Existing law makes it a crime to possess specified controlled substances or paraphernalia. Existing law makes it a crime to use or be under the influence of specified controlled substances. Existing law additionally makes it a crime to visit or be in any room where specified controlled substances are being unlawfully used with knowledge that the activity is occurring, or to open or maintain a place for the purpose of giving away or using specified controlled substances. Existing law makes it a crime for a person to rent, lease, or make available for use any building or room for the purpose of storing or distributing any controlled substance. Existing law authorizes forfeiture of property used for specified crimes involving controlled substances.

This bill would authorize state or local health departments to authorize the operation of specified adult public health or medical intervention programs intended to reduce death, disease, or injury due to the use and administration of controlled substances. The bill would exempt a person from the criminal sanctions above while he or she is operating an adult public health or medical intervention program authorized by a state or local health department.

Existing law makes it a crime to possess specified controlled substances. substances or paraphernalia. Existing law makes it a crime to use or be under the influence of specified controlled substances. Existing law additionally makes it a crime to visit or be in any room where specified controlled substances are being unlawfully used with knowledge that the activity is occurring, or to open or maintain a place for the purpose of giving away or using specified controlled substances. Existing law makes it a crime for a person to rent, lease, or make available for use any building or room for the purpose of storing or distributing any controlled substance. Existing law authorizes forfeiture of property used for specified crimes involving controlled substances.

This bill would exempt a person from those criminal sanctions while he or she is using or operating an adult public health or medical intervention that is permitted by state or local health departments and intended to reduce death, disability, or injury due to the use of controlled substances. authorize state or local health departments to authorize the operation of specified adult public health or medical intervention programs intended to reduce death, disease, or injury due to the use and administration of controlled substances. The bill would exempt a person from the criminal sanctions above while he or she is operating an adult public health or medical intervention program authorized by a state or local health department.

Existing law makes it a crime to possess specified controlled substances. Existing law additionally makes it a crime to visit or be in any room where specified controlled substances are being unlawfully used with knowledge that the activity is occurring, or to open or maintain a place for the purpose of giving away or using specified controlled substances. Existing law makes it a crime for a person to rent, lease, or make available for use any building or room for the purpose of storing or distributing any controlled substance. Existing law authorizes forfeiture of property used for specified crimes involving controlled substances.

This bill would exempt a person from those criminal sanctions while he or she is using or operating an adult public health or medical intervention that is permitted by state or local health departments and intended to reduce death, disability, or injury due to the use of controlled substances.

Date of Hearing: April 5, 2016

Counsel: David Billingsley

ASSEMBLY COMMITTEE ON

, Sr., Chair

ABPCA Bill Id:

Author:() – As Ver:

SUMMARY:

Decriminalizes conduct connected to use and operation of an adult public health or medical intervention facility that is permitted by state or local health departments and intended to reduce death, disability, or injury due to the use of controlled substances. Specifically, this bill:

1. Allows state or local health departments to authorize the establishment and operation of an adult public health program intended to reduce death, disease, or injury due to the use and administration of controlled substances.
   
2. States that such public health program includes, but is not limited to, supervised consumption services where adults may consume preobtained controlled substances under the supervision of staff in a safe and hygienic facility.
   
3. Specifies that at a minimum these programs shall provide substance use disorder treatment either directly or through referral.
   
4. Provides that any person or entity, including, but not limited to, property owners, managers, employees, volunteers, and clients or participants, involved in the operation or utilization of such an adult public health or medical intervention program shall not be arrested, charged, or prosecuted for specified drug related offenses, or have his or her property subject to forfeiture, or otherwise be penalized solely for actions or conduct allowed by state or local health departments.

EXISTING LAW:

1. Provides that the possession of cocaine, cocaine base, heroin, opium, and other specified controlled substances listed in the controlled substance schedule, unless upon the prescription of a physician, dentist, podiatrist, or veterinarian licensed to practice in this state, shall be punished by imprisonment in a county jail for not more than one year, except at specified. (Health and Saf. Code, § 11350(a).)
   
