The Health 202: Congress appears ready to buck Sessions on medical marijuana

Congress will likely renew protections next month for state medical marijuana laws -- but pro-pot lawmakers and advocates are still watching nervously in case Attorney General Jeff Sessions launches a last-minute sabotage campaign.
For nearly three years now, Congress has maintained a policy prohibiting the Justice Department from using federal funds to prevent states allowing medical marijuana – which now number 29 plus the District of Columbia – from carrying out their own laws.
The amendment, offered by Reps. Dana Rohrabacher (R-Calif.) and Earl Blumenauer (D-Ore.), will soon expire unless Congress renews it. And it seems likely lawmakers will include the language in a spending bill keeping the government open past Sept. 30, with one possible hiccup – intervention by Sessions, who’s famously known for his abhorrence to cannabis.

Sessions, who prepared a speech in April whose initial text (later revised) called marijuana “only slightly less awful” than heroin, apparently asked congressional leaders to undo the state medical marijuana protections in a letter that became public in June. In that letter, Sessions argued the Rohrabacher-Blumenauer amendment would restrict the DOJ from enforcing the federal Controlled Substances Act.
“I believe it would be unwise for Congress to restrict the discretion of the Department to fund particular prosecutions, particularly in the midst of an historic drug epidemic and potentially long-term uptick in violent crime,” Sessions wrote. “The Department must be in a position to use all laws available to combat the transnational drug organizations and dangerous drug traffickers who threaten American lives.”
Yet Sessions is up against a Congress filled with an unprecedented number of pro-pot lawmakers from a record number of states where it’s legal.
Last November’s election brought sweeping victories for the pro-marijuana crowd: Seven states plus the District now allow recreational use after voters in California, Massachusetts, Maine and Nevada approved such measures. And four more states – Florida, North Dakota, Arkansas and Montana – approved medical use laws, making it legal in more than half the states for doctors to prescribe marijuana to patients.
It's notable that each time the House has approved the Rohrabacher-Blumenauer language, it’s been by increasingly wider margins. The protections for state medical marijuana laws were included with little controversy in the spring spending bill. And last month, the Senate Appropriations Committee passed such protections, offered by Sen. Pat Leahy (D-Vt.), by voice vote.

“This is the most sympathetic Congress we’ve ever had to issues of cannabis,” Blumenauer told me.
Blumenauer said he’s had no concrete assurances yet from GOP leaders that they’ll include the protections in the spending bill they need to pass by Oct. 1 in order to keep the government funded (and in his Arizona rally remarks last night, Trump suggested he'd be open to a shutdown over funding for his border wall). But Blumenauer is “reasonably confident” the language will ultimately be renewed, barring an intervention by Sessions.
Advocates are also expecting Congress to keep protecting states with medical marijuana laws, even though they’ve been deeply dismayed by Sessions and his past, well-documented opposition to pot.
“I am cautiously optimistic that we are going to retain the protections,” said Justin Strekal, political director for the pro-pot group National Organization for the Reform of Marijuana Laws (known as NORML).
The Obama administration made clear in the 2013 “Cole” memo – drafted by then-deputy attorney general James Cole – that it would mostly avert its eyes from state laws. The document warns U.S. attorneys in all 50 states to let states go ahead with legalization efforts, as long as pot isn’t being made available to minors or in states where it isn’t legal.
For the moment, it’s unclear how hard Sessions will try to combat the legalized marijuana trend sweeping the country (a Justice Department spokeswoman didn’t respond to my questions about his approach). The AG certainly has the power to make life very, very difficult for users and growers of the drug, which remains illegal under federal law.
Most significantly, Sessions could direct U.S. attorneys to go after those involved with recreational marijuana. He could use a process called asset forfeiture to seize money and property from them. He could choose to prosecute anyone involved in the industry.
That’s because Congress has so far rejected the next step, which would be to protect states that allow recreational use. Two years ago, the House defeated by a 222-206 margin a bipartisan amendment from Reps. Tom McClintock (R-Calif.) and Jared Polis (D-Colo.) to prohibit federal authorities from prosecuting people for use, sale or possession of marijuana in a state in which the drug is legal under relevant state laws.

