“I’m so sorry, honey,” she said. “This is what I found by the street. I’ll send you a picture.”

For a split second before I got the picture she texted me I thought one of our cats had been hit by a car. I braced myself, but wasn’t at all prepared for what I saw instead. Someone had printed out my photo and profile page from the Tennessee sex offender registry, laminated it, stapled it to a wooden stake and planted it in my front yard. With slurs scrawled across in permanent marker. For everyone to see.

The first thing I felt wasn’t anger. It was shame. Not of who I am today but of who I was back then.

It felt like a home invasion, and they didn’t even enter my house. Or like a curse, like the past itself had come walking up our driveway; a version of me from 16 years ago that doesn’t exist anymore. Outwardly I brushed it off, telling my wife the person who did this didn’t deserve our energy. But the sight of my face on that sign cracked me open.

The first thing I felt wasn’t anger. It was shame. Not of who I am today but of who I was back then. Over the past 16 years, 10 of which I spent in prison, I’ve worked to repair what I can and rebuild my life on honesty and accountability. But the registry is designed to freeze you forever as a single moment in time—often your worst moment.

Later that night I did feel anger. I was thinking about how much malice someone must have in their heart to do something like this. But as I sat with that feeling, I realized something uncomfortable, but honest: Maybe whoever did this did it because they were a survivor of sexual abuse.

One way or another, they were probably hurting from something and hadn’t received the support they needed to heal.

In the six years since I completed my sentence and began life on the registry, I’ve learned that it fails everyone—survivors, perpetrators and the public. It does nothing to improve public safety. And though it follows us the rest of our lives, it’s not designed for survivors or perpetrators to receive long-term trauma-informed care. It doesn’t provide anyone with healthy outlets for difficult emotions. It doesn’t encourage healing and rebuilding. What it does encourage is public shaming, harassment and reliving the trauma at every turn. So people numb the pain and isolate, or they lash out.

Protecting the public from dangerous repeat predators is a fine goal, but that’s not what the sex offender registry does.

I reported the incident to my parole officer. They were sympathetic, but didn’t have much to say. They told me I could file a police report about the trespassing, but I wasn’t interested in doing that. When I talked to my treatment group, they suggested I could put up a “No Trespassing” sign, but that didn’t feel right either. I didn’t want to make myself or anyone else more involved in the criminal-legal system. I didn’t want more signs in my yard. So that was that.

Survivors deserve safe spaces to process the trauma inflicted on them. People who have caused harm deserve the chance to rehabilitate themselves and rejoin their communities. But fear never leads to healing.

If the information on the registry were only accessible to law enforcement and were proven useful to public safety in that context, I would support it. Protecting the public from dangerous repeat predators is a fine goal, but that’s not what the sex offender registry does. It’s bloated with people who are not high-risk for victimizing anyone, and it’s increasingly become a tool used to criminalize low-income, vulnerable communities. And it creates a culture of paranoia and vigilantism—one that offers the public a false sense of security, if any at all. Public shaming is not public safety.

After the sign of my past shame was staked in our yard, I realized you can’t control other people’s reactions. But you can control yours.

Top image via State of Ohio. Inset image via Jeff Noland.

The post The Sex Offender Registry Isn’t Meant for Public Safety. Just Public Shaming. appeared first on Filter.

“The enforcement of drug distribution laws to increase public safety for residents in San Francisco may be having an unintended negative consequence of increasing opioid overdose mortality,” write the authors of a new paper, published March 19 by the American Medical Association (AMA). “To reduce overdose mortality, it may be better to focus on evidence-based health policies and interventions.”

Chances of a fatal overdose within 100 yards of a drug seizure rose within a day of police action, they write, and “elevated risk persisted for seven days” afterward. Similar results were seen when the team analyzed overdoses within 250-yard and 500-yard zones around an earlier drug seizure.

“Within each space-time kernel, the strength of the association, all of which were statistically significant, dissipated the further away in time and distance from the law enforcement drug seizure event,” they write, noting that the magnitude of the risk “diminished over time.”

The authors—from RTI International, the University of California, San Francisco, and the University of Washington, go further than saying the new findings reinforce previous research. They argue that no compelling evidence so far supports the idea that policing and seizing drugs is an effective approach to minimizing drug use or harms.

“To our knowledge, no evidence-based approach exists that shows supply-side interventions, such as policing and seizing drugs, reduces drug use or drug-related health problems,” they write in their report. “Instead, our study suggests that law enforcement interventions to arrest people selling drugs in the unregulated drug market and seize the drugs they are selling may have deleterious outcome on public health by increasing overdose mortality.”

Federal funding for the study came from the National Institute on Drug Abuse and the United States Centers for Disease Control and Prevention.

The five-person research team drew on mortality data from San Francisco’s Office of the Chief Medical Examiner and drug distribution arrest data from the San Francisco Police Department, looking at records between 2020 and 2023. The aim was to assess “whether location and time of law enforcement drug seizures were associated with subsequent opioid-involved overdose mortality,” the authors write.

