Decriminalization

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Chronicle AM: Uruguay Marijuana Pharmacy Sales Begin, DPA Names New Chief, More... (7/19/17)

All New England states have now either decriminalized or legalized marijuana, the Drug Policy Alliance names a new head, Uruguay begins legal pot sales at pharmacies, and more.

Marijuana Policy

Massachusetts Legalization Implementation Bill Could Go to Governor This Week. Legislative leaders defended their compromise pot bill, House Bill 3818, Wednesday, and votes on the bill could come at any time. The measure is expected to pass the legislature and then head to the desk of Gov. Charlie Baker (R), who is expected to sign it. The bill increases taxes from 12% to up to 20%, and would allow authorities in localities that didn't vote in favor of the legalization initiative to ban pot businesses without a popular vote.

New Hampshire Governor Signs Decriminalization Bill. Gov. Chris Sununu (R) has signed into law House Bill 640, which eliminates criminal penalties for the possession of up to three-quarters of an ounce of marijuana. Instead of jail time, violators will face a $100 fine for a first offense, $200 for a second, and $350 for a third offense within three years of the original offense. With the state now adopting decriminalization, all of New England has now either legalized or decriminalized marijuana possession.

Drug Policy

Drug Policy Alliance Names New Executive Director. The Drug Policy Alliance (DPA), the nation's most powerful drug reform organization, has selected a replacement for founder and long-time executive director Ethan Nadelmann, who stepped down earlier this year.The DPA board of directors announced Tuesday it had voted unanimously to appoint Maria McFarland Sánchez-Moreno as Nadelmann's successor. McFarland Sánchez-Moreno is moving over from Human Rights Watch, where for the past 13 years she served as Co-Director of the US Program, where she picked up plenty of domestic and international drug policy experience. She also pushed for the group to more directly take on the war on drugs as a human rights issue, and as a result, Human Rights Watch became the first major international human rights organization to call for drug decriminalization and global drug reform.

International

Uruguay Legal Marijuana Sales in Pharmacies Get Underway. Pharmacists in Uruguay began selling marijuana to customers Wednesday, the last step in a pioneering national legalization process that began more than three years ago. Uruguay is the first country in the world to completely legalize marijuana for recreational use. Canada is set to be next.

Chronicle AM: MI Init Signatures Coming Fast, OR Decriminalizes Drug Possession, More... (7/11/17)

Michigan legalizers are fast off the mark in their initiative signature-gathering campaign, the Drug Policy Alliance and 30 groups call for drug decriminalization, Oregon is set to defelonize drug possession, and more.

Marijuana Policy

Michigan Initiative Campaign Already Has 100,000 Raw Signatures. The Coalition to Regulate Marijuana Like Alcohol, which wants to put a legalization initiative on the November 2018 ballot, announced Monday that signature gathering was ahead of schedule and that the group had already passed the 100,000 mark. To qualify for the ballot, the group must collect 252,523 valid voter signatures within a six-month period. They began signature gathering in late May.

DC Public Use Marijuana Arrests Tripled Last Year. More than 400 people were arrested in the nation's capital last year for publicly using marijuana, a nearly three-fold jump over the 142 arrested in 2015. And this year so far the pace of arrests remains steady. Some advocates criticized the increase in arrests, with Adam Eidinger, the man behind DC's legalization law, saying the right to smoke marijuana in the District is effectively reserved for "those who own private property," with renters, residents of public housing, and visitors out of luck. "A lot of it is people not realizing they can't smoke in public," he said of the increase in arrests. "A lot of it is people who have no place else to go."

Medical Marijuana

Puerto Rico Governor Signs Medical Marijuana Bill. Gov. Ricardo Rosello, a former biomedical engineer, on Sunday signed into law a bill that legalizes and regulates medical marijuana in the US territory. The move comes after Rossello criticized an earlier executive order allowing medical marijuana as insufficient. "As a scientist, I know firsthand the impact that medicinal cannabis has had on patients with various diseases," he said. "The time has come for Puerto Rico to join the flow of countries and states that have created similar legislation."

Drug Policy

Drug Policy Alliance Report Calls for US Drug Decriminalization. In a new report endorsed by more than 30 organizations, the Drug Policy Alliance is calling for the end of arresting people simply for using or possessing drugs. "Our current laws have branded tens of millions of people with a lifelong criminal record that makes it hard to get a job or an apartment," said Art Way, senior director of national criminal justice strategy at the Drug Policy Alliance. "The experience of the last few decades shows that criminalization has been utterly ineffective in reducing problematic drug use."

Sentencing

Oregon Defelonizes Drug Possession. The state legislature has approved House Bill 2355, which makes simple possession of drugs such as heroin, MDMA, and meth a misdemeanor punishable by no more than a year in jail. Under current law, drug possession is a felony punishable by up to 10 years in prison. The bill also includes a provision aimed at reducing racial profiling by police. The legislature also approved House Bill 3079, which reduces penalties for property crimes often related to problematic drug use. Gov. Kate Brown (D) is expected to sign the bills into law shortly.

Chronicle AM: WHO Calls for Drug Decrim, NV Legal MJ Sales Start Saturday, More... (6/29/17)

Massachusetts pols continue to work on a legalization implementation compromise, Nevada legal marijuana sales begin Saturday, a pair of federal sentencing reform bills get introduced, the World Health Organization calls for global drug decriminalization, and more.

Legal marijuana sales begin a minute after midnight Saturday -- but don't light up on the Strip! (Wikimedia)
Marijuana Policy

Possible Tax Compromise in Massachusetts. House Speaker Robert DeLeo (D-Winthrop) has said he may be willing to move away from the House's position that retail marijuana sales be taxed at 28%, more than twice the 12% envisioned in the legalization initiative and the competing Senate bill. "I suppose there could be some negotiation," he said, referring to a legislative conference committee trying to reach agreement. "I found they are having fruitful conversations, so to speak, so I am hopeful," DeLeo said.

Nevada Legal Sales Begin at 12:01 a.m,Saturday. Nevadans and visitors will be able to legally purchase marijuana as of a minute after midnight Saturday. A few dozen medical marijuana dispensaries have been licensed to sell their products to anyone 21 and over with a proper ID as a stopgap measure before the recreational marijuana sales system goes online next year, and at least some of them will be open Saturday night to take advantage of the commencement of early legal sales. But tourists in particular will have to figure out where to smoke it -- there's no smoking on the strip, in casinos, or hotel rooms.

