Category Archives: War On Drugs

Its no secret that diabetes is becoming the scourge of America. It plagues one in 10 Americans, and every one of us probably knows someone who struggles with the disease.

In 2017 the U.S. mortality rate for diabetes was 42% higher than the average among 10 other industrialized countries. Thats a poor showing for America.

Many of those Americans are taking insulin, a drug discovered a century ago. Sales of drugs to treat diabetes have increased about 212% from $24 billion in 2011 to $75 billion in 2020, second in total revenue only to drugs used to treat rheumatoid arthritis and other inflammatory diseases.

With all that money spent on pharmaceuticals to control the disease, you would think the U.S. was getting a loud bang for its buck. Thats not the case.

Reporters at Reuters, the global news service, have just produced an amazing series about diabetes in America revealing that disease has produced a medical catastrophe.

One of the series authors, Chad Terhune, told me the U.S. had been making a lot of progress until around 2010-2011 when complications from the disease seem to have rounded a corner in middle-aged adults.

Diabetes has followed the obesity crisis, Terhune told me. It has a lot to do with healthy lifestyles and health disparities. Its a reflection of income inequality. Sedentary lifestyles, unhealthy diets and lack of consistent medical care for many people also contribute to the halt in progress in improving outcomes for people with the disease.

We also know some patients ration their diabetes medications and skip doctors appointments because they dont have the money to pay the large deductibles and other out-of-pocket costs.

Ironically, it was the insurance industry that pushed those onerous costs onto policyholders to discourage them from seeing doctors. The goal was to impose high cost sharing by their insurance policies in the hope that if people had to pay more out-of-pocket, theyd be less inclined to go to the doctor for every minor ailment. The goal was to lower the overall cost of health care for the country and, of course, benefit insurance companies through fewer claims to be paid out.

Some 20 years after that cost-containment strategy surfaced, the strategy seems has backfired harming thousands of diabetic patients. Delays in care simply impose higher costs because people dont show up for treatment until they are much sicker.

One study of lower-income workers and their family members who had diabetes had 22% more emergency room visits for preventable complications after they had switched to high deductible plans.

Reuters reporters didnt just interview patients, researchers, and experts in diabetes care. They examined the rates of potentially avoidable hospitalizations related to diabetes tracked by the federal Agency for Healthcare Research and Quality.

They found from 2016 to 2017, the most recent year of available data, hospitalization rates increased for short-term complications, long-term complications, and lower-extremity amputations. When reporters asked for more recent state-specific data, only eight states responded.

One was Indiana. Rates of short-term diabetes complications and amputations increased in all responding states, except Indiana. Rates of controlled diabetes without mention of complications decreased nationally from 2011 to 2015 and in six states that responded through 2018. Indiana, however, reported an increase. So Indiana results are mixed making it hard to judge how well Indiana is doing in preventing diabetes complications.

The Reuters series on diabetes illustrated the three evils in Americas health system: underuse, overuse, and misuse of medical services. It serves as a warning not just for diabetics but for the rest of us who inevitably will need health care in our lives.

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Why the U.S. is losing the war on diabetes - Evening News and Tribune

A sense of dj vu has descended all across concert venues in Houston and the culprit is omicron.

The fast-moving strain of the COVID-19 virus has been wreaking havoc on the live music scene, leading to a handful of cancellations. It was likely the cause behind the postponement of the much anticipated New Year's Eve homecoming show for Houston-based world-beaters, Khruangbin, at the 713 Music Hall.

The seemingly exponential rise in cases leaves any early-2022 show a crapshoot, raising concerns over future concerts whether it's due to staffing issues or bands rescheduling shows out of an abundance of caution.

That leaves it up to ticketholders to check the latest status of gigs, not only to make sure they are still a go, but whether COVID safety measures are in place at the venues. In other words, have those vaccination cards and 72-hour COVID test results handy before heading out.

Hopefully, the following January shows will still happen as we have a full slate ahead. CultureMap's best shows of the month are as follows:

Clay MeltonThursday, January 6The Big Barn at Dosey Doe

Equally influenced by Stevie Ray Vaughan and John Mayer, Houston-based Clay Melton is establishing himself as one of the hottest blues-rock acts in the Lone Star State. Simply put, the talented young guitarist-vocalist can shred and is an extremely fun watch, backed by a rock-solid unit in his longtime drummer, Zach Grindle, and bassist Zach Cox.

Hell be recording a live album from the unique confines of The Big Barn at Dosey Doe in Spring alongside a whos-who in the local music scene, including Sir Earl Toon of Kool & the Gang, Evelyn Rubio, and Sarah Grace. That follows the well-received 2021 EP, Back to Blue.

Tickets start at $15 plus fees. Doors open at 6:30 pm.

CultureMap Local Show of the Month: BowiElvis FestivalSaturday, January 8The Continental Club and Big Top Lounge

January 8 holds a special place in the hearts of music fans across the globe as the day produced two of the greatest pop icons in modern musical history: David Bowie and Elvis Presley. Those two cultural forces will meet at the return of BowiElvis Festival.

The 13th edition is back after a one-year hiatus and will feature a number of acts celebrating the late-singers, including Graveltooth, Johnny Falstaff, India Tigers in Texas, Sara Van Buskirk, Elise Morrison, Yaupon, and a burlesque performance by Dem Damn Dames.

Bands will play Bowie and Elvis cover songs in addition to original tunes, and guests can participate in face painting and a costume contest alongside catering that features "The King" Elvis's favorite banana and peanut butter sandwich and "The Bowie," a croque madame with Gruyre, ham, and a fried egg.

Tickets start at $20 plus fees in advance, $35 at the door. Doors open at 7 p.m.

CultureMap Recommends: TWRP with Rich AucoinSunday, January 9White Oak Music Hall (Upstairs)

Hailing from the frosty hinterlands of Canada, fans of high-energy weirdness are in for a real treat when TWRP (formerly Tupperware Remix Party) and Rich Aucoin take over White Oak Music Hall. Both hail from the creative Halifax, Nova Scotia scene and are getting huge accolades not only for their synth-driven indie sounds, but their insane live performances. TWRP's concert gear recalls Power Rangers mixed with Devo, Daft Punk, and manga comic books.

The secret weapon on this bill is Aucoin, a genius-level multi-instrumentalist whose exuberant intellect is expressed in award-winning videos and movie-synched live shows that include actual surfing on crowds and crazy-fun dance parties underneath a elementary school parachute. His latest album,United States, is a amazing listen as well, an ultimately uplifting treatise on modern America. This show is sold out but is worth every penny on the resale market.

Tickets are sold out but there is a waitlist. Doors open at 8 pm.

Washed Out Thursday, January 13Warehouse Live

One of the leaders of the late-2000s chillwave movement alongside luminaries such as Toro Y Moi, Neon Indian, Small Black and others, Ernest Greenes Washed Out project is a vibe unto itself.

Combining dream pop with 80s synths and gentle vocals, Washed Out first garnered major notice with his 2009 EP Life of Leisure,lead single Feel It All Around becoming the title credits song for the hit comedy show, Portlandia.

The song is seemingly now ensconced on the playlist at any and every upscale eatery. His latest is 2020s Paracosm.

Tickets start at $25 plus fees. Doors open at 8 pm.

Maze featuring Frankie Beverly with The Isley Brothers and LeVelleSaturday, January 15Toyota Center

Classic soul and funk gets a major spotlight with a Toyota Center bill that includes Maze, led by Frankie Beverly. Originally from Philadelphia, Maze first made waves when they hooked up with Marvin Gaye in the '70s, scoring hit songs such as "Joy and Pain," "Before I Let Go," and "Happy Feelin's" [sic].

They'll be joined by the timeless, former Motown act, The Isley Brothers, who are instantly recognizable with the hits "This Old Heart of Mine (Is Weak for You)," "Shout," and "Twist and Shout," famously covered by The Beatles.

Tickets start at $69.50 plus fees. Doors open at 6:30 pm.