Yet if Sessions tries to remove pot protections, it’s unlikely to be at the behest of the White House. President Trump said several times during his campaign that legalization should be up to the states, and even at one point expressed support for pot's medical use.
“The marijuana thing is such a big thing,” Trump said at a campaign rally in Nevada in October 2015. “I think medical should happen, right? Don’t we agree? I think so. And then I really believe we should leave it up to the states.”
One thing’s for certain – in a popularity contest between the president and legalized pot, the pot wins (recent polls show that six in 10 Americans now think it should be legal). Blumenauer was happy to note the reality.
“In the nine states where both Donald Trump and marijuana were on the ballot, marijuana got a lot more votes than Trump,” he told me.

OOF: Recent government reports have indicated large increases in the number of Americans addicted to and dying from heroin, but brace yourself for some more bad news: The problem is even worse than government data indicates, The Post's Keith Humphreys writes.
The most-quoted figure is 561,000 people with a diagnosable heroin use disorder, which comes from the federal government’s annual National Household Survey on Drug Use and Health (NSDUH). This survey has two serious flaws that lead it to dramatically underestimate the prevalence of heroin use disorder: It excludes people who are incarcerated and people who are living on the street, both of whom have very high rates of drug use, and it relies on self-reports.
"The degree to which NSDUH underestimates the prevalence of heroin use disorder is enormous," Keith writes. "In 2010, a research team combined NSDUH data with that from other studies to determine that NSDUH could only identify 60,000 of the 1 million Americans who used heroin daily or near daily heroin users.  As most daily or nondaily heroin users would meet diagnostic criteria for heroin use disorder, NSDUH’s most recent estimate of 591,000 probably didn’t even capture the depth of the problem back in 2010, which was before the heroin problem exploded."
"The true level of heroin use disorder today could easily be double or even triple NSUDH’s estimate, but no one can truly know," he continues. "As successive Congresses have clamped down on federal spending, many government agencies have been forced to curtail their research capacity. National programs that gathered substance use data from people entering jails and from emergency room patients fell under the budget ax in 2014 and 2011, respectively."

OUCH: We already knew top Senate Republican Mitch McConnell and President Trump weren't exactly besties. But their relationship has disintegrated to the point that they've not spoken with each other in weeks, and McConnell has privately speculated that Trump won't be able to salvage his administration, the New York Times reports.
"What was once an uneasy governing alliance has curdled into a feud of mutual resentment and sometimes outright hostility, complicated by the position of Mr. McConnell’s wife, Elaine L. Chao, in Mr. Trump’s cabinet, according to more than a dozen people briefed on their imperiled partnership," Alexander Burns and Jonathan Martin write. "Angry phone calls and private badmouthing have devolved into open conflict, with the president threatening to oppose Republican senators who cross him, and Mr. McConnell mobilizing to their defense."
Alex and Jonathan detail a dramatic back-and-forth between the two -- including a phone call that "quickly devolved into a profane shouting match." "During the call, which Mr. Trump initiated on Aug. 9 from his New Jersey golf club, the president accused Mr. McConnell of bungling the health care issue. He was even more animated about what he intimated was the Senate leader’s refusal to protect him from investigations of Russian interference in the 2016 election."
For his part, McConnell has fumed over Trump’s regular threats against fellow Republicans and criticism of Senate rules, and questioned the president's understanding of the presidency in a public speech. But he's made even sharper comments privately, "describing Mr. Trump as entirely unwilling to learn the basics of governing....In offhand remarks, Mr. McConnell has expressed a sense of bewilderment about where Mr. Trump’s presidency may be headed, and has mused about whether Mr. Trump will be in a position to lead the Republican Party into next year’s elections and beyond, according to people who have spoken to him directly."

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