06/19/16 Doug McVay

We hear from Jesce Horton and Charlo Greene with the Minority Cannabis Business Association, and the US Senate Homeland Security Committee hears about harm reduction, supervised injection facilities, and heroin maintenance treatment.

Century of Lies
Sunday, June 19, 2016
Doug McVay
Drug War Facts
Download: Audio icon col061916.mp3



JUNE 19, 2016


DEAN BECKER: The failure of drug war is glaringly obvious to judges, cops, wardens, prosecutors, and millions more now calling for for decriminalization, legalization, the end of prohibition. Let us investigate the Century Of Lies.

DOUG MCVAY: Hello, and welcome to Century Of Lies. Century Of Lies is a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org.

Last weekend I attended a networking rally in Portland, Oregon, organized by the Minority Cannabis Business Association. Brought back some good audio for you. Let's get straight to it.

I'm at the Minority Cannabis Business Association networking rally here in Portland, Oregon, and speaking with Charlo Greene. Charlo, tell our listeners a little bit about yourself -- about your story, how you got here.

CHARLO GREENE: Well, I was working as a news anchor and journalist for some time. I learned about the real harm that prohibition was causing as a reporter in Anchorage, Alaska, and I decided to use the access that I had to create Alaska's first safe access point for patients, the Alaska Cannabis Club. And, as we grew, and I was the weed lady by night and reporter by day, it just wasn't sustainable and I knew I had to choose. And, it became really, really clear to me that I had become a journalist so I could be led to cannabis activism, and so I decided to step away from my job, my career, my life as I knew it, very publicly, and I did so on live TV, in September of 2014. And since then, I've been advocating for cannabis reform, advocating for greater diversity in the industry that we're forming now, and just really fighting for freedom and fairness.

DOUG MCVAY: Of course, you're now part of the Minority Cannabis Business Association, that's this event here. What's your role with MCBA?

CHARLO GREENE: Well, I'm on the board of advisers -- excuse me, Board of Directors. And I have been for some time, and so I, we're all working together, we're all different pieces of the puzzle nationally, soon internationally. Just throwing together what is that we need to address as far as education, social justice, what are the needs of communities of color and what can we do as people that are aware and that are in the industry? What can we do to connect those dots? So, that's what I'm here doing. As an individual, my, what I bring to the table is my ability to have these sorts of conversations, and to help facilitate conversations and to bring these sorts of things to light.

DOUG MCVAY: Now, there are going to be other networking rallies, I was on your website, you have other events going on. Are you going to have more of these around the west coast, around the country, what's happening?

CHARLO GREENE: Well, all around the country. Our next event is planned for northern California, right after, or right around the NCIA, National Cannabis Industry Association, business summit, in Oakland. So I believe that's June 22, head to MinorityCannabis.org to doublecheck that. But we plan on having a number of these events. I also have been organizing events where other members of Minority Cannabis Business Association have been attending, like the Cannabis Diversity Summit we held in Denver, Colorado. That was a huge turnout. We had a panel of industry leaders, all from communities of color, so it was the first time people that looked like me got to see us represented, in a form and fashion that was aspirational. And so it's great that Jesce's doing that here, and I look forward to helping him, and having him help me, and Go Green and the Minority Cannabis Business Association are working hand in hand to just reach out and welcome as many diverse people into the industry while we still have a chance in this space.

DOUG MCVAY: Terrific. Any closing thoughts for the listeners, I know you've got -- there's a lot of people here who'd probably like to talk to you.

CHARLO GREENE: Well, I plan on talking to a lot of these people on my own show, CharloGreene.com, you can find out more information about Charlo's Place, my talk show focused on exploring the world in weed. We're just getting started, so make sure that you tune in and check out what's really happening with the industry. It's a lot of fun. We have these different guests come over to my place, and we have a chef cook up some really great cannabis infused food for them, or we might be heading over to the dab bar, or farming my plants, because I need some help with that too. It's just a more intimate look at what's going on, so there isn't all that stigma and fear surrounding it. So that's Charlo's Place, and again CharloGreene.com is where you can find out more on that.