CultureMap Show of the Month: Sir Elton JohnFriday, January 21 and Saturday, January 22Toyota Center

The last time Sir Elton John rolled through town with his Goodbye Yellow Brick Road tour to perform to a sold-out Toyota Center crowd, it was under the guise of being his last tour before setting off into the sunset. That show included a roll-call of greatest hits that would be a wonderful bookend to a storied career (read the CultureMap review here).

But alas, the icon had second thoughts and is back for a two-show encore, perhaps bolstered by the fantastic hit Dua Lipa/PNAU collaboration, "Cold Heart," that resulted in John's biggest hit song in years, reaching No. 1 in the U.K. and No. 11 in the U.S.

Expect a look back on his biggest hits, a stellar live band, and eye-popping visuals for John fans, or music fans in general, this show is a must-see.

Tickets start at $69.50 plus fees. Doors open at 7 pm.

Shawn ColvinFriday, January 21Heights Theater

We were set to recommend the Lucinda Williams concert at Heights Theater this month but that one is sold out. For those looking for a fantastic singer-songwriter, Shawn Colvin will also appear in the intimate venue.

Colvin got her start in the Midwest and quickly garnered attention when she joined the famed Greenwich Village folk circuit in New York. A tour with Susanne Vega led to a recording contract and since then, she became a fixture at the Lilith Fair tours and racked up three Grammy Award wins, including two for her hit song, "Sunny Came Home," which picked up Record of the Year and Song of the Year.

Her latest isThe Starlighter, a collection inspired by the children's music book,Lullabies and Night Songs.

Tickets start at $28 plus fees. Doors open at 7 p.m.

The War on Drugs with Lo MoonWhite Oak Music Hall (Lawn)

Finding that sweet spot between Bruce Springsteen and Bob Dylan juxtaposed with layered indie guitars, The War on Drugs developed a distinctly American rock sound that recalls vast landscapes and gritty stories of the everyman, set to a sonic palette made for today's audiences.

Led by Adam Granduciel, the band initially started after he struck up a friendship with psych-rocker Kurt Vile. But it wasn't until Vile departed that the band truly took off with 2014'sLost in the Dreamachieving modern classic status and catapulting the act to festival headliners.

The 2017 releaseA Deeper Understanding and last year'sI Don't Live Here Anymore were critical smashes, solidifying The War on Drugs as a touring force.

Tickets start at $46 plus fees. Doors open at 8 pm.

Cat PowerThursday, January 27House of Blues

Cat Power's Chan Marshall has had a strange career. Starting off as an unassuming indie darling most noteworthy for the excellent 1998 full-lengthMoon Pix, the demands of the road proved at times too much for the Atlanta-based singer-songwriter. Show performances were erratic and oftentimes awkward with her deeply personal lyrics at odds with rowdy crowds.

Thankfully, with her social anxiety issues behind her, Marshall has gained new confidence not only as a frontwoman but also as a recording artist, producing excellent albums over the last decade and touring with the likes of Alanis Morissette. She'll be releasing a covers album this year.

Tickets start at $35 plus fees. Show starts at 7 pm.

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9 coolest concerts to ring in the new year in Houston this January - CultureMap Houston

At a time when drug addiction is on the rise, villagers in quaint Jharag have waged a war on chitta, a highly addictive synthetic drug made from heroin and other substances.

The panchayat of Jharag in Shimla districts Jubbal and Kotkhai assembly segment has brought a resolution to reward people providing information about drug peddlers active in the area. Jharag is famous for its local deity Nageshwar Devtas temple and has a population of about 1,800. The panchayat comprises five villages.

For quite some time, reports have been pouring in about drug peddlers from nearby areas trying to lure the youth from our panchayat to buy drugs. Some unknown vehicles which do not belong to the locals have been frequenting the villages as well, said panchayat pradhan Ashok Sarta, adding that drug addiction was certainly a cause of concern

The panchayat passed a resolution with unanimity to fight the drug menace and also expose the peddlers from nearby villages and panchayats, he said. The panchayat will reward those giving information about the drug peddlers. We have also formed a team of teenagers from different wards to keep tabs on the addicts as well as the local smugglers and suppliers, Sarta added.

The use of drugs has increased manifolds in the urban as well as rural regions of the state. According to a survey of the National Drug Dependence Treatment Centre at All India Institute of Medical Sciences (AIIMS), Delhi, the prevalence of the usage of charas and ganja is 1.2% in the country, while its higher than the national average at 3.2% in Himachal Pradesh. Similarly, the use of opioids is 2.8% in Punjab, 2.5% in Haryana, 2% in Delhi and 1.7% in Himachal Pradesh against the national average of 0.7%.

But a dangerous trend in recent years has been the shift of the users to chemical drugs. According to the health departments reports, there are nearly 1,170 patients (drug users) lodged in 27 de-addiction centres in HP.

The count of those addicted to chitta (also called diacetylmorphine, a semi-synthetic adulterated form of heroin) has surpassed that of cannabis (charas) and other hard drugs as 34.61% of the addicts in the centres are chitta consumers.

Another major cause for concern, according to the same report, is that the highest number of addicts are in the age group of 15-30 years.

There been a significant rise in the consumption of synthetic drugs among the youths. Not only boys, but girls too are falling prey to addiction, said Dinesh Sharma, head of psychiatry department in the states premier institute Indira Gandhi Medical College (IGMC).

The hospital runs a special outdoor patient department (OPD) for addicts on Saturdays. The trend of using injectable drugs is growing among the youth, particularly in the age group between 17 and 25 years, he said. It is also leading to increase in liver-related diseases like hepatitis C, he added.

With illicit drug trade on the rise, Himachal Pradesh Police had re-devised its strategy to catch smugglers and keep track of addicts.

HP director general of police Sanjay Kundu added Register 29 in all police stations to track addicts and offenders booked under the Narcotic Drugs and Psychotropic Substances (NDPS) Act.

The station house officers (SHOs) concerned maintain the register and create a database for analysis and better prevention of drug trafficking.

The prevalence of drug addiction and trafficking is more among those aged between 26 and 35 years, who comprise 37% of the total people booked under the NDPS Act.

Gaurav Bisht heads Hindustan Times Himachal bureau. He covers politics in the hill state and other issues concerning the masses. ...view detail

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Panchayat in Shimla district wages a war on chitta and its users - Hindustan Times

As people of color make up an increasing number of the people who misuse and develop an opioid addiction, those who receive treatment remain overwhelmingly white. (AdobeStock)

John Woodyear is a primary care physician who specializes in addiction treatment. On most days, his waiting room at the Family Care Clinic & Associates is filled with patients waiting to get their prescription for buprenorphine, a medication to treat opioid substance use disorder (SUD) sold under the brand names Subutex and Suboxone.

Research shows that the medication can reduce the risk of overdose by half and double a patients chances of entering long-term recovery.

Woodyear estimates that more than 90% of his SUD patients are white. That would be expected in the nearly all-white counties in the western part of the state that have been hardest hit by the opioid crisis, or even if Woodyear was white.

But the 68-year-old physician is Black and practices in Troy, a town in Montgomery County that is 36% Black. The racial make-up of his patient population represents a disturbing fact about opioid addiction treatment: as people of color make up an increasing number of the people who misuse and develop an opioid addiction, those who receive SUD treatment remain overwhelmingly white.

Since the current opioid crisis started unfolding in the late 1990s, addiction has increasingly been spoken of as a public health concern. The white, middle-class, suburban and rural populations that were most affected are portrayed as victims, both of overzealous prescribing of prescription opioids and unscrupulous pharmaceutical companies, who are deserving of compassion and care.

Even the language used to describe addiction is less stigmatizing; patients with substance use disorder are no longer referred to as addicts or junkies.

This is a marked contrast to the national response to the crack cocaine epidemic of the 1980s and the war on drugs, declared by Richard Nixon in 1971. For decades, addiction has been considered a personal moral failing that needs to be addressed by punitive measures and incarceration.

Those efforts criminalized substance use, particularly in Black communities. That more punitive approach was on display in the distinctions made between Black and white drug users prosecuted for possession of crack cocaine and powder cocaine in the 1980s. Black people were prosecuted more frequently for crack cocaine, which carried longer and harsher sentences, than were whites for cocaine, which carried lesser penalties, even for greater quantities of drugs.

