The Science of Toxicology and U.I. or "Under the Influence and/or Intoxication?" of Cannabis/Marijuana and D.O.A. Drug Testing


The Official Court Documents that I present to you below here, {THIS ONE TIME, FOR FREE = this offer will not last and is for a limited amount of time = THIS SET OF DOCUMENTS WILL GO MISSING AND A FEE WILL BE CHARGED LATER FOR THIS INFORMATION} The following Documents were presented, accepted and registered by the Criminal or Courts as "Evidence" as they were listed by the Kentucky Courts in a case I recently Advocated in on behalf of James E. Coleman.
Are in fact, the PROOF, that Cannabis/Marijuana/Hemp or Unspecified levels of Cannabinoids are natural within the human body and that their presence or levels or "analytical threshold" combined with the fact that this test measures "no quantification of a specific compound" in the blood, are proof, there has been no measure of  intoxication, performed by this test where cannabiniods are concerned and that this test can not show toxicity.
According to this Expert Witness.
Therefore they are unable to test levels for intoxication as they claim is claimed by the manufacture of the test and/or Law Enforcement in U.I. charges or related cases. These documented facts apply to the Test it’s self given and the Cannabinoid levels… Therefore apply to all these D.O.A. = "Drug of Abuse" Blood Serum U.I. Test used by Law Enforcement and Not the Individual. As these facts apply to all humans and all these Test.




Every 25 seconds in the United States, someone is arrested for the simple act of possessing drugs for their personal use…

Interview: Why the US Should Decriminalize Drug Use




Neal Scott may die in prison. A 49-year-old Black man from New Orleans, Neal had cycled in and out of prison for drug possession over a number of years. He said he was never offered treatment for his drug dependence; instead, the criminal justice system gave him time behind bars and felony convictions—most recently, five years for possessing a small amount of cocaine and a crack pipe. When Neal was arrested in May 2015, he was homeless and could not walk without pain, struggling with a rare autoimmune disease that required routine hospitalizations. Because he could not afford his $7,500 bond, Neal remained in jail for months, where he did not receive proper medication and his health declined drastically—one day he even passed out in the courtroom. Neal eventually pled guilty because he would face a minimum of 20 years in prison if he took his drug possession case to trial and lost. He told us that he cried the day he pled, because he knew he might not survive his sentence.[1]


Just short of her 30th birthday, Nicole Bishop spent three months in jail in Houston for heroin residue in an empty baggie and cocaine residue inside a plastic straw. Although the prosecutor could have charged misdemeanor paraphernalia, he sought felony drug possession charges instead. They would be her first felonies.

Nicole was separated from her three young children, including her breastfeeding newborn. When the baby visited Nicole in jail, she could not hear her mother’s voice or feel her touch because there was thick glass between them. Nicole finally accepted a deal from the prosecutor: she would do seven months in prison in exchange for a guilty plea for the 0.01 grams of heroin found in the baggie, and he would dismiss the straw charge. She would return to her children later that year, but as a “felon” and “drug offender.” As a result, Nicole said she would lose her student financial aid and have to give up pursuit of a degree in business administration. She would have trouble finding a job and would not be able to have her name on the lease for the home she shared with her husband. She would no longer qualify for the food stamps she had relied on to help feed her children. As she told us, she would end up punished for the rest of her life.


Every 25 seconds in the United States, someone is arrested for the simple act of possessing drugs for their personal use, just as Neal and Nicole were. Around the country, police make more arrests for drug possession than for any other crime. More than one of every nine arrests by state law enforcement is for drug possession, amounting to more than 1.25 million arrests each year. And despite officials’ claims that drug laws are meant to curb drug sales, four times as many people are arrested for possessing drugs as are arrested for selling them.

As a result of these arrests, on any given day at least 137,000 men and women are behind bars in the United States for drug possession, some 48,000 of them in state prisons and 89,000 in jails, most of the latter in pretrial detention. Each day, tens of thousands more are convicted, cycle through jails and prisons, and spend extended periods on probation and parole, often burdened with crippling debt from court-imposed fines and fees. Their criminal records lock them out of jobs, housing, education, welfare assistance, voting, and much more, and subject them to discrimination and stigma. The cost to them and to their families and communities, as well as to the taxpayer, is devastating. Those impacted are disproportionately communities of color and the poor.

This report lays bare the human costs of criminalizing personal drug use and possession in the US, focusing on four states: Texas, Louisiana, Florida, and New York. Drawing from over 365 interviews with people arrested and prosecuted for their drug use, attorneys, officials, activists, and family members, and extensive new analysis of national and state data, the report shows how criminalizing drug possession has caused dramatic and unnecessary harms in these states and around the country, both for individuals and for communities that are subject to discriminatory enforcement.

There are injustices and corresponding harms at every stage of the criminal process, harms that are all the more apparent when, as often happens, police, prosecutors, or judges respond to drug use as aggressively as the law allows. This report covers each stage of that process, beginning with searches, seizures, and the ways that drug possession arrests shape interactions with and perceptions of the police—including for the family members and friends of individuals who are arrested. We examine the aggressive tactics of many prosecutors, including charging people with felonies for tiny, sometimes even “trace” amounts of drugs, and detail how pretrial detention and long sentences combine to coerce the overwhelming majority of drug possession defendants to plead guilty, including, in some cases, individuals who later prove to be innocent.

The report also shows how probation and criminal justice debt often hang over people’s heads long after their conviction, sometimes making it impossible for them to move on or make ends meet. Finally, through many stories, we recount how harmful the long-term consequences of incarceration and a criminal record that follow a conviction for drug possession can be—separating parents from young children and excluding individuals and sometimes families from welfare assistance, public housing, voting, employment opportunities, and much more.

