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People Visiting Safe Injection Sites Are Less Likely To Die Compared To Other Drug Consumers, Study Finds

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As a growing number of Democratic presidential contenders are voicing support for harm reduction programs such as supervised injection facilities (SIFs), a recent study shows that these candidates are on the right track if they’re really interested in helping save the lives of people who use currently illegal drugs.

Researchers in British Columbia, Canada, found that people “who reported using supervised injection facilities on an at least weekly basis had a reduced risk of dying compared to those who reported less than weekly or no use of this health service.”

Previous studies have shown that safe injection sites help reduce overdose deaths. However, there are only approximately 140 legally operating sites in the world, including in Canada, Australia and Europe. To date, no SIFs have legal approval to operate in the U.S., though some cities are exploring allowing such facilities to open.

To understand whether SIFs affect overall mortality, researchers used data from two prospective cohort studies of people who inject drugs (PWID) in Vancouver, Canada. Every six months between December 2006 and June 2017, participants responded to a questionnaire asking about sociodemographic information, drug use, use of health interventions such as SIFs and more. They were also asked to provide blood samples for medical testing or monitoring.

Ultimately, the total sample included 811 participants. More than half (432) reported frequent (that is, at least weekly) SIF use at baseline. Over the span of the study period, 112 participants died, corresponding to a crude mortality rate of 22.7 deaths per 1,000 person-years. The leading causes of deaths were non-accidental (which included neoplasms and circulatory disease), ill-defined or unknown, overdose and HIV-related.

After adjusting for several factors, including age, sex, HIV seropositivity, public injection and more, researchers found that “frequent SIF use remained significantly associated with decreased risk of all-cause mortality.”

“Existing modeling and simulation studies indicate that SIFs avert numerous overdose deaths per year,” the study, which was published in the journal PLOS Medicine in late November, states. “Moreover, past research relying on aggregate data has demonstrated the role of SIFs in reducing local population-based rates of fatal overdose. However, we believe that ours is the first study to identify an individual-level association between frequent SIF use and decreased risk of all-cause mortality among a community-recruited cohort of PWID.”

Although researchers did not investigate why there was an association between frequent SIF use and a lower risk of all-cause mortality, they do offer some potential explanations based on existing literature. Studies have shown that supervised consumptions sites are associated with safer syringe use, including a decline in sharing, reusing, outdoor injecting and hurried injecting. Additionally, these facilities are equipped to handle medical emergencies, such as overdose, and are staffed with people trained in addiction treatment.

“Together with the findings of previous research,” the authors write, “our findings underscore the need for continued efforts to enhance access to SIFs as a strategy to reduce mortality among PWID. In particular, given that SIFs have limited geographic coverage and that PWID have been found to often encounter long wait times in accessing SIF services in this setting, the broader expansion of SIFs may serve to improve service accessibility and thereby reduce the potential for mortality and other harms among this population.”

Lead author Mary Clare Kennedy summarized her study results online, tweeting in part: “Our findings add to the large body of scientific evidence demonstrating the critical role of supervised injection facilities in saving lives, reducing harm & promoting health among people who inject drugs.”

“At a time when evidence-based interventions are urgently needed to address the disproportionately high burden of preventable deaths and suffering experienced by people who use drugs, efforts to scale up access to supervised injection facilities should be a public health priority.”

On the presidential campaign trail, entrepreneur Andrew Yang, South Bend, Indiana Mayor Pete Buttigieg, former Housing and Urban Development Secretary Julián Castro, Sen. Elizabeth Warren (D-MA) and Sen. Bernie Sanders (I-VT) have all voiced support for safe consumption sites.

Civil Rights Groups Push To End Criminalization Of Marijuana And Other Drugs

Photo by Jair Lázaro on Unsplash 

Marijuana Moment is made possible with support from readers. If you rely on our cannabis advocacy journalism to stay informed, please consider a monthly Patreon pledge.

Kimberly Lawson is a former altweekly newspaper editor turned freelance writer based in Georgia. Her writing has been featured in the New York Times, O magazine, Broadly, Rewire.News, The Week and more.

