Which Pharmacy Chain is Truly Anti-Smoking?

CVS Pharmacies recently took the remarkable step of ending its sales of tobacco products nationwide. The remaining US pharmacy chains were recently asked to follow CVS’ lead by a range of public health advocacy groups including the American Academy of Pediatrics, the American College of Cardiology, the American Lung Association, Action on Smoking & Health, the Campaign for Tobacco Free Kids, Legacy, the National African American Tobacco Prevention Network and the Trust for American’s Health.

But one prominent organization refused to sign: The American Cancer Society. Peter M. Bach, M.D., wondered why this was so, and more generally why Walgreens, which continues to sell coffin nails, draws more praise from the American Cancer Society than does CVS. His answer:

the society received donations from the pharmacy chain…the chain fund-raises for the Cancer Society from its customers, through things like keypad donations at checkout counters.

The American Cancer Society points out, and Bach acknowledges, that Walgreens is a leader in providing anti-smoking programs for its employees. But this is a paltry financial commitment to the cause compared to that of CVS, which is forsaking $2 billion in annual sales. As Bach sees it, the American Cancer Society is giving Walgreens cover to not acknowledge its hypocrisy:

at the end of the day a corporate vision “to be the first choice in health and daily living for everyone in America” is incongruous with selling the leading cause of preventable death at your cash registers.

News Chew

The DEA has apparently been staking out Midwest Hydroganics of Illinois for a few years; 46-year-old Angela Kirking is only the most recent individual to be hassled after shopping there. Whether or not the search warrant holds, discovering some weed in a lady’s “art room” seems like a waste of clean uniforms.

In the gritty TV show where I imagine all drug raids take place, pulling up a few grams of weed is hardly a DUN DUN DUN moment. I can’t think of a more benign place for marijuana to be found than in the art room of some funky lady who paints faces for a living and eats the petals off her organic hibiscus plant.

Now that she knows the DEA is watching the spot she bought some compost at that one time, she does not plan to take her business elsewhere.

“I’d love to send all my friends [to Midwest Hydroganics] to see how far they take this.”

Her new goal in the drug war is to run the DEA around until they tucker themselves out. This week I am helping my landlord put in a bunch of raised beds and beside the buttloads of weed the City of Oakland requires we grow, I will be sticking in a hibiscus.

Stories like these don’t help the DEA with their reputation for being a little silly and maybe a lot deaf.  In a press conference last week DEA Chief Michele Leonhart provided a pull-quote for all saying the trend of relaxing opinions on cannabis in the U.S. only makes her “fight harder.”

It’s unnerving for a government agent to declare that citizens don’t know what’s good for them and the more those citizens change their minds, the harder that agency will resist changing gears. Because you’ll see, you’ll all see!

America is uninterested in seeing the Angela Kirkings of the world arrested at gunpoint for a stash of what they probably adorably still call dope. But for each article written about an upper-middle-class white lady getting arrested for possession, law enforcement arrests lots of black and brown people for pretty much the same thing without the media saying “boo.” Articles like the one in the Shorewood Patch get picked up because they fit a certain storyline. More on that in a later post

Anyway, if all this seems anecdotal, here comes some fun new data from Pew Research showing that most people in the U.S. think cannabis will eventually be legal everywhere. Regarding the “hard” drugs, a growing majority of Americans believe time and resources are better spent on recovery than prosecution. Also cocaine use is down (yay) and heroine use is up (boo).

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

A Different Approach to State-Federal Marijuana Enforcement

In Colorado and Washington now and presumably in other states in the next few years, marijuana legalization exists in strange world of federal-state confusion. Producing, selling and using the drug is legal in states that opt for legalization, but remains illegal at the federal level. This has implications for infrastructure (e.g., whether banks will allow marijuana dispensaries to open accounts) and for taxation (e.g., whether the IRS will allow marijuana producers to deduct expenses). It also has implications for the future, as the next president and attorney general could decide to ramp up federal enforcement at a moment’s notice.

One commonly proposed solution to all these challenges is for the federal government to proactively accommodate legalizing states. Mark Kleiman has argued that the federal government should issue revocable waivers of the Controlled Substances Act (CSA) to states that want to conduct legalization experiments.

A new paper by Erwin Chemerinsky, Jolene Forman, Allen Hopper and Sam Kamin argues that a different approach to cooperative federalism is possible and has been used with other laws:

We propose an amendment to the CSA that would allow states and the federal government to cooperatively enforce and regulate marijuana. As with the Clean Air Act, Clean Water Act, and Affordable Care Act, state law would govern in states that have legalized recreational or medical marijuana, and federal law would supplement state law only when states defer to federal law or fail to satisfy federal requirements. Just as the Environmental Protection Agency works with states to enforce air and water pollution laws, federal agencies could continue to cooperate with opt-­‐out states and local governments to enforce marijuana laws. However, state laws and regulations would control within those states’ borders, rather than the CSA.