“Exposure to law enforcement drug seizure events was significantly associated with community spread of opioid overdose.”

San Francisco was “of particular interest given that it is the second most densely populated large city in the US and has been engaging in heightened law enforcement drug enforcement since 2019.”

Around that year, fentanyl entered the local drug supply, leading to record high overdose death rates, the report states. That led to more drug law enforcement and a more aggressive approach to policing by San Francisco’s mayor and district attorney.

During the study period, 2,674 “drug seizure crime events” took place, fluctuating between 16 and 106 actions per month. (The lowest period was in April 2020, at the beginning of the COVID-19 pandemic, when residents were told to shelter in place.)

Opioid-involved overdose, meanwhile, accounted for 1,833 deaths during the study period, ranging from 25 to 59 per month.

Analyzing the two sets of data against one another revealed a meaningful relationship between a police drug seizure and fatal opioid overdose.

“We found that exposure to law enforcement drug seizure events was significantly associated with community spread of opioid overdose events,” the authors write, “where the rate of future overdose events was higher in the days following and in locations around law enforcement drug seizure events in San Francisco.”

Authors noted that the findings reflect those in a similar study in Indianapolis, Indiana, which found that the rate of future nonfatal overdose was more than twice as high in areas close to recent opioid-related drug seizures.

The new analysis also found that overdose death rates went up during San Francisco’s COVID-prompted shelter-in-place ordinance.

“Isolating people in single room occupancy hotels was a good policy to limit COVID-19 transmission, but for those who were using drugs it meant there was no one there.”

“Isolating people in single room occupancy hotels was a good policy to limit COVID-19 transmission, but for those who were using drugs it meant there was no one there to witness and help them if they overdosed,” the authors write.

“Ways to mitigate this problem,” they continue, “include installing overdose prevention sites in single-room occupancy hotels and providing a safe supply of drugs.”

Areas with “higher socioeconomic deprivation” also had higher overdose mortality rates, aligning with findings from past research in various countries.

In terms of how to bring down opioid overdose rates, the new study points to “numerous evidence-based alternatives to law enforcement that address public safety and health concerning opioid use.”

Among them are easier access to medications for opioid use disorder or even providing users with “a safer supply of regulated opioids.”

“Randomized clinical trials have shown that providing a regulated supply of diacetylmorphine (the active ingredient in heroin) to people dependent upon opioids is a more effective way to retain people in treatment and to reduce their involvement in illicit drug use and other criminal activities than standard methadone treatment,” the report states.

Decriminalizing the possession and use of drugs is another approach—one that’s “brought down overdose mortality and HIV rates in Portugal without raising crime rates,” the authors note, “and early data from Oregon suggests that it did not produce increases in other crimes.”

“Another evidence-based alternative is to provide people with a supervised place to use drugs at overdose prevention sites,” they continue, “which have been shown to reduce overdose deaths and crime and social disorder in the neighborhoods in which they are placed.”

The research team state that the findings speak to the need to rethink drug policies in response to the overdose crisis.

“We recommend trying evidence-based approaches that have worked elsewhere, including providing a safe supply of drugs.”

“As we are confronted with overdose rates that have contributed to a decline in US life expectancy since 2020, we need to consider how existing policies are contributing to this significant public health problem,” they write, adding:

“We recommend trying evidence-based approaches that have worked elsewhere, including providing a safe supply of drugs to people who are dependent, offering no-cost substance use disorder treatment on demand, drug decriminalization, and providing a safer environment to use drugs, such as overdose prevention sites.”

The new study, published in JAMA Network Open, comes on the heels of another AMA-published report around marijuana and drug testing during pregnancy.

That research found that removing isolated marijuana use as a reason to order urine drug screenings during pregnancy “was associated with improved racial parity in testing and reporting” of test results to child protective services, “with no evidence of decreased identification of non prescribed, non cannabis substances” and “no significant association between the intervention and any measured neonatal outcomes.”

Another recent study that drew on federal data found that Atlanta’s move to decriminalize marijuana in 2017, contrary to warnings from some critics, led to a decrease in law enforcement reports involving violent charges.

“Decriminalization led to a reduction in violent crime,” that report states, “likely due to police reallocating resources from marijuana enforcement to violent crime prevention.”

In October 2024, two other federally funded reports published by the AMA examined issues of cannabis and pregnancy. One study found that cannabis use during early pregnancy was not associated with child autism, while the other found no association with increased risk for early childhood developmental delays.

As for other AMA-published research, a study from late 2024 found that psilocybin-assisted therapy in a group of frontline clinicians during the pandemic “resulted in a significant, sustained reduction of symptoms of depression.”

A separate AMA-published study that received federal funding analyzed product listings on a popular marijuana advertising site and found that nearly half of all products were “flavored,” based on notes in the product descriptions. Researchers cited concerns that those flavors—along with cannabis-infused edibles, products like concentrates and merely listing retailers and products online—may make marijuana more appealing to young people.

Image via City and County of San Francisco

This story was originally published by Marijuana Moment, which tracks the politics and policy of cannabis and drugs. Follow Marijuana Moment on X and Facebook, and sign up for its newsletter.