Families, friends, and neighbors understandably want government to take actions to prevent the potential harms of drug use and drug dependence. Yet the current model of criminalization does little to help people whose drug use has become problematic. Treatment for those who need and want it is often unavailable, and criminalization tends to drive people who use drugs underground, making it less likely that they will access care and more likely that they will engage in unsafe practices that make them vulnerable to disease and overdose.

While governments have a legitimate interest in preventing problematic drug use, the criminal law is not the solution. Criminalizing drug use simply has not worked as a matter of practice. Rates of drug use fluctuate, but they have not declined significantly since the “war on drugs” was declared more than four decades ago. The criminalization of drug use and possession is also inherently problematic because it represents a restriction on individual rights that is neither necessary nor proportionate to the goals it seeks to accomplish. It punishes an activity that does not directly harm others.

Instead, governments should expand public education programs that accurately describe the risks and potential harms of drug use, including the potential to cause drug dependence, and should increase access to voluntary, affordable, and evidence-based treatment for drug dependence and other medical and social services outside the court and prison system.

After decades of “tough on crime” policies, there is growing recognition in the US that governments need to undertake meaningful criminal justice reform and that the “war on drugs” has failed. This report shows that although taking on parts of the problem—such as police abuse, long sentences, and marijuana reclassification—is critical, it is not enough: Criminalization is simply the wrong response to drug use and needs to be rethought altogether.

Human Rights Watch and the American Civil Liberties Union call on all states and the federal government to decriminalize the use and possession for personal use of all drugs and to focus instead on prevention and harm reduction. Until decriminalization has been achieved, we urge officials to take strong measures to minimize and mitigate the harmful consequences of existing laws and policies. The costs of the status quo, as this report shows, are too great to bear.





The DEA is withdrawing a proposal to ban another plant after the Internet got really mad

By Christopher Ingraham October 12 at 10:42 AM

The Drug Enforcement Administration is reversing a widely criticized decision that would have banned the use of kratom, a plant that researchers say could help mitigate the effects of the opioid epidemic.

Citing the public outcry and a need to obtain more research, the DEA is withdrawing its notice of intent to ban the drug, according to a preliminary document that will be posted to the Federal Register Thursday.

The move is “shocking,” according to John Hudak, who studies drug policy at the Brookings Institution. “The DEA is not one to second-guess itself, no matter what the facts are.”

The DEA had announced in August that it planned to place kratom in schedule 1 of the Controlled Substances Act, the most restrictive regulatory category, as soon as Sept. 30. But since announcing their intent to ban kratom, the “DEA has received numerous comments from members of the public challenging the scheduling action,” acting administrator Chuck Rosenberg wrote in the notice, “and requesting that the agency consider those comments and accompanying information before taking further action.”

A spokesman for the Drug Enforcement Administration did not immediately respond to requests for comment.

[What it’s like to be high on kratom, according to the people who use it]

Kratom is a plant from southeast Asia that’s related to coffee. It contains a number of chemical compounds that produce effects similar to opiates when ingested.

People who take it have have said kratom helped them overcome addiction to opiates or alcohol and treat otherwise intractable pain. Researchers say that their work with kratom could eventually lead to the development of nonaddictive alternatives to powerful opiate painkillers. Placing kratom in schedule 1 would cripple researchers ability to study the drug, they say.

U.S. lawmakers were among the groups expressing their displeasure with the DEA’s intent to ban kratom. A group of 51 U.S. representatives wrote to the DEA saying that the DEA’s move “threatens the transparency of the scheduling process and its responsiveness to the input of both citizens and the scientific community.”

Another group of nine senators said the DEA’s “use of this emergency authority for a natural substance is unprecedented,” and urged the administration to reconsider.

The DEA will now open up a period for public comment until Dec. 1 of this year. It is also asking the FDA to expedite a “scientific and medical evaluation and scheduling recommendation” for the active chemical compounds in kratom.

At the close of the comment period, a number of things could happen. The DEA could decide to permanently place the plant in a schedule of the Controlled Substances Act, which would require an additional period for lawmakers and the public to weigh in. It could also decide to temporarily schedule kratom, which would not require any additional comment.

It could also decide to leave kratom unregulated.

[Police arrest more people for marijuana use than for all violent crimes — combined]

Advocates for kratom use, who say the plant has helped them treat pain and stop taking more powerful and deadly opiate painkillers said they are elated.

“I am in tears,” Susan Ash of the American Kratom Association said in an email. “Our voices are being heard, but we still have a long road ahead of us.

Lawmakers who criticized the initial announcement to ban kratom are also pleased. “Concerned citizens across the country have made it clear, they want the DEA to listen to the science when it comes to the potentially life-saving properties of kratom,” said Mark Pocan (D.-Wis.) in an email.

Researchers are welcoming the move, but they point out that the future of their work with the plant is an uncertain one.

“It’s certainly a positive development,” said Andrew Kruegel of Columbia University in an email. Kruegel is one of the researchers working to develop next-generation painkillers based on compounds contained in kratom.

Kruegel says that the FDA’s evaluation of the drug will carry a lot of weight in the DEA’s decision. But the kind of rigorous, controlled trials that the FDA typically refers to in situations like this simply don’t exist for kratom.

“Unfortunately, in the United States I don’t think we have a good regulatory framework for handling this situation or taking perhaps more reasonable middle paths” between banning the drug outright or keeping it unregulated, Kruegel says.

