Do Democrats Care About The Overdose Crisis?

grygielny Harm Reduction, Legalization, Marijuana Legalization, Uncategorized

“Let justice roll down like waters.”Amos 5:24 Dear Friends and Colleagues,  A recent Axios-Ipsos poll asked what Americans thought was the #1 threat to public health. Opioids/fentanyl came in at number one with 26% of respondents naming it the top issue.  What is striking, however, is the dramatic partisan divide. Only 17% of Democrats answered opioids/fentanyl while 37% of Republicans answered the same.  What does this mean? Probably a lot of different things. (Feel free to email us with your thoughts.) To quote my old boss, Jim Wallis of Sojourners, it seems to be a classic case of when “the Right gets it wrong and the Left doesn’t get it.”  But this is also an area where those partisan categories don’t quite fit.  There are two issues that rise to the surface for me in the old Left vs Right framework: proximity and moral narrative.  First, let’s look at proximity. Or, why the Left doesn’t get it.  While it is notable how widespread the overdose crisis is, not every community is hit equally.  When looking at racial demographics, Indigenous and Black communities have been hit the hardest.  When looking at a county level, Republican counties have higher death rates than Democratic counties.  It isn’t surprising that the poll also found, “People with a high school education or less are, by a three-to-one margin, more concerned with opioids over obesity compared to those with a college degree, who see obesity as the bigger issue.” This means college-educated, middle-class, white professionals living in Democratic counties are some of the least connected to the overdose crisis.  They also happen to be a core constituency for Democrats and (probably) over represented in media and government.  It’s a pretty good case for saying “the Left” just doesn’t get it.  Second, is moral narrative. Or, why the Right gets it wrong.  In Crack in America: Demon Drugs and Social Justice, Craig Reinarman and Harry Levine demonstrated that public concern about crime and crack cocaine didn’t track trends in drug use or crime. Instead, public concern followed media coverage and media coverage went in waves tied to election cycles.  In the 80’s and 90’s, politicians created a narrative of moral decay that could only be stopped with a campaign for “law and order.” During the 2022 midterm elections, Republican leadership created a new narrative of the “fentanyl border crisis.” Instead of moral decay from within, it was a message of threat from the without.  This establishes a moral narrative of Americans as the innocent victims of an evil invading force that must be stopped.  And this is a good case for why the Right gets it wrong.  The good news is that while some of the Right gets it wrong and some of the Left doesn’t get it, the exceptions are growing.  Christina Dent, a conservative Christian, leads End it For Good, a non-profit in Mississippi committed to increasing public health and safety by ending the “War on Drugs.”  Rev. Erica Poellet is a progressive faith leader who runs Faith in Harm Reduction committed to engaging all people of faith in working together with people who use drugs to create a more just world.  It can be frustrating to see those who still don’t understand the scope and severity of the crisis. It is concerning when there are those who do understand but support policies that will only make the situation worse.  But there is hope. And awareness is growing. In the past month, this newsletter has grown by over 25%. We are glad you are here and keep spreading the word! Timothy McMahan KingSenior Fellow, CNDP Research and roundup compiled by Cassidy Willard, Research Associate Australia Moves Forward On Psychedelic Access Australia’s Therapeutic Goods Administration recently approved a request to reschedule psilocybin and MDMA under that country’s drug-classification scheme, making Australia the first country in the world to recognize the psychedelic drugs as medicines. Effective July 1, 2023, the TGA will add psilocybin and MDMA to Schedule 8 of Australia’s list of Controlled Drugs, permitting qualified psychiatrists to prescribe MDMA to treat post-traumatic stress disorder and psilocybin for treatment-resistant depression.  The decision was largely based on the research and data being produced under current FDA trials in the United States. Hopefully, these steps will continue to put pressure on policy makers in the United States to acknowledge that the Schedule 1 classification in the United States has always been based on a lie. Highlighting the Work of Overdose Prevention Centers Australia’s Therapeutic Goods Administration recently approved a request to reschedule psilocybin and MDMA under that country’s drug-classification scheme, making Australia the first country in the world to recognize the psychedelic drugs as medicines. Effective July 1, 2023, the TGA will add psilocybin and MDMA to Schedule 8 of Australia’s list of Controlled Drugs, permitting qualified psychiatrists to prescribe MDMA to treat post-traumatic stress disorder and psilocybin for treatment-resistant depression.  The decision was largely based on the research and data being produced under current FDA trials in the United States. Hopefully, these steps will continue to put pressure on policy makers in the United States to acknowledge that the Schedule 1 classification in the United States has always been based on a lie. National Push to Legalize Fentanyl Test Strips Rev. Sharp was interviewed by the Epoch Times on the rising focus on harm reduction.   Rev. Alexander Sharp, founder of Clergy for New Drug Policy, said he was “heartened by the depth of the response” that is currently happening with regard to this crisis. “So often what you get is the reaction that you can’t do anything because it falls under the category of harm reduction,” Sharp told The Epoch Times, saying that “while it appears to be enabling” the use of drugs, “that concept is horribly misguided.” God and Pot Timothy McMahan King was interviewed for an article at Religion Unplugged on the upcoming vote in Oklahoma on adult-use cannabis: Timothy McMahan King…echoed Tilley’s perspective on criminal justice reform.  “You can be concerned about the effects of drugs in society,” said King, an evangelical-turned-Episcopalian who wrote the book “Addiction Nation” and a Christianity Today cover story on his battle with opioid addiction.  “But if you pursue a punitive path, you might actually be … creating more harm from drugs,” he added, “than if we go this path that focuses on regulation, education and treating drug use as a public health issue, not a criminal one.”