The post SFPD Drug Seizures “Significantly” Linked to Fatal Overdose, Data Show appeared first on Filter.

“Discipline for illegal stops and frisks, even when substantiated by [the Civilian Complaint Review Board], is not pursued with the same vigor and resolve as for other misconduct,” the report stated. “Penalties for wrongdoing … even when repeated, are rare.”

The NYPD did not respond to Filter‘s request for comment. CCRB, the city’s police oversight agency, declined, saying it was still reviewing the report.

Stop-and-frisk refers to detaining and searching someone simply because an officer decides they look suspicious. The NYPD has historically used stop-and-frisk to target young Black and Brown men. In 2013, a federal judge ruled that this violated the Fourth Amendment protection against unreasonable search and seizure, as well as the Fourteenth Amendment protection against racially discriminatory policing. Oversight measures for the practice, including the independent monitor, were ordered in an effort to prevent officers from abusing their power.

Since Mayor Eric Adams took office in 2022, NYC has seen a resurgence of stop-and-frisk.

Stop-and-frisk peaked in 2011, at more than 685,000 people detained. Of those, 605,328—88 percent—were ultimately not cited or arrested. The practice declined in the years following the court ruling, reaching a record low of 8,947 in 2021. But since Mayor Eric Adams (D) took office in 2022, NYC has seen a resurgence of stop-and-frisk, with 16,971 incidents reported in 2023.

Yung-Mi Lee, a legal director at Brooklyn Defender Services, told Filter this owes to Adams—a former NYPD officer himself—reviving the department’s “anti-crime” unit. The plainclothes unit was implicated in killing Eric Garner in 2014, and disbanded in 2020 in the wake of the protests over the murder of George Floyd by Minneapolis police officer Derek Chauvin.

“You can’t create a specialized unit that engages in dragnet policing where they stop everyone, violate their constitutional rights, and then justify their actions by saying, ‘We found a gun,’” Lee said. “It’s probably a gun in thousands of illegal searches. These encounters are humiliating and invasive.”

She said that today, there’s still no real way to hold officers accountable for misconduct. Filing a complaint with the CCRB is often too intimidating or inaccessible. 

“I’ve seen many people who [file complaints] constantly targeted by police officers.”

“I’ve seen many people who have done so and are constantly targeted by police officers,” Lee said. “Then they have to go through the investigation process. If there is a recommendation for discipline by the CCRB, the commissioner routinely overrules that. Even though misconduct was found by the CCRB, the commissioner will ignore it and the officer is not held accountable.”

The new report, which runs over 500 pages, described this at length. In one example from 2018, camera footage showed an illegal stop-and-frisk in the Bronx by an officer who’d already undergone five trainings and been cited in 10 CCRB complaints. The police commissioner agreed that the officer’s actions were illegal, but overruled the CCRB, and rather than impose discipline simply directed the officer to undergo a sixth training. The same officer was named in three separate civil lawsuits that were settled for a total of $266,500.

“Police Commissioners, over time, have demonstrated an inordinate willingness to excuse illegal stops, frisks and searches in the name of ‘good faith’ or ‘lack of malintention, relegating Constitutional adherence to a lesser rung of discipline,” the report stated. “[B]e it sergeants or higher ranked officers… discipline for such failures is close to non-existent.”

Lee doesn’t see things changing, at least while Adams is in office.

“This is a mayor whose platform is ‘tough on crime,’” she said. “[In reality] it’s, ‘We’ll do whatever it takes even if we have to trample on people’s constitutional rights.’”

The public is invited to submit comment on the report through December 25.

Photograph via City of New York

The post For NYPD Stop-and-Frisk Abuses, Discipline Is “Close to Nonexistent” appeared first on Filter.

I found community on the street with other LGBTQ people, most of them with backgrounds like mine. I met witty, clever older trans women who could talk shit like sharp shooters from the Wild West. They taught me that there would always be people who’d try to control my body, try to reap the benefits for themselves regardless of what I wanted. That people would want to use my butthole, to put it succinctly, so I could charge entry or I could let them hang out for free.

It’s easy to assume I was being “groomed,” but that’s not what was happening. I learned that there was power in the marketing and sale of my own body, my own presence, my own company. It was cathartic in a way; it almost felt like reclaiming some control over my trauma from childhood abuse. Sex work wasn’t always voluntary, but much of the time it was.

Even at that very young age, we saw sex work as liberation. We saw sex work as survival. We saw sex work as power. And we saw sex work as a way to have a good time, because with all the things that a lot of us had been through, we understood that life was fleeting.

When I was arrested at 19, I was working with a white trans girl who happened to be 17—I didn’t know that, but I’d be lying if I said I’d have done anything differently. Had we been the same age, it would have been a misdemeanor. But the way media and law enforcement told it, all of a sudden I was a killer pimp drag queen, grooming America’s innocent youth. I was charged with multiple counts of human trafficking, ended up taking a plea deal for pimping and pandering of a minor and sexual exploitation of a minor, was sent into the men’s prison system, and paroled out at age 32 to begin navigating the hurdles of the sex offender registry.