Still, he says, “the FDA is a scientific agency rather than a law enforcement agency, so I am encouraged that they will now be having more serious input on this important policy decision.”

Marc Swogger, a clinical psychologist at the University of Rochester Medical Center who has published research on kratom use and earlier called the decision to ban the plant “insane,” said in an email that “I’m happy to see this. It is a step in the right direction and a credit to people who have spoken out against scheduling this plant.”


New Study Confirms Marijuana Use Up Drastically in Workforce

Cully Stimson / @cullystimson / October 12, 2016 / comments

This November, there are a record number of ballot initiatives in at least nine states regarding so-called medical marijuana or outright legalization of the Schedule I drug. The pot pushers, both small businesses and large, want more people smoking, eating, and consuming more pot because it is good for their bottom line.

Before voting yes, voters—and, in particular, employers—should take a look at more disturbing data that was released two weeks ago at a national conference.

At the annual Substance Abuse Program Administrators Association conference, Quest Diagnostics—one of the nation’s largest drug-testing companies—unveiled the results of its Drug Testing Index. The index examines illicit drug use by workers in America each year.

In 2015, Quest examined more than 9.5 million urine, 900,000 oral fluid, and 200,000 hair drug samples. Following years of decline in overall illegal drug usage, the results showed that the percentage of employees testing positive for illicit drugs has steadily increased over the last three years to a 10-year high.

The Drug Testing Index is an analysis of test results from three categories of workers—including federally mandated, safety-sensitive workers, the general workforce, and the combined U.S. workforce

Oral fluid drug testing results—best at detecting recent drug usage—showed an overall positivity rate increase of 47 percent over the last three years in the general workforce to 9.1 percent in 2015 from 6.7 percent in 2013.

According to Quest, the increase was “largely driven by double-digit increases in marijuana positivity.” In fact, according to the report, in 2015 there was a “25 percent relative increase in marijuana detection as compared to 2014.” The report also showed a significant increase in heroin positivity in urine tests for federally mandated safety-sensitive employees.

Another disturbing trend is the rising positivity rate for post-accident urine drug testing in both the general U.S. and the federal mandated, safety-sensitive workforces. According to the index, post-accident positivity increased 6.2 percent in 2015, compared to 2014, and increased a whopping 30 percent since 2011.

To those of us who have warned about the growing liberalization of the use of marijuana, from so-called “medical marijuana” to recreational abuse of the Schedule I drug, the results of the index are all too predictable.

It is also not surprising that none of the major organizations that push for pot legalization and decriminalization of marijuana have written major stories about the Quest Diagnostics report.

The more people use marijuana, the more likely it is that those who work and are subject to testing will pop positive for marijuana, even in safety-sensitive jobs. Think about that next time you hop on an airplane, ride Amtrak, or go about your daily life thinking everyone is focused on their job and your safety.


Why are more Americans in jail for marijuana use than violent crime?

More people in the United States are now in jail for marijuana possession than for all violent crimes combined, a new study finds….On any given day in the US, at least 137,000 Americans are in prison on drug possession, not sales, charges, says a new report that finds that the “tough on drugs” policies may be disproportionately affecting low-income, black Americans.

By Ellen Powell, Staff October 12, 2016

More people in the United States are now in jail for marijuana possession than for all violent crimes combined, a new study finds….

The report, released Wednesday by the American Civil Liberties Union and Human Rights Watch, points out that violent crime arrests in the US have dropped 36 percent in the past two decades. Meanwhile, arrests for drug possession – including marijuana and other illicit drugs – are up 13 percent. Those arrests tend to be concentrated in neighborhoods with high crime rates, where police officers are on the lookout for any offense. As a result, lower-income, black Americans are most likely to be arrested for possessing even trace amounts of illicit drugs. (Black Americans are 2.5 times as likely to be arrested on drug-related charges, according to federal data, even though they use drugs at the same rate as white Americans.) Those who can’t afford to post bail spend substantial amounts of time in jail, even before their case goes to trial.

Tougher sentencing was intended to get chronic repeat offenders off the street, reduce drug use, and protect public health. But the “tough on drugs” policy prevalent since the 1980s isn’t working, the report argues. Criminalizing drug possession is derailing individuals’ lives and hurting the families who depend on them, while doing little to prevent drug use and abuse.

“While families, friends, and neighbors understandably want government to take action to prevent the potential harm caused by drug use, criminalization is not the answer,” Tess Borden, the study’s author, said in a Human Rights Watch press release. “Locking people up for using drugs causes tremendous harm, while doing nothing to help those who need and want treatment.”


Test your knowledgeHow much do you know about marijuana? Take the quiz

The report comes at a time when the Obama administration and a bipartisan effort in Congress has already taken steps at judicial reform. For example, the 2010 Fair Sentencing Act erased a 5-year-minimum sentence for simple crack possession. As The Christian Science Monitor reported, “much of the Obama administration’s work has been done courthouse by courthouse. For one, the Department of Justice has guided prosecutors to curb the use of mandatory minimums for drug crimes. But the president has also made broader strokes.” 

Since 2014, the Obama administration expanded the criteria for clemency-seekers, leading to hundreds of who were given long-term sentences for drug charges to be released. 

But the ALCU report says that in some states, such as Texas, a “habitual offender” law means prosecutors still can push for longer sentences, including life sentences, for those with two prior convictions. The actual amount of the drug that individuals possess doesn’t matter.