DOUG MCVAY: Terrific. Charlo Greene, thank you so much.

CHARLO GREENE: Thank you for having me.

DOUG MCVAY: That again was an interview with Charlo Greene. You can find out more about her at CharloGreene.com, that's CharloGreene.com.

We're here at the Minority Cannabis Business Association networking rally in Portland. I'm speaking with my friend Leland Berger. Lee, you were talking about some of the criminal law developments and especially about criminal record expungement. Could you give folks a quick primer on criminal record expungement.

LELAND BERGER: Well, we've been able to accomplish in Oregon a thing that even the New York Times noticed, that anybody with any prior marijuana conviction is now able to expunge it. And, the thinking was, as explained by Representative, soon to be state senator, Lew Frederick, that, you know, why should you be convicted of something that's now legal? And removing the prior convictions through a motion to set aside the record of the arrest and the conviction can help people who are applying for worker permits under the OLCC rules for the adult use system or for, or people who are applying for licenses as well.

DOUG MCVAY: And so, criminal record expungement, you apply to the court, petition the court, and they erase your record? How, I mean --

LELAND BERGER: Well, what they do is they seal the record, they direct the record of your arrest and conviction to be sealed. They instruct the state police and the local police agencies to remove it from the database. If you go online to the court databases and you search for the person's name, it's no longer there. If you call the court clerk, they say we don't have a file for that person. It works well like that. Where it's problematic is, that a lot of employers rely on these businesses that mine public data, and they don't always catch up with this kind of a change, so an employer could be checking with an agency that hasn't looked at the records that shows that you're able to seal the arrest and conviction record.

DOUG MCVAY: And then there's things like these mugshots websites, I mean, that wouldn't, it wouldn't take you off of one of those, would it, or would it?

LELAND BERGER: No, the mugshot websites is a thing that you have to handle individually. It's an unfortunate reality, but what you would need to do is send a copy of the order setting aside the record of arrest and conviction to the website, and demand that they delete it from the server.

DOUG MCVAY: Well, okeh.

LELAND BERGER: Kind of like a Hillary tweet, right? Delete this account.

DOUG MCVAY: Okeh, so, any thoughts for the listeners?

LELAND BERGER: Well, I think that the next session is going to be interesting, because at least Portland NORML is going to be moving forward to try to be a part of an effort to end cannabigotry, and to amend the Indoor Clean Air Act to allow the clubs to reopen, and also to create a server -- a temporary server event -- temporary server permits, temporary event permits, so that we can go to events, and cannabis can be distributed. It's kind of interesting to be in this room, which historically was where Oregon NORML handed out medical cannabis to patients for all those years. A lot of cannabis left this room for patients, so. Anyway. It's great seeing you, Doug. Thanks.

DOUG MCVAY: Leland, thank you, brother.

LELAND BERGER: You're welcome.

DOUG MCVAY: That was an interview with my good friend Leland Berger. Lee Berger is an attorney in Portland, Oregon.

I'm at the Minority Cannabis Business Association networking rally in Portland, speaking with Jesce Horton. Jesce, you're the founder and chairman of MCBA, right?

JESCE HORTON: That's correct, Doug, I am a co-founder and the chairman of Minority Cannabis Business Association.

DOUG MCVAY: Right on. I've talked to a few of the folks, a couple of your other board members, but tell me about the MCBA. What made you decide to -- why'd you do it?

JESCE HORTON: Yeah, sure, Doug. Well, I got into the industry myself after leaving the engineering profession, and saw the lack of diversity, right, the lack of people that I could reach out to directly about specific issues that people of color face in the cannabis industry. So, as I started to realize the dynamic and the different things that were holding people back, I realized, you know, not only was that going to be a problem for the industry, from a viewpoint or perspective in understanding that this cannabis prohibition has been used in so many different ways to target minorities and to keep them down, and that that type of perspective, as the industry is growing, is not good.