Attitudes around substance use only began to change once white communities started experiencing high rates of dependence and death from opioids. There are signs, however, that this more enlightened attitude and view of addiction does not extend to all opioid victims.

The gap between the rates at which Black people and white people use and die from opioid overdoses has narrowed steadily in recent years. While the most recent NC DHHS data shows that white North Carolinians overdose deaths were twice the rate of members of the Black community, the rates were comparable on a national scale (19.0 and 17.1), according to data compiled by the Kaiser Family Foundation.

Those numbers flipped during the COVID-19 pandemic, according to preliminary data from the Centers for Disease Control and Prevention (CDC). For the first time in more than 20 years, the rate of Black overdose deaths surpassed that of whites.

So how and why did opioids, substances derisively called hillbilly heroin, become the drug of choice for Black people? The Agency for Healthcare Research and Quality (AHRQ) says virtually every street drug is now contaminated by synthetic opioids such as fentanyl and carfentanil, which are cheaper and more powerful.

Shuchin Shukla, a faculty physician and opioid educator at the Mountain Area Health Education Center in Asheville, says the North Carolina General Assemblys refusal to expand Medicaid has crippled the states ability to address addiction and overdose deaths with treatment.

Theres plenty of research showing how overdose rates changed in states that expanded Medicaid, says Shukla. One way or another, the taxpayers are paying for this. We can pay through outpatient treatment, which is relatively cheap and medically and ethically sound, or we can pay for jails and prisons, ER visits, ambulance rides, HIV and Hepatitis C treatment.

That is what North Carolina is currently doing.

Much of substance use treatment services are funded by grants and philanthropic entities, which are inadequate to cover the need. As a result, a substantial share of federal grants are diverted to provide services that would otherwise be covered by Medicaid.

But even those grants are not distributed equitably. A $54 million federal grant allowed the state to provide treatment to 12,000 people, only 7.5% of whom were Black and less than 1% were American Indian, the population most devastated by the opioid crisis.

Many addiction medicine specialists see medication-assisted therapy (MAT) treatment as the best hope for curbing opioid misuse and overdose. Because MAT drugs are also opioids, they satisfy the opioid craving and stave off withdrawal without producing that euphoric high. A variety of studies have found that MAT can cut the all-cause mortality rate among addiction patients by half or more.

In Charlotte, officials and advocates in the substance abuse field gathered for a groundbreaking at a new Wellpath Community Care Center scheduled to open in north Charlotte in early 2022. The care center, located at the corner of West Sugar Creek Road and Hunter Avenue in the Derita neighborhood, will implement MAT programming and outpatient substance use disorder treatment for people struggling with opioids or other substances including alcohol, tobacco, methamphetamine, fentanyl, and cocaine.

Its a comprehensive approach to substance abuse treatment, Wellpath Vice President Melissa Bishop told Queen City Nerve at that event. Well be providing services not only for substance use but also co-occurring services for people struggling with anxiety or depression, which will help in their engagement and treatment and stability. Its a one-stop shop rather than having to make them go to multiple providers.

There are many barriers to accessing this treatment in North Carolina, one of 11 states where buprenorphine prescribers per opioid death rates are well below the national average. Doctors are required to complete an eight-hour training program and get a waiver from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to prescribe buprenorphine for addiction; physician assistants and nurse practitioners require 24 hours of training.

The spike in overdose mortality during the pandemic, particularly among Black and Latino communities, led to several new initiatives and additional funding to train more health care providers to prescribe the drug. But getting more doctors on board remains a challenge.

Woodyear is federally certified to prescribe buprenorphine to up to 275 patients, the maximum allowed, and has tried to recruit more MAT providers to the closest population center, Pinehurst, without much success. He said he believes doctors have a prejudice bias toward treating people with addiction.

They dont want them in the office with their middle-class, upper-class patients, he said. They dont want their waiting room looking like an arraignment court.

Blake Fagan is chief education officer at UNC Health Sciences at MAHEC. He once vowed hed never prescribe MAT because he saw it as substituting one addiction for another. After some tragic experiences with his patients, he changed his tune. These days, Fagan not only prescribes MAT, he sees that primary care doctors in residency programs in North Carolina are qualified to prescribe the drug, too.

Despite the widespread acknowledgement that SUD is a crisis irrespective of race and/or ethnicity, there are vast disparities in who has access to quality treatment and care. Few people of any race identified as needing SUD treatment actually receive it but the numbers are most abysmal for people of color: just 10 and 8% of Black and Latino individuals with substance abuse disorder, respectively according to data from SAMHSA. A 2019 national study published in JAMA Psychiatry reported that more than 97% of people prescribed buprenorphine in an in-office setting were white.

Medicare or Medicaid paid for the visits in only 19% of the cases.

Even people with private insurance encounter barriers to opioid addiction treatment. A cohort study published in JAMA Network Open found that only 16.6% of commercially insured patients obtained follow-up treatment after a nonfatal opioid overdose; Black patients were half as likely as whites to obtain a treatment referral.

The numbers are even more dismal for those who are uninsured or on Medicaid who have fewer options for opioid addiction and substance use treatment. Although the Medicaid program covers the drug, low reimbursements discourage many providers from accepting patients who have the coverage.

Woodyear says he is one of the few providers of medications for opioid use disorder who accept Medicaid.

Buprenorphine and the once-a-month injectable Vivitrol are available in regular outpatient settings and mostly to people with private insurance. This was always the plan, says Tracie Gardner, senior vice president of policy advocacy at Legal Action Center which seeks to end punitive measures for health conditions like addiction.

When people observed the uptick in opioid use disorder among white people, they determined that an office-based approach would be preferable because of the belief and stereotypes we have constructed around methadone maintenance, says Gardner. Methadone has been highly racialized and has a very complex and complicated history. It is still under the purview of the Drug Enforcement Agency whereas buprenorphine is treated like a medication to be offered through a health care provider.

The racial disparities also extend to treatment outcomes. Only 28% of clients completed treatment, and the survey results indicate that Black and Latino people are less likely to complete treatment compared to whites. The lack of racial diversity among treatment providers is also a factor. There is a dearth of treatment providers who can address the needs of racially marginalized patients and offer treatment services that take their cultural identity into account.

Drug overdose deaths topped 100,000 in a one-year period during the pandemic for the first time ever, according to provisional data released by the CDC in mid-November.

Thats probably way underestimated just like the number of deaths from COVID is probably way underestimated, Woodyear said. Were dealing with an epidemic that we need to bring the same energy to treating as we have brought to the pandemic.

This article originally appeared at North Carolina Health News, an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. This story is part of a reporting fellowship on health care performance sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.

Become a Nerve Member: Get better connected and become a member of Queen City Nerve to support local journalism for as little as $5 per month. Our community journalism helps inform you through a range of diverse voices.

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Opioid Addiction Treatment in NC Not Separate but Still Unequal - qcnerve.com

Key Rhode Island lawmakers say they are nearing an agreement on a marijuana legalization bill that they plan to introduce within days. But one part of the deal might jeopardize support from the governor.

Legislators have been in talks for months to reconcile competing legalization proposals that have been brought forward by the House, Senate and governors office. Many issues have been resolved over the course of negotiations, but the question of who should be in charge of regulating the programan existing agency or a newly created bodyhas been a sticking point.

Lawmakers are now signaling that the best route to satisfy both sides would be to create a compromise approach where a state agency like the Department of Business Regulation (DBR) and a new independent cannabis commission would each play a role.

House Speaker Joseph Sherkarchi (D) said in opening remarks at the start of the 2022 session on Tuesday that lawmakers have spent months analyzing the complex issue of marijuana legalization.

The House and Senate intend to soon have a draft of legislation ready, which will serve as a framework to begin a robust public hearing process, he said. We may not be the first state to legalize marijuana, but our goal is to do it in a way that is best for all of Rhode Islanders.

The speaker said in a recent interview with The Boston Globe that lawmakers have come together on a framework that will probably be introduced in mid-January. That will likely include a proposal to create a hybrid model for regulating the market.

