Diversion: A Landmark Bill

grygielny Diversion, IL

On May 31, the Illinois General Assembly passed legislation that will assist police in diverting individuals, including low level drug users and the mentally ill, into treatment programs rather than jails or prison. The bill is the first of its kind in the nation. Senate Bill 3023 formalizes a process called “diversion” which first gained national attention three years ago. The Police Chief of Gloucester, Massachusetts posted on Facebook that if drug users came directly to his office he not would arrest them but would steer them to treatment. The message went viral. Illinois’ legislation should serve as a roadmap for police and treatment providers. It authorizes them to establish diversion programs. It offers immunity from civil liability for participants and establishes eligibility for funding. It also requires the Illinois Criminal Justice Authority to gather program data and measure performance. Since then, Jac Charlier, National Director for Justice Initiatives at Illinois Treatment Alternatives for Safe Communities (TASC), has worked with police chiefs and social service providers to organize programs around the country based on this concept. Charlier helped to establish the PTAC Collaborative (Police, Treatment, and Community). This organization reports that over 500 out of 1,800 police departments in the U.S. are now practicing what he calls “deflection” in some form. Clergy for a New Drug Policy has been working to publicize and advocate for diversion programs since their inception. Progressive activists in the Quad Cities with whom we met last week expressed strong interest in advocating for this measure. They felt that the cost savings of treatment compared to incarceration should be persuasive to community leaders. The greatest obstacle to wider implementation is the lack of treatment facilities. In the May 24 issue of Chicago Reporter, Curtis Black wrote that “many existing programs… stabilize communities and prevent violence. But they are never brought to scale or funded sustainably. Instead we continue to pour money into arresting and imprisoning people.” Nationally, drug and mental health treatment is available for only about ten percent of those who need it. In the Chicago Reporter, Jack Charlier noted that “No community in the United States has sufficient behavioral health services.” About 1,300 police forces do not yet include deflection in their array of services. SB 3023 is intended to encourage them to do so. Reverend Alexander Sharp 

Understanding My State: IL

grygielny Drug Education, IL, State

I live in Illinois. My state has received a B- in its approach to the War on Drugs and how it aligns with a “health not punishment” response to drug use. This grade tells me that we have some important changes we can and must make. We must move to taxing and regulating marijuana, legalizing low level recreational use. I am pleased that we have decriminalized marijuana so that low level possession is treated as a civil offense, like a traffic ticket. However, marijuana arrests continue, especially in poor neighborhoods of color. The illicit drug market encourages gang activity and violence. Prohibition of marijuana breeds a War on Drugs mentality. Police continue to be seen as a hostile presence just over marijuana.  We must seek to do more than reform civil asset forfeiture.  We must abolish it. With the ACLU taking the lead, Illinois has reversed a laughable part of a bad law. When police seize property allegedly related to a drug crime, the burden of proving guilt now rests with the government rather than the accused. But our grade is still a D+. The standard of proof is too low: “preponderance of evidence,” rather than “beyond a reasonable doubt.” The government does not even have to establish that a crime has been committed. Police retain and fund their budgets with the proceeds they seize. Conflict of interest continues almost unabated.  I am heartened that we are finding ways to ways to save lives, ease suffering, and help people restore their lives through harm reduction policies. We no longer insist upon the “abstinence only” demand that has dominated this country’s approach to drug use and recovery. But I do not understand why we do not provide Medicaid coverage for access to methadone. This could permit many people struggling with a heroin abuse disorder to work and remain with their families while receiving treatment.  Fortunately, we do not have private prisons in Illinois, nor do we send prisoners to private prisons out-of-state. Thus, we do not support an industry that lobbies for laws that wants as many people in prison as possible. But even after those convicted of drug felonies have paid their debt to society and been released from prison, they are denied access to key benefits, including nutrition assistance. If we can change this, our grade will be an A rather than a B+.  Our state map does not yet track some important things we are working in Illinois. Sentencing reform is critical.  We are hoping for a bill that would reclassify most low-level drug offenses as misdemeanors rather than felonies. We are about to become one of the first states to pass legislation that provides a roadmap for police departments to divert drug abusers to treatment rather than jail or prison. And we may well be the first state to make it possible for our medical marijuana program to help those suffering from opioid abuse.  We are making progress in Illinois. This new map shows me where we should concentrate our efforts.  What does the map tell you about what you can do in your state?  Reverend Alexander Sharp 