But also what I realized was that, from an economic standpoint, the industry was missing out. From communities of color, they were starting to get more bitter, right, about the cannabis industry, that not only do they not have a chance to benefit or be a business owner, or sometimes even have a job in the cannabis industry because of different things that have happened historically, but also, they weren't seeing the benefits in their community. They would see dispensaries that are moving in, and nobody worked in those dispensaries that looked like them, or nobody who owned those dispensaries, or that dispensary wasn't allocating any of that profit back to that community to help.

And in making those communities even more bitter about cannabis, and about prohibition, we're missing out on the opportunity to grow our diverse list of business owners, to grow a diverse list of employees, and as Sara Batterby, who was here speaking today said, that diversity most certainly means more dollars. Diversity most certainly means good business. And in looking at the overall business and health of the industry and sustainability, diversity has to be a cornerstone.

DOUG MCVAY: So, how has the, how's MCBA been doing?

JESCE HORTON: We've been doing fantastic. So, we started in October, we brought on some board members who we knew had unique perspectives into what was happening across the country, because these different pieces of legislation in different cities and different states happened so differently, we wanted to have a perspective and a viewpoint on exactly that was working. So we brought on new board members in October, we brought in a full slate of 15 board members, and then we launched the organization in April, once we had an idea of what type of programs we wanted to develop, what type of companies wanted to work with us, right, and we were able to really provide value to the members. Then we launched the organization on 4/20 of this year.

And since then, we have 900 members who have signed on, mostly individual members who want to learn about how the cannabis industry can benefit either their economic potential or their day to day life.

DOUG MCVAY: Now, you have a business here in Portland, right?

JESCE HORTON: Yeah, I do, I have a business in Portland, a cultivation facility called Panacea Valley Gardens as well as a dispensary that I'm partnered with some great people, called Panacea.

DOUG MCVAY: Terrific. And, well, how's business?

JESCE HORTON: You know, business is great, I think. Not so much from a money making standpoint, because of the different things we have to deal with, with tax codes, and the fact that we're just getting started from an adult use standpoint. However, it's been excellent in the ability to make a little money, be able to pay my bills, but be able to help a lot of people not only benefit from cannabis but benefit from the industry. So everything's been fantastic.

DOUG MCVAY: Cool. I'm curious, do you think you're going to go with the adult use market, or do you plan to stay with medical, or maybe both?

JESCE HORTON: You know, I think both. That's a good question. I have some really amazing medical patients who need assistance, and who are really relying on us. I want to make sure that we can continue to serve them in a way that is affordable and that's beneficial for them. And also beneficial for the people who are running that facility, so we're going to keep a portion of our facility medical, and what we may do is, we actually just closed on another building where we're going to open that up as an adult use facility. So we'll say both.

DOUG MCVAY: Where can people find out more about Minority Cannabis Business Association, and of course, do you have any closing thoughts for the listeners?

JESCE HORTON: Yeah, of course. If you want to learn more about MCBA, please go to MinorityCannabis.org. We also have an Instagram account, MinorityCannabis, Twitter, and Facebook. And the last thing that I really want to say is that, and I said it earlier today, is that this business, even though we exist to increase the number of people of color in the industry, ultimately for the purpose of improving the industry as a whole, it won't be done without everyone. We need, and as you can see in the room there was a large diversity of people who are both very involved in the cannabis industry, or who don't have any knowledge of the cannabis industry, and we understand that this industry was birthed from activists, from people who understand injustice, and who want to work to do the right thing. So even though we're the Minority Cannabis Business Association, it's going to take the majority, it's going to take the minority, it's going to take everyone to make this industry not just another industry, but a better industry.

DOUG MCVAY: Jesce, I just wish you all the luck in the world. Thank you so much.

JESCE HORTON: Thanks a lot, Doug, I really appreciate it, thank you so much for KBOO and all the sponsors here tonight, we wouldn't have been able to do it without you.

DOUG MCVAY: That was Jesce Horton, he is a co-founder of the Minority Cannabis Business Association. Before him, you heard Charlo Greene and Leland BergerI spoke with all of them at at networking rally in Portland, Oregon that was organized by the Minority Cannabis Business Association. For more information, check out their website at MinorityCannabis.org.

