High Society – A Senator’s Perspective on Overdose

Josh Miller is a RI senator (Democrat – District 28) first elected in 2006 to represent Cranston and Warwick. Since his election, Senator Miller has proven to be a leader on environmental, economic and social issues, as well as a pioneer in the health and human services arena. He has also been a strong advocate for regulating and taxing cannabis, sponsoring the Regulation & Taxation Bill (RI House Bill 5777), which would virtually end marijuana prohibition in Rhode Island. We sat down with Senator Miller at the Hot Club in Providence (he is one of the owners) to ask more about the bill and its status.

Motif: With the congressional body in recess for the year, is there any chance of progress on that bill in the near future?

Josh Miller: There are some very important bills that have a hope of being considered. Hopefully the Good Samaritan law [see motifri.com/goodsamaritan] will be one of them. But it’s extremely unlikely that the Regulation & Taxation Bill will be considered before the legislature reconvenes [officially] in January.

Motif: Cannabis was a politically taboo topic until quite recently, but you have been championing an end to prohibition for years.

JM: I was co-chair of the commission that was assigned to investigate decriminalization years ago. We recommended decrim, and it took three or four years from there to pass. Some of the same people who were opposed to decrim are now proponents, but opposed to tax and regulate. It happens in politics – sometimes people are opposed until they’re not.

Motif: Polls have shown that public opinion has clearly turned to favor some form of legalization and/or regulation. What’s the delay on the lawmaker side?

JM: I think of it a little like Marriage Equality. Something that seemed to make so much sense to some people, they couldn’t understand what was taking so long. But to others it seemed to happen surprisingly fast. Once the tide of public opinion turned overwhelmingly, the lawmakers followed – but it took them some time. Public opinion changes faster than that of elected officials. Officials have to believe they will not be politically harmed for changing their minds. But once public opinion clearly passes a tipping point, then it becomes safe for the officials as well. Public favor [for marijuana legalization] has gone from around 30% to around 60%.

Motif: I’ve heard a lot of our elected officials say they want to “wait and see” what happens in Colorado and Washington. Are they helping? Or providing an excuse for procrastination? What else do we need to see from waiting?

JM: To move elected officials, you also need to present data. It takes time to pick your approach, to accumulate more facts and dismiss more myths. Colorado and Washington are helping. It’s also helping that in those states, from governors to a lot of law enforcement, there are a lot of people who are directly involved who are changing their minds, who are no longer opposed to regulation.

There are lots of components of tax and regulate – so it’s a bit complex, and people need to move away from the simple, knee-jerk law and order response.

Motif: So what can a voter do to help move regulation forward?

JM: There are reps and senators who would vote for it but are concerned about inspiring electoral opponents. There is a very active minority opposed to this bill that could make life difficult by running against them or by creating political challenges for them. As public support is made clearer and grows, that can become less threatening, and building elected support becomes easier.

Motif: By legalizing and regulating, would we be sending a message to young people that cannabis consumption is more ok? Is that going to encourage underage consumption?

JM: Compare it to the Prohibition – when alcohol became ok for adults and regulated, it became less available to those under age. Of course underage drinking still happens, but we can enforce it more thoroughly without a criminal infrastructure protecting it.

Motif: What about hemp?

JM: The biggest stumbling block to legalizing hemp without marijuana is that you create this silly enforcement obstacle, because you really can’t tell the two plants apart. You need to run tests in a lab. So the two really go hand-in-hand. If marijuana is legal and regulated, it becomes easy to make the case for hemp.

Motif: What about other relevant legislation?

JM: I already mentioned the good Samaritan law – that’s important. That could save lives.
We gained a lot of support for a law that would make it legal to prescribe marijuana for PTSD. We saw some very compelling testimony. We had one person – a veteran in a wheelchair – who hadn’t slept through the night in years. Marijuana enabled him to go from 13 different combined prescriptions that weren’t working, to two that enabled him to actually sleep through the night. That’s a victory on a different front, but it’s encouraging [this bill has not been voted through yet].

MR: What is motivating you to champion this cause?

JM: Every advocate has their own top priority – a lot of them, it’s financial. The NAACP’s primary interest is in the fact that minorities are 2.5 times as likely to be incarcerated for marijuana-related offenses [compared to whites]. Some advocates focus on legalization for the job creation it would produce. Others for the tax revenue, or what could be done with that [revenue]. The proposed bill includes that an appropriate proportion of the additional tax income would go toward treatment and education, especially for those under 18, and toward boosting immediate and appropriate access to treatment. We still don’t have the treatment capabilities we need to meet the demand, and that motivates a lot of advocates.