2. Makes the possession of methamphetamine and other specified controlled substances listed in the controlled substance schedule, unless upon the prescription of a physician, dentist, podiatrist, or veterinarian licensed to practice in this state, punishable by imprisonment in a county for a term not to exceed one year, except as specified. (Health and Saf. Code, § 11377(a).)
   
3. States that any person who has under his or her management or control any building, room, space, or enclosure, either as an owner, lessee, agent, employee, or mortgagee, who knowingly rents, leases, or makes available for use, with or without compensation, the building, room, space, or enclosure for the purpose of unlawfully manufacturing, storing, or distributing any controlled substance for sale or distribution can be punished by imprisonment in the county jail up to three years (Health & Saf. Code, § 11366.5, subd. (a).)
   
4. Specifies that any person who utilizes a building, room, space, or enclosure specifically designed to suppress law enforcement entry in order to sell, manufacture, or possess for sale any amount of drugs, as specified, shall be punished by imprisonment in the county jail for three, four, or five years. (Health & Saf. Code, § 11366.6.)
   
5. Provides that until January 1, 2021, as a public health measure intended to prevent the transmission of HIV, viral hepatitis, and other bloodborne diseases among persons who use syringes and hypodermic needles, and to prevent subsequent infection of sexual partners, newborn children, or other persons, the possession solely for personal use of hypodermic needles or syringes if acquired from a physician, pharmacist, hypodermic needle and syringe exchange program, or any other source that is authorized by law to provide sterile syringes or hypodermic needles without a prescription shall not be criminalized. (Health & Saf. Code, § 11364, subd. (c).)
   
6. Specifies that notwithstanding any other provision of law and until January 1, 2021, as a public health measure intended to prevent the transmission of HIV, viral hepatitis, and other bloodborne diseases among persons who use syringes and hypodermic needles, and to prevent subsequent infection of sexual partners, newborn children, or other persons, a physician or pharmacist may, without a prescription or a permit, furnish hypodermic needles and syringes for human use to a person 18 years of age or older, and a person 18 years of age or older may, without a prescription or license, obtain hypodermic needles and syringes solely for personal use from a physician or pharmacist. (Business & Prof. Code, § 4145.5, subd. (b).)
   
7. Classifies controlled substances in five schedules according to their danger and potential for abuse. Schedule I controlled substances have the greatest restrictions and penalties, including prohibiting the prescribing of a Schedule I controlled substance. (Health & Saf. Code, §§ 11054 to 11058.)

FISCAL EFFECT:

Unknown

COMMENTS:

1. Author's Statement: According to the author, "Across the United States, heroin and opiate use and overdose is on the rise. Legislation in many states, including California, has improved access to sterile needles; broadened the use life-saving drug naloxone, which reverses the impact of opiate overdose; and continued the utilization of drug courts and drug diversion programs. However, with 125 Americans dying every day, and California hospitals treating one overdose every 45 minutes, we must continue to look for innovative strategies for addressing this epidemic.
   
   “This bill would extend the harm reduction strategies we are already using in California, by enabling Local Health Jurisdictions to authorize programs to provide medical supervision to consumers of pre-obtained drugs, in order to save lives, connect individuals with vital services like detoxification and housing, and reduce public nuisance and potentially hazardous litter. Research has shown these programs reduce overdose mortality, public injection, litter from drug use, and public nuisance all while increasing access to treatment, safe use behaviors, and entrance into detoxification services. In a single year the Canadian safe consumption facility made more than 2,000 referrals to community-based services: 37% were for addictions counseling, 12% for detoxification, 16% for community health centers, 4% for methadone maintenance therapy, and 3% for long-term recovery houses. The research shows no increase in the number of people who use drugs, drug trafficking and consumption crimes, or relapse rates. A simulation of the population of Vancouver suggests that their program has contributed to the prevention of 1191 HIV infections and 54 hepatitis C virus infections, and saved over 1300 years of life and $14 million.”
   