You're listening to Century of Lies, a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org.

The US Senate's Homeland Security and Governmental Affairs Committee recently held a roundtable discussion titled “America’s Insatiable Demand for Drugs: Examining Alternative Approaches.” The senators heard from a few really smart, articulate people, as well as one prohibitionist who had been part of the drug czar's office during the Bush administration. Let's hear from some of the smart articulate ones. First, here's Doctor D. Scott McDonald, a physician from Canada who's one of the researchers looking into heroin maintenance. Dr. McDonald is introduced by Senator Ron Johnson, a Republican from Wisconsin.

SENATOR RON JOHNSON: One thing I, we missed in my opening statement, I just want to lay out a couple of facts. The US has spent an estimated one trillion dollars on the war on drugs over the last 40 years. There are roughly 27 million illegal drug users in the US. In 2014, there were 47,000 drug overdoses, an average of 129 people per day. So it gives you kind of the magnitude of the problem. On an annual basis, we probably spend about 31 billion dollars on the war on drugs, and, certainly my conclusion would be is, we're not winning that war. So this is really about looking at different approaches. My own -- I had a nephew die of a fentanyl overdose in January, so, this affects every community in America.

But with that, again, I want to thank the witnesses. I know this has been kind of on again off again. I know, Dr. McDonald, you had probably a pretty fun flight, I love those redeyes myself, so I truly, truly appreciate you doing that, and we'll start off with Dr. McDonald. We'd like to give you guys, you know, about five minutes to do an opening statement, then we'll kind of get into a free flowing discussion. But our first witness is Dr. Scott McDonald, he's a physician lead at the Providence Crosstown Clinic in downtown Vancouver, British Columbia. Crosstown is the only clinic in North America providing opiate assisted treatment for people with severe opiate use disorders. Dr. McDonald.


SENATOR TOM CARPER: Did you fly in this morning?

D. SCOTT MCDONALD, MD: I flew in this morning, yes.

SENATOR RON JOHNSON: Make sure your microphone is in.

SENATOR TOM CARPER: Can I get you a cup of coffee?

ETHAN NADELMANN: I'll pinch him.

D. SCOTT MCDONALD, MD: At Providence Crosstown Clinic, a hundred --

SENATOR RON JOHNSON: Push it right next to your mouth.

SENATOR TOM CARPER: Go like this and see if it's working. Go on.

D. SCOTT MCDONALD, MD: A hundred and forty people are receiving daily treatment with injectable opioids, an intensified form of medication assisted treatment. And I want to thank the government of British Columbia for supporting our clinic, and making the delivery of this treatment possible in Vancouver. About half are receiving treatment with hydromorphone, a widely available licensed pain medication. The remainder receive diacetylmorphine. Our patients can come up to three times a day for treatment. Half come twice per day, and the other half come three times a day. About a third take a small dose of methadone with their last session at night. All these patients have a chronic disease, a medical condition for life that can be successfully managed. Treatment prevents withdrawal, and stabilizes their lives. Here they have an opportunity to deal with underlying psychological and mental health issues. In time, some will step down to less intensive treatments, or gradually wean themselves off.

These patients were all participants in SALOME, the Study to Assess Longer-term Opioid Medication Effectiveness. SALOME was the follow-up to NAOMI, the North American Opioid Medication Initiative, which showed that diacetylmorphine, or prescription heroin, is superior to methadone in that group of patients who continue to use illicit heroin despite attempts at the standard treatments. A small group of NAOMI folks received hydromorphone, and in a surprise finding, these experienced drug users could not distinguish which treatment they received. And the beneficial treatment effect was preserved in the hydromorphone arm.

