Wednesday, 20 February 2019

Legalize Pot? Amid Opioid Crisis, Some New Hampshire Leaders Say No Way

Nick Bickford, from Manchester, N.H., said he became addicted to heroin when he was 16. He said the state should get its opioid crisis under control before it considered legalizing marijuana.CreditCreditTony Luong for The New York Times
By Kate Taylor
    MANCHESTER, N.H. — The push to legalize recreational marijuana is sweeping the Northeast: Massachusetts, Vermont and Maine have done it, and the governors of Rhode Island, Connecticut, New York, and New Jersey say they want their states to do it, too.

    But in New Hampshire, Gov. Chris Sununu and some other state leaders are opposed. 

    The problem, they say, is not just about pot. It’s about opioids — drugs that have ripped across this state, devastating thousands of residents and leaving New Hampshire in recent years with one of the highest per capita death rates from opioid-related overdoses. After so many deaths, so much misery and so much state money spent fighting opioids, the opponents say, how could anyone even think about easing access to some other drug?

    There is little consensus about a relationship between marijuana use and opioid addiction, and the debate in New Hampshire, where a key vote on the issue is expected this week, is tapping into a national discussion about whether marijuana is a gateway drug or something else entirely.

    “When we are dealing with opioids as the single biggest health crisis this state has ever had, you are going to tell me legalizing more drugs is the answer?” Mr. Sununu said last fall. 

    “Absolutely not.”

    In New Hampshire, this is not primarily a partisan fight. Mr. Sununu is one of a handful of Republican governors in a part of the country where Democrats mostly control state capitals, but he is also part of a bipartisan group that sees New Hampshire’s uniquely ruinous opioid crisis as a cautionary tale. Senator Jeanne Shaheen, a Democrat, has expressed concerns about legalizing recreational marijuana and Senator Maggie Hassan, also a Democrat, says she is against it.

    New England tends to embrace liberal policies on social issues, and this state, with its “Live Free or Die” motto, celebrates personal freedom and limited government. Following other New England states, New Hampshire in 2013 legalized medical marijuana and in 2017, during Mr. Sununu’s administration, decriminalized possession of small amounts of pot. But opioid addiction has ravaged communities in New Hampshire, and the crisis has become a point of public distress. Some 424 people in the state died of opioid-related overdoses in 2017, and the number of children in foster care has more than doubled since 2014.

    Nick Bickford, a 21-year-old from Manchester who said he became addicted to heroin when he was 16, said that he had lost nine close friends to overdoses since he quit using two years ago.

    “It’s so common, to the point that I’ll see someone I haven’t seen in a while, and they ask, ‘Oh, has anyone died I didn’t hear about?’” Mr. Bickford said. “The worst thing is that you just get kind of numb to it.” Mr. Bickford said the state should get its opioid crisis under control before it considered legalizing marijuana. “There’s so many bigger things to be focusing on,” he said.
    A look at how opioids hijack the brain, from temptation and tolerance to relapse and recovery.
    Mr. Sununu is tapping into anxiety about the ongoing toll of the crisis as he pushes against efforts in the Democratic-controlled state legislature to legalize and create a market for marijuana. At a meeting in December of a state commission on alcohol and drug abuse, Mr. Sununu called the debate over marijuana legalization “the next major battle” in the state’s response to the opioid crisis. He urged the commission, which includes medical and drug treatment experts, as well as the heads of various state departments, to take an official position opposing the legislation, which it did at its meeting last month. And he is pressing the matter at a time when new questions are being raised nationally about whether marijuana is as benign as its proponents suggest, with a much debated new book drawing a link between marijuana use and psychosis.

    “He’s hitting a chord,” Ronald G. Shaiko, a senior fellow at the Nelson A. Rockefeller Center for Public Policy and the Social Sciences at Dartmouth College, said of the governor. “To the extent that citizens don’t believe that government’s responded well” to the crisis, he continued, “this is just another problem to lay over on top of that.” A poll in 2017 found that 53 percent of New Hampshire adults considered drug misuse the most significant issue facing the state.

