Last week, the Alabama Legislature took some of the first steps on SB165—a bill that would ultimately legalize medical cannabis in Alabama. This bill would move Alabama from the minority of states that continue to prohibit the prescribing of medical marijuana to the majority of states that do. While advocates and proponents of this bill have offered a number of arguments for and against the legalization of medical cannabis, a common thread has come to dominate much of the public debate over this bill. And that thread concerns the impact legalization of medical cannabis would have on the opioid crisis.
As the defining public health crisis of this generation, the opioid crisis has rightly been placed at the forefront of the medical cannabis conversation. In 2017, one American died of an opioid overdose every 11 minutes, and some estimates place the cost of the opioid crisis at over $500 billion. Alabama has not been immune from this crisis, and Blue Cross Blue Shield estimates that its Alabama members were more likely than others across the country to be on a long-duration opioid regime. Given the high stakes involved, the question of how medical cannabis legalization will affect the opioid crisis is obviously an important one.
In a study recently published in the Journal of Health Economics, two co-authors and I investigated the impact of medical cannabis access laws on opioid prescriptions across the country. In that study, we found strong and consistent evidence that enacting medical cannabis access laws reduces opioid prescriptions. In general, these laws decrease opioid prescriptions by 4.2 percent. While this may not, by itself, be enough to reverse the opioid crisis, reducing opioid prescriptions is an important step in addressing this crisis.
Our study was not the first to examine the impact of medical cannabis access laws on opioid prescriptions. However, the strength of our study lies not in its novelty, but in the data it analyzes. Instead of examining counts of opioid prescriptions among Medicare or Medicaid beneficiaries, we analyzed a dataset of over 1.5 billion individual opioid prescriptions across the country. This dataset included approximately 90 percent of all opioid prescriptions written in the United States between 2011 and 2018. And our data came from prescriptions paid for by commercial insurance, Medicaid, Medicare, other government assistance, and even cash.
With such rich data available in our study, we were able to obtain a clearer picture of the effect of medical cannabis access laws than has previously been possible. While we found that these laws reduced opioid prescriptions in general by 4.2 percent, they had larger impacts on certain groups. For example, medical cannabis access laws reduced opioid prescriptions to those with commercial insurance by 4.4 percent and to those with Medicaid by 5.2 percent.
These laws may reduce opioid prescriptions in various ways, and our study found suggestive evidence that one important way may be facilitating the substitution of cannabis for opioids in the treatment of pain. In addition to reducing the use of prescription opioids, our study revealed evidence that medical cannabis access laws also reduce NSAID prescriptions. NSAIDS are often found in common, over-the-counter pain medications. This reduction in another type of medication used in the treatment of pain suggests that the reduction in prescription opioids may be driven by a decreased need for pain treatment once individuals can access medical cannabis. And our results are consistent with the conclusion of the National Academies of Sciences, Engineering, and Medicine which found “conclusive. . . evidence that cannabis. . . [is] effective. . . [f]or the treatment of chronic pain in adults.”
As the Alabama Legislature completes its task of debating whether to join the majority of states that allow access to medical cannabis, understanding the role of this law in the opioid crisis will be critically important.
Opinion | Jobs to move America
Before COVID-19 swept the country, public officials celebrated Alabama’s 2.7 percent unemployment rate: it was a record low for our state, and lower than the national average. But statistics never tell the full story. Were the jobs Alabamians working good ones? With paid sick, family, and medical leave to protect workers from COVID-19? Were people working more than one job to make ends meet?
As we reckon with a pandemic and pending economic recession of a magnitude difficult to comprehend, Alabama needs to start looking beyond unemployment rates to ask some soul-searching questions. As industry after industry demands huge public bailouts, the South’s history of offering big corporate giveaways represents a glaring example of why public subsidies should only be on the table if public officials put people and workers first.
Corporate subsidies, in the form of economic tax incentives, have become a popular tool that cities and states use to lure companies to a specific location. The fight over where Amazon would set up its second headquarters — cities raced to provide the most attractive incentive packages, offering billions of our public dollars to sweeten the deal — put a spotlight on the problems with these subsidies. Even after national outrage over the bidding war for Amazon, economic development specialists and elected officials continued to tell us that these subsidies were critical to creating jobs and growing the economy. Cities and states like Alabama still compete aggressively to bring corporations to our backyards, using our public dollars as bait. Promises of subsidies include abatement of income and property taxes, infrastructure development, workforce training, and sometimes cash. But the problem that COVID-19 has brought into sharp relief is that promises made are not always promises delivered. What’s worse, many of these promises weren’t good enough to begin with.
