Abstract The objective of the paper is to understand the impact of the COVID-19 focusing event that resulted in a distinctive response by the Federal government. The paper focuses on the rapid deregulation that occurred in the opioid use disorder treatments. We frame the narrative using primarily the economic literature on deregulation during a crisis. The temporary deregulation has significantly increased access to treatment and medications and allows for the discovering of a different equilibrium. We also suggest other deregulations that need to be considered. In this paper, we suggest that the provisional deregulations should be made permanent to improve the outcome of the patients who abuse opioids.
Abstract In 2014, Congress removed industrial hemp with a concentration of ≥0.3% tetrahydrocannabinol (THC) dry weight from the definition of marijuana in the federal Controlled Substances Act (CSA). Hemp production was authorized in a limited pilot program until 2018, when Congress passed the Agricultural Improvement Act (Farm Bill) that expanded the program to anyone licensed to produce hemp by the U.S. Department of Agriculture (USDA) or by a USDA-approved State or Indian tribe. Hemp’s greatest value is in two of its 80-plus molecules: cannabidiol (CBD) and THC. These molecules, present in all forms of Cannabis sativa L. (cannabis), including hemp, have medicinal and recreational uses. By removing hemp from the CSA, the Farm Bill altered the legal status of hemp’s extracts, including CBD and THC. In 2018, Epidiolex®, the world’s first and only CBD-based medicine, was approved in the U.S. The drug was placed in Schedule V of the CSA to comply with an international drug treaty requiring control of cannabis and all its extracts. In April 2020, Epidiolex was removed from the CSA schedules. This occurred, according to the Drug Enforcement Administration (DEA), because with a THC content below 0.3%, Epidiolex no longer met the Farm Bill’s criteria as a controlled substance. This review discusses the Farm Bill’s hemp provisions and how they have affected the legal status of hemp derivatives CBD and THC. The review also discusses a loophole in the Farm Bill that decriminalizes the production of marijuana by negligent hemp farmers. In passing, we discuss how lobbying by the hemp/CBD industry influenced passage of the Farm Bill.
Abstract Using data from New York, NY; Los Angeles, CA; Prince George’s County, MD; and Louisville, KY, we examine trends in racial disparities in the enforcement of misdemeanor marijuana possessionbefore and after marijuana reforms. In these jurisdictions, we find that changes to marijuana enforcement were associated with reductions in arrest rates for Black, Hispanic, and White people, though the rate of decline varied by jurisdiction. Black people were arrested at the highest rates in relation to their proportion of the population. In three of the four jurisdictions where issuing criminal citations was an enforcement option, racial/ethnic disparities in arrest rates increased post-reforms; legalization and the option to issue a civil citation were associated with reductions in racial/ethnic disparities. Trends in this study provide policymakers with information to implement effective reforms that target racial disparities in marijuana possession arrests.
Abstract Reducing substance use among individuals subject to community supervision is an important goal for many judges and community corrections officers. Some jurisdictions have had success by ordering justice-involved individuals to frequent substance use testing with swift, certain, and fair (SCF) sanctions for non-compliance. South Dakota’s 24/7 Sobriety program is one example of a SCF program that has also been adopted statewide in Montana, North Dakota, and other jurisdictions. As other entities outside the Great Plains attempt to adopt the 24/7 approach, there is a need to examine how the program is implemented. This paper examines a 24/7-inspired pilot program that was implemented in a southwestern county in the US in 2018. Data on participation rates and testing results for the 6-month pilot program were examined. Using a semi-structured interview protocol with questions that were adapted from the Consolidated Framework for Implementation Research (CFIR) interview guide, we interviewed nine individuals from six stakeholder groups: 1) Court, 2) District Attorney, 3) Public Defender, 4) Probation, 5) Sheriff, and 6) the non-profit organization that administered the testing. There were important differences in how the program was implemented in the county versus South Dakota’s 24/7 program—namely, there was a different target population, participation was voluntary, and testing was conducted in a different setting which increased costs. While county stakeholders decided to discontinue the program after the pilot period, it was able to implement a SCF program and overcome many of the challenges it confronted. There is some interest in exploring implementation of the SCF with those arrested for driving under the influence of alcohol in the county. For jurisdictions considering the implementation of an SCF program, it makes sense to start with a pilot program with pre-determined objectives and timeline for consistency. It is also crucial to hold regular meetings with all relevant stakeholders before and during the pilot to address context-specific challenges. Conducting an implementation analysis of this process based on the CFIR guide can be useful for understanding why the pilot was a success or failure, and how it may be improved.
Abstract “Where Commerce Meets a Revolution” is the motto of the National Cannabis Industry Association and its annual meetings. “Commerce” clearly refers to the developing for-profit cannabis industry. “Revolution” refers to the ongoing legalization of the drug. “Meets” is more ambiguous: It may suggest an encounter between two similar things, a possible clash of opposites, or something in between. The ambiguity here provides an opportunity to examine how a social movement that understood itself as promoting freedom and social justice thinks about and engages a profit-making industry that its own success has created, acknowledging conflicting values, while also trying to find ways to manage this conflict. Drawing on interviews with major movement actors, I use the concepts of institutional logics and institutional entrepreneurship to examine the relationship between the legalization movement and the cannabis industry.