And what most concerns many low-income Americans is the impact on families. While the accused are in jail, even before trial, they’re not earning a wage, meaning that in some homes the water and lights could be cut off. A woman in Louisiana with a prison record told the rights groups that because of her probation, her family could not get food stamps for a year. That means her children will be eating whatever she can find in the dumpster, she explained. It can also be hard for those arrested to find a job when they get out. 

“When you’re a low-income person of color using drugs, you’re criminalized…. When we’re locked up, we’re not only locked in but also locked out. Locked out of housing…. Locked out of employment and other services,” said one New York City man who had been repeatedly arrested for drug charges over the past 30 years.

Criminalizing drugs, the report says, can actually increase the risks associated with drug use. Driving traffic underground “discourages access to emergency medicine, overdose prevention services, and risk-reducing practices such as syringe exchanges.”

The report calls for an increase in rehabilitation programs and a move to treat drug use as a public health issue, rather than lumping it in with violent crime. That’s an approach the Obama administration is on-board with, Mario Moreno, spokesman for the Office of National Drug Control Policy, suggested. “We cannot arrest our way out of the drug problem,” he told CBS.


Marijuana Possession Played Key Role in Police Shooting of Keith Scott

By Daniel Politi


Possession of marijuana played a significant role in the police killing of Keith Lamont Scott on Tuesday. Charlotte-Mecklenburg Police Department Chief Kerry Putney said during a news conference that officers were trying to serve a warrant for someone else when they spotted Scott rolling “what they believed to be a marijuana ‘blunt’" in his car. At first they allegedly didn’t think much of it, until they saw Scott had a weapon and thought, “uh oh, this is a safety issue for us and the public,” Putney said.

Putney spoke at a news conference in which he announced police would release body cam and dash cam videos of the encounter.

Along with the videos, the police also released a statement on what is known about the case. Although at first “officers did not consider Mr. Scott’s drug activity to be a priority” that changed once they saw him hold up a gun. “Because of that, the officers had probable cause to arrest him for the drug violation and to further investigate Mr. Scott being in possession of the gun.”

The police released photographs of the gun, ankle holster and joint he had on him at the time of the shooting.

“It was not lawful for [Scott] to possess a firearm. There was a crime he committed and the gun exacerbated the situation,” Putney said. The press conference marked the first time law enforcement had mentioned the detail about the marijuana.

“Due to the combination of illegal drugs and the gun Mr. Scott had in his possession, officers decided to take enforcement action for public safety concerns,” notes the statement.

Putney continued to insist that Scott “absolutely” had a gun, although he acknowledged that wouldn’t be clear from the released video. He also stood by earlier statements that the shooting was justified and officers acted lawfully. “Officers are absolutely not being charged by me at this point,” he said.

The official police statement says officers “gave clear, loud and repeated verbal commands to drop the gun” but Scott “refused to follow the officers repeated verbal commands.” And then Scott “exited the vehicle with the gun and backed away from the vehicle while continuing to ignore officers’ repeated loud verbal commands to drop the gun.” That was seen as “an imminent physical threat” and an officer opened fire. A lab analysis “revealed the presence of Mr. Scott’s DNA and his fingerprints” on the gun that was loaded, notes the police statement.

Daniel Politi has been contributing to Slate since 2004 and wrote the "Today’s Papers" column from 2006 to 2009. You can follow him on Twitter @dpoliti.


Kratom Advocates Sip Tea and Seethe at White House Rally Against DEA Ban

One user plans to move to Canada. Another plans to quit. Many more don’t know what to do.

By Steven Nelson | Staff Writer Sept. 13, 2016, at 6:20 p.m.

Several protest attendees brought their own bottle of kratom tea Tuesday to the White House. Those who did not were offered a Solo cup.

Several protest attendees brought their own bottle of kratom tea Tuesday to the White House. Those who did not were offered a Solo cup. Steven Nelson for USN&WR

Hundreds of passionate protesters gathered Tuesday near the White House to demand that the popular plant product kratom remain legal. It was jointly a business industry conference, a tea party and a desperate consumer lobbying effort — but the clear-eyed crowd appears to have little chance of near-term victory.

A comprehensive U.S. ban likely will take effect on Sept. 30, just a month after the Drug Enforcement Administration surprised users by saying it would invoke emergency powers to make leaves from the tree grown in Southeast Asia illegal by labeling two main constituents Schedule I substances.

In the face of long odds and silence from Capitol Hill, the event called by the American Kratom Association sought to pressure officials to reconsider while laying the groundwork for what may become a protracted re-legalization campaign.

A large jug of brewed kratom sat in the middle of Pennsylvania Avenue, with red Solo cups offered to anyone who wanted some. At least one reporter sipped the brew, which tasted like astringent green tea. Another journalist took a pill offered as a free sample by a businessman.

Kratom users who attended the rally said it’s wrong for them to lose legal access to what they say is an effective treatment for pain, addiction, depression and other conditions.

Though many said they were angry, chant-leaders asked the crowd of a couple hundred to stay on message and favored reason over rage, which often is a leading emotion at White House protests staged by marijuana reform advocates who say decades in Schedule I has stalled medical cannabis research amid millions of arrests.

“I’m usually very quiet but felt the need to come out and speak,” says Veronika Bamford-Conners, a kratom-selling store owner from Sullivan, Maine, where, she says, most of her customers are older than 55.

“If they don’t have insurance and can’t afford medications, they find a cheaper alternative in kratom,” she says, though some seem to prefer relief from the leaf to painkillers, such as a 73-year-old man who she says called her weeping “because pharmaceuticals were killing him” before.

Chants at the rally advertised the death toll from accidental overdoses of opioids – more than 28,000 in 2014 alone, including legal painkillers and illegal drugs like heroin – with the low or nonexistent U.S. toll from kratom.