Major Steps Forward on Election Day

Rev. Alexander E. Sharp Decriminalization, Legalization, Marijuana Legalization

As a result of ballot initiatives approved in six states on Election Day, it now possible to visualize an end to the War on Drugs with some clarity.   The most dramatic breakthrough, of course, was the strong mandate – 59% in favor and 41% opposed – to decriminalize low-level drug possession in Oregon. “Yes on Measure 110” means that treatment rather than criminalization will be an option for all persons using drugs who seek it.   CNDP endorsed and publicized this initiative. Our piece in the current issue of The Christian Century describes how the initiative will work, and why we believe what happened in Oregon is not just an isolated phenomenon in a predominantly liberal state.  Instead, it is a harbinger of what we will see elsewhere soon.   According to the Drug Policy Alliance, “The Oregon victory demonstrates that decriminalization is politically viable, spurring potential efforts in other states, including California, Vermont, and Washington, and even in Congress.”   Legalization of cannabis for adult use also received a strong mandate. Initiatives were approved in four states:  Arizona, Montana, South Dakota, and New Jersey.  South Dakota also approved medical cannabis, along with Mississippi. We were especially gratified by the results in New Jersey, where we traveled last January to recruit clergy and testify on behalf of the Initiative.   No longer do we need to think of cannabis legalization as something inching its way forward.  Fifteen states, covering one-third of the U.S. population, have taken this step.  70% of all states have now approved medical cannabis.  Especially striking is the fact that all sections of the country are stepping forward. We were delighted, and frankly, a little surprised, when Oklahoma approved medical cannabis three years ago. But now we see Mississippi and South Dakota approving initiatives. All of this makes it reasonable to anticipate some kind of breakthrough on cannabis legislation at the federal level within perhaps the next couple of years, if not sooner.  To all of you who have participated in the work of Clergy for a New Drug Policy, thank you for all you have done to help bring about these results.  

Legalizing All Drugs: What Would It Look Like?