Testimony before the IL Senate on Marijuana Legalization: Leslie Mendoza Temple, MD, ABOIM

grygielny Decriminalization, Drug Education, IL

January 22, 2018 Good morning, Senator Steans, Representative Davis and esteemed members of the General Assembly. My name is Leslie Mendoza Temple. I am a board-certified Family and Integrative Medicine physician in Glenview, Illinois. I also served as the former Chair of the Medical Cannabis Advisory Board for the Illinois Department of Public Health.  It is important to note for the record that I am not speaking on behalf of any institution or my employer.  I am speaking from my personal viewpoints and experience as a clinician….and as the proud mother of 3 sons, ages 7, 9 and 11 years old.  I have no financial or other beneficial relationship with the medical cannabis industry. My Integrative Medicine practice attracts patients with complex medical conditions- primarily cancer, chronic pain, neurologic, psychiatric, and digestive conditions.  Many of my patients seek my care as the last-ditch effort, referred by their physicians, they prefer to treat their conditions as naturally as possible and find their way to me. I have written certifications for over 400 patients, with over 200 patients returning so far for their follow up appointments, providing me feedback on their medical cannabis experience. I have studied this feedback. An independent chart review of my certified patients showed that over 80 percent of them had  experienced relief of one or more symptoms from their chronic condition.  Medical cannabis plus or minus medications have reduced or completely relieved many of my patients’ insomnia, pain, seizures, and digestive problems. I have seen my patients reduce their benzodiazepines, their sleep medications, and most importantly, reduced or eliminated the opioids.\ Considering the opioid and heroin epidemic, medical cannabis is a crucial part of the solution to this crisis and needs more eligible conditions to be added to the program.  Anytime opioids have been prescribed for chronic pain from all sources, patients should have the option to use medical cannabis instead. Medical cannabis is not a perfect drug however, with 29% of my patients experiencing confusion about what to take, how to take it, and varying strain availability from the cultivators and dispensaries. Despite these challenges, medical cannabis is without a doubt, one of the most important tools I have discovered in my practice, alongside good nutrition, exercise, sleep regulation, acupuncture, meditation, medications, and stress reduction strategies. As I gain more experience with patients using cannabis in a medical, therapeutic way, I have learned more about this substance, far beyond what I was ever taught during medical school or residency training. I have struggled with how to approach the question about legalizing it for adult use.  After speaking with folks on both sides of the issue, both with passionate belief and strong conviction in their viewpoints, and without investment in the industry, and with the mother’s lens.  I have come to the following conclusions which I hope are helpful to this panel and the audience. I am in favor of regulating cannabis for adult use, over age 21. I am against its prohibition given that our current system of prohibition has failed on many levels. Regulating cannabis production and sale may help increase safety of untainted supply by going through vetted cultivators; taxation can create funding to improve drug addiction and education services; legalizing it has implications that can divert funding away from the criminal system and towards education and rehabilitation. Regarding the commercialization of legal recreational cannabis, I would say there is already a very large scale, for-profit industry surrounding current usage.  It is an illegal black market industry run by addiction profiteers who manage (with crime and violence) the supply and sale of billions of dollars annually to people of all ages. They are the gateway drug towards harder substances like heroin, crack, cocaine, and LSD. We are well aware of the public health costs of that “industry’s” 80+ yrs control of the market – and none of them are funneling money into drug education.  I’d like to try a different approach now, please. My editorial:  I do not condone its use, personally, for getting high – whether one is an adult or a child. I don’t condone alcohol or cigarettes either – for anyone. But, it is not my place to govern this aspect of life for others but rather, to guide my patients towards making healthy choices. If funds towards drug education and increased resources towards drug rehabilitation are NOT included in the legislation, then I will not support this bill.  If marketing is not controlled with strict limits on advertising targeted at youth, then I will oppose the bill.  On another note, I don’t want to see a cannabis leaf emblem marketed on every billboard going down the 294, nor do I want to see a cannabis dispensary on every street corner.  In a free market economy, I am not sure how this will all shake out if this passes. So, that’s what the hearing process is all about.  It’s a chance for our voices to be heard about how this legislation should go, if legalized adult cannabis is going to be a reality. Cannabis should be kept out of the hands of children (and their pregnant mothers) whose brains are at risk for cognitive harm. I believe that strong education can help youth make better decisions about the true potential risks of underage cannabis use, which is loss of one’s highest intellectual potential while the brain is still forming, among other risks.  There’s a recent publication on the Monitoring the Future study, a survey of 1.1 million 8th-12th graders.  In the journal, Addiction, researchers made an interesting observation.  The perception of cannabis’ harmfulness increased in 8th graders in medical cannabis states while their use of cannabis decreased by 33%.      I see a huge opportunity here.  Education is an area I believe where we physicians, policymakers, schools, and the addiction healthcare community can shine in Illinois. If we take a stronger role in educating youth about the hazard of cannabis use at an early age on the brain, we could protect more kids from the potential damage they can sustain from early cannabis use.  Let’s learn from the mistakes and missed opportunities seen in early adopter recreational states – if Illinois is to legalize cannabis for adult use.   Keyes KM, et al. How does state marijuana policy affect US youth? Medical marijuana laws, marijuana use and perceived harmfulness: 1991-2014. Addiction . 2016 Dec;111(12):2187-2195.