But Gov. Dan McKee (D), who proposed having DBR itself regulate the cannabis industry in legalization legislation he filed last year, hasnt yet signed off on the hybrid idea, Rep. Scott Slater (D) told Marijuana Moment.

That said, if we put a bill that most people are behind, the lawmaker doesnt expect a veto.

I think we should have a bill soon, Slater, who filed a bill to end cannabis prohibition last year, said.

Sen. Josh Miller (D), sponsor of one legalization proposalthat was approved in the Senate last year, told Marijuana Moment that he agreed that lawmakers should have a bill very soon with a structure very close to what the speaker described. Millers legislation had proposed creating a new cannabis commission to oversee the market.

Senate President Dominick Ruggerio (D) said in his session opening remarks on Wednesday that the bill the body passed last year included substantial measures to rectify the wrongs associated with the decades-long policies of prohibition.

He noted that Senate leaders have been working in recent months with the House on a deal that maintains the core principles of our proposal.

Because of those efforts, he said, I anticipate the General Assembly will legalize cannabis this legislative session.

Shekarchi told The Globe that the forthcoming negotiated bill could still be changed even after its introduction.

But that doesnt mean thats the end, he said. Thats the beginning of a processa very robust, public, transparent process where Im sure the bill will continue to change and evolve.

Marijuana Moment is already tracking more than 800 cannabis, psychedelics and drug policy bills in state legislatures and Congress this year. Patreon supporters pledging at least $25/month get access to our interactive maps, charts and hearing calendar so they dont miss any developments.Learn more about our marijuana bill tracker and become a supporter on Patreon to get access.

The speaker previously said that hed be open to a compromise on regulatory structureand hinted at the possibility of a hybrid model.

Another issue related to how many marijuana business licenses also appears closer to resolution. Millers bill proposed as many as 150 cannabis shops, whereas McKees plancalled for 25 and Slater wanted just 15 in his separate House bill. Miller said at an event in October that were probably down to more in the 30, 40 range as part of a deal.

Negotiatorsalso recently reached an agreementto place a temporary moratorium on approving additional cannabis cultivator licenses. Some have protested adding cultivators beyond the existing medical marijuana licensees because they say theres already a sufficient supply to meet demand in the adult-use market.

Ruggerio, for his part, said in September that lawmakers are very close to reaching a dealon a marijuana legalization bill

We sent legislationwhich we think is a very good piece of legislationover to the House before we left in June, the senator said, referring to the legalization bill that his chamber approvedin June. They are working on that legislation with some of the House people at this point in time.

Another thing that remains to be seen is whether the negotiated legalization bill thats ultimately produced will satisfy advocates and progressive lawmakers, some of whom have rallied behind an agenda for reformthat emphasizes the need for bold social equity provisions.

While each of the competing bills contain components meant to address the harms of marijuana criminalization, the coalition led by Reclaim Rhode Island has said theyre insufficient. Advocates and supportive lawmakers have laid out specific items that they want to see incorporated such as setting aside half of cannabis business licenses for communities most impacted by prohibition.

We cant reverse the harm of the war on drugs, but we can start to repair it by passing automatic expungement and waiving all related fines, fees and court debt, Rep. Karen Alzate (D), chair of the Rhode Island Legislative Black and Latino Caucus, said in September. This bold legalization plan offers us the chance to turn a new leaf for the Ocean State, and its time we take it.

Ruggerio said he does feel that the legalization bill that was approved in the Senate contained very strong social justice provisions and the expungements provision is as close to automatic as practical.

He also said in July that hesnot disappointed the House hasnt advanced legalization legislationyet and that what we really wanted to do was send it over and have them take a look at itwhen his chamber passed its cannabis reform measure.

A coalition of 10 civil rights and drug policy reform advocacy groupsincluding the Rhode Island chapters of the ACLU and NAACPhad demanded that lawmakers move ahead with enacting marijuana reform in the state before the end of 2021. But that did not pan out.

Lawmakers have noted that neighboring states likeConnecticut and Massachusetts have enacted legalization, and that adds impetus for the legislature to pursue reform in the state.

Shekarchi, meanwhile, said in July that he doesnt intend to let regional pressure dictate the timeline for when Rhode Island enacts a policy change. Social equity, licensing fees, labor agreements and home grow provisions are among the outstanding matters that need to be addressed, the speaker said.

The House Finance Committeeheld a hearing on Slaters legalization measurein June.

The governor previously told reporters that while he backs legalization it is not like one of my highest priorities, adding that were not in a race with Connecticut or Massachusetts on this issue.

I think we need to get it right, he said, pointing to ongoing discussions with the House and Senate.

The House Finance Committee discussed the governors proposal to end prohibitionat an earlier hearing in April.

Both the governor and the leaders legalization plans are notably different than the proposal that former Gov. Gina Raimondo (D) had included in her budget in 2020. Prior to leaving office to join the Biden administrationas commerce secretary, shecalled for legalization through a state-run model.

McKee gave initial insights into his perspective on the reform last January, saying that its time that [legalization] happens and that hes more leaning towards an entrepreneurial strategythere to let that roll that way.

Shekarchi, meanwhile, has said hesabsolutely open to the idea of cannabis legalizationand also leans toward privatization.

In late 2020, the Senate Finance Committee began preliminary consideration of legalizationin preparation for the 2021 session, with lawmakers generally accepting the reform as an inevitability. I certainly do think well act on the issue, whether its more private or more state, Sen. Ryan Pearson (D), who now serves as the panels chairman, said at the time.

Meanwhile, the governor in Julysigned a historic bill to allow safe consumption siteswhere people could use illicit drugs under medical supervision and receive resources to enter treatment. Harm reduction advocates say this would prevent overdose deaths and help de-stigmatize substance misuse. Rhode Island is the first state to allow the facilities.

The Senate Judiciary Committee also held a hearing last year on legislation that would end criminal penalties for possessing small amounts of drugsand replace them with a $100 fine.

Illinois Sets Marijuana Sales Record In December, With Nearly $1.4 Billion Sold In 2021

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Connecticut Marijuana Business License Applications Will Be Accepted Starting Next Month, Officials Announce - Marijuana Moment

Libertarians believe that the War on Drugsisineffective, unfair, and immoral. We advocateending it.

The War on Drugs is ineffective at limiting access to dangerous drugs and, instead, empowers dangerous gangs that make incredible fortunes on the black market for these illegal drugs.

The War on Drugs has imprisoned millions of non-violent people. This is unfair to these people and also uses up resources that would be better spent prosecuting and imprisoning people who are violent.

The War on Drugs is largely responsible for the militarization of police forces in America. It has pitted police against citizens and this is unfair to both. Police need to be able to focus onprotecting the American public from violent offenders and fraud.

Lastly, Libertarians believe that it is immoral for the government to dictate which substances a person is permitted to consume, whether it is alcohol, tobacco, herbal remedies, saturated fat, marijuana, etc. These decisions belong to individual people, not the government.

Because of all of these things, Libertarians advocate ending the War on Drugs.

For more information on the pro-liberty approach on this topic, we invite you to watch the following videos from Learn Liberty:

Continued here:

War on Drugs | Libertarian Party

MIAMI Nearly 13 years and 1,300 miles removed from the violent streets of Medelln, Carlos Mario Aguilar has rebuilt his life in South Florida. The alleged Colombian crime boss known by the alias Rogelio has escaped his blood-soaked past to enjoy life in a luxurious gated community and a job at a logistics company.

While the families of cartel victims seldom see justice served, Rogelio is a free man thanks to the very thing Colombian kingpins once feared most: facing American justice.

Drug lord Pablo Escobar famously said he would prefer a tomb in Colombia than a jail in the United States, but surrender and extradition are now seen by some savvy, lawyered-up cartel bosses as an expedited pass to freedom.

With President Richard Nixons launch of the War on Drugs now marking its 50th anniversary, Rogelios case offers a stark reminder that one key strategy of U.S. anti-drug policy has morphed into something unrecognizable from its original intent.

Early efforts were focused on disrupting drug distribution in the United States, and eventually evolved into removing all-powerful cartel bosses from their key networks, trying to hold them accountable in the United States since they often enjoyed impunity at home.