Rev. Alexander E. Sharp Decriminalization, Legalization

On Saturday, November 9, five panelists convened to discuss the topic “Legalize All Drugs?!  Exploring Options for Legal Regulation in a Post-Prohibition World.” Following are excerpts from the discussion. Moderator: Why do you think we should legalize and regulate all drugs?  What are the harms that we’re trying to address? Zoe Dodd: The high number of individuals from black and indigenous communities who are incarcerated disproportionately in Canada is one reason.   The other is the overdose crisis. We have thousands of people who are dying.  Scott Bernstein: In Canada we have rolled out harm reduction quite robustly. We have over 40 supervised consumption sites in the country now.  But we’re not seeing dramatic declines in overdose deaths. When we decriminalize, we only take care of half of the problem, and legalizing would allow us to actually create a safer supply that could address it. Steve Rolles: The distinction between legalization and decriminalization can be confusing and unhelpful. They’re all part of the same piece for me.  So many of the harms that people are dealing with are the result of illegal supply and prohibition. So for me, regulation and legalization is part of harm reduction. Moderator: What would legalization look like?   Rolles: We can propose four or five options ranging from medical prescription models, like heroin assisted therapy, through a kind of pharmacy sales model. We could have a trained vendor who gives medical advice. Or more conventional licensed retailing like cannabis dispensaries. Or a model with vending and consumption on the premises, like a bar or a cannabis coffee shop in the Netherlands. We have to look at the risks of particular drugs and the regulatory tools that we have, and try and match them up in a reasonable way. The more dangerous drugs would be more regulated, the less risky drugs less so: we can create a kind of risk/availability gradient. In doing that, we could begin to shepherd people towards safer products and safe behaviors. Prohibition does the complete opposite. It is crazy that we can get heroin laced with fentanyl on the streets really easily, but we can’t get smokable opium. All of the weed in the U.K. at the moment is super strong. If you want to get milder weed or hash, you can’t. It’s just not there. Prohibition does that. It tilts the market towards the most dangerous products, the most dangerous behaviors. And regulation can tilt the market the other way if we do it sensibly. Bernstein: We regulate all kinds of harmful or risky activities from driving to sky-diving to foods and drinks and all kinds of things. And so it’s really just drugs and a few other things that are left out of this regulated system.  Moderator: Are there examples of jurisdictions where specific drugs have been legalized that we can look to as models? Rolles: The most obvious ones are the medical prescription models. In many countries in Europe and elsewhere in the world, they prescribe injectable heroin. Now, because it’s a medical intervention, it doesn’t have to be legalized as such because it’s legal anyway.  Dodd: In Canada, we have what’s called “safer supply”—the Canadian Association of Safer Supply, the Canadian Association of People Who Use Drugs. We have injectable heroin programs. They are very hard to get into. You have to come in every day, so you’re kind of really chained to a clinic. But people like it; it’s changed their lives. There’s a doctor in London, Ontario who is giving people hydromorphone. She has 190 patients in her program. She’s been running it for three years. She prescribes to them. People can take their doses at home. Nobody has died in her program. We are in the midst of this devastating overdose crisis but none of the 190 people have died of overdose in her program. Rolles: There are traditional plants that are used in a quasi-legal informal space in many countries, whether in Africa, whether in Southeast Asia, whether it’s some of the psychedelics like mushrooms and peyote in the Americas. They’re regulated much more by social norms than by legal infrastructure but there’s certainly a lot we can learn from those drugs as well. Moderator: Legalization may be scary to a lot of people concerned about increased use or overdose. So what should be the response to people who have those concerns? Bernstein: There are a lot of myths around legalization.  I’m coming to think about this as mostly a knowledge translation problem for the public. One myth is that legalization means easy access to drugs or increased use.  Another is government control of all aspects. Government has to set some rules, but there could be a variety of models. We have to move away from “should we legalize all drugs” to how we do it in a way that is very digestible to people and allows them to engage in the planning. Moderator: What can we learn from already legal and regulated substances?  Rolles: Big tobacco, big pharma, big cannabis have been responsible for horrible things we need to learn from and not repeat. But there are examples of good practice. Tobacco regulation has moved in the last 20 years towards a much more appropriate level of regulation. We’ve prevented branding and marketing and advertising almost completely in the U.K. You can now buy as much tobacco as you like, but it’s in plain packages with health warnings. There are bans on smoking in public places. With alcohol regulation, we’re still some way behind. Alcohol brands in the U.K. are sponsoring our Olympic team, which is completely inappropriate. And so we need to be not doing a lot of those things. But we also need to learn from good practice in alcohol, tobacco, and pharmaceutical regulation. Snapp: In Mexico and Colombia, the public health crisis is around violence. We’re concerned with countries that are having overdose crises, but we’re also concerned about people who are just being outright killed.  For me, going back to the question of “how do you change, how do you convince people,” you have conversations with them. When you explain to people what’s going on, they get it. They’re not stupid; it’s just that nobody’s talked to them about this. And nobody’s told them the truth.  Moderator: In the next decade, what you would like to see with respect to legalization and regulation?   Bernstein: I think the horizon on legalizing all drugs is probably 10 to 15 years away in Canada.  It’s a big lift, but I think we actually have a system supportive of social and racial justice. Dodd: For me, it looks like people not dying. It looks like getting out of this overdose crisis. It looks like demilitarization. It looks like friends being free. Like some of my friends in prison right now haven’t even had their trials and they’ve been sitting, waiting for 18 months. It looks like people who also sold drugs getting amnesty. You can’t legalize drugs and say, “It’s okay now, but it was bad then.  You have to sit inside prison and serve out your term.” Black and indigenous people overrepresent the prison population for Canada’s drug users. Those people need out and their communities need reparations. Rolles: Cannabis has been the first drug to legalize. It is not culturally frightening because it is widely used and relatively low risk. As you move towards more risky drugs, legalization becomes more politically difficult.  But the big health gains are probably going to be with the more risky drugs. The conversation does now feel like it is beginning. The Abridged Medical Journal and the American Public Health Association now advocate openly for legalization and regulation of all drugs. Amnesty International, one of the largest NGOs in the world, soon will be looking at this through a human rights lens. So it is entering the kind of mainstream political discourse.  We all need to encourage that to move forward. If there’s one thing I’ve learned, it’s that exposure to this debate only ever moves people in one direction—and it’s not towards a War on Drugs.