Testimony before the Illinois Senate Hearing on Cannabis Regulation and Taxation: Molly Lotz

grygielny Decriminalization, Drug Education, IL

January 22, 2018 Good morning esteemed members of the Illinois General Assembly My name is Molly Lotz.  I am a School Social Worker and Counselor from Colorado.  When Colorado legalized recreational marijuana consumption and sales I was working in an alternative school in a mountain town.  Still working at the same school, two years later, and after early sales of recreational marijuana, my students started to come to me and ask for straightforward information on how marijuana use might affect the developing brain.  They had been exposed to a DARE type of program during their early education and now, just 6 years later, legalized recreational marijuana was my students’ reality.  They had parents who were using recreationally, they had grandparents who were using marijuana medicinally and I realized that in Colorado at least, we couldn’t teach marijuana to our youth in the same way as other substances.  We had to tease out marijuana education and not lump it with heroin and methamphetamine.  My students needed, and were, in fact, asking for accurate, fact-based, not fear-based, information on how marijuana might affect them and their developing bodies and brains.  I took a look and found not a single post-legalization, marijuana-specific curriculum available to help me support my students navigate this new reality.   So I teamed up with a fellow educator and we decided to create what our students were asking for:  A comprehensive marijuana-specific, curriculum that informs and empowers youth using up-to-date research and information on how marijuana use affects them.  What we knew is that youth needed the facts about how marijuana affects them and understand the difference between adult use and youth use as well as recreational use and medicinal use.  We  created a program that promotes delaying first use and/or abstinence during adolescence by supporting youth’s self-efficacy and to inform them using honest and accurate information.  Recognizing the detrimental educational impacts of a marijuana policy violation, we also created a program that allows administrators to keep kids with a marijuana policy infraction in schools and at the same time still addressing the policy violation in an effective way thus disruption the school to suspension to drip out to prison pipeline. This approach has been shown to increase youths’ perception of risk around youth marijuana use while at the same time not vilifying the adults in their life who may use medicinally or recreationally.  Youth need to be made aware of increasing marijuana potencies and concentrates as well as how early marijuana use can impact brain and cognitive development and functioning.  Youth need to know that a marijuana policy violation in their school or community can lead to long term consequences like impacting educational opportunities such as FAFSA eligibility and a possible school suspension or expulsion.  If we don’t give our youth this information to accompany recreational marijuana campaigns or commercial rollout, we are doing them a great disservice.  Additionally, if we doing acknowledge and educate youth on how their classmates may be using marijuana medicinally we are going backwards and not evolving with the changing landscape.  We have to help educators find the balance between educating youth about the risks of adolescent recreational use and providing a safe and compassionate environment for medicinal needs.  Old drug education programs do not do this. One of the top issues on voter’s minds is youth marijuana access and education.  Colorado legalized before proper marijuana educational programs were in place and is not paying catch up.  Illinois can prevent this.  Several Colorado schools and youth serving organizations have already adopted this progressive approach to youth marijuana education.  I would ask that as you develop recreational marijuana policies and appropriations that you consider implementing a progressive youth marijuana educational campaign so you can go to your constituents and feel confident that there is an effective solution to addressing the concerns around youth access and education. Thank you for the opportunity to speak with you today. Molly Lotz, LCSW Co-founder of Marijuana Education Initiative School Social Worker