2. Supervised Injection Facilities and Drug Consumption Rooms: This bill would allow state or local health departments to authorize public health programs such as supervised injection facilities and drug consumption rooms. Supervised injection facilities and drug consumption rooms are professionally supervised healthcare facilities where drug users can consume drugs in safer conditions. One of their primary goals is to reduce morbidity and mortality by providing a safe environment for more hygienic drug use and by training clients in safer drug use. The drug consumption room seeks to attract hard-to-reach populations of drug users, especially marginalised groups and those who use drugs on the streets or in other risky and unhygienic conditions. At the same time, they seek to reduce drug use in public and improve public amenity in areas surrounding urban drug markets. A further aim is to promote access to social, health and drug treatment facilities. (http://www.drugwarfacts.org/cms/Safe_Injection#sthash.jb2AsCAE.dpbs)
   
3. Increasing Opioid and Heroin Overdoses in California: An August 17, 2015 article in the Sacramento Bee discussed the increase California hospitals have been seeing in opioid and heroin overdoses.
   
   “California hospitals treated more than 11,500 patients suffering an opioid or heroin overdose in 2013, new state figures show. That's roughly one overdose every 45 minutes. It's also up more than 50 percent from 2006.
   
   “. . . Opioid overdoses resulting in ER visits and hospitalizations increased steadily nearly every year from 2006 to 2013, according to the Office of Statewide Health Planning and Development. Opioid deaths peaked in 2010 and have dropped slightly in following years, according to the California Department of Public Health. (http://www.sacbee.com/siteservices/databases/article31324532.htm)
   
4. California Allows Sale of Hypodermic Needles: California has allowed the sale of hypodermic needles and syringes for a number of years. SB 1159 (Vasconcellos), Chapter 608, Statutes of 2004, established a five-year pilot program to allow California pharmacies, when authorized by a local government, to sell up to 10 syringes to adults without a prescription. Within several years there were hundreds of pharmacies, reaching a total of 650 by the suspension of the pilot. The pilot was suspended when statewide sales were authorized by SB 41 (Yee), Chapter 738, Statutes of 2011. SB 41 also required the Department of Public Health (DPH) to evaluate the results of the pilot project.
   

In July 2010, DPH published an evaluation of the pilot. The report had a number of findings. Among the most relevant were that an increased number of intravenous drug users (IDUs) reported using pharmacies as a source of their syringes. The availability of these sterile syringes seemed to impact behavior. A significantly lower portion of IDUs reported sharing of syringes and there was no evidence of increased unsafe discard of used hypodermic needles or syringes was observed in the Disease Prevention Demonstration Projects (DPDP). DPH reported that the level of injection of illegal drugs decreased among publicly funded HIV testing clients. The report also found that drug related crime remained stable in the jurisdictions that authorized DPDPs. Nevertheless, DPH concluded that the program appeared to be having the desired effect of augmenting access to sterile syringes.

There are a host of studies both domestically and internationally that provide evidence that provision of sterile hypodermic needles and syringes reduces HIV transmission. Public health experts, including the Centers for Disease Control and Prevention, have identified access to sterile syringes as one component of a comprehensive HIV prevention strategy designed to reduce HIV transmission among IDUs. In the last 10 years, a number of national organizations have endorsed deregulation to allow IDUs to purchase and possess syringes and needles without a prescription, including the American Medical Association, the American Pharmaceutical Association, the NABP, the National Alliance of State and Territorial AIDS Directors, and the Association of State and Territorial Health Officials.

1. If This Bill Becomes Law, the Conduct Allowed would Still be Criminal Under Federal Law: State authorization does not nullify federal drug laws. As a result state authorization for drug consumption rooms would not prevent them from being shut down by federal law enforcement agencies. Likewise, state authorization does not provide immunity from federal criminal proceedings, if federal law enforcement was inclined to pursue them.
   