The cops who arrested us had found a crack pipe, so the prosecutor also said I’d gotten my victim addicted to drugs to coerce her.

There were different factors that played a role. Back then I was an up-and-coming entertainer in the young gay Atlanta scene, which made the story more salacious and lurid. And a bunch of us were living in this big house with an older landlord, who had a lot of young boyfriends. We weren’t involved in each other’s business at all, other than him being my landlord, but legally our cases became linked under a part of Georgia hearsay law known as res gestae. Essentially, this makes evidence from one case admissible in another, if it involves similar conduct and occurred around the same place or time period. And of course, I’m Afro-Latina and the girl I was working with was white.

I’ll never forget the prosecutor during my plea hearing. She got up and told everyone how I wanted people to think I was a victim too, but in reality I was a very conniving and calculating predator who targeted vulnerable youth intending to turn them out as prostitutes. The cops who arrested us had found a crack pipe, so the prosecutor also said I’d gotten my victim addicted to drugs to coerce her and feed my own habit. They made it sound like I was keeping multiple 5-year-olds chained up in a basement, even though my charges only ever said I had one victim and we were only two years apart in age.

Arbitrary distinctions make people out as either victims who need help, or predators who target America’s children.

During the two years I sat in county jail fighting my case, no one ever cared that I’d once been trafficked myself. Reporters didn’t even get my name right, let alone ask for my side of my own story.

A decade and a half ago, the media portrayed human trafficking as something that happened in faraway countries. But today, the national narrative is that sex workers were all victims who’ve been abducted and are waiting to be saved by law enforcement.

When you read a headline that says multiple underage victims were rescued in a successful anti-human trafficking sting, resulting in multiple arrests, what actually happened is quite likely to be a story more like mine. It’s the same kind of narrative applied to illicit drugs, where arbitrary distinctions make people out as either victims who need help, or predators who target America’s children. When in reality, those people were often all doing the same thing, and just trying to get by rather than hurt anyone.

The idea that all sex work is born of sheer desperation, that all sex workers are trafficking victims, is a lie that exists to further attack and stigmatize disenfranchised communities of color. People who use sex work to survive, so many of whom are trans women of color, often find a lot of freedom in it. People who choose sex work also were rarely choosing from an endless list of other options. Those truths can exist at the same time.

Image via United States Customs and Border Protection

The post Sex Workers Are “Trafficking Victims” Until Cops Don’t Want Them to Be appeared first on Filter.

The lawsuit against the Metropolitan Nashville Police Department (MNPD) was filed in July 2023, by a former Memphis police officer under the name “John Doe.” He claimed that the department rescinded his job offer after learning his status, even after a medical provider attested to the fact that that Doe’s suppressed viral load meant he could not transmit the virus to others and therefore his HIV did not present any danger to the public. The MNPD paid out a $145,000 settlement for violating the Americans With Disabilities Act (ADA) and updated its civil service policies accordingly. 

In October 2023, a different federal lawsuit filed against Tennessee alleged that the state’s “aggravated prostitution” statute violated the ADA by discriminating against people living with HIV. The statute imposes harsher criminal penalties on sex workers if they are known to be living with HIV, making their charge a felony rather than the misdemeanor it is for everyone else. On February 15, following an investigation, the Department of Justice also sued Tennessee for violating the ADA by enforcing the statute.

In the 1980s, many states began passing laws criminalizing people living with HIV. Tennessee, however, is the only state in which people with HIV convicted for engaging in sex work are required to register as “violent sex offenders.” The registry is lifelong. 

HIV today is considered a chronic illness, rather than a terminal one. Antiretroviral medications make someone’s viral load undetectable, which means it’s untransmittable to others. This has been widely publicized by the federal U=U campaign.

The fact that someone was taking antiretroviral medication would not have stopped Tennessee from convicting them of “aggravated prostitution.” These laws purport to be about the threat of HIV transmission, but really they criminalize HIV status itself. They don’t require any transmission or even physical contact to have occurred in order for someone to be prosecuted.

The MNPD lawsuit garnered a lot of attention because media is always quick to rush to the defense of cops, and John Doe was a former Memphis “Officer of the Year.”

“There are many concerning aspects of this discriminatory policy but a particular one is the racial aspect,” Jose Abrigo, HIV project director at Lambda Legal, the firm representing John Doe, stated in 2023. “The MNPD’s discriminatory policy clearly has a disproportionate impact on Black people and people of color. Discriminating on the basis of HIV status brings up other potential intersectional issues of race, gender, sexual orientation and, of course, stigma.”

HIV criminalization laws have always disproportionately been wielded against Black people; Brown people; queer people; trans people. Sex offender registries bar people from housing and employment opportunities for the rest of their lives. Nashville has been the site of most of the enforcement of Tennessee’s “aggravated prostitution” statute. There certainly are many concerning aspects of MNPD discriminatory practices, but cops aren’t the ones suffering the most harm.

Top photograph via City of Minneapolis. Inset graphic via Centers for Disease Control and Prevention.

