Tag: drug policy

A primer on fentanyl(s)

The synthetic opioids - usually referred to both in the press and by law enforcement as “fentanyl” - have now outstripped not only the prescription opioids such as oxycodone but also heroin in terms of overdose deaths, and (as you can see below) the trend line is almost vertical.

Keith Humphreys warns of “fentanyl’s potential to permanently alter illegal drug markets.”

Kevin Drum asks about the causes of the change:   “Fentanyl has been around for a long time, and only recently has its use become widespread. Why?”

Why, I thought you’d never ask. Settle back; this is a complicated story, and it’s going to take a while to tell. But Keith is right: this is a BFD. So it’s worth understanding. Continue reading “A primer on fentanyl(s)”

Changing my mind on cannabis legalization in Arizona

Since I don’t vote in Arizona (though, as it happens, I was born there) I hadn’t studied the details of the cannabis-legalization proposition which will appear on the ballot there this fall. So when the Sandra Day O’Connor Institute invited me to join a panel discussion, I came in thinking only what I generally think about such measures:

  1. Cannabis ought to be legal. Prohibition has broken down to the point where the harms associated with trying to control an illegal market generating $40 billion a year in criminal revenues greatly exceed the benefits, and there’s no plausible route back to effective prohibition.
  2. We ought to legalize in a way that makes moderate use by adults easy, while discouraging the formation of bad cannabis habits (an increasingly common problem) and use by minors.
  3. Alcohol-style legalization, which is what the ballot propositions generally offer, is a bad way to do that, because a for-profit industry (like the existing illicit industry) will make most of its money selling to heavy daily users rather than casual users, and about half the daily users - by their own self-report - have lost control of their cannabis habits.
  4. There are lots of other, better options.
  5. Even within a for-profit model, there are plenty of ways to encourage temperance, starting with keeping prices high, restricting persuasive marketing, and requiring that sales clerks have training in pharmacology and the prevention of substance use disorders and a professional responsibility to give advice in the interest of their customers, not their employers.
  6. It would therefore be better to handle this through the usual legislative process rather than by initiative.
  7. To make that workable, Congress should act to allow states to legalize (waiving the federal criminal laws that would otherwise apply) if their plans to do so meet rather strict criteria, as determined by the Secretary of HHS and the Attorney General. Those waivers should have to be renewed periodically, in order to hold the states and the industry to the promises made in order to get them.
  8. But since the state and federal legislative processes clearly won’t do what a majority of the voters clearly want them to do, I’d vote for any halfway-reasonable legalization initiative, both to end the arrests sooner rather than later and to nudge the legislators along.

So, going in to the discussion, I was prepared to advise Arizona voters to hold their noses and vote “yes.”  That’s the same advice I’d give voters in California.

But clearly there are some propositions that are so bad, and so hard to fix, that the voters ought to reason the other way: vote “no” to encourage the advocates to come up with something less awful. My conclusion, after participating in the discussion, is that Measure 205 is bad enough to warrant that treatment.

What changed my mind?

Continue reading “Changing my mind on cannabis legalization in Arizona”

Mexico’s Missing Marijuana Mystery

Every year, soldiers roam Mexico’s hinterland in search of illegal marijuana plots. Massive eradication campaigns have been part of Mexican life since the 1940s. No other country on Earth has impounded so much cannabis for so many years.

That could be changing. According to recent official numbers (p. 51), marijuana seizures and eradication declined steeply in 2013, to lows unseen since the early 1990s. Does this signal a major policy shift? Maybe. Here are the facts:

  1. Between 1995 and 2012, marijuana seizures averaged 1631 metric tons per year. In 2013, the total haul was 972 tons, 40% below the historical average. Even more surprising, less than half of the impounded volume was captured in the second semester (Note: I estimated second semester numbers by looking at this, p. 34). Traditionally, marijuana seizures are heavily concentrated in the months of October and November, right after the crop. Somehow, that did not happen in 2013.
  2. Eradication numbers are even more striking. From 1995 to 2012, Mexican authorities destroyed an average of 24,120 hectares (59,601 acres) of marijuana plots per year. In 2013, only 5,364 hectares (13,254 acres) were eradicated, almost 80% below the historical norm. And again, not much seems to have happened in the second half of the year, i.e., the prime months for marijuana eradication.

