A Vermont perspective on the next decade of drug reform

Photo by Julia Guerrein/The Forum

By Jacob Evans, Forum Contributor

Vermont holds the honor of being the first state to legalize cannabis through a legislative action rather than a voter referendum. Our legislative predisposition to addressing cannabis has slowed progress, even while the current statute retains unaddressed issues: No legal mechanism for residents to acquire cannabis seeds should someone want to grow; non-property owners with no legal route to acquire cannabis unless it is gifted to them; and gifting itself a grey area, even with post hoc guidance in a July 23, 2018 advisory letter from AG Donovan.

After passing the Senate and stalling in House committee last session, the tax-and-regulate bill (S. 54) will be back on the agenda this session. The same hurdles, detailed in a VTDigger article from May 14, 2019, remain: cost of regulating before any tax revenue is realized, allocating funds for education and prevention, and driver impairment testing in the form of a controversial saliva test. Notwithstanding strong support within the Democrat and Progressive caucuses, these challenges need resolution. And upon resolution, a less-than-enthusiastic Governor must sign off on the plan.

Most involved parties acknowledge tax-and-regulate is a when question, not an if. Recognizing the eventuality of a tax-and-regulate model in Vermont, where does the drug reform movement shift its attention? Though legalized cannabis offers avenues for freedom of choice in personal use and business/tax revenue potential, it is also somewhat empty for socially beneficial purposes. Especially when not combined with broad expungement provisions. Evidence indicates the next wave of reformation is poised to be one of helping and healing those in need.

Criminal justice reform, as it pertains to drug policy reform, has placed an emphasis on expunging records for low level offenses and finding diversionary and treatment paths for simple possession infractions. The ongoing opioid epidemic has mainstream medical providers embracing harm reduction principles in an effort to protect public health and destigmatize use as a mechanism to promote treatment.

A November 2018 Vox article highlights the needle exchange program implemented by the Howard Center in Burlington, and their providing immediate access to Medication Assisted Treatment (MAT) on-site. In June 2019 the UVM Health Network received a $1.5 million grant to provide immediate MAT in hospital emergency departments. These immediate MAT programs are key to combating the initial period of vulnerability for lethal overdose in patients who have been revived by Naloxone. My own professional background in substance use/mental health treatment forced me to confront the fallout from the opioid epidemic firsthand. It is heartening to see an embrace of MAT and approaches that meet clients where they are at, which often means accepting a client’s current use while helping to make their use safer. I am most heartened for what lies on the horizon.

An array of other Schedule I substances are currently advancing through the medical model, much as cannabis did in the 1990s, showing promise for treating a myriad of conditions. The Multidisciplinary Association for Psychedelic Studies (MAPS) currently oversees Phase 3 trials-the last step to FDA approval- utilizing MDMA (3,4-Methylenedioxymethamphetamine), commonly known as ecstasy or molly, as a psychotherapeutic adjunct in addressing treatment-resistant PTSD. Prior trials were so successful that, in 2017, the FDA designated MDMA-treatment a “Breakthrough Therapy.” This designation provides a fast-track to gain approval from the FDA, opening the door to widespread clinical application. What’s more, on January 17, 2020 MAPS announced via press release that the FDA has granted expanded access to provide MDMA-assisted psychotherapy to an additional 50 patients outside of the 200-300 currently in the midst of the Phase 3 trials. This recognition, of both the importance and the success of treatment, may be an important harbinger of things to come.

Other promising treatment programs utilizing Schedule I substances, such as LSD and Psilocybin, are currently underway in Phase 2 for depression, anxiety, and addiction. Johns Hopkins Medicine, a longtime research institution for psychedelics, established a $17 million Center for Psychedelic and Consciousness Research in September 2019. Public advocacy movements in Denver, CO and Oakland, CA were successful in passing psilocybin decriminalization referendums in 2019. Referendums which, as discussed in a June 2019 NPR story, were largely driven by public demand for access to medicinal and therapeutic benefits of the compound. Additionally, a bill filed in the Vermont House of Representatives on January 22, 2020 proposes to decriminalize certain psychedelics, including psilocybin, in recognition of their medical, spiritual, and religious applications.

The unlimited potential for progressive movement in this field feels unique compared to so many overly-politicized, and hopelessly polarized, policy stalemates. Time will tell how successfully these big ideas can get integrated into a society so steeped in prohibition.

Jacob Evans is a student ambassador for Students for Sensible Drug Policy (SSDP).

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