The post HIV Rights Advance for Cops, Ahead of the Sex Workers They Criminalize appeared first on Filter.

On March 25, the City Council unanimously approved Resolution 2024-0031, Addressing Spokane Overdoses, which calls on various Washington State authorities to create or improve reporting for overdose data. An amendment from Council Member Jonathan Bingle further calls on the legislature to amend House Bill 1713, the state’s involuntary commitment act.

Commonly known as “Ricky’s Law,” HB 1713 was implemented in 2018. It directed the state health department to open “secure withdrawal management and stabilization” facilities in which people could be mandated for detox. In order for someone to be involuntarily committed to such a facility, authorities must show that they’re a serious threat to themselves, to others, or to property; or that they’re “gravely disabled” due to substance use disorder (SUD).

Under Bingle’s amendment, “the documented administration of [naloxone] constitutes a presumption that an individual has a substance abuse addiction that is a danger to” themselves. The fact of having been administered naloxone would satisfy the criteria in and of itself.

Overdose is not evidence of substance use disorder.

At a March 25 briefing session, Bingle stated that being administered naloxone “is indicative that the individual experiencing fentanyl or other opioid overdose has an addiction to opioids and, therefore, should require treatment … it is clear to me that they are a danger to themselves.”

Overdose is not evidence of SUD. It is true that many people who regularly use opioids overdose while doing so. But many people who do not regularly use opioids overdose when they do use them, because they do not have an opioid tolerance.

The vast majority of overdoses happen because the drug supply is not regulated and most people have no way of knowing what they are using or how strong it is. Some people who overdose from fentanyl did not know they were using it, but for people who do use it intentionally—whether because they prefer it or because they don’t have access to other opioids—the problem is that they still don’t know how much they are using. Fentanyl test strips do not tell you this information.

Being administered naloxone doesn’t mean someone used opioids at all, let alone that they use them regularly. Cops administer Narcan to themselves or their partners all the time. No one’s proposing that they be taken off the streets because they’re dangerous.

Mandatory treatment does not work.

Earlier in March, the Council began formally discussing whether to declare a public health emergency for “the opioid and fentanyl crisis,” though that appears unlikely to happen. Spokane has seen the greatest overdose spike anywhere in the state, and first responders report administering naloxone an average of twice a day.

“This straightforward addition would help those who have ceded their agency to a substance,” Bingle continued. Apparently this justifies the state taking it instead.

Mandatory treatment does not work. Research shows the practice is not only ineffective, but harmful. When it involves forced detox at the kind of inpatient programs being described here, it is likely to raise the overdose risk for many people by lowering their tolerance then putting them back out on the street, where they will immediately go find the substance they did not intend to stop using in the first place.

Under Washington State’s “Good Samaritan” law, someone who overdoses is granted legal immunity from drug possession penalties if they were incriminated as a direct result of first responders being called to the scene. Why criminalize them for no other reason than that someone administered them naloxone?

Ideally, naloxone is administered by a civilian and so authorities never need to be involved at all. That’s what happens when people are able to use drugs in their homes, with people they trust.

“[T]he Spokane City Council further requests a voluntary monthly report from all shelters serving the unhoused population setting forth the number of demonstrated uses the uses of naloxone in their facilities,” the draft resolution states. The Council approved it on the same day it announced new funding for encampment sweeps.

That is who this proposal would hurt: people who overdose inside shelters and are administered naloxone by staff. The difference between involuntary commitment and remaining free is whether or not you can afford a home.

Photograph via Clermont County, Ohio

The post Spokane Eyes Involuntary Treatment for Anyone Revived With Naloxone appeared first on Filter.

“The rats are eating our marijuana,” Kirkpatrick told the council’s Criminal Justice Committee. “They’re all high.”

Kirkpatrick’s mention of stoned rats, first reported by NOLA.com, was among a laundry list of housekeeping items she flagged for city leaders. “It’s not just at police headquarters,” she said. “It is all the districts. The uncleanliness is off the charts.”

While it wasn’t clear from Kirkpatrick’s comments what kind of cannabis products the rats are reportedly eating, it’s unlikely that unprocessed marijuana flower would get them high. While research has indicated that rats respond to marijuana smoke and vapor much like humans do, raw marijuana contains hardly any active THC. Instead, it contains THC-A, which must undergo a process known as decarboxylation to become psychoactive.

Other common cannabis products do include active THC, however—including edibles, tinctures and some concentrates—and could theoretically get rats high. It’s not likely stoned rats are any more dangerous than sober ones, though; research suggests THC makes rodents more sluggish and could reduce stress in female rats.

In footage of the hearing published by WWLTV, Kirkpatrick also mentions rat droppings on workers’ desks.

“When we say we value our employees,” she said, “you can’t say that and at the same time allow people to work in conditions that are not acceptable.”

Morale among police is already low, Kirkpatrick added, and “this work environment does nothing to boost that morale.”

Officials are working to rent space in another building to relocate the headquarters, which they estimate will be cheaper than the roughly $30 million price tag to fix the current building.