So what explains those less than impressive results? There are three distinct possibilities: Continue reading “Mexico’s Missing Marijuana Mystery”

Congress meddles in DC cannabis policy. Bad move. Good results?

Congress meddles in DC cannabis policy. Bad move. Good results?

No, Congress shouldn’t have meddled in DC home rule by blocking the city from legalizing cannabis on the alcohol model. But the result is to leave in place the “Grow and Give” system the Washington voters approved. On its merits, that system deserves a trial, and we should watch the results closely

The (Drug Control) Empire Strikes Back

By and large, I’m not a fan of the work of the (self-appointed) Global Commission on Drug Policy. The Commission’s latest report draws strong conclusions:

Ultimately the most effective way to reduce the extensive harms of the global drug prohibition regime and advance the goals of public health and safety is to get drugs under control through responsible legal regulation.

Unfortunately, those strong conclusions aren’t backed with strong evidence or strong argument. Calling your drug laws “regulations” or “taxes” rather than “prohibitions” doesn’t make them any easier to enforce. The claim that it’s possible to “get drugs under control through responsible legal regulation” has, for now, to be filed under “Interesting, If True.” Experiments with legal supply of “cannabis, coca leaf, and certain novel psychoactive substances” are a good idea, but of course most of the action in the “war on drugs” is in cocaine, heroin and methamphetamine; the drugs we would most like to legalize in terms of reducing the costs of prohibition would be among the hardest to legalize successfully in terms of public health. (We always have the bad example of  alcohol - which causes more violence, more health damage, and more addiction than all the illicit drugs combined - staring down at us.)

That said, the frustration with current drug policies that motivates the Global Commission is entirely justified. Changing the goals and means of the current international drug control regime in the direction of less violence and less incarceration is harder and more complex than denouncing the drug war in abstract terms, and less dramatic than legalization, but it’s necessary and important work, and someone who reads the Commission’s reports but doubts the existence of a regulatory utopia might be motivated to engage in that work.

Naturally, the international drug control empire is going to fight back. Yuri Fedotov, one of its Grand Pooh-Bahs as Director of the UN Office on Drugs and Crime (serving, one might note, as the representative of a government with an especially stupid, vicious, and unsuccessful set of drug policies), says of the Commission report that “It’s very hard to reconcile these recommendations with the major provisions of drug-control conventions.” That, of course, is true.

But what Fedotov doesn’t say, and which is also true, is that it’s very hard to reconcile the premises of the drug-control conventions with observable reality. The Single Convention was written in 1961, before anyone knew about neurotransmitters and receptors. Why should we allow the outdated concepts embodied in that treaty and its successors - treating drugs with abuse potential as evil rather than risky, and assuming that the answer to illicit markets is always more and more law enforcement - to continue to dominate our thinking?

It’s too bad that many of the folks who are willing to say that the existing international drug control regime is based on fantasy insist on pushing the equal and opposite fantasy that there’s a magic wand called “regulation” that we could wave at the problem to bring it under control. But the first step in fixing something is noticing that it’s broken and the Global Commission has at least taken that first step. UNODC and its sister agency INCB, and their allies around the world, are still - if you’ll pardon the use of a technical term - in denial.

 

 

 

 

Bureaucratic politics 101: the U.S. adjusts its position on the drug treaties

INL’s Shawshank Redemption: thanks to cannabis legalization in WA and CO, the US now finds “flexibility” in the drug control treaties.

Historically, the United States was the chief architect of the prohibition-oriented international drug control regime, and among the most “hawkish” of the signatories (along with Sweden, France, Russia, Japan, and Singapore, and much of the Arab world). The U.S. did a bunch of finger-wagging at the Dutch for their relatively liberal policies. And the Bureau of International Narcotics and Law Enforcement in the State Department (“INL” in Alphabet-speak, informally “Drugs and Thugs”) has long been one of the more hawkish players in internal drug-policy debates.