Medical Marijuana

Nevada Dispensaries Get Tougher Regulations on Edibles as Legal Sales Loom. Gov. Brian Sandoval (R) Monday signed a Taxation Department emergency regulation that will impose tougher regulations beginning Saturday, the same day legal recreational pot sales through dispensaries begins. Under the new regulations, edibles can't contain more than 10 milligrams of THC per dose or 100 per package, they can't resemble lollipops or other products marketed to children, they can't look like real or fictional characters or cartoons, and they can't have images of cartoon characters, action figures, toys, balloons or mascots on the packaging.

Sentencing

Cory Booker Files Bill to Encourage States to Reduce Prison Populations. Sen. Cory Booker (D-NJ) has filed Senate Bill 1458, "to establish a grant program to incentivize states to reduce prison populations, and for other purposes." The bill is not yet available on the congressional web site.

Keith Ellison Files Bill to Defelonize Drug Possession, End Crack/Powder Cocaine Sentencing Disparity. Rep. Keith Ellison (D-MN) has filed House Resolution 3074, "to reclassify certain low-level felonies as misdemeanors, to eliminate the increased penalties for cocaine offenses where the cocaine involved is cocaine base, to reinvest in our communities, and for other purposes. The bill is not yet available on the congressional website.

International

UN World Health Organization Calls for Global Drug Decriminalization. The call came in a joint United Nations statement on ending discrimination in health care. One way that nations can do that, WHO said, is by: "Reviewing and repealing punitive laws that have been proven to have negative health outcomes and that counter established public health evidence. These include laws that criminalize or otherwise prohibit gender expression, same sex conduct, adultery and other sexual behaviors between consenting adults; adult consensual sex work; drug use or possession of drugs for personal use; sexual and reproductive health care services, including information; and overly broad criminalization of HIV non-disclosure, exposure or transmission."

Human Rights Watch Calls Duterte's First Year a Human Rights Calamity. The New York-based human rights watchdog said Wednesday Philippine President Rodrigo Duterte's first year in office was "a human rights calamity" with thousands of people killed in Duterter's war on drugs. "President Duterte took office promising to protect human rights, but has instead spent his first year in office as a boisterous instigator for an unlawful killing campaign," Phelim Kine, deputy Asia director at Human Rights Watch said in a statement. "Duterte has supported and incited 'drug war' killings while retaliating against those fearless enough to challenge his assault on human rights," he added. Human Rights Watch also slammed Duterte for subjecting critics of his anti-drug campaign to harassment, intimidation, and even arrest. "A UN-led international investigation is desperately needed to help stop the slaughter and press for accountability for Duterte's human rights catastrophe," the group said.

Chronicle AM: IL Passes Forfeiture Reform, House Heroin Task Force Proposals, More... (6/28/17)

Utah's new medical marijuana initiative is exposing fissures between the LDS leadership and membership, an asset forfeiture reform bill sits on the desk of Illinois' governor, a bipartisan House heroin task force releases its proposals, and more.

Utahns are ready for medical marijuana. (Harborside)
Medical Marijuana

Utah Poll Has Strong Support for Medical Marijuana. Just days after the Utah Patient Coalition took initial steps to put an initiative on the November 2018 ballot, a poll it sponsored showed that 73% of Utah voters support the initiative, with only 20% opposed. Support came from all demographic groups, including active Mormons, 63% of whom said they were in favor.

Mormon Church Opposes Utah Medical Marijuana Initiative. The powerful Salt Lake City-based Church of Jesus Christ of Latter Day Saints (Mormons) has come out in opposition to a medical marijuana initiative filed this week by the Utah Patients Coalition. The church acknowledged ongoing interest in medical marijuana and said it supported further research but argued that approval of medical marijuana should come after "the FDA approval process that all other drugs must go through before they are prescribed to patients."

Asset Forfeiture

Illinois Legislature Passes Asset Forfeiture Reform. The legislature last Friday gave final approval to an asset forfeiture reform measure, House Bill 303, that raises the standard of evidence for seizures from probable cause to a preponderance of the evidence and bars seizures of under $500 in most drug cases. The bill does not, however, require a criminal conviction before a seizure can occur -- a sop to prosecutors and law enforcement groups who lobbied for that provision to be dropped. The bill now awaits action from Gov. Bruce Rauner (R).

Heroin and Prescription Opioids

House Bipartisan Heroin Task Force Releases Proposals. A bipartisan group of House members released a raft of proposals Tuesday aimed at fighting the nation's drug problems as "an American issue," not a partisan one. The package of bills from the Bipartisan Heroin Task Force includes increased funding for drug-screening gear at the border, studies on the effects of synthetic drug use, greater flexibility for use of health savings accounts, and creation of treatment centers for infants exposed to opioids during their mothers pregnancy.

International

Georgia Parliament Takes Up Drug Decriminalization. The Parliamentary Health Committee has introduced a bill to decriminalize the possession of all drugs that was developed by the National Drug Policy Platform, a grouping of more than 40 NGOs. The bill would annul the country's much-criticized strict 2007 drug law, as well as making changes to at least 10 criminal and administrative laws. The core principle behind the bill is to shift the country's drug policy away from a criminal justice approach, treating drug use instead as a public health issue. Earlier this month, parliament gave initial approval to marijuana decriminalization. Both pot decrim and broader drug decrim should be addressed during parliament's looming autumn session.

Chronicle AM: Roger Stone Wants to Legalize, MA Regulation Battle, More... (6/19/17)

The politics of marijuana regulation continue to roil Massachusetts, Trump adviser and political trickster Roger Stone has formed a legalization lobbying group, the government of the Republic of Georgia backs away from harsh pot sentences, and more.

What is political trickster Roger Stone up to? (alternet.org)
Marijuana Policy

Trump Associate Roger Stone Forms Legalization Lobbying Group. Longtime political trickster and Donald Trump associate Roger Stone announced last Friday that he has formed the United States Cannabis Coalition for the express purpose of legalizing marijuana. He will be joined by former Minnesota Gov. Jesse Ventura (I), as well as both Democratic and Republican political strategists. "I am going to be working with a coalition of Republicans and Democrats, progressives and libertarians, liberals, and conservatives to persuade the president to keep his campaign pledge," Stone said, "and to remind the president that he took a strong and forthright position on this issue in the election." During the campaign, Trump said marijuana legalization should be a state issue and that he was "100%" behind medical marijuana.