Marijuana remains prohibited for adults in Louisiana, with small amounts punishable by a $100 fine. Medical marijuana is legal, however, and has been sold in dispensaries since 2019.

In 2023, state lawmakers passed a marijuana expungements bill that then-Gov. John Bel Edwards (D) signed into law in June. The change made it so that by petitioning the courts, someone’s first conviction for possessing up to 14 grams of cannabis as a first can be wiped after 90 days from the time of the conviction.

At the time, polling from Louisiana State University found that seven in 10 Louisianans support legalizing adult-use cannabis. When the survey was administered a decade earlier, in 2013, only 42 percent of Louisiana residents said they supported the reform.

Despite the findings, adult-use legalization continues to stall in the Louisiana legislature. The governor did sign a cannabis decriminalization bill into law in 2021—making it so possession of up to 14 grams of marijuana is punishable by a $100 fine—but broader reform hasn’t made it across the finish line.

That said, the governor previously said that he does think that Louisiana will inevitably legalize cannabis for adult use at some point.

Photograph via State of Arkansas

This story was originally published by Marijuana Moment, which tracks the politics and policy of cannabis and drugs. Follow Marijuana Moment on Twitter and Facebook, and sign up for its newsletter.

The post New Orleans Police: Rats Eating Drugs in Evidence Room, “They’re All High.” appeared first on Filter.

Some are already aware that these claims aren’t true, or aren’t interested one way or the other. But some are receptive to the information once they have it, and see that it’s not incompatible with their training objectives regarding officer safety or public safety. Often the myths passed down from cop to cop make overdose response more difficult and less safe, both for the overdose victims they’re responding to and for the cops themselves.  

It’d be preferable to everyone if law enforcement officers weren’t the ones getting dispatched to overdoses, but for the time being that’s the world we live in. The following information is applicable regardless of personal ideology or experience level using Narcan. It just makes using it safer and easier.

You Don’t Need to Wake Them Up to Reverse the OD

It’s a misconception that an overdose isn’t over until the person is fully conscious. On the streets, cops are often dispatched after 911 operators established that the victim was “unresponsive.” In prisons and jails, corrections officers will call over the intercom that they have an “unresponsive inmate,” then step away and wait for backup without checking if the person has a pulse or is breathing. Narcan is administered until the person is “responsive,” which is understood to mean “until the person is awake.” It’s supposed to mean “until the person is breathing on their own.”

The safest way to administer Narcan is to give them one dose, then wait at least two minutes before considering whether to give them a second. If they start to breathe on their own and are taking at least eight breaths per minute—whether or not they’ve opened their eyes yet—then they don’t need any more Narcan. 

Eight breaths per minute is a somewhat subjective benchmark for “normal breathing.” You might read elsewhere that the number of breaths per minute is as low as five, or at least 12. There isn’t an exact consensus, but most experts would consider eight to 10 breaths per minute to be safe.

Likewise, some overdose-reversal resources might say to give someone a second dose of Narcan if normal breathing hasn’t resume after three minutes, rather than two minutes. There isn’t a definitively correct answer, but you should always wait at least two minutes and never more than five.  

Extra Narcan Doesn’t Make It Work Better

When you’re mailing a letter, you need one stamp, maybe two. You can put a bunch of extra stamps on the envelope “just to be safe,” but that doesn’t mean they’re necessary, and they won’t make the letter get there any faster.

Narcan works by going to the same receptors in the brain that opioids go to, and bumping off whatever opioids happened to be there first. Once it hits about half the relevant receptors, the overdose is reversed. This generally takes between two and five minutes.

If you give someone additional doses of Narcan right after you gave them the first one, it won’t make the first dose reach those receptors any faster. When it looks like it doesn’t work until you hit them with three or four or five doses, but it’s only been a couple of minutes, then what you’re seeing is the effect of the first dose getting where it needs to go. 

If you ask colleagues how they know that multiple doses of Narcan were needed, they’re probably going to tell you that multiple doses of Narcan were used. It’s a case of “correlation not causation,” which is common in narratives about illicit drugs. Another example is the purported rise in THC overdose among children, based on the volume of calls to Poison Control Centers. Which doesn’t indicate how many children actually overdosed on THC, but the number of times someone said they did.

It’s true that “every second counts” when someone’s not getting oxygen to their brain, but faster-acting alternatives like Opvee are more harmful than Narcan without being any more effective. While waiting for Narcan or any overdose-reversal agent to kick in and allow the person to breathe on their own again, the important thing is that someone else breathe for them.

You Can Save Them Without Narcan

If you can’t find any Narcan, or are waiting on someone to bring it, rescue breathing can take its place until backup arrives or the overdose dissipates naturally. The latter might take hours, but as long as the person keeps getting oxygen delivered to their brain, they don’t need Narcan to survive. They should also receive rescue breathing after the first dose while waiting to see if a second is necessary.