The treaties, on their face, require the criminalization of not only drug dealing but drug use. One of the arguments made against the tax-and-regulation approaches adopted by initiative in Colorado and Washington State was that their adoption would put the country out of compliance with its treaty obligations. There are legal loopholes: the treaties acknowledge that their obligations apply to each signatory only insofar as consistent with its domestic institutional arrangements. Since the U.S. federal government, the party bound by the treaties, lacks the constitutional power to require criminalization at the state level, it’s not clear that the actions by Colorado and Washington State voters can be said to have been illegal under international law.

Uruguay has gone further, legalizing at the national level. The Uruguayan government argues that even that is allowed by the treaties, because the treaties recite the reduction of illegal drug trafficking and the protection of public health among their stated goals, and the Uruguayan law is designed to accomplish those goals. Whatever the merits of that argument legally - personally, I don’t think it passes the giggle test, though as a policy matter I’m glad Uruguay is making the experiment and hope it succeeds - it is one that the United States could once have been counted on to scorn.

And yet, when the U.N. Commission on Narcotic drugs met in Vienna last month, and some member countries got up to criticize the Uruguayan move (which the International Narcotics Control Board, the referee set up by the treaties, promptly denounced) the U.S. had no comment on that issue.

In part that reflects changing U.S. public opinion about cannabis, and the more liberal stance of the Obama Administration compared to its predecessors. But in part it reflects the fact that INCB also blasted Colorado and Washington State, putting INL in the position of having to defend the permissibility under international law of those regimes and of the accommodating stance toward them adopted by the Justice Department. So the voters in those two states in effect forced a change in our national stance in international fora.

Here’s Ambassador William Brownfield, the Assistant Secretary of State in charge of INL, explaining the new stance: the treaties, we are now told, are “living documents,” allowing “flexibility” in how different nations choose to meet their obligations, and we should seek a new consensus about what that means.

Obvious, once it’s happened. (It might not have happened in, say, the Romney Administration.) But, as far as I know, not predicted in advance by anyone, least of all by me.

Footnote It would be easier to take more seriously the self-appointed “Global Commission on Drug Policy” if spokespeople such as Michel Kazaktchine didn’t insist on making nonsensical claims, such as that minor drug offenses account for half of U.S. incarceration (the actual figure is more like 20% for all drug offenses) and that prohibition has failed to reduce consumption (compared to what?) and that alcohol and tobacco control via taxation and regulation have been more successful (by what measure).

Cannabis legalization and the empirical-minded median voter

Opinion shift toward support for legal cannabis has been decisive. But a plurality still says “Wait and see.”

No big surprises from the cannabis questions in the latest CNN-ORC poll. It looks as if the Gallup numbers from earlier in the year (58 for legalization, 39 against) were a bit of an outlier; the gap seems to be nearer 10 points than 20, which makes a difference. But the CNN-ORC findings, along with those from the Pew survey, confirm the decisive shift in public opinion. Support for legalization now has a clear majority. Most interesting finding, to my eyes: the new poll asked the question two ways:

“Do you think the use of marijuana should be made legal, or not?”

“Do you think the sale of marijuana should be made legal, or not?”

The answers were virtually identical: 55/44 for legal use, 54/45 for legal sale. So for those of us who have wondering whether the “use” question was inappropriately lumping supporters of decriminalization with supporters of full commercial availability, the answer is “No.” A majority really favors full legalization. On the other hand, when the question gets specific, the majority disappears:

“As you may know, Colorado now allows anyone over the age of 21 to purchase small quantities of marijuana for their own use from businesses that have been licensed by the state government to sell marijuana. Do you think this is a good idea or a bad idea, or do you want to see what happens in Colorado and other states that legalize marijuana before you decide how you feel about this matter?”   

“Good idea” leads “bad idea” by a small plurality, 33/27, but the largest group (37%) wants to wait and see.  Yes, of course phrasing the question that way encouraged the wait-and-see answer, but it’s encouraging that so many voters are empirically-minded on this issue rather than fixed in one of two fact-proof ideological camps.

