This month, @ONDCP announced @POTUS's position on permanently making an entire class of chemicals pre-emptively illegal. Amid concerns about the OD epidemic OOH and the drug war OTOH, the admin issued a trying-to-please-everyone-and-as-a-result-pleasing-no-one "compromise." A 🧵
Until now, for a drug to be illegal, it must be proven: 1)psychoactive 2)dangerous/addictive 3)have 0 medical value. Proving this takes time. Cartel labs recognize this and invent endless compounds LIKE fentanyl but NOT fentanyl to evade law enforcement. These are analogues.
In '18, DEA temporarily made all fentanyl analogues illegal—even those not yet invented yet, or not yet proven dangerous. They said this would make it easier to go after dealers of these deadly new inventions, and reduce incentives to create new ones.…
The wonky name for this is "class-wide scheduling of fentanyl analogues," and it's been temporarily extended several times, including in May. Soon Congress must decide whether to make it permanent. Policy people were waiting for word on @POTUS's position.…
Trouble is, chemistry is unpredictable. Changing one tiny thing about a molecule can change how it acts in the body. Imodium, eg, has the identical core chemical structure to fentanyl, but you can safely buy it over the counter (and not to get high).…
By making all analogues preemptively illegal, we risk sending people to prison for possessing or selling chemical compounds that don't turn out to be dangerous at all. This happened to Todd Coleman—and "undoubtedly," countless others we don't know about.…
The temporary ban also applied mandatory minimums to punishments for fentanyl analogues. Mandatory minimum sentences are one of the most harmful legacies of the War on Drugs, and @POTUS promised on the campaign trail to end them.
The mandatory minimums for fentanyl analogues are HARSHER than the ones for fentanyl itself. The 5 year mandatory minimum is triggered by 40 grams of fentanyl but only 10 grams of a fentanyl analogue. 10 grams is the weight of 4 quarters.
So here's what @POTUS did: he split the baby. He is calling for the class-wide scheduling to become permanent. And to exempt any of the substances that haven't been individually proven dangerous from mandatory minimums.…
Make no mistake, fentanyl (and to a lesser extent their analogues) are legit a huge, deadly, urgent crisis. But in the US, declaring a chemical illegal seems to be the only way we know how to deal with a drug crisis.…
I feel for lawmakers. After generations of having one tool in your toolbox, it'd be really hard to say, let's try something different with this thing that's killing tens of thousands of Americans each year. Let's see if we can figure out a solution that doesn't involve prison.
That would be reasonable given, y'know, overdoses are still rising at record rates—and it can't be said that we haven't been policing drugs hard enough or aggressively enough, right? (Right?) Maybe that tack is...not working?…
But imagining some new way to manage this fentanyl overdose crisis would be tantamount to conceding that we need to reimagine the whole damn thing. And that's not likely, given this kind of rhetoric.…
So we end up with this. And the drug war marches on. /fin…

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More from @schwartzapfel

10 Aug
Amid an overdose crisis of historic proportions, we have medications that can cut overdose deaths by up to 60%—more than half!—among folks released from prison. But they are sorely underutilized.…
Risk of OD death is sky-high among those just released from prison. Reduced access to opioids behind bars → reduced tolerance and increased cravings. Enter methadone and buprenorphine (aka Suboxone), which maintain tolerance and eliminate cravings.…
State prison systems are increasingly providing the meds. Still <1/2, but way more than a few years back, when you could count the # of states on one hand. The bureau of prisons, which incarcerates ~200k people in prisons across the country, should be leading the way. It isn't.
Read 8 tweets
7 Jun 19
This woman died in jail detoxing from a drug her physician prescribed her. She was trying to do the right thing and take care of herself after a relapse.…
Like most jails, the Charleston jail at the time did not provide suboxone (or, it seems, basic medical care for people in withdrawal).…
Most withdrawal deaths in jail, the person is coming off of heroin or somesuch. This is clearly never OK—withdrawal deaths are entirely preventable with basic medical care like hydration—but clearly the jail is not going to provide heroin.…
Read 4 tweets

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