As a non-lawyer, I don’t have the chops to evaluate their legal argument, but if you do or just want to learn more about another proposal to resolve the current federal-state conundrum regarding marijuana, you can download the full text of the paper for free here.

News Chew

What responsibility does the cannabis industry have to keep their marketing away from children?

Partnership at Drugfree.com, formerly Partnership for a Drug-Free America, has decided against running ads critical of cannabis legalization in Colorado and Washington, but they will be staging an educational PR campaign focused on how legalization could affect minors.

Does free speech mean that cannabis sellers should be able to advertise wherever they want? Marketing restrictions are in place in both Washington and Colorado, but CEO of the Partnership Steve Pasierb has said he believes those restrictions will ultimately fall apart in court. It seems natural that cannabis marketing could go the way of liquor and cigarettes but it has been well argued that those restrictions don’t go far enough. Will it take a lawsuit settlement to restrict cannabis marketing for good?

http://adage.com/article/news/anti-drug-ad-group-fighting-legalized-pot/292263/

Different Perspectives on How to Legalize Marijuana

The New America Foundation and Washington Monthly hosted an intelligent and engaging group of guests this morning who debated how marijuana should be legalized. One thing that is evident on the panel and is also occurring around the country is that while liberals and libertarians often agree that they want marijuana prohibition to end, they don’t agree on the best form for a legalized market. Broadly speaking, liberals tend to be more skeptical of corporate control of the endeavor (e.g., as exists for tobacco) than are libertarians. Wherever you stand, watching this program is well worth your time.



Video streaming by Ustream

News Chew

On Monday Mississippi Gov. Phil Bryant signed a bill requiring any individual seeking Temporary Assistance for Needy Family (TANF) cash assistance who are deemed “reasonably likely to have a substance use disorder” to undergo drug testing before they can receive cash support.

Does this program provide effective incentives for addicts to get clean? Or is it essentially punitive? Does this mean families with an addict head of household will have to jump through more hoops to pay their and their children’s expenses? How does this help?

Those who test positive for a controlled substance may still receive cash assistance if they enroll in and complete an offered drug treatment plan. Cash assistance will end if any follow-up drug test (during or after treatment) is positive, with substantial waiting periods to re-apply: 90 days for the first positive test, 12 months for the second. Individuals chosen for drug testing will be determined by their answers to a written questionnaire.

It looks like the screening process won’t effect TANF food stamps or EBT, so reflects a logic that a drug addict cannot be trusted with cash money.

Bryant said the new program will “make a positive difference for families impacted by substance abuse,” indicating that the screening process is an appropriate part of the TANF program’s mission to provide a “safety net for families in need.”

It goes into effect July 1st.

The bill: http://billstatus.ls.state.ms.us/documents/2014/html/HB/0001-0099/HB0049SG.htm

Gov. Phil Bryant’s March 12 press release http://www.noodls.com/view/80D7DF07DB8AEEB593396EC182D7A0FDDB18BD57?1267xxx1394671736

Reason, Hit & Miss: smoking edition

Libertarians, like stopped clocks, are right twice a day. Jacob Sullum at Reason Hit & Run has a fine time taking down an astoundingly silly piece in the New York Times, which uses the fact that nicotine is toxic in large doses to claim vendors are “selling a poision by the barrel.” Of course e-cigarette “juice” comes with some risk of accidental poisoning, but so does gasoline. And gasoline doesn’t have any promise of eliminating hundreds of thousands of smoking deaths per year.

I’d say that the NYT piece reads like parody of public-health hysteria, but in fact the fringes of the public-health community do a form of self-parody beyond the capacity even of The Onion. (Had you heard that people who don’t use e-cigarettes in order to quit cigarettes don’t quit cigarettes? And that therefore e-cigarettes aren’t helpful in quitting smoking? Srsly.)

Score one for the libertarians.