Even among those who oppose legal pot, most prefer to have users pay fines rather than going to jail. And support for medical marijuana is overwhelming: 88/10.

All of this suggests that those who oppose legalization have chosen a grossly inappropriate strategy, if their objective is winning as oppposed to mere fundraising and personal advancement. Moral denunciation, opposition to medical research (with actual cannabis, not hypothetical individual molecules), and support for user penalties are all losing moves. Instead of simply posing  their own prejudices and certainties against those of the legalizers, they ought to offer cautious experimentalism. The median voter might buy “Wait and see,” if it appeared sincere. But she’s way past “No, nay, never!”

Footnote Logically, of course, “Wait and see” isn’t a clear pragmatic implication of uncertainty. Waiting also has costs. The right conclusion is “Make cautious changes that are easy to modify in the light of new evidence, and watch for that evidence.” The big problem for the “No” side is that if there are going to be large bad consequences from legalization, they will likely develop over years, not months.

Alcohol as a panacea

No, there’s no real proof that moderate alcohol use is good for health. Maybe moderation is good for health.

Everyone “knows” that two glasses of red wine a day are good for your health. But, as Will Rogers said, it’s not what you don’t know that hurts you: it’s what you know that ain’t so. A paper by Hans Olav Fekjær and commentaries by Jurgen Rehm and Sven Andréasson, all in the latest issue of Addiction, review the evidence.

Yes, moderate drinkers have better health, on many dimensions, than non-drinkers and heavy drinkers. That’s the problem: too many dimensions, with too little biological mechanism. The logical thought is that people who drink in moderation probably have, on average, better health habits in other respects than those who don’t drink at all, since by definition they’ve avoided taking their alcohol use to excess while the abstainers either haven’t run that risk or have found that they can’t drink just a little. It’s also the case that, in Western cultures, drinking is normal while non-drinking is somewhat deviant. The fact that in India, where drinking isn’t a social norm, drinking isn’t associated with better cardiovascular health seems to me to seriously weaken the case for a causal connection in other societies.

Why the “Moderate drinking is good for what ails ya” theory has found such ready acceptance, while a comparable finding about moderate cannabis use and academic performance was ignored, is left as an exercise for the reader.

Federalism and cannabis policy: the terms of a bargain

Policy waivers and Sec. 873 contractual agreements: how to use the states as laboratories for cannabis policy.

The Journal of Drug Policy Analysis has just published a new paper (behind a paywall) in which I offer two alternatives to the options currently in public discussion as to how the federal government can deal with state-level cannabis legalization.

This fall, Washington and Colorado intend to start licensing businesses to produce and sell cannabis under voter-passed initiatives, even though the stuff remains illegal under federal law. The federal government has not yet said what it plans to do about it, and its three obvious options – acquiescing, cracking down, and muddling through – all have fairly serious drawbacks.

A number of what Keith calls Formerly Important Persons have demanded that the feds crush the state-legal Colorado and Washington markets. Since every participant in those markets needs a license, that wouldn’t be hard to do: any federal judge would cheerfully enjoin someone applying for license to commit a federal felony from doing so.

But the state-legal commercial markets represent only one of three systems that can deliver cannabis to customers. The loosely-regulated “medical marijuana” markets would be a far tougher nut for the feds to crack. And the purely illicit system, which handles the vast bulk of transactions today, is way too big for 4000 DEA agents to suppress without help. More than 90% of arrests for growing and dealing marijuana are made by state and local cops. So the feds need state and local authorities in Washington and Colorado to maintain pressure on illegal growing.

Constitutionally, the states have no mandate to even have drug laws, let alone enforce them. In this case, federalism is more than a legal doctrine: it’s a brute fact.

So: Washington and Colorado would like the feds to let their new commercial systems operate. And the feds would like Washington and Colorado to suppress production for out-of-state sale. When each of two parties has something the other wants, that’s the basis for a bargain.