My priorities aren’t any better or worse than any of these. Mine is doing something about the overdose epidemic. By taking cannabis away from the drug dealers, from the black market where you have access to other drugs that can kill you and where handguns come into play, we can have a direct impact on the dangerous overdoses.

MR: You take away the most common entry point into the more criminal culture?

JM: Cannabis is a gateway drug for drug dealers to connect with customers. Look at everything we know about the finances and economy of the underground drug culture. By criminalizing marijuana, we are financing an underground economy that encourages addiction. We are choosing that over a regulated economy. And from a criminal justice perspective, we are choosing incarceration over treatment programs. There’s a money trail – where does it end up? We really have a chance to move money from cartels that are financing conflict around the world and paying for guns where they shouldn’t be, over to entrepreneurs and schools and road building.

MR: So by legalizing and regulating cannabis, you’d expect to see a decrease in other drug-related crime and abuse?

JM: … If you’re already going to a drug dealer for marijuana, it’s much easier for them to introduce the more dangerous drugs — the illegal prescription drugs and the opiates, which are creating the overdose epidemic. Those are costing lives.

There are so few fixes out there, which is part of why the rate of abuse has accelerated so quickly. I’ve had the good fortune to be surrounded by really good people who know and care a lot about this issue. Like Tom Codere, who helped make SAMHSA programs happen on the federal level. Jim Gillen of Anchor Recovery [Mr. Gillen sadly passed away earlier this month], Johnathan Goyer of Project Weber, Dr. David Lewis at the Brown University Center for Alcohol and Addiction Studies (CAAS) and ER physician Dr. Otis Warren – people who have made it their life work to try to prevent this epidemic, and who’ve given me a lot of insight on the issue.

One of the reasons we have a crisis is that it’s not just affecting the people you might have previously stereotyped as addicts. It could be your daughter, sister, mother or brother. The prescription of opiates has risen significantly over the last two decades. Oxycontin and others have driven a change in prescription trends. And a percentage of those prescribed will become addicted, and then turn to the black market to continue once their prescriptions have run out. From there, it’s a downhill battle toward overdose, or graduating to heroin and other stronger drugs. So much of it starts with prescriptions for injuries, or after surgery – we’re at a point where there’s not a community or demographic that’s left out of those who’ve suffered from overdoses. It’s really a cross section of our society. Everybody knows somebody it’s gotten out of control for, even if you don’t realize it. In 2014, [according to David Spencer of RI Data – datary.org] there were 232 RI deaths by overdose. If a plane crashed with that many people, laws would be changed – regulations would change, and you’d see something happen, and quickly. That is a larger number than suicides, car accidents and murders combined. But so far, it’s escaping under the radar in some ways. This is a way to help that situation – by reducing the strength and accessibility of that black market, and by funding treatment options.

MR: How time-sensitive is this issue?

JM: It’s not that leadership is being obstructionist – they’re being protectionist – but not realizing that that time is past. And there is definite time-sensitivity that they’re missing. There’s a referendum coming up in Massachusetts in 2016, and others down the line in almost every New England state. Based on polling, these referendums will pass. RI can either be ahead of the curve or behind the curve. If we’re ahead, obviously it will make a revenue difference. But also, once we’ve realized that tax and regulate is the better course, why continue on a course that you know is costing money and lives? Are you going to switch directions quickly, or let more damage be done?

MR: What about hemp?

JM: The biggest stumbling block to legalizing hemp without marijuana is that you create this silly enforcement obstacle, because you really can’t tell the two plants apart. You need to run tests in a lab. So the two really go hand-in-hand. If marijuana is legal and regulated, it becomes easy to make the case for hemp.

MR: What about other relevant legislation?

JM: I already mentioned the good Samaritan law – that’s important. That could save lives.

We gained a lot of support for a law that would make it legal to prescribe marijuana for PTST. We saw some very compelling testimony. We had one person – a veteran in a wheelchair – who hadn’t slept through the night in years. Marijuana enabled him to go from 13 different combined prescriptions that weren’t working, to two that enabled him to actually sleep through the night. That’s a victory on a different front, but it’s encouraging [this bill has not been voted through yet].