2001), but the rates of drug use after that have not changed significantly, or, in some cases, have actually declined since 2001, and remain below the average rates in both Europe and the United States. And importantly, adolescent use, and use by people who are deemed “dependent” or who inject drugs, has decreased in Portugal since 2003.
So decriminalization may yet prove to be an attractive alternative to prohibition for the more dangerous drugs in the United States. No one wants to see a cocaine store on the corner, but neither do most people want to ruin an individual’s life with a long prison sentence for the use of cocaine. If it is a problem, it is a medical one, not a criminal justice problem.
And Portugal has experienced more than a 60 percent decrease in the number of people arrested and prosecuted for drug offenses. More than 80 percent of the cases coming before the “dissuasion commissions” are perceived to have no problems and receive no sanction.
The percentage of prisoners in Portuguese prisons for drug offenses has been reduced from a high of 44 percent to the current rate of 13 percent. And drug overdose deaths have decreased from 80 in 2001 to 16 in 2012. In the U.S., for comparison, more than 14,000 people died from prescription opioid overdoses alone each year.
“There is no doubt that the phenomenon of addiction is in decline in Portugal,” Portugal’s Drug Czar Dr. Joao Goulão explained, according to Drug Policy Alliance. He attributed this shift to “a set of policies that target reduction of both supply and demand, including measures of prevention, treatment, harm reduction and social reinsertion.” Adding that, “[t]he biggest effect has been to allow the stigma of drug addiction to fall, to let people speak clearly and to pursue professional help without fear.”
And he strongly favors a policy of harm reduction. “I think harm reduction is not giving up on people,” Dr. Goulão said, according to Vice, “…assuming that even if someone is still using drugs, that person deserves the investment of the state in order to have a better and longer life.”
And even the United Nations Office on Drugs and Crime has concluded that “Portugal’s policy has reportedly not led to an increase in drug tourism. It also appears that a number of drug-related problems has decreased.” And some leading independent researchers investigating the Portugal experiment wrote in the British Journal of Criminology in 2010 that “contrary to predictions, the Portuguese decriminalization did not lead to major increases in drug use. Indeed, evidence indicates reductions in problematic use drug-related harms and criminal justice overcrowding.”
So What Can We Learn From Portugal
First, we can begin to stop treating so harshly illicit drug users, who use something other than marijuana. Sure heroin and cocaine and methamphetamine are more potentially dangerous than marijuana; but that does not mean those drug users should be treated like criminals. If, like Portugal, we can minimize abuse, greatly reduce the number of people arrested on drug charges, reduce overdose deaths, reduce adolescent drug use and problematic drug abuse, greatly reduce our prison population, and still maintain a safe, free and open society, then why would we not want to begin to move in that direction?
Also, we can learn from Portugal the importance of adopting a policy of harm reduction that recognizes the value of all lives, including those who may, for a time, use dangerous drugs, and to provide needed mental health services to those whom we can identify as problem drug abusers. Portugal seems to make it clear that their success simply could not have been possible without making health care professionals available to those who will avail themselves of that help.
And third, we can and should learn that the stigma of drug use or abuse — regardless of the drug involved — needs to be eliminated, to create an environment in which individuals feel free to seek help without fear of being labeled a bad person. It’s time to treat drug abuse as a medical issue, not primarily a criminal justice issue.