Massachusetts Senate Plan Would Not Raise Taxes. State Sen. Patricia Jehlen (D-Somerville) last Friday released the Senate's plan to implement marijuana legalization, a sharp contrast with the House bill that would raise the tax rate on marijuana from 12% to 28% and allow local elected officials to ban pot businesses. Jehlen's bill would keep the tax rate at the 12% envisioned by last fall's successful initiative. "A high tax rate is not the will of the voters," she said after releasing the outline of the Senate bill. "You want to start low enough to make the legal market catch hold." The two bills should pass their respective houses and go to conference committee later this month.

Mobile Retreats from Decriminalization Ordinance. Mobile, Alabama, Mayor Sandy Stimpson has requested that discussion of a municipal ordinance to decriminalize marijuana possession be withdrawn from the agenda for Tuesday's city council meeting. The reason for the withdrawal is unclear, but the topic has been controversial with law enforcement and city staff.

Medical Marijuana

Arkansas Medical Marijuana Regulations Take Another Key Step. The Legislative Council, which serves as the legislature's governing body between sessions, last Friday approved draft rules from the Alcoholic Beverage Commission, the Department of Health, and the Medical Marijuana Commission aimed at regulating the state's nascent medical marijuana system. The state will begin accepting applications for licenses to operate marijuana cultivation centers and dispensaries June 30.

New Mexico Nixes Medical Marijuana for Opioid Addiction, Alzheimer's. Rejecting the recommendation of the state Medical Marijuana Advisory Board, Secretary of Health Lynn Gallagher declined to add opioid use disorder and Alzheimer's as qualifying conditions for medical marijuana.

International

After Protests, Georgia Marijuana Reform Bill Filed. The government has filed a bill in parliament that would end prison sentences for the possession, cultivation, or sale of less than 70 grams (a bit more than a quarter-pound) of marijuana. The move comes after mass protests last weekend over the arrests of two rappers on what are widely believed to be trumped-up marijuana charges for releasing videos critical of police. The bill would also slash by nearly half prison sentences for marijuana offenses involving larger quantities.

America, We Can Fix This: 24 Ways to Reduce Opioid Overdoses and Addiction [FEATURE]

Drugs, mainly opioids, are killing Americans at a record rate. The number of drug overdose deaths in the country quadrupled between 1999 and 2010 -- and compared to the numbers we're seeing now, those were the good old days.

Some 30,000 people died of drug overdoses in 2010. According to a new estimate from the New York Times, double that number died last year. And the rate of increase in overdose deaths was growing, up a stunning 19% over 2015.

The Times' estimate of between 59,000 and 65,000 drug overdose deaths last year is greater than the number of American soldiers killed during the entire Vietnam War, greater than that number of people killed in the peak year for car crash deaths, greater than the number of people who died in the year the AIDS epidemic peaked, and higher than the peak year for gun deaths.

In the first decade of the century, overdoses and addiction rose in conjunction with a dramatic increase in prescription opioid prescribing; since then, as government agents and medical professionals alike sought to tamp down prescribing of opioids, the overdose wave has continued, now with most opioid OD fatalities linked to illicit heroin and powerful black market synthetic opioids, such as fentanyl and carfentanil.

The Centers for Disease Control and Prevention says we are in the midst of "the worst drug overdose epidemic in history," and it's hard to argue with that.

So, what do we do about it? Despite decades of failure and unintended consequences, the prohibitionist reflex is still strong. Calls for more punitive laws, tougher prosecutorial stances, and harsher sentences ring out from state houses across the land to the White House. But tough drug war policies haven't worked. The fact that the overdose and addiction epidemic is taking place under a prohibition regime should make that self-evident.

More enlightened -- and effective -- approaches are now being tried, in part, no doubt, because today's opioid epidemic is disproportionately affecting white, middle class people and not the inner city black people identified with heroin epidemics of the past. But they are also being tried because for the past quarter-century an ever-growing drug reform movement has articulated the failures of prohibition and illuminated more effective alternatives.

The drug reform movement's most powerful organization, the Drug Policy Alliance, this spring published A Public Health and Safety Approach to Problematic Opioid Use and Overdose, which lays out more than two dozen specific policy prescriptions in the realms of addiction treatment, harm reduction, prevention, and criminal justice that have been proven to save lives and reduce dependency on opioids. These policy prescriptions are doable now -- and some are being implemented in some fashion in some places -- but require that political decisions be made, or that forces be mobilized to get those decisions made. Some would require a radical divergence from the orthodoxies of drug prohibition, but that's a small price to pay given the mounting death toll.

Here are 24 concrete policy proposals that can save lives and reduce addiction right now. All the facts and figures are fully documented in the heavily-annotated original. Consult it if you want to get down to the nitty-gritty. In the meantime:

Addiction Treatment

1. Create Expert Panel on Treatment Needs: States should establish an expert panel to address effective treatment needs and opportunities. The expert panel should evaluate barriers to existing treatment options and make recommendations to the state legislature on removing unnecessary impediments to accessing effective treatment on demand. Moreover, the panel should determine where gaps in treatment exist and make recommendations to provide additional types of effective treatment and increased access points to treatment (such as hospital-based on demand addiction treatment). The expert panel must also set evidence-based standards of care and identify the essential components of effective treatment and recovery services to be included in licensed facilities, especially with regards to medication-assisted treatment, admission requirements, discharge, continuity of care and/or after-care, pain management, treatment programming, integration of medical and mental health services, and provision of or referrals to harm reduction services. The expert panel should identify how to improve or create referral mechanisms and treatment linkages across various healthcare and other providers. The panel should establish clear outcome measures and a system for evaluating how well providers meet the scientific requirements the panel sets. And, finally, the expert panel should evaluate opportunities under the ACA to expand coverage for treatment.

2. Increase Insurance Coverage for Medication-Assited Treatment (MAT): Seventeen state medical plans under the Patient Protection and Affordable Care Act (ACA) do not provide coverage for methadone or buprenorphine for opioid dependence. Moreover, the Veterans Administration's (VA's) insurance system has explicitly prohibited coverage of methadone and buprenorphine treatment for active duty personnel or for veterans in the process of transitioning from Department of Defense care. As a result, veterans obtaining care through the VA are denied effective treatment for opioid dependence. Insurance coverage for these critical medications should be standard practice.