    Tym Rourke, a member of the state commission on alcohol and drug abuse who oversees addiction-related programs for the New Hampshire Charitable Foundation, said that it really did not matter whether marijuana was more or less safe for the average person than other addictive substances, like alcohol.

    “For some people, it’s unsafe,” he said. “And as we are grappling with a high volume of individuals struggling with the consequences of substance misuse, do we really want to create a system that puts another substance more into the marketplace or more into their presence?”

    Gov. Chris Sununu of New Hampshire has taken a firm stance against a bill that would legalize recreational marijuana.CreditJim Cole/Associated Press
    Speaking of those who are in recovery from addiction, he said, “Do we want them to have to drive to work past a dispensary?”

    But supporters of legalizing recreational marijuana are trying to flip the argument on its head. 

    They say legal marijuana could actually help solve the crisis, by helping people get off opioids.

    They point to a 2018 study that showed an association between marijuana use, at least daily, and remaining in medication-assisted treatment. Another study, from 2014, found that states with medical marijuana programs had lower death rates from opioid overdoses than states without.

    “What we’ve come to understand is that marijuana in many instances is an exit drug, not a gateway drug,” State Representative Renny Cushing, a Democrat and the lead sponsor of a bill being considered in the New Hampshire House, said.

    But even those experts who believe that marijuana may have a role in helping people with opioid addiction say that much more research is needed, and that marijuana should not be a substitute for treatment with methadone or buprenorphine, which have been found to substantially reduce deaths among people addicted to opioids. Recently, some states have begun encouraging people to switch from opioids to medical marijuana, or even making opioid addiction a qualifying condition to get medical marijuana — a move that some experts have found alarming.

    Mr. Cushing’s bill would make it legal for people 21 and over to possess, consume, buy and grow small amounts of marijuana, and would create a commission to license and regulate marijuana cultivation, production and retail establishments. Taxing marijuana sales could bring New Hampshire between $15.3 million and $57.8 million a year, a state commission has said. 

    The bill, which is likely to be voted on in a House committee on Thursday, is expected to pass the House; if it passes the Democratic-held Senate and reaches the governor’s desk, Mr. Sununu, who declined to be interviewed for this story, has promised to veto it.

    Some people suggest that opponents are using New Hampshire’s opioid crisis to back up their argument, when their real reason for opposing legalization is a more general discomfort with drugs of any kind.

    Keith Howard, the executive director of Hope for New Hampshire Recovery and a member of the governor’s commission on alcohol and drug abuse, said that he was neutral on the bill.

    The opioid crisis and the question of whether to legalize marijuana “have nothing to do with each other,” he said, though “in debate it’s very easy to conflate the two and then use the power of deaths from opioids to bolster an argument about marijuana.”

    Complicating matters, people directly affected by opioids have mixed views on marijuana.

    On a recent, gray afternoon in Manchester, men and women went in and out of Hope for New Hampshire Recovery, Mr. Howard’s recovery center, to attend groups, meet with coaches, paint, or simply be surrounded by people who would not judge them.

    Tristen Thibault, 22, who said he had struggled with addiction to heroin and methamphetamines and had been clean for three months, said that he didn’t use marijuana now because he was on probation for drug possession and lived in a sober house. But in the past, he said, marijuana had been important to him because it eased the pain associated with a medical condition called hereditary spastic paraplegia, which makes it difficult for him to walk.

    “I’ve never hit a rock bottom with pot,” he said, drawing a contrast with heroin and meth. 

    “I’ve never sold everything I had for it. I’ve never screwed over people that I love for it.”

    He said he thought that if recreational marijuana were legalized, “there would be, I would say, maybe a decrease in the heroin and meth and all that, because it’s something legal that you can do that makes you feel good, that helps you through the day.”

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