Yet today traffickers have learned how to game this process, preserving some of their fortune for their families while getting lighter sentences. Some forfeited money offsets the costs of U.S. anti-drug efforts, but the home countries can often see little return.

An investigation by OCCRP and partners, including the Miami Herald and el Nuevo Herald, using data collected in Colombia and Mexico, shows that extradition has become a game often stacked in favor of well-connected criminals. Meanwhile, the drug trade remains intact and thriving.

OCCRP compiled a sample of 37 separate extradition cases of mid- to top-level Mexican and Colombian drug traffickers for the period 2005-2015, data that showed how some of the worlds biggest cartel operatives have been treated sympathetically. Of those 37 cases, 23 of the individuals spent or will have spent 10 years or less in U.S. custody. Just two were given life sentences. The shortest periods of detention ranged from one to three years, with one high-ranking defendant spending just eight months behind bars before being deported back to Colombia.

The end result of such leniency is that falling into the hands of the Americans decades after Escobar famously went to war with the Colombian state to avoid that very fate is no longer something many drug lords wish to elude at all costs. Instead of waiting for the net to close, many now choose to go quietly and cooperate with U.S. authorities by providing information on their allies and enemies. Some even circumvent the extradition process entirely, surrendering in third countries and striking their own backroom deals with the U.S.

They picked up on the formula, especially the bigger guys, said David Zapp, a New York defense lawyer who has represented many top-level traffickers. The word goes out that if you cooperate and help Team America, you will do very well.

American officials defend the practice of giving more lenient sentences to those who cooperate, saying that although lighter deals for major bosses some of whom are suspected of atrocities in their home countries may seem unpalatable, they can provide information that helps to break up criminal groups.

Its crucial, its critical, you could not do it without cooperation, said Michael Nadler, a former federal prosecutor for the Southern District of Florida.

But many veterans of the five-decade War on Drugs say extradition and other strategies have fallen short, as cartels have evolved into multi-layered organizations that are no longer centralized. They also traffic women, smuggle other goods, extort businesses and even fund illicit gold mines.

We destroy illicit crops, destroy laboratories, seize precursor chemicals, seize large tons of drugs, said Wilson Martinez, a former Colombian deputy attorney general. But we remain at the same point.

At a luxurious gated community in Boca Raton, parents in luxury cars wait outside the adjoining elementary school to fetch their children. Theres little to hint that the notorious Carlos Mario Aguilar, or Rogelio, lived for a number of years in one of the nearby million-dollar homes.

A corrupted criminal investigator from the Colombian Prosecutors Offices Technical Investigations Team, known by the Spanish acronym CTI, Rogelio worked in the 1990s and 2000s with the Oficina de Envigado (the Envigado Office), the hit squad and debt collection agency of Medelln overlord Diego Murillo, alias Don Berna. Envigado is a town near Medelln.

During this time, Rogelio also allegedly worked with the United Self-Defense Forces of Colombia, or AUC, a 30,000-strong paramilitary death squad that partnered with the Oficina.

Rogelio is very powerful and nobody wants to mess with him, said one human rights defender in Medelln, asking for anonymity because both the Oficina and the AUC are alleged to have disappeared hundreds of victims. That fear remains.

When Don Berna was extradited to the United States in May 2008, Colombian government documents show Rogelio was next in line to head the Oficina. The U.S. Justice Department says the crime group continues to specialize in money laundering, extortion, and murder for hire.

A network diagram of the leaders of the Oficina de Envigado in 2006. Carlos Mario Aguilar, alias Rogelio, can be seen on the far right. Second from left is the drug lord Diego Murillo, alias Don Berna. (Justice and Peace Tribunal, Colombia/TNS)

Rogelios time at the top of Medellns underworld didnt last long, but that decision was his. Later in 2008, he himself surrendered to the United States, having made a secret deal to cooperate.

This was no two-way agreement between the United States and Colombia, one source with inside knowledge of the case said. The cartel boss first made his way to Argentina, before taking a commercial flight from Panama to the United States, handing himself over to the Americans while Colombian authorities were kept in the dark. We did everything behind their back because we didnt trust them, the source said.

By 2015, records show, Rogelio had been released from an American prison after serving barely more than seven years. His case file has remained a deep secret, sealed by a judge. Authorities did not respond to repeated requests for comment.

Rogelios lenient treatment is not an anomaly, according to Michael S. Vigil, former chief of international operations for the U.S. Drug Enforcement Administration (DEA).

The agreement, for example, [was] that he wasnt going to do a lot of time if he cooperated, which obviously he did, and the fact that he would be allowed to remain in the United States, said Vigil, who retired in 2004 and remains active as a consultant.

Vigil added that sending him back to Colombia would be an automatic death sentence.

These sorts of deals are necessary, said Bonnie S. Klapper, a former federal prosecutor who now defends accused traffickers.

If you are going to cooperate someone, you are going to have to live up to your word and make sure that person doesnt have to go back to their country and likely get killed, she told OCCRP.

Today, far from the Medelln drug war he oversaw, Rogelio appears to be keeping his head down in Florida.

Legal documents obtained by OCCRP show he reported working as a service assistant at a trucking company, earning under $50,000 a year. He has a credit card with a major financial institution, a Florida drivers license and had lived at the plush Boca Raton residence for a number of years since his release from prison.

Rogelio owes much to his sister, Cruz Elena Aguilar, sources said. She was a Colombian prosecutor in the 1990s who later moved to the United States. Before leaving, she had become embroiled in a public scandal over her perceived closeness to the people she was meant to be investigating, with some of this easy familiarity captured on video according to Colombian media reports.

In a past broadcast on Colombias W Radio, Cruz Elena admitted helping the Medelln drug lord Don Berna her brothers onetime boss find an American lawyer. American legal sources acknowledge that Cruz Elena has worked as a facilitator for traffickers who have been captured and face extradition, or wish to surrender.

While Cruz Elena declined requests for comment, the prosecutor-turned-defense attorney Klapper offered a sympathetic view, insisting Cruz Elenas work as a facilitator is above board.

I trust her completely. I have never seen her cross the line, and I would not be working with her if this were the case, said Klapper, who helped break up Colombias Norte del Valle Cartel. No case is worth my reputation.

Today, Cruz Elena works as an American paralegal. Her U.S.-raised daughter Daniela Posada is a member of the Florida Bar and has worked defense cases involving high-profile traffickers, including Daniel Barrera Barrera, alias El Loco, who lorded over Colombias eastern plains before capture in 2012.

Carlos Mario Aguilar, aka Rogelio, did not answer requests for comment, by email and via legal channels.

During the 2000-2006 presidency of Vicente Fox, the Mexican government had repeatedly balked at extraditing traffickers to the United States because of the possibility that defendants could face the death penalty, outlawed under Mexicos constitution.

Felipe Caldern succeeded Fox in 2006 and declared his own war on drug trafficking. By 2008, he had partnered with the United States on the Merida Initiative, a transnational security deal aimed at interdicting drugs, stopping money laundering, reducing production, and dismantling criminal organizations.

As Mexicos ambassador to the United States from 2007 and 2013, Arturo Sarukhan signed off on numerous extraditions as part of a strategy to remove capos from cartels whose tentacles extended into Mexican prisons.

Structural weaknesses and corruption in Mexicos penitentiary system allowed them to continue operating from jail, Sarukhan said in an interview in Washington, D.C. By extraditing them, you degraded that capability. Id rather have them up here.

In a gesture to show Mexico took the Merida Initiative seriously, Caldern extradited more than a dozen traffickers in a single swoop before the deal was even inked. These included Osiel Crdenas Guilln, who headed Mexicos notorious Gulf Cartel, which sprung from the eastern border state of Tamaulipas.

Crdenas earned the nickname El Mata Amigos, or The Friend Killer, for allegedly murdering a cartel partner. He created the brutal Los Zetas, the Gulf Cartels military-trained enforcement wing. Looking past the Gulf Cartels trail of violence, the U.S. government decided to negotiate.

In exchange for relevant information, Crdenas was extradited in 2007. In 2010 he was sentenced to a 25-year term and forfeited $50 million in money and property. Hes set to be released in 2024.