Some people suffering from severe opiate use disorder need an intensified treatment like this. While methadone and buprenorphine are effective treatments for many people, and should remain the first line responses, no single treatment is effective for all individuals. Every person left untreated is at high risk for serious illness, and premature death. Despite positive results for diacetylmorphine published in the New England Journal of Medicine, only Denmark acted on these results and incorporated prescription heroin into their health system. But it did lead to our follow-up study, and testing of hydromorphone or Dilaudid as a potential treatment. And hydromorphone has the advantage over diacetylmorphine of already being a licensed pharmaceutical.

The SALOME group underwent stringent testing and controls to show need for treatment. For them, the standard treatment, suboxone and methadone, had not worked, and most had multiple prior attempts at treatment. They had used injectable opioids for at least five years, and on average 15 years. They had medical and psychological health problems. They had nearly universal involvement in the criminal justice system. In short, we were able to recruit those patients appropriate for an intensified treatment like this.

At the start of the study, they were using illicit opioids every day. And by six months, their use was down to just three to five days per month.

SENATOR TOM CARPER: Excuse me, three to what?

D. SCOTT MCDONALD, MD: Three to five days per month. Nearly 80 percent were retained in care, and that high rate continues to this day. At outset, they were engaged in illegal activities on average 14 days per month, and with treatment, that reduced to less than 4 days. This study was published this past April in the Journal of the American Medical Association Psychiatry. And I'd like to acknowledge Health Canada for allowing us to investigate this important scientific question, and allowing for a number of our patients to continue on diacetylmorphine, those who need it on a compassionate basis.

Supervised injectable hydromorphone is indicated for the treatment of severe opioid use disorder, and we are using injectable hydromorphone as a medication assisted treatment, an intensified medical intervention as part of the treatment continuum. Severe opioid use disorder is a chronic disease that needs to be managed long-term, just like type 2 diabetes or hypertension. Without our treatment, this group's only option would be illicit opioids through the narco-capitalist networks.

We still have people who use drugs on the street in Vancouver, but we have another option in addition to needle exchanges: supervised consumption rooms.

SENATOR RON JOHNSON: What do you call it, supervised consumption --

D. SCOTT MCDONALD, MD: Supervised consumption rooms, or injection sites. These are legally protected places where drug users consume pre-obtained illicit drugs in a safe, non-judgmental environment. Vancouver has two such sites. These sites provide an important entry point for people into medical care and substance treatment. They also provide value over needle exchanges alone, as needles and equipment are all contained onsite, and needles will not end up in playgrounds or schoolyards, where they could cause injury. To contrast with these harm reduction interventions, our clinic, Crosstown, we are providing a medical treatment, providing injectable medication in a specialized opioid clinic under supervision of medical professionals, not only ensuring the safety of the patients and the community, but we also provide comprehensive care.

We are able to use hydromorphone off-label in Canada for treatment of substance use disorder, but some jurisdictions restrict its use to pain. I have seen remarkable transformations in our patients. Some of our patients have already returned to work or school. Supervised injectable hydromorphone is safe, effective, cost-effective. It's a useful tool when the standard treatments are not effective. Treatments are dispensed within our opioid treatment clinic and prescribed on a dispensing basis onsite. In this setting, hydromorphone is not susceptible to diversion, and an exemption for its use could be considered in jurisdictions where its use to treat substance use disorder is prohibited by law.

In British Columbia, we need every tool in the toolkit to rise to this challenge of opioid epidemic. Injectable opioid assisted treatment in a supervised clinic is one effective approach. Supervised consumption rooms, like Insite in Vancouver, are valuable for public health. Of course, we would like to see an end to people dependent on heroin. But, for those already suffering, it is essential to provide care, and care based on evidence.

DOUG MCVAY: That was Dr. Scott McDonald, a Canadian physician and researcher, speaking before the US Senate Homeland Security and Governmental Affairs Committee. Now, let's hear an exchange between Senator Kelly Ayotte, a Republican from New Hampshire, and Arlington, Massachusetts Police Chief Frederick Ryan.

SENATOR KELLY AYOTTE: What can we do? We're supporting the CARA for, that I think are, we need to expand the treatment of those who are, and the demand side.


SENATOR KELLY AYOTTE: But, I just, chief, I don't know, what's your thoughts?