3. Establish and Implement Office-Based Opioid Treatment for Methadone: Currently, with a few exceptions, methadone for the treatment of opioid dependence is only available through a highly regulated and widely stigmatized system of Opioid Treatment Programs (OTPs). Moreover, several states have imposed moratoriums on establishing new OTPs that facilitate methadone treatment despite large, unmet treatment needs for a growing opioid-dependent population. Patients enrolled in methadone treatment in many communities are often limited to visiting a single OTP and face other inconveniences that make adherence to treatment more difficult. Initial trials have suggested that methadone can be effectively delivered in office-based settings and that, with training, physicians would be willing to prescribe methadone to their patients to treat their opioid dependence. Office-based methadone may help reduce the stigma associated with methadone delivered in OTPs as well as provide a critical window of intervention to address medical and psychiatric conditions. Office-based opioid treatment programs offering methadone have been implemented in California, Connecticut, and Vermont.

4. Provide MAT in Criminal Justice Settings, Including Jails/Prisons and Drug Courts: Individuals recently released from correctional settings are up to 130 times more likely to die of an overdose than the general population, particularly in the immediate two weeks after release. Given that approximately one quarter of people incarcerated in jails and prisons are opioid-dependent, initiating MAT behind bars should be a widespread, standard practice as a part of a comprehensive plan to reduce risk of opioid fatality. Jails should be mandated to continue MAT for those who received it in the community and to assess and initiate new patients in treatment. Prisons should initiate methadone or buprenorphine prior to release, with a referral to a community-based clinic or provider upon release. In addition, drug courts should be mandated to offer participants the option to participate in MAT if they are not already enrolled, make arrangements for their treatment, and should not be permitted to make discontinuation of MAT a criterion for successful completion of drug court programs. The Substance Abuse and Mental Health Services Administration will no longer provide federal funding to drug courts that deny the use of MAT when made available to the client under the care of a physician and pursuant to a valid prescription. The National Association of Drug Court Professionals agrees: "No drug court should prohibit the use of MAT for participants deemed appropriate and in need of an addiction medication."

Medication-Assisted Treatment (MAT) can help.
5. Offer Hospital-Based MAT: Emergency departments should be mandated to inform patients about MAT and offer buprenorphine to those patients that visit emergency rooms and have an underlying opioid use disorder, with an appointment for continued treatment with physicians in the community. Hospitals should also offer MAT within the inpatient setting, and start MAT prior to discharge with community referrals for ongoing MAT.

6. Assess Barriers to Accessing MAT to Increase Access to Methadone and Buprenorphine: A number of known barriers prevent MAT from being as widely accessible as it should be. The federal government needs to reevaluate the need for and effectiveness of the OTP model and make necessary modifications to ensure improved and increased access to methadone. And, while federal law allows physicians to become eligible to prescribe buprenorphine for the treatment of opioid dependence, it arbitrarily caps the number of opioid patients a physician can treat with buprenorphine at any one time to 30 through the first year following certification, expandable to up to potentially 200 patients thereafter. Moreover, states need to evaluate additional barriers created by state law, including, among others, training and continuing education requirements, restrictions on nurse practitioners, insurance enrollment and reimbursement, and lack of provider incentives.

7. Establish and Implement a Heroin-Assisted Treatment Pilot Program: Heroin-assisted treatment (HAT) refers to the administering or dispensing of pharmaceutical-grade heroin to a small and previously unresponsive group of chronic heroin users under the supervision of a doctor in a specialized clinic. The heroin is required to be consumed on-site, under the watchful eye of trained professionals. This enables providers to ensure that the drug is not diverted, and allows staff to intervene in the event of overdose or other adverse reaction. Permanent HAT programs have been established in the United Kingdom, Switzerland, the Netherlands, Germany and Denmark, with additional trial programs having been completed or currently taking place in Spain, Belgium and Canada. Findings from randomized controlled studies in these countries have yielded unanimously positive results, including: 1) HAT reduces drug use; 2) retention rates in HAT surpass those of conventional treatment; 3) HAT can be a stepping stone to other treatments and even abstinence; 4) HAT improves health, social functioning, and quality of life; 5) HAT does not pose nuisance or other neighborhood concerns; 6) HAT reduces crime; 7) HAT can reduce the black market for heroin; and, 8) HAT is cost-effective (cost-savings from the benefits attributable to the program far outweigh the cost of program operation over the long-run). States should consider permitting the establishment and implementation of a HAT pilot program. Nevada and Maryland have introduced legislation of this nature and the New Mexico Legislature recently convened a joint committee hearing to query experts about this strategy.

8. Evaluate the Use of Cannabis to Decrease Reliance on Prescription Opioids and Reduce Opioid Overdose Deaths: Medical use of marijuana can be an effective adjunct to or substitute for opioids in the treatment of chronic pain. Research published last year found 80 percent of medical cannabis users reported substituting cannabis for prescribed medications, particularly among patients with pain-related conditions. Another important recent study reported that cannabis treatment "may allow for opioid treatment at lower doses with fewer [patient] side effects." The result of substituting marijuana, a drug with less side effects and potential for abuse, has had profound harm reduction impacts. The Journal of the American Medical Association, for instance, documents a relationship between medical marijuana laws and a significant reduction in opioid overdose fatalities: "[s]tates with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws."Another working paper from the RAND BING Center for Health Economics notes that "states permitting medical cannabis dispensaries experienced a 15 to 35 percent decrease in substance abuse admissions and opiate overdose deaths." There is also some emerging evidence that marijuana has the potential to treat opioid addiction, but additional research is needed.

Harm Reduction

9. Establish and Implement Safe Drug Consumption Services: States and/or municipalities should permit the establishment and implementation of safe drug consumption services through local health departments and/or community-based organizations. California and Maryland have introduced legislation to establish safe drug consumption services, and the City of Ithaca, New York has included a proposal for a supervised injection site in their widely-publicized municipal drug strategy. In Washington State, the King County Heroin an Prescription Opiate Addiction Task Force has recommended the establishment of at least two pilot supervised consumption sites as part of a community health engagement program designed to reduce stigma and "decrease risks associated with substance use disorder and promote improved health outcomes" in the region that includes the cities of Seattle, Renton and Auburn.