Science & Health

Impact Of Marijuana Legalization On Crime Reduction Is Being Underestimated, New Study Finds

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Studies have repeatedly identified an association between the legalizing marijuana and reductions in crime—but the impact of the policy change is being significantly understated because of limitations in the research methodology, a new paper co-authored by a federal official asserts.

Most studies looking at crime and cannabis rely on FBI data sourced from local police departments across the country. But reporting that data to the federal agency is entirely voluntary, leaving knowledge gaps that have underplayed the extent to which legalizing medical cannabis reduces violent and property crime.

That’s according to researchers from the U.S. Department of Agriculture’s (USDA) Economic Research Service and Appalachian State University, who published a working paper with their findings this month.

“U.S. drug policy presumes prohibition reduces crime. Recently states have enacted medical marijuana laws creating a natural experiment to test this hypothesis but is impeded by severe measurement error with available data,” the abstract states.

To account for those shortcomings, the researchers developed “a novel imputation procedure to reduce measurement error bias and estimate significant reductions in violent and property crime rates, with heterogeneous effects across and within states and types of crime, contradicting drug prohibition policy.”

“We demonstrate uncorrected measurement error or assuming homogeneous policy effects leads to underestimation of crime reduction from ending marijuana prohibition,” the authors said in the paper, which is titled, “Smoke and Fears: The Effects of Marijuana Prohibition on Crime.”

To improve upon existing research, the study authors said they used a “multiple imputation procedure for agency-level crime data to fill in the gaps in the [Uniform Crime Reporting] data that accounts for the inherent uncertainty in these imputed values in the subsequent statistical analysis.”

“Our results indicate that [medical marijuana laws] result in significant reductions in both violent and property crime rates, with larger effects in Mexican border states,” they wrote. “While these results for violent crime rates are consistent with previously reported evidence, we are the first paper to report such an effect on property crime as well. Moreover, the estimated effects of MMLs on property crime rates are substantially larger, which is not surprising given property crimes are more prevalent.”

While the study specifies that the USDA’s official’s involvement in the study “should not be construed to represent” the government’s position on the issue, it’s notable that an agency representative even participated and effectively reached the conclusion that the theory that criminalizing drugs—as the federal government has done for decades—reduces crime seems to be unfounded.

Other data has similarly challenged the notion that prohibition reduces crime.

In 2020, researchers looked at how adult-use marijuana legalization in Washington and Colorado affected crime rates in neighboring states, and the resulting study determined that passage of recreational cannabis laws may have actually reduced certain major crimes in nearby jurisdictions.

The previous year, a federally funded study found that legalizing marijuana has little to no impact on rates of violent or property crime. The policy change did seem connected to a long-term decline in burglaries in one state, however.

A 2018 study from the think tank RAND said county-level data from California suggested that there was “no relationship between county laws that legally permit dispensaries and reported violent crime,” the researchers wrote. What’s more, there was a “negative and significant relationship between dispensary allowances and property crime rates,” though it’s possible that’s the product of “pre-existing trends.”

That same year, researchers at Victoria University of Wellington and Harvard University found that medical marijuana laws essentially have a null effect of crime rates, with one big exception: A nearly 20 percent reduction in violent and property crimes in California following the legalization of medical cannabis there.

DEA marijuana seizures have significantly declined as more states have moved to legalize cannabis, a new study led by a top marijuana investigator for the federal government found. And at the same time, marijuana arrests are also dropping across the country, and they dipped significantly in 2020, recent FBI data shows.

Federal marijuana trafficking cases also continued to decline in 2020 as more states have moved to legalize, an analysis from the U.S. Sentencing Commission (USSC) that was released in June found.

Federal prosecutions of drug-related crimes overall increased in 2019, but cases involving marijuana dropped by more than a quarter, according to a report released by Supreme Court Chief Justice John Roberts that year.

A study released by the Cato Institute in 2018 found that “state-level marijuana legalization has significantly undercut marijuana smuggling.”

DEA Proposes Dramatic Increase In Marijuana And Psychedelic Production In 2022, Calling For 6,300 Percent More MDMA Alone

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DEA Proposes Dramatic Increase In Marijuana And Psychedelic Production In 2022, Calling For 6,300 Percent More MDMA Alone

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The Drug Enforcement Administration (DEA) is proposing a dramatic increase in the legal production of marijuana and psychedelics like psilocybin, LSD, MDMA and DMT to be used in research next year.