Most overdose-reversal resources underemphasize rescue breathing and overemphasize chest compressions. However, this is generally to “increase participation from lay personnel” who might be less willing to try the former than the latter. First responders trained in chest compressions and rescue breathing are advised to do both, but there’s actually very little evidence that chest compressions are beneficial in the context of opioid overdose. Rescue breathing, on the other hand, is the tried-and-true method of keeping someone alive until Narcan can be administered, and while you wait for it to work.

Narcan Works on Fentanyl

Higher-potency versions of Narcan aren’t necessary to counteract higher-potency opioids, nor are longer-acting versions necessary because Narcan “wears off too quickly.” Regular Narcan works the same way on all opioids, including fentanyl and fentanyl analogs, regardless of their potency.

It is true that people who were just given Narcan often overdose again within the next few hours, but this phenomenon is due to people adding more opioids to their system, rather than residual opioids in their system reactivating.

Compared to lower-potency opioids like heroin, fentanyl overdoses are more dangerous because they happen more quickly. Someone can fall into respiratory depression and die in the time it takes for someone else to arrive with Narcan, which is why it’s critical to carry it on your person and why it needs to be especially accessible to the people most likely to be in close proximity to an overdose.

Too Much Narcan Is Harmful

The most effective version of naloxone, the main ingredient in Narcan, is the 0.4 mg intramuscular vial you use like an EpiPen. That dose is the amount most adults need to for the naloxone to reach half the relevant receptors in their brain, and thus reverse the overdose.

When arriving at the scene of an overdose, it can seem intuitive to hit the person with Narcan a couple of times back-to-back, especially if you don’t know how long they’ve already been unresponsive. The problem is that in most cases, a standard 4 mg Narcan nasal spray already contains a bigger dose than they needed, and multiple doses or higher-potency formulations almost guarantee it. For someone with an opioid tolerance, waking up by way of an unnecessarily large dose of Narcan is extremely painful, and is often the catalyst for overdosing again shortly after an attempt to alleviate that pain.

If you’ve ever revived someone with Narcan who then took a swing at you, chances are it could have been avoided by only giving them the amount that they needed.

Image via San Diego County Sheriff’s Department

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The rationale behind Good Samaritan laws is that people aren’t necessarily afraid of paramedics, but of the cops who tend to show up along with them. By assuring anyone who calls 911 that they won’t be prosecuted for having drugs on them, or for being high, they’ll be less likely to flee the scene without rendering aid. In theory, everyone’s safer.

State public awareness campaigns will make sweeping statements about how the law protects you—you—when you call 911, then make some reference to the fine print. If you are in possession of too much drugs; in possession of pipes or syringes; sell drugs; share drugs; have prior drug convictions; have open warrants; are on parole; have OD’d before; or have called for help before, then the law probably protects people who are not you.

Many Good Samaritan laws grant immunity for possession, but few for sale or sharing. Nine states have laws that lack any protections related to “paraphernalia.” Only seven include anything about civil asset forfeiture.

In West Virginia, immunity for the person who OD’d is contingent on completion of a drug court program. Ohio requires both the person who OD’d and the person who called 911 to get a referral to addiction treatment within 30 days, and to produce documentation showing they’ve completed it if the prosecuting attorney requests it.

In many states, the person who called 911 is required to use their full legal name, stay at the scene and provide their contact info; Alaska requires they show ID. If they don’t “fully cooperate,” they don’t get immunity and neither does the person who OD’d.

Of the 48 states with Good Samaritan laws on the books, eight don’t extend any immunity to people who OD using opioids.

Alabama, Indiana, Oklahoma and Wisconsin only grant immunity to the person who called 911, not the person they called about. Alaska, Arkansas, Maryland and South Dakota extend it to people who seek help on their own behalf, but someone OD’ing from opioids (or other banned substances with sedative effects) can’t call 911 on themselves, any more than they can Narcan themselves. They are unconscious. 

Texas won’t grant immunity to anyone who’s been involved in a documented OD in the past 18 months.

In Tennessee and Iowa, the law doesn’t apply to the person who OD’d if records show they’ve OD’d before; Iowa extends this to the person who sought help, too. Ohio will grant immunity to the same person twice, but not a third time. 

Texas, which was the third remaining state without a Good Samaritan law before enacting a messy one in 2021, won’t grant immunity to anyone who’s been involved in a documented OD in the past 18 months. Or to anyone with prior drug convictions.

In South Carolina, if the person who called 911 or otherwise sought help has sought help for others in the past, immunity from prosecution hinges on how the court views “the circumstances of the prior incidents and the related offenses.”

Good Samaritan laws sometimes protect eligible parties from being charged with drug possession. But in many states, the law only protects people from being prosecuted—not from being arrested.

In the original version of HB 2487, Kansas would have extended immunity to up to four people who call 911 or otherwise report an active OD to emergency medical services, in addition to the person who OD’d. The version headed to the Senate pared that back to one, and also removed a portion that would have protected people from punishment for violating terms of parole or probation.

Good Samaritan laws aren’t written to protect people who use the most stigmatized drugs every day, or who use them in stigmatized ways.