In Alabama, we celebrate the ribbon cutting of a new manufacturer breaking ground on a new plant and announcing new jobs that will be created. Yet, rarely are we told how much the state or municipality paid to the corporation to bring those jobs to the area or given details about the return on investment. Now that COVID-19 is shutting down production at manufacturing plants across our state, leaving many workers high and dry, it’s time to ask how our public dollars can be most effectively invested in private companies to ensure the outcomes we need.
Corporate subsidies have cost Alabama over $3.5 billion dollars over the past decade. The public has no information on how money was spent — or what we got for it. These subsidies do not require corporations to commit to providing a living wage; any paid sick, family, or medical leave; or hiring goals for marginalized communities. Most taxpayers don’t even know where to look for the information. This story holds true across the South.
Alabamians, like many of our Southern neighbors, cannot afford any loss of revenue. According to Alabama Possible, our state’s poverty rate is 18.9 percent, making us the 6th poorest state in the country. Our education system, mental health services, and public infrastructure are in dire need of funding. The National Center for Education Statistics ranks Alabama last in math, reading, and science. We also rank at the bottom in teacher pay, infrastructure, and access to health care. As a result, we lack the services and infrastructure needed to support working families through a crisis like COVID-19.
Why? For decades, our state has siphoned money from these critical public services and social infrastructure to provide corporations with handsome tax incentives in exchange for little more than a handshake deal. Our state is lining the pockets of corporate CEOs, not workers and communities.
COVID-19 makes it clear that Southerners deserve a better deal.
Which is why Jobs to Move America is building a research-action program, headquartered in Birmingham, to win sunshine and accountability policies in the South. We believe that together, we can turn the tide on endless and unaccountable corporate giveaways. We can demand limits on incentives and institute requirements that companies receiving our precious public dollars provide a living wage, benefits, a safe work environment free of racism and gender discrimination, and hiring preferences for marginalized and underrepresented communities. We can also demand a public accountability report about every company that receives subsidies so that Southerners can scrutinize whether their public dollars are actually doing public good.
To get there, we need to understand and document all the public dollars that our state has given away. We’ll write reports about that spending, we’ll dig into the consequences of corporate giveaways on our communities and workers. We’ll work in coalition with community-based organizations and social justice groups, like Alabama Arise, to educate public officials and community leaders about the impact of these subsidies. And eventually, we’ll win legislation that ensures our public dollars create the kind of return on investment that we believe in: good jobs and healthy communities.
Do Mercedes, Amazon and Walmart really need generous tax subsidies to operate business as usual? The clear answer is no. It is time to get our priorities in order and take care of our own people — instead of corporate shareholders.
Patricia Todd is the Southern Director at Jobs to Move America. Patricia has socially and professionally advocated for public policies relevant to social justice, education, HIV/AIDS, and a wide range of issues affect the entire Birmingham community for over twenty years. Patricia was elected to the Alabama Legislature as the State Representative for House District 54 in November of 2006 as the first openly gay elected official in Alabama’s history. She retired from the legislature in 2018.
Opinion | For humanitarian and public health reasons, we need to get people out of our jails
For the Lord hears the needy and does not despise his own people who are prisoners (Psalm 69:33)
We are facing a crisis unlike any in our lifetime. A virus is infecting us at unprecedented rates. Over 100,000 have been infected in the United States and the death toll in our country is already in the thousands.
But we’re not doing everything possible to keep us safe. The county jails in Alabama, which lock up thousands of people, are a major health risk. The incarcerated population can’t practice “social distancing” and instead are left to languish in these facilities with no soap or supplies to sanitize their own cells.
Imprisoned people are highly vulnerable to outbreaks of contagious illnesses such as COVID-19. People incarcerated in jails are housed in close quarters, and are often in poor health. And, according to a report from the Association of County Commissions of Alabama, the county jail population quadrupled between 2014 and 2018.
The way to mitigate that health risk is clear. We need to release people who are no risk to our communities and vulnerable to exposure immediately. And jail officials need to come up with a plan, and make it public, for how they will deal with a COVID-19 outbreak in their facility.
Gov. Kay Ivey acknowledged the danger in her State of Emergency declaration, finding that “the condition of jails inherently heightens the possibility of COVID-19 transmission.” Ivey’s declaration said that people charged with crimes could be served with a summons instead of being arrested. But that doesn’t do much for the people already locked up and awaiting trial.