   21 U.S.C. 844 and 21 U.S.C. 856 are two federal laws which prohibit behavior related to activity at a drug consumption room.
   
   21 U.S.C. 844 prohibits possession of drugs.
   
   21 U.S.C 856 prohibits:
   
   (a) knowingly open, lease, rent, use, or maintain any place, whether permanently or temporarily, for the purpose of manufacturing, distributing, or using any controlled substance;
   
   (b) manage or control any place, whether permanently or temporarily, either as an owner, lessee, agent, employee, occupant, or mortgagee, and knowingly and intentionally rent, lease, profit from, or make available for use, with or without compensation, the place for the purpose of unlawfully manufacturing, storing, distributing, or using a controlled substance.
   
   Those sections would criminalize the behavior of both the clients using the facilities and the owners or operators of the facilities.
   
   California already has existing law which is in conflict with federal drug law. California authorized medical marijuana in 1996 when Prop 215 was passed. Prop 215 was, and continues to be, in conflict with federal drug law.
   
2. Argument in Support: According to National Association of Social Workers, California Chapter, “Supervised Consumption Services (SCS) have been utilized in Vancouver, Sydney and nearly 100 other locations around the world to reduce overdoes death and injury, decrease public health concerns like discarded syringes and public injection, reduce the transmission of infectious diseases, and provide entry to treatment for this most marginalized group. This bill removes certain legal barriers to the implementation and operation of public health and medical intervention programs intended to reduce death, disability, or injury due to the use of controlled substances.”
   
3. Argument in Opposition: According to The California Police Chiefs Association, “As currently written, AB 2495 fails to provide for minimum regulations for supervised injection sites (SIS), such as hours of operation, resources for recovery, data collection, specialized training for employees, minimum safety requirements, and local authority over the zoning of SISs. Furthermore, AB 2495 does not require any evaluation or analysis of the impat of SISs on public health and safety. The SIS located in Vancouver frequently referenced by the proponents of this model was developed in 2002 as a focused research project. Unfortunately, nothing in AB 2495 requires the study of the impacts of an SIS in California.
   
   “Lastly, AB 2495 will put California law enforcement in the inappropriate position of enforcing a state law at odds with federal law. While the federal government has opined on the issue of state marijuana laws diverging from federal law, there has been no indication that the federal government will take a hands off approach surrounding SISs.”
   
4. Prior Legislation:
   
   1. SB 41 (Yee), Chapter 738, Statutes of 2011, authorized a county or city to authorize a licensed pharmacist to sell or furnish 10 or fewer hypodermic needles or syringes to a person 18 or older for human use without a prescription.
      
   2. SB 1159 (Vasconcellos), Chapter 608, Statutes of 2004, established a five-year pilot program to allow California pharmacies, when authorized by a local government, to sell up to 10 syringes to adults without a prescription.
      

REGISTERED SUPPORT / OPPOSITION:

Support

Aids Project Los Angeles
A New Path
Asian American Drug Abuse Program
California Hepatitis Alliance
Centerforce
Harvey Millk LGBT Democratic Club
Homeless Health Care Los Angeles
Homeless Youth Alliance
Humboldt Area Center for Harm Reduction
Law Enforcement Against Prohibition
Legal Services for Prisoners with Children
Los Angeles Community Health Project
National Association of Social Workers, California Chapter
Needle Exchange Emergency Distribution
San Francisco AIDS Foundation
San Francisco Hepatitis C Task Force
S.T.O.P. Hepatitis Task-Force
Tarzana Treatment Centers

Opposition

Association for Los Angeles Deputy Sheriffs
California Association of Code Enforcement Officers
California College and University Police chiefs Association
California Police Chiefs Association
California Narcotic Officers’ Association
California State Sheriffs’ Association
Los Angeles County Professional Peace Officers Association
Los Angeles Police Protective League
Riverside Sheriffs Association

Analysis Prepared by: