BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2495


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          Date of Hearing:  April 5, 2016
          Counsel:               David Billingsley


                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY


                       Reginald Byron Jones-Sawyer, Sr., Chair





          AB  
                       2495 (Eggman) - As Amended  March 30, 2016




          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  








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            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.)









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          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  








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            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,  








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            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.h 
            tm  )

          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)  








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            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.


          5)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.








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          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.  

          6)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."

          7)Argument in Opposition:  According to The California Police  
            Chiefs Association, "As currently written, AB 2495 fails to  








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            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."

          8)Prior Legislation:  

             a)   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.

             b)   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








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          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:              David Billingsley / PUB. S. / (916) 319-3744