And a COVID-19 outbreak in these jails with the current incarcerated population would be disastrous for public health. The incarcerated people who get infected would have to be taken to our already overcrowded hospitals, and people who work in the jails are also in danger of both being infected, and spreading the infection to people on the outside. Lowering the total number of people locked up would make an outbreak less likely, and also make it easier to quarantine people who have been infected.
But there is also a moral and humanitarian reason to get people out of these jails. The crime rate in our state didn’t quadruple in the last few years, but our jail population did. Many of the people now locked up aren’t there because they committed horrible crimes, they’re locked up because they’re too poor to afford bail. Some are even elderly and therefore at “higher risk for severe illness”, according to the CDC.
It is wrong to lock people up because they can’t afford to pay bail. If a judge has already decided that someone does not pose a threat to the community and they can get out of jail if they can pay a fee, then they shouldn’t be locked up at all during a crisis like this.Poverty is not a crime and under these circumstances, it should not put you at risk of contracting COVID-19.
Last month county jail inmates with bonds under $5,000 were ordered released in Autauga, Elmore and Chilton Counties, as long as the sheriffs and wardens sign off on it. Mobile Countyhas also announced it would release certain pre-trial inmates.. These actions were taken due to fears of the spread of COVID-19.
Other states have also started doing this. Montana, California, New Jersey, Washington and Wyoming are amongthe states that have actively worked to reduce it’s incarcerated population in the last few weeks.
Actions like these need to be the norm going forward. COVID-19 is scary, but we must meet it with Christian love and compassion. We must extend that to our brothers and sisters behind bars who pose no threat to our communities and are awaiting their day in court. We must consider those who are elderly and already ill. This virus is the worst thing many of us have seen in our lifetimes, let’s combat it with love and compassion, instead of hate and fear.
Opinion | Remembering civil rights icon Rev. Joseph E. Lowery
Co-founder of the Southern Christian Leadership Conference, SCLC, Rev. Joseph E. Lowery died on March 27, 2020. He and his clerical brother, Dr. Martin Luther King, Jr. envisaged SCLC as the national platform needed to inveigh segregation, materialism, and militarism in the South and nation. King became the first SCLC president in 1957, a position he held until his assassination in 1968. Lowery headed SCLC from 1977 until 1997.
Born in Huntsville, Alabama, Lowery taught school in Birmingham before becoming a minister. He pastored his first church in the Magic City. He also led the Warren Street Methodist Church in Mobile, Alabama and became the leader of the Alabama Civic Affairs Association, the precursor of the Montgomery Improvement Association, MIA.
Perhaps less known is that Joseph Lowery was the last living co-defendant of the landmark Sullivan v. New York Times Company, a libel lawsuit filed by City of Montgomery and State of Alabama officials against the New York Times and Reverends Ralph D. Abernathy, Fred L. Shuttlesworth, Joseph E. Lowery, and Solomon S. Seay, Sr. Montgomery City Police Commissioner L. B. Sullivan, Public Affairs Commissioner Frank Parks, and Mayor Earl James filed $500,000,00 libel lawsuits each. Gov. John Patterson sued the same defendants adding Dr. Martin Luther King, Jr. for $1 million dollars.
The City and State alleged that the March 29, 1960 New York Times advertisement paid for by The Committee to Defend Martin Luther King, Jr. and the Struggle for Freedom in the South, defamed and libeled the plaintiffs by knowingly publishing false statements. A chief bone of contention was a paragraph, 39 words, describing actions of the City of Montgomery Police Department against Alabama State College students. On February 25, 1960, those same ASC students sat-in at the Montgomery County Courthouse Cafeteria. This was Alabama’s first sit-in demonstration. The ad claimed “police armed with shotguns and tear gas ringed the campus and padlocked the dining hall.”
The New York Times ad sought to raise funds for a trial Dr. King faced in Alabama for tax fraud. The City and State targeted the ministers because they were signatories to the ad. LorraineHansbury, Eleanor Roosevelt, Langston Hughes, Nat King Cole, and Ruby Dee, among others, also signed the ad. Defense counsel argued the Black ministers were included because of their friendships with Dr. King. The lawsuits sought to harass, harangue, and financially ruin these civil rights leaders. Temporarily, that is exactly what the suits accomplished. A collective judgment of $3 million dollars, and an inability to secure a surety bond, allowed the State to garnish the personal property of Abernathy, Seay, Shuttlesworth, and Lowery. Each saw their automobiles seized and sold. The Marengo County Sheriff also sold 300 acres of land owned by the Rev. Abernathy and his extended family since Reconstruction.