10. Maximize Naloxone Access Points, Including Lay Distribution and Pharmacy Access, As Well As Immunities for Prescription, Distribution and Administration:Naloxone should be available directly from a physician to either a patient or to a family member, friend, or other person in a position to assist in an overdose, from community-based organizations through lay distribution or standing order laws, and from pharmacies behind-the-counter without a prescription through standing order, collaborative agreement, or standardized protocol laws or regulations. Though some states, including California, New York, Colorado and Vermont, among others, have access to naloxone at each of these critical intervention points, many others only provide naloxone through a standard prescription. Civil and criminal immunities should be provided to prescribers, dispensers and lay administrators at every access point. In addition, all first responders, firefighters and law enforcement should be trained on how to recognize an overdose and be permitted to carry and use naloxone. Naloxone should also be reclassified as an over-the-counter (OTC) medication. Having naloxone available over-the-counter would greatly increase the ability of parents, caregivers, and other bystanders to intervene and provide first aid to a person experiencing an opioid overdose. FDA approval of OTC naloxone is predicated on research that satisfies efficacy and safety data requirements. Pharmaceutical companies, however, have not sought to develop an over-the-counter product.88 Federal funding may be needed to meet FDA approval requirements.

11. Provide Dedicated Funding for Community-Based Naloxone Distribution and Overdose Prevention and Response Education: Few states provide dedicated budget lines to support the cost of naloxone or staffing for community-based opioid overdose prevention programs. The CDC, however, reports that, between 1996 and 2014, these programs trained and equipped more than 152,280 laypeople with naloxone, who have successfully reversed 26,463 opioid overdoses.89 Without additional and dedicated funding, community-based opioid overdose prevention programs will not be able to continue to provide naloxone to all those who need it, and the likelihood of new programs being implemented is slim. A major barrier to naloxone access is its affordability and chronic shortages in market supply, 90 which overdose prevention programs, operating on shoestring budgets, can have a difficult time navigating.

12. Improve Insurance Coverage for Naloxone: Individuals who use heroin and other opioids are often both uninsured and marginalized by the healthcare system.91 States should insure optimal reimbursement rates for naloxone to increase access to those who need it most – users themselves.

Overdose reversal drugs need to be made much more widely available -- and affordable. (health.pa.gov)
13. Provide Naloxone to Additional At-Risk Communities: People exiting detox and other treatment programs as well as periods of incarceration are at particularly high risk for overdose because their tolerance has been substantially decreased. After their period of abstinence, if they relapse and use the same amount, the result is often a deadly overdose. States should require overdose education and offer naloxone to people upon discharge from detox and other drug treatment programs and jails/prisons. The Substance Abuse and Mental Health Services Administration has declared that prescribing or dispensing naloxone is an essential complement to both detoxification services as well as medically supervised withdrawal. Vermont passed legislation making naloxone available to eligible pilot project participants who are transitioning from incarceration back to the community. In addition, there are other programs/studies that provide naloxone to recently released individuals on a limited basis, including in San Francisco, California, King County, Washington and Rhode Island.

14. Encourage Distribution of Naloxone to Patients Receiving Opioids: Physicians should be encouraged to prescribe naloxone to their patients and opioid treatment programs should inform their clients about naloxone, if prescribing or dispensing an opioid to them. Pharmacists should similarly be encouraged to offer naloxone along with all Schedule II opioid prescriptions being filled, for syringe purchases (without concurrent injectable medication), and for all co-prescriptions (within 30 days) of a benzodiazepine (such as Valium™, Xanax™ or Klonopin™) and any opioid medication. The Rhode Island Governor's Overdose Prevention and Intervention Task Force found that offering naloxone to those prescribed a Schedule II opioid or when co-prescribed a benzodiazepine and any opioid would have reached 86% of overdose victims who received a prescription from a pharmacy prior to their death, and could have prevented 58% of all overdose deaths from 2014 to 2015.

15. Expand Good Samaritan Protections: "Good Samaritan" laws provide limited immunity from prosecution for specified drug law violations for people who summon help at the scene of an overdose. But, protection from prosecution is not enough to ensure that people are not too frightened to seek medical help. Other consequences, like arrest, parole or probation violations, and immigration consequences, can be equal barriers to calling 911. States with Good Samaritan laws already on the books should evaluate the protections provided and determine whether expansion of those protections would increase the likelihood that people seek medical assistance.

16. End the Criminalization of Syringe Possession: Syringes should be exempt from state paraphernalia laws in order to provide optimal access to people who inject drugs. Twenty-two states criminalize syringe possession. Thus, even if there is a legal access point, such as pharmacy sales, paraphernalia laws still permit law enforcement to arrest and prosecute individuals in possession of a syringe. Public health and law enforcement authorities should not be working at cross-purposes.

17. Reduce Barriers to Over-The-Counter Syringe Sales and Permit Direct Prescriptions of Syringes: While the non-prescription, over-the-counter sale of syringes is now permitted in all but one U.S. state, access is still unduly restricted.States should evaluate the potential barriers to accessing syringes over-thecounter and implement measures to improve access. Moreover, doctors should be permitted to prescribe syringes directly to their patients, a practice few states currently permit.

18. Authorize and Fund Sterile Syringe Access and Exchange Programs; Increase Programs: States should explicitly authorize and fund sterile syringe access and exchange programs, and states that have already authorized them should evaluate how to increase the number or capacity of programs to ensure all state residents – whether in urban centers or rural communities -- have access to clean syringes, as well as evaluate any possible barriers to access such as unnecessary age restrictions.

19. Provide Free Public, Community-Level Access to Drug Checking Services: Technology exists to test heroin and opioid products for adulterants via GC/MS analysis, but it has so far been unavailable at a public level in the US (aside from a mail-in service run by Ecstasydata.org). Making these services available in the context of a community outreach service or academic study would lower the number of deaths and hospitalizations and also allow for real-time tracking of local drug trends.

Prevention

20. Establish Expert Panel on Opioid Prescribing: Though the CDC has issued guidelines for prescribing opioids for chronic pain, the guidelines are voluntary and are likely to exacerbate disparities in treatment that already exist. Research has shown, for example, that African Americans are less likely than whites to receive opioids for pain even when being treated for the same conditions. Moreover, the CDC guidelines only address prescribing practices for chronic pain, not prescribing practices more broadly. States should accordingly establish an expert panel to undertake an assessment as to whether prescribing practices, such as co-prescriptions for benzodiazepines and opioids or overprescribing of opioids, have contributed to increased rates of opioid dependence, and, if so, the expert panel should develop a plan to address any such linkages as well as any treatment disparities. The plan must account for the potential negative effects of curtailing prescribing practices or swiftly reducing prescription opioid prescribing volume. A task force in Rhode Island found that while changes in opioid supply can have the intended effect of reducing availability of abuse-able medications, they have also been linked to an increase in transition to illicit drug use and in more risky drug use behaviors (e.g., snorting and injecting pain medications). The plan must also account for chronic pain patients, particularly those already underserviced, and not unduly limit their access to necessary medications. Finally, to the extent prescribing guidelines are issued as part of the plan, they should be mandatory and applied across the board.