If passed, Kansas will be one of 22 states with a Good Samaritan law that protects people who’d otherwise face prison time for drug possession—but offers no immunity for those facing prison time because they’re under some form of community supervision like parole, probation or pretrial release.

New Jersey’s law states that e.g. parole shouldn’t be revoked as a result of seeking or obtaining help, but it may call for “establishing or modifying the conditions of parole or probation supervision.” Maryland’s law excludes the person who OD’d, assuming they didn’t call on their own behalf. Lawmakers want to make sure no one ends up with criminal charges because they tried to save a life—except for the people they can send back to prison without any new charges being filed to begin with.

Good Samaritan laws aren’t written to protect people who use the most stigmatized drugs every day, or who use them in stigmatized ways. Mostly they’re written for people with no involvement in the criminal-legal system. They encourage everyone involved in an OD to call for help, and only make it safe for some of them.

Top image via Office of Nevada Attorney General. Second image via City of New York. Third image via Town of Fairhaven, Massachusetts.

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Kloxxado, the opioid overdose antidote manufactured by Hikma Pharmaceuticals, was approved in May 2021. It’s a nasal spray exactly like Narcan—just double the dose. People who use opioids want it kept far away from them, but it’s been enthusiastically endorsed by law enforcement departments, in accordance with the profession’s misguided beliefs about how overdose works.

The first analysis of Kloxxado’s real-world use was conducted by the New York State Department of Health, New York State Police (NYSP) and Albany Medical College. They found no apparent benefits compared to Narcan—but some very apparent harms. The findings were published in a Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report on February 8.

The analysis of NYSP overdose response data spanned March 2022, when three troops began using Kloxxado, to August 2023. The showed that whether the officers used 4 mg Narcan or 8 mg Kloxxado made no difference in survival rate. It also made no difference in how many doses were used. If cops decide naloxone isn’t working fast enough, they’ll use a second dose regardless of whether that brings someone to 8 mg or 16 mg.

The right dose of naloxone is the lowest one that restores normal breathing. The unnecessary dose is the one wakes them up.

Naloxone can be safely administered to anyone—babies; dogs—but it can have harms for people who use opioids, depending how it’s administered. The right dose of naloxone is the lowest one that restores normal breathing. The unnecessary dose is the one wakes them up.

If you give just enough to get someone breathing on their own again and then stop, they can peacefully sleep it off. If you keep giving them more, they go into precipitated withdrawal, a state torturous enough that it leaves people at immediate risk of overdosing again when they seek to relieve the symptoms. The dramatic, sitting bolt upright, huge gasp of air type of reversal doesn’t have to happen—cops just keep going until it does, as if it’s supposed to be the norm.

“No significant differences were observed in survival,” the authors stated in the report. “[H]owever, persons who received the 8-mg intranasal naloxone product had 2.51 times the risk for opioid withdrawal signs and symptoms, including vomiting, than did those who received the 4-mg.”

Despite what the CDC and the National Institute on Drug Abuse and the National Harm Reduction Coalition say from time to time, fentanyl doesn’t require more naloxone than less-potent opioids like heroin. Naloxone usually works after just the first dose, it just takes two or three minutes for that dose to kick in. If you’ve waited that long (give rescue breaths!) and don’t see someone breathing on their own, then it’s time for the next one. 

The authors also note that previous research has also found no evidence supporting the belief that fentanyl is too strong for naloxone. It is simply a thing cops say because they heard other cops say it, and it sounds right. They’ll hit someone with one dose of Narcan, reach right over the little step-by-step instruction pamphlet to grab a second, and have pumped in three or five or eight doses by the time the first one’s had a chance to work. Then they’ll tell journalists how it takes so much more Narcan to bring someone back these days, so you know the fentanyl is getting stronger.

Naloxone works the same way on fentanyl as it does on heroin or hydrocodone.

Naloxone, whether it’s injected into the muscle or sprayed up the nose, doesn’t act on the opioids themselves. It acts on the brain’s mu receptors, and when it finds them it knocks off any opioids that happened to be sitting there first. All opioids, no matter their potency, occupy these same receptors, which is why naloxone works the same way on fentanyl as it does on heroin or hydrocodone.

Once the naloxone reaches about 50 percent of your mu receptors, overdose is reversed. You only have so many mu receptors, so extra doses don’t make the naloxone work faster or better. 

Usually about 0.4 mg of naloxone will do it, which is why that’s is the amount contained in each vial of the generic intramuscular kind. Narcan contains a higher dose than that because a nasal spray doesn’t deliver naloxone as efficiently as an intramuscular shot. But at 10 times higher, the recipient is probably already getting more than they need, and nasal sprays aren’t a delivery system that can be titrated. If cops are starting people off with 8 mg of naloxone and then moving up by increments of the same, all it does it guarantee suffering.

“This initial study suggests no benefits to law enforcement administration of higher-dose naloxone,” the report concluded. Law enforcement will suggest them anyway.

Correction, February 21: This article has been updated to reflect that the CDC was not affiliated with the research, and to correctly identify the police department. It is NYSP, not NYPD.

Photograph via City of Franklin, Tennessee

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