Last October, when President Trump declared the opioid crisis a public health emergency and “a problem the likes of which we have not seen,” he declined to call for any additional funding to address the crisis and instead promised a “really tough, really big, really great advertising” campaign, as if replaying Nancy Regan’s “Just Say No” lecture is all someone addicted to OxyCodone, heroin or fentanyl needs to hear.
The nation’s effective response to addiction to opioids and other drugs and the related issues of public health and law enforcement are now further in danger of being set back 30 years by Attorney General Jeff Sessions’ announcement last week to rescind Obama-era guidance on a federal “hands-off” response to marijuana prosecution in states that have legalized medical and recreational cannabis.
Never mind that Sessions is backtracking on a repeated pledge by Donald Trump during the presidential campaign that he would not go after states that had legalized marijuana because he was “a states’ (rights) guy,” and Session’s own promise to senators prior to his confirmation that he would leave in place what is called the Cole Memo. It’s up to Republicans and other supporters of federalism to consider Trump’s and Sessions’ commitment to that conservative ideal.
And never mind that a recent Gallup poll found that 64 percent of Americans favor legalization of marijuana and its support among Republicans was 51 percent.
What is more damaging is what Sessions’ reversal will mean for public health and a just and fair application of the law.
Because Sessions can’t dictate the actions of state and local law enforcement, he instead is limited to directing the 93 U.S. attorneys to use their own discretion within their districts in prosecuting marijuana cases, lifting the Cole Memo’s guidance that advised using the Justice Department’s limited resources to pursue only those cases involving children, drug cartels, transportation across state lines and driving under the influence of cannabis.
The result could mean that prosecution of cases in states such as Washington, Oregon and now California, could be determined by where someone lives. An Everett owner of a retail cannabis shop might not face being shut down, while one in Walla Walla could.
Sessions’ decision also is likely to reverse progress that had been made in getting banks and insurance companies to work with legitimate retail shops to provide their services. This, according to a commentary in The Hill, will mean more cash on the street and less financial accountability for the cannabis industry. And that will drive out more of the “good actors,” who are now growing, manufacturing and marketing marijuana, allowing the black market to again fill the vacuum.
But Sessions’ action also threatens to stymie research into the potential that marijuana has to directly aid in the fight against opioid addiction as well as its use in treatment of other medical conditions.
A handful of pharmaceutical companies are in the early stages of research and development of marijuana-based painkillers, which would offer an alternative to highly addictive opioids, Scientific American and Reuters reported last summer, research that has been aided by medical marijuana laws in 29 states and the District of Columbia. Multiple studies have shown that states where medical marijuana is legal report fewer deaths related to opioid addiction, Reuters reported last year.
Marijuana-based painkillers, some with their psychoactive properties lessened or removed, could be a boon to pain treatment. While all medications have side effects, cannabis-based medications would seem to be a far-safer and far less-addictive alternative to opioids. And there has yet to be a reported case of a fatal overdose from marijuana.
But opening up the doors to more research and development would require the reversal of a U.S. Drug Enforcement Agency decision from 2016. Washington state and Rhode Island asked the DEA in 2011 to review marijuana’s federal Schedule 1 classification, which lumps it in with dangerous drugs that lack any medical application, such as LSD and heroin. The states sought a reclassification of cannabis as a Schedule 2 drug, joining drugs with medical uses, such as oxycodone, methadone and Adderall, a move that would have made it easier to research medical applications and treatments.
The DEA — using circular logic more fitting a pot-induced fog — declined, reasoning that because marijuana lacked any accepted medical use, it would not reclassify cannabis and loosen restrictions on research that might then result in accepted medical uses. Rather than pursuing marijuana prosecutions, Sessions should be encouraging the DEA to reclassify marijuana and ease rules on research.
Because of opioid addiction, we are facing a disease that killed 59,000 Americans in 2016. It is, as Trump correctly declared, a public health emergency.
But worse than ignoring the crisis, the response that the Trump administration has laid out — failing to make investments to bolster a public health response to opioid addiction and wasting time and resources on marijuana — amounts to a surrender of lives and resources to opioids.