Testimony Before Illinois General Assembly Committees on Marijuana Legalization: Rev. Alexander E. Sharp

grygielny Decriminalization, Drug Education, IL

January 22, 2018 I am the Rev. Alexander Sharp, Executive Director, Clergy for a New Drug Policy.  We reach out to clergy nationally to end the War on Drugs and seek a health, not punishment response to drug policy.  Because we are based in Illinois, and I have been doing faith-based education and advocacy work for over 20 years, a substantial number of clergy and lay leaders in Illinois are aware of our work. It might seem unusual for clergy to be advocating for marijuana legalization.  I am not advocating for marijuana use, although I don’t think it is wrong, any more than using alcohol, a far more dangerous drug, is wrong. Many clergy support marijuana legalization because of our sense of how best to influence and even change behavior, especially of our youth.  What the failed War on Drugs has taught us over the past 45 years is that prohibition does not work. Why?  Prohibition refuses to accept reality.   Drugs are a reality in our society.  Cigarettes, alcohol, and potentially addictive behaviors like gambling are with us.  The issue, therefore, becomes how to prevent not use but abuse.  I wish someone would make this point to U.S. Attorney General Jeff Sessions when he appears to say that all drug use is bad. Instead of prohibition, we need to focus on preventing abuse though regulation and education.  Cigarettes are legal, but smoking has gone down by 50% in the last 25 years.  Alcohol is legal, but that we have made progress here as well.  Marijuana is illegal, and use has not gone down.  What’s wrong with this picture is that with marijuana, we have persisted in mindless prohibition. I stress to my clergy colleagues that “legalization” is the wrong word.  We seek the “regulation” of marijuana.  That means that marijuana now obtained in the illicit market will be clearly labeled and packaged. People will know what and how much they are using.  That is far from the case with back alley and school yard purchases. I’ve used these policy arguments with clergy across the country, and they get it. But beyond these policy wonk arguments, at the end of the day, we must educate each other, especially of our young people.  We must communicate with them in a way that makes sense to them.  They need to trust us.  I don’t see how that is possible when we equate marijuana and prohibition. Our youth didn’t believe us when we preached “Just Say No” in the 1980’s.  When it comes to marijuana, they do not believe us now. The DARE programs where a law enforcement officer stands in front of a classroom and says “this is your brain on drugs” didn’t work when they were first tried.  These programs have adjusted since the 1980’s but they are still not effective. I have attended many conferences where medical experts have described in elaborate detail how marijuana if heavily used can be harmful to young, still developing brains.  It can affect motivation.  I believe them. The problem is not that these facts are wrong.  Our kids should hear and take to heart every one of them.  The problem is that it is very hard to communicate them in the context of a policy – namely prohibition – rooted in abstinence. Further, the very concept of harm reduction is impossible if abstinence is the only response to drug use.  To deny the goal of harm reduction is immoral.  The best in our faith traditions tells us that persuasion, with compassion, mercy and forgiveness; rather than punishment – in the form of jail and incarceration – are the best paths to changing hearts and minds. All of this gives us a response to one final question that is frequently asked:  We’ve got alcohol and cigarettes, but why marijuana?  Do we really need another legal drug? My response: if really believe regulation and education are the best way to shape individual moral behavior, we should legalize marijuana even if alcohol and cigarettes had never happened. Marijuana legalization stands on its own merits.  That why I urge your support for SB 316.