Not only did Crdenas enjoy lenient treatment, his family kept its privileged lifestyle in Mexico. His daughters social-media photos later showed trips on private jets to foreign countries. In 2018, Crdenas son was arrested for brandishing a gun at a Texas bar while waving a U.S. District Attorneys badge.

Word that Osiel, after extradition, snitched on colleagues led the Zetas to break off from the Gulf Cartel, with catastrophic consequences.

That created the fracture of the Gulf Cartel and the Zetas, created more violence and this violence spread throughout Mexico, said Arturo Fontes, a security consultant who retired after 28 years in the FBI combating cartels. And a lot of people died on both sides of the border.

That view was seconded by Mexican security expert Alejandro Hope, who argued the Gulf Cartel leaders extradition had a detonating effect that sparked the flames of violence.

The exact details of Crdenas case much like the case of the Colombian, Rogelio remain largely a mystery.

Felix Jimenez, a former DEA official who led the New York office, insisted that plea deals such as the one extended to the Gulf Cartel leader have helped weaken criminal organizations.

Extradition has been an extremely useful strategy against traffickers who are terrified of being sent north, Jimenez said, and thus offer insider information for reduced sentences.

A U.S. lawyer who represents both Crdenas and his son Osiel Jr., told OCCRP by email that the family doesnt respond to media questions.

Even if Mexico wanted to build a case at home against traffickers such as Crdenas, U.S. law enforcement is unlikely to share what theyve gotten in exchange for its leniency, said Gerardo Rodrguez Snchez Lara, a Mexican security analyst.

There is an asymmetric relationship here, he said. If you work with someone who does not want to give information, it is really difficult.

Although the U.S. government and local police confiscated some $50 million from Crdenas and federal agents were seen posing in photos with their share, $29.5 million Mexico didnt receive a dime.

Unlike Colombia, Mexico does not have a central fund through which criminals assets can be seized and shared between the sending and receiving countries in cases involving extradition.

Colombia and the United States have a deal for the distribution of criminal assets seized based on the participation level of each country, according to Martinez, the countrys former deputy attorney general.

Since the death of the Medelln kingpin Escobar in 1993, U.S. extradition strategy in Colombia and, later, in Mexico has focused on headline-grabbing capos. In recent years, the trickle of organized crime figures extradited, either after surrender or capture, has grown into a torrent.

Data obtained in Colombia show drug trafficking is by far the main crime for which Colombians are extradited to the United States. Data obtained in Colombia show that 76% of all extradition requests for Colombian citizens by the United States between 2008 and 2018 involved drug-related offenses. The United States made 1,156 requests for suspected traffickers from Colombia during that decade.

On yearly average, more than 98% of all extradition requests for drug cases were approved, with just a handful of requests rejected each year.

Colombian extraditions werent always so robust. A U.S. State Department report in 2001 said just 12 Colombians were sent to the United States between 1997 and 2001, most for drug-related offenses. Those cases came after a six-year extradition hiatus.

After a terror campaign against the Colombian state by the so-called extraditables a group of people who could conceivably be extradited, led by Escobar a new Colombian constitution in 1991 brought the extradition of Colombian nationals to a halt. A few years later, however, American pressure led Colombia to re-implement a partial extradition process.

In this 1983 file photo, Medellin drug cartel boss Pablo Escobar watches a soccer game in Medellin, Colombia. (AP Photo, File)

As the hunt for Escobar neared its end in 1993, U.S. authorities began to focus on the so-called kingpin strategy, zooming in on the capture of cartel leaders and trying to dismantle the hierarchical structures of these groups, rather than their day-to-day criminal activities.

Since the early 2000s, Colombia has sent numerous high-profile narco-traffickers to the United States, perhaps the most famous being 14 paramilitary leaders from the AUC a list that included Rogelios boss, Don Berna in May 2008.

Similar data on extraditions is not available for Mexico, which is the largest transit point for narcotics coming into the United States.

A useful proxy, however, is data from the U.S. Marshals Service. It handles the majority of extradition cases, and agency data compiled by the University of San Diego show there were 770 extraditions from Mexico. between 2003 and 2016. Of those, 45% involved narcotics charges by far the largest category of offense. Before that period, just eight people were extradited from Mexico between 1980 and 1994 under all categories of crime.

Mexico has caught up in recent years, culminating in the extradition of El Chapo in 2017. American officials bucked the trend with El Chapo, refusing to grant him any leniency and handing him a life sentence.

FILE - In this Feb. 22, 2014 file photo, Joaquin "El Chapo" Guzman, the head of Mexico's Sinaloa Cartel, is escorted to a helicopter in Mexico City following his capture in the beach resort town of Mazatlan, Mexico. The Mexican drug kingpin, who was convicted in a New York federal court in February 2019 on multiple conspiracy counts in an epic drug-trafficking case, was sentenced to life behind bars in a U.S. prison. (AP Photo/Eduardo Verdugo, File)

Notwithstanding El Chapos conviction, some experts feel the attention on kingpins is outdated.

Yesid Reyes, a former Colombian justice minister, said criminal groups have abandoned the model of mega cartels like Medelln and Cali. Colombia now has a multiplicity of mini cartels.

We continue to use a single formula, which is the repression of all links in the drug trafficking chain, he said, but traffickers have changed their styles.

Sarukhan, the former Mexican ambassador, argues that cutting off the head of an organization does little to break up the broader drug trade. That requires a strategy of reducing demand for narcotics in consuming nations, and deploying an army of skilled financial sleuths who can disrupt the financial wherewithal of these groups much like the successful post-9-11 approach to terror financing.

scar Naranjo, a former police general who has also served as Colombias vice president, is credited with taking down a number of top-level traffickers. He feels crime groups are no longer reliant on vertical command structures, and instead operate like fragmented criminal holdings, with many perpetrators, some of whom are invisible.

Even when the big boss is removed, theyre often simply replaced, said Maria McFarland Snchez-Moreno, a lawyer and author of the book There Are No Dead Here, about cartel and paramilitary infiltration of the Colombian government. She pointed to Rogelios case.

He ended up being the head of the Oficina after Don Berna was extradited, and then he got extradited. But theres still an Oficina, she said.

Jair Sanchez, suspected of trafficking huge amounts of cocaine from Colombias Pacific coast, was in a hurry to be extradited. Hed been shot in the stomach in the western city of Cali, and believed that rumors of his intention to cooperate with U.S. authorities had put a target on his back. He wanted to be taken by the Americans as soon as possible.

Arrested at a hospital in March 2015, the former Norte del Valle Cartel boss known as Mueble Fino, or Fancy Furniture, because of his luxurious lifestyle, was soon sent to the United States.

His American defense team pleaded for leniency. One court document cited mitigating factors such as the allegedly minor role he played in a deal involving at least 450 kilograms (992 pounds) of cocaine, and the fact that he had actually requested an expedited extradition. That same document shows the defense conceded that information Mueble Fino provided to authorities was stale.

Ultimately, with U.S. authorities having agreed to avoid the maximum life sentence, and sentencing guidelines left to the consideration of the court once he pleaded guilty and cooperated, Mueble Fino was sent back to Colombia in March 2019, having served less than four years.

Back home, he joined another criminal organization called La Gran Alianza, according to authorities.He was re-captured in 2021 and charged with homicide and kidnapping.

The days of people like Escobar choosing death over extradition seem long ago, and the cases of Mueble Fino and Rogelio demonstrate how a well-timed self-surrender or extradition can benefit top bosses.

Many times they tell us stuff we already know, which does very little in terms of impacting ongoing operations, said Jack Riley, a former acting DEA administrator who led efforts to capture Mexicos El Chapo. I dont want to hear historical stuff. I want to hear actionable things that we can do now to disrupt or dismantle these organizations.

Extradition has become its own cottage industry of opportunist traffickers, lawyers with dollar signs in their eyes, and snitches looking to gain favor, said Riley.

You have literally thousands of informants who trawl [the criminals] who the U.S. wants, and work on providing information on them for us, he said. Thats important because we need that information but its kind of spawned its own dark-side economy for extradition.

Laura Borbolla, a Mexican prosecutor in charge of extradition during the Caldern era, said the United States has very easy rules to abide by: plead guilty, return profits, and youll do alright.