And the Controlled Substances Act (Sec. 873, if you’re keeping score at home) orders the Attorney General to cooperate with state and local officials in enforcing the law, and authorizes him, “notwithstanding any other provision of law,” to enter into “contractual arrangements” with states and localities. The paper proposes that he use that authority to make formal deals with Colorado and Washington in which the Justice Department would agree to keep hands off state-licensed businesses in return for the states’ active help in suppressing interstate trade. That wouldn’t make the state-authorized activity legal, but it could formalize a program of targeted, selective enforcement that would give state licensees an effective safe harbor.

That seems to me a clear second-best to my preferred option, which would be a Congressionally-authorized program of policy waivers. As with the waivers that allowed state-level experiments with alternatives to AFDC, cannabis policy waivers could allow the states, in good Brandeisian fashion, to act as the “laboratories of democracy” in a policy area where there is currently much more passion than knowledge.

Here’s the abstract of the paper:

Passage of marijuana-legalization initiatives in Colorado and Washington poses a problem for the federal government: marijuana remains illegal under federal law, but the federal government lacks the capacity to fully enforce that law without state and local cooperation. Complete deference to state legalization would put each state’s cannabis policy at the mercy of its neighbors’. A system of legislatively-authorized policy waivers would allow controlled exploration of alternative systems of control. In the absence of such authorization, the executive branch could use existing authority to craft cooperative agreements with the states intended to confine the effects of each state’s new policies within its own borders.

More detail in this UCLA press release.

Bob Young at the Seattle Times and Jordan Schrader at the News-Tribune have stories.

Rights, outcomes, and the Golden Rule in drug policy

In which Schelling, Rawls, Kant, and Jesus of Nazareth gang up on John Stuart Mill.

At yesterday’s Brookings/WOLA Congressional briefing on cannabis policy, I made my usual argument that (in rough numbers) 80% of the users of almost any drug use it moderately, take no harm from it, and do no harm to others, but that the other 20%, who use more than is good for them, account for 80% of the consumption and an even larger fraction of damage to themselves and others. My conclusion from that was the necessity of regulation, since the industry that sells the drug (or offers other potentially habit-forming services such as gambling) will always be financially dependent on dependent problem users, while the public interest is in serving the desires of non-dependent non-problem users while minimizing the number of dependent users.

Jonathan Rauch, who heads the Brookings side of the project, found that line of argument troubling. He asked me whether the interests of the responsible 80% should really have to yield to the interests of the irresponsible 20%. (Since the two groups aren’t distinguishable at a glance, there’s no way of restricting the consumption of problem users without somewhat inconveniencing non-problem users.)

That question, asked by someone whose intellect and ethical sensibility I have come to respect, led me to reflect on the difference between a moralistic or rights-based approach to a problem such as this one and a policy-analytic or outcomes-based approach. If you think of problem users and non-problem users as different people, it’s natural to ask which group’s interests ought to make way for the other’s. That seems to be a moral or constitutional question. But if you think of yourself as a potential user of a drug (or, as Jonathan suggested to me, the parent of a potential user), unable to know in advance whether your (or your child’s) use will remain controlled or will instead progress to dependency, and ask how much inconvenience in controlled use you want to sacrifice for protection against a bad habit, then you confront a practical problem rather than a moral one.

(Some readers will recognize in this Schelling’s solution to the puzzle of why it’s justified to save a larger rather than a smaller number of lives, when that’s the choice; if you imagine yourself as a member of one of the two groups, without knowing which one, it’s obvious you’d prefer a higher probability of survival to a lower one. Jonathan instead recognized this as a Rawlsian veil-of-ignorance argument, which also seems right to me.)

Of course, this same approach can be applied well beyond drug policy. Asking “How much do the non-poor owe to the poor?” is a moral question. Asking “How much protection would a reasonable person want against the risk of poverty?” sounds more like a computation. Of course, if you think of yourself as naturally immune to the risks of drug abuse or of poverty, you’ll be more inclined to let the drug abusers, and the poor, go hang. But that seems to me compatible neither with the Categorical Imperative nor with the Golden Rule. If we accept arguments from symmetry in physics, why not in ethics?