21. Mandate Medical Provider Education: States should mandate that all health professional degree-granting institutions include curricula on opioid dependence, overdose prevention, medication-assisted treatment, and harm reduction interventions, and that continuing education on these topics be readily available.

22. Develop Comprehensive, Evidence-Based Health, Wellness, and Harm Reduction Curriculum for Youth: State education departments, in conjunction with an expert panel consisting of various stakeholders that ascribe to scientific principles of treatment for youth, should develop a comprehensive, evidence-based health, wellness, and harm reduction curriculum for use in schools that incorporates scientific education on drugs, continuum of use, and contributors to problematic drug use (e.g., coping and resiliency, mental health issues, adverse childhood experiences, traumatic events and crisis), as well as how reduce harm (e.g., not mixing opioids with benzodiazepines). Education departments should also establish protocols and resources for early intervention, counseling, linkage to care, harm reduction resources, and other supports for students.

CRIMINAL JUSTICE

23. Establish Diversion Programs, Including Law Enforcement Assisted Diversion (LEAD): LEAD is a pre-booking diversion program that establishes protocols by which police divert people away from the typical criminal justice route of arrest, charge and conviction into a health-based, harm-reduction focused intensive case management process wherein the individual receives support services ranging from housing and healthcare to drug treatment and mental health services. Municipalities should create and implement LEAD programs and states and the federal government should provide dedicated funding for such programs. Various other forms of diversion programs exist and can be implemented should LEAD prove unsuitable to a particular population or municipality.

24. Decriminalize Drug Possession: Decriminalization is commonly defined as the elimination of criminal penalties for drug possession for personal use. In other words, it means that people who merely use or possess small amounts of drugs are no longer arrested, jailed, prosecuted, imprisoned, put on probation or parole, or saddled with a criminal record. Nearly two dozen countries have taken steps toward decriminalization. Empirical evidence from the international experiences demonstrate that decriminalization does not result in increased use or crime, reduces incidences of HIV/AIDs and overdose, increases the number of people in treatment, and reduces social costs of drug misuse. All criminal penalties for possession of small amounts of controlled substances for personal use should be removed.

Chronicle AM: NH Decrim Goes to Governor, VA Secretary Open to MedMJ for PTSD, More... (6/1/2017)

A decriminalization bill is heading to the New Hampshire governor's desk, Vermont's governor holds out hope for a legalization bill, Trump's opioid addiction commission will meet in a couple of weeks, and more.

Marijuana Policy

Nevada Pot Shop Rollout Could Be Delayed By Lawsuit. A state district court judge on Tuesday issued a temporary restraining order prohibiting the state Department of Taxation from enforcing a Wednesday deadline for license applications for the state's program to get legal marijuana sales off to an early start. The order came in response to a lawsuit from the Independent Alcohol Distributors of Nevada, who complain that the ballot measure that legalized weed in the state gave liquor wholesalers exclusive rights to distribution licenses for the first 18 months of sales. Distributors are those responsible for transporting marijuana from grows and production facilities to dispensaries.

New Hampshire Legislature Gives Final Approval to Decriminalization Bill. The House on Thursday voted to accept Senate changes to House Bill 640, which will decriminalize the possession of up to three-quarters of an ounce of marijuana. The bill now goes to the desk of Gov. Chris Sununu (R) is expected to sign the bill into law within the next couple of weeks.

North Dakota Legalization Signature Drive Will Begin in Fall. Proponents of a 2018 legalization initiative campaign say they will begin a signature gathering campaign in the fall, once students return to classes. A core group of individuals is working on a draft to be submitted to the secretary of state's office later this summer.

Vermont Governor Says Talks Continue on Marijuana Legalization Bill. Gov. Phil Scott (R) said Wednesday he thought it was still possible to pass a marijuana legalization bill during a two-day veto session set for later this month. Republican legislative leaders have said they wouldn't allow a parliamentary maneuver necessary to pass a revised legalization bill, but Scott said that if his public safety concerns are addressed, he could reach out to GOP leaders.

Medical Marijuana

VA Secretary Says He's Open to Medical Marijuana for PTSD. Department of Veterans Affairs Secretary David Shulkin on Wednesday said he is open to expanding the use of medical marijuana to treat soldiers with post-traumatic stress disorder in states where it is legal. "There may be some evidence that this is beginning to be helpful and we're interested in looking at that and learning from that," Shulkin said during a press conference. "Right now, federal law does not prevent us at VA to look at that as an option for veterans... I believe that everything that could help veterans should be debated by Congress and by medical experts and we will implement that law."

Drug Policy

Trump Addiction Commission Set to Meet June 16. The Office of National Drug Control Policy (ONDCP -- the drug czar's office) has announced that the President's Commission on Combating Drug Addiction and the Opioid Crisis will hold an inaugural meeting on June 16. The commission, which is loaded with drug policy conservatives, is charging with providing "advice and recommendations for the President regarding drug issues." The meeting will be at 12:30pm ET and will be available for public viewing via live stream.

International

Peru Takes First Casualties in Offensive in Key Coca Growing Region. A week after Peru announced that security forces were entering the region known as the Valleys of the Apurimac, Ene, and Mantaro Rivers (VRAEM) in a bid to suppress the coca crop in the country's largest coca growing region, two policemen were killed in an ambush by presumed drug traffickers Wednesday. Police said they were killed in the Luricocha district, where traffickers have allegedly allied themselves with remnants of the Shining Path guerrillas.

Canada Tories Want to Remove Home Grow Provisions From Legalization Bill. Conservatives in parliament are criticizing a provision in the legalization bill that would allow adults to grow up to four marijuana plants per household. "Is there any easier way to get marijuana than if your parents and everybody have got plants in the kitchen?" Tory justice critic Rob Nicholson, a former attorney general, asked in a speech to the House. Another Tory MP, Marilyn Gladu, warned that children could eat the plants. "Kids eat plants all the time because their parents do not put them up in the cupboard,” she said, ignorant of the fact that THC in marijuana plants must be heated in order to convert non-psychoactive THCA to THC, the stuff that gets people high.