In a notice scheduled to be published in the Federal Register on Monday, the agency said there’s been a “significant increase in the use of schedule I hallucinogenic controlled substances for research and clinical trial purposes,” and it wants authorized manufacturers to meet that growing demand.

DEA had already massively upped its proposed 2021 quota for cannabis and psilocybin last month, but now it’s calling for significantly larger quantities of research-grade marijuana and a broader array of psychedelics to be manufactured in 2022.

It wants to double the amount of marijuana extracts, psilocybin and psilocyn, quadruple mescaline and quintuple DMT. What especially stands out in the notice is MDMA. The agency is proposing an enormous 6,300 percent boost in the production of that drug—from just 50 grams in 2021 to 3,200 grams in the coming year—as research into its therapeutic potential continues to expand.

LSD would see a 1,150 percent increase, up to 500 grams of the potent psychedelic.

Marijuana itself would get a 60 percent boost under DEA’s proposal, up to 3.2 million grams in 2022 from the 2 million grams last year.

Here’s a visualization of the proposed quota increase from 2021 to 2022 for marijuana and cannabis extracts:

For all other THC, psilocybin, psilocyn and MDMA:

And for other psychedelic substances like LSD, mescaline and DMT:

DEA said in the Federal Register notice that it has been receiving and approving additional applications to “grow, synthesize, extract, and manufacture dosage forms containing specific schedule I hallucinogenic substances for clinical trial purposes” to achieve these ambitious quotas.

“DEA supports regulated research with schedule I controlled substances, as evidenced by increases proposed for 2022 as compared with aggregate production quotas for these substances in 2021,” the agency said, adding that it working “diligently” to process and approve marijuana manufacturers applications in particular, as there’s currently only one farm at the University of Mississippi that’s permitted to cultivate the plant for research.

“Based on the increase in research and clinical trial applications, DEA has proposed increases in 3,4- Methylenedioxyamphetamine (MDA), 3,4-Methylenedioxymethamphetamine (MDMA), 5-Methoxy-N,N-dimethyltryptamine, Dimethyltryptamine, Lysergic acid diethylamide (LSD), Marihuana, Marihuana Extract, Mescaline, Psilocybin, Psilocyn, and All Other Tetrahydrocannabinols to support manufacturing activities related to the increased level of research and clinical trials with these schedule I controlled substances.”

Here are the exact numbers for the proposed 2021 and 2022 quotas:

Substance 2021
2022 proposed
Marijuana 2,000,000 3,200,000
Marijuana extract 500,000 1,000,000
All other tetrahydrocannabinol 1,000 2,000
Psilocybin 1,500 3,000
Psilocyn 1,000 2,000
MDMA 50 3,200
LSD 40 500
Mescaline 25 100
DMT 50 250
5-MeO-DMT 35 550
MDA 55 200

A 30-day public comment period will be open after the notice is formally published on Monday.

It’s difficult to overstate just how significant the proposed 2022 increases are, but it’s certainly true that scientific and public interest in marijuana and psychedelics has rapidly increased, with early clinical trials signaling that such substances show significant therapeutic potential.

National Institute on Drug Abuse (NIDA) Director Nora Volkow told Marijuana Moment in a recent interview that she was encouraged by DEA’s previous proposed increase in drug production quota. She also said that studies demonstrating the therapeutic benefits of psychedelics could be leading more people to experiment with substances like psilocybin.

Advocates and experts remain frustrated that these plants and fungi remain in the strictest federal drug category in the first place, especially considering the existing research that shows their medical value for certain conditions.

A federal appeals court in August dismissed a petition to require the DEA to reevaluate cannabis’s scheduling under the Controlled Substances Act. However, one judge did say in a concurring opinion that the agency may soon be forced to consider a policy change anyway based on a misinterpretation of the therapeutic value of marijuana.

Separately, the Washington State attorney general’s office and lawyers representing cancer patients recently urged a federal appeals panel to push for a DEA policy change to allow people in end-of-life care to access psilocybin under state and federal right-to-try laws.

Singer Melissa Etheridge And Activist Van Jones Promote Psychedelics Reform As Movement Grows

Image element courtesy of Kristie Gianopulos.