The DEA says it believes 15 deaths were caused by kratom, though American Kratom Association founder Susan Ash says the group hired a toxicologist who concluded each case could be attributed to other drugs.

Many kratom users say the plant has helped them abstain from substances they formerly were addicted to, often heroin or prescription painkillers.

“Kratom saved me, I was a bad heroin addict,” says David Allen, who traveled from Chapel Hill, North Carolina. “It keeps cravings away and helped me not drink. I came because I don’t want to lose my medicine.”

Allen says that although the DEA – and even some former kratom users – say the drug can lead to dependence, it’s nothing like the grasp of opioids. He says he believe it’s about as abusable as coffee, which comes from a related plant, and that like coffee withdrawal, ending kratom can cause minor headaches.

Brad Miller, a physics teacher at Spotsylvania High School in Virginia, says he drinks small amounts of kratom tea between three and five times a day to treat arthritis in his knees. He says the effects are “very mild” and “just enough to take the edge off so I can get through my day standing.”

Miller says prescribed painkillers from his rheumatologist were too strong and that unlike opioids he hasn’t developed an addiction to kratom. He says he went on a weeklong camping trip and – unlike the experiences of some users – felt no withdrawal symptoms.

“I didn’t have withdrawal symptoms, but I did have arthritis pain,” he says. “I’d be surprised if anyone has experienced strong withdrawal symptoms.”

Though Miller and others at the event said they aren’t sure what they will do at the end of the month, Heather Hawkins says she’s made up her mind to move to Canada, where kratom remains legal.

Hawkins, a journalist with northern Florida’s Pensacola News-Journal and owner of the Kratom Literacy Project, says she has an incurable bladder disease and is eyeing Vancouver after already moved to the Sunshine State from Alabama in reaction to a local kratom ban.

Talk about moving abroad often is spouted unseriously by political partisans around election time, but Hawkins says she’s completely serious after living in a painkiller-induced haze that left her depressed and unable to get out of bed.

“I’m not going to stay here [if the ban takes effect] because I’m not going back to that life,” she says.

Hawkins says she’s in addiction recovery from cocaine, which she says she used as self-medication to give her the energy to power through her pain and despair, and that if she regarded kratom as a drug she would not take it.

Though kratom is widely known for claims that it can help keep opioid addicts clean, it’s also credited with sapping desire for other substances.

Jeremy Haley, owner of Colorado’s Rocky Mountain Kratom, says he began using kratom in 2012 after a drunk driving arrest, and that it has helped veer him away from his alcoholism, which runs in the family.

Although the ban hasn’t yet taken effect, Haley says local officials have shut down his shop for what he views as dubious reasons, making him unable to sell the remaining inventory – the latest in what he says has been a constant regulatory headache that featured him asking Yelp reviewers to delete positive reviews to placate federal officials who wanted proof he was not marketing kratom for human consumption.

Haley plans to open a totally legal apothecary shop if the ban takes effect.


Pot Breathalyzer Hits the Street

A futuristic drug-detecting fingerprint scanner may soon follow.

The Law of Unintended Consequences: Illicit for Licit Narcotic Substitution

Image result for heroin plant

Originally written July 15, 2014 at LINK below

Martin R. Huecker, MD and Hugh W. Shoff, MD, MS


The dealers will not use it. Heroin dealers have explicit knowledge of the addictive properties of their product. The heroin addict is no longer the desperate character living under a bridge. She is a 17-year-old high school senior who runs out of her grandmother’s oxycodone. He is the stockbroker who weighs the economics of purchasing one oxymorphone on the street for $100 or ten doses of heroin for $200. Because these people are ingesting and injecting products of unknown composition and unfamiliar potency, they can potentially overdose. If lucky, they end up in the emergency department rather than the morgue.

Kentucky ranks third in the nation in drug overdose mortality rate per 100,000 persons, with opioid pills making up the majority.1 In response to these statistics, the State of Kentucky passed House Bill One (HB1) in April 2012, effective October 2012. Also known as “the pill mill bill,” HB1 contains provisions intended to limit opioid prescriptions by pain management physicians and by other acute care providers such as emergency physicians. To prescribe narcotic pain medications, physicians must perform a full history and physical, prescribe only a short course, educate the patient on risks of controlled substances, and obtain a report from a statewide prescription monitoring program (PMP) (Kentucky All Schedule Prescription Electronic Reporting [KASPER]).2

As a result, the number of registered KASPER users in Kentucky has gone from 7500 to 23,000 from December, 2011 to November, 2012. Reports are up from 3300 to 17000 in the same time frame.3 According to the same press release, Kentucky witnessed a decrease of 10.4% total prescriptions in the first six months since HB1 was enacted.3

Mandating PMP reports, as sixteen states currently do, leads to an increase in reports, but so far no statistical difference in opioid overdose mortality.1,4,5,6 In fact, this legislation may not even lower the rate of opioid consumption, rather may shift which opioids are being prescribed.6

Researchers in Ohio looked at the impact of real time PMP information on opioid prescriptions. With PMP data, providers changed prescriptions in 41% of cases; 61% giving fewer opioids but 39% prescribing more opioids.7

House Bill One was intended to and has reduced opioid prescriptions in Kentucky. Forty-four pain clinics in Kentucky closed overnight.8 Preliminary analysis at a large, metropolitan emergency department has shown a decrease in prescriptions for hydrocodone and oxycodone, along with a decrease in ED administration of these medications. This type of “pill mill” legislation has been passed in Louisiana, Florida, Texas and California with varying results.9