Chronicle AM: Senators' Sessions Forfeiture Letter, Canada Legalization Debate, More... (5/31/17)

A bipartisan group of US senators has sent Attorney General Sessions a letter asking him to rein in federal civil asset forfeiture, the Rhode Island House is voting on a pot legalization study commission, the Canadian parliament begins debating the government's legalization bill, and more.

Marijuana Policy

California Senate Votes to Make Marijuana Use in Cars an Infraction. The state Senate on Tuesday approved Senate Bill 65, which would prohibit the use of marijuana in automobiles because of concerns over drugged driving. The bill would make the offense a violation, punishable by no more than a fine. The bill now goes to the Assembly.

Rhode Island House to Vote Today on Legalization Study Commission. The House is set to vote today on a bill creating a 17-member panel to "conduct a comprehensive review and make recommendations regarding marijuana and the effects of its use." The commission would have until March 1, 2018 to report its findings to the General Assembly. Adopting the bill effectively blocks legalization in the state until next year at the earliest. This measure is supported by anti-reform state Attorney General Peter Kilmartin and Smart Approaches to Marijuana. If the measure passes the House, it then goes to the Senate.

Wisconsin Decriminalization Bill Gets Lone Republican Supporter. Legislative proponents of marijuana decriminalization held a press conference on Tuesday to rally support for a bill that would remove criminal penalties for possession of 10 grams or less. Three Democratic cosponsors were joined by Republican Rep. Adam Jarchow (District 28) at the presser, where they conceded their bill was unlikely to pass this year, but was intended to get the ball rolling.

Medical Marijuana

Arkansas Regulators Delay Voting on Final Rules for Another Week. The state Medical Marijuana Commission needs another week to finalize some rules, commission Chairwoman Dr. Ronda Henry-Tillman said Tuesday. If it indeed finalizes rules next week, applications for medical marijuana businesses will open up on June 30.

Asset Forfeiture

Bipartisan Group of Senators Ask Session to Rein In Asset Forfeiture. Six US senators have sent a letter to Attorney General Jeff Sessions asking him to change Justice Department policy on civil asset forfeiture. "We encourage the Department of Justice to revise its civil asset forfeiture practices to reflect our nation's commitment to the rule of law and due process," Sens. Mike Lee (R-UT), Rand Paul (R-KY), Mike Crapo (R-ID), Martin Heinrich (D-NM), Tom Udall (D-NM) and Angus King (I-ME) wrote to Sessions. "We encourage the Department of Justice to revise its civil asset forfeiture practices to reflect our nation's commitment to the rule of law and due process." Noting that Supreme Court Justice Clarence Thomas had recently expressed skepticism about the practice, they added: "You need not wait for Supreme Court censure before reforming these practices, and, in any event, the Department of Justice should err on the side of protecting constitutional rights."

International

Canada Begins Debating Government's Marijuana Legalization Bill. Parliamentary debate on the C-45 legalization bill got underway Tuesday. Supported by Prime Minister Justin Trudeau, the bill is expected to pass, making Canada the second country after Uruguay to legalize marijuana.

South African Opioid Substitution Program Underway. The city of Tshwane and the University of Pretoria are collaborating on a pilot opioid substitution therapy (OST) program in seven clinics in central Pretoria and Tshwane townships. Doctors are prescribing drugs such as methadone and buprenorphine to be consumed under direct supervision of health workers. The program also links patients to counseling and job skills, as well as testing for HIV and Hep C.

Chronicle AM: Israel Decrim Now in Effect, VT MJ Advocates Seek Path Forward, More... (5/30/17)

There may be hope, albeit slim, for legalization yet this year in Vermont, Israeli marijuana decriminalization has gone into effect, South Carolina becomes the 31st hemp state, and more.

Marijuana Policy

Keeping Hope Alive in Vermont. Marijuana legalization advocates met last Friday with members of Gov. Phil Scott's (R) staff to discuss possible revisions in the marijuana legalization bill, Senate Bill 22, that could make it palatable enough to Scott to make him put away his veto pen. Scott vetoed the bill last week, saying he was not philosophically opposed to legalization, but wanted tougher penalties for using marijuana around children and a delay in the deadline for a legislative commission to study legalizing marijuana commerce. The current bill would only legalize personal possession and cultivation.

Medical Marijuana

Detroit Has Closed 167 Unpermitted Dispensaries; More to Come. The city's crackdown on illegally operating dispensaries has seen 167 of them shuttered since the campaign began last year, and another 51 are in line to be closed in coming weeks, according to Detroit corporation counsel Melvin Butch Hollowell. The city had identified 283 illegally operating dispensaries and has a goal of reducing the number in the city to 50.

Hemp

South Carolina Becomes 31st Hemp State. Gov. Henry McMaster (R) has signed into law House Bill 3559, which establishes a state hemp program that will award 20 licenses to farmers to grow and harvest hemp fields of up to 20 acres each. The bill passes the House unanimously and the Senate with a single "no" vote.

International

Trump Budget Would Cut in Half Mexican Drug War Aid. The administration's proposed budget for next year would cut almost in half foreign aid payments to Mexico, most of which goes to the police and military to wage the drug war south of the border. The budget does include $1.6 billion for building the border wall, though.

Israel Marijuana Decriminalization Has Gone Into Effect. As of this week, marijuana possession is decriminalized in Israel. People caught in possession of 15 grams or less will face a $280 fine for a first offense and a $560 fine for a second offense. Third time offenders will be investigated for drug offenses and have the violation added to their criminal records, while fourth-time offenders will face arrest.

How Many States Will Legalize Marijuana This Year? [FEATURE]

This article was produced in collaboration with AlterNet and first appeared here.

In the euphoric aftermath of marijuana legalization victories in California, Maine, Massachusetts, and Nevada last November, the marijuana blogosphere was alive with predictions about which states would be next to free the weed. Extract listed 10 states, MerryJane went big with 14 states, the Joint Blog listed five states, Leafly homed in on six states, and Weed News went with seven states. AlterNet got into the act, too, with "The Next 5 States to Legalize Marijuana."