The New York Times won its appeal to redress the State cases in the federal courts. Montgomery County Senior Circuit Judge Walter B. Jones heard the original five cases. A racial cyborg, Jones pronounced from the bench that the Fourteenth Amendment was irrelevant in Alabama and that the Sullivantrial would be conducted “in the belief and knowledge that the white man’s justice . . . brought over to this country by the Anglo-Saxon Race . . . will give the parties at the Bar of this Court, regardless of race or color, equal justice under law.” Four years after it all began, the Supreme Court of the United States reversed the judgments against the defendants.
As we pray for the repose of Rev. Joseph Echols Lowery, we should remember part of his prayer at President Barack Obama’s 2009 inauguration; “We ask you [Lord] to help us work for that day when Black will not be asked to get back . . . and when white will embrace what is right.”
Opinion | A little effort can make a big difference in the fight against COVID-19
Will Ainsworth is Alabama’s lieutenant governor.
Every American was a bit disappointed when the White House announced this week that social distancing guidelines will remain in place at least until April 30, and some governors across the nation have mandated that statewide shelter-in-place orders may be enforced until the end of June.
Working from home, avoiding contact with others, and venturing into public only when absolutely necessary can make life seem much like the Bill Murray movie, “Groundhog Day.” Each day, the temptation to break a social distancing guideline becomes a little harder to resist and the desire to ignore protocols and immediately return to your normal routine becomes that much greater.
But facts, statistics, and simple, everyday hard truths demand that we not only hold the course in the fight against COVID-19, but also practice stricter self-discipline in how we act and what we do.
As this column is being written, Alabama is teetering on the edge of its 1,000th documented case of Coronavirus, and 19 of our fellow Alabama citizens have already succumbed to the deadly sickness.
Every indicator points to the situation getting significantly worse in our state before it begins to improve, and President Trump has ordered additional ventilators sent to Alabama from the national stockpile in order to prepare for what awaits us.
If current trends continue, Alabama’s healthcare resources will likely be pushed beyond capacity by the end of the month, and the number of hospital and ICU beds that are needed will exceed the total number we have in the state.
The good news is that Alabamians can prove all of these projections and possible doomsday scenarios wrong if we just use common sense, take self-responsibility, and follow the rules that health professionals suggest.
Too many among us are still refusing to take the COVID-19 crisis seriously, and by doing that, they threaten their own lives along with the lives of everyone they love and everyone they meet.
Since Gov. Kay Ivey declared the state’s Gulf Coast beaches closed in order to enforce social distancing, the Alabama Law Enforcement Agency has reported a dramatic surge in weekend traffic on Alabama’s lakes and rivers.
My family and I live by Lake Guntersville, and we have noticed the massive groups of people congregating together, jumping from party boat to party boat, and ignoring every rule about social distancing and self-isolation that the Center for Disease Control has asked us to follow.
It may come as a surprise to these weekend revelers, but sun, water, and cold beer are not effective vaccines against COVID-19.
For proof of this fact, just look toward the group of University of Wisconsin-Madison students who spent their Spring Break in Gulf Shores in mid-March. Upon their return north, several of the students have displayed symptoms and tested positive for COVID-19, and all of them are currently under quarantine.
Each time an individual or family decides to strictly follow CDC guidelines and do their part in the fight against Coronavirus, the numbers bend in our direction, and all of us get that much closer to safely resuming normalcy.
Assuming Alabama has a daily infection rate of 20 percent, trends show that we can expect to have more than 245,000 total cases of COVID-19 by May 1, but if through discipline and resolve we can reduce that daily growth to 10 percent, a little more than 9,000 cases will occur. At five percent growth, we have only 1,600.
In other words, just a little effort and diligence from all of us can make a tremendous difference. Social distancing is recommended because the virus that causes COVID-19 can travel at least three feet when coughed or sneezed, and it can live on surfaces for days.
The rules for social distancing are easy to understand and follow, and they require you to remain at least six feet away from others, wash your hands frequently with soap, sanitize and wipe down surfaces, stay at home to stop the spread, and self-quarantine and contact your physician if you experience symptoms.
President Trump was wise to extend the social distancing requirements for at least another month, but all of us look forward to the day when future extensions will not be necessary. To accomplish that goal, we must each remember three simple things – stay smart, stay healthy, and, most importantly, stay home.
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