Florida had a sharp decrease in opioid prescriptions after similar legislation. Having 90 of the top 100 physicians on the Drug Enforcement Agency (DEA) 2010 list of top opioid purchasers, Florida saw the number decrease to 13 in 2011, and zero as of April 2013.10 In 2011, Ohio passed a “pill mill bill” to crack down on pain management clinics.11 This legislation led to seizing of 91,000 prescription pills with 38 doctors and 13 pharmacists losing their medical licenses. In the end, 15 medical professionals were convicted on diversion charges.11 With all of this, pill overdose deaths began to decline, but heroin overdoses “skyrocketed.”11

The unintended but foreseeable consequence of such measures has been increase in distribution, abuse, and overdose of heroin. Heroin has gained market share in a similar way in the past. In 2010, Purdue Pharma began manufacturing a reformulated OxyContin after a $600 million fine for misrepresentation.12 Endo Pharmaceuticals Inc. followed in 2011 with an Opana ER reformulation. This resulted in making the pills harder to crush into powder for snorting or injecting.13,14 States such as Florida, Ohio, Minnesota, and Utah have seen patients turn to heroin after crackdown on prescription opioid availability.11,14

The New England Journal of Medicine warned us of what would be a two-fold increase in heroin use after the reformulation of Oxycontin.15 In the 2010 ODLL report, the United States DEA also attempted to warn health care organizations that Oxycontin users might switch to heroin.16,17 The first paper we know of to report this warning was published 3 years later in 2013.16 This paper, a qualitative study of the transition of opioid pill users to heroin users, provides insight into the economic and convenience factors associated with the switch. The researchers interviewed a small sample of heroin users, forty-one in all. All but one of the 19 heroin users aged 20–29 started with pills and progressed to heroin – “termed pill initiates.”16

Numerous popular news reports directly implicate decreased opioid pill availability in the rise of heroin abuse and overdose.16 However, very little discussion of this phenomenon has entered the emergency medicine literature.

The drug cartels have capitalized on the United States opioid appetite and now decreased supply of pills. The route from Mexico to Detroit, then south through Ohio, ends up in northern and central Kentucky. The Kentucky State Police recovered 433 samples of heroin in 2010. In 2012 the number was 1349.13 In Lexington, KY, the eight total heroin arrests in 2011 exploded into 160 in the first 6 months of 2013.18,19 Undercover narcotics officers in Lexington find it easier to buy heroin than marijuana.

Heroin-related overdoses in Kentucky increased from 22 cases in 2011 to 143 cases in 2012, and 170 in the first 9 months of 2013.8,20,21 Kentucky’s percentage of overdose deaths involving heroin went from 3.2 in 2011 to 19.5 in 2012 and up to 26 in 2013.8.21 This phenomenon has occurred in Florida, California, Massachusetts, New York, Oregon, Washington and Ohio.11,2224

The emergency medicine literature has minimal recent discussion of heroin overdose management in the ED; nor have we discussed secondary prevention. Supportive therapy suffices in the ED, with liberal naloxone use and airway protection. State and federal actions to curb heroin deaths can be effective. Good Samaritan laws, present in only one third of states, protect from prosecution those lay individuals attempting to help themselves or companions in overdose situations.

Also present in only one third of states are laws to expand community access to reversal agents such as naloxone. Twenty-two states have laws requiring or recommending education for opioid prescribers. Medicaid expansion to cover substance abuse treatment has occurred thus far in less than half (24) of states.1

As more states enact measures intended to reduce total opioid prescriptions, legislators and healthcare providers alike must be aware of the predictable and devastating rise in heroin sales, abuse, and overdose. Funding for this legislation should include monies allocated toward substance abuse treatment programs and availability of naloxone. Similarly, pill mill bills could universally be coupled with Good Samaritan laws in anticipation of the increase in parenteral opioid overdoses. Funds could be allocated to lay population education via public service announcements. Stricter punishments for drug traffickers could accompany such legislative changes. Many of these measures have been presented as interventions to combat prescription opioid abuse and can now be applied to the subsequent heroin abuse and overdose dilemma.9

At the first line of medical care, emergency physicians must be involved in efforts to minimize collateral damage in this long-term process of curing America’s addiction to opioid drugs and their horrible consequences.


Marijuana Missionaries: First Cannabis Church Rolls Into Michigan

There’s no religious dogma in this church, but these marijuana missionaries are intent in on bringing ostracized stoners back into the fold.

By Beth Dalbey (Patch Staff) – September 19, 2016 10:05 pm ET

Marijuana Missionaries: First Cannabis Church Rolls Into Michigan

Congregants in this church aren’t high on Jesus. In fact, the very name of the church sounds like lyrics from a rock and (ahem) roll song or the backdrop for a classic Cheech and Chong movie.

It’s true that First Cannabis Church of Logic and Reason’s sacrament might be a doobie or marijuana-infused brownie instead of the body and blood of Christ, and its dogma is steeped in giving thanks to the cannabis plant for its healing nature and the sense of well-being it gives users instead of Jesus’ sacrifices for sinners.

The church, made up of a congregation of mostly atheists and agnostics, made its debut in Lansing, Michigan, earlier this summer.

So, how can it be a church if its members eschew a higher power — beyond, that is, the feeling of euphoria they get from smoking pot or the satisfaction of using a sustainable crop for fuel and fiber?

“Well, the reality is it sounded better than a cannabis cult,” organizer Jeremy Hall told the Lansing State Journal after the congregation’s inaugural service last June that included time for fellowship and a potluck with “both medicated and non-medicated food.”