But unlike the first eight states, which all legalized it via the initiative and referendum process, for legalization to win this year, it would have to be via a state legislature. Yet here we are, nearing the halfway point of 2017, and we're not seeing it. And we're unlikely to see it for the rest of this year. The states that had the best shots are seeing their legislative sessions end without bills being passed, and while bills are alive in a couple of states -- Delaware and New Jersey -- they're not likely to pass this year either.

To be fair, we have seen significant progress in state legislatures. More legalization bills have been filed than ever before, and in some states, they are advancing like never before. In Vermont, a bill actually got through the legislature, only to fall victim to the veto pen. But actually getting a legalization bill past both houses of a legislature and a governor has yet to happen.

And while there is rising popular clamor -- buoyed by favorable opinion polls -- for state legislatures to end pot prohibition, the advocacy group most deeply involved in state-level legalization efforts, the Marijuana Policy Project (MPP), understands the difficulties and intricacies of working at the state house. While it has worked hard, it made no promises for victory this year, instead saying it is committed to "ending prohibition in eight more states by 2019."

That MPP list doesn't include initiative states, of which we could see a handful next year. MPP is already involved in Michigan, where legalization is polling above 50%, and first-stage initiative campaigns are already underway in Arizona, Arkansas, Missouri, and the Dakotas. It would be disappointing for reform advocates if they have to wait until November 2018 and the popular vote to win another legalization victory, and given the progress made in state houses this year, they hope they won't have to. Still, legalization at the state house is proving a tough row to hoe.

Drug War Chroniclethought the best prospects were in Connecticut, Maryland, New Mexico, Rhode Island, and Vermont. Here's what's happened so far:

Connecticut. Legalization isn't quite dead yet this year, but it is on life support. A legalization bill died in the General Assembly after getting several hearings this year, but failing to even get a vote in the judiciary and public safety committees. In a last-ditch move, Assembly Democrats this month included marijuana legalization in their budget recommendations as a means of addressing budget problems, but they conceded they don't have enough votes in their caucus to pass it and said they added legalization merely "to spur conversation." The dour figure of Gov. Dannel Malloy (D) and his hints of a veto didn't help.

Maryland. A Senate legalization measure, Senate Bill 927, and its House companion, House Bill 1186, both got committee hearings, but neither could get a vote out of disinterested committee chairs. A bill that would have amended the state constitution to legalize personal possession and cultivation, Senate Bill 891, suffered the same fate. The General Assembly is now adjourned until January 2018.

New Mexico. Hopes for legalization this year in the Land of Enchantment crashed and burned back in February, when a measure to do just that, House Bill 89, died an ignominious death in the House Business and Industry Committee. Four out of five committee Democrats joined all five committee Republicans to bury it on a 9-1 vote. And the legislature killed a decriminalization bill, too, before the session ended. Again, a veto threat-wielding governor in the background, Susana Martinez (R), didn't help.

Rhode Island. Although a full third of House members cosponsored the legalization measure, House Bill 5555, the House Judiciary Committee this month failed to vote on it, instead passing House Bill 5551, which punts on the issue by instead creating a commission to study marijuana legalization and report back in March 2018. That bill now awaits a House floor vote.

Vermont. The Green Mountain State became the first to see a marijuana legalization bill, Senate Bill 22, approved by the legislature, only to see it vetoed last week by Republican Gov. Phil Scott, who cited concerns about drugged driving and youth access. Scott did leave the door open for a modified bill to win his approval this year, but that would require legislators to agree on new language and get it passed during a two-day "veto session" next month, which in turn would require Republican House members to suspend some rules. That's looks unlikely, as does the prospect of a successful veto override. But it's not dead yet.

When it comes to pot, New England is hot.
For reform advocates, it's a case of the glass half full.

"This is still a historic time," said Justin Strekal, political director for the National Organization for the Reform of Marijuana Laws (NORML). "For the first time, we saw a state legislature pass a bill removing all penalties for the possession and consumption of marijuana by its citizens. We've had great victories in the past 10 years, but they've all been through the initiative process. Now, with the polls continuing to show majorities favoring outright legalization, legislators are feeling more emboldened to represent their constituents, but it won't happen overnight."

"We've seen bigger gains than any other year in history," said MPP Communication Director Mason Tvert. "There's never been a legislature in all our history that passed a law making marijuana legal for adults, and now one did. That's pretty substantial."

But Tvert conceded that legalization via the state house is a course filled with obstacles.

"In Rhode Island, the leadership is still holding it up, although it looks like it will pass a legalization study commission," he said. "In Delaware, a bill passed easily in committee, but it needs two-thirds to pass the House, and that's tough to do in the first year. In Vermont, last year, we had the governor, but not both houses of the legislature; this year we had the legislature, but not the governor," he elaborated.

"That's the nature of representative democracy and the structure of government in the US," Tvert said. "It requires a lot of pieces to fall into place."

"One of the biggest obstacles we face is the demographics of those chair those legislative committees," said NORML's Strekal. "They tend to skew toward older, more prohibitionist age brackets, but as these turn over to a new generation of legislators and elected officials, we should be able to get more of those bills out of committee, like we just saw in Delaware."

Tvert pointed to an example of the committee chair bottleneck in the Lone Star State.

"It's one thing to lose on a floor vote in the House," he said. "It's another thing to have a whip count showing you could win a floor vote, and you can't get a vote. That was the case in Texas with both medical marijuana and decriminalization. They had immense support and couldn't get votes."

Despite the vicissitudes of politics at state capitals, marijuana reformers remain confident that history is on their side.

"This is a situation where times are changing and people are becoming increasingly impatient," said Tvert. "When you have people's lives negatively affected by prohibition and obvious solutions staring you in the face, it's understandable that some people get antsy, but we've seen some pretty significant developments this year, and there will be more to come."

Tvert compared the legalization situation now with medical marijuana a few years back.

"With medical marijuana, we won in five initiative states between 1996 and 2000 before Hawaii became the first legislative medical marijuana state," he noted. "Since then, there've been nine more initiative states and 14 more legislative states. Now, we've seen eight states legalize in through initiatives in 2012 and 2016, Once this gets through one state legislature, the floodgates will open."

NORML's Strekal was taking the long view.

"In the grand scheme of things, this movement is chugging along much faster than other issues have advanced historically," he said. "It's important to keep in mind how far we've come."

But marijuana legalization is still a work in progress, and we've still yet to see that first legislative state fall. Maybe next year.

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