On the other hand, another Hit-and-Runner furiously denounces the Maryland legislature for raising tobacco taxes, a demonstrably effective means of reducing smoking, because a predictable side effect will be increased smuggling from states with lower taxes. Libertarian conclusion: cigarette taxes are evil. Alternative conclusion: cigarette taxation should be a federal rather than a state matter, or alternative the federal government should provide incentives for high-tax states to moderate their levies and for low-tax states to raise theirs. After all, it takes two to make a price gradient, and the health benefits of coordinating on higher rather than lower taxes are obvious. (Jon Caulkins and I argue for doing something to protect poor elderly addicted smokers from the personal-budget impact of higher taxes, but of course as long as e-cigarettes are taxed at lower rates than tobacco cigarettes they have a self-help alternative.) Of course it’s all due to “politicians’ appetite for other people’s money,” as if citizens didn’t want public services or as if public services didn’t have to be paid for. Since, outside of Libertarianland, we have to tax something, why not tax things we want less of (bad habits, pollution, and congestion) rather than things we want more of, such as work?

What’s ultimately boring about libertarianism is the utter predictability of most of its adherents. You don’t have to ask them what they think about an issue, or bother them with facts: all you have to do is compare the issue with their prejudices.

Footnote Sullum rather lost his temper when I pointed out that his over-the-top attacks on President Obama’s cannabis policies reflect the partisan bias of the people who pay the bills at Reason.com. But when the House of Representatives passed a bill that in effect demanded that the Obama Administration crack down on cannabis legalization in Washington State and Colorado, Sullum criticized the bill (while of course piling on examples of what he taxes to be the Obama Administration’s lawlessness). But he never quite manages to say that what the House Republicans unanimously voted for amounts to a demand that people go to federal prison for selling cannabis in states that have chosen to regulate the drug rather than prohibiting it. This is an issue on which the Administration and all but five of the House Democrats came down on Sullum’s side of the question, while all the House Republicans came down on the other side. But somehow that issues in an even-handed denunciation of “partisanship” rather than a clear statement that anyone who wants more liberal laws about cannabis ought to punish the Republicans by voting Democratic, or at least staying home.

Note also the difference in Sullum’s language. He turned his own misunderstanding of the Controlled Substances Act, and the court cases interpreting that act, into an accusation that the President “had not read” the law. Sullum treats the House Republicans much more gently; their treatment of drug issues is “the weakest part of their case against [Obama].” In fact, of course, it’s Constitutionally illiterate. The Congress passes laws, but the decision to prosecute – or not – resides in the executive branch. Sullum and his colleagues play for the Red Team; that’s their right, and their occupation. The readers of Reason, however, should be aware of the fact, and take what is written there with the requisite complement of sodium chloride.

Link of the Day

Republicans jump on the legalizing kick because marijuana’s an industry now and We Love Industry. I don’t know how to make an emoticon of a smiley face with $$ for eyes but if I did this is where I would put it.

http://www.latimes.com/nation/la-na-pot-lobby-20140323,0,3970994.story#axzz2wvbcwpdi

 

Talking cannabis in DC Friday morning

The Washington Monthly and the New America Foundation will sponsor a discussion of cannabis policy, featuring a number of the usual suspects. Be there, or be square. Here’s the announcement:

The Corporate Takeover of Marijuana

Friday, March 28, 2014 – 9:30am – 11:00am
New America Foundation
1899 L Street NW Suite 400
Washington, DC 20036

The practical question is no longer whether to legalize marijuana; a solid majority of Americans now favors it, and state after state is moving in that direction. The practical question is how to legalize it without greatly expanding the incidence of problem use and use by adolescents.

The current issue of the Washington Monthly offers a strong critique of the trend toward commercialization, loose regulation, and low taxes as states “issue local licenses to commit federal felonies.” Drug policy expert Mark Kleiman proposes, as an alternative, a change in federal law that would allow state-level legalization, but only on terms designed to prevent market domination by large corporate enterprises whose profits will come not from selling pot to occasional smokers but from expanding the ranks of daily (even hourly) habitual users via exploitative marketing techniques like TV commercials on Super Bowl broadcasts. And Jonathan Rauch argues that the biggest threat marijuana legalization is bad implementation of the kind we saw last fall with health care exchanges.

Join the conversation online using #potinc and following @NewAmerica and @washmonthly.

If you are unable to join us in person, please tune in to our live webcast of the event. No sign up is required to view the streaming video.

PARTICIPANTS

Mark Kleiman
Professor of Public Policy, University of California Los Angeles
Co-author, Marijuana Legalization: What Everyone Needs to Know

Alison Holcomb
Criminal Justice Director, ACLU of Washington State

Jonathan Rauch
Senior Fellow, the Brookings Institution

Sue Rusche
President and CEO, National Families in Action

Moderator:
Paul Glastris
Editor in chief, the Washington Monthly
2009-2010 Bernard L. Schwartz Fellow, New America Foundation

Introduction:
Phillip Longman
Senior Research Fellow, New America Foundation
Senior editor, the Washington Monthly