First Cannabis Church in Indiana

The First Church of Cannabis traces its roots to Indiana as a political statement in response to the Religious Freedom Restoration Act, backed by Indiana Gov. Mike Pence, now Republican presidential nominee Donald Trump’s running mate.

Self-anointed Grand Poobah Bill Levin has made all sorts of glib proclamations, including the Deity Dozen, which is sort of like the Ten Commandments— for example, “Do not be a ‘troll’ on the internet, respect others without name calling and being vulgarly aggressive,” and “Treat your body as a temple. Do not poison it with poor quality foods and sodas.” Also, don’t be a jerk, or words to that effect.

There are also marijuana-based churches in Florida, Alabama, Oregon and Arizona. Many of them embrace organized religion to one extent or another, but Hall is more resolute in his iteration.

At the First Cannabis Church of Logic and Reason in Michigan, it’s all cannabis, all the time — whether in its leafy tobacco form, as fiber for clothing, as a biofuel or for shelter, paper and plastics.

It’s a miracle,” Hall told The Detroit News. “It can save humanity. Cannabis is something to be put on a pedestal, to be revered.”

What’s God Got To Do With It?

An ordained minister with the online Universal Life Church and a marijuana caregiver who originally hails from Ypsilanti, Hall moved back to Michigan from Tennessee in part because legal medical marijuana is available for treatment of his wife’s lupus.

He hopes congregants at the Lansing church can change attitudes about pot smokers with service projects around the city, like a recent cleanup at a Lansing park.

From his early youth indoctrinated in the Young Earth Creationist congregation — a fundamentalist church that rejected evolution and forbade the use of radios because it supposedly played the devil’s music — to his new role as the founder of the First Cannabis Church of Logic and Reason, Hall has experienced both ends of the religious spectrum.

Though he rejected many of the tenets of his early teachings and other religions, he told The Detroit News he liked the fellowship aspect of church in general and the way a house of worship can gather in people who live on the margins. So he formed a church, taking God out of the equation.

Still, Hall’s church embodies the WWJD — “What would Jesus do?” — spirit more than you might think, even though it is not rooted in Christianity.

On a flyer seeking participants in a recent park cleanup, Hall acknowledged that pot smokers “have been demonized in the eyes of the public as miscreants and law breakers, ignorant and unmotivated.”

So, just as Jesus reached out to the disenfranchised, the church is a chance for Hall and his wife to reach out to people who have been “using cannabis and feeling ostracized” by their regular places of worship, Michigan Radio reported.

“We’re using our church to elevate the community and to show we aren’t a drain on society or a bunch of unmotivated criminals,” Hall told the Lansing State Journal.

Pot City, Michigan?

Not surprisingly, the church, located in the shadow of four medical marijuana dispensaries, has some detractors.

The Rejuvenating South Lansing citizens’ group, which wants more restrictions on dispensaries, worries the church further mainstreams marijuana use and will draw more users to the city.

“This is just another way they can do whatever they want,” Elaine Womboldt, the group’s founder, told The Detroit News. “We don’t want to be known as the pot city of Michigan.”

Also, at the first service earlier this summer, a lonely protester, Quaker traditionalist Rhonda Fuller, of Lansing, held a sign that warned the only people who benefit from marijuana are profiting financially from it: “It’s about money, not you. It’s misery for everyone else.”

Fuller told The Detroit News it’s unconscionable to call the First Church of Cannabis a church.

“Anyone can call anything a church,” she said. “It has nothing to do with Christianity — but neither does most churches.”


Is pot as dangerous as heroin? Feds’ decision on rescheduling marijuana coming soon

El Monte Police Lt. Christopher Williams looks over a portion of about 500 marijuana plants in various stages of growth after serving a search warrant at a home at 4300-block of Huddart Avenue in El Monte on Monday March 9, 2015.


By Brooke Edwards Staggs, The Orange County Register

Posted: 07/09/16, 8:37 PM PDT


At the same time Californians are preparing to vote on the legalization of adult marijuana use, the federal government is weighing whether pot should continue to be classified as a top-tier narcotic on par with heroin.

Within a month, the Drug Enforcement Administration is expected to release a much-anticipated decision that could alter cannabis’ ranking in the hierarchy of controlled substances — a formal listing that affects everything from medical research to taxing policy.

Since the list was created in 1970, marijuana has been ranked in Schedule I — the most restrictive category ­alongside heroin, LSD and peyote. The designation is reserved for drugs the DEA says have no proven medical use and are highly addictive.

What about Congress?

Even if the Drug Enforcement and Food And Drug administrations don’t recommend changing where marijuana falls on the controlled substances list, Congress could.

Elected officials are more likely to be influenced by growing public acceptance of marijuana — particularly if they represent one of 25 states with legal marijuana programs.

“I think that’s probably an easier sell than the decision coming from doctors and police,” said John Hudak, a deputy director with the Brookings Institution.

Some members of Congress support rescheduling marijuana, including Sen. Barbara Boxer. Some have even pitched descheduling it, including presidential hopeful Bernie Sanders. But none of those efforts gained traction, and Paul Armentano with the advocacy group NORML isn’t optimistic Congress will act on the issue anytime soon.

“I’m not aware of a single hearing much less a vote even in a subcommittee that has ever taken place at the Congressional level specific to the notion of reclassifying marijuana,” he said.

“We’re bound by the science,” said Melvin Patterson, spokesman for the DEA.

But many experts and advocates say the current classification is increasingly at odds with scientific studies on marijuana, which suggest the drug has medical value in treating chronic pain, seizures and a number of other conditions, with a lower addiction rate than alcohol.