CHIEF FREDERICK RYAN: Yeah, you know, in Massachusetts, under Governor Baker's leadership, we've got the State Without Stigma campaign, which has been incredibly effective. One of our treatment providers is the face of the State Without Stigma campaign. Coming from the governor's office. That messaging was huge in terms of us going out and having dialogue at community meetings, and people saying, hey, this is coming from the governor's office, this is important stuff. You know, and it further illustrates --

SENATOR KELLY AYOTTE: Let me say, I admire Governor Baker's leadership on this, and I thank him for it.

CHIEF FREDERICK RYAN: I do too, he's been incredibly effective, and he invited Chief Campanello and I, when he signed the legislation. But, you know, we can't keep drugs out of our prisons. You know, if we think we're going to keep it off the streets of America through heavily weighted enforcement priorities, we're simply, we've simply got it wrong. And so it speaks to the need for treatment and prevention. And I've learned a lot during this process. And the other notion, that we need to have a bed for everybody, you know, and that goes with the stigma too. I need to be in some bed somewhere in some institution because I have this substance use disorder.

SENATOR KELLY AYOTTE: Do you have a lot of medication assisted treatment, and something that isn't an institutionalized --

CHIEF FREDERICK RYAN: And that's where I was going with this, you know, and the physicians can speak to this better than I can, but as I understand it, the one addiction that's most likely to respond to a medication assisted treatment is an opiate addiction. And we've seen, with Vivitrol, like the senator mentioned, incredible effectiveness, and we've partnered with a Vivitrol clinic. One of the challenges there, and one of the things, you know, your committee might be able to look at, is it's incredibly expensive. And so, we've got patients that we've got into a Vivitrol clinic, and they go for many, many months, and they've, they're over the physical addiction, now this has become sort of a bit of a crutch, you know, and getting, weaning them back off Vivitrol is becoming challenging as well.

SENATOR KELLY AYOTTE: We also have caps on certain forms of treatment as well --


SENATOR KELLY AYOTTE: -- that need to be addressed, that we've pushed. I just want to make sure that, as I look at, to your point, Dr. Murray, you know, one gram of fentanyl is the equivalent, according to the CDC, of 7,000 street doses of heroin. So this obviously is a very, very powerful synthetic drug. As I, the drug deaths in my state are being driven by fentanyl. I mean, that is where we've seen a marked, losing a person a day, by the fentanyl. And, as we talk about increasing the efforts on treatment and, obviously, I wouldn't have led the effort on CARA with great people like Ron, and prevention, which I think is key and we have not invested enough and that we need to invest more. Chief, I know you want that to be your emphasis and I'm with you and I've got my local chief from, Nick Willard, who's the chief in our largest city, Manchester, who's a great guy, and he'll say the same thing to me. But, also, he'd say to me, I don't want you to totally give up on the demand, and so, whether it's the fentanyl piece or, so I hope we're not saying that, we're not going to totally abandon our demand efforts, but we need to do more focused on the treatment.

DOUG MCVAY: That was from a Senate Homeland Security and Governmental Affairs Committee roundtable discussion on drug use in America. In that last segment we heard New Hampshire Senator Kelly Ayotte; Arlington, Massachusetts police chief Frederick Ryan; and Ethan Nadelmann, executive director of the Drug Policy Alliance [note: Ethan's comments were cut for time -- maybe next week].

And well, that's it for today. Thank you for joining us. You have been listening to Century Of Lies, a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org. The Drug Truth Network is on Facebook, please give its page a like. Drug War Facts is on Facebook too, give it a like and share it with friends. You can follow me on Twitter, I'm @DougMcVay and of course also @DrugPolicyFacts.

We'll be back next week with thirty minutes of news and information about the drug war and this Century Of Lies. For now, for the Drug Truth Network, this is Doug McVay saying so long. So long!

For the Drug Truth Network, this is Doug McVay asking you to examine our policy of drug prohibition: the century of lies. Drug Truth Network programs archived at the James A. Baker III Institute for Public Policy.