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Head Of Federal Marijuana Farm’s Study Says Illegal Cannabis Seizures Have ‘Decreased Dramatically’ Amid Legalization Movement

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State-level marijuana legalization has left the Drug Enforcement Administration (DEA) with far fewer samples of seized illicit cannabis to analyze, a study led by a top marijuana investigator for the federal government says.

That finding backs up the claim often made by legalization advocates that as more legal markets come online, consumer demand for unregulated cannabis from illicit channels will decline.

“The number of samples received over the last 5 to 6 years has decreased dramatically owing to the legalization of marijuana for either medical or recreational purposes in many U.S. states,” the study, authored by Mahmoud ElSohly, who runs the nation’s only federally authorized cannabis cultivation facility at the University of Mississippi, found.

Seizures have “precipitously declined over time, starting in the year 2011 (>2342 exhibits) to 2019 (<100 exhibits),” the study, published in the journal Biological Psychiatry earlier this year, says. “This is possibly the result of the legalization of cannabis for medical or recreational use in many states that has curtailed DEA enforcement efforts.”

The dwindling seizure numbers reported in the study are only the latest indication of the unregulated market’s shrinkage as the cannabis legalization movement continues to have success in a growing number of states.

At the same time that DEA marijuana seizures are declining, marijuana arrests are also dropping across the country, and they dipped significantly in 2020, recent FBI data shows.

Federal marijuana trafficking cases also continued to decline in 2020 as more states have moved to legalize, an analysis from the U.S. Sentencing Commission (USSC) that was released in June found.

Federal prosecutions of drug-related crimes overall increased in 2019, but cases involving marijuana dropped by more than a quarter, according to a report released by Supreme Court Chief Justice John Roberts that year.

A study released by the Cato Institute in 2018 found that “state-level marijuana legalization has significantly undercut marijuana smuggling.”

Even as the number of DEA illicit cannabis samples has gradually decreased amid the legalization movement, the more limited supply still shows that THC potency has increased over time, according to the recent study published in Biological Psychiatry.

The average THC potency in seized marijuana increased from 9.75 percent in 2009 to 14.88 percent in 2018 and then slightly decreased to 13.88 percent in 2019, the study found. The researchers also noted that there’s been a more recent shift over the past two years with cannabis containing more balanced ratios of THC to CBD, a non-intoxicating cannabinoid.

Average CBD concentrations in seized marijuana decreased from 0.4 percent in 2009 to 0.14 percent in 2017. But then the concentration of the cannabinoid “climbed to approximately 0.6 percent in 2019.”

Again, this data comes from illicit cannabis that was obtained by DEA, not marijuana that’s legally available in state markets. Researchers are currently unable to study the cannabis that consumers actually purchase in licensed dispensaries, but that could change under legislation that’s advancing in Congress.

“These results are in agreement with other potency monitoring programs in several European countries,” the study authors wrote. “There appears to be a recent trend of the inclusion of higher CBD levels containing chemovars in illicit cannabis.”

ElSohly’s cannabis cultivation facility at the University of Mississippi is currently the only place authorized by the federal government to grow marijuana for research purposes. And advocates, scientists and lawmakers have complained that research relying on the government’s cannabis is compromised because it generally contains significantly lower levels of cannabinoids compared to products available in state-legal dispensaries.

DEA is in the process of approving additional manufacturers, however, with the hope to expanding the supply of cannabis for scientists and producing studies that more accurately account for what consumers are getting from state-licensed retailers.

The agency also recently proposed a massive increase in the production of marijuana and psilocybin for research purposes, with the intent of aiding in the development of new federally approved therapeutic medications.

ElSohly, for his part, said in 2019 that he’s confused as to why consumers would want marijuana containing 15 percent or more THC when, according to him, even eight percent is too high.

Skeptics and opponents of cannabis reform have placed a large emphasis on THC potency and its rise over recent years. At one point in 2019, a key Republican Senate committee chairman suggested that he would be unwilling to advance a bill to protect banks that service state-legal marijuana businesses unless businesses were required to cap THC at two percent.

Top Federal Drug Official Gives Maryland Lawmakers Marijuana Legalization Advice At Workgroup Hearing

Photo courtesy of Mike Latimer.

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