The DEA ranking also lags behind a growing public consensus. Roughly 80 percent of Americans believe medical marijuana should be legal, according to recent polls, while some 60 percent support legalizing the drug for all adults.

“In 2016, this notion that cannabis possesses potential harms equal to that of heroin … simply doesn’t pass the smell test,” said Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, or NORML.

Medical marijuana is now legal in 25 states. Recreational use is allowed in four states plus Washington, D.C. If California green-lights recreational use this November, one in six Americans would live in a state where adults would be allowed to freely use cannabis.

The question of how cannabis should be ranked has been hotly debated since Congress placed it in the Schedule I group when it passed the Controlled Substances Act nearly 46 years ago. The drug’s classification has been reviewed periodically, with the latest reexamination prompted by a petition filed with the DEA five years ago by the then-governors of Rhode Island and Washington.

In April, the DEA advised Congress that it expected to announce a decision in the first half of 2016.

Patterson said officials now “clearly anticipate something happening in the next month.”

The agency has several options: keep cannabis as a Schedule I drug; reclassify some or all of its compounds to a lower schedule; or remove the plant from the controlled substances list altogether.

There is a greater chance than ever that marijuana will be rescheduled, said John Hudak, who studies the topic as a deputy director with the Brookings Institution. But he still expects pot to remain a Schedule I drug.


“It needs to cross a threshold that says it has an accepted medical value,” Hudak said. “While there are plenty of patients and doctors who do believe it has medical value, that’s not a universal belief in the medical community.”

Leslie Bocskor, president of Las Vegas-based cannabis advisory firm Electrum Partners, thinks the odds slightly favor a reclassification of marijuana to Schedule II. That category includes morphine and cocaine, which the DEA says are highly addictive but have some medical value. A form of cocaine, for example, is used by some dentists as a local anesthetic.

The least restrictive of the five schedule categories, Schedule V, includes cough syrup with a bit of codeine.

Alcohol and tobacco aren’t included on the DEA’s controlled substances list, even though federal studies have found both are associated with higher dependency rates than marijuana.

Patterson said the DEA frequently hears from people frustrated that marijuana hasn’t been rescheduled sooner.

“They have their mind made up on what marijuana does in the short term,” he said. “But what about different strains? What about 10 years from now or even 20 years from now? Long-term effects matter.”

For the medical marijuana community, even reclassifying cannabis as a Schedule II drug would offer some vindication.

“At a minimum, it would bring an end to the federal government’s longstanding intellectual dishonesty that marijuana ‘lacks accepted medical use,’ ” Armentano said.

Such a shift by the DEA also might offer a small boost to at least half-a-dozen states with medical or recreational marijuana initiatives on the ballot this November.

That potential to give some credence to legalization efforts is one of the reasons a few members of Congress, including Sen. Chuck Grassley of Iowa, and the organization Smart Approaches to Marijuana, or SAM, cite in arguing against reclassifying marijuana.

“Rescheduling would simply be a symbolic victory for advocates who want to legalize marijuana,” SAM wrote in a policy paper on the issue.

But both the California and American medical associations say rescheduling pot could lower the barriers a bit for federally sanctioned drug research.

The DEA has never turned down a marijuana research request that met federal criteria, Patterson said. But experts say red tape related to Schedule I drug research is so formidable that it discourages applications. So while there are tens of thousands of peer-reviewed studies on marijuana, there are few costly and rigorous double-blind, placebo-controlled trials involving cannabis.

Moreover, researchers say, marijuana studies are saddled with restrictions that don’t apply to other Schedule I drugs.

Since 1968, for example, the federal government has said only a tightly controlled stock of high-quality marijuana grown under contract by the University of Mississippi can be used for FDA-approved studies. Armentano said that restricts the supply available for research.

If marijuana were reclassified to at least Schedule III — alongside Tylenol with codeine and anabolic steroids — it would mean the nation’s rapidly growing number of cannabis-related businesses could begin deducting operating expenses from their federal taxes.

Under a tax rule imposed during the Reagan Administration’s 1980s anti-drug war, businesses dealing in Schedule I or II substances are prohibited from writing off common expenses such as rent, utilities or advertising.

Harborside Health Center, a large Oakland dispensary, has been battling the IRS over the rule for five years, after being assessed $2.4 million for illegal deductions. A decision in that case is expected soon.

Even if cannabis was moved down the controlled substances list to the least-restrictive category, the industry would still be likely to face business and regulatory hurdles.

Armentano likened such a change, should it come, to the first stride in a marathon.

“Technically, it gets you closer to the finish line,” he said. “But you still have a whole hell of a long way to go.”

Pot would remain an illegal substance under federal law. Reclassification wouldn’t necessarily open access to banking services, Hudak said. And doctors wouldn’t automatically switch to writing prescriptions, as opposed to “recommendations,” for medical marijuana, since that’s only allowed for FDA-approved drugs.

“There are certain people who play up rescheduling as an earth-shattering reform,” Hudak said. “It is not.”

He said sweeping changes would only come in the unlikely event that cannabis was completely descheduled, putting it on par with alcohol.

That would allow local governments to create cannabis policies free from federal interference, Armentano said, the way they can set their own hours for when bars stop serving alcohol or make entire counties “dry.”

Armentano isn’t optimistic the DEA will move marijuana to a less restrictive category, but he said there’s been one positive result from the current review.

“There’s attention being paid to how they handle this situation in a way that just wasn’t there before,” he said. “If the DEA goes down the same path as it has in the past, I think they’re going to have some explaining to do.”