If, in addition to this, you give me information on your collaborators, so that I can combat this type of behavior in my country, then I can allow you to keep [certain] properties, she added.

U.S. deals like the one extended to Rogelio complicate efforts to pursue justice for victims in Colombia. For example, a number of his CTI investigative colleagues in Medelln were killed in the late 1990s while fighting the same crime groups he ended up working for.

I think Colombian investigators should have many questions for him about the killings in the late 1990s, said McFarland, the lawyer and author. I think Rogelio has a lot of questions to answer around that. This is just one example of truth-telling thats not possible once youve [sent] somebody to the U.S.

Five decades into the War on Drugs, the battlefield has changed little. Tougher U.S. sentences initially encouraged traffickers to seek deals. Yet production and consumption have not been dented, and legal experts feel the sentencing guidelines have become overly malleable.

Production has grown, consumption has grown, violence associated with drug trafficking and production has grown, corruption has grown, said Police Gen. Naranjo.

Data from the United Nations Office on Drugs and Crime said yearly potential cocaine production in Colombia hit 1,228 metric tons in 2020, up from 695 metric tons in 2000.

Sarukhan, the former Mexican ambassador to the United States, said traffickers must be attacked at the structural level: the accountants and money launderers, or those that hire and train hitmen. The scant amount the DEA spends on the financial sleuths who follow the money electronically amounts to a sparrows fart in a typhoon.

His advice? Put money laundering at the top of the tool kit.

Vigil, the former DEA international operations boss, says a constant strategy of attacking the top of the tree will continue to yield incomplete results.

I dont refer to it as the war on drugs. I call it the permanent campaign on drugs, he said, adding that there will always be a supplying country as long as a strong market persists.

Unless we dampen demand for drugs, then if its not Mexico or its not Colombia, it will be another country, said Vigil.

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An addictive war: How drug cartel bosses are playing the US justice system - Anchorage Daily News

The former home of the Human Services Department is being repurposed to house an inpatient drug treatment center in Las Vegas.

Editors note: The following is part of an ongoing series on the roots of addiction in San Miguel and Mora counties, and the solutions being pursued by local leaders in an effort to help those suffering from addiction.

Officials in Las Vegas and San Miguel County are moving forward with plans to launch a criminal diversion program aimed at helping people who are struggling with substance use. The program, known as Law Enforcement Assisted Diversion, or LEAD, was launched a decade ago in Seattle, but those behind the national program have found success in small towns as well.

Brendan Cox, the director of policing strategies for LEAD National Support, told the Optic that achieving success in smaller communities requires a change in mindsets from those in law enforcement, and from members of the community.

LEAD is taking a very different approach. LEAD is saying were not going to punish people, were not going to coerce people, and thats one of the keys, Cox said. Were offering help.

Under LEAD, that help begins with law enforcement officers in the community. Upon encountering someone struggling with addiction who has committed a non-violent crime, the officer can choose to divert them into the LEAD program instead of arresting them. LEAD caseworkers can then connect the person with a variety of services, including housing or addiction treatment.

Once someone is accepted into treatment, any criminal charges theyre facing are deferred as they begin the program. After completing the intake process, the diverted charges are dismissed altogether.

The decision to arrest or divert someone into the program is always at the law enforcement officers discretion, and certain criminal charges automatically disqualify someone from being eligible for the program, for instance, violent crimes or the sale of illegal narcotics.

Leadership within the Las Vegas Police Department and the San Miguel County Sheriffs Office have announced support for the implementation of LEAD, and county leaders are working to convert a building on Hot Springs Boulevard, near the New Mexico Behavioral Health Institute, into a treatment facility that would offer a substance abuse treatment program.

With strong support from these agencies, and the Fourth Judicial District Attorneys office, Las Vegas LEAD program is beginning to take shape; however Cox, a retired police chief from Albany, New York, said another key component in launching a successful LEAD program is having strong support from the community. He also acknowledged that support can sometimes be difficult to attain because of the way law enforcement and courts have treated substance use and addiction in the past.

We need to get into the community and talk through this and recognize that for 50-plus years, weve had a war on the people of our community a war that we never should have had especially against people of color by white people, like me, Cox said. We need to recognize that, and change that.

Because of the current approach to substance use in communities in the U.S., and the harm the approach has caused, Cox said program managers often encounter resistance from potential program participants that results in some people refusing help.

Weve done so much damage, weve created so much trauma in our communities, that people dont want to take the olive branch of help from law enforcement because theyre afraid of the message that sends, he said. I think its difficult enough for law enforcement folks to change, but I think we also have to accept and understand why the community has a hard time understanding it. We have beaten our communities up with the war on drugs for over 50 years now.

The snitch label

One major hurdle encountered by LEAD program managers, especially in small communities, is a resistance to accepting help for fear that program managers and case workers will expect information on other crimes in exchange for the diversion of criminal charges. Those behind the program stressed the label is completely false.

Carey Deacon, program director for the LEAD program in Alamosa, Colorado, said that its a delicate balance because LEAD case workers must have relationships with members in law enforcement in order for the program to work, but she said those relationships do not require case workers to share personal information about program participants, or any illegal activity theyve been involved with.

Were trying to build better relationships with law enforcement and our participants, but its not like were divulging their life stories or their secrets, or anything that might get them in more trouble, she said.

The biggest problem with the false label is that it prevents people from accepting help from the program, and oftentimes, the people who refuse help are the ones who could benefit the most from LEAD, Cox with LEAD National Support said. One reason the snitch label is often applied in small communities is that more people are aware of whats happening in town.

When people see an interaction between law enforcement and somebody that is known to the community as someone whos involved in criminal activity, and suddenly they see that person still out in the community or they dont see that person arrested then they make an assumption that the person must have given somebody information, and thats why theyre still out, Cox said.

Unlike other programs, having a relapse or another setback doesnt result in a program participant being kicked out, either. Instead, LEAD is about giving people an option to receive help rather than forcing them to complete a program while a criminal charge is held over their head for years.

No one can ever be worse off for being in LEAD, Cox said. No information thats shared is ever to be punitive is ever to be in a fashion that were trying to use against the person. Its shared because were trying to reduce barriers that are in the way.

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The Path Forward: Community mindset key to success of diversion program - Las Vegas Optic

SRINAGAR: Behind his macho image lies a defeated man.

For eight years, Basit (name changed) consumed weed and heroin to get high, but instead, he went downhill losing everything in the process.

Sitting before a group of counselors, he burst into tears and poured his heart out. Had I seen people suffering from addiction, I would not have consumed drugs. My friends told me it will not cause any harm. But eight years on, I have reached a stage where it is very hard to leave drugs, said Basit.

How did he start?

Coming from an affluent family, he tried drugs to get high. But after a week, he started getting panic attacks. I tried hard to leave drugs, but could not. I could stay good only for one hour without drugs. Later I start sweating, getting goosebumps, and aggressive behavior, he said.

Basit started with smoking weeds which he continued for three-to-four years. Later he wanted to try new things and started administering heroin injections to get high. I used foil once in 2012. But after I got stomach pain, I switched to injectables. I was studying and helping my family in the business. Somehow I developed this addiction which is now killing me, he said.

How many people take drugs in J&K?

During the recent meeting of the state-level committee of the narco coordination center, it was informed that six lakh people are affected by drug-related issues in Jammu and Kashmir.

It was informed that Jammu and Kashmir is situated in close vicinity to the golden crescent which produces 80 percent of the worlds opium and is considered as the prime source of the illicit drug trade.

Initially every drug addict takes drugs for the thrill. After one week, he starts feeling the craving. I was taking one gram injection. My body has developed a high tolerance level. I could not get high for more than a minute. A stage comes when addicts want to relieve pain rather than getting high, said Basit.

Drug relapse cases

Data released by the Institute of Mental Health and Neurosciences (IMHANS), Kashmir, reveal that there have been 3538 admissions since the pandemic broke out last year. Interestingly, 12 percent of OPD attendees were first-time users who took to drugs during the lockdown period. Also, 24 percent of the drug abusers had relapsed during the lockdown.

Figures of SMHS hospitals Drug De-addiction Centre reveal that 489 patients were treated in the Outpatients Department (OPD) in 2016-2017. The figures rose to 3622 in 2017-18 and 5113 in 2018-19. From April to June 2019, 1095 patients were treated in the OPD of SMHS hospitals Drug De-addiction Centre.

Data shows that the number of patients admitted during 2015-2016 was 116. The number increased to 203 in 2015 -2016. Around 207 were admitted in 2016- 2017 followed by 374 in 2017-2018. The number increased to 624 in 2018-2019.

Police figures reveal that 21871 patients have been treated in Drug De-Addiction and Rehabilitation Center, Srinagar, from February 2008 to May 2019. Of whom 2315 were admitted to the indoor patients department.

Modus operandi

What has added a new dimension is that drug users have become peddlers to sustain their addiction. My daily expenditure on drugs is Rs 3000. For example, if I am earning say Rs 30,000, wherefrom will I get Rs 60000?. What drug users do is that they take up peddling also. For example, if they sell three cents for Rs 3000, they earn enough money to sustain themselves. Plus they save seven cents which they used for personal consumption. I have seen people from very good families selling drugs to sustain, he said.

Police figures reveal that 21871 patients have been treated in Drug De-Addiction and Rehabilitation Center, Srinagar, from February 2008 to May 2019. Of whom 2315 were admitted to the indoor patients department.

War on drugs

Data released by Jammu and Kashmir police reveal that 1132 drug-related cases were registered in 2020. Around 1672 persons involved in drug smuggling and peddling were arrested. Around 35 drug peddlers were booked under Public Safety Act (PSA).

Likewise, 152.18 kgs of heroin were seized in 2020. Besides, 563.61 kgs of charas/ganja and 22230.48 kgs of opium/poppy/cannabis derivatives were seized during the year. Around 339603 capsules, 57925 intoxicating bottles, and 265 intoxicative Injections were also seized during the anti-narcotics drive this year.

Most of the drugs come from Punjab and the border. The consignment goes to Anantnag wherefrom it is sent to other districts, said Basit.

( Name has been changed for privacy.)

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Confessions of an addict: How youth are falling prey to drugs in Kashmir - The Kashmir Monitor

Five years ago, California voters overwhelmingly chose to legalize the adult use of marijuana. The passage of Proposition 64 was supposed to replace the states vast illegal and quasi-legal medical marijuana market, in which virtually anyone could get their hands on marijuana, with a tightly controlled system of safe products, taxed sales and regulated commerce.

In recommending Proposition 64 to voters, the Times Editorial Board argued that its better for public health, for law and order, and for society to treat marijuana more like alcohol and less like heroin as a legal regulated product for adults.

And backers of the initiative said it would create a controlled market that allowed adults access to safe, regulated marijuana products while protecting children. The new government-overseen industry would reduce the environmental harm of illegal pot farms, lessen the power of criminal drug gangs and help repair damage from War on Drugs that disproportionately targeted Black and Latino communities.

But today many of the promises of Proposition 64 remain unfulfilled.

The black market is as big as ever, with roughly 75% of marijuana sales in the state coming from unlicensed sellers. Illegal pot farms are still degrading sensitive environmental habitat. Untested and unregulated cannabis products, including edibles and oils, still flood the market. And the pledge to help communities disadvantaged by the War on Drugs is still a work in progress. California, which was one of the first states to end prohibition, has become an example of how not to legalize marijuana.

Proposition 64 fulfilled at least part of the proponents mission: Adult use of marijuana has been decriminalized and normalized. Prosecutors have cleared tens of thousands of marijuana-related convictions from individuals records. Pot shops were deemed essential businesses and allowed to stay open during the COVID-19 closures. Pop star Justin Bieber croons about getting his weed from California, and even traditional media companies offer cannabis gift guides.

But underneath that widespread acceptance is a big problem the vast majority of marijuana consumed in the state is not legal.

It was always going to be a challenge transitioning to a regulated system; unauthorized and quasi-legal medical marijuana growers, manufacturers and sellers operated in the state for years. But even those in the industry have been surprised by the continued vibrancy of the black market, which is due, in part, to requirements, such as high taxes and local control, in Proposition 64. Now, the abundance of illegal pot makes it nearly impossible for California to do what the initiative intended.

An imperfect initiative Even before election day, there were tensions and contradictions baked into Proposition 64. To appease local government and law enforcement groups, the initiative gave cities and counties the power to completely ban marijuana-related businesses in their jurisdictions. And thats exactly what two-thirds of localities have done. That doesnt mean people arent selling or buying marijuana in those communities theyre just doing it illegally, using unlicensed shops or local dealers.

Proposition 64 was also pitched as a cash cow for the state. The initiative imposed taxes on commercial cultivation and sales, and it allowed local governments to layer on their own taxes. The hope was that marijuana would bring in more than $1 billion of state tax revenue every year to pay for afterschool programs, job training, drug addiction treatment, environmental cleanup and other worthy services. (Cannabis tax revenues exceeded $800 million in 2020-21.)

But the steep state and local taxes can add 50% or more to the price of products in a legal pot shop. When the cost of labor, product testing and packaging is factored, running a licensed business often doesnt pencil out especially when there are plenty of black market operators still producing and selling to customers, who may not know or care that theyre buying illegal pot.

And that undermines another Proposition 64 goal to ensure marijuana products are tracked, tested, pesticide free and safe for consumers. This has real implications for public safety. In early 2020, authorities seized marijuana vape cartridges from illegal shops in Los Angeles that contained a dangerous additive blamed for an outbreak of deadly lung illnesses.

Meanwhile, even as the large-scale licensed pot farms have grown in places like Santa Barbara and Monterey counties, illegal marijuana cultivation has continued to thrive, often to the detriment of the environment. In rugged Northern California coastal areas, illicit growers flatten hillsides, spray pesticides and divert streams just when salmon and other fish species are migrating in the late summer and fall.

In the Southern California deserts, illegal marijuana plantations have stolen precious water supplies and trampled plants and wildlife. And environmental groups that backed Proposition 64 say they still dont know how marijuana tax revenue is being spent to repair environmental damage from illegal grows; the state hasnt been transparent in how the money is being used.

Can this market be saved?There is still time to fix the system to achieve the promise of Proposition 64. But it will take a lot of work and committed leadership from state lawmakers and local elected leaders, many of whom have kept cannabis policy at arms length.

California can emerge from this marijuana mayhem by flipping the incentives. Its too easy and profitable to remain in the black market and too onerous and expensive to join the legal one. By easing licensing procedures or reducing taxes temporarily, and ramping up enforcement and penalties for illegal operators, the state has a better chance of coaxing fence-sitting operators to get licensed. Earlier this year the state consolidated cannabis industry regulation in one department to help speed up regulatory reform. But the work is challenging because Proposition 64 required a two-thirds vote by the Legislature to make significant alterations to marijuana laws. (In recent years, most states have legalized marijuana through legislative vote, not initiative, which makes it easier to adjust the laws going forward.)

Plus, the state cant do it alone. Far too many cities and counties still ban cannabis businesses. Proposition 64 guarantees that right, which is why some advocates are floating the idea of another ballot measure to eliminate cities and counties veto power over marijuana businesses. Local leaders have to acknowledge that refusing to recognize a now-legal industry is only encouraging the black market. Some localities are beginning to shift. Los Angeles County, for example, is considering revisiting its ban on pot shops in unincorporated areas.

Transforming Californias marijuana market is going to take real political leadership, which has been lacking at all levels of government. Gov. Gavin Newsom bears a special responsibility. As lieutenant governor, Newsom led a commission to study marijuana legalization and he campaigned for Proposition 64 two years later. However, until recently, hes mostly shied away from marijuana politics. But theres now widespread agreement that Californias marijuana system needs an intervention to prevent the legal market from collapsing.

Its time for Newsom and lawmakers to get to work to find the right balance that will help the legal, regulated market grow while protecting public health and the environment. We cant wait another five years to get this right.

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Editorial: Californians overwhelmingly supported legalizing marijuana. Why is